Discipline - Internal Medicine and Nephrology - Clinical Hospital of Nephrology Dr.Carol Davila

Associate Professor Capusa Cristina-Stela, PhD tenured
Associate Professor Girneata Liliana, PhD tenured
Lecturer Stancu Simona Hildegard, PhD tenured
Assistant Professor Zugravu Adrian-Dorin, PhD tenured
Assistant Professor Stefan Gabriel, PhD tenured
Assistant Professor Ene Corina-Daniela, PhD tenured
Assistant Professor Andreiana Iuliana, PhD tenured
Assistant Professor Dicu-Andreescu Ioana, PhD fixed term
Assistant Professor Badea Carmen Antonia, PhD fixed term
Assistant Professor Mehedinti Ana-Maria, PhD tenured
Assistant Professor Ciurea Otilia Andreea, PhD tenured

The „Dr. Carol Davila” Clinical Hospital of Nephrology building was constructed during the period 1896-1900 and was initially “Palatul Curtii de Conturi” until 1948, when it was used as a hospital. In 1953, a medical clinic belonging to UMPh Bucharest was established in the hospital, under the leadership of senior lecturer Prof. Dr. Constantin C. Dimitriu, which pursued scientific research in the domain of kidney disease and wrote the first treatise on nephrology in Romania, together with dr. Vincenţiu Beroniade in 1963.

Prof. Dr. Aurel Păunescu-Podeanu was head of the clinic during the period 1965-1972, while from 1974 onwards, Prof. Dr. Nicolae Ursea maintained this position. The latter guided the hospital’s specialization towards Nephrology, contributed to the development of the medical system relating to nephrology and dialysis in Romania, and established the recognition of nephrology as a medical specialty on its own. In 1974, the hospital established the first chronic dialysis center in our country, and in 1994 – the Romanian Renal Register (for patients on dialysis).

Also during this time, the hospital conducted didactic activities relating to the medical education in internal medicine of students from the faculty of general medicine and also from the faculty of paediatrics. Since 1995, the Clinic has been teaching the Nephrology module for 5th year students at the faculty of medicine and also for medical residents/specialists.

In 2002, after the retirement of Prof. N. Ursea, the leadership of the discipline passed to Prof. Dr. Gabriel Mircescu. He promoted and open and interactive teaching style, effective communication with his collaborators and rigorous and accurate scientific activity.

The discipline, as a whole, ensures specialized medical assistance in the field of nephrology to patients with kidney disease. Medical activities are organized in two nephrology sections: one compartment of Acute Nephrologic Therapy, and the other for hemodialysis and peritoneal dialysis.

Within the hospital, there is a pathological anatomy laboratory, specialized in renal histopathology, which permits the interpretation of renal biopsies using all three complementary examination methods (optical microscopy, immunofluorescence and electron microscopy).

Likewise, the hospital has a complex laboratory for medical analyses, accredited by RENAR, which includes hematology, biochemistry, immunology and microbiology laboratories, staffed with specialized medical personnel and high-level equipment (including the ability to perform ELISA testing).

Functional investigations (ECG, respiratory exams) and imagistic tests (radiology, abdominal and cardio-vascular echography, radioisotope explorations and endoscopic ones) are often conducted. All of these facilities ensure a material basis for high quality medical assistance, as well as teaching and research activities.

The discipline currently has two doctoral students enrolled (Prof. Dr. Gabriel Mircescu şi Prof. Dr. Mircea Penescu). All of the academic personnel in our clinic have participated in national and international multicenter clinical studies, as well as research projects within the clinic for over 15 years.

During this interval the following grants where obtained through competition:

  • VIASAN 70/2001 “Aspecte de epidemiologie moleculară a tulpinilor de E. coli izolate din ITU ale adulţilor” – aspects of molecular epidemiology of E. coli strains isolated in the IUT of adults;
  • VIASAN 227/2004 (contractul 425/2004) „Implicaţiile modalităţii de administrare a fierului asupra stresului oxidativ la pacienţii hemodializaţi” – implication of iron administration method on oxidative stress in hemodialysis patients;
  • CEEX 34/2005 “Cercetări avansate în toleranţa imună cu scopul identificării de căi terapeutice novatoare în patologia bolilor autoimune” – advanced research on immune tolerance with the goal of identifying novel therapeutic approaches in autoimmune diseases;
  • CEEX 79/2006: “Mecanisme celulare şi moleculare în fibroza tubulo-interstiţială şi stadializarea sa în glomerulonefritele cronice” – cellular and molecular mechanisms in tubule-interstitial fibrosis and its staging in chronic glomerulonephritis;
  • Programul RO01 - Fondul pentru Relaţii Bilaterale la Nivel Naţional, contract 798/2016 “Analiza comparativă a incidenţei glomerulopatiilor primitive diagnosticate prin biopsie în România şi Norvegia: Studiu retrospectiv în ultimile două decenii” – a comparative analysis of the incidence of primary glomerulopathies diagnosis through biopsy in Romania and Norway: a retrospective study of the last two decades.

