Nephrologist consultation

A nephrologist is a doctor who specializes in diseases and conditions that affect the kidneys. They treat conditions such as chronic kidney disease, kidney infections, and kidney failure.

When to Consult a Nephrologist

The primary causes of chronic kidney diseases include congenital defects, urinary flow obstruction, hereditary diseases, glomerular and systemic diseases. Acute kidney disease may occur as a result of trauma, poisoning, or other illnesses.

Family doctors refer patients to nephrologists with the following symptoms:

• blood or protein in the urine, elevated creatinine and urea levels in the blood;
• kidney infections;
• swelling;
• arterial hypertension of unclear origin;
• back or abdominal pain of unclear origin;
• kidney stones, polycystic kidney disease;
• renal artery stenosis;
• kidney failure, both acute and chronic;
• the use of nephrotoxic drugs.

Nephrologists in the 'Dobrobut' medical network treat the following diseases:

• glomerulonephritis;
• pyelonephritis;
• interstitial nephritis;
• amyloidosis;
• polycystic kidney disease;
• secondary nephritis (for example, hypertensive, diabetic, gouty nephropathy, lupus nephritis).

Kidney damage can also occur in other diseases, such as diabetes, hypertension, viral and bacterial infections, hepatitis, heart failure, as a result of taking various medications. Therefore, nephrologists closely cooperate with other specialists: oncologists, cardiologists, infectious disease specialists, gastroenterologists, urologists, gynecologists.

Doctors of the Dobrobut medical network use various diagnostic methods and apply modern methods of treating patients with kidney diseases. Our specialists are guided by the principles of evidence-based medicine, recommendations of European and American medical communities.

Diagnostics

Given the frequent asymptomatic manifestation of kidney diseases, it is very important to identify the problem and its cause in time.

When diagnosing kidney diseases, both laboratory and instrumental research methods are used.

Laboratory diagnostic methods allow the nephrologist to obtain data on the condition and functioning of the patient's body, determine the level of important elements in the body and understand the origin of the disease.

Among the modern methods of laboratory diagnostics used by nephrologists of the Dobrobut medical network:

• complete blood and urine tests;
• proteinogram (determination of protein fractions of blood serum);
• blood and urine electrolytes;
• neurological markers: creatinine, urea, cystatin C, beta 2 microglobulin, albumin/creatinine ratio;
• autoimmune markers;
• urine tests according to Nechyporenko, according to Zimnytsky;
• daily proteinuria (detection of protein in urine analysis).

The main and mandatory method of instrumental diagnostics is renal ultrasound. Of the invasive examination methods, diagnostic nephrobiopsy may be prescribed.

What will renal ultrasound show

• kidney and renal parenchyma sizes;
• nephrosclerosis;
• calculi and calcifications;
• kidney cysts;
• dilatation of the pelvic system, hydronephrosis;
• anomalies of the structure and position of the kidneys.

How the ultrasound procedure is performed

The patient needs to undress to the waist and lie on a couch, first on one side, then on the other. The doctor installs special sensors on certain points of the back - they transmit ultrasound to a powerful computer, where the waves are converted into images. The functional diagnostics doctor sees a real image of the kidneys on the monitor and interprets it.

The duration of the examination is 20 minutes. There are no contraindications to this type of examination.

Diagnostic nephrobiopsy may be prescribed from invasive examination methods.

Percutaneous needle biopsy of the kidney (PNB) plays an important role in the diagnosis of kidney diseases. It is performed to clarify or supplement the diagnosis, determine the stage of the disease, choose a treatment strategy and predict the course of kidney pathology.

How the needle biopsy procedure is performed

The procedure is performed on an outpatient basis or in a day hospital and is performed on an empty stomach. The patient needs to undress to his underwear, remove jewelry and lie on the couch on his stomach on a cushion. ChPBP is performed in a small operating room under constant ultrasound control, performed under local anesthesia infiltration from the back with a disposable puncture needle.

Puncture nephrobiopsy is performed under the condition of a normal state of the blood coagulation system and the absence of persistent high arterial hypertension, which allows to minimize the risk of bleeding. The duration of the procedure is 20-30 minutes. After the procedure, a general blood test and ultrasound of the kidneys are monitored after 1-2 hours and the next day; the patient is recommended to stay in bed for 10-12 hours lying on his back.

The obtained material is sent to the pathomorphological laboratory for electro-microscopic and immunohistochemical examination. The nephrologist evaluates the results of the histological report, establishes a diagnosis, determines the severity of kidney damage, the risks of progression of renal failure, and the optimal basic therapy.

Preparation for the procedure

As a preparation, a preliminary consultation with a urologist who plans to perform a nephrobiopsy is required. You must bring the following examination results to the consultation: referral to a nephrologist, renal ultrasound, complete blood count, blood creatinine, complete coagulogram, Lee-White blood clotting time, blood type, Rh factor, blood pressure diary.

Modern nephrology offices of the Dobrobut medical network are equipped with pulse oximeters - portable devices that allow you to determine the level of blood oxygen saturation, which is important in diagnosing certain kidney diseases.

A wide range of diagnostic tools and techniques allows nephrologists of the Dobrobut medical network to quickly and accurately diagnose and prescribe optimal treatment. All studies and examinations are carried out in comfortable conditions for patients. At the appointment, the nephrologist explains in detail to the patient the need for the treatment method in each individual case.

Treatment

Dobrobut medical network nephrologists apply progressive methods of conservative treatment, use international protocols and modern standards of evidence-based medicine.

During the appointment, Dobrobut medical network nephrologists:

• collect anamnesis - find out the patient's complaints and all circumstances related to these complaints (lifestyle, heredity);
• conduct a physical examination of the patient - assess the physique, condition of the skin and subcutaneous tissue, paying attention to changes in skin color, the presence of edema;
• nephrologists must determine the characteristics of hemodynamics - pulse and blood pressure;
• conduct a percussion symptom or Pasternatsky symptom, palpation of the kidneys if necessary;
• listen to the abdominal aorta and renal arteries with a stethoscope as needed

Differences between nephrology and urology

The fields of nephrology and urology overlap somewhat, as both treat the kidneys. While a nephrologist focuses on diseases and conditions that directly affect the kidneys, a urologist focuses on diseases and conditions that can affect the male and female urinary tract.

The urinary tract consists of the kidneys, ureters, bladder, and urethra.

Conditions that a urologist can treat include

• kidney stones;
• bladder infections;
• bladder control problems;
• erectile dysfunction;
• prostate disease.

By contacting the Dobrobut medical network, you can be sure of the quality and timeliness of medical care. Qualified and experienced doctors, using modern expert-class equipment, will establish an accurate diagnosis and prescribe the most optimal treatment. Our specialists are constantly improving their level of knowledge and competence and implementing modern achievements and developments in world medicine into practice.