The kidneys are essential organs for filtering harmful substances from the body, and clinical nephrology involves medical treatment of kidney diseases and conditions. This may entail working with other areas of the body that also are influenced by the kidneys. Kidney problems can cause electrolyte imbalances in the bloodstream, resulting in serious symptoms including excess fluid in the tissues, mental confusion or irregular heartbeat. Clinical nephrology also can help patients who have high blood pressure, because hypertension can be destructive to the kidneys.
Patients who are in renal failure as a result of damaged kidneys need dialysis to perform the functions the kidneys no longer can. Clinical nephrology manages the process of dialysis, which is a system of removing blood from the body, cleaning the blood, and returning it the body for circulation. Most people have two kidneys but can survive with only one as long as it's healthy. A patient suffering kidney failure may eventually need a kidney transplant.
Some people develop kidney stones, which are a collection of urine crystals and deposits, such as calcium. Stones form in the kidney and, if they are large enough, can get stuck as they travel with urine to the bladder, causing back pain and bloody urine. A kidney stone that does not pass is treated by a nephrologist, who can use shock wave therapy to break up the stone or remove the stone through surgery.
Nephrologists may also work with internal medicine specialists to manage the condition of patients who have diabetes. Diabetes results in high levels of blood glucose, which can damage the tiny blood vessels of the kidneys, injuring their ability to filter substances. Diabetic patients may excrete higher levels of protein in the urine, which can be an early sign of kidney damage. A nephrologist can prescribe medications that control blood pressure and manage blood sugar levels to slow the potential damage to the kidneys and prevent renal failure.
Training in clinical nephrology involves intensive preparation and work with patients suffering from kidney disease. A nephrologist is a physician who has gone through medical school and, typically, three years of internal medicine training followed by two more years of specialty training focused on kidney diseases. During specialty training, a clinical nephrologist works with patients who need dialysis or kidney transplants, manages patient medications to slow disease progression, and consults with other healthcare providers. Eventually, a nephrologist must take a licensing examination to become certified in this type of clinical specialty.