There are two major types of doctors that work on the kidney: nephrologists and urologists. Urologists are surgeons of the urinary tract that can remove cancers of the kidneys, open up blockages in the ureters from stones, or help drain the bladder better. Nephrologists are medical specialist of the kidneys that can help maximize the kidney's function and support it with dialysis if necessary.
Kidney Disease Overview
Chronic kidney disease (CKD) is often referred to as the "silent killer," as many people have mild symptoms or no symptoms at all when they are diagnosed.
There are many different terms which can be used to describe kidney diseasewhich can add to the confusion. As noted above, Nephrologists are doctors who treat kidney disease, with the Greek term "nephros" meaning kidneys. You may also hear the term renal disease used to describe kidney problems. The term renal comes from the Latin root "renes" which also means kidneys.
What types of medical conditions may affect your kidneys, what are some of the common symptoms, and when you should be referred to a nephrologist?
Conditions Treated by Kidney Doctors (Nephrologists)
Kidney doctors care for people with a number of different types of kidney disease including:
- Acute kidney injury: Acute kidney disease refers to the rapid onset of kidney disease often related to conditions such as shock (reduced blood perfusion of the kidneys), dehydration, kidney problems related to surgery, or inadequate drainage from the urinary tract (ureter, bladder, prostate, urethra).
- Chronic renal failure: Chronic kidney disease can be caused by a number of different conditions
There is a wide range of medical problems that can affect the kidneys in different ways. Some of the more commonconditions which can cause kidney failureinclude:
- Diabetes (diabetic nephropathy): Diabetes is the leading cause of kidney failure in the United States
- Kidney disease related to high blood pressure and heart disease (cardiorenal syndrome)
- Obesity
- Chronic kidney infections
- Kidney stones which cause obstruction
- Congenital (from birth) kidney problems such as horseshoe kidney
- Glomerulonephritis: Glomerulonephritis is an inflammation of the kidneys which can be caused by a number of different processes, including the bacteria which causes strep throat.
- Kidney disease related to lupus (lupus nephritis)
- Polycystic kidney disease: Cystic kidney disease is hereditary, though the severity of the disease, as well as age of onset, can vary
- Autoimmune diseases such as IgA nephropathy
- Kidney failure secondary to liver disease (hepatorenal syndrome)
Chronic kidney disease is described by five stages based on the severity of the disease. Grade 1 kidney failure refers to a mild disease, whereas grade 5 renal failure usually indicates that dialysis or a kidney transplant will be needed.
In addition to managing kidney problems (trying to correct the condition or prevent it from worsening), kidney doctors manage the symptoms often associated with kidney diseases, such as electrolyte disturbances (especially problems with potassium levels) and high blood pressure.
Symptoms of Kidney Disease
In order to understand the more common symptoms of kidney disease, it's helpful to review the structure and function of the kidneys. Your kidneys are located onyour flanks, near your spine. Injuries to your back or side below your diaphragm may cause injuries to your kidneys.Your kidneys perform several important functions. These include filtering your blood to remove toxins, maintaining the proper levels of electrolytes (such as sodium and potassium) to ensure proper functioning of your cells, and maintaining fluid balance in your body.
If you become dehydrated, your kidneys initially work to restore the fluid status to your body, but kidney injuries may occur with prolonged or severe dehydration. If your kidneys are not functioning properly, the level of sodium and potassium in your body may be affected.Electrolyte problems with kidney disease can be serious, Since the right amount of potassium is necessary for proper functioning of your heart, kidney problems may result in abnormal heart rhythms.
Abnormal blood pressure, whether high or low can result in kidney damage. Kidney damage, in turn, can cause problems with regulating your blood pressure.
The kidneys are also responsible for making a hormone involved in the production of red blood cells. For this reason, kidney disease can result in anemia, a lower red blood cell count.
Some people have urinary problems, such as difficulty urinating. Occasionally people also have flank pain, due to the location of the kidneys.