Additionally, three research projects were financed with grants obtained from private institutes and one project was financed through non-returnable structural funds POSCCE 2007-2013, Axa Prioritartă 3 (for IT system development). Three national multicenter studies were initiated and coordinated by the clinic (regarding the treatment of renal anemia and mineral metabolism disturbances associated with chronic kidney disease).

Due to the constant flow of research activities, members of the discipline often participate in scientific events related to this specialty, both nationally and abroad, and they publish between 2 and 5 articles in journals ranked by ISI Thomson or CNCSIS annually. Young medical residents are implicated in these research projects, as well as students that choose to conduct their licentiate project under the guidance of the discipline’s personnel.

The experience accumulated through research activities in the domain of nephrology and through medical care of patients with kidney disease has allowed members of our discipline to write various treatises and specialty monographs, as well as the redaction – with the Romanian Nephrology Society – of practical medical guides addressing chronic kidney disease and some of its aspects (anemia, phosphorus and calcium metabolism, nutrition, psychological implications).

The nephrology module for student in 5th year from the faculty of medicine lasts four weeks; during this interval, students attend theoretical courses and a clinical component, the latter of which takes up about two thirds of the total allocated time.

The general objective is to teach students basic notions of kidney anatomy, physiology and physiopathology, with the goal of being able to interpret clinical and paraclinical data, formulating a correct diagnosis of renal disease and proposing an adequate therapeutic plan. After completing the Nephrology module, students are expected to:

  • obtain and interpret anamnesic data about disturbances of diuresis, micturition, nephrogenic pain and exposure to nephrotoxic agents (medications, domestic and industrial toxins);
  • perform the physical exam for the urinary apparatus correctly;
  • measure and correctly interpret arterial blood pressure values;
  • interpret the urinalysis result;
  • investigate and interpret proteinuria;
  • interpret uroculture results and choose, based on an antibiogram, the necessary treatment for a urinary tract infection;
  • interpret renal ultrasound results;
  • recognise and measure renal shadows and suspicious radio-opaque images of calculi on a simple renal radiograph;
  • recognise elementary lesions (stasis, deformity, amputation, ulceration) on a urograph;
  • calculate glomerular filtration (direct or estimated) and interpret any modifications;
  • integrate clinical and laboratory data, in order to recognise and adopt a correct clinical attitude towards hydro-electrolyte and acid base disturbances, chronic kidney disease, acute kidney injury, nephrogenic hypertension, nephritic and nephrotic syndromes, primary glomerulopathies, lupus nephritis, diabetic nephropathy, urinary tract infections (including the distinction between non-complicated and complicated infections and identification of the clinical form of the urinary tract infection), tubulo-interstitial nephropathies, renal lithiasis (renal colic due to lithiasis), nephropathy during pregnancy and frequent vascular nephropathies (nephroangiosclerosis and atherosclerotic nephropathy).

Student attendance during the clinical component is mandatory. Absences may be recovered, with the approval of the head of the discipline, outside of the regular hours dedicated to the lecture and clinical practice for students; however, no more than one absence may be recovered in one day. Student evaluations will include a practical and written component.

The practical exam takes place individually, at a patient’s bedside, and the student is expected to present the clinical case and discuss it with the examiner. This exam is eliminatory (graded as either pass or fail), and the minimum knowledge requirement to pass includes: to perform a correct anamnesis and clinical exam, identify major nephrologic syndromes and establish general therapeutic objectives.

The written exam takes place on the last day of the module, and comprises 5-8 clinical cases from the nephrology topics covered throughout the module (32-40 questions in total, open-ended, short-answer). The grade obtained at the written examination will be the student’s final grade for the module.

