When something gets to our kidneys, that’s a case for the nephrologist. In fact, there can be many different reasons for this. The saying isn’t without reason: these two bean-shaped organs are responsible for detoxifying the body. They filter out all kinds of waste products that accumulate in the blood as a result of our metabolic and energy-burning processes. They then excrete them in the urine. This makes it clear: as soon as the kidneys aren’t functioning properly—that is, when kidney failure occurs—the entire body is affected.
As a branch of internal medicine, nephrology plays an important role. It focuses on diseases and functional disorders of the kidneys. In addition to kidney failure, these can include kidney stones or kidney gravel. Kidney gravel consists of crystallized, insoluble salts that accumulate in the kidney or the renal pelvis.
Since the kidneys perform their functions throughout the entire body, kidney dysfunction is often the result of other diseases. Some cases of kidney failure are caused by diabetes, as high blood sugar damages the kidneys.
Even high blood pressure, viral infections, and toxins can severely impair kidney function. Whether congenital or acquired, if the kidneys’ filtration capacity is too low, patients must undergo regular dialysis. If a kidney transplant is necessary, nephrologists prepare for the surgery—and continue to care for patients afterward.
What is nephrology?
Nephrology is a subspecialty of internal medicine that deals with the diagnosis and treatment of the following conditions:
- Kidney diseases
- High blood pressure
- Disturbances of acid-base balance and electrolyte balance
Common nephrological conditions
Typical conditions in nephrology include, for example:
- High blood pressure
can also be a sign of kidney damage or kidney disease. Renal artery stenosis (RAS) may be a cause of high blood pressure.
- Renal Artery Stenosis
A nephrologist diagnoses renal artery stenosis when the blood vessel (the renal artery) supplying the kidney is narrowed.
Renal artery stenosis, in turn, can be caused by arterial calcification (arteriosclerotic renal artery stenosis) or a defect in the structure of the vessel wall (fibromuscular renal artery stenosis).
- Glomerulonephritis
Glomerulonephritis is initially an inflammation of the glomeruli that can spread to the entire kidney. If glomerulonephritis is left untreated, it can lead to chronic kidney failure.
- Chronic Kidney Insufficiency
Chronic renal insufficiency, also known as chronic kidney failure, is the end stage of chronic kidney disease.
In renal insufficiency, the kidneys are no longer able to function adequately. Therefore, renal replacement therapy in the form of dialysis or a kidney transplant is required. Dialysis is then necessary for the rest of the patient’s life.
Dialysis is a medical procedure that removes harmful substances from the blood @ Maria /AdobeStock
- Vesicorenal Reflux
Vesicorenal reflux is a kidney disease in which urine flows back from the bladder into the renal pelvis. Vesicorenal reflux does not initially cause any symptoms.
However, patients with vesicorenal reflux are more prone to urinary tract infections.
In the long term, however, the following symptoms may also develop:
- High blood pressure
- Kidney failure
- Urinary incontinence and
- Developmental disorders
- Kidney stones
Kidney stones are crystalline deposits in the kidneys consisting of various substances, most commonly calcium oxalate or uric acid.
If they enter the ureter with the urine, they can become lodged there and cause cramping pain. A nephrologist refers to this as renal colic.
Kidney stones @ New Africa /AdobeStock
- Kidney Cancer
Kidney cancer, also known as a malignant kidney tumor, is a serious kidney disease. Fortunately, it is relatively rare.
Nephrologists believe that smoking, kidney cysts, and certain medications are risk factors for kidney cancer.
Kidney cancer rarely causes symptoms at first, but later it can lead to pain in the kidney area or blood in the urine.
Kidney cancer is occasionally discovered incidentally during an ultrasound examination.
Diagnostic Procedures in Nephrology
Important diagnostic procedures in nephrology include laboratory tests and imaging studies, such as:
- X-rays and
- ultrasound
If kidney disease is suspected, the nephrologist will order urine tests to determine specific kidney function values.
The doctor uses test strips to check for the presence of (red or white) blood cells in the urine.
In addition, they determine:
- the protein content
- the amount of nitrite
- ketone bodies, and
- glucose (sugar) in the urine
Measuring the pH level also plays an important role. Under a microscope, experts can further examine cells and other components of urine.
A complete blood count provides important insights, as some diseases alter the composition of the blood.
Through antibody testing (serology), doctors can determine whether the patient has been exposed to a specific pathogen.
Ureteroscopy and ureterorenoscopy are endoscopic procedures. Both examine the ureter and the kidney.
These procedures are used in the following cases:
- Suspected kidney stones and ureteral stones
- Ureteral strictures and
- Blood in the urine
In nephrology, X-ray and ultrasound examinations are used to provide a detailed image of the kidneys and the blood vessels supplying them. This allows, for example, the detection of abnormalities in the kidney (kidney cancer).
Blood in the urine @ Orawan /AdobeStock
Which medical specialists focus on nephrology?
Kidney specialists are physicians who have completed advanced training to become board-certified specialists in internal medicine with a focus on nephrology. They are called nephrologists.
Training to become a nephrologist takes six years and includes specific diagnostic tests and therapeutic procedures.
These include, for example:
- Blood pressure management
- Ultrasound examinations of the kidneys
- Performing dialysis, and
- Counseling dialysis patients
About the medical author
Dr. Claus Puhlmann
Medical Author · Medical journalist
Dr. Claus Puhlmann – medical author: expert articles, professional insights and medical knowledge in the Leading Medicine Guide.
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