Subspecialty Careers: Nephrology
The Discipline
The word nephrology comes from the word nephros, the Greek word for kidney. Nephrology involves the diagnosis and management of diseases of the kidneys, the contiguous collecting system, and the associated vasculature.
The commonly encountered conditions in nephrology include disorders of fluid, electrolyte, and acid-base balance. Other problems include disorders involving the glomerulus, asymptomatic urine abnormalities, tubulointerstitial disorders, renal vascular diseases, renal failure, nephrolithiasis, tubular defects, and infections and neoplasms of the kidney, collecting system, and bladder. The nephrologist must understand how systemic diseases affect the kidneys, and recognize the potential toxicities of various therapeutic and diagnostic agents.
Procedures
Important procedural skills for the nephrologist include peritoneal dialysis, percutaneous kidney biopsy, and temporary placement of vascular access for hemodialysis. In addition, the nephrologist is expert at interpreting 24-hour urine excretion of minerals and electrolytes, serological tests for evaluating glomerulopathies, acid-base studies, and studies of sodium and water balance.
Training
Nephrology fellowship training requires two years of accredited training beyond general internal medicine residency. Of the two years, a minimum of 12 months must include clinical training in the diagnosis and management of a broad spectrum of renal diseases.
Certification
The American Board of Internal Medicine, ABIM, offers certification in nephrology.
Training Positions
For the 2012-2013 academic year, there are 147 ACGME-accredited training programs in Nephrology with 903 active positions.
Major Professional Societies
Major Publications
- American Journal of Kidney Diseases
- Journal of the American Society of Nephrology
- Kidney International