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Nephrology is a medical science that deals with the diagnosis and treatment of kidney diseases (medication, dialysis, transplantation), as well as the monitoring patients with kidney transplants.

Most diseases affecting the kidney are not limited to the organ itself, but are a manifestation of general disorders. It has now been proven that chronic kidney disease is a risk factor for the development and progression of cardiovascular disease.

On the other hand, some chronic diseases of other organs (hypertension, diabetes mellitus, hepatitis, rheumatic diseases, etc.) can cause kidney damage.

The reason to consult a nephrologist is usually:

• swelling;
• redness or darkening of the urine;
• pain in the lumbar region;
• high blood pressure (hypertension) that is difficult to treat;
• deviations in the biochemical analysis of blood (increased creatinine or urea) or in the analysis of urine (any changes - protein in the urine, red blood cells or leukocytes in the urine, as well as cylinders, bacteria, crystals or acetone in the urine);
• anemia (decreased hemoglobin and erythrocytes) of unexplained origin;
• a sharp increase or decrease in the amount of urine per day.

Nephrologist's consultation is necessary in the presence of diseases:

• glomerulonephritis;
• urinary tract infections;
• pyelonephritis;
• acute renal failure (decrease or cessation of urine flow);
• chronic renal failure;
• complications of chronic renal failure (anemia, vitamin D deficiency, osteoporosis, disorders of water and electrolyte metabolism);
• kidney damage in diabetes mellitus, hypertension, obesity, and other chronic diseases.

Common diseases

• Interstitial nephritis;
• Sickle cell nephropathy;
• Glomerulonephritis;
• Vascular diseases of the kidneys (unilateral or bilateral stenosis of the renal artery, kidney infarction, thrombotic microangiopathy, hypertensive nephropathy, kidney damage in systemic scleroderma, vasculitis, atheroembolism of the kidneys);
• Hereditary glomerular disease (Alport syndrome, glomerular thin basement membrane disease);
• Cystic kidney disease (polycystic kidney disease, medullary cystic disease, acquired cystic disease);
• Isolated defects of tubular function (renal glucosuria, cystinuria, vitamin D-resistant rickets, Fanconi syndrome, renal tubular acidosis);
• Kidney damage in other diseases, including systemic (kidney damage in patients with diabetes mellitus, hepatic-renal, pulmonary-renal, malignant diseases, renal tuberculosis, systemic vasculitis, systemic lupus erythematosus, etc.);
• Drug-related kidney disease.

All of the above diseases, with inadequate or untimely treatment started, can result in complications such as chronic kidney disease. The urgency of the problem today cannot be underestimated: the number of people with this condition is increasing every year in the world; the number of those requiring renal replacement therapy (hemodialysis) is also increasing. Today, doctors are increasingly talking about the "epidemic" nature of the spread of chronic kidney disease.

In order to prevent kidney disease, it is necessary to diagnose, treat and prevent any disease that occurs with kidney damage in time.

In this regard, it is important to know the symptoms by which you can suspect kidney disease in time:

• pain or tenderness in the lumbar region;
• changes in urine volume;
• increased blood pressure;
• changes in laboratory parameters (increased levels of creatinine, urea, potassium, sodium in the blood; the presence of erythrocytes, leukocytes, protein in the urine);
• swelling;
• general weakness, increased body temperature;
• yellowness or pallor of the skin.

What does a nephrologist do?

Reception of a patient with a nephrologist begins with complaints' listening, asks about the lifestyle, hereditary predispositions, and conducts a general examination.

At an appointment with a nephrologist for a more accurate diagnosis, the following laboratory tests may be prescribed:

• tests that will help assess the level of creatinine, calcium, urea, electrolytes, phosphate;
• analysis of C-reactive protein;
• biochemical analysis of blood and urine to determine the rate of erythrocyte sedimentation.

After reviewing the test data, the nephrologist may prescribe a number of additional studies:

• ultrasound of the kidneys and abdominal organs;
• angiography (special X-ray examination);
• kidney biopsy;
• computed tomography of the kidneys;
• scintigraphy (radionuclide examination);
• magnetic resonance imaging of the kidneys.
• Treatment consists of two components:
• specific treatment for a specific disease;
• nephroprotective treatment, universal for all kidney pathologies.

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