Tests conducted by your primary care provider or other practitioner indicate you may have a problem with your kidney function. Early referral to a nephrology specialist is important. You may also have a problem with kidney stones. Nephrologists can help identify your risk factors for forming kidney stones and develop a plan of care to reduce stone frequency or even cease new stone formation altogether. 

A nephrologist is a physician who specializes in the diagnosis, treatment and management of kidney disease, high blood pressure, kidney stones, and other kidney-related disorders.  In addition to completing a residency in internal medicine, nephrologists must complete several years of additional training.

A nephrologist is a medical doctor who focuses on the treatment of diseases of the kidney.  An urologist is medical doctor who focuses on the treatment of the diseases of the urinary tract and prostate. These two specialists often work together to address different aspects of a patient’s medical needs. 

Your kidneys are bean-shaped organs, each about the size of your fist. They are located near the middle of your back, just below the rib cage. The kidneys are sophisticated trash collectors. Every day, your kidneys process about 200 quarts of blood to sift out about 2 quarts of waste products and extra water. The waste and extra water become urine, which flows to your bladder through tubes called ureters. Your bladder stores urine until you go to the bathroom.

The wastes in your blood come from the normal breakdown of active muscle and from the food you eat. Your body uses the food for energy and self-repair. After your body has taken what it needs from the food, waste is sent to the blood. If your kidneys did not remove these wastes, the wastes would build up in the blood and damage your body.
There are a number of ways you can protect your kidneys and slow the progression of CKD.

Good blood pressure control, diet modifications, smoking cessation and if you are a diabetic, keeping your blood sugar in a safe range are all ways you can positively affect your kidney function. In addition, keep informed about your test results, ask questions, and be involved in your treatment plan.

You are the most important member of your health care team.

CKD is chronic kidney disease. CKD is defined as a decreased level of kidney function or the evidence of kidney damage for greater than three months. Individuals at risk for developing kidney disease are those with diabetes, high blood pressure or a family history of kidney disease.

Blood Tests – Serum creatinine, GFR, Electrolytes, BUN, Hemoglobin, Intact Parathyroid Hormone, & Vitamin D.

Urine Tests – Microalbumin, Protein/Creatinine Ratio, Urine Analysis.

Imaging– A renal ultrasound may be recommended to assess the size, shape and anatomy of your kidney. In addition, a CT scan, MRI or MRA may be recommended to determine possible reasons for your kidney disease.

Biopsy – A kidney biopsy is a test where a small piece of kidney tissue is removed by a needle. The tissue is examined under a microscope to determine the cause of kidney disease. This is not necessary in all cases of kidney disease. 

Litholink Analysis  This is a special urine test done for kidney stone patients in order to analyze the chemical makeup of their urine in order to identify and modify any risk factors that are likely causing kidney stones to form. 

Diabetes is the most common cause of chronic kidney disease (CKD) in the United States. High blood sugar levels can damage the blood vessels and affect the filtering ability of the kidney. Controlling your blood sugar can help slow the progress of your kidney disease.

High blood pressure damages the blood vessels and reduces blood supply to the kidney. High blood pressure can cause kidney problems and kidney problems can cause high blood pressure. Uncontrolled high blood pressure can cause a decrease in kidney function and irreversible kidney damage.

Common medications to avoid are NSAIDS (anti-inflammatory medications), enemas and laxatives — unless ordered by the nephrologists, any “cure-all” remedies and various food supplements, herbal medicines and vitamins. It is a good idea to check with your nephrologist prior to starting any new over the counter or prescription medications.

Dialysis is a process that cleans and filters your blood. There are two types of dialysis, hemodialysis and peritoneal dialysis.

Hemodialysis – Hemodialysis cleans your blood using a machine with a special filter called a dialyzer. During a hemodialysis treatment blood travels from your body through tubes to the dialyzer which filters out wastes and extra water. The cleaned blood flows through another set of tubes back into your body.

Peritoneal Dialysis – Peritoneal dialysis removes wastes and extra water from your body using the lining of your abdomen (peritoneum) to filter your blood. A special solution travels through a soft tube into your abdomen. The solution draws wastes and extra water from tiny blood vessels in your peritoneum back into the solution which is then drained from your abdomen through the soft tube.
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