SERVICES
Nephrology/Kidney disease
Nephrology is a vital subspecialty of internal medicine that focuses on the kidneys’ structure, functions, and diseases. The kidneys play a crucial role in maintaining homeostasis; they filter blood, remove waste, balance electrolytes, regulate blood pressure, and produce hormones critical for red blood cell production and bone health. Consequently, nephrologists are tasked with diagnosing and managing a variety of renal-related conditions that can significantly impact overall health.
Chronic Kidney Disease (CKD)
CKD is a progressive loss of kidney function over time, typically due to diabetes, hypertension, or glomerulonephritis. Internists monitor CKD through regular assessments of kidney function, managing the underlying conditions, and implementing lifestyle changes and medications to slow progression.
Acute Kidney Injury (AKI)
This condition is characterised by a sudden decline in renal function, often reversible with prompt treatment. Causes include dehydration, medication effects, and post-surgical complications. Internists treat AKI by addressing the underlying causes, ensuring proper fluid management, and monitoring renal parameters closely.
Diabetic Nephropathy
A common complication of diabetes, this condition leads to progressive damage to the kidneys. Internists focus on tight glycaemic control, controlling blood pressure with ACE inhibitors or ARBs, and regularly monitoring kidney function to delay progression.
Hypertensive Nephropathy
Chronic high blood pressure can cause significant kidney damage. Internists play a critical role in managing hypertension through a combination of dietary changes, antihypertensive medications, and lifestyle modifications aimed at protecting renal function.
Glomerulonephritis
This encompasses a variety of inflammatory conditions affecting the kidney’s glomeruli. Symptoms may include blood in the urine, proteinuria, and oedema. Internists collaborate with nephrologists for management that may involve immunosuppressive therapy, lifestyle changes, and monitoring for complications.
Electrolyte Disorders
Conditions such as hyperkalemia (high potassium) or hyponatraemia (low sodium) result from kidney dysfunction. Internists evaluate and manage these imbalances, often requiring dietary adjustments or medications to restore equilibrium.
FAQ
• Four times for four hours weekly
• Five times for three hours weekly
• Six days for eight hours in the night per week
• Cramps
• A drop in your blood pressure
• Risk of infection at the site of entry
• Blood clotting
"It all starts by caring enough to engage the patient in the decision-making. Many people argue that 'We don't have time for this in the consultation. I'd rather just tell people what I think is best for them, and then, they can decide whether they want it or not.' Well, that's not very caring. This might be efficient, but it does not reflect the best that we can offer.'"
Dr Victor Montori, on shared decision-making