Nephrology: Treatment, Effects & Risks

Nephrology is the name given to renal medicine, derived from the Greek word nephros for the kidney. It is a medical discipline that focuses on possible diseases, diagnoses, therapies and functions of the kidneys. Thus, nephrology is an important area of internal medicine.

What is nephrology?

Nephrology is the term used to describe kidney medicine, derived from the Greek word nephros for kidney. Put simply, nephrology is internal medicine, whereas a urologist performs surgical procedures on the kidney and specializes in the treatment and diagnosis of draining urinary tract and male genitalia. In nephrology, the focus is on diseases specifically related to the kidneys, but also on the effects of disorders of kidney function. The purpose of nephrology is to treat diseases of the kidney with conservative, non-surgical therapy. The nephrologist’s specialty lies in diagnosis and treatment, but also in consultation. Thus, patients with hypertension and kidney disease will find consultative support from the nephrologist, as well as advice on prevention. Another aspect of nephrology is stabilizing the function of the kidney balance, but also monitoring secondary diseases such as changes in water and blood salt balance, kidney replacement procedures and blood purification. The care of sufferers who have high blood pressure is known as hypertensiology and is one of the most important subspecialties of nephrology.

Treatments and therapies

Nephrology encompasses a wide range of medical conditions. These include, partly as a secondary disease, ailments such as hypertension as well as disorders of the water and electrolyte balance of the human organism and the acid-base balance. Glomerulopathies in acute, subacute and chronic form are diseases of the renal corpuscles. Interstitial nephropathies are inflammatory diseases of the kidneys. The kidneys are involved in a variety of systemic diseases such as diabetic or hypertensive nephropathy, plasmacytoma or rheumatic diseases. Goodpasture’s syndrome is a disease of the immune system involving the kidneys. Furthermore, there are diseases of the kidney that are hereditary, such as cystic kidney disease, sponge kidney disease or various metabolic diseases that are associated with renal dysfunction, such as Wilson’s disease, Fabry’s disease or Lowe’s syndrome. The field of nephrology includes hypertensive diseases such as primary or renovascular hypertension or renal artery stenosis. Pregnancy can lead to gestational hypertension or renal dysfunction, which also fall within the core area of nephrology. Metabolic alkalosis and acidosis as well as disorders of potassium, chloride, phosphate, sodium and calcium balance are metabolic disorders of acid-base and water and electrolyte balance. Diseases associated with bone disorders or diabetes mellitus as well as liver and kidney transplants require the ordination of nephrology. Transplantations in particular require professional, sensitive preparation and care after the procedure. Nephrology also serves to perform operations in which a dialysis shunt or a dialysis catheter is placed. In the case of very severe forms of Crohn’s disease, nephrology provides support in gastroenterology, as well as in ENT medicine in the event of a hearing loss or tinnitus. Nephrology is called in for acute poisoning or very severe forms of heart failure. Focusing on kidney diseases, clinical pictures such as acute or chronic kidney failure as well as diseases of the glomeruli in inflammatory form, nephrology is an essential field of internal medicine. In addition, there is renal anemia, anemia resulting from chronic renal failure, as well as

hematuria and proteinuria, when blood and protein are deposited in the urine. In cases of malignant kidney disease such as renal cancer or complaints such as renal colic, decreased kidney function, the advice of a nephrologist should be sought.

Diagnosis and examination methods

Diagnosis and examination methods in nephrology include chronic renal replacement therapy, known as hemodialysis or peritoneal dialysis. Renally eliminated drugs are administered for problems caused by chronically impaired renal function.If dialysis is required due to terminal renal insufficiency, treatment is carried out by specialists in nephrology. However, kidney transplantation may also be necessary, the preparation and follow-up of which is another important task of the nephrologist. Lipiapheresis procedures are necessary for people who have severely elevated blood lipid levels. Dialysis procedures are performed after polytrauma, sepsis, or other poisonings that result in acute renal failure. Dialysis is a therapy for a wide variety of poisonings. In laboratory diagnostics, the values of urea, creatinine, uric acid, sodium, calcium and phosphate, potassium, chloride as well as protein are examined in order to better assess kidney function as well as acid-base balance. A regular blood count and blood gas analysis provide valuable information about possible diseases. The urine provides information. Thus, spontaneous urine or midstream urine is distinguished from collected urine and examined with test strips for erythrocytes, leukocytes, protein, pH, nitrite, ketone bodies and glucose. With an additional transmitted light microscopy, larger urine components such as urine cylinders or cells that stand out can be examined more closely. Then it must be clarified whether any blood in the urine comes from the kidneys or the urinary tract. A phase contrast microscopy is performed using the so-called dark field technique. A collection urine test, usually collected over 24 hours, can be used for further analysis. Dialysis refers to blood washing with artificial kidneys or peritoneal dialysis, which provides patients after a kidney transplant. The aim of nephrology is to improve the prevention as well as the early detection of diseases of the kidneys and high pressure. A treatment plan for the patient after a diagnosis in consultation with the nephrologist is an important tool for those affected. Nephrology encompasses a variety of diagnostic options, therapies, and procedures related to kidney disease.