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What Does A Nephrologist Do? And Why You May Need One.

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A nephrologist is a physician who specializes in the field of nephrology.


Nephrology is a specialty of internal medicine that focuses on the management and treatment of kidney disease or kidney disorders.

The kidneys have several vital functions, including:

  • removing waste and excess fluid from the blood
  • maintaining your body’s electrolyte balance
  • releasing hormones with functions such as managing blood pressure


Primary care physicians often work to help prevent the early stages of kidney disease. As the situation progresses, a primary care physician may refer you to a kidney specialist, or the nephrologist.

A Nephrologist has completed a 3-year residency in Internal Medicine and a specialty fellowship in nephrology that is typically at least 2 years. Some nephrologists have sub-specializations in areas of nephrology such as hypertension (high blood pressure), transplant, glomerular disorders (protein or blood in urine), or critical care medicine.

What Conditions Does A Nephrologist Treat?

  • protein or blood in the urine
  • chronic kidney disease
  • kidney stones
  • kidney infections
  • kidney swelling due to glomerulonephritis or interstitial nephritis
  • kidney cancer
  • polycystic kidney disease
  • renal artery stenosis
  • nephrotic syndrome
  • end-stage kidney disease
  • kidney failure, both acute and chronic

A nephrologist may also be involved in the management of the following common conditions:

  • high blood pressure
  • diabetes
  • heart disease
  • peripheral vascular disease

Types Of Tests A Nephrologist My Order

Blood tests

  • Serum creatinine. Creatinine is a waste product and is present at higher levels in the blood of people with kidney dysfunction. This is the single best routine blood test to screen for kidney problems.
  • Blood urea nitrogen (BUN). This is also a waste product related to a protein that is found in the blood and a sign of kidney dysfunction.
  • Glomerular filtration rate (GFR) – This test measures how well your kidneys are filtering your blood. GFR begins to decrease below normal levels in kidney disease.
  • Estimated Glomerular filtration rate (eGFR) – This is a test that uses other laboratory data to approximate the glomerular filtration rate. The eGFR relates to the severity of kidney dysfunction which is broken into Stages from Stage 1 to Stage 5.
Stage 1Stage 2Stage 3Stage 4Stage 5
eGFR in the normal range (greater than 90) with other signs of kidney damage, like protein in the urine or physical damage to the kidneyseGFR in the normal range (60-89) with other signs of kidney damage, like protein in the urine or physical damage to the kidneyseGFR 30-59, moderate kidney damageeGFR 15-29, severe kidney damageeGFR less than 15, the kidneys are close to failure or have already failed

Urine tests

  • Urinalysis. A simple urine test can help to reveal the presence of abnormal amounts of blood, glucose, or protein, or whether there may be an infection.
  • Albumin/creatinine ratio (ACR). This measures the amount of the protein, albumin in your urine. Albumin in the urine may be a sign of kidney dysfunction.
  • 24-hour urine collection for Creatinine Clearance. This method uses a special container to collect all of the urine that you produce during a 24-hour period to calculate the amount of creatinine that is cleared. This may provide a more accurate assessment of kidney function compared with the eGFR.


In addition to reviewing and interpreting laboratory tests, a nephrologist may also perform or work with other specialists on the following procedures:

  • imaging tests of the kidneys, such as ultrasound (Renal Sonogram)
  • dialysis, including placement of the dialysis catheter or creation of a Fistula or Graft for dialysis use
  • kidney biopsies
  • kidney transplants

What Is The Difference Between Nephrologists And Urologists?

The fields of nephrology and urology share some overlap because they can both involve the kidneys. Nephrologists are the medical specialists of the kidney whereas Urologists are surgical specialists of the kidneys.  A Urologist also focuses on diseases and conditions that can affect the male and female urinary tracts such as the ureters, bladder, and urethra. A urologist also works with the male reproductive organs, such as the penis, testes, and prostate.

When To See A Nephrologist

Kidney disease is very common. About 1 in 7 Americans have kidney disease and it is estimated that 33% of the population is at risk. The risk factors for chronic kidney disease are:

  • diabetes
  • High blood pressure (hypertension)
  • heart disease
  • obesity
  • a family history of kidney problems

Early stages of kidney disorders may not have any symptoms or may have nonspecific symptoms such as fatigue, sleep problems, and changes in urination. Regular testing can monitor your kidney function, particularly if you’re at risk for kidney disease. An abnormality in one of the tests above would often lead to a referral to a nephrologist. You may also seek the attention of a nephrologist if you have:

  • protein in your urine
  • recurring kidney stones
  • high blood pressure that’s more challenging to control
  • swelling in your legs
  • a rare or inherited cause of kidney disease


A nephrologist is a type of doctor who specializes in diseases and conditions that affect the kidneys. Nephrologists work to treat conditions such as chronic kidney disease and help delay the progression of kidney disease to end-stage kidney disease (requiring dialysis or transplant).

PRINE Health is a medical group with several nephrologists along with primary care and other complementary providers. If you need a Nephrologist, we are here to help. Contact us today!

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