nephrology

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jayman

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sorry if this sounds elementary to some, but could someone comment on the most common/frequent things that a nephrologist does during the course of a day? just trying to get a flavor for the field.

thanks.

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most function as consultants for patients with renal disease in the hospital; most places do not admit patients as part of a "renal service" (maybe in larger centers that i am not used to seeing). most oversee dialysis units and clinics (HD and PD). clinics can cover anything from pre-transplant, hypertension-related issues, and management of CRI/CRF.

most nephrologists in private practice, at least the one that takes care of 2 of my family members, do a lot of general IM management as well. One was called in for my grandmother when she needed plasmapheresis in the hospital for CIDP.

personally, i think the need for nephrologists and hepatologists will rise as this population gets "greyer"; as long as HTN and DM continue to be prevalent, those who end up needing transplants will rise. Liver disease is not as prevalent, but since most of that is chronic, the need for hepatologists down the road will be there for pre-transplant assessment, I think.

-S.
 
The work of a nephrologist can be divided into maintenance and replacement. The maintenance deal with HTN, DM, other kidneys disease and renal insufficiency in general and keep the patients from HD. the replacement deals with HD and transplant and quality of life.
Depends on how long you get in your career and how many patients you have, a nephrologist can just see renal patients and let PCPs take care of other medical problems. Many nephrologists elect to do general medicine (30%) and 70% of their time for kidney related.
In term of practice, majority of nephrologists work as a group so that they can share the call schedule. Because of that they can afford to see pts at different hospitals. They can work at a contractor with dialysis or take care of HD center of their own practice
 
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Dialysis, and any patient in the hospital with an unexplained rise in creatinine, basically is the majority of the day (or often, and explainable rise, even). Then there's the occasional interesting case, like polycystic kidney, Wegener's, Goodpasture's, etc. Depends on where you practice, too. But the future is dialysis.
 
I'm a little fuzzy in understanding the jurisdiction of the liver. In my experience, GI docs handle liver disease very well, and they are trained to do so. Where does the hepatologist come into play?
 
Originally posted by RockandRolldoc
I'm a little fuzzy in understanding the jurisdiction of the liver. In my experience, GI docs handle liver disease very well, and they are trained to do so. Where does the hepatologist come into play?

Hepatologists are GI docs who choose to specialize in the liver. Hepatologists do things like manage hepatitis, both chronic and acute, they get called for elevated liver enzymes and are able to do things like biopsy livers. One GI doc told me that he would never specialize in hepatology because their patients are usually pretty sick and incurable compared to your run of the mill IBS patient.
 
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