Nonspecific or vague symptoms are common, and a reason why you should see your healthcare provider even if you can't precisely identify your symptoms. These may include fatigue, insomnia, or a metallic taste in your mouth.
Early on with kidney disease, and sometimes even with advanced kidney disease, people may have few symptoms. In fact, the most common symptom of kidney disease is no symptoms at all!
Diagnosing Kidney Disease
There are several different types of tests which can be done to screen for and follow kidney problems. These include blood tests such as BUN(blood urea nitrogen), Cr (creatinine), and GFR (glomerular filtration rate), urine tests (especially looking for protein in the urine), and imaging tests such as CT, MRI, and IVP.
When to Get a Referral to a Nephrologist
The time it's best to see a nephrologist can certainly vary depending on your particular conditions. That said, you should ideally be seen by a nephrologist when your glomerular filtration rate (GFR) starts trending down.
Seeing a nephrologist is vital.Multiple medical studieshave clearly proved that patients who are referred late to nephrologists aremore likely to die, orprogress to dialysis.
Risk Factors for Kidney Disease
Since kidney disease can become serious before symptoms are present, it's important to have a high index of suspicion and be aware of conditions which predispose you to kidney disease. People who are at greater risk of developing renal failure include those with:
- Diabetes
- Long-standing high blood pressure
- Heart diseases such as coronary artery disease, or congestive heart failure
- Other vascular diseases such as cerebrovascular disease (strokes) and peripheral vascular disease (such as aortic aneurysms)
- A family history of kidney disease
- Prolonged use of non-steroidal anti-inflammatory drugs (NSAIDS) such as Advil (ibuprofen) and Celebrex
Treatments
Most early kidney issues can be treated with medications or changes in what you are drinking (fluids). In advanced stages nephrologists may need to initiate dialysis since this is the only way your body will be able to remove toxins and balance electrolytes (the kidneys have failed and can not do that job anymore).
Being Your Own Advocate With Your Kidneys
When it comes to living with kidney disease, recovery usually does not happen once your GFR has chronically declined to the advanced stages. Hence, the emphasis really needs to be on prevention.The next time you see your healthcare provider make sure to discuss the results of your GFR and ask if you should beseen by a specialist.
Bottom Line on When to See a Kidney Doctor
The best time to see a kidney doctor will vary based on your kidney function, the particular renal condition you have, and other risk factors. It appears that a referral to see a nephrologist should be considered for an elevated Cr (stage 4) or a GFR less than 30, but some people should see a kidney doctor much sooner. Since timely consultation with a nephrologist is correlated with survival, it's best to err on the side of seeing one of these healthcare providers earlier rather than later.
Kidney Disease Doctor Discussion Guide
Get our printable guide for your next healthcare provider's appointment to help you ask the right questions.
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Cleveland Clinic. Kidney Failure.
(Video) How to Keep Your Kidneys Healthy: 10 Ways To Fight Kidney Disease!Potpara TS, Jokic V, Dagres N, et al. Cardiac Arrhythmias in Patients with Chronic Kidney Disease: Implications of Renal Failure for Antiarrhythmic Drug Therapy. Curr Med Chem. 2016;23(19):2070-83. doi:10.1093/eurheartj/ehy060
Centers for Disease Control. National Chronic Kidney Disease Fact Sheet.
Kazancioğlu R. Risk factors for chronic kidney disease: an update. Kidney Int Suppl (2011). 2013;3(4):368-371. doi:10.1038/kisup.2013.79
National Institute of Diabetes and Digestive and Kidney Diseases. Choosing a Treatment for Kidney Failure.
Additional Reading
Kim, D., Kim, M, Kim, H. et al. Early Referral to a Nephrologist Improved Patient Survival: Prospective Cohort Study for End-Stage Renal Disease in Korea. PLoS One.
Smart, N., and T. Titus. Outcomes of Early versus Late Nephrology Referral in Chronic Kidney Disease: A Systematic Review. American Journal of Medicine.
Smart, N., Dieberg, G., Ladhani, M., and T. Titus. Early Referral to Specialist Nephrology Services for Preventing Progression to End-Stage Kidney Disease. Cochrane Database for Systematic Reviews.
