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People do not generally think too much about their kidneys, yet they are a vital part of our life system. Nephrologists are specialists who are experts in the treatment of kidney insufficiency and kidney disease. Nephrology refers to the field related to medical conditions of the kidney. Nephrologists treat people with kidney diseases of various types, including kidney failure, cystic kidney disease, inflammation of blood vessels in the kidneys, kidney stones, and pediatric kidney problems. Nephrology also includes illnesses caused by abnormalities of the body's water and mineral balance, hypertension (high blood pressure) and diabetes-related kidney diseases.

The kidneys are an important part of our bodies. Their primary function is to remove fluid and waste from the body in the form of urine. The body has two kidneys, yet if one of them is damaged, stops working, or is donated for kidney transplant, the body can function with only one kidney. If both kidneys stop functioning, patients experience end-stage renal disease (ESRD), or total kidney failure. Without immediate treatment, a fatality may occur in days due to the build-up of toxins and fluid in their body. The kidneys also regulate blood pressure and the balance of certain important elements in the body such as potassium, sodium, calcium, phosphate and magnesium.

Nephrologists may be consulted for problems due to abnormal development of the kidneys such as hydronephrosis, or to help care for a baby when their kidneys are not functioning correctly. Nephrologists might order tests, such as an electrolytes or abdominal ultrasounds to evaluate these problems. They work closely with patients with kidney failure and provide consultation services to patients with questions about various kidney problems.

Prevention and treatment methods range from special diets to transplants. Patients with abnormal kidney functions often require very specialized diets, including drinking excessive fluids. Some nephrologists recommend medications to control blood pressure, which help slow or prevent progressive kidney disease. Patients with more advanced kidney disease often need other medications to control or prevent acid build-up, bone disease and anemia.

Another method of treatment is through dialysis. Although dialysis is not a cure, it is a life-saving process that artificially replaces some of the functions of the kidney. There are generally two types of dialysis: hemodialysis and peritoneal dialysis. Hemodialysis involves removing blood from the body and filtering it in a machine. Alternatively, peritoneal dialysis is internal or in-body dialysis, using a blood-cleansing solution called dialysate that is infused via a catheter placed into the peritoneal cavity, the region of the abdomen that is lined by the peritoneum. The dialysate works to extract toxins and excess fluid from the blood. After a period of time, the solution is then drained from the body and fresh fluid replaced.

The most serious form of treatment, usually used as a last resort, is transplantation. The best possible source of kidney donation is a close relative whose blood and tissue-type match the patient. New anti-rejection drugs have improved the success rates of transplants from organ donations received from other than blood relatives.
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  Interests and Skills  
Nephrologists are interested in helping people, first and foremost. They have the intellectual ability required to successfully complete the academic training and to pursue a course of lifelong learning and the stamina required to work long hours. They have excellent communication skills and can get along with people well and instill confidence. They will need emotional strength and maturity, and passion, empathy and energy.

Nephrologists should enjoy finding solutions to problems, dealing with people, and directing the work of others. They must also be proficient in nephrological medicine - they must have and apply the knowledge to diagnose illnesses. Also, ethics is a strong point for these types of people because they have to do what is right for their patients with their best interests in mind.

  Typical Tasks  
  • Diagnose and treat diseases and disorders of the kidneys and genitourinary organs
  • Examine patients using x-ray machines, fluoroscopes, and other equipment to aid in determining the nature and extent of disorders or injuries of the kidneys
  • Treat patients using diathermy machines, catheters, cystoscopes, radium emanation tubes, and similar equipment
  • Perform dialysis, surgery on damaged and cancerous kidneys, and transplant surgery in the most serious cases
  • Prescribe and administer antibiotics and anti-rejection drugs to combat infections or relapses
  • A nephrologist's working conditions depend on where they work. However, most work long days, about 60 to 70 hours per week. They may work rotating shifts or be on call. When on call, they can be called into the hospital at any time, day or night. Some also work evenings and weekends to accommodate patients' schedules. In a typical day, most nephrologists see a succession of patients, and may spend a considerable amount of time doing paperwork. This occupation can be both emotionally demanding and emotionally rewarding.

  Workplaces, Employers and Industries  
  • Nephrologists work in hospitals, universities, have their own private practice or work with a group of other specialists in a group practice. Some also work for pharmaceutical companies and research facilities.

  Long Term Career Potential  
Nephrologists can learn new skills, add more patients, or change jobs. They may work primarily as surgeons, specialize as oncologists, or become directors of research, hospital administrators, medical school administrators, and teachers in medical schools and residency programs. They may manage clinics or do research for pharmaceutical companies. They may also write and publish in scientific and medical journals or take jobs in medical public relations.

  Educational Paths  
Becoming a nephrologist requires a long educational road, so be prepared for a lifelong learning experience. Most nephrologists start with a Bachelor of Science degree, however some Bachelor of Arts graduates may be accepted into medical school programs. While in high school, take math and science classes. Also, not all medical schools require a bachelor's degree and with good marks, some students can get accepted after two years of undergraduate studies. Check with the school for their requirements before applying.

Nephrologists complete four years of medical school and then spend four to six years in a residency program in nephrology. Completion of the qualifying licensing examinations is required to practice medicine. Licensure by the regional licensing authority is required.

Finally, before entering medical school, volunteer in a hospital, nursing home or community center. This will give you valuable experience in dealing with people who need help and what it is like to work as a doctor.

Bureau of Labor Statistics, U.S. Department of Labor, Occupational Outlook Handbook, 2014-15 Edition, http://www.bls.gov/ooh/
Bureau of Labor Statistics, U.S. Department of Labor, Occupational Employment Statistics, 2002, http://www.bls.gov/oes/2002/oes_nat.htm

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