Nephrology is a special field of internal medicine that deals with the diagnosis and treatment of kidney diseases, high blood pressure and disorders of the acid-base balance and electrolyte balance.
Typical diseases that are treated in nephrology include
High blood pressure can also be an expression of kidney damage / kidney disease. Renal artery stenosis (NAST) can be a possible cause of high blood pressure. A nephrologist speaks of renal artery stenosis when the blood vessel (the renal artery) that supplies the kidney is narrowed. The cause of renal artery stenosis is arteriosclerosis (arteriosclerotic renal artery stenosis) or a defect in the structure of the vessel wall (fibromuscular renal artery stenosis).
Glomerulonephritis is an inflammation of the renal corpuscles (glomerula), which can then spread to the entire kidney. If glomerulonephritis is not treated, this kidney disease can develop into chronic renal failure.
Chronic renal insufficiency, also known as chronic kidney failure, is the final stage of chronic kidney disease. In renal failure, the kidney is no longer able to perform its function adequately. Renal failure therefore requires so-called renal replacement therapy in the form of dialysis or a kidney transplant. Dialysis is then necessary for the rest of the patient's life.
The nephrologist defines vesicorenal reflux as a kidney disease in which urine flows from the bladder via the ureters back into the renal pelvis. Vesicorenal reflux does not initially cause any symptoms. However, patients with vesicorenal reflux are more susceptible to urinary tract infections, and in the long term it can also lead to high blood pressure, renal insufficiency, urinary incontinence and developmental disorders.
Kidney stones are crystalline deposits in the kidneys that consist of various substances, usually calcium oxalate or uric acid. If they enter the ureter with the urine, they can become lodged there and cause cramp-like pain. The nephrologist then speaks of renal colic.
Kidney cancer, also known as a malignant kidney tumor, is a serious kidney disease but is fortunately relatively rare. Nephrologists assume that smoking, kidney cysts and some medications are risk factors for kidney cancer. Initially, kidney cancer rarely causes symptoms, but later it can lead to pain in the kidney area or blood in the urine, among other things. Kidney cancer is occasionally discovered as an incidental finding during an ultrasound scan.
Important diagnostic procedures in nephrology include laboratory tests and imaging examinations such as X-rays and ultrasound.
If kidney disease is suspected, the nephrologist will determine certain kidney values as part of urine tests.
Using test strips held in the spontaneous urine, the kidney expert will check whether blood cells (red and white) are present in the urine. In addition, the protein content (proteins) and the amount of nitrite, ketone bodies and glucose (sugar) in the urine are determined.
The pH value measurement also plays an important role. Any cells and other urine components can be further examined under the microscope.
The blood count analysis provides important information, as some diseases change the composition of the blood. Antibody determination (serology) can be used to determine whether the patient has currently or in the past had contact with a particular pathogen.
Ureteroscopy and ureterorenoscopy are endoscopic procedures that can be used to examine the ureter and kidney. The nephrologist will use these procedures, for example, for
- Suspected kidney stones and ureteral stones,
- ureteral strictures and
- blood in the urine
in the urine. X-ray and ultrasound examinations are used in nephrology to more precisely visualize the kidneys and the vessels supplying the kidneys. Changes in the kidney (kidney cancer) can be detected in this way, for example.
Kidney experts are doctors who have undergone further training to become specialists in internal medicine with a focus on nephrology and then call themselves nephrologists. Further training to become a nephrologist takes six years and includes defined examinations and therapeutic procedures that the prospective nephrologist must learn.
These include, for example, adjusting blood pressure, ultrasound examinations of the kidneys, carrying out dialysis and advising dialysis patients.
