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Nephrology, from the Greek word “nephros,” for kidney, is the study of the kidneys and renal system. Physicians who practice this specialty are variously called nephrologists or kidney doctors, although the former is the more correct term. Nephrologists specialize in the diagnosis, treatment and prevention of a wide variety of renal diseases.
Beginning a Career in Nephrology
Nephrology is a subspecialty of internal medicine, where nephrologists begin their careers. After completing college, medical school and residency as a student of internal medicine, a nephrologist must pass the certification exam from the American Board of Internal Medicine. Only then can she go on to the two- or three-year fellowship training that will qualify her to practice nephrology. Among the topics she will study in her fellowship are disorders and diseases of the kidneys, ureters and urinary bladder. She will also learn about diseases and conditions related to kidney problems, such as high blood pressure and mineral metabolism.
Nephrologists treat and manage kidney disease and other renal conditions. Among these are chronic and polycystic kidney disease, acute and chronic renal failure, kidney stones, hypertension and cancer of the kidneys, ureters or bladder. The kidneys are instrumental in maintaining the balance of minerals such as calcium, sodium or potassium in the body, and nephrologists also learn how to manage conditions related to mineral metabolism. One of the nephrologist’s primary goals is to maintain or preserve kidney function as long as possible to prevent patients from needing dialysis treatment.
Procedures and Testing
Although nephrologists are not surgeons, they perform certain procedures for diagnostic purposes. After examining the patient and collecting a health history, the nephrologist typically orders various lab tests to evaluate the patient’s kidney function. She may also order diagnostic tests such as an intravenous pyelogram -- an X-ray study of the kidney -- or other diagnostic examinations. If necessary, she will perform a kidney biopsy, in which a sample of tissue is removed from the kidney for examination in the laboratory. If the patient needs surgery, however, she will make a referral -- often to a urologist, who specializes in renal surgery.
Even with treatment, some patients will eventually need dialysis because their kidneys have partially or completely failed and can no longer filter urine. The nephrologist will determine when a patient has reached that point based on blood tests and other diagnostic tests that indicate kidney function. A patient who needs dialysis has two options -- a shunt, which allows the patient’s blood to be run through a dialysis machine to purify it of wastes, or peritoneal dialysis, which uses the abdominal wall as a filter for the same purpose. In either case, the nephrologist will manage the patient’s dialysis treatment.
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