Who needs to see a kidney specialist (nephrologist)?
There are two types of kidney specialist.
- A nephrologist is a doctor who specialises in diagnosing and treating kidney conditions. They are from a group of hospital doctors called physicians, who do not do operations. You might need to see a nephrologist if you have (or are at risk for) kidney disease or issues affecting kidney function.
- A urologist is a doctor that does operations on the kidney, prostate, baldder, penis or testicles. They look after people with kidney stones, cancer or urinary tract infections (UTIs).
Note. Seeing a nephrologist doesnt mean you need dialysis. Most people referred to one, do not.
Common reasons to see a nephrologist
- Chronic Kidney Disease (CKD). Diagnosed or suspected CKD (especially if stage 3 or higher). This means your glomerular filtration rate (GFR) will be < 60 mL/min (normal is 90-120 ml/min)
- Protein in the Urine (Proteinuria) – if your urinary Albumin-to-Creatinine Ratio (ACR) is > 30 mg/mmol (normal is <3). If ACR > 100, most (no-diabetic) patients will require a kidney biopsy that the nephrologist will organise. Severe proteinuria is called Nephrotic Syndrome (when ACR > 220). Almost all (non-diabetic) patients with nephrotic syndrome, need a kidney biopsy
- Blood in the Urine (Haematuria). Especially if there’s no clear cause; and after kidney or bladder cancer, urinary tract infection (UTIs), and kidney stones, have been ruled out by a urologist
- Acute Kidney Injury (AKI). Rapid drop in kidney function, requiring hospitalisation.
- Electrolyte Imbalance. Persistent or unexplained issues like high potassium (hyperkalaemia) or low sodium (hyponatraemia) levels in the blood
- High Blood Pressure (Hypertension) – that is hard to control by your GP; or the GP thinks there is an underlying cause; or it is resistant to treatment, or suspected to be related to kidney disease.
- Inherited Kidney Disorders. Examples include Polycystic Kidney Disease (PKD) or Alport Syndrome.
- End-Stage Kidney Failure (Stage 5 CKD), i.e. on dialysis (haemodialysis or peritoneal dialysis) or a need (or have) a kidney transplant. Nephrologists manage patients on dialysis, or those being prepared for a kidney transplant.
Who does not need to see a nephrologist?
- Most patients with UTIs
- Most patients with kidney stones – unless they are recurrent or there is a suspicion of an inherited or rare cause
- Patients with kidney cancer.
