The Ultimate Guide to Choosing a Medical Specialty, Third Edition by Freeman Brian

Author:Freeman, Brian
Language: eng
Format: epub
Publisher: McGraw-Hill Education
Published: 2012-08-24T04:00:00+00:00

Nephrology

Fascinated by urine, the kidney, and complex renal physiology? Nephrologists are masters of fluid, electrolytes, and acid–base homeostasis. After all, the kidneys are responsible for filtering out impurities from the blood. As part of their diagnostic workup, they analyze acid–base studies, electrolyte panels, and urine collections. In this highly intellectual specialty, they treat all types of diseases of the renal system, such as infection, kidney stones, alkalosis/acidosis, autoimmune disorders, and renal artery stenosis. The nephrologist must understand how systemic diseases such as hypertension and diabetes affect the kidneys, as well as be able to identify renal toxic effects of any medication. Long-term relationships are formed with patients who require chronic dialysis, and life-saving interventions such as acute hemodialysis are often provided within the intensive care setting. Nephrologists also treat postrenal transplant patients and manage the complications of chronic immune suppression secondary to posttransplant medical therapy.

There are several procedural skills to master, particularly the placement of hemodialysis and peritoneal catheters and the ability to biopsy tissue from the kidney. Some nephrologists gain additional interventional training and perform thrombectomies and even angioplasty of renal arteries. Although it requires technical skill, nephrology is also one of the most cognitive subspecialties within internal medicine. You can practice as a consultant, direct a dialysis center, work as an intensivist, or practice both nephrology and general medicine. Although dialysis patients can be demanding at times, solving their complex medical problems is highly gratifying. Nephrology fellowships require 2 years of training.

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