By Dr Ananya Mandal, MD
A nephrologist is a physician who studies and deals with nephrology. Nephrology is the adult and pediatric study of the kidneys and its diseases. The nephrologist deals with the diagnosis and management of kidney disease. The kidneys are vital for maintaining normal fluid and electrolyte balance in the body.
Diseases affecting the kidneys
Diseases including diabetes and high blood pressure also affect the kidney adversely and it is a nephrologist who deals with preventing and treating renal damage caused by these systemic or whole body diseases as well.
Nephrologists deal with kidney disorders including:-
fluid and electrolyte disorders
acute kidney disease
acute renal failure
chronic kidney diseases
chronic renal failure
end stage renal disease and dialysis
They need to be well aware of medications and clinical pharmacology, high blood pressure management, diabetes management and its complications, epidemiology of diseases and infections as well as nutritional management for prevention and treatment of kidney diseases.
In the United States, after completion of medical school, a nephrologist needs to complete a three year residency in internal medicine which is to be followed by two year (or longer) fellowship in nephrology. It is mandatory to complete the internal medicine training for three years to obtain certification to become a nephrologist.
Nephrologists also must be approved by the board. To qualify the board’s standards education and training must be adequate.
Thereafter the nephrologist would need to take the board’s examination. If a physician passes the examination, then he or she can become a nephrology specialist. Nephrologists further require two to three years of training in an ACGME or AOA accredited fellowship in nephrology.
The nephrologist also undergoes training in procedures including kidney biopsies, pathology of the kidneys, biopsy of the kidneys under guidance of ultrasound, insertion and placement of temporary dialysis arteriovenous cathethers, placement of tunnelled hemodialysis catheters and placement of peritoneal dialysis catheters.
They are also trained in plasmapheresis and other procedures. They can train as interventional nephrologists, dialytician or a transplant nephrologist. Once the training is completed they need to take the ABIM or AOBIM nephrology examination.
Pediatric nephrology training
Physicians who have trained as pediatric physicians for three years in pediatric internal medicine are able to train for pediatric nephrology. Physicians who have training in both medicine and pediatrics may further train in both adult and pediatric nephrology.
Reviewed by April Cashin-Garbutt, BA Hons (Cantab)