ABIM Nephrology study guide
ABIM Nephrology · Work through your exam, one topic at a time.
The ABIM Nephrology Certification Examination is the American Board of Internal Medicine's assessment for physicians who have completed nephrology fellowship training and wish to be certified in the subspecialty. Candidates are typically internists who have finished an accredited nephrology program and are building a career in consultative nephrology, dialysis, transplantation, or academic practice. The ABIM Nephrology study guide has 12 sections and about 2,655 words.
01Glomerular Disease
Glomerular disease questions reward a pattern-recognition approach: nephritic (hematuria, RBC casts, hypertension, oliguria, subnephrotic proteinuria) versus nephrotic (proteinuria 3.5 g/day, hypoalbuminemia, edema, hyperlipidemia). Then place the lesion by complement and immunofluorescence.
255 words, about 1 min02Tubulointerstitial and Vascular Disease
This domain covers acute interstitial nephritis (AIN) , chronic tubulointerstitial nephritis , and vascular diseases: thrombotic microangiopathy (TMA) , renal artery stenosis , hypertensive nephrosclerosis , scleroderma renal crisis , and atheroembolic disease . AIN classically presents with AKI, sterile pyuria, WBC casts, and eosinophiluria after drugs (NSAIDs, PPIs, beta-lactams, sulfonamides, checkpoint inhibitors).
266 words, about 1 min03Acute Kidney Injury
Frame AKI by prerenal , intrinsic (tubular, glomerular, interstitial, vascular), and postrenal causes. Use the KDIGO definition (creatinine rise ≥0.3 mg/dL in 48 h or ≥1.5× baseline in 7 days; urine output <0.5 mL/kg/h for 6 h).
248 words, about 1 min04Chronic Kidney Disease and Progression
CKD is defined by ≥3 months of decreased GFR (<60) or markers of kidney damage (albuminuria, hematuria, structural abnormality). Stage by GFR category (G1–G5) and albuminuria category (A1–A3).
236 words, about 1 min05Fluid, Electrolyte, and Acid-Base Disorders
Use systematic acid-base analysis: pH, PaCO2, HCO3, then calculate anion gap (Na − [Cl + HCO3]), check delta-delta , and assess compensation. High-AG acidosis: MUDPILES (methanol, uremia, DKA, propylene glycol, isoniazid, lactate, ethylene glycol, salicylates).
215 words, about 1 min06Hypertension and Vascular Disorders
Know primary vs secondary hypertension : young onset, resistant hypertension, hypokalemia (hyperaldosteronism), episodic headache/sweating (pheochromocytoma), renal bruit (renal artery stenosis), and cushingoid features. Malignant hypertension causes TMA, papilledema, and end-organ damage; treat with controlled reduction, not rapid normalization.
207 words, about 1 min07Dialysis and Renal Replacement Therapy
Know hemodialysis (HD) vs peritoneal dialysis (PD) vs continuous renal replacement therapy (CRRT) . HD uses diffusion and ultrafiltration via an arteriovenous access (fistula preferred, then graft, then catheter); PD uses the peritoneum with dwell times.
231 words, about 1 min08Kidney Transplantation
Understand rejection types : hyperacute (preformed antibodies, minutes-graft removal), acute cellular (days–weeks, T-cell mediated), acute antibody-mediated (donor-specific antibodies, C4d staining), and chronic (interstitial fibrosis, transplant glomerulopathy). Immunosuppression : induction (basiliximab or antithymocyte globulin), maintenance (tacrolimus, mycophenolate, steroids), and treatment of rejection (pulse steroids, thymoglobulin, plasmapheresis/IVIG for antibody-mediated).
203 words, about 1 min09Nephrolithiasis and Cystic Kidney Disease
Stone types: calcium oxalate (most common), calcium phosphate, uric acid (radiolucent, alkaline urine dissolves), struvite (staghorn, urease producers), cystine (hexagonal, young patients). Evaluate with stone analysis, 24-hour urine, and serum chemistries.
193 words, under 1 min10Inherited and Congenital Kidney Disease
Know Alport syndrome (X-linked COL4A5; hematuria, hearing loss, ocular lesions, progressive CKD), thin basement membrane disease (benign familial hematuria), Fabry disease (alpha-galactosidase A; proteinuria, angiokeratomas, neuropathy), cystinosis , primary hyperoxaluria , and congenital anomalies of the kidney and urinary tract (CAKUT) . Also autosomal dominant tubulointerstitial kidney disease and nail-patella syndrome .
197 words, under 1 min11Pharmacology and Drug-Related Kidney Disease
Know nephrotoxic patterns: hemodynamic (NSAIDs, ACE inhibitors/ARBs, calcineurin inhibitors, SGLT2 inhibitors early), acute tubular injury (aminoglycosides, amphotericin, cisplatin, contrast), AIN (PPIs, NSAIDs, beta-lactams, checkpoint inhibitors), crystal nephropathy (acyclovir, indinavir, methotrexate, uric acid), TMA (calcineurin inhibitors, quinine, VEGF inhibitors), and osmotic nephrosis (IVIG, mannitol). Dosing: adjust renally cleared drugs (aminoglycosides, vancomycin, gabapentin, metformin-avoid in severe CKD).
193 words, under 1 min12Perioperative and Critical Care Nephrology
Perioperative AKI arises from hypovolemia, hypotension, sepsis, nephrotoxins, and contrast . Recognize sepsis-associated AKI (inflammation, microcirculatory dysfunction), cardiorenal syndrome , and abdominal compartment syndrome (bladder pressure).
211 words, about 1 min