Nephrology or Renal Medicine is a branch of internal medicine devoted to the study, diagnosis, and treatment of kidney disease.
The kidneys remove waste products, toxins, drugs and excess fluids from the blood, which are then excreted in the urine. The kidneys are also very important in the control of blood pressure and produce active vitamins and hormones that help keep bones strong and prevent anaemia.
Kidney disease results in the loss of the kidney’s ability to clear waste products, which then accumulate in the blood. Kidney function is therefore usually assessed by measuring the levels of waste products in the blood. This includes measuring the levels of creatinine in the blood. As kidney function declines creatinine levels build up in the blood.
Kidney disease can also be detected by examining urine. Testing the urine for blood and protein is also a very sensitive indicator of kidney damage.
Because the kidneys are involved in the control of blood pressure, an early sign of kidney damage is the development of high blood pressure.
However in the early stages of kidney disease there are often few symptoms. Kidney disease may not become apparent until there is a significant loss of kidney function. It is therefore necessary to use blood tests and urine tests to detect early kidney disease.
Untreated kidney disease can lead to irreversible loss of kidney function and can progress to end-stage kidney failure. In the advanced stage of kidney disease dangerous levels of fluid and wastes accumulate in the body. In many situations advanced and severe kidney disease will require dialysis or transplantation.
Common kidney disorders include
Chronic Kidney Disease: Treatment for chronic kidney disease focuses on identifying the cause and slowing the progression of the kidney damage. This is achieved by treating the underlying cause and by treating high blood pressure. In addition chronic kidney disease is often complicated by the development of accelerated cardiovascular disease, anaemia and bone disease. Effective management of chronic kidney disease includes reducing the risk of cardiovascular disease and correcting anaemia and bone disease.
Diabetic Kidney Disease is the most common cause of kidney disease in Australia. The majority of diabetic nephropathy arise in patients with Type 2 diabetes who initially present with protein in the urine and hypertension. However, other causes of kidney damage need to be considered in patients with diabetes including renovascular disease, atheroembolism, toxin exposures, or other glomerular diseases. Several studies have demonstrated that strict control of blood pressure, blood glucose and lipids can prevent or delay the progression of diabetic kidney disease.
Other causes of kidney damage that can result in chronic kidney disease include:
- Renovascular disease,
- Hypertensive disorders.
- Immunologic renal disease including primary and secondary glomerulonephritis,
- Inherited kidney diseases including polycystic kidney disease.
In some instances kidney disease is so severe that it results in significant loss of kidney function such that waste products accumulate to dangerous levels in the blood. In such circumstances dialysis may be required. Dialysis treatments include hemodialysis and peritoneal dialysis. In addition some patients may benefit from receiving a kidney or kidney pancreas transplant.
Specialist Kidney Services provided by Professor Kesh Baboolal include the assessment and treatment of patients with:
- Diabetic kidney disease
- Chronic kidney disease
- Glomerular disease
- Acute Kidney Injury
- Hypertension
- Renal artery stenosis
- Resistant Hypertenison
- Polyciystic and inherited kidney disease
- Dialysis treatments
- Kidney Transplant
- Kidney Pancreas Transplants