What is nephrology?
Nephrology is a subspecialty of internal medicine. It deals with the diseases of the kidney and its conservative (non-surgical) therapy. In addition, include high blood pressure, disorders of fluid and electrolyte balance and disorders of acid-base balance to a field. The main aim of nephrologists is the stabilization of renal function in order to delay the need for continuous renal replacement therapy (hemodialysis, peritoneal dialysis) as far as possible. Typical problems associated with chronic renal impairment are renal anemia, hypertension, renal osteomalacia and the need for dose adaptation of many renal-eliminated drugs. If renal disease has occurred, the nephrologist leads the dialysis treatments and / or prepares the kidney.
Their follow-up is also one of the tasks of the neurologists, as well as the treatment of patients with high blood pressure and the implementation of the various Lipidaphereseverfahren in patients with severely elevated blood lipid levels. In the context of intensive care medicine is the nephrologist, acute renal failure, e.g treated after multiple trauma, sepsis or intoxication by dialysis method. Finally, many poisonings are treated in this way.
Diagnostic methods
The Nephrology uses essentially the following method:
Laboratory diagnostics
Blood
To assess the renal function and acid-base balance in general, the following parameters are analyzed in serum:
-Creatinine
-Urea
-Uric acid
-Sodium
-Potassium
-Calcium, usually together with phosphate
-Chloride
-Protein
In addition, the blood count and blood gas analysis are determined regularly. Depending on the problem or underlying (or suspected) disease further analyzes are required if applicable.
Urine
Here, the random urine or midstream urine be distinguished from the urine. In the investigation of spontaneous urine following parameters are semiquantitative strip test examines:
-Erythrocytes or hemoglobin
-Leukocytes
-Protein
-PH
-Nitrite
-Ketone bodies
-Glucose
Usually a transmitted light microscopy is connected, striking more urine constituents such as cells or casts can be further differentiated. To answer the question whether blood in the urine comes from the kidneys or the urinary tract, a phase-contrast microscopy is performed in dark-field technique often additionally.
For further clarification of the cause of kidney disease, a urine examination is often necessary in the urine collected the entire amount over a defined period (usually 24 hours) and the composition is then analyzed.
Renal diseases
The following medical conditions are at the heart field of nephrology (the list is not exhaustive):
Glomerulopathies
-Acute and subacute glomerulonephritis
-Chronic glomerulonephritis
-Glomerular disorders in other underlying diseases
Interstitial nephropathies
-Acute interstitial nephritis
-Analgesic
Post Renal nephropathy
-Reflux nephropathy
-Obstructive nephropathy
Other Nephropathies
-Balkan nephropathy
-Shine nephritis
-Uratnephropathie
-Nephrocalcinosis
Renal involvement in systemic diseases
-Diabetic nephropathy
-Hypertensive nephropathy or Nephrosclerosis
-Amyloidosis
-Plasmacytoma
-Sarcoidosis
-Rheumatic diseases
-Connective tissue diseases
-Vasculitis
-Diseases of the immune system such as goodpasture's syndrome, Cryoglobulinemia
Hereditary diseases of the kidney
-Renal cyst
-Medullary sponge kidney
-Nephronophthisis
-Alport syndrome
-A variety of hereditary tubulopathies, including renal glucosuria, Renal Tubular Acidosis, Bartter syndrome, diabetes insipidus, diabetes insipidus
-Metabolic disease with renal impairment, including galactosemia, Wilson's disease, cystinosis, Lowe syndrome, Fabry disease, LCAT deficiency
High-pressure conditions
-Primary hypertension
-Renovascular hypertension and renal artery stenosis
Kidney and Hypertension disorders in pregnancy
-Pregnancy hypertension
-Renal dysfunction in pregnancy