Nephrologists Treat Conditions of the Kidney

Nurse and human kidney
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Nephrology is the medical specialty which focuses on the treatment of kidney conditions and abnormalities. A physician who practices nephrology is called a nephrologist.

Nephrology is a subspecialty of internal medicine. Therefore, a nephrologist would complete the same training as an internist and then complete an additional fellowship in nephrology.

Nephrologists diagnose causes and levels of kidney failure and prescribe appropriate treatment such as medication, diet changes, or dialysis. If none of these treatments work, a kidney transplant would be performed by a transplant surgeon.

Education and Training for Nephrology

A physician can specialize in nephrology through two different educational paths. In both cases, they would first complete medical school as an MD or DO and then spend at least five years in specialty training. To specialize in adult nephrology, the doctor would complete a three-year residency in internal medicine and then a fellowship in nephrology of at least two years.

To specialize in pediatric nephrology, a doctor would complete either a three-year pediatric residency or a four-year combined internal medicine and pediatrics residency, and then a three-year fellowship in pediatric nephrology.

After completing this training, the doctor is eligible to take the exam and be board certified in nephrology by the American Board of Internal Medicine or the American Osteopathic Board of Internal Medicine. Some nephrologists continue with additional fellowships in nephrology subspecialties.

Subspecialties include dialysis, kidney transplantation, chronic kidney disease, onconephrology, and procedural nephrology.

Where Do Nephrologists Work?

Most nephrologists (70 percent according to the American Medical Association's data) go into private practice after their fellowship, in a single specialty group or a multispecialty group practice. The next biggest percentage at about 20 percent go into academic positions, which may be in research as well as in teaching or affiliated practices. Small numbers of nephrologists work for drug companies, medical device manufacturers, or dialysis providers. Some work for large managed care organizations. A few work at a hospital.

Nephrologists are needed throughout the United States. But they tend to cluster near where they trained, resulting in oversaturated areas and those where their services would be in more demand.

What Kind of Conditions and Patients Do Nephrologists Treat?

The kidney is affected by many chronic and systematic diseases as well as acute injury, infections, and kidney stones. There is a growing need for renal medicine due to the prevalence of diseases such as diabetes and hypertension. As the Baby Boom generation enters their later years, there will be further need for nephrology.

Patients would be referred to a nephrologist if there are any signs of kidney disease, including blood or protein in the urine, disturbances of electrolyte and acid/base balance, kidney stones, acute kidney failure, and chronic kidney disease. A nephrologist might perform a kidney biopsy.

Nephrologists often care for patients for a long period of time, managing their kidney problems through end-state renal failure. The nephrologist must coordinate care with primary care physicians, surgeons, and other health professionals. Patients may be referred for dialysis or a kidney transplant.

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