Nephrology: Taking A Look Inside of the Kidneys

 By: Dhyan Patel

Nephrology


Note: This article is part of a student-run educational series on medical specialties, based on research and/or shadowing (in person or virtual), in order to educate other students who are interested in healthcare careers and may lack the ability to shadow specialists in their areas.

Background

Every second of our lives, our kidneys work tirelessly. They filter out blood, remove waste, balance electrolytes, and regulate blood pressure. Although many people overlook them due to the fact that they might not seem as important as the heart or brain, they are one of the most important organs. Without them the body would quickly lose its balance. When these organs begin to stop functioning properly, they require a specialist known as a nephrologist in order to restore the balance of the body.


Nephrology refers to the branch of internal medicine that is dedicated to study and treat kidney diseases. Nephrologists manage everything from kidney disease and high blood pressure to kidney failures and transplants. They work hard to ensure that every organ in their patient's body is functioning properly.

So, what do they do?

Nephrologists focus on the kidneys and look at how they interact with other organs in the body. Due to the fact that kidneys play an important role in filtering the blood and regulating fluids within the body, nephrologists deal with one of the most complex systems in the body.


Some common conditions that are treated by nephrologists include:

  • Chronic kidney disease (CKD)

  • Acute kidney injury (sudden loss of kidney function)

  • Hypertension (high blood pressure)

  • Kidney stones

  • Glomerulonephritis (inflammation of kidney filters)

  • Polycystic kidney disease

  • End stage renal disease

  • Electrolyte imbalances


Treatments to these problems might include giving medications, adjusting lifestyles, or providing a dialysis (process that artificially filters the blood when the kidneys can no longer do so). For patients with irreversible kidney failure, nephrologists may also coordinate kidney transplants.


Additional Information

Although kidneys might seem small in size, the contributions they make for the body are substantial. Each kidney contains about a million microscopic filtering units called nephrons that work together to remove toxins, control blood pressure, and balance minerals like sodium and potassium.


Nephrologists may use advanced technology in order to monitor and manage kidney functions such as

  • Blood and urine tests to measure the waste products and detect early signs of kidney disease

  • Imaging techniques such as ultrasounds or CT scans in order to visualize the kidney structure

  • Biopsies in order to diagnose inflammation, scarring, or other damage

  • Dialysis machines, which act as artificial kidneys by filtering blood.

Required education and training

In order to become a nephrologist, an individual first must earn their bachelor’s degree and complete medical school. After that they must complete a three-year residency program in internal medicine. Following their residency, they must enter a two year long nephrology fellowship, where they gain hands-on experience with diagnosing and managing patients who have kidney diseases, oversee dialysis treatments, and care for transplant patients.


Some people may choose to pursue further specializations such as

  • Transplant nephrology - focusing on kidney transplant care and immunosuppressive therapy

  • Interventional nephrology - performing procedures like catheter placements and biopsies

  • Critical care nephrology - managing kidney failures in critically ill patients.

Importance

Having healthy kidneys is essential for a healthy life. As kidney problems begin to rise, so do other major health problems. As a result, nephrologists play a crucial role in detecting and treating problems that may affect the kidneys early in order to avoid future complications and give their patients the ability to live a healthy life.

References


American University of Antigua. (2024, April 9). How to Become a Nephrologist: All You Need to Know. American University of Antigua. https://www.auamed.org/blog/how-to-become-a-nephrologist-all-you-need-to-know/

Associates in Nephrology. (2024, July 19). What Conditions Can a Kidney Specialist Treat? - Associates in Nephrology, PC. Associates in Nephrology, PC. https://www.associatesinnephrologypc.com/2024/07/19/what-conditions-can-a-kidney-specialist-treat/

Cleveland Clinic. (2023, September 5). What Is A Nephrologist? When To See One & What To Expect. Cleveland Clinic. https://my.clevelandclinic.org/health/articles/24214-nephrologist

Commonwealth Nephrology Associates. (2024, June 7). Expert Care for Kidney Health: The Role of a Nephrologist: | Commonwealth Nephrology Associates. Commonwealth Nephrology Associates. https://www.bostonkidney.com/2024/06/07/understanding-the-role-of-a-nephrologist-expert-care-for-kidney-health-and-disorders/#:~:text=Kidney%20Stones:%20These%20are%20hard,prevent%20new%20ones%20from%20forming.

Durham Regional Hospital. (2020, August 17). What Does A Nephrologist Do? - Durham Nephrology Associates, PA. Durham Nephrology Associates, PA. https://www.durhamnephrology.com/what-does-nephrologist-do/#

Rutgers New Jersey Medical School. (2025). Rutgers.edu. https://njms.rutgers.edu/departments/medicine/internal_medicine/im-neph.php

NIH. (2022). Kidney Biopsy. National Institute of Diabetes and Digestive and Kidney Diseases; NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/diagnostic-tests/kidney-biopsy

NIH. (2016). Chronic Kidney Disease Tests & Diagnosis. National Institute of Diabetes and Digestive and Kidney Diseases; NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/kidney-disease/chronic-kidney-disease-ckd/tests-diagnosis

NIH. (2024). Kidney Disease - Research - NIDDK. National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/about-niddk/research-areas/kidney-disease

University of Minnesota. (2022, August 30). Nephrology Specialties. Medical School. https://med.umn.edu/dom/divisions/nephrology-hypertension/specialties

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