Nephrologist

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Who is a Nephrologist?

A nephrologist is a medical specialist in the kidneys and urinary system. Nephrologists' knowledge of these body parts allows them to analyze, diagnose, and treat kidney and urinary system diseases. Abnormal test results, such as a urine or blood test, predispose you to visit a nephrologist. Nephrology is a specific field that primarily focuses on the kidneys and problems with these organs.

The kidneys perform essential functions, such as removing unnecessary substances from the body, so worrying symptoms can occur when their function is disrupted. Many kidney and urinary system diseases can be acute, mild, or chronic. Nephrologists deal with diseases such as organ failure, inflammation, or kidney stones, but also an essential condition for nephrologists is diabetes. The changes associated with diabetes cause deterioration in blood flow and kidney function, so patients with diabetes need frequent help from nephrologists to avoid serious complications.

Nephrologists can perform many tests to help diagnose the kidneys and urinary system. They can also interpret indicators from urine or blood samples related to the kidneys. Nephrologists can also tailor treatment appropriately to address abnormalities, prescribe medication, make recommendations, and, if qualified, perform kidney surgery. Find out more about the nephrology profession.

Nephrologist: Who Is, Diagnostic Strategies, and Health Issues

Diagnostic Strategies

Nephrologists can carry out various tests to detect kidney or urinary system problems. Kidney experts first interview the patient, looking at a range of symptoms. Kidney diseases may not give any symptoms for a long-term period. Therefore, it is also essential to undergo regular essential examinations as a preventive goal. Nephrology tests include:

Morphology

Regular blood tests can give results that suggest kidney problems. The organs filter the blood, cleansing it of toxins, so some abnormalities can be found in the blood when they do not function correctly. The blood ureaTrusted Source test is critical. This indicator allows kidney function to be assessed efficiently. The urea test is usually done together with a creatinineTrusted Source determination, which can indicate kidney damage. The glomerular filtration rate is also essential in a blood test for kidney health, as it assesses the glomerular filtration rate in the kidneys and uric acid, high levels of which can cause gout or kidney stones. Therefore, it is a basic test ordered by nephrologists.

Urinalysis

Another important test that a nephrologist may recommend is a urinalysis. A urine laboratory test is essential for kidney and urinary tract diseases because it can assess the chemical state of the urine. The test can determine the color, clarity, and proper urine pH. In addition to being necessary for urine constituents, the test can detect and determine levels of bilirubinTrusted Source, glucoseTrusted Source, proteinsTrusted Source, and other elements. Vital are proteins, or albuminTrusted Source, which, when in excess, can indicate deterioration of urinary function. Creatinine levels can also be determined in urine, a standard component.

Nephrologist: Who Is, Diagnostic Strategies, and Health Issues

Urinary Tract Ultrasound

Imaging tests used by nephrologists include urinary ultrasound. It is an extension of abdominal ultrasound to evaluate the urinary system. During the diagnostic ultrasound, the nephrologist individually checks the condition of the internal organs in the abdominal cavity. The examination allows a broad assessment of various body parts, such as the bladder, ureters, kidneys, and, in men, the prostate gland. The nephrologist analyses the changes occurring within the soft tissues of the urinary tract. Urinary ultrasound allows the amount of urine backing up in the bladder to be assessed, which is essential information for the urologist. Nephrologists often do the examination, as it allows the detection of many abnormalities within the urinary tract.

Urography

Urography is another test nephrologists use to assess the urinary system. The examination uses contrast, which is injected into the patient's body. The contrast allows better visualization of the organs on the X-ray images taken. The X-rays enable obstacles to the flow of urine to be picked up. The examination can also help detect many abnormalities of the kidneys and urinary system, such as kidney stones, tumors, or anatomical malformations. However, it should be noted that urography is not indicated for everybody. For patients with severe kidney damage, contrast administration may worsen their condition so that nephrologists may opt for other diagnostic modalities for severe conditions.

Cystography

A radiological examination of the lower urinary tract is used to diagnose certain diseases, allowing assessment of the bladder. The imaging test can also assess the efficiency of the valve mechanisms in the ureteral outlets to the bladder. Like urography, the examination involves filling the bladder with a shadowing agent and taking a series of X-rays within the pelvis, allowing the interior of the bladder to be accurately imaged. The results can be used to assess, among other things, whether the bladder's size is standard and leaky. Any bladder abnormalities can be made clear, providing the nephrologist with valuable information for diagnosis.

Nephrologist: Who Is, Diagnostic Strategies, and Health Issues

Pielography

Pielography is another test of nephrological interest. It is a more invasive imaging study of the urinary system. Pielography allows the assessment of the ureters and the pyelocalyceal system independently of renal function. However, due to its invasiveness, the test is not widely used as complications may occur after the examination. Pyelography is also an examination using X-rays after administering a shadowing agent. Still, guiding the catheter into the ureter can damage the urinary tract or inflammation. For this reason, it is only used in exceptional cases.

Renal Scintigraphy

Renal scintigraphy is another imaging study used by nephrologists. Radiation allows the structure and function of the urinary system to be assessed. Diagnosticians also use intravenous injection of a small amount of isotope. The substance flows with the blood to the kidneys, which allows their blood supply, structure, and function to be assessed. When the substance flows with the urine excreted by the kidneys into the bladder, it additionally makes it possible to determine whether the urine outflow from the kidneys is normal. Renal lesions can also be detected because of the isotope distribution. It is a critical and helpful examination but has some contraindications.

