Nephrology

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Nephrology is a sub-specialty of internal medicine that focuses on diagnosis and treatment of kidney disease. Because the kidney performs a lot of critical functions, Nephrologist maintain experience in primary kidney disorders, but also in the management of systemic consequences of renal dysfunction. Although prevention, identification and management of early kidney disease are a large part of general internal medicine practice, Nephrologist are involved in patient care for more complex or advanced kidney disorders.

Examples of conditions cared for by nephrologists include primary kidney disorders such as glomerular diseases (such as glomerulonephritis or the nephrotic syndrome), tubulointerstitial kidney diseases, tubular defects, and the effects of toxins on the kidney, including various diagnostic and therapeutic agents. Knowledge of disorders of the kidney vasculature (such as renal artery stenosis), infections and neoplasms of the kidney, and abnormalities of the kidney, collecting system and bladder (such as nephrolithiasis) are important aspects of nephrology
practice. A thorough understanding of the involvement of the kidneys in other systemic diseases (such as vasculitis or heart failure) is a primary role of nephrologists, and because of the central role of the kidney in maintaining blood pressure, nephrologists also possess expertise in the management of hypertension, particularly when difficult to control. Nephrologists also help in managing fluid, electrolyte, and acid-base disturbances, particularly those occurring in advanced kidney disease. A major role of nephrology is the oversight of dialysis (including
hemodialysis and peritoneal dialysis) in patients requiring renal replacement therapy, and participation in the kidney transplant process, if indicated.

Many nephrologists work in individual or group practices seeing patients in consultation for other physicians and following patients with chronic kidney disease longitudinally. Nephrologists may also provide in-hospital consultation as part of their practice. Nephrologists also oversee dialysis units which may be associated with their own practice, may be free-standing, or affiliated with a hospital. Some clinicians maintain practices containing a mix of nephrology and general medical patients.  In academic settings, nephrologists provide consultative and ongoing care in ambulatory and inpatient settings, perform basic science and clinical research in kidney diseases, and teach medical students and residents