By Veeraish Chauhan, MD
Veeraish Chauhan, MD, FACP, FASN, is a board-certified nephrologist who treats patients with kidney diseases and related conditions.
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FAQs
What are the 3 early warning signs of kidney disease? ›
- Dizziness and Fatigue. One of the first possible signs of weakening kidneys is the experience of overall weakness in yourself and your overall health. ...
- Swelling (Edema) ...
- Changes in urination.
If you have diabetes, get checked every year. If you have high blood pressure, heart disease, or a family history of kidney failure, talk with your health care provider about how often you should get tested. The sooner you know you have kidney disease, the sooner you can get treatment to help protect your kidneys.
When should you worry about your kidneys? ›Generally, earlier stages are known as 1 to 3. And as kidney disease progresses, you may notice the following symptoms. Nausea and vomiting, muscle cramps, loss of appetite, swelling via feet and ankles, dry, itchy skin, shortness of breath, trouble sleeping, urinating either too much or too little.
What are the signs that your kidneys are not working properly? ›- Decreased urine output, although occasionally urine output remains normal.
- Fluid retention, causing swelling in your legs, ankles or feet.
- Shortness of breath.
- Fatigue.
- Confusion.
- Nausea.
- Weakness.
- Irregular heartbeat.
- High blood pressure.
- Swelling in your hands or feet.
- Urinary tract infections.
- Protein in your urine.
- Blood in your urine (also called hematuria)
- Kidney damage that shows up in an ultrasound, CT scan, MRI, or kidney biopsy.
Glomerular filtration rate is the best overall indicator of kidney function. It is superior to the serum creatinine level, which varies with age, sex, and race and often does not reflect kidney function accurately.
How can I check my kidney at home? ›- Best blood sample test: LetsGetChecked Kidney Test.
- Best blood test for detailed results: Verisana Kidney Function Test.
- Best urine-based test: Healthy.io Minuteful Kidney.
- Best combination kit: Labcorp OnDemand Kidney Health Test Package.
When kidneys are failing, the increased concentration and accumulation of substances in urine lead to a darker color which may be brown, red or purple. The color change is due to abnormal protein or sugar, high levels of red and white blood cells, and high numbers of tube-shaped particles called cellular casts.
What are the symptoms when creatinine is high? ›Symptoms that go along with high creatinine and can develop rapidly may include: fluid retention, particularly in your lower body. passing low amounts of urine. feeling weak or fatigued.
What are 3 diseases that affect the kidney? ›- Atypical hemolytic uremic syndrome (aHUS)
- Alport syndrome.
- Amyloidosis.
- Cystinosis.
- Fabry disease.
- Focal segmental glomerulosclerosis (FSGS)
- Glomerulonephritis (glomerular disease)
- Goodpasture syndrome.
What does it feel like when your kidneys hurt? ›
Kidney pain often feels like a dull ache that gets worse if someone gently presses on that area. While it is more common to feel kidney pain on only one side, some health problems may affect both kidneys and cause pain on both sides of your back.
What are the 5 stages of kidney failure? ›- Stage 1 with normal or high GFR (GFR > 90 mL/min)
- Stage 2 Mild CKD (GFR = 60-89 mL/min)
- Stage 3A Moderate CKD (GFR = 45-59 mL/min)
- Stage 3B Moderate CKD (GFR = 30-44 mL/min)
- Stage 4 Severe CKD (GFR = 15-29 mL/min)
- Stage 5 End Stage CKD (GFR <15 mL/min)
- A constant, dull ache in your back.
- Pain in your sides, under your rib cage or in your abdomen.
- Severe or sharp pain that comes in waves.
- Pain that spreads to your groin area.
- Kidney pain is often accompanied by nausea or vomiting, especially if the pain is due to kidney stones.
It was thought that kidney cells didn't reproduce much once the organ was fully formed, but new research shows that the kidneys are regenerating and repairing themselves throughout life. Contrary to long-held beliefs, a new study shows that kidneys have the capacity to regenerate themselves.
