Nephrology (Kidney Clinic)
Nephrology (from the Greek nephros, meaning “kidney”, combined with the suffix -logia, meaning “study of”) is a medical specialty that deals with the kidney and its clinical, morphological and pathophysiological study. 10% of the population worldwide is affected by chronic kidney disease (CKD) with over 2 million people globally receiving either dialysis treatment having benefited from a kidney transplant. It is estimated that 1.5 billion people will be living with kidney disease by 2050.
The kidneys are due to the bean-shaped organs located on both sides of the spinal column, they are vital within the human body. The role of the Kidneys includes:
- Remove waste drugs and drugs products from the body
- Filter the blood and balance the body’s fluids
- Release hormones that regulate blood pressure
- Produce an active form of vitamin D that promotes strong, healthy bones
- control the production of red blood cells.
Kidney diseases are often silent and arrive late to the nephrologist; It would be very important to get to the nephrologist early to reach the earliest possible diagnosis.
Symptoms not to be underestimated are:
- Constant fatigue and low energy
- High blood pressure
- Loss of appetite, nausea, unpleasant breath
- Sleep disturbances: sleep apnea and difficulty falling asleep
- Itching and dryness of the skin
- Continuous urge to urinate, especially at night
- Presence of blood in the urine:
- Foamy urine
- Swelling of the feet and ankles
- Muscle cramps
Frequent causes of Chronic Kidney Disease are:
- High blood pressure
- Kidney stones
- Diabetes: Type 1 or type 2
- Obstruction of the urinary tract due, tumors, or enlarged prostate
- Polycystic kidney disease where large cysts or fluid-filled are formed within the kidney impairing its function is a congenital inherited condition and can involve other organs and be associated with other diseases.
- Cardiovascular disease
- Genetics. History of kidney disease in the family
Consultant Nephrologists at Valiant Clinic & Hospital is well-trained to deal with the following diseases that come under the scope of Nephrology:
- Primary and Secondary high blood pressure diagnosis and treatment
- Urine abnormalities include excess excretion of protein, sugar, blood, casts, crystals, etc.
- Kidney and urinary tract infections
- Kidney stones
- Mineral bone diseases, such as Osteopenia and Osteoporosis
- Metabolic disorders such as gout and hyperuricemia
- Glomerular disorders that affect the tiny filtering systems of the kidneys called “ glomerulus”
- Preparing patients in end-stage renal disease for a kidney transplant and following them after the transplantation surgery
- Renal injury (failure) that can be sudden or acute or chronic (long term)
- Effects of diseases like diabetes and high blood pressure on kidneys
- Acid-base imbalances and electrolytes disorders
- Nephrotic syndrome and nephritis
- Secondary effects of drugs and toxins on the kidneys
- Autoimmune diseases include autoimmune vasculitis, lupus, etc.
- ADPKD: Polycystic kidneys diseases
- Renal consequences from obesity
- Prevention of malnutrition and muscular hypotrophy in dialyzed patients
Diagnosis of kidney issues after the following tests:
- Urine analysis may reveal excess proteins that are being excreted along with urine from the body. This is a sign of kidney damage that is especially seen in diabetic nephropathy or in long term kidney diseases.
- Blood tests reveal raised or altered levels of urea, creatinine and electrolytes including sodium, potassium, calcium, magnesium, phosphates, blood urea nitrogen, etc.
- Glomerular Filtration Rate (GFR) is a test to estimate the level of kidney function and determine the stage of chronic kidney disease. In clinical practice, estimation of GFR is based on serum creatinine, age, gender.
- Ultrasound scanning is one of the commonest and most used non-invasive imaging studies for kidneys diseases such as hydronephrosis, polycystic kidney disease, kidney stones, etc.
- Renal biopsy: If a kidney lesion is detected, a small amount of renal tissue is taken using long thin hollow needles under the guidance of ultrasound or other imaging studies.
Other imaging studies, including:
- Computed Tomography scan (CT scan) or Magnetic resonance imaging (MRI) scan. This can also help detect renal tumours and cancer.
- MR angiography to detect abnormalities in the blood vessels within the kidneys
- In patients with normal kidney function, Intravenous urography (IVU), a test where an iodinated contrast dye is injected into the veins of the person, which is then imaged using X rays or other imaging studies like CT scan to detect the flow of the blood and formation of urine in the kidneys as well as its outflow as it traverses through the kidneys.
- Scintigraphy is another test using radioactive isotopes that helps detect abnormal functions of the kidney and its vessels.
Renal Arteriography involves the insertion of a thin catheter into the femoral artery and under guidance through an imaging study
Dr. Enrica Falbo
MD, CSST, MSc