The kidneys filter waste products and excess fluids from the blood, maintaining electrolyte balance, regulating blood pressure, and producing hormones that control red blood cell production.
Why Would You See A Nephrologist?
If you are experiencing any kidney-related symptoms, such as swelling in the legs or hands, changes in urination patterns, excessive thirst, high blood pressure, persistent itching, loss of appetite and weight loss, muscle cramps, shortness of breath, puffy eyes, cognitive changes, and anaemia, you might be referred to a nephrologist to check your kidneys. Nephrologists specialise in:
- Chronic Kidney Disease
- High Blood Pressure and Kidney Problems
- Electrolyte and Acid-Base Disorders
- Kidney Stones
- Urinary Tract Infections (UTIs)
- Kidney Transplantation
- Acute Kidney Injury
- Polycystic Kidney Disease
- Nephrotic Syndrome
- Renal Failure
What Tests Are Done To Check Kidney Function?
Kidney function tests provide information about the kidneys' ability to filter waste products, maintain electrolyte balance, and produce urine.
- Serum Creatinine: Creatinine is a waste product produced by muscle metabolism and is filtered out by the kidneys. Elevated levels of creatinine in the blood can indicate impaired kidney function.
- Blood Urea Nitrogen (BUN): BUN measures the amount of urea nitrogen in the blood. High levels can indicate kidney dysfunction.
- Estimated Glomerular Filtration Rate (eGFR): eGFR provides an estimate of the kidney's filtration rate and is used to determine the stage of chronic kidney disease.
- Urinalysis: This test examines a urine sample for the presence of red and white blood cells, protein, glucose, and other substances.
- Urine Protein/Creatinine Ratio: This test measures the amount of protein in the urine relative to the creatinine level. Elevated levels of protein may indicate kidney damage.
- Ultrasound: Ultrasound imaging uses sound waves to produce images of the kidneys. It can detect kidney abnormalities, such as kidney size, cysts, tumours, or obstructions.
- CT Scan or MRI: These imaging techniques provide detailed images of the kidneys and surrounding structures. They help evaluate kidney anatomy, identify tumours, or investigate potential abnormalities.
In some cases, a kidney biopsy may be performed to obtain a small sample of kidney tissue for microscopic examination. Biopsies help to diagnose specific kidney diseases and guide treatment decisions.
What Are The 5 Stages Of Kidney Disease?
The five stages of kidney disease are determined based on the estimated Glomerular Filtration Rate (eGFR), which measures the kidney's filtering capacity. The stages are as follows:
There is evidence of kidney damage in this stage, such as abnormal urine tests or imaging studies, but the kidney function is still considered normal or slightly reduced.
In stage 2, there is a mild reduction in kidney function, indicating a slight decrease in the kidney's ability to filter waste products from the blood.
Stage 3 is divided into two sub-stages:
Stage 3a: eGFR between 45-59 mL/min/1.73 m²
Stage 3b: eGFR between 30-44 mL/min/1.73 m²
In stage 3, there is a moderate decline in kidney function, categorised based on the severity of the decrease. At this stage, some symptoms and complications of kidney disease may appear.
In stage 4, there is a significant decrease in kidney function. This stage is associated with a higher risk of complications and the need for renal replacement therapies like dialysis or kidney transplantation.
Stage 5 is the most advanced stage of kidney disease, where the kidneys have lost nearly all their function. The kidneys can no longer effectively remove waste products and excess fluid from the body at this stage. Patients with kidney failure or end-stage renal disease typically require dialysis or a kidney transplant to survive.
Is Nephrology Different From Urology?
Yes, nephrology and urology are distinct medical specialities, although they both deal with aspects of the urinary system.
Nephrologists are medical doctors who specialise in the medical management of kidney-related conditions. Nephrologists primarily deal with the internal structure and function of the kidneys, including managing chronic kidney disease, kidney failure, kidney transplantation, and electrolyte imbalances.
They are trained to evaluate and manage conditions like glomerulonephritis, nephrotic syndrome, kidney stones, polycystic kidney disease, and systemic diseases that affect the kidneys, such as diabetes and autoimmune disorders.
Nephrologists may prescribe medications, recommend lifestyle modifications, and provide guidance for dialysis or kidney transplantation if necessary.
Urology, on the other hand, is a surgical speciality that focuses on diagnosing and treating conditions related to the urinary tract in both males and females, as well as the male reproductive system.
Urologists diagnose and treat conditions such as urinary tract infections (UTIs), kidney stones, bladder disorders, urinary incontinence, urinary tract obstructions, and urological cancers (e.g., bladder cancer, kidney cancer, prostate cancer).
Urologists are also involved in surgical procedures related to the urinary system, including minimally invasive, endoscopic, and reconstructive surgeries.
Urologists may also address male-specific conditions such as erectile dysfunction, infertility, and prostate-related disorders.
While there is some overlap in managing specific conditions, nephrologists primarily focus on medical management and non-surgical interventions for kidney-related diseases. At the same time, urologists specialise in medical and surgical interventions for a broader range of urinary system conditions.
Frequently Asked Questions
Significant swelling of your legs, feet and hands are a worrisome symptom, meaning that you are retaining too much fluid. This could be accompanied by a decrease in urine output and high blood pressure.
Over time, kidneys gradually lose their ability to function properly, leading to chronic kidney disease - the most common kidney condition worldwide.
There are various causes of chronic kidney disease, including diabetes, high blood pressure, glomerulonephritis, and polycystic kidney disease. As the condition progresses, it can lead to kidney failure, requiring treatments such as dialysis or kidney transplantation.