Nephrology

Nephrology is the branch of medicine that studies kidney diseases.
The kidneys are vital organs located symmetrically on either side of the spine. If kidney function is impaired, renal replacement therapy with dialysis or renal transplantation is necessary.

• Taking care of patients with various forms of acute kidney damage, in the context of systemic, autoimmune, urological or other diseases.
• Investigation and therapy in patients with elevated blood pressure (hypertension).
• Taking care of patients with inflammatory and autoimmune diseases, e.g., glomerulonephritis.
• Taking care of patients with genetic kidney diseases, e.g., renal polycystosis.
• Implementation of necessary measures to prevent progression of chronic kidney disease to renal failure, e.g., in patients with diabetic or hypertensive nephropathy.
• Optimal preparation for replacement therapy and quality care in hemodialysis and peritoneal dialysis in advanced renal disease.
• Transplantation preparation and taking care of kidney transplant patients.
• Care and optimal prevention of kidney stones, in close collaboration with urology.

The functions of the kidney

The kidneys are vital organs; they filter the blood to cleanse it of metabolic waste products, regulate the body's water and salt content, maintain circulating blood volume, regulate blood pressure, and produce hormones needed for the functioning of other organs and to maintain strong bones.

If the kidneys don't work

Several diseases can affect the kidneys. Early and accurate diagnosis is essential in order to properly treat kidney disease, avert disease progression to kidney failure, and thus avoid dialysis.

The importance of prevention

Ten percent of adults and one in five elderly suffer from chronic kidney disease. Kidney disease is often asymptomatic until the advanced stage.
Diabetes, high blood pressure, atherosclerosis, some autoimmune diseases or dysfunction of other organs are the main causes of chronic kidney disease. Those conditions that can cause chronic kidney disease (e.g., diabetes, hypertension) need to be addressed early in order to intervene before the kidney damage is irreversible.
Prevention requires optimal control of blood pressure, cardiovascular risk factors, and -in the case of diabetes- blood glucose.
It is recommended that patients with risk factors have blood and urine tests at regular intervals to identify kidney disease early.

Diagnosis

First, the diagnostic picture is defined by careful history taking by the nephrologist who inquires about the patient's medical and family history. Next, a complete clinical examination is performed; further investigations may include:

• Blood tests.
• Urinalysis.
• Biopsies.
• Renal ultrasound.

Treatments

For many types of kidney disease there are now -specific therapies to prevent irreversible kidney damage and thus disease progression. Advanced kidney disease, on the other hand, requires replacement of the kidney's cleansing function by dialysis or renal transplantation.

• Peritoneal dialysis: uremic toxins are removed through the abdominal cavity. The patient independently takes care of dialysis at home by performing fluid exchanges through an abdominal catheter. The method thus allows the patient to maintain greater autonomy and flexibility in daily life, few dietary restrictions.
• Hemodialysis: purification is done through a machine that filters the patient's blood. The treatment lasts 3-4 hours and is usually performed 3 times a week in dialysis centers. In special cases, hemodialysis can also be done at home.
• Renal transplantation: renal transplantation is the treatment of first choice for patients with renal failure. The transplantation operation takes place in the designated university centers. However, in our outpatient clinics we take care of the preparation and treatment of renal transplant patients.