Nephrology

Nephrology Certification Examination Blueprint

What Does the Examination Cover?
The exam is designed to evaluate the extent of the candidate's knowledge and clinical judgment
in the areas in which a nephrologist should demonstrate a high level of competence. Expertise
in the broad domain of nephrology, and the diagnosis and treatment of both common and rare
conditions that have important consequences for patients, will be assessed. The exam also will
test knowledge of general internal medicine as encountered in the practice of nephrology.

Exam content is consistent with a pre-established blueprint, or table of specifications. The
blueprint is developed by the Subspecialty Board on Nephrology and is reviewed and revised
annually to ensure that it is current. In addition, practicing nephrologists, nephrology trainees,
and training program directors are surveyed periodically to provide feedback on the blueprinting
process. The blueprint serves as a guide in developing the exam.

The majority of questions (over 75 percent) are based on patient presentations occurring in
settings that reflect current medical practice. Questions requiring simple recall of medical facts
are in the minority; the majority of items require integration of information from several sources,
prioritization of alternatives, and/or utilization of clinical judgment in reaching a correct
conclusion. Some questions require interpretation of pictorial material such as radiographs,
sonograms, photomicrographs, and radionuclide studies.

The content areas covered and their relative proportions of coverage in specified areas are as
follows:

Medical Content Category Relative Percentage Chronic kidney disease 14 Glomerular/Vascular
disorders 12 Kidney transplantation 10 Hypertension 10 Electrolyte physiology: Sodium/Water 10 AcidBase/Potassium 10 Clinical pharmacology
and Miscellaneous 10 Tubular/Interstitial and
cystic disorders 6 Mineral metabolism 8 Acute renal failure/ICU
nephrology 10 Total 100%
Cross-Content Areas Relative Percentage Adolescent Medicine 2 Basic Science 2 Critical Care Medicine 2 End-of-Life/Palliative Care 2 Clinical Epidemiology 2 Ethics 2 Geriatric Medicine 5 Nutrition 2 Preventive Medicine 2 Medical Literature 2



Content Outline of the Certification Examination

This content outline describes a typical Nephrology Certification Examination; actual content on
a specific examination may vary. Each medical-content category from the examination blueprint
is listed in boldface below, along with target blueprint percentage and total number of questions
in the category. Within each category, the approximate distribution of questions in specified
areas also is listed.

Medical Category (Relative Percentage) Number of Questions Sodium/Water (10%) 1921 as follows: Hyponatremia 79 Hypernatremia 35 Oliguria/Polyuria 13 Salt excess 24 Salt depletion 24 Other disorders 01
AcidBase/Potassium (10%) 1921 as follows: Metabolic acidosis 46 Metabolic alkalosis 24 Mixed respiratory and acidbase disturbances 24 Hyperkalemia 35 Hypokalemia and potassium deficiency 24 Respiratory acidbase disorders 13 Other disorders 01 Medical Category (Relative Percentage) Number of Questions Mineral metabolism (8%) 1517 as follows: Renal osteodystrophy 46 Nephrolithiasis 35 Disorders of calcium metabolism 46 Disorders of phosphate metabolism 13 Disorders of magnesium metabolism 13 Other disorders 01
Chronic Kidney Disease (14%) 2729 as follows: Anemia 35 Cardiovascular disease 35 Hemodialysis 68 Peritoneal dialysis 35 Progression to ESRD 24 Differential diagnosis 24 Complications/Outcomes 24 Other disorders 01
Hypertension (10%) 1921 as follows: Essential hypertension/pathogenesis 02 Hypertension with kidney disease 35 Renovascular hypertension 35 Other secondary forms of hypertension 35 Pharmacology of hypertension therapy 35 Complications/Target-organ damage 13 Epidemiology/Genetics 02 Other disorders 01
Tubular/Interstitial & Cystic Disorders (6%) 1113 as follows: Urinary tract infections 13 Renal tubular disorders 13 Chronic tubulointerstitial disease 79 Other disorders 01 Medical Category (Relative Percentage) Number of Questions Glomerular/Vascular (12%) 2325 as follows: Indications/complications of kidney biopsy 02 Nephritic glomerular disorders and vasculitis/vasculopathy 68 Nephrotic/heavy-proteinuric glomerular disorders 57 Diagnosis of glomerular/vascular disorders based on kidney
biopsy 35 Diagnosis/treatment of diabetic nephropathy 24 Epidemiology/natural history of glomerular disorders 02 Other disorders 01
Kidney Transplantation (10%) 1921 as follows: Pharmacology of immunosuppressive drugs 46 Long-term complications 35 Recipient/donor outcomes (i.e., patient/graft survival rates,
causes of patient death, graft loss) 35 Immunology and clinical patterns of allograft rejection 13 Perioperative management 13 Recipient and donor evaluation 24 Miscellaneous 01
Pharmacology/Miscellaneous (10%) 1921 as follows: Nephrotoxicity 810 Drug selection and dosing in kidney disease 46 Drug interactions/adverse effects 24 Evaluation of hematuria and other urological conditions 02 Mechanisms 02 Miscellaneous 01
Acute Renal Failure/ICU Nephrology (10%) 1921 as follows: Differential diagnosis 35 Management 79 Prevention 02 Complications/Outcomes 46 ICU 13 Miscellaneous 01

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