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What Is a Nephrologist?

Nephrologists, or kidney doctors, study the kidneys and any diseases that affect them. They complete 2 more years of training after medical school and residency.

If your primary care or family doctor thinks your kidneys aren’t working well, they may send you to a nephrologist. They’ll look for the cause of the problem and come up with a treatment plan that slows or stops it. You might need a referral from your regular doctor for insurance to cover the cost of your visit.

Some of the diseases nephrologists treat are:

Kidney disease. This is when your kidneys are damaged over time. You might not have severe symptoms until the disease is more advanced. But if your doctor catches it early, medications and lifestyle changes may help you avoid more damage.

Kidney damage from cancer. Several types of cancer or their treatments can injure your kidneys. Examples of damage include blocked urine flow, toxin buildup in the kidneys, and sudden kidney failure. Cancers linked to kidney problems include:

• Multiple myeloma
• Bladder cancer
• Cervical cancer
• Colon cancer
• Prostate cancer

High blood pressure.If you have high blood pressure that’s been hard to get under control, your nephrologist can help.

Nephrotic syndrome. This is when protein leaks into your urine. It can lead to swelling in different parts of your body.

Polycystic kidney disease. This happens when fluid-filled cysts grow in your kidneys. If they get too big, they can cause damage and may lead to kidney failure. The condition may bring on symptoms like back or side pain, a bigger belly, and bloody pee.

Where Do Nephrologists Work?

Nephrologists usually have their own office or work in a group with other nephrologists. They also work at hospitals and at dialysis centers.

What to Bring to Your First Appointment

Make sure you have these at your first visit:

• A list of symptoms and how long you have had those symptoms
• A list of all of your current doctors and their contact information
• An updated list of medications
• Current insurance cards
• Your medical history
• Other medical records including lab tests and any imaging studies of your abdomen you may have had

Your nephrologist will probably give you a physical exam and ask about your medical history. They may also do these tests:

Urine collection. You’ll pee in a cup. In some cases, you might have to collect your urine in a special container over 24 hours. A lab will check the levels of waste products, protein, hormones, minerals, and other things. They also look for blood or signs of inflammation.

Ultrasound. This imaging technique makes pictures of your kidneys by using sound waves.

Biopsy. This is a procedure to remove and study one or more small pieces of your kidney. Your nephrologist may do the biopsy with a needle or during surgery. They’ll check the samples under a microscope.

What to Ask Your Nephrologist

You can ask these questions at your first appointment. Write the answers down, or have a loved one join you to take notes.

• Why did my doctor refer me to you?
• Why aren’t my kidneys working well?
• How poorly are they working compared to healthy kidneys?
• Is it possible I have kidney disease? If so, can you explain what stage the disease is in and what that means?
• What are my treatment options?
• What are the side effects of each treatment?
• Once I have a treatment plan, what are some tips that can help me stick with it?
• Should I make lifestyle changes (like eat different foods or get exercise)?
• Should I call you if I have new questions or problems?