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Nephrology is a forte of prescription and pediatrics that frets about

the kidneys: the investigation of typical kidney capacity and

kidney issues, the protection of kidney wellbeing, and the

treatment of kidney issues, from eating routine and medicine to

renal substitution treatment (dialysis and kidney transplantation).

Fundamental conditions that influence the kidneys, (for example,

diabetes and immune system malady) and foundational issues

that happen because of kidney issues, (for example, renal

osteodystrophy and hypertension) are likewise examined in

nephrology. A doctor who has embraced extra preparing to end

up a specialist in nephrology may call themselves a nephrologist

or renal doctor.

The expression "nephrology" was first utilized as a part of around

1960. Before at that point, the claim to fame was normally alluded

to as "kidney drug.


Nephrology concerns the finding and treatment of kidney

ailments, including electrolyte unsettling influences and

hypertension, and the care of those requiring renal substitution

treatment, including dialysis and renal transplant patients.

Numerous infections influencing the kidney are fundamental issue

not constrained to the organ itself

not constrained to the organ itself, and may require unique

treatment. Illustrations incorporate procured conditions, for

example, foundational vasculitides (e.g. ANCA vasculitis) and

immune system ailments (e.g., lupus), and inherent or hereditary

conditions, for example, polycystic kidney sickness.

Patients are alluded to nephrology authorities after a urinalysis,

for different reasons, for example, intense kidney disappointment,

ceaseless kidney malady, hematuria, proteinuria, kidney stones,

hypertension, and clutters of corrosive/base or electrolytes.


Dr. Manish Jain​ is a MD in Internal Medicine (MRMC Gulbarga),

DM in nephrology (SRMC, Chennai) and Clinical Fellow at

University of British Columbia, Vancouver, Canada. He is at

present filling in as a Consultant (Nephrologist and Transplant

Physician) at Medanta. He holds extraordinary enthusiasm for

renal transplant and clinical Nephrology. He additionally filled in

as Assistant Professor at MMCHRI Kanchipuram where he built

up Nephrology Department and began the Dialysis unit. He is

currently associated with Medanta-The Medicity in Sector-38,

Gurgaon. ​Find More ​Nephrologists in Medanta, Gurgaon.



History and physical examination are central to the diagnostic

workup in nephrology. This may include inquires regarding family

history, general medical history, diet, medication use, drug use

and occupation. Examination typically includes an assessment of

volume state, blood pressure, skin, joints, abdomen and flank.

Examination of the urine (urinalysis) allows a direct assessment

for possible kidney problems, which may be suggested by

appearance of blood in the urine (haematuria), protein in the urine

(proteinuria), pus cells in the urine (pyuria) or cancer cells in the

urine. A 24-hour urine collection can be used to quantify daily

protein loss (see proteinuria), urine output, creatinine clearance or

electrolyte handling by the renal tubules.

Basic blood tests can be used to check the concentration of

hemoglobin, platelets, sodium, potassium, chloride, bicarbonate,

urea, creatinine, calcium, magnesium or phosphate in the blood.

All of these may be affected by kidney problems. The serum

creatinine concentration can be used to estimate the function of

the kidney, called the creatinine clearance or estimated

glomerular filtration rate (GFR). More specialized tests can be

ordered to discover or link certain systemic diseases to kidney

failure such as infections (hepatitis B, hepatitis C), autoimmune

conditions (systemic lupus erythematosus, ANCA vasculitis),

paraproteinemias (amyloidosis, multiple myeloma) and metabolic

diseases (diabetes, cystinosis).

structural abnormalities of the kidneys

Structural abnormalities of the kidneys are identified with imaging

tests. These may include Medical ultrasonography/ultrasound,

computed axial tomography (CT), scintigraphy (nuclear medicine),

angiography or magnetic resonance imaging (MRI).

In certain circumstances, less invasive testing may not provide a

certain diagnosis. Where definitive diagnosis is required, a biopsy

of the kidney (renal biopsy) may be performed. This typically

involves the insertion, under local anaesthetic and ultrasound or

CT guidance, of a core biopsy needle into the kidney to obtain a

small sample of kidney tissue. The kidney tissue is then examined

under a microscope, allowing direct visualization of the changes

occurring within the kidney. Additionally, the pathology may also

stage a problem affecting the kidney, allowing some degree of

prognostication. In some circumstances, kidney biopsy will also

be used to monitor response to treatment and identify early



Treatments in nephrology can include medications, blood

products, surgical interventions (urology, vascular or surgical

procedures), renal replacement therapy (dialysis or kidney

transplantation) and plasma exchange. Kidney problems can

have significant impact on quality and length of life, and so

psychological support, health education and advanced care

planning play key roles in nephrology.

chronic kidney disease is typically managed with

Chronic kidney disease is typically managed with treatment of

causative conditions (such as diabetes), avoidance of substances

toxic to the kidneys (nephrotoxins like radiologic contrast and

non-steroidal anti-inflammatory drugs), antihypertensives, diet

and weight modification and planning for end-stage kidney failure.

Impaired kidney function has systemic effects on the body. An

erythropoetin stimulating agent may be required to ensure

adequate production of red blood cells, activated vitamin D

supplements and phosphate binders may be required to

counteract the effects of kidney failure on bone metabolism, and

blood volume and electrolyte disturbance may need correction.

Auto-immune and inflammatory kidney disease, such as vasculitis

or transplant rejection, may be treated with immunosuppression.

Commonly used agents are prednisone, mycophenolate,

cyclophosphamide, ciclosporin, tacrolimus, everolimus,

thymoglobulin and sirolimus. Newer, so-called "biologic drugs" or

monoclonal antibodies, are also used in these conditions and

include rituximab, basiliximab and eculizumab. Blood products

including intravenous immunoglobulin and a process known as

plasma exchange can also be employed.

When the kidneys are no longer able to sustain the demands of

the body, end-stage kidney failure is said to have occurred.

Without renal replacement therapy, death from kidney failure will

eventually result. Dialysis is an artificial method of replacing some

kidney function to prolong life. Renal transplantation replaces

kidney function by inserting into the body a healthier kidney from

an organ donor and inducing immunologic tolerance

an organ donor and inducing immunologic tolerance of that organ

with immunosuppression. At present, renal transplantation is the

most effective treatment for end-stage kidney failure although its

worldwide availability is limited by lack of availability of donor


Most kidney conditions are chronic conditions and so long term

followup with a nephrologist is usually necessary.