Teaching Renal Physiology in the Laboratory with Case Studies

Students from middle school through undergraduates appreciate learning about diseases with the Kidney Under Pressure unit. The unit was written for Frontiers in Physiology of the American Physiological Society by Dr. Jeffrey Osborn and colleagues at the Medical College of Wisconsin. It is being modified and field‐tested for web publication by the Education Office of the APS. I have repeatedly used parts of the unit in my own teaching and outreach activities. The unit includes patient note cards for 8 patients with different kidney diseases (renal failure following long‐term hypertension, diabetic nephropathy, severe dehydration, kidney stones, kidney infection, renal failure caused by congestive heart failure, trauma‐induced acute renal failure, and polycystic kidney disease). Simulated urine is prepared with glucose and/or protein and can be easily analyzed with urine test strips. In addition, cytology slides are available of a smear of the patient's urine. Students are in small groups of 3‐4 and fill out a patient health chart. They may request various laboratory tests to evaluate the symptoms. After obtaining additional information, their task is to diagnose the disease. Their written report includes the evidence that they obtained to lead them to choose the particular disease and their diagnosis. Another section asks them to describe in detail the disease that their patient had and the physiological problems caused by the disease. They are asked to reflect on what they learned in the laboratory. Each group presents their patient to the rest of the class in a mini grand rounds format and there is discussion about what they found and what it means. Students of all ages enjoy the "playing doctor" aspects of this activity. If resources about kidney diseases are provided, they justify their diagnoses carefully. Students comment on how much fun the activity is and how it helped them learn about the causes of kidney problems.