Where do you itch with kidney disease? ›Itching with kidney disease can be generalized, or it can occur in specific parts of the body. Common areas for this type of itching include the head, arms, back, and abdomen. It also tends to be worse at night, which can disturb your sleep.
Can early stage kidney disease be cured? ›Living with stage 1 kidney disease
There is no cure for kidney disease, but it may be possible to stop its progress or at least slow down the damage. In many cases, the correct treatment and lifestyle changes can help keep a person and their kidneys healthier longer.
- Protein in your urine.
- High blood pressure.
- Swelling in your hands or feet.
- Urinary tract infections.
- Blood in your urine (also called hematuria)
- Kidney damage that shows up in an ultrasound, CT scan, MRI or kidney biopsy.
Urine albumin-to-creatinine ratio (UACR).
A UACR test lets the doctor know how much albumin passes into your urine over a 24-hour period. A urine albumin test result of 30 or above may mean kidney disease. It's important to know that: The test may be repeated once or twice to confirm the results.
In people with acute kidney failure, though, kidney failure develops rapidly over a few hours or a few days. People at high risk are those who are already hospitalized, or who are critically ill from other causes and need intensive care. Acute kidney failure requires immediate treatment.
How long can kidney disease go undetected? ›2 out of 5 adults who have CKD don't know they have severe chronic kidney disease. People with CKD can live for years without knowing, as it doesn't always have the most clearly defined symptoms.
How long can you live with kidney disease? ›
Without dialysis or a kidney transplant, kidney failure is fatal. You may survive a few days or weeks without treatment. If you're on dialysis, the average life expectancy is five to 10 years. Some people can live up to 30 years on dialysis.
What vitamins are hard on kidneys? ›You may need to avoid some vitamins and minerals if you have kidney disease. Some of these include vitamins A, E and K. These vitamins are more likely to build up in your body and can cause harm if you have too much.
What part of the body is kidney pain? ›You might feel kidney pain or discomfort as a dull, one-sided ache in your upper abdomen, side or back. But pain in these areas is often unrelated to your kidneys. Your kidneys are situated in the back of your abdomen under your lower ribs, one on each side of your spine.
Is clear pee good? ›Clear urine is a sign of good hydration and a healthy urinary tract. However, if they consistently notice clear urine and also have extreme or unusual thirst, it is best to speak to a doctor.
What happens when your kidneys start shutting down? ›If your kidneys stop working completely, your body fills with extra water and waste products. This condition is called uremia. Your hands or feet may swell. You will feel tired and weak because your body needs clean blood to function properly.
Do kidneys have anything to do with poop? ›Increasingly severe constipation was linked to a higher risk of developing kidney disease. Dr. Kovesdy points to the link between our intestinal health and our kidneys, suggesting his study sheds light on the causes of kidney disease, as well as treatment and prevention.
What medications cause high creatinine levels? ›Several drugs, such as cimetidine, trimethoprim, corticosteroids, pyrimethamine, phenacemide, salicylates and active vitamin D metabolites, have been reported to increase plasma creatinine without influencing its glomerular filtration.
Does walking reduce creatinine? ›Walking every day should be a very healthy form of exercise and should not change your serum creatinine in any way.
What foods to avoid if your creatinine is high? ›Reduce your protein intake
People following diets very high in red meat or other protein sources, including dairy products, may have higher creatinine levels than people who eat fewer of those foods. If you eat lots of red meat, switch to more vegetable-based dishes. Try swapping out beef burgers for: vegetable patties.
When kidneys are failing, the increased concentration and accumulation of substances in urine lead to a darker color which may be brown, red or purple. The color change is due to abnormal protein or sugar, high levels of red and white blood cells, and high numbers of tube-shaped particles called cellular casts.
Where do you itch with kidney disease? ›
Itching with kidney disease can be generalized, or it can occur in specific parts of the body. Common areas for this type of itching include the head, arms, back, and abdomen. It also tends to be worse at night, which can disturb your sleep.
