Kidney Failure

Kidney Failure Evaluation at Southland Urology

While urologists and nephrologists both work with kidneys, their roles in diagnosing kidney failure differ significantly. Urologists are surgical specialists who primarily address structural or obstructive issues of the urinary tract that can lead to kidney failure, such as kidney stones, tumors, or blockages. In contrast, nephrologists are medical doctors who specialize in the diagnosis and medical management of conditions that affect the function of the kidneys, including chronic kidney disease, hypertension-related kidney damage, and electrolyte imbalances.

Understanding Kidney Failure

Types and Causes of Kidney Failure

Kidney failure can be categorized into two main types: acute kidney injury (AKI) and chronic kidney disease (CKD). AKI is a sudden, rapid loss of kidney function, often caused by an event like a serious infection, severe blood loss, or a blockage in the urinary tract. This type is often reversible if the underlying cause is addressed quickly. CKD, on the other hand, is a gradual and long-term decline in kidney function, typically caused by chronic illnesses such as diabetes or high blood pressure. CKD is not reversible but can be managed to slow its progression. The urologist’s role is most pronounced in cases of AKI caused by an obstruction, as well as in the management of structural issues that can contribute to CKD.

Urologist’s Role in Diagnosis

While a nephrologist is the primary specialist for