We specialize in the diagnosis and treatment of diseases of the kidney and urinary system, such as inflammation of the kidneys, chronic kidney disease, effects of high blood pressure and diabetes on the kidneys. We treat side effects of medications on the kidneys and also complications of many other diseases on the way the kidneys function to filter the blood and keep it clean. We also manage electrolyte disorders such as low or high sodium, potassium, calcium. We are available to manage but do not do surgery on patients who develop kidney stones, but we do diagnose and prescribe medications to prevent them to come back again.
We do follow up for patients with end stage kidney disease who already are on dialysis and prepare them to become candidates for kidney transplant and we follow up patients already transplanted after the surgery.
When to refer patients to us?
There are a lot of different reasons to refer patients from the primary care practice to a nephrologist, the following list can help you identify the most important problems that we can help you with:
- Urine albumin-to-creatinine ratio (ACR) ≥300 mg/g (34 mg/mmol)
- Hematuria not secondary to urological conditions
- Inability to identify a presumed cause of CKD
- eGFR below 60 or decline of more than 30 percent in fewer than four months without an obvious explanation
- Difficult to manage complications such as anemia requiring erythropoietin therapy and/or IV Iron infusion, and abnormalities of bone and mineral metabolism requiring phosphorus binders or vitamin D preparations
- Serum potassium greater than 5.5 meq/L, also low potassium levels, low or high sodium and calcium levels.
- Difficult to manage drug complications
- Resistant hypertension
- Recurrent or extensive nephrolithiasis
- Confirmed or presumed hereditary kidney disease
We are available to assist primary care physicians and other specialists in the diagnosis and care of patients at all stages of CKD. These functions include determination of the cause of CKD, recommendations for specific therapy, suggestions for treatments to slow progression in patients who have not responded to conventional therapies, identification and treatment for kidney disease–related complications, and preparation for dialysis. Because patients with CKD are at risk for a diverse set of adverse outcomes (not just kidney failure), referral to other appropriate specialists (eg, cardiologists for those with complex CVD) should also be considered.
If you are a patient or a referring physician and you believe it is time to utilize our services, please contact us on the form to the right or call us at 209 (725)-2121 for nephrology services today.