How can I check my kidney at home? ›- Best blood sample test: LetsGetChecked Kidney Test.
- Best blood test for detailed results: Verisana Kidney Function Test.
- Best urine-based test: Healthy.io Minuteful Kidney.
- Best combination kit: Labcorp OnDemand Kidney Health Test Package.
It was thought that kidney cells didn't reproduce much once the organ was fully formed, but new research shows that the kidneys are regenerating and repairing themselves throughout life. Contrary to long-held beliefs, a new study shows that kidneys have the capacity to regenerate themselves.
What are 5 common causes of kidney failure? ›- Diabetes, which is the most common cause.
- High blood pressure, which is the second most common cause.
- Autoimmune diseases, such as lupus and IgA nephropathy.
- Genetic diseases (diseases passed down from one or both parents), such as polycystic kidney disease.
- Nephrotic syndrome.
Clear urine is a sign of good hydration and a healthy urinary tract. However, if they consistently notice clear urine and also have extreme or unusual thirst, it is best to speak to a doctor.
What are the 5 stages of kidney failure? ›- Stage 1 with normal or high GFR (GFR > 90 mL/min)
- Stage 2 Mild CKD (GFR = 60-89 mL/min)
- Stage 3A Moderate CKD (GFR = 45-59 mL/min)
- Stage 3B Moderate CKD (GFR = 30-44 mL/min)
- Stage 4 Severe CKD (GFR = 15-29 mL/min)
- Stage 5 End Stage CKD (GFR <15 mL/min)
Half-and-half nails, absence of lunula, and splinter hemorrhage are the most frequent nail alterations in patients with chronic renal failure. Half-and-half nails, or Lindsay's nails, are characterized by a red, pink, or brown discoloration of the distal nail bed occupying 20%-60% of the nail length.
What are 3 common causes of chronic kidney disease? ›- Diabetes. Too much glucose, also called sugar, in your blood damages your kidneys' filters. ...
- High blood pressure. High blood pressure can damage blood vessels in the kidneys so they don't work as well. ...
- Other causes of kidney disease. Other causes of kidney disease include.
Common eye problems for people with kidney disease or who are on dialysis. Dry, red, and sore eyes that feel gritty. These symptoms may occur because of impaired blinking and tear formation, leading to dry eyes. Extra calcium and phosphate can also settle in the eyes and cause irritation.
Can bloodwork show kidney problems? ›Because your kidneys remove waste, toxins, and extra fluid from the blood, a doctor will also use a blood test to check your kidney function. The blood tests will show how well your kidneys are doing their job and how quickly the waste is being removed. Here are a few blood tests that are used: Serum creatinine.
How can I tell if my back pain is kidney related? ›
- A constant, dull ache in your back.
- Pain in your sides, under your rib cage or in your abdomen.
- Severe or sharp pain that comes in waves.
- Pain that spreads to your groin area.
- Kidney pain is often accompanied by nausea or vomiting, especially if the pain is due to kidney stones.
Kidney pain often feels like a dull ache that gets worse if someone gently presses on that area. While it is more common to feel kidney pain on only one side, some health problems may affect both kidneys and cause pain on both sides of your back.
How do you strengthen your kidneys? ›- Make healthy food choices. ...
- Make physical activity part of your routine. ...
- Aim for a healthy weight. ...
- Get enough sleep. ...
- Stop smoking. ...
- Limit alcohol intake link. ...
- Explore stress-reducing activities. ...
- Manage diabetes, high blood pressure, and heart disease.
ACE inhibitors and ARBs are two types of blood pressure medicine that may slow the loss of kidney function and delay kidney failure.
How can I rebuild my kidneys? ›- Stay hydrated. The most common reason for the formation of kidney problems is lack of water. ...
- Vitamin C. Vitamins and minerals are powerful antioxidants. ...
- Apples. ...
- Kidney beans. ...
- Lemon juice and honey. ...
- Watch blood pressure. ...
- Dates.