What a nephrologist does and how it differs from a urologist
A nephrologist is an internal medicine specialist who deals with how the kidneys work. They follow how well the kidneys clean the blood, how they control blood pressure, salt and water in the body, and why there is protein or blood in the urine.
A urologist is a surgeon for the urinary tract and prostate. You see a urologist when a stone needs to be removed, when urine is blocked or when a change needs surgery. You see a nephrologist when the problem is in the kidney tissue itself and in kidney function.
The two doctors often work together. After the exam the nephrologist tells you whether you also need a urologist, a cardiologist or an endocrinologist, for example with diabetes.
When to see a nephrologist
Kidney disease does not hurt for a long time and gives no clear symptoms. That is why it is usually found by chance, in routine blood and urine tests. A nephrologist exam makes sense when you have:
- raised creatinine or a reduced estimated filtration rate (eGFR) in your results
- protein or blood in the urine, even without symptoms
- high blood pressure that is hard to control or started at a younger age
- kidney cysts or polycystic kidney disease in the family
- long-standing diabetes, to check whether it has affected the kidneys
What happens at a nephrologist exam
The exam starts with a conversation. The nephrologist asks how long your results have been abnormal, what medicines you take, whether you have swelling, changes in urination and illnesses in the family. Some painkillers and blood pressure medicines affect the kidneys, so the medicine list matters.
The doctor then measures your blood pressure, checks your legs for swelling and examines you. They read earlier creatinine, urea, potassium and urine results carefully, because for the kidneys the trend over time matters more than a single number.
At the end you get an explanation, a plan and a written report. The plan may be a further test, a kidney ultrasound, a change of treatment or a follow-up in a few months.
Nephrologist exam with kidney ultrasound
Ultrasound shows kidney size, tissue thickness, cysts, stones and widening of the collecting system. Together with blood and urine tests this gives a fuller picture than any result alone.
If you have not had a kidney ultrasound recently, you can book a nephrologist exam with ultrasound. You then come with a full bladder and the ultrasound is done in the same appointment. If you already have a recent ultrasound report, bring it and a nephrologist exam alone is enough.
What to bring to a nephrologist exam
The exam needs no special preparation. It helps most when the doctor can see results from several months, so bring them even if they are old. It is useful to have:
- blood tests with creatinine, urea and potassium, ideally several in a row
- a urine test and, if you have it, the urine albumin to creatinine ratio
- a list of all medicines, including painkillers and supplements
- earlier ultrasound reports and hospital discharge letters
- blood pressure readings taken at home over the past weeks
What creatinine, eGFR and protein in the urine mean
Creatinine is a waste product the kidneys remove. From it, your age and sex the lab calculates eGFR, an estimate of how much blood the kidneys filter per minute. The lower the eGFR, the weaker the kidneys work.
If eGFR is below 60 or there is protein in the urine for more than three months, this is called chronic kidney disease. It does not mean dialysis. In many people, with treatment and blood pressure control, the disease progresses slowly or stays the same for years.
A single raised creatinine can be caused by dehydration, hard exercise or a medicine. That is why the nephrologist often asks for a repeat test before drawing a conclusion. Blood and urine tests can be done in the laboratory of the same hospital.
When not to wait for an appointment
Some situations need emergency care, not a booked exam. These include a sudden drop in or stop of urination, severe flank pain with high fever, shortness of breath with swelling, and very high blood pressure with headache or vision problems.
In these cases call emergency services or go to the nearest emergency department. Book a nephrologist exam once the situation has settled, for further follow-up.
Cost of a nephrologist exam
A nephrologist exam costs 8,000 RSD. A nephrologist exam with kidney ultrasound in the same appointment costs 12,000 RSD. Blood and urine tests are charged separately, according to the laboratory price list.
- Nephrologist exam
- Nephrologist exam with ultrasound
Nephrologist examfrom 8,000 RSD
View the current price in our price listFor an appointment call 062-399-888.
Questions about the nephrologist exam
A nephrologist exam costs 8,000 RSD, and a nephrologist exam with kidney ultrasound 12,000 RSD. Laboratory tests are paid separately.
When you have raised creatinine, a low eGFR, protein or blood in the urine, blood pressure that is hard to control or kidney cysts. Also with long-standing diabetes, to check the kidneys.
The doctor talks with you, measures your blood pressure, examines you and interprets your blood and urine tests. At the end you get a treatment or testing plan and a written report.
Not for the exam itself. If you have blood tests the same day, come fasting, and for the exam with ultrasound come with a full bladder.
A nephrologist treats kidney function and tissue with medicines and monitoring. A urologist is a surgeon for the urinary tract, stones that need removing and the prostate.
Not necessarily. Creatinine can rise temporarily because of dehydration, exercise or a medicine. The nephrologist looks at the trend across several results before drawing a conclusion.
With recurring stones the nephrologist looks for the cause in blood and urine tests and advises on diet and treatment. Stone removal is done by a urologist.
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