Nephrology is specialty of medicine concerned with kidney physiology, kidney disease, the treatment of kidney problems and renal replacement therapy.
Systemic conditions that affect the kidney (e.g diabetes and Hypertension) and systemic problem that occur as a result of kidney problems (e.g metabolic bone disease and Hypertension ) are also studied in nephrology.
A nephrologist is a doctor who specializes in kidney care and treating disease of the kidney. The term nephrologist comes from the greek word ”nephros” wich mean renal and ‘ologist” refers to someone who studies. Nephrologists are educated in internal medicine and undergo very hard training to specialize in treating of kidney disease and kidney transplant clinic.
Diagnosis of kidney problems is arrived at after the following tests:
- Urine analysis, which may reveal excess proteins that are being excreted along with urine from the body. This is a sign of kidney damage that is especially seen in diabetic nephropathy or in long term kidney diseases.
- Blood tests which reveal raised or altered levels of urea, creatinine and electrolytes including sodium, potassium, calcium, magnesium, phosphates, blood urea nitrogen, etc.
- Glomerular Filtration Rate (GFR), a test to estimate level of kidney function and determine stage of chronic kidney disease. In clinical practice, estimation of GFR is based on serum creatinine, age, gender.
- Ultrasound scanning, one of the commonest and most used non-invasive imaging studies for kidneys diseases such as hydronephrosis, polycystic kidney disease, kidney stones, etc.
Other imaging studies, including:
- Computed Tomography scan (CT scan) or Magnetic resonance imaging (MRI) scan. This can also help detect renal tumors and cancer.
- MR angiography to detect abnormalities in the blood vessels within the kidneys
- Renal biopsy: If a kidney lesion is detected, a small amount of renal tissue is taken using long thin hollow needles under the guidance of ultrasound or other imaging studies.
- In patients with normal kidney function, Intravenous urography (IVU), a test where an iodinated contrast dye is injected into the veins of the person, which is then imaged using X rays or other imaging studies like CT scan to detect the flow of the blood and formation of urine in the kidneys as well as its outflow as it traverses through the kidneys.
- Scintigraphy, another test using radioactive isotopes that helps detecting abnormal functions of the kidney and its vessels.
- Renal Arteriography involves insertion of a thin catheter into the femoral artery and under guidance through an imaging study.
Consultants Nephrologists at HSMC are well-trained to deal with the following diseases that come under the scope of Nephrology:
- Primary and Secondary high blood pressure diagnosis and treatment
- Urine abnormalities, which include excess excretion of protein, sugar, blood, casts, crystals, etc.
- Kidney and urinary tract infections
- Kidney and bladder stones
- Glomerular disorders that affect the tiny filtering systems of the kidneys called the glomerulus
- Renal vascular diseases affecting the blood vessel networks within the kidneys
- Preparing patients in end stage renal disease for kidney transplant and following them after the transplantation surgery
- Renal injury (failure) that can be sudden or acute or chronic( long term)
- Effects of diseases like diabetes and high blood pressure on kidneys
- Acid-base imbalances and electrolytes( metabolic) disorders
- Nephrotic syndrome and nephritis
- Secondary effects of drugs and toxins on the kidneys
- Autoimmune diseases including autoimmune vasculitis, lupus, etc.
- ADPKD: Polycystic kidneys diseases where large cysts or fluid filled sacs are formed within the kidney impairing its functions – this is a congenital inherited condition
- Renal consequences from obesity
- Prevention of malnutrition and muscular hypotrophy in dialyzed patients