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A nephrologist is a medical doctor who specializes in kidney care and treating diseases of the kidneys. The term nephrologist comes from the Greek word “nephros”, which means kidney or renal and “ologist” refers to someone who studies. Nephrologists are also called kidney doctors. Nephrologists are educated in internal medicine and then undergo more training to specialize in treating patients with kidney diseases. They commonly treat chronic kidney disease (CKD), polycystic kidney disease (PKD), acute renal failure, kidney stones and high blood pressure and are educated on all aspects of kidney transplantation and dialysis.
Nephrology is categorized as a specialty of internal medicine. Nephrologists must graduate from an approved medical school, complete a three-year residency in internal medicine and pass the American Board of Internal Medicine (ABIM) certification exam before they can begin to study nephrology.
Once they have passed the ABIM exam and been accepted into a nephrology program, they must complete a two- to three-year fellowship in nephrology. This fellowship must be accredited by the Accreditation Council for Graduate Medical Education (ACGME).
During this fellowship, aspiring nephrologists learn about:
In addition, most nephrology fellowships require one to two years of clinical or laboratory research, during which time each physician becomes a true expert in more specialized areas of study.
During fellowship, nephrologists-in-training learn to diagnose and manage kidney diseases. They must be familiar with all surgical procedures associated with dialysis such as vascular access and catheter placement. They become experts on all forms of dialysis treatment such as hemodialysis and peritoneal dialysis and learn to perform kidney biopsies, tests during which small pieces of tissue are collected from the kidney for examination under a microscope. Once this is done, they are eligible to take the ABIM nephrology exam.
To specialize in pediatric nephrology (caring for children), students must take additional courses and pass another exam.
What does a nephrologist do?
A nephrologist generally sees patients who are referred by their primary care physicians or general physicians for problems related to the kidneys, high blood pressure or certain types of metabolic disorders. If someone feels they are having problems with their kidneys, they can seek out the care of a nephrologist. When a kidney doctor first meets with a patient, he or she will usually go over the patient’s medical history and do a complete physical.
A nephrologist will then do blood and urine tests to determine how well the patient’s kidneys are functioning. He or she may also order a kidney ultrasound. When necessary, a nephrologist may perform a kidney biopsy in order to better determine what is wrong with the kidneys. However, a nephrologist is not a surgeon and typically does not perform operations. Treatment of kidney cancer, prostate operations and removal of kidney stones are usually handled by a different type of physician known as a urologist.
If a nephrologist finds that a patient’s kidneys are not functioning as they should, he or she will help diagnose the cause and prescribe a treatment plan. If a kidney doctor detects kidney disease, he or she will do tests to determine what stage of kidney disease the patient is in and plan the patient’s treatment. The nephrologist will usually refer the patient to a renal dietitian, renal social worker and renal nurse who will help with the patient’s care. If the patient needs dialysis or a kidney transplant, his or her kidney doctor will discuss the different types of dialysis or refer the patient to a transplant center.
Nephrologists generally meet with dialysis patients several times per month and other types of kidney patients every one to three months. When a patient comes in for a check-up, the kidney doctor will evaluate the patient’s medical condition, address any new problems, check test results, make changes to the patient’s dialysis prescription if needed and refill or prescribe medications. During these visits, the nephrologist is also likely to adjust blood pressure medicines and may initiate or adjust therapy for a variety of other problems, such as diabetes, anemia and high cholesterol.
Every nephrologist has received extensive training in general internal medicine, and many nephrologists will treat their patients for other things besides kidney problems. It’s important that patients tell their kidney doctors if they notice any changes in their health.
Also, depending on the dialysis center, a nephrologist may have a managerial role in how the center runs. If this is the case, he or she will set up the policies and procedures for how the center should run, how dialysis treatments should be done and what roles the employees at the center will play in the process.
A person may be referred to a kidney doctor if he or she is experiencing:
Nephrologists, also referred to as kidney doctors, specialize in kidney care and commonly treat chronic kidney disease (CKD) and manage dialysis care for people with end stage renal disease. People with kidney problems may be referred to a nephrologist by their primary care physician or they may choose to go to a kidney doctor if they believe they have issues with their kidneys.
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