Nephrologist

What is a nephrologist?

A nephrologist (neh-frah-leh-jist) is a doctor with expertise in the care of kidneys. Your kidneys are part of your urinary system. They’re bean-shaped organs that filter your blood and remove waste, excess water and electrolytes, which leave your body as urine (pee).

What is a pediatric nephrologist?

A pediatric nephrologist is a doctor who specializes in kidney care and treatment in newborns, children, adolescents and young adults.

What does a nephrologist do?

A nephrologist diagnoses and treats kidney conditions and kidney failure. In addition, they also recognize how kidney conditions affect other parts of your body, including:

• Autoimmune diseases.
• Cardiovascular disease.
• High blood pressure (hypertension).

How do you become a nephrologist?

To become a nephrologist, doctors must complete:

• Four years of college.
• Four years of medical school.
• Three years of residency (continued training concentrating on the field of internal medicine or pediatrics).
• Two to three years of a fellowship (concentrating on the field of nephrology). You may also add another year to your fellowship to get additional training in transplant nephrology or interventional nephrology.
• Licensing/certification. In the United States, nephrologists must pass a board certification exam in internal medicine and nephrology by the American Board of Internal Medicine or the American Osteopathic Association.

What is transplant nephrology?

Transplant nephrology specializes in kidney and pancreas transplants as well as caring for kidney and pancreas transplant recipients.

What is interventional nephrology?

Interventional nephrology specializes in treating and maintaining access to blood vessels for dialysis. In addition, interventional nephrologists perform kidney biopsies. They have training in:

• Placing or removing catheters (soft, hollow tubes that allow fluids to flow into or out of your body).
• Placing stents (plastic tubes that keep your blood vessels open).
• Removing blood clots.
• Performing fistulograms (an imaging test that checks for an abnormal connection in your kidney called a fistula).
• Performing kidney biopsies.

What are common conditions that a nephrologist treats?

Some of the most common conditions that a nephrologist may treat include:

• Diabetic and other kidney diseases.
• High blood pressure.
• Kidney failure.
• Cystic kidney disease.
• Kidney stones.
• Nephrotic syndrome.
• End-stage renal (kidney) disease.
• Hemolytic uremic syndrome.
• Urinary tract infections (UTIs).
• Kidney infections.
• Hyponatremia and other electrolyte disorders.
• Toxic overdoses that require dialysis.
• Glomerulonephritis (GN).

What types of tests and procedures does a nephrologist perform?

Common tests and procedures that nephrologists perform include:

• Imaging tests. Kidney imaging tests may include X-rays, CT scans and ultrasounds.
• Kidney function tests. Kidney function tests determine how well your kidneys are working. These tests include blood tests and urine tests.
• Dialysis. If your kidneys don’t work properly, dialysis performs the functions of your kidney. During dialysis, a machine removes your blood, filters out waste products and excess fluid and returns your blood to your body.
• Kidney biopsy. Your nephrologist will take a small tissue sample from your kidneys to help diagnose a kidney condition.
• Kidney transplant care. During a kidney transplant, your transplant surgeon inserts a healthy kidney from a donor into a space in your pelvis. Your own kidneys almost always remain with you even after they fail. Your nephrologist will work with your transplant surgeon to help prepare you for the procedure and help with follow-up care and recovery.

What is the difference between a nephrologist and a urologist?

The differences between a nephrologist and a urologist may be confusing because their areas of expertise overlap a little.

Nephrologists specialize in conditions that affect your kidneys. A nephrologist is the best doctor to treat you if you have a condition that affects your kidneys or kidney function.

A urologist is a doctor who specializes in diagnosing and treating conditions that affect your urinary system. Your urinary system includes your bladder, urethra, ureters and kidneys. They also specialize in conditions, symptoms and treatments that affect the male and female reproductive systems. A urologist is the best doctor to treat you if you have a condition affecting your urinary system or reproductive system.

Another key difference between a nephrologist and a urologist is that urologists have surgical training. Urologists only take care of kidney diseases that may require an intervention, like kidney cancer or kidney stones. Nephrologists don’t do surgery.

When should I see a nephrologist?

You should see a nephrologist if you have any symptoms of kidney disease. Signs of kidney disease may include:

• Biological family history of kidney disease. If one of your direct genetic (biological) relatives has kidney disease, you may be at greater risk of kidney disease. A nephrologist can help prevent kidney disease or treat its earliest stages.
• Diabetes. Diabetes can damage your kidneys. If you have diabetes, you are at a higher risk of kidney failure.
• High blood pressure. High blood pressure can also damage your kidneys. Your kidneys use blood vessels to help filter waste and excess fluids from your blood. High blood pressure can make your blood vessels less elastic, which reduces blood and oxygen flow to your kidneys. Reduced blood and oxygen flow can cause kidney failure.
• Changes in your pee. Changes in your pee or peeing habits may indicate a kidney condition. Signs may include peeing more often or less often, frothy pee or pee that’s darker in color.
• Brain fog. Brain fog may be a symptom of kidney disease. It isn’t a medical condition, but your healthcare provider may use the term to describe slow or impaired thinking. You may be easily confused, forgetful or unable to focus.

What does a nephrologist do on a first visit?

During your first visit, your nephrologist will:

• Look over your medical records.
• Ask about your symptoms.
• Perform a physical examination.
• Order blood tests, urine tests and imaging tests.

How do I prepare for a nephrology appointment?

It’s helpful to prepare for your first nephrology appointment. It’s a good idea to:

• Fill out any forms your nephrologist gives you prior to the appointment.
• Bring a list of the most important issues you want to discuss with your nephrologist.
• Note any changes in your overall health.
• Keep a diary of all of your symptoms. Record all of your symptoms, including the day and time they occurred and how long they lasted.
• Learn about your family medical history. This information can help your nephrologist with their diagnosis.
• Wear loose, comfortable clothing that you can easily change. Examples include T-shirts, sweatshirts, button-down shirts, skirts, casual dresses and athletic apparel.
• Compile a list of any surgeries you’ve had.
• Bring copies of any test results or lab work ordered by other healthcare providers outside your nephrologist’s healthcare network.
• Include names and contact information for your current primary care physician and any other healthcare providers you see regularly.
• If you check your blood pressure at home, bring your monitor.
• Bring a list of all current medications you take. Include prescription medications, over-the-counter (OTC) medications, vitamins and supplements.
• Bring your current insurance cards.
• Bring a friend or relative with you to take notes. This person can also help you ask questions, review your appointment, schedule tests and remind you about follow-up appointments.
• Ask if you should schedule follow-up appointments.