Nephrology
Nephrology is the branch of internal medicine dealing with the study of the function and diseases of the kidney. The word nephrology is derived from the Greek word nephros, which means "kidney", and the suffix -ology, or "study of".
Contents
Scope of the specialty
Most diseases affecting the kidney are not limited to the organ itself, but are systemic disorders. Nephrology concerns itself with the diagnosis of kidney disease and its treatment (medication, dialysis), and follow-up of renal transplant patients. Additionally, most nephrologists consider themselves to be expert in the care of electrolyte disorders and hypertension. Given that most renal conditions are chronic, nephrologists "grow with their patients".
Who sees a nephrologist?
Patients are referred to nephrology specialists for various different reasons, such as :
- Acute renal failure, a sudden loss of renal function
- Chronic renal failure; another doctor has detected symptoms of declining renal function, often a rise in creatinine.
- Hematuria (blood loss in the urine)
- Proteinuria the loss of protein especially albumin in the urine
- Kidney stones
- Cancer of the kidney, mostly renal cell carcinoma but this is usually the domain of the urologist
- Chronic or recurrent urinary tract infections
- Hypertension that has failed to respond to multiple forms of anti-hypertensive medication or could have a secondary cause
- Electrolyte disorders or acid/base imbalance
Urologists are surgical specialists of the urinary tract. They are involved in renal diseases that might be amenable to surgery:
- Diseases of the Bladder and prostate such as malignancy, stones, or obstruction of the urinary tract.
Diagnosis
As with the rest of medicine, important clues as to the cause of any symptom are gained in the history and physical examination.
Laboratory tests are almost always aimed at: urea, creatinine, electrolytes, and urinalysis-- which is frequently the key test in suggesting a diagnosis.
More specialized tests can be ordered to discover or link certain systemic diseases to kidney failure such as hepatitis b or hepatitis c, lupus serologies, paraproteinemias such as amyloidosis or multiple myeloma or various other systemic diseases that lead to kidney failure. Collection of a 24-hour sample of urine can give valuable information on the filtering capacity of the kidney and the amount of protein loss in some forms of kidney disease. However, 24-hour urine samples have recently, in the setting of chronic renal disease, been replaced by spot urine ratio of protein and creatinine.
Other tests often performed by nephrologists are:
- Renal biopsy, to obtain a tissue diagnosis of a disorder when the exact nature or stage remains uncertain.;
- Ultrasound scanning of the urinary tract and occasionally examining the renal blood vessels;
- CT scanning when mass lesions are suspected or to help diagnosis nephrolithiasis;
- Scintigraphy (nuclear medicine) for accurate measurment of renal function (rarely done), diagnosis of renal artery disease, or 'split function' of each kidney;
- Angiography or Magnetic resonance imaging angiography when the blood vessels might be affected
Therapy
Many kidney diseases are treated with medication, such as steroids, DMARDs (disease-modifying antirheumatic drugs), antihypertensives (many kidney diseases feature hypertension). Often erythropoietin and vitamin D treatment is required to replace these two hormones, the production of which stagnates in chronic renal disease.
When symptoms of renal failure become too severe, dialysis might be required. Please refer to dialysis for a comprehensive account of this treatment.
If patients proceed to renal transplant, nephrologist often monitor the immunosuppressive regimen and the infections that can occur at this stage.
List of useful articles and CME resources in Nephrology
Free Nephrology CME and educational Resources
- Hypertension, Dialysis, and Clinical Nephrology - HDCN provides up-to-date, selected information on renal disorders and their treatment (hemodialysis, peritoneal dialysis), and about hypertension, dialysis, and clinical nephrology topics
- The International Society of Nephrology (ISN) is a global professional organization representing physicians and scientists around the world with the mission to enhance knowledge, research, clinical practice and leadership in nephrology on a global level, according to local needs.
External links
Video CME
Clinical Trials
Useful Articles
Health science - Medicine |
Anesthesiology - Dermatology - Emergency Medicine - General practice - Intensive care medicine - Internal medicine - Neurology - Obstetrics & Gynecology - Pediatrics - Podiatry - Public Health & Occupational Medicine - Psychiatry - Radiology - Surgery |
Branches of Internal medicine |
Cardiology - Endocrinology - Gastroenterology - Hematology - Infectious diseases - Nephrology - Oncology - Pulmonology - Rheumatology |
Branches of Surgery |
General surgery - Cardiothoracic surgery - Neurosurgery - Ophthalmology - Orthopedic surgery - Otolaryngology (ENT) - Plastic surgery - Podiatric surgery - Urology - Vascular surgery |
WikiMD Sponsors - W8MD Weight Loss, Sleep and MedSpa CentersPronounced weightMD, our state of the art W8MD weight loss, sleep, holistic IV nutrition and aesthetic medicine programs can help you not only to lose weight, and sleep better but also look your best! Since its inception in 2011, W8MD’s insurance physician weight loss program has successfully helped thousands of patients. W8MD Weight Loss W8MD’s Physician weight loss is unique in many ways with a comprehensive multidisciplinary approach to weight loss. Weight Loss Success Stories.... W8MD Sleep Services Sleep medicine program uses state of the art technology to diagnose and treat over 80 different sleep disorders. W8MD Sleep Services… W8MD Medical Aesthetic Services Medical aesthetic program offers a wide variety of advanced laser skin treatments including oxygen super facials, photofacials and Affordable Botox. W8MD Aesthetic Services… IM and IV nutrition therapy includes booster shots for B12, vitamin B complex, Vitamin C, Detox treatments and IV nutrition therapy. W8MD IV Nutrition… |
W8MD Weight Loss, Sleep & Medical Aesthetics |
Disclaimer: The entire contents of WIKIMD.ORG are for informational purposes only and do not render medical advice or professional services. If you have a medical emergency, you should CALL 911 immediately! Given the nature of the wiki, the information provided may not be accurate and or incorrect. Use the information on this wiki at your own risk! See full Disclaimers.WikiMD is supported by W8MD Weight loss, Poly-Tech Sleep & Medical Aesthetic Centers of America.