Find a Nephrology Doctor for Kidney Disease Treatment

What is the Meaning of Nephrology?

Nephrology deals with kidney disease and the kidney's functions. The word "nephros" originates from the Greek and essentially means "kidney". Nephrologists treat high blood pressure diseases as well, since there is a close relationship between kidney function (renal function) and blood pressure.

What are the Kidneys' Functions?

One of the kidney's tasks is to cleanse the blood from superfluous or harmful metabolic products and to remove excess water from the body. The blood flows through the two small renal organs about 300 times a day. The so-called urinary excreted substances as well as liquids are filtered from the blood vessels by a complicated system based on osmosis. This material is then added to the urine. Certain medicines are broken down in the same fashion.

In addition, the kidneys produce a hormone called renin, which is important for the regulation of blood pressure. The organizational units of the kidney are called glomeruli or renal corpuscles. These are small vascular bundles surrounded by a connective tissue capsule. Here, the primary urine is formed, which initially contains a lot of water and is then substantially concentrated by its resumption.

If the renal function is restricted or fails completely, it has very serious effects on the whole body. The urinary substances are deposited in the internal organs and impair their functions. The disturbed fluid and electrolyte balance leads to water retention and cardiac arrhythmia. Decreased or excessive formation of renin has a strong influence on the blood pressure.

Which Kidney Diseases are Treated by Renal Doctors?

Renal and kidney-dependent high blood pressure diseases are generally treated by kidney doctors or nephrologists. The kidney disease symptoms are extremely diverse. The most important signs of illness include:

• Acute or chronic renal insufficiency: Due to multiple reasons, mostly caused by diabetes mellitus, a sudden or slowly developing kidney failure may occur. This defect is diagnosed by the detection of elevated levels of urinary excreted substances such as creatinine, urea and uric acid in the blood. The discovery of protein and blood cells in urine lead to the same diagnosis. Urine production can be reduced, but in some other cases be extremely elevated. In addition, edemas often occur. Skin changes and general physical complaints are possible as well.
  If renal failure is caused by a primary illness or a trauma, the cause may be successfully treated. In many cases, renal function regenerates. If regeneration fails or the kidney damage is already too pronounced, renal replacement therapy (dialysis) or a transplantation must be performed.
• Inflammatory kidney diseases: These include numerous forms of bacterial and non-bacterial inflammation. Worth mentioning here is glomerulonephritis, which is an inflammation of small bundles of blood vessels making up the kidney. If the tissue between glomeruli is affected, it is called interstitial nephritis. Left untreated, both forms can lead to renal failure.
• Renal cancer: Like every other organ, the kidney can also be affected by cancer, but it's very rare to happen. A tumor can develop in the kidney or manifest itself as a metastasis of another cancer. Unfortunately, the risk of a malignant tumor of the kidney forming metastasis is very high.
• Renal artery stenosis: A renal artery stenosis occurs after a gradual narrowing of the renal arteries, which supply the two organs with blood. The cause of a stenosis is mostly arteriosclerosis due to high blood pressure. Subsequently, a renal failure appears as a consequence.

Which Examinations do Kidney Doctors Perform?

For a kidney specialist, a urine test is the easiest way to evaluate renal function. The detection of protein and blood cells in the urine indicate a renal dysfunction. For further clarification, a blood test is needed to check the levels of urinary excreted substances in the blood.

The most important parameters are creatinine (a degradation product of the muscles excreted by the kidney) and urea (a product of protein metabolism). If a certain value is exceeded, a limited renal function can be assumed. Diagnostic methods such as X-ray, ultrasound, and angiography are used for further analyzations.

Nephrology Treatment Methods

Kidney disease therapy depends on the cause and the extent of renal damage. It is always the cause that needs to be treated: Inflammations, diabetes, and high blood pressure are treated medically whereas very advanced stenosis is treated by balloon dilatation and the insertion of a stent. In case of tumor disease, the kidney is to be surgically removed and medicines are administrated.

If the cause cannot be treated or the kidney damage is very advanced, one of the therapeutic focuses of nephrologists is the renal replacement therapy or dialysis. This procedure mimics the renal function. The blood is extracted from the patient into the machine and purified from urinary excreted substances and waste fluids. This process works according to similar principles as the kidney itself. Afterwards, the filtered blood is returned to the patient. This procedure has to be performed several times a week for several hours but allows the patient at least to survive despite limited or missing renal function.

If kidney failure is caused by a prior disease that has been cured, it is possible that the organ function regenerates again. In this case, the affected person needs dialysis only temporarily. If the renal function is not restored, dialysis therapy must be continued until a donor organ is available for transplantation. Approximately 2000 kidney transplants are performed annually in Germany.

Which Doctors and Hospitals are Specialized in Nephrology?

Someone who suffers from kidney disease ought to seek the best medical care. Therefore, the patient wonders where to find the best kidney doctor in Germany. Since this question has no objective answer and a serious doctor would never claim to be the best, one can only rely on the doctor’s expertise. The more kidney diseases a doctor has treated, the more experienced he presumably has become in his craft. Through their experience and many years of working as nephrologists, they are the right contacts for the treatment and diagnosis of kidney disease as well as for performing a kidney surgery.

Sources:

http://www.niere-hochdruck.at/was-ist-nephrologie/

http://www.internisten-im-netz.de/de_schwerpunkt-nephrologie_612.html

http://www.dgfn.eu/patienten/basisinformationen-zur-nephrologie.html