When to see a Nephrologist

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By Dr Ananya Mandal, MD

Nephrologists are physicians who deal with diseases of the kidneys and fluid and electrolyte imbalances.

Patients are first examined and assessed by general physicians who refer them to nephrologists when kidney disease or abnormalities are confirmed.

Some of the common reasons for referral to a nephrologist who specializes in kidney diseases include:-

Acute renal failure or sudden loss of kidney functions
Chronic renal/kidney disease or CKD with long term decline in kidney functions
Presence of blood, proteins or casts and crystals in the urine
Long term or recurring kidney infections including cystitis (bladder infections) and Pyelonephritis (kidney infection)
Kidney stones or patients who have recurrence of kidney stone formation
Uncontrolled high blood pressure
Acid base imbalance or electrolyte disorders
Cancers of the kidneys or urinary bladder
Diabetic nephropathy or diabetic kidney disease
Hypertensive nephrosclerosis or kidney damage due to high blood pressure
Atheroembolic kidney disease or kidney damage due to atherosclerosis and resulting thrombosis
Renal blood vessel disease
Nephritic syndrome
Nephrotic syndrome
Glomerulonephritis
Acute tubular necrosis
Dialysis and its long term complications - dialysis includes hemodialysis as well as peritoneal dialysis
Autoimmune diseases including autoimmune vasculitis, lupus, etc.
Hydronephrosis or damage to the kidneys due to backward flow of urine possibly due to obstruction in the outflow of urine.
Tubulo/interstitial renal diseases
Cystic diseases including polycystic kidney disease where fluid filled sacs are formed in the kidney impairing functions
Drugs or toxins that have caused kidney damage
Clinical disorders of major electrolytes (Potassium K+, Calcium Ca2+, Magnesium Mg2+, Phosphates PO42- )

Nephrology and urology

The nephrologist usually works in conjunction with Urologists who deal with the surgical aspects of kidney disease and diseases of the bladder, ureters and urethra.

Reviewed by April Cashin-Garbutt, BA Hons (Cantab)