A nephrologist is an internist who treats disorders of the kidney, both chronic and acute, disorders of high blood pressure, fluid, electrolyte and mineral balance, and manages complications of kidney failure necessitating dialysis (removal of fluid and body wastes) when the kidneys do not function. This specialist consults with surgeons about vascular and peritoneal cavity access for dialysis as well as kidney transplantation.
A career in nephrology provides the opportunity to care for patients with a wide spectrum of diseases across the entire continuum of acute to chronic illness. Nephrologists are experts in the care of kidney disease stemming from mild reversible acute renal injury to its most advanced state when kidney function is insufficient to sustain life without renal replacement therapy. The expertise of a nephrologist is frequently called upon to design treatment plans that prevent injury or manage its consequences, including prescribing renal replacement therapy in the form of dialysis or evaluating and managing a patient through kidney transplantation. Many nephrologists practice across the continuum of chronic kidney disease by diagnosing its origins and prescribing therapies and counseling patients to prevent its progression. In the event of advanced stages of disease, nephrologists educate and prepare patients for transplantation, renal replacement therapy or conservative medical management. The nature of chronic kidney disease management provides an unparalleled opportunity to form enduring relationships with patients and their families leading to a most rewarding career as a care provider. In addition to serving in the role of consultant for patients with acute and chronic kidney disease, hypertension, electrolyte abnormalities and kidney stones, nephrologists may also serve in the role of primary care provider for patients receiving dialysis treatment or those who have received a kidney transplant.
Outside of the clinical care highlighted previously, some nephrologists may choose to focus on a specific area of kidney disease care such as hypertension, transplantation, specific dialysis modalities or interventional nephrology.
Administratively, nephrologists serve as the medical directors for dialysis units, leading multidisciplinary teams to ensure the quality of the care delivered to the patients and maintaining compliance with regulatory standards set forth for dialysis facilities.
Considering that dialysis is a life-sustaining therapy, nephrologists play an integral role at the end of life for patients with complications from their advanced kidney disease through utilization of shared decision-making methods designed to smooth the transition from advanced kidney disease to end- stage renal disease for patients and families.