The human body is a complex machine that constantly tries to achieve a normal controlled internal environment and respond appropriately to the changes in the external environment. This mechanism is called homeostasis. It is this homeostasis that makes survival of human species possible. To achieve this, the body has been equipped with multiple organs and organ systems that work constantly. In keeping body alive, energy needs to be generated and the waste products of metabolism that occurs need to be eliminated. Kidneys perform a very pivotal role in removing most of these waste products, which include ammonia, urea, bilirubin, creatinine, uric acids, drugs and other xenobiotics, by filtering the blood and excreting the final product called urine. Apart from this, the other important functions that kidneys perform are:

  • Regulation of blood ionic composition
  • Regulation of blood pH
  • Regulation of blood volume
  • Regulation of blood pressure
  • Maintenance of blood osmolarity
  • Hormone production
  • Regulation of blood glucose level

The functional unit of the kidney is called a nephron. Each kidney contains around 6-14 lakh nephrons and sometimes up to 20 lakh nephrons. These nephrons act as filters that selectively filter the waste products, reabsorbing the components that are needed for the body. A nephron is divided into different segments, each performing a specific set of function. Almost 95% of the blood that is purified by nephrons is reabsorbed, resulting in a daily output of around 1.8 litres of urine.

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Frequently asked questions about Nephrologist

What does a nephrologist do?

A nephrologist is a medical expert that has an experience in prevention, diagnosis and treatment of the diseases that affect the kidney. The doctor can diagnose and provide the necessary treatment which can involve surgical intervention also.

What is the difference between a nephrologist and a urologist?
A nephrologist treats the diseases of the kidneys only whereas a urologist treats any disease or disorder affecting any part of the urinary system. Thus problems related to prostate are treated by urologist and not by a nephrologist.
What common diseases affect the kidneys?

Many diseases affect the kidney and different clinical manifestations occur depending on the site involved. The most common diseases that affect the kidneys are:

  • Nephrolithiasis (kidney stones)
  • Acute kidney injury
  • Chronic kidney disease
  • Glomerulonephritis
  • Polycystic kidney disease
  • Nephritic syndrome and nephrotic syndrome
  • Kidney cancers
  • Nephropathy
What are the usual tests that a nephrologist performs?

The usual blood tests include the levels of BUN (Blood Urea Nitrogen) and serum creatinine. He or she may also advise urine tests to check the presence of components not commonly found in the urine like blood or protein. The frequency of micturition and the volume of urine may also be considered.

What is the treatment of kidney stones?

The doctor tries conservative treatment to eradicate stones by prescribing medications and asking the patients to take plenty of fluids. If the conservative treatment doesn’t work and the pain is severe or disrupting the normal activities, the nephrologist may ask the patient to get the stone surgically removed. Location, size and composition of the stone and the anatomy of the urinary tract are important determinants to choose the best surgical intervention. The least invasive option is the Extracorporeal shockwave lithotripsy (ESWL). It uses shock waves that are generated outside the body to fragment the stone. The other more frequently used procedure is to remove stone by basket extraction or laser fragmentation. Percutaneous nephrostolithotomy is the most preferred procedure for large upper-tract stones.

Is a nephrology consultation possible online?

With the advent of modern technology, it is very possible for the patient experiencing any symptoms affecting the urinary tract system to at least get a probabilistic diagnosis by connecting with the leading online nephrologist consultation with MediFlam. Then the nephrologist can advise the patient for further process to confirm the diagnosis and get treated at the earliest.

Is MediFlam good for online nephrology consultation?

Mediflam has a stringent process of checking the qualifications of doctors that are taken on the platform so that the patients get access to the best qualified doctors to get the best possible diagnosis. Mediflam has a panel of some of the best nephrology doctors available in India. We at MediFlam make sure that our platform provides hassle free experience to the patients as well as the doctor at the best cost possible. Our doctors work in close conjunction with the patients so as to provide them quick diagnosis, treatment and regular follow ups through online nephrology consultation.