The Discipline offers the following courses for further professional development:

  1. Lectures and clinical demonstrations on hemodialysis and peritoneal dialysis
  2. Chronic kidney disease – introductive course for family doctors

For the academic year 2016-2017, the following course is planned:

  • “Renal biopsy as an instrument for deepening our knowledge in the domain of glomerular diseases – introductive course in nephropathology” financed by the bilateral relations fund – RO14 program, Research in Priority Sectors
  • renal anemia
  • chronic kidney disease
  • epidemiology of chronic kidney disease
  • glomerulopathies
  • histology of kidney disease
  • phosphorus and calcium metabolism
  • nutrition in chronic kidney disease
  • oxidative stress
  • systemic vasculitis
  1. Aspects of the pathogenesis and treatment of anemia associated with chronic kidney disease. “Aspecte ale patogeniei şi tratamentului anemiei asociate Bolii cronice de rinichi”
  2. Evaluation and therapeutic intervention for mineral and bone metabolism abnormalities associated with chronic kidney disease. “Evaluare şi intervenţie terapeutică în anomaliile metabolismului mineral şi osos asociate Bolii cronice de rinichi”
  3. Nutritional intervention in chronic kidney disease. “Intervenţie nutriţională în Boala cronică de rinichi”
  4. Epidemiology of chronic kidney disease and of the methods for substitution of renal function in Romania. “Epidemiologia Bolii cronice de rinichi şi a metodelor de substituţie a funcţiilor renale în România”
  5. Cellular and molecular mechanisms of tubulo-interstitial fibrosis in chronic glomerulonephritis. “Mecanisme celulare şi moleculare în fibroza tubulo-interstiţială din glomerulonefritele cronice”
  1. Monografia „Glomerulopatiile” sub red. G Mircescu. Edit. Medicală, Bucureşti, 2016, ISBN 978-973-39-0184-2
  2. Monografia „Iron therapy in renal anaemia”. Autori: G Mircescu, RR Crichton, P Geisser. Edit. UNI-MED, Verlag AG, Bremen 2013, ISBN 978-38-37422-91-7
  3. Monografia „Rinichiul în lupusul eritematos sistemic”. Autori: M Penescu, M Răuţă, E Mandache. Edit. Universitară “Carol Davila”, Bucureşti, 2013, ISBN 973-70864-0-6
  4. „Ghid practic de dializă”. sub red. N Ursea, G Mircescu, Edit. Fundaţiei Române a Rinichiului, Bucureşti, 2003, ISBN 973-98051-6-7
  5. Articolul „Ketoanalogue-supplemented vegetarian very low-protein diet and CKD progression”. Autori: L Gârneaţă, A Stancu, D Dragomir, G Ştefan, G Mircescu. J Am Soc Nephrol, 2016; 27(7):2164-2176
  6. Articolul „ANCA positive crescentic glomerulonephritis outcome in a Central East European cohort: A retrospective study”. Autori: I Andreiana, S Stancu, A Avram, L Ţăran, G Mircescu. BMC Nephrology, 2015;16:Article 90
  7. Articolul „Abdominal aortic calcification and renal resistive index in patients with chronic kidney disease: is there a connection?”. Autori: G Ştefan, C Căpuşă, S Stancu, L Petrescu, ED Nedelcu, I Andreiana, G Mircescu. Journal of Nephrology, 2014;27(2):173-179
  8. Articolul „Does Dialysis Modality Influence the Oxidative Stress of Uremic Patients?”. Autori: C Căpuşă, I Stoian, E Rus, D Lixandru, C Bărbulescu, G Mircescu. Kidney and Blood Pressure Research, 2012;35(4):220-225
  9. Articolul „Bone marrow iron, iron indices, and the response to intravenous iron in patients with non-dialysis dependent CKD”. Autori: S Stancu, A Stanciu, A Zugravu, L Bârsan, D Dumitru, M Lipan, G Mircescu. Am J Kidney Dis, 2010; 55(4):639-647
  10. Articolul „Intravenous iron supplementation for the treatment of anaemia in pre-dialyzed chronic renal failure patients”. Autori: G Mircescu, L Gârneaţă, C Căpuşă, N Ursea. Nephrol Dial Transplant, 2006; 21(1):120-124

University of Medicine and Pharmacy "Carol Davila" Bucharest

Adress:
Dionisie Lupu Street, no. 37, Sector 2, Bucharest

Fiscal code: 4192910
bank account: RO57TREZ70220F330500XXXX
Bank: Sector 2 Treasury

Phone:
+4021 3180719
+4021 3180721
+4021 3180722
rectorat@umfcd.ro

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