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NEPHROLOGY

Nephrology

Nephrology is a branch of medicine concerned with kidney disease, kidney problems treatment and renal replacement treatments. Diabetes, hypertension, metabolic bone disease and autoimmune disease are some conditions that affect the kidneys.

Nephrologists are trained medical professionals who undergo an additional three years training after completing their undergraduate medical course and train either in Internal medicine or Paediatric nephrology and also do 1-2 years of internship in nephrology.

Earlier this branch of medicine was known as kidney medicine and the term Nephrology was coined in 1960.

The kidneys play a vital role for human lives with their complex, intricate network of tubes, blood vessels and tubules filtering the blood of excess water and waste products. They also maintain electrolytes,fluids,acid-base regulation which are altered by drugs,toxins and due to diseases.Nephrologists take into consideration family, medical history,diet,medication,drug use and occupation. Kidney functioning is lost due to many things like deformities occurring at birth where kidneys are malformed, blocked or even completely absent, hereditary conditions,drugs,toxins overdose, hypertension, infections, kidney stones and diabetes.

Nephrologists conduct tests and procedures like urinalysis, pathology of kidney, ultra sound and biopsy of kidney and also do temporary dialysis, renal replacement therapy and kidney transplantations. Blood tests and urine tests show the level of sugar, urea and creatinine and show urine abnormalities such as protein excess excretion,pus cells,cancer cells,casts and crystals, and also kidney and bladder stones. In some cases, the nephrologists have to work in sync with urologists when it concerns with the urinary bladder and urethra along with the kidneys.

Nephrologists improve the chances of survival of patients first by prescribing drugs, in some cases steroids and when the kidneys can no longer support the demands of the body they try to help artificially by dialysis and only as a last resort they do kidney transplants when it is also the end stage of renal failure and the kidneys are unable to clear waste products from the blood. These patients are first done artificial filtering of the bloodstream by dialysis until they get suitable kidney donors. Kidney or renal transplantation is by far the most effective treatment for renal failures but are too expensive and also are limited due to the lack of availability of organ donors.

Haemodialysis is an external device which works like an artificial kidney to clear the metabolic waste from blood of a patient and they can survive for many years through this, in acute chronic kidney failures. peritoneal dialysis is a catheter placed in the abdomen which removes waste from blood. Glomerulus is the disorder affecting the tiny filtering systems of the kidney.

Nephrologists also treat cancer of urethra, kidneys,bladder,polycystic kidney and nephritis. Damage to kidney leads to accumulation of fluids and imbalances in blood components excreted by kidney.In such cases we find edema which is swelling of the legs and face and in long term leads to anaemia. When blood tests reveal increased levels of creatinine,urea,and also electrolytes,sodium,bicarbonate,chloride,calcium,phosphate and potassium it is a sign of kidney damage. Kidney’s structural abnormalities are identified with ultrasound, CT scan and MRI.

An MR angiography is done to detect the abnormalities of the blood vessels within the kidney. Renal biopsy is done to find out the lesions found on kidneys and scintigraphy,intravenous urography, renal arteriography are other tests done to detect the functioning and abnormalities in kidneys. Renal biopsy is also used to find out whether there is early relapse and monitor kidney's response to treatment. Psychological support is also given to patients to cope with the impact caused by kidney problems.

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