A kidney is a complex organ containing many macroscopic and microscopic structures. A nephron itself is divided into:

  • Glomerulus
  • Tubule
  • Collecting duct

Any part of the nephron can be affected which can lead to the abnormal function of the kidneys. Apart from the parts of nephron, other parts of the kidneys can also be affected leading to the development of diseases. The most common symptoms of the diseases that affect the kidneys can be grouped into well-defined syndromes. Some are unique to glomerular diseases while others present in diseases that affect any one of the components. They are as follows:

  • Elevation of blood urea nitrogen (BUN) referred to as azotemia
  • Uremia which refers to the clinical manifestations of azotemia
  • Nephritic syndrome characterized by presence of visible blood in urine or blood cells in urine. It is caused by inflammatory glomerular disease
  • Nephrotic syndrome characterized by the presence of proteins in urine. It is also a result of inflammatory glomerular disease.
  • Asymptomatic hematuria or proteinuria or a combination of these two
  • Acute kidney injury characterized by a rapid decline in Glomerular Filtration Rate (GFR) within hours to days. In most severe forms it is characterized by oliguria (decreased urine output) or anuria (total failure of kidneys to produce urine).
  • Chronic Kidney Disease (CKD) characterized by a diminished GFR that is constantly less than 60 ml/min/1.73 sq. m. for at least 3 months. It can also be marked by albuminuria (presence of albumin in urine).
  • Renal tubular defects characterized by polyuria (excessive urine production), nocturia (waking up at night multiple times to urinate), and electrolyte disorders (metabolic acidosis).
  • Urinary tract obstruction and renal tumors present with varied symptoms depending on the anatomic site of the pathology.
  • Nephrolithiasis, also known as kidney stones or renal stones, is manifested with spasms of severe pain (renal colic) and hematuria (presence of blood in urine), often with recurrent stone formation.

The principal systemic manifestations of chronic kidney disease and uremia based on the different aspects that it affects are:

Fluid and electrolytes

  • Dehydration
  • Edema (fluid build-up in the body)
  • Hyperkalemia (excess potassium in the body)
  • Metabolic acidosis

Calcium phosphate and bone

  • Hyperphosphatemia (increased phosphate levels in the body)
  • Hypocalcemia (decreased calcium levels in the body)
  • Secondary hyperparathyroidism
  • Renal osteodystrophy

Hematologic

  • Anemia
  • Bleeding diathesis

Cardiopulmonary

  • Hypertension
  • Congestive heart failure (CHF)
  • Cardiomyopathy
  • Pulmonary edema
  • Uremic pericarditis

Gastrointestinal

  • Nausea and vomiting
  • Bleeding
  • Esophagitis
  • Gastritis
  • Colitis

Neuromuscular

  • Myopathy
  • Peripheral neuropathy
  • Encephalopathy

Dermatologic

  • Sallow color
  • Pruritus
  • Dermatitis

A number of diseases that affect the kidney can occur. Some of these include:

  • Glomerulonephritis
  • Nephritic syndrome
  • Nephrotic syndrome
  • IgA nephropathy (Berger disease)
  • Alport syndrome
  • Hereditary nephritis
  • Lupus nephritis
  • Diabetic nephropathy
  • Henoch-Schönlein Purpura
  • Goodpasture syndrome
  • Microscopic polyangiitis
  • Wegener granulomatosis
  • Acute tubular injury
  • Tubulointerstitial nephritis
  • Pyelonephritis and Urinary tract infection
  • Urate nephropathy 
  • Myeloma kidney
  • Nephrosclerosis
  • Renal artery stenosis
  • Thrombotic microangiopathies
  • Sickle cell nephropathy
  • Polycystic kidney disease
  • Medullary sponge kidney
  • Nephronophthisis
  • Multicystic renal dysplasia
  • Urinary tract obstruction (obstructive uropathy)
  • Urolithiasis (renal stones)
  • Different types of kidney cancers
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