A nephrologist is a physician who specializes in the diagnosis and treatment of kidney conditions. Kidneys play an essential role in filtering blood and removing waste from the body as part of the urinary system. The goal of nephrology is to prevent infections and diseases of the kidneys and other urinary organs, and to treat them effectively when they occur.

Nephrologists complete medical or osteopathic school and a residency in internal medicine or pediatrics; some pursue additional subspecialty training in nephrology. They are licensed to practice and often board certified, with many maintaining certification through ongoing education.

What Does a Nephrologist Do?

Nephrologists diagnose and treat a wide range of renal symptoms and conditions, including:

• Cystic kidney disease
• Electrolyte disorders
• End-stage renal disease (ESRD)
• Glomerulonephritis
• Hemolytic uremic syndrome
• Kidney failure
• Kidney infections (pyelonephritis)
• Kidney stones
• Nephrotic syndrome
• Polycystic kidney disease
• Renal artery stenosis
• Recurrent urinary tract infections

Kidney specialists also monitor chronic conditions that negatively impact the urinary system, such as hypertension (high blood pressure) and diabetes. They provide care for kidney complications related to cancer and its treatments, also referred to as onconephrology.

Nephrologists serve patients through doctor–patient interaction, conducting physical exams, ordering tests, prescribing medications, and performing specialized diagnostic procedures such as kidney biopsy and managing dialysis. In some settings they may place temporary dialysis catheters. They collaborate with urology or interventional radiology for ureteral stents or kidney-stone procedures.

Nephrologists are found in both private-office and hospital settings. Many are also involved in university-based research programs.

What Types of Nephrologists Are There?

Nephrologists are trained in one or more specialties:

• Critical-care nephrology: An exclusive focus on critically ill or injured patients.
• Dialysis care: Expertise in hemodialysis and peritoneal dialysis management.
• General nephrology: Comprehensive diagnosis and treatment of kidney conditions and disorders.
• Interventional nephrology: Dialysis access procedures and kidney biopsy in select centers.
• Onconephrology: Kidney care for people receiving cancer treatment (managing kidney effects of cancer and therapies).
• Pediatric nephrology: Diagnosis and treatment of renal disorders in children and adolescents.
• Transplantation (transplant nephrology): Evaluation, preparation, and post-operative care for individuals undergoing a kidney transplant.

When Should You See a Nephrologist?

You should see a nephrologist whenever you experience the symptoms commonly associated with a kidney disease or infection:

• Bloody or cloudy urine
• Brain fog
• Fatigue
• Fever
• Foamy urine
• Frequent urination
• Inability to urinate
• Muscle cramping
• Nausea or vomiting
• Painful urination
• Pelvic pain
• Swelling in the limbs or face
• Urinary leakage

You may also want to see a nephrologist if you have a chronic medical condition, such as diabetes or hypertension, or a family history of kidney disorders, such as polycystic kidney disease.

What Can I Expect at My Visit to a Nephrologist?

A visit to a nephrologist will begin like any other medical visit. They will conduct a physical exam, ask about your symptoms, and record your family history. Your nephrologist will also ask you lifestyle questions, for example, what your diet is like, how much you exercise, whether you smoke, and how much you drink.

Lab work will play a critical role in your diagnosis. Your nephrologist may order one or more of the following blood or urine tests to collect data for diagnostic evaluation:

• Blood urea nitrogen (BUN): Measures how much urea, a waste product, is present in the bloodstream.
• Estimated glomerular filtration rate (eGFR): Assesses how effectively the kidneys filter the blood.
• Serum creatinine: Measures a bloodstream waste product related to muscle metabolism.
• Urine albumin-to-creatinine ratio (ACR): Measures albumin levels in urine.
• Creatinine clearance: Uses blood and urine samples to determine the rate at which creatinine clears from the bloodstream.
• Urinalysis: Checks for the presence of proteins, glucose, or bacteria in urine.
• 24-hour urine collection: Collects urine over a daylong period for extensive laboratory analysis.

Your nephrologist may also order imaging scans of your kidneys, such as X-rays, computed tomography (CT) scans, or ultrasounds.

On confirming a diagnosis, your nephrologist can prescribe medications that are appropriate for your condition and arrange for additional care with urology, interventional radiology, or surgery if a procedure is needed. These might include a tissue-sample biopsy, dialysis, blood-clot removals, or catheter placements.

If you’re experiencing symptoms or have a family medical history that concerns you, the Baptist Health nephrology team is ready to serve. For more information, use our online provider directory.

Nephrologist FAQs

Should I see a nephrologist for kidney stones?

Yes. Nephrologists help manage kidney stones with medications and by coordinating procedures such as lithotripsy with urology or interventional radiology. Kidney-stone treatment is also performed by urologists, whose specialty is the urinary system overall, with a greater focus on surgery.

Do nephrologists perform surgery?

Typically no, but with some exceptions. Nephrologists most commonly treat kidney conditions by non-surgical means, such as medications. In some settings they may place temporary dialysis catheters or perform kidney biopsy. They work closely with urology and surgery for procedures that require an operation.

Are a nephrologist and a urologist the same thing?

No. A nephrologist is a kidney specialist who diagnoses and treats renal conditions with medications and non-surgical or minimally invasive procedures. A urologist is a specialist who focuses on the broader urinary system and performs surgical procedures on the urinary tract.