Nephrology

Nephrology is a subspecialty of internal medicine that deals with the diagnosis and treatment of kidney diseases, as well as the treatment of kidney failure (renal insufficiency) with renal replacement therapy – dialysis.

The kidneys are vital organs responsible for filtering waste products and toxins from the blood, regulating the fluid and electrolyte balance, producing hormones that regulate blood pressure, and producing red blood cells.

Who is a nephrologist?

A nephrologist is a medical specialist involved in kidney healthwho treats conditions affecting kidney function, such as chronic kidney disease, kidney stones, glomerulonephritis,and kidney failure. Nephrologists also treat systemic conditions affecting the kidneys, such as diabetes and autoimmune diseases, as well as hypertension (high blood pressure) and electrolyte imbalance.

The human body has two kidneys, each approximately the size of a fist. They are located just below the chest in the middle of the back, on each side of the spine. One kidney is sufficient to enablethe normal functioning of the human body.

When should you visit a nephrologist and how arekidney diseases and conditions prevented?

There are many potential reasons why your GP may recommend that you see a nephrologist. Nephrologists provide a complete diagnostic and therapeutic approach to renal diseases, including rare and complicated diseases.

It is important to schedule an appointment with a nephrologist if any of the following symptoms/issues are present:

• Protein or blood in the urine
• Uncontrolled hypertension
•Kidney stones
• Chronic and acute kidney inflammation
• Kidney failure (renal insufficiency)
• Necessary care after kidney transplantation

Maintaining optimal kidney health is crucial for your body’s overall well-being and longevity.

The followingare the most common kidney diseases encountered in practice:

1. Chronic renal failure: A progressive condition characterized by gradual loss of kidney function over time. Common causes are diabetes, hypertension, glomerulonephritis, and polycystic kidney disease (PKD).
2. Kidney stones: Solid deposits of minerals and salts that can form in the kidneys and cause severe pain when passing through the urinary tract. Diet, dehydration, and genetic predisposition can contribute to stone formation.
3. Glomerulonephritis: Inflammation of the kidney filtering units (glomeruli), which leads to the accumulation of protein in the urine, blood in the urine, and renal function deterioration. It can be acute or chronic, and it can be the result of infections, autoimmune disorders, or systemic diseases.
4. Acute kidney failure: A sudden drop in kidney function, often due to conditions such as severe infections, dehydration, medications, or kidney damage from trauma or surgery. Timely intervention is crucial to prevent complications and restore kidney function.

Prevention of kidney disease involves adopting a healthy lifestyle and managing risk factors such as diabetes, hypertension, obesity, and smoking. Key preventive measures and nephrology prevention strategies include maintaining a balanced diet and a sufficient intake of fluids, to improve kidney function and prevent kidney stones.

Regular monitoring of blood pressure, blood sugar levels, cholesterol levels, and management of these conditions through medication, diet, and lifestyle changes helps preserve kidney function. In addition, it is important to avoid smoking and limit alcohol consumption.

A key factor in preventing kidney disease is prompt medical attention after experiencing symptoms such as changes in urination (frequency, color, odor), swelling (edema) of the face and extremities, fatigue, nausea, or unexplained changes in body weight.

What does an examination by a nephrologist look like and which tests does the nephrologist perform?

At your first doctor-patient consultation, the nephrologist first reviews your medical records, asks you about your symptoms, and inquires about your reasons for scheduling the examination. After that, the nephrologist performs a physical examination. Blood and urine tests as well as imaging diagnostics are performed after that, if necessary. Laboratory analysis of urine primarily includes the detection of the presence of bacteria, blood, and proteins. The most important blood testsdetermineurea and creatinine levels, which are used to assess renal function.

Common tests and procedures that nephrologists perform or refer patients for include the following:

• Tests of kidney function–these determine how well the kidneys are functioning (blood and urine tests).
• Imaging– kidney imaging may include X-rays, ultrasound, CT scan (CT urography), and MR urography.
• Renal biopsy– a nephrologist takes a small tissue sample from your kidneys to help diagnose a kidney condition.