What is a nephrologist?

A nephrologist is a licensed medical doctor who has additionally completed at least three years of post graduate training in general internal medicine and two years of specialized training in nephrology. Nephrology is the study of kidney function and kidney diseases, and nephrologists are often referred to as “kidney doctors.” If you have chronic kidney disease (CKD), you may have been advised to see a nephrologist. Visiting a nephrologist sooner rather than later is generally recommended, because studies show that people with early stage CKD who visit a nephrologist soon after referral tend to do better overall than people who postpone a visit. 

Who needs a nephrologist?

The following are symptoms that could prompt a person to see a nephrologist:  

  • Blood or protein present in urine
  • High blood pressure (hypertension)
  • Kidney stones
  • Electrolyte disorder
  • Fluid retention

What happens during a visit to the nephrologist?

The nephrologist will look at your medical history and ask questions about any signs or symptoms you are currently experiencing to get a picture of your entire health. You will be given a physical exam and have tests done, which may include a urinalysis, urine culture, blood test, X-ray, sonogram and/or kidney biopsy. 

What treatment can I expect from a nephrologist?

Kidney disease develops through five stages. A nephrologist will plan a suitable course of treatment for the stage you are in. The early stages of kidney disease may be treated with a healthy kidney-friendly diet, exercise and medicine that bring high blood pressure and diabetes under control. 

A moderate stage of kidney disease may call for a diet and exercise plan as well as medication and monitoring. Any medications you currently take that may contribute to kidney inflammation are likely to be reviewed and removed, or one medication may be switched to another that has less negative impact on the kidneys. The dosage of some medications may be decreased because of reduced kidney function. Kidney specialists are experts in the nutritional requirements of their patients and will refer you to a dietitian who specializes in medical nutrition therapy for kidney patients. A kidney diet is a specialized food plan that can be a great help in managing your CKD. 

In stage five CKD, also known as end stage renal disease (ESRD), a renal replacement therapy becomes necessary to sustain life and several options are available for patients to discuss with their nephrologist. One treatment option is hemodialysis. The average in-center hemodialysis treatment is performed three times per week, each session lasting from three to five hours. When this treatment is done at home it is called home hemodialysis (HHD). Treatments are usually performed for two to three hours, five to six days a week. 

Another treatment called peritoneal dialysis (PD) runs fluid in and out of the abdominal membrane, which has a cleansing effect on the blood. PD is done seven days a week at home and is performed either manually or by a machine at night. 

A kidney transplant may be recommended as another treatment option. After transplantation, the nephrologist will stay in close contact, monitoring the body’s acceptance of the donor organ as well as blood pressure, medications and other health concerns. 

Summary

When kidneys stop functioning properly, it is the job of a nephrologist to diagnose the problem as well as treat it. Nephrologists are important doctors who make sure people with kidney disease and other kidney ailments are treated properly, whether they have acute renal failure or need to go on dialysis. It is best to see a nephrologist immediately if you experience any symptoms of kidney problems.

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