Complete Guide on Nephrology
Nephrology is the branch of internal medicine's subspecialty that deals with the diagnosis and treatment of kidney-related diseases. A human body has two kidneys; they are the bean-shaped organs located on either side in the retroperitoneal space. Kidneys are responsible for removing waste products and excess fluid from the body. They are also critical for retaining fluid intake and maintaining electrolyte concentrations that may be subjected to change due to numerous conditions or medicines.
Several kidney complications are systematic disorders, i.e. they are not only confined to the organ itself. These conditions need specialized treatment and medical care.
The Nephrology Division at Narayana Health Hospitals offers comprehensive care to patients suffering from a spectrum of chronic and acute kidney diseases. We are one of the best kidney hospitals in India renowned for using advanced facilities and treatment options. The Nephrology experts at NH consistently invest time, effort, and expertise to help people maintain their kidney health through various non-invasive procedures.
Our team of experienced Nephrologists is acclaimed for its rare clinical skills and for providing top-notch treatment to all classes of people ranging from children to adults. We at NH boast an adroit team of professionals including kidney transplant specialists, nephrologists, urologists, and other nursing staff.
Diseases Treated Under the Branch of Nephrology
Nephrology focuses on ensuring the normal functioning of kidneys by treating conditions that hinder its processes. The various conditions that fall under the scope of nephrology include:
- Urine abnormalities such as excess excretion of protein, sugar, blood, casts, and crystals
- Glomerular complications that affect the tiny filtering systems of the kidneys known the glomerulus
- Cancers of the kidneys, bladder, and urethra
- Acute, sudden, long-term or chronic Renal failure
- Kidney infections
- Effects of diseases like diabetes and hypertension on the kidneys
- Acid-base fluctuations.
- Kidney and bladder stones
- Ill effects of toxins and drugs on the kidneys
- Nephrotic syndrome and nephritis
- Renal vascular diseases that disturb the blood vessel networks within the kidneys.
- Tubulointerstitial diseases affecting the kidneys tubules
- Autoimmune diseases including lupus and autoimmune vasculitis
- Dialysis and its associated long-term complications - hemodialysis as well as peritoneal dialysis
- Renal Transplantations
- Polycystic kidneys diseases in which large cysts or fluid-filled sacs grow within the kidney damaging its normal functioning – this may be congenital, inherited or genetic.
- Anemia related to kidney disease.
- Bone disease related to kidney disease
The Nephrology team at NH specializes in offering evaluation and treatment for a wide range of kidney-related complications including:
- Amyloidosis: This disease is characterized by abnormal growth of protein known as amyloids in different parts of the body.
- Diabetic kidney disorder: The long-standing complications of diabetes contribute to kidney diseases. It is one of the prominent causes of kidney failure. Around one-third of people having diabetes are exposed to the risk of developing diabetic nephropathy.
- Electrolyte disorders: This condition results from an abnormal imbalance of minerals in the body that results in potentially harmful damage to vital organs including the brain and muscles.
- Glomerulonephritis: This is a kind of disease that develops due to inflammation in tiny kidney organs called glomeruli. The glomeruli are important structures that are responsible for removing extra fluid and waste from your bloodstream.
- Hypertension (chronic hypertension): This refers to high blood pressure, a condition wherein arteries are exposed to a consistent increase in blood pressure levels. This condition affects different body organs and results in illnesses involving kidney failures, heart failure, aneurysm, and stroke.
- Kidney disease: Kidney diseases comprise a wide range of damages to the organ that results in its system failure. These complications make kidneys inefficient to remove waste and excess fluid from the body.
- Kidney failure: Also referred to as a renal failure, this is a medical condition in which kidneys become incapable of filtering out waste products from the blood.
- Lupus nephritis: This is a condition in which inflammation of kidneys occurs due to systemic lupus erythematosus (SLE), an autoimmune disease.
- Nephrotic syndrome: This is a kind of kidney disorder that occurs due to damage in small blood cells of the kidney. This syndrome results in excretion of excessive protein in your urine.
- Pyelonephritis: This is a kind of bacterial infection that leads to inflammation of substances of the kidney.
- Polycystic kidney disorder: It is a genetic disorder that leads to the development of a cluster of cysts within kidneys and results in high blood pressure and kidney failure.
- Renal insufficiency: This is a medical condition in which blood flow to kidneys reduces significantly due to renal artery diseases and leads to poor kidney functioning.
Signs and symptoms of Nephrology Diseases
Some common signs and symptoms that indicate the risk of severe kidney complication include:
- Frequent swelling in the legs, ankles, or feet
- Consistent headaches
- Dry and itchiness in the skin
- Reduced sense of taste and appetite
- Less energy and trouble concentrating
- Unexplained confusion, memory problems, or trouble focusing
- Pain, fluid in the joints, or stiffness
- Unexplained blood pressure problems
- Muscle cramps, numbness, or weakness
- Exhaustion during the day but problems sleeping at night
- Blood in the urine (hematuria)
- Reduced urine output not related to dehydration
- Abnormal weight loss
Treatments Available for Nephrology Diseases
The state-of-the-art dialysis units with modern equipment and facilities for nephrology treatment operates 24/7 at full capacity across all multispecialty hospitals of Narayana Health. Different services offered by the nephrology department include-
- Continuous Renal Replacement Therapy (CRRT)
- Peritoneal Dialysis (CPD)
- Plasma Dialysis (Plasmapheresis)
- Liver Dialysis (MARS Therapy)
- Kidney Transplant
- Combined Kidney & Liver Transplant and Kidney Biopsy
Continuous Renal Replacement Therapy (CRRT)
Patients who are critically ill tend to have a high metabolic rate as their bodies are trying to recover from the disease. They need vasoactive drugs and continuous waste elimination while also simultaneously receiving large volumes of fluid in the form of nutritional and inotropic agents and drug infusions. Therefore, CRRT or continuous renal replacement therapy is followed so that wastes and water can be gently removed without causing hypotension.
CRRT is a slow form of haemodialysis, where the blood is removed and pumped through a hemofilter.
Peritoneal Dialysis (CPD)
During peritoneal dialysis, a fluid known as dialysate is put into the peritoneal or abdominal cavity with the help of a catheter. The dialysate is allowed to sit there for several hours while waste products pass from the capillaries into the liquid. The dialysate is then drained out.
Liver Dialysis (MARS Therapy)
The Molecular Adsorbent Recirculating System or MARS therapy is based on the concept of albumin dialysis and quite effectively eliminates the protein-bound and water-soluble toxins. The treatment procedure could facilitate liver regeneration and stabilisation of vital organ functions.
Patients with kidney failure have to go for dialysis or a kidney transplant. Dialysis takes time, and patients have to visit a dialysis centre frequently for treatments. But with a liver transplantation, they don’t have to depend on a dialysis machine and can have a chance at leading a better quality of life.
Combined Kidney & Liver Transplant and Kidney Biopsy
Combined kidney and liver transplantation are usually done in patients with cirrhosis and other kidney diseases associated with it.
During a kidney biopsy, the doctor will collect samples of the kidney to check them in great detail under special microscopes. It can be done either through percutaneous biopsy or open biopsy. In a percutaneous biopsy, a needle is advanced through the skin over the kidney and guided to the required place by ultrasound.
In an open biopsy, the sample is taken from the kidney during surgery.
Other treatment options available are:
- Full range dialysis services and chronic dialysis on an outpatient basis.
- Chronic peritoneal dialysis care, including continuous cycling peritoneal dialysis (CCPD) or continuous ambulatory peritoneal dialysis (CAPD).
- Real-time ultrasound guidance for Percutaneous needle biopsy of native kidneys and kidney transplants.
- Percutaneous cannula placement through ultrasound guidance
- Dialysis and transplant services for patients with end-stage renal complications.
- Therapies to all end-stage renal disease, including kidney transplantation, hemodialysis, and peritoneal dialysis.
- Continuous renal replacement therapy, including citrate anticoagulation for critically ill patients.
Common Medical Procedures Used in Nephrology
There are several medical procedures that your Nephrologists may use for diagnosing, monitoring, and treating kidney diseases. Some of the most common ones are:
Ultrasound: Ultrasound is an imaging test that uses high-frequency sound waves to capture internal images of your kidneys. This test helps in the identification of abnormalities in kidneys such as a change in size and position. Moreover, it can detect the presence of obstructions involving the formation of cysts or tumors.
CT scan: As known as computed tomography, a CT scan allows doctors to capture cross-sectional images of kidneys. Sometimes the process may also be performed using intravenous contrast dye. This test can identify obstruction in organs in a more precise manner.
Biopsy: A biopsy involves removing tiny samples of tissues by inserting a thin needle. These cells from your body help healthcare professionals examine the condition in laboratories.
You doctor may conduct a biopsy for some specific reasons including:
- Assessing kidney damage
- Identifying disease processes and checking its response to treatment
- Analyzing the complications associated with transplantation
Hemodialysis: Hemodialysis is a specialized process that uses an artificial kidney machine called hemodialyzer for extracting extra waste, fluid, and chemicals from the blood before returning it to the body. After purification blood is returned to the body through a catheter or port, in leg, arm, or neck.
This procedure is usually used for patients who have reached the end stage of kidney failure. At this stage, 85–90% functioning of kidneys is lost and during this a patient requires around 4 hours of hemodialysis sessions three times a week.
Kidney transplant: Transplantation is a surgical procedure that involves removing a particular section or the entire of the damaged kidney and replacing it with a matching donor organ.
What are the 3 early warning signs of kidney disease? ›
- Dizziness and Fatigue. One of the first possible signs of weakening kidneys is the experience of overall weakness in yourself and your overall health. ...
- Swelling (Edema) ...
- Changes in urination.
The main test for kidney disease is a blood test. The test measures the levels of a waste product called creatinine in your blood. Your doctor uses your blood test results, plus your age, size, gender and ethnic group to calculate how many millilitres of waste your kidneys should be able to filter in a minute.What level of creatinine indicates kidney failure? ›
Usually a creatinine level more than 1.2 for women and more than 1.4 for men may be a sign that the kidneys are not working like they should. If your serum creatinine test results are higher than normal, your doctor may want to run other tests.What foods help repair kidneys? ›
- Dark leafy greens. Dark leafy green vegetables such as kale, spinach, chard, and collard greens are loaded with vitamins A and C, calcium, and many other important minerals. ...
- Berries. ...
- Cranberries. ...
- Sweet potatoes. ...
- Olive oil. ...
- Fatty fish. ...
When kidneys are failing, the increased concentration and accumulation of substances in urine lead to a darker color which may be brown, red or purple. The color change is due to abnormal protein or sugar, high levels of red and white blood cells, and high numbers of tube-shaped particles called cellular casts.How do you know if something is wrong with your kidneys? ›
If you feel the need to urinate more often, especially at night, this can be a sign of kidney disease. When the kidneys filters are damaged, it can cause an increase in the urge to urinate. Sometimes this can also be a sign of a urinary infection or enlarged prostate in men. You see blood in your urine.What is harmful to kidneys? ›
The two most common conditions that affect your kidneys are diabetes and high blood pressure. A balanced diet and regular exercise can help keep both under control. With diabetes, it's also important to keep a close eye on your blood sugar and take insulin when you need it.What stage of kidney disease causes symptoms? ›
Stage 3 of CKD
You may begin to have symptoms, such as feeling weak and tired or swelling in your hands or feet.
There's no cure for chronic kidney disease (CKD), but treatment can help relieve the symptoms and stop it getting worse. Your treatment will depend on the stage of your CKD. The main treatments are: lifestyle changes – to help you stay as healthy as possible.Why would I be referred to nephrology? ›
They work to 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.
What part of the body is nephrology? ›
Sometimes called renal medicine, nephrology is a specialty within the internal medicine field related to kidney care. It is often connected with hypertension or high blood pressure. Nephrologists are medical professionals who diagnose, treat, and manage acute and chronic kidney problems and diseases.What is a serious creatinine level? ›
A creatinine level of greater than 1.2 for women and greater than 1.4 for men may be an early sign that the kidneys are not working properly. As kidney disease progresses, the level of creatinine in the blood rises.What medicine reduces creatinine? ›
N-acetylcysteine has been reported to lower serum creatinine in normal individuals.What is a normal GFR for a 70 year old? ›
However, we know that GFR physiologically decreases with age, and in adults older than 70 years, values below 60 mL/min/1.73 m2 could be considered normal.Are eggs good for kidneys? ›
Egg whites provide a high quality, kidney-friendly source of protein. Plus, they're an excellent choice for people undergoing dialysis treatment, who have higher protein needs but need to limit phosphorus.Which fruit is best for kidney? ›
Fruit: apples, cranberries, grapes, pineapple, and strawberries. Vegetables: cauliflower, lettuce, onions, peppers, and radishes.
To get the best health benefits, be sure to choose 100% organic water-based cranberry juice. So how does cranberry juice help? It can prevent bacteria from sticking to the walls of your kidneys, which helps prevent an infection from forming in the first place.Where do you itch with kidney disease? ›
Itching with kidney disease can be generalized, or it can occur in specific parts of the body. Common areas for this type of itching include the head, arms, back, and abdomen. It also tends to be worse at night, which can disturb your sleep.Does clear pee mean kidney failure? ›
An occasional clear pee isn't a big deal. But if it's an ongoing issue you may be lowering salt and electrolyte levels below what your body needs. What if your urine is clear and you're not knocking back glass after glass of water? That may signal an underlying kidney problem or diabetes.What color of urine is not good? ›
If your urine is cloudy, brown, blue, or green and doesn't return to a pale straw color, schedule an appointment to speak with a doctor.
Can kidney problems affect your legs? ›
Your kidneys remove extra fluids and salt from your body. When they can no longer do this, the fluids and salt build up in your body. This build-up causes swelling, which you may notice in your: Legs.What drugs can damage kidneys? ›
Most street drugs, including heroin, cocaine and ecstasy can cause high blood pressure, stroke, heart failure and even death, in some cases from only one use. Cocaine, heroin and amphetamines also can cause kidney damage.Is Cheese good for the kidneys? ›
Milk, yogurt, and cheese can be part of a healthy kidney diet. Shop for natural cheeses, avoiding items labeled “cheese food” or “cheese product.” Greek yogurt and cottage cheese can be easy and tasty snacks, and, in most cases, milk servings should be 1 cup per day.What not to drink if you have kidney problems? ›
Avoid fruit juices and other sugar-sweetened beverages if you have kidney disease and diabetes. These drinks tend to be high in added sugar that can cause rapid spikes in blood sugar.How long does it take for kidney disease to get worse? ›
Chronic kidney disease occurs when a disease or condition impairs kidney function, causing kidney damage to worsen over several months or years. Diseases and conditions that cause chronic kidney disease include: Type 1 or type 2 diabetes. High blood pressure.Does kidney disease progress quickly? ›
Created: March 8, 2018; Next update: 2021. Chronic kidney disease usually progresses slowly. Blood and urine tests can help doctors to decide whether the kidneys are still working well enough or whether dialysis will be needed soon, for example.How quickly does kidney disease start? ›
Kidney diseases happen when your kidneys are damaged and can't filter your blood. The damage can happen quickly – when it's caused by injury or toxins – or, more commonly, over months or years.Can kidney disease go back to normal? ›
While it's not possible to reverse kidney damage, you can take steps to slow it down. Taking prescribed medicine, being physically active, and eating well will help. You'll also feel better and improve your overall well-being.Can you live a long normal life with kidney disease? ›
Many people with chronic kidney disease (CKD) are able to live long lives without being unduly affected by the condition. Although it's not possible to repair damage that has already happened to your kidneys, CKD will not necessarily get worse.How long can you live without treating kidney disease? ›
Each person's medical status is unique. People with kidney failure may survive days to weeks without dialysis, depending on the amount of kidney function they have, how severe their symptoms are, and their overall medical condition. Is death from kidney failure painful? Not usually.
What happens at your first visit to a nephrologist? ›
Your nephrologist will review your medical history, and do a complete physical exam to determine how your kidneys are functioning. Your nephrologist will order blood and urine tests and a diagnostic imaging of your kidneys may also be required.What diseases do nephrologists treat? ›
- Amyloidosis. ...
- Diabetic kidney disorder. ...
- Electrolyte disorders. ...
- Glomerulonephritis. ...
- Hypertension (chronic hypertension) ...
- Kidney disease.
In the United States, diabetes and high blood pressure are the leading causes of kidney failure, accounting for 3 out of 4 new cases.Why would my doctor send me to a nephrologist? ›
A nephrologist is a medical doctor who specializes in diagnosing and treating kidney conditions. You should see a nephrologist if you have any signs of kidney disease or other conditions that may damage your kidneys.What kind of physical exam does a nephrologist do? ›
The nephrologist will check your heart condition, lung condition, and look for swelling in your lower extremities or your face. Your nephrologist may recommend that you undergo laboratory tests and/or scans, like a blood test, urine test, or kidney ultrasound, depending on your condition.How difficult is nephrology? ›
For many students during medical school, nephrology is a complex and difficult course, which may lead them to not consider the field when selecting a specialty. Jhaveri et al.  reported, among US fellows, that 31% of respondents indicated nephrology as the most difficult physiology course during medical school.What medications cause high creatinine levels? ›
Several drugs, such as cimetidine, trimethoprim, corticosteroids, pyrimethamine, phenacemide, salicylates and active vitamin D metabolites, have been reported to increase plasma creatinine without influencing its glomerular filtration.What level of creatinine requires dialysis? ›
Usually, when the creatinine clearance falls to 10-12 cc/minute, the patient needs dialysis.Can high creatinine be cured? ›
In many cases, medications can help resolve high creatinine levels by treating the condition that's causing the increase. Some examples include antibiotics for a kidney infection or medications that help control high blood pressure.What vitamins help high creatinine? ›
Vitamins for Kidney Health
- Vitamin D. ...
- Iron. ...
- Vitamin B9. ...
- Vitamin B12.
What vitamins are good for creatinine levels? ›
Special renal vitamins are usually prescribed to kidney patients to provide the extra water soluble vitamins needed. Renal vitamins contain vitamins B1, B2, B6, B12, folic acid, niacin, pantothenic acid, biotin and a small dose of vitamin C.What vegetables are good for creatinine? ›
- Red bell peppers. 1/2 cup serving red bell pepper = 1 mg sodium, 88 mg potassium, 10 mg phosphorus. ...
- Cabbage. 1/2 cup serving green cabbage = 6 mg sodium, 60 mg potassium, 9 mg phosphorus. ...
- Cauliflower. ...
- Garlic. ...
- Onions. ...
- Apples. ...
- Cranberries. ...
Most of these studies have been cross-sectional and have rather uniformly shown that the GFR declines steadily with aging, beginning at age 30–40 years, with an apparent acceleration in the rate of decline after age 65–70 years (6–9).How can elderly improve GFR? ›
Avoid processed foods and choose fresh fruits and vegetables instead. Follow a low-salt diet. Salt should be limited especially if you have high blood pressure, protein in your urine, or swelling, or difficulty breathing. Eating less than 2000 mg a day of sodium is recommended.When should I worry about my GFR? ›
A GFR of 60 or higher is in the normal range. A GFR below 60 may mean kidney disease. A GFR of 15 or lower may mean kidney failure.What are the symptoms of stage 1 kidney disease? ›
- High blood pressure.
- Swelling in your hands or feet.
- Urinary tract infections.
- Protein in your urine.
- Blood in your urine (also called hematuria)
- Kidney damage that shows up in an ultrasound, CT scan, MRI, or kidney biopsy.
Nausea and vomiting, muscle cramps, loss of appetite, swelling via feet and ankles, dry, itchy skin, shortness of breath, trouble sleeping, urinating either too much or too little.What can be mistaken for kidney problem? ›
Conditions that can be mistaken for kidney stones, sharing similar symptoms: Appendicitis or lower back pain. Urinary tract infection (UTI) Stomach flu or virus.How do you feel when your kidneys are failing? ›
Kidney failure is a condition in which one or both of your kidneys no longer work on their own. Causes include diabetes, high blood pressure and acute kidney injuries. Symptoms include fatigue, nausea and vomiting, swelling, changes in how often you go to the bathroom and brain fog.How to clean kidneys? ›
- Drink Water. Most people need to drink around two to three liters of water per day. ...
- Low Sodium Diet. ...
- Maintain Normal Blood Pressure. ...
- Maintain a Healthy Body Weight. ...
- Prevent Diabetes. ...
- Exercise. ...
- A Kidney Healthy Diet.
Can you live with kidney disease without knowing? ›
Many people with chronic kidney disease (CKD) will not have symptoms because it does not usually cause problems until it reaches an advanced stage.How long can you live with kidney disease? ›
If you choose to start dialysis treatment, stage 5 kidney disease life expectancy is five to 10 years on average, though some patients have lived on dialysis for 20 years or more. If you have a kidney transplant, a living donor kidney can function for 12 to 20 years, and a deceased donor kidney for 8 to 12 years.Can you have kidney disease for years and not know? ›
Symptoms of CKD
There are usually no symptoms of kidney disease in the early stages. It may only be diagnosed if you have a blood or urine test for another reason and the results show a possible problem with your kidneys.
His doctor explained that kidney disease in its early stages does not cause symptoms. “Kidney disease doesn't affect your ability to make urine in its early stages, David,” she said. She told him, “In fact, a person can lose a lot of kidney function before symptoms of kidney disease occur.” “But I don't feel any pain.Where does it hurt if you have kidney problems? ›
Kidney pain, or renal pain, is usually felt in your back (under the ribs, to the right or left of the spine). It can spread to other areas, like the sides, upper abdomen or groin. If you have a kidney stone, you usually feel the pain in your back, side, lower belly or groin.What hurts when your kidneys are failing? ›
Kidney pain — also called renal pain — refers to pain from disease or injury to a kidney. You might feel kidney pain or discomfort as a dull, one-sided ache in your upper abdomen, side or back.How do I know if my kidney is getting worse? ›
lower back pain or flank pain. fatigue or weakness. swelling, especially in your hands or feet, or under your eyes. a bad taste in your mouth, or food doesn't taste good.Can your kidneys repair themselves? ›
It was thought that kidney cells didn't reproduce much once the organ was fully formed, but new research shows that the kidneys are regenerating and repairing themselves throughout life. Contrary to long-held beliefs, a new study shows that kidneys have the capacity to regenerate themselves.