What is a nephrologist?

The word "nephrology" is made up of the two ancient Greek words νεφρός (kidney) and λόγος (teaching). It therefore translates as "the science of the kidneys" or "renal science". As a branch of internal medicine, nephrology encompasses numerous tasks relating to the kidneys and the diseases of this organ. In the following article, we take a closer look at this exciting specialism and show you how you can become a nephrologist.

What does a nephrologist actually do?

A nephrologist is a medical specialist who specialises in kidney diseases. The most common tasks in nephrology include the diagnosis and treatment of renal insufficiency, kidney failure and high blood pressure associated with the kidneys.

The nephrologist treats patients with diabetes mellitus, for example, to prevent kidney damage. He also carries out dialysis treatments and is an important point of contact in the event of a kidney transplant. He works closely with urologists and deals with metabolic disorders and the body's fluid and electrolyte balance. The

Aftercare following kidney disease and the prevention of kidney damage are also important focal points in nephrology. Nephrologists offer specialised care and are the central point of contact for complex kidney problems.

What is the difference between nephrology and urology?

Nephrology and Urology are different specialisms that are often confused by laypeople. We would therefore like to clarify how nephrology differs from urology.

Nephrology focusses on the function of the kidneys and corresponding kidney diseases. Nephrologists treat renal insufficiency, kidney failure and certain hypertensive diseases, for example.

They carry out dialysis and, if necessary - together with transplant doctors - a kidney transplant and take care of aftercare. The urologist, on the other hand, treats diseases of the urinary tract, including the kidneys, urethra and bladder.

Urologists perform surgical procedures more frequently than nephrologists and also treat prostate problems, among other things. Urology and nephrology often work together, especially in complex diseases. Nevertheless, their work differs significantly.

Common clinical pictures of the kidney

The speciality of nephrology is extremely diverse, as there are numerous diagnoses and treatment options that you have to deal with as a nephrologist, from simple renal pelvic inflammation to the need for a kidney transplant.

It would go beyond the scope of this article to go into all the diseases that nephrology specialists are confronted with. We would therefore like to present some examples of common problems.

Kidney stones

Kidney stones are crystalline deposits in the kidneys that can be caused by disorders in the mineral metabolism. One of their main effects is severe pain.

Treatment ranges from fluid intake to eliminate small stones to ultrasound treatment and surgical interventions.

Kidney tumours

Kidney tumours can be malignant or benign. They are often only recognised when they impair kidney function. The treatment options include Surgeryradiotherapy and chemotherapy.

Cystic kidneys (polycystic kidney disease)

Polycystic kidney disease is a genetic disorder in which numerous cysts form in the kidneys and impair kidney function. Symptoms include high blood pressure and altered urine. Treatment includes effective pain management and, in severe cases, kidney transplantation.

Diabetic nephropathy

Diabetic nephropathy is a common kidney disease in nephrology and is defined as affecting people with diabetes. It leads to a gradual deterioration in kidney function. Symptoms include high blood pressure and increased protein loss, which can be detected in the urine.

Early treatment and correct blood glucose control are crucial to avoid the need for renal replacement therapy.

Pyelonephritis

Pyelonephritis is a bacterial infection of the kidney. It causes fever, pain and changes in the urine. Nephrology specialists treat this disease with antibiotics. Prompt treatment is important and aims to prevent serious complications and damage to the organism.

Replacement of certain functions of damaged kidneys

In patients with severe kidney disease or specific metabolic disorders, the kidneys can no longer fulfil their vital filtering function to a sufficient extent. In nephrology, these functions are then performed outside the body by machines. There are two main procedures involved:

Dialysis

Dialysis is an important form of treatment in nephrology. It fulfils an important function of the kidneys in patients with renal insufficiency and kidney failure. The blood is cleansed of waste products and excess salt and then returned to the body.

Dialysis saves lives and is therefore an important achievement of modern medicine. However, it is stressful for patients, which is why the prevention of disease and the long-term preservation of kidney function should always be the main goals of renal medicine.

Apheresis

Apheresis is a special type of blood washing in which harmful substances are removed directly from the blood. This method is used for serious metabolic disorders or severe infections. Apheresis offers an effective treatment option for patients with rare diseases or special kidney conditions.

The type of apheresis depends on the type of kidney disease present. For example, certain proteins such as autoantibodies, certain cell types or fats can be filtered out of the blood.

How to become a nephrologist

As nephrology is a speciality of internal medicine, the full title for trained specialists in this field is "specialist in internal medicine and nephrology". In order to become a nephrologist, you must first Study medicine and then undergo six years of further training to become a specialist.

Study of human medicine

The medical degree programme is the foundation stone for your career as a nephrologist. It has a standard period of study of six years. The degree programme is divided into a clinical and a pre-clinical part. In the pre-clinical part, the main focus is on basic subjects, in particular anatomy, physiology and biology.

The clinical section then deals with the individual medical specialities, including the speciality of nephrology. Finally, you will complete a practical year (PJ) and will have achieved your first goal after the state examination: you will be allowed to work as a doctor and treat patients.

Training as a specialist in internal medicine and nephrology

After studying medicine and obtaining your licence to practise medicine, you have the opportunity to obtain the title "Specialist in Internal Medicine and Nephrology" through 72 months of further training and a subsequent specialist examination.

During your training, you will complete at least 36 months in internal medicine, including at least 6 months in dialysis and 24 months in inpatient care.

In addition, 24 months in two other specialist competences are required, as well as 6 months in the emergency department and 6 months in intensive care medicine.

After successfully passing the specialist examination, you can use the title Specialist in Internal Medicine and Nephrology and are optimally prepared to treat people with kidney disease.