Kidney Biopsy

A kidney biopsy is an invasive diagnostic procedure. A section is taken from the patient's organ, which can be assessed using a microscope. Anesthesia is used during a kidney biopsy, performed under ultrasound guidance. Some symptoms may occur after a kidney biopsy, but serious complications are rare. A kidney biopsy may be necessary for certain diseases. The indication for biopsy is usually an unknown cause of disease. With acute and refractory symptoms, a kidney biopsy may point to the cause to tailor better individual treatment.

Nephrologist: Who Is, Diagnostic Strategies, and Health Issues

Health Issues

Nephrologists treat many diseases. Nephrologists, as part of their specialization in nephrology, acquire relevant medical knowledge in diagnosing and treating various ailments related to the kidneys and urinary system. The specialists, therefore, deal with health problems such as:

Renal Abnormalities

Abnormalities of normal kidney function can cause the development of several diseases related to this organ. Among others, kidney stonesTrusted Source are distinguished, a common problem nephrologists deal with. It is an ailment in which the presence of deposits in the urinary system that have not dissolved causes various problems and painful symptoms. Kidney stones can be caused by an abnormal outflow of urine or an improper urine composition, which may be associated with kidney abnormalities. Renal or urinary abnormalities are also associated with renal uremia or inflammatory nephropathy, which causes renal acidosis. It is essential to diagnose renal abnormalities and start treatment as soon as possible, as it can lead to irreversible kidney damage.

Acute and Chronic Renal Impairment

Acute or chronic renal failureTrusted Source is a common problem that nephrologists seek to treat. The acute type is associated with a sudden impairment of kidney function. Many factors can lead to this kidney disease. Reduced blood flow through the kidneys is the most common cause, causing an increase in blood creatinine levels. The second most common cause is toxic factors such as drugs or alcohol. Organ failure can cause various impairments and obstructions of urine outflow from the kidneys. Symptoms are related to the urinary system and can be multiple depending on the cause of kidney failure. Kidney failure can also be chronic, which is usually progressive, meaning that it causes deterioration of kidney function.

Nephrologist: Who Is, Diagnostic Strategies, and Health Issues

Urinary Tract Infections

Nephrologists also investigate and treat various inflammatory conditions of the kidneys and urinary tract. Such conditions include glomerulonephritisTrusted Source. The inflammatory process in these areas causes abnormal kidney function and kidney failure. Inflammation of the kidneys can also be of an acute or chronic type. The cause of this kidney disease is an abnormal function of the immune system, which reacts inappropriately to infectious agents or drugs. If glomerulonephritis is severe, it can result in increased symptoms. In addition, cystitis and different urinary tract infections may also be the focus of nephrologists.

Disease Complications

Complications of some diseases can cause problems with the kidneys and urinary system. Examples include diabetic nephropathyTrusted Source, which is associated with kidney damage that develops as a result of chronic hyperglycemia. Diabetic complications affecting kidney function can result from inadequate treatment or lack of treatment of the underlying disease. In preventing diabetic kidney disease, the most important thing is to keep blood glucose concentrations within recommended limits, so patients with diabetes need the care of nephrologists.

Nephrologist: Who Is, Diagnostic Strategies, and Health Issues

Genetic Diseases

Congenital disabilities of the kidneys and urinary tract can also cause problems. Some complaints may be related to anatomical abnormalities of the organs. Examples include Fabry diseaseTrusted Source, a congenital genetic defect caused by an enzyme. This defect causes damage to blood vessels and disorders of many organs, such as the kidneys. Genetic diseases related to the kidneys and urinary system include polycystic kidney degeneration or cystinuriaTrusted Source. Nephrologists can detect genetic defects with special tests and tailor appropriate treatment and care.

Tumors

Neoplastic diseases can also develop within the kidneys and urinary system. The nephrologist can detect cancer with tests. In such situations, time is of the utmost importance and affects the prognosis of patients. Unfortunately, kidney cancer often develops without any symptoms and is, therefore, detected too late. Thus, preventive examinations are important. Some, even subtle signals, should prompt patients to visit a nephrologist.

Signs

Kidney and urinary tract diseases can vary and require a different therapeutic approach, which the nephrologist selects based on the diagnosis. However, several vital signs may suggest kidney problems. Signs that a nephrologist should investigate include:

Urinary Disturbances

Kidney and urinary tract problems can present in various abnormalities related to urinary function. Patients notice frequent trips to the toilet due to an increased need to urinate. There may also be pain and burning during urination, a change in the color of the urine, and a change in the amount, that is, a significant reduction, increase, or stoppage of urine output. On the other hand, blood in the urine is an important signal that should not be ignored, and you should go to a nephrologist.

Nephrologist: Who Is, Diagnostic Strategies, and Health Issues

Pain

Sick kidneys or the urinary system can also give signs of pain. Pain in the lower back may occur if the right and left sides are affected, as the kidneys are located in these areas. Pain may also affect the lower abdomen, possibly indicating bladder problems. The pain may increase during urination. In nephrolithiasis, renal colic typically occurs, marked by intense pain attacks in the lumbar region.

Swellings

Various kidney and urinary tract diseases share common symptoms, including swelling. Swelling in kidney disease occurs due to a change in the concentration of albumin in the blood, further decreasing oncotic pressure. In addition, a shortage of fluid in the vessels signals the body to retain water and sodium. Therefore, swelling of the legs and other body parts may indicate kidney problems.

Systemic Symptoms

Kidney and urinary tract diseases can also produce subtle, uncharacteristic symptoms. Such symptoms include fever and general weakness in patients, possibly due to abnormal kidney function or ongoing inflammation. As renal excretory function deteriorates, additional complaints, including nausea and vomiting, occur.

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August 31, 2024
10 minutes read
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