Medical Exam

To put it simply, nephrology is the branch of medicine dealing with the kidneys.

Nephrology is different from urology, which focuses on the urinary tract. The kidneys are part of the urinary system, but nephrology and urology are two different specialties.

A doctor who treats disorders of the kidneys is a nephrologist. Nephrologists work to identify a reversible cause of kidney disease and develop treatment plans that help prevent further damage — and sometimes even restore lost function.

Because the kidneys also affect— and are affected by — your overall health, nephrologists are trained in other areas of your health, including blood pressure. If your primary care doctor thinks you have kidney disease, an electrolyte disorder, or a complex case of high blood pressure, you may be referred to a nephrologist.

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Why Are the Kidneys Important?

Your kidneys are two bean-shaped organs that filter waste and excess water from the blood. That waste and water become urine.

Your kidneys also do other jobs, like helping your body maintain healthy blood pressure. They help produce red blood cells and regulate minerals like potassium, calcium, and sodium.

Conditions like diabetes and cardiovascular disease make kidney problems more likely to develop.

What Does a Nephrologist Do?

A nephrologist is an expert in kidney disease. They diagnose kidney problems and come up with treatment plans to slow, stop, or even reverse the disease. In some cases, they get people ready for a kidney transplant.

Some nephrologists focus on specialties such as kidney-related high blood pressure, kidney transplants, and dialysis. Nephrologists go through years of intensive training.

Because the kidneys affect and are affected by so many other elements of your health, nephrologists also are the primary experts for a number of disorders that may not directly involve the kidneys — most commonly, electrolyte disorders (like hyponatremia), high blood pressure, and a number of autoimmune disorders.

What Conditions Does a Nephrologist Treat?

Nephrologists try to catch kidney disease early, before it becomes irreversible. The UPMC nephrology team will work with you to identify and treat the causes of kidney disease, such as high blood pressure.

Nephrologists treat a wide range of kidney conditions and diseases, including:

Chronic kidney disease

Diabetes, high blood pressure, and other conditions can damage your kidneys and lead to chronic kidney disease (CKD). Doctors can’t cure damage already done to the kidneys, but early detection and treatment can slow its progress.

CKD is very common. The Centers for Disease Control and Prevention estimates that 15 million Americans suffer from CKD. It often goes undetected until the later stages.

In CKD, waste builds to high levels in your blood. That can cause complications like anemia, weak bones, and nerve damage. CKD also increases your chances of developing heart disease.

If it progresses, CKD can lead to kidney failure.

Kidney failure

When your kidneys are unable to filter blood, you’re experiencing kidney failure. There is no cure for kidney failure, but you have options for treatment. Your nephrologist will recommend dialysis or a kidney transplant.

Dialysis is a system of cleaning your blood when your kidneys can’t do the job. It requires you to be on a dialysis machine several hours per day. Sometimes people undergo dialysis while waiting for a kidney transplant.

High blood pressure linked to kidney disease

Chronic high blood pressure (also called hypertension) can damage the kidneys. In turn, damaged kidneys can’t do their job of regulating blood pressure. Your nephrologist can help you manage your blood pressure along with kidney disease.

Acute kidney injury

Sometimes kidneys stop working suddenly (as opposed to CKD, which is a gradual process). The cause of acute kidney injury is often a medical emergency that causes your blood pressure to drop. That could be a heart attack, a bad burn, or an infection. Sometimes pregnancy complications cause acute kidney injury.

Your kidneys may be able to recover from an acute kidney injury. It depends on what caused the injury and your overall health.

Electrolyte deficiency disorders

If you have kidney damage from diabetes or high blood pressure, your electrolytes may be to blame. Electrolytes are minerals in your blood like calcium, sodium, and potassium. They help maintain blood pressure, repair damaged tissue, and send electrical impulses to the nerves and muscles.

Treatment and outcome depend on the type of electrolyte disorder you have and how severe it is.

Inherited kidney disorders

Nephrologists also treat kidney problems inherited from your parents. Again, treatment and outcome depend on the type of disease and how much damage has been done to the kidneys.

Some of the most common inherited kidney disorders are:

  • Polycystic kidney disease (cysts growing inside the kidneys cause damage)
  • Genetic glomerular diseases (damage membranes that keep protein in the bloodstream)
  • Genetic electrolyte disorders
  • Genetic blood pressure disorders

What Tests Do Nephrologists Use?

Your nephrologist can learn more about your kidney problems by running a series of tests. These may include:

  • Blood tests
  • CT scans
  • Kidney biopsies
  • Ultrasounds
  • Urine tests
  • X-rays

Your nephrologist will gather as much information as possible about your kidney problems. The more they know, the quicker they can stop or slow the progression of your disease.

To learn more about nephrology and kidney disease, visit UPMC.com/KidneyDisease, book an appointment, or contact us.

Sources

National Institute of Diabetes and Digestive and Kidney Diseases, Kidney Disease Statistics for the United States. Link.

American Medical Association, Nephrology Specialty Description. Link.

National Kidney Foundation, Chronic Kidney Disease. Link.

Medical News Today, What is a Nephrologist? Link.

The Centers for Disease Control, Chronic Kidney Disease in the United States, 2019. Link.

U.S. National Library of Medicine, Acute Kidney Failure. Link.

About UPMC

Headquartered in Pittsburgh, UPMC is a world-renowned health care provider and insurer. We operate 40 hospitals and 700 doctors’ offices and outpatient centers, with locations in central and western Pennsylvania, Maryland, New York, and internationally. We employ 4,900 physicians, and we are leaders in clinical care, groundbreaking research, and treatment breakthroughs. U.S. News & World Report consistently ranks UPMC Presbyterian Shadyside as one of the nation’s best hospitals in many specialties and ranks UPMC Children’s Hospital of Pittsburgh on its Honor Roll of America’s Best Children’s Hospitals.