Nephrologist: Your Kidney Doctor & Dialysis Expert

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What is a nephrologist?

A nephrologist specializes in the health needs of people with kidney diseases and disorders. Nephrologists diagnose and treat kidney problems, such as kidney stones and kidney failure. They also help manage the conditions that kidney diseases can cause, such as high blood pressure.

A nephrologist typically:

  • Evaluates a patient’s medical history and kidney function

  • Diagnoses and treats acute and chronic diseases and conditions that affect the kidneys including high blood pressure (hypertension), diabetes, kidney disease, kidney failure, and kidney stones

  • Evaluates whether a person with kidney disease needs dialysis or a kidney transplant

  • Orders and performs kidney dialysis procedures

  • Analyzes the results of kidney disease screenings including urine tests, blood tests, and biopsies

  • Orders and interprets laboratory and imaging tests and prescribes medications

  • Provides care before and after kidney transplants and other kidney surgeries

  • Creates lifestyle plans for helping patients maintain their kidney function including dietary and medication changes

  • Oversees healthcare professionals who help patients manage their kidney conditions, such as surgeons, nutritionists, occupational therapists, physical therapists, and social workers

Nephrologists may also be known by the following names: kidney doctor, renal specialist, or kidney specialist.

Who should see a nephrologist?

People with kidney-related disorders should see a nephrologist on a regular basis to monitor their kidney function and manage their symptoms. To minimize the risk of complications and to help ensure kidney health and overall health, any person who has a disease related to the kidneys should seek care from a nephrologist.

When should you see a nephrologist?

Consider seeking care from a nephrologist if you develop any of the following symptoms or conditions:

What conditions and diseases does a nephrologist treat?

A nephrologist treats kidney-related conditions and diseases including:

  • Diabetes, a chronic disease that affects your body’s ability to use sugar for energy

  • Fluid and electrolyte imbalance, which can be due to kidney disease, excessive diarrhea and vomiting, or certain medications

  • Gout, a metabolic imbalance leading to excess uric acid in the circulation and the accumulation of painful urate crystals within the joints.

  • High blood pressure (hypertension), which can damage your kidneys. High blood pressure can also be caused by renal artery stenosis, a narrowing of the arteries that supply blood to your kidneys.

  • Kidney cancer, which is often treated by removing all or part of the affected kidney

  • Kidney disease, which can be due to kidney infection, kidney obstruction, and renal artery stenosis

  • Kidney failure, which occurs when your kidneys are unable to remove waste products from your body

  • Kidney stones, which are often due to chronic dehydration

What tests does a nephrologist perform or order?

A nephrologist can order or perform a wide variety of diagnostic and screening tests, including:

  • Biopsy to find the source of any abnormalities found in blood and urine testing, as well as to gauge the extent of damage to the kidneys

  • Blood and urine tests to reveal how well the kidneys are filtering waste and fluids, and to see whether an infection is present

  • Imaging procedures, such as computed tomography (CT) and ultrasound, to check for blockages and structural abnormalities in the kidneys

What procedures and treatments does a nephrologist perform or order?

Nephrologists order or perform various procedures and treatments to manage kidney-related conditions. Nephrologists are trained in both medical and minor surgical treatments, such as placing renal artery stents. Nephrologists do not perform major surgery, such as kidney transplant, but they are familiar with all aspects of the patient’s care before and after transplant. Depending on your condition, your nephrologist will refer you to a general surgeon, transplant surgeon, or other surgical specialist, such as a urologist. Common procedures and treatments include:

  • Dialysis to artificially filter toxins and fluids out of the blood when the kidneys no longer perform this function themselves

  • Kidney stone treatment to break up kidney stones with medication, surgery, or extracorporeal shock wave lithotripsy (ESWL)

  • Post-kidney transplant treatments and care to ensure transplanted kidneys function correctly and to treat side effects and conditions caused by the transplant procedure

  • Renal angioplasty and renal stent placement to widen a renal artery and improve blood flow to the kidneys

Nephrologist training and certification

A doctor may practice nephrology without becoming board certified in the specialty. However, education, training, experience and certification are key elements in establishing a doctor’s level of competence. Board certification verifies that a doctor has completed residency training in internal medicine and specialized training in nephrology, and has passed competency examinations.

A board-certified nephrologist has earned certification in nephrology by the American Board of Internal Medicine or the American Osteopathic Board of Internal Medicine.

A board-certified nephrologist has:

  • Graduated from medical school or a college of osteopathic medicine, earning an MD or DO degree

  • Completed specialized residency training in internal medicine and subspecialty fellowship training in nephrology

  • Passed certification exams that validate the doctor’s knowledge and skills in internal medicine and nephrology

To maintain board certification in nephrology, a doctor must participate in an ongoing certification program.
Nephrology is a subspecialty of internal medicine. Nephrologists can also gain expertise in certain areas of medicine related to nephrology including:

  • Geriatric nephrology focuses on the kidney care of aging patients. This is not a formal, board-certified subspecialty.

  • Interventional nephrology focuses on providing diagnostic and therapeutic procedures for people with kidney disease, such as diagnostic ultrasound, kidney biopsy, renal artery angiogram, and insertion of dialysis catheters. This is not a formal, board-certified subspecialty.

  • Pediatric nephrology focuses on kidney care of infants and children. A pediatric nephrologist must first gain board certification and undergo residency training in pediatrics before completing a fellowship to subspecialize in pediatric nephrology.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2017 Nov 2
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
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