A nephrologist is a doctor who specializes in treating diseases that affect the kidneys. You may need to see a nephrologist if you have chronic kidney disease, kidney infections, or kidney failure.

Nephrology is a specialty of internal medicine that focuses on treating diseases that affect the kidneys.

You have two kidneys below your ribcage on either side of your spine. The kidneys have several vital functions, including:

  • removing waste and excess fluid from the blood
  • maintaining your body’s electrolyte balance
  • releasing hormones with functions such as managing blood pressure

A nephrologist is a doctor who specializes in treating kidney diseases. They also know how kidney disease or dysfunction can affect other parts of the body.

Although your primary care doctor will work to help prevent and treat the early stages of kidney disease, they may refer you to a nephrologist to help diagnose and treat more severe or complex kidney conditions.

To start on the path to becoming a nephrologist, you must first complete medical school. Medical school lasts 4 years and requires a prior bachelor’s degree.

After receiving your medical degree, you’ll need to complete a 3-year residency in internal medicine. A residency allows new doctors to receive further training and education in a clinical setting and under the supervision of more senior clinicians.

Once certified in internal medicine, you must complete a 2-year fellowship in nephrology. This fellowship further hones the knowledge and clinical skills required for the specialty.

After you complete your fellowship, you must pass an exam to become board certified in nephrology.

Nephrologists can work with you to help diagnose and treat the following conditions:

A nephrologist can also be involved when other factors cause kidney disease or dysfunction, including:

If you visit a nephrologist, they may perform the following tests and procedures and also interpret the results.

Laboratory tests

A wide range of tests can help assess kidney function. A healthcare professional typically performs these tests on a blood or urine sample.

Blood tests

  • Glomerular filtration rate (GFR): This test measures how well your kidneys filter your blood. In kidney disease, GFR begins to drop below normal levels.
  • Serum creatinine: Creatinine is a waste product and is present at higher levels in the blood of people with kidney dysfunction.
  • Blood urea nitrogen: As with creatinine, finding high levels of this waste product in the blood is a sign of kidney dysfunction.

Urine tests

  • Urinalysis: A doctor can use a dipstick to test a urine sample for pH and the presence of abnormal amounts of blood, glucose, protein, or bacteria.
  • Albumin/creatinine ratio: This urine test measures the amount of the protein albumin in your urine. Albumin in the urine can be a sign of kidney dysfunction.
  • 24-hour urine collection: This method uses a special container to collect the urine you produce during a 24-hour period. A doctor can use this sample for further testing.
  • Creatinine clearance: This is a measure of creatinine from both a blood sample and a 24-hour urine sample used to calculate the amount of creatinine that has exited the blood and moved to the urine.

Procedures

In addition to reviewing and interpreting the results of your laboratory tests, a nephrologist may also perform or work with other specialists on the following procedures:

The fields of nephrology and urology share some overlap because they can both involve the kidneys. While a nephrologist focuses on diseases and conditions that affect the kidney more directly, a urologist focuses on those that can affect the male and female urinary tract.

The urinary tract includes the kidneys, as well as the ureters, bladder, and urethra. A urologist also works with the male reproductive organs, such as the penis, testes, and prostate.

Conditions that a urologist may treat can include:

Your primary care doctor can help prevent and treat the early stages of kidney disease. However, sometimes these early stages may not have symptoms or may have nonspecific symptoms such as fatigue, sleep problems, and changes in the amount you urinate.

Regular testing can monitor your kidney function, particularly if you’re at risk for kidney disease. These groups include people with:

  • high blood pressure
  • diabetes
  • heart disease
  • a family history of kidney problems

Testing can detect signs of decreasing kidney function, such as a decreasing GFR value or an increase in the level of albumin in your urine. If your test results indicate rapid or continuing deterioration of kidney function, your doctor may refer you to a nephrologist.

Your doctor may also refer you to a nephrologist if you have any of the following:

  • advanced chronic kidney disease
  • large amounts of blood or protein in your urine
  • recurring kidney stones, though your doctor may refer you to a urologist for this condition
  • high blood pressure that’s still high even though you’re taking medications
  • a rare or inherited cause of kidney disease

If you need to contact a nephrologist, your primary care doctor should be able to refer you. In some cases, your insurance company may require a referral from your primary care doctor before you can visit a specialist.

If you choose not to get a referral from your primary care doctor, check with your insurance company for a list of nearby specialists covered in your insurance network.

A nephrologist is a doctor who specializes in diseases and conditions that affect the kidneys. They treat conditions such as chronic kidney disease, kidney infections, and kidney failure.

Your primary care doctor will likely refer you to a nephrologist if you have a complex or advanced kidney condition that requires the care of a specialist.

It’s important to remember that if you have specific concerns about kidney problems, you can discuss them with your doctor and request a referral if necessary.