What Is a Nephrologist?

A nephrologist is a highly trained doctor specializing in kidney health

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A nephrologist is a doctor who specializes in kidney health and kidney disease. A nephrologist can diagnose and treat kidney failure, and can help people in kidney failure by prescribing medications, offering special diet advice and coordinating dialysis care when the time comes.

People with diabetes may have long-term complications that involve kidney disease and eventual failure. A nephrologist is an important member to add to your personal healthcare team, if you have symptoms of kidney disease.

Beyond diabetes, you may be referred to a nephrologist if you experience any of the following symptoms: 

  • Kidney stones
  • Hypertension (high blood pressure)
  • Acute renal failure
  • Chronic or repeated urinary tract infections (UTI)
  • Fluid retention
  • Decline in kidney function
  • Electrolyte disorder
  • Protein or blood detected in urine

How to Become a Nephrologist

Nephrology, which is the branch of internal medicine that deals with the kidney, is the nephrologist's specialty. To become a nephrologist, a doctor must successfully complete medical school, and then go on to a residency program for a term usually of three years. After completing residency, the doctor must pass the American Board of Internal Medicine's (ABIM) certification exam to become a board-certified doctor, and may then proceed on to specialized research in nephrology. This is done in an accredited nephrology fellowship program, usually two to three years in length through a university hospital.

Many nephrology fellowships also require laboratory or clinical research for one to two additional years.

For doctors who wish to work with children, they must specialize in pediatric nephrology. This requires additional training and successful exam completion. 

What a Nephrologist Does

As specialists, patients usually visit a nephrologist on referral from their primary care physicians.

Nephrologists take blood and urine tests to establish how the patient’s kidneys are functioning. They also employ ultrasound to examine the kidney.

Once a nephrologist determines there is a problem with kidney function, they will make a diagnosis (which may involve consultations with doctors in other specialties). In the case of kidney disease, further testing may be necessary to identify the stage of the kidney disease. The nephrologist will prescribe a plan of treatment for the patient.

Though their expertise is in the kidney and they do perform kidney biopsies, nephrologists are not surgeons normally and would not typically perform surgeries such as the removal of kidney stones or the treatment of kidney cancer. These procedures would be referred to a urologist.

Your nephrologist may see you several times each month if you are on dialysis. For other kidney ailments, you may see your doctor once every month or two, depending on the situation. It is often important that your kidney issue be monitored or treated regularly.

As such, your nephrologist may also take care of other routine or common medical issues you may have beyond simply your kidneys. Your nephrologist is trained in internal medicine, so they are well prepared for other problems you may encounter during treatment, so be sure to let your doctor know if you do experience other concerns.

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