Definition & Overview
Nephrology is the medical branch of science that deals with the diseases of the kidneys, which utilize a complex network of blood vessels, tubes, and tubules that are responsible for filtering out the waste products in the body. Any damage or dysfunction of any of these parts can result in kidney problems.
Who Should Undergo & Expected Results
Nephrology consultation is recommended for patients who have or suspected of having the following conditions:
- Fluid and electrolyte disorders
- Kidney stones
- Acid-base disorders
- Tubulointerstitial diseases
- Glomerular diseases
- Mineral metabolism disturbances
- Acute and chronic renal failure
- Acute and chronic kidney disease
- End-stage renal disease and dialysis
During the consultation, the nephrologist will make a thorough assessment to determine if the patient is at risk of developing kidney diseases. If the patient has been previously diagnosed with a kidney problem, the consultation will focus on developing a treatment plan as well as preventing or reducing associated risks.
How Does the Procedure Work?
A nephrology consultation begins just like with any other doctor meeting. The nephrologist will review your medical history, possibly ask further questions for clarification and perform a complete physical exam. After obtaining specific information such as weight and blood pressure for reference, the doctor will order urine and blood tests to assess the health of your kidneys.
In preparation for the consultation, patients are advised to bring the following medical documents that will provide the doctor with a more profound history of the condition. This helps ensure the accuracy of the diagnosis.
- An updated list of medications
- Laboratory test results
- Radiology reports (CT scan, ultrasound, etc.)
- Any special nutrition programs or diet planning that you follow
- A list of questions that you want to ask your doctor
When discussing your health with your doctor, be as open and honest as possible. Disclose other information that are normally not included in reports, like if you have been smoking but have stopped, your tendency to miss or forget taking your medications on time, or any alcoholic indulgences that you have succumbed to, as these will help in properly and accurately assessing your overall health.
To diagnose any kidney condition, nephrologists check the levels of creatinine and BUN (blood urea nitrogen). They also rely on GFR or the Glomerular Filtration Rate to classify the extent of a chronic kidney disease. A GFR of over 90mls/min/1.73m2 is indicative of normal kidney function. From this baseline number, and if there are additional mitigating factors, a nephrologist can begin to determine how a patient fares in relation to having chronic kidney disease.
Depending on the extent of the patient’s condition, a nephrology consultation could be:
Consultative general nephrology – Kidney complications arising from other conditions may be referred to a nephrologist for management and treatment.
Chronic kidney disease management – When a patient is diagnosed with chronic kidney disease (CKD), regardless of what stage it is, the patient will automatically require constant and regular monitoring to reduce complications and slow the progression of the condition that can lead to complete kidney failure. Consultations are scheduled every three to six months and involve adjusting treatments and medications based on current results.
End-stage renal disease treatment – In cases like these, dialysis is often a part of the treatment to sustain kidney function. The nephrologist works with a team to provide the best dialysis treatment and if possible, allow for a possible kidney transplantation at the earliest time.
Long-term care after kidney transplant – When a patient undergoes a kidney transplant, a nephrologist consultation becomes inevitable. The doctor has to closely monitor the behavior of the new kidney as well as how the body is reacting to it and must be on-hand to adjust treatment protocols as necessary.
Possible Complications and Risks
Nephrology consultation, in itself, is safe. In fact, it is beneficial as the earlier that the problem is diagnosed, the higher the chances that kidney problems will be resolved and risks that come with the disease are minimized. However, certain tests and procedures that may be performed during the consultation carry some risks and complications, which will be discussed by the nephrologist to the patient before they are initiated.
- American Society of Nephrology