Kidney Disease

Many diseases affecting the kidney are systemic disorders not limited to the organ itself, and may require special treatment. Patients are referred to a nephrologist for various reasons, those conditions include:

• Acute renal failure, a sudden loss of renal function
• Chronic kidney disease, declining renal function, usually with an inexorable rise in creatinine
• Hematuria, blood in the urine
• Kidney stones, notably for recurring stone patients
• Chronic or recurrent urinary tract infections
• Hypertension that has failed to respond to multiple forms of anti-hypertensive medication or could have a secondary cause
• Electrolyte disorders or acid/base imbalances
• Diagnosis

A nephrologist will use a variety of tools when diagnosing kidney disease. Laboratory tests are almost always aimed at urea, electrolytes and urinalysis, which is frequently the key test in suggesting a diagnosis.

Other tests may include: Ultrasound scanning of the urinary tract, CT scanning when mass lesions are suspected, Renal biopsy, to obtain a tissue diagnosis of a disorder when the exact nature or stage remains uncertain or Magnetic resonance imaging (MRI) when the blood vessels might be affected.

Treatment and Management

Once diagnosed, many kidney diseases are treated with medication, such as steroids or anti-hypertensives (many kidney diseases feature high blood pressure.) A nephrologist may also recommend changes in diet and fluid intake in an effort to manage the disease and avoid or reduce the impact of re-occurrences. When chronic kidney disease progresses to later stages, dialysis or transplant is required.

 Maria C. Bermudez, M.D.

Dr. Bermudez served her internal medicine residency at the Geisinger Medical Center, Danville, PA and completed a fellowship in nephrology at the Albert Einstein College of Medicine/Montefiore Medical Center, New York, NY.