Nephrology is the branch of medicine that deals with the diagnosis and treatment of kidney diseases including electrolyte disturbances and hypertension, as well as the care of those patients who require renal replacement therapy, including dialysis and renal transplant patients.

Most disorders affecting the kidney are not limited to the organ itself, but are systemic disorders, and may require special treatment, such as systemic vasculitides or other autoimmune diseases, such as lupus.

Patients are referred to Nephrologists for reasons such as:
• Acute renal failure i.e. a sudden loss of renal function.
• Chronic kidney disease which is the declining renal function, usually with an inexorable rise in creatinine.
• Haematuria that is the blood loss in the urine
• Proteinuria i.e. the loss of protein especially albumin in the urine
• Kidney stones
• Chronic or recurrent urinary tract infections
• Hypertension that has failed to respond to multiple forms of anti-hypertensive medication or could have a secondary cause
• Electrolyte disorders or acid/base imbalance

Associated Diagnostic Procedures:

Important clues as to the cause of any symptom are gained in the history and physical examination. Laboratory tests are almost always aimed at: urea, creatinine, electrolytes, and urinalysis- which is frequently the key test in suggesting a diagnosis.

More specialized tests can be ordered to discover or link certain systemic diseases to kidney failure such as hepatitis b or hepatitis c, lupus serologies, paraproteinemias such as amyloidosis or multiple myeloma or various other systemic diseases that lead to kidney failure.

Other tests often performed by Nephrologists are:

• Renal biopsy, to obtain a tissue diagnosis of a disorder when the exact nature or stage remains uncertain.;

• Ultrasound scanning of the urinary tract and occasionally examining the renal blood vessels;

• CT scanning when mass lesions are suspected or to help diagnosis nephrolithiasis;

• Scintigraphy (nuclear medicine) for accurate measurement of renal function, diagnosis of renal artery disease, or 'split function' of each kidney;

• Angiography or Magnetic resonance imaging angiography when the blood vessels might be affected.

Therapy:

Most disorders of the kidney diseases are treated with medication, such as steroids, DMARDs (disease-modifying antirheumatic drugs), antihypertensives (many kidney diseases feature hypertension). Often erythropoietin and vitamin D treatment is required to replace these two hormones, the production of which stagnates in chronic kidney disease.

When chronic kidney disease progresses to stage five, dialysis or transplant is required. If patients proceed to transplant, nephrologists will continue to follow patients to monitor the immunosuppressive regimen and watch for the infection that can occur post transplant.

Procedures:

• Renal Replacement Therapy

• Hemodialysis

• Peritoneal Dialysis

• Kidney Biopsy

• Kidney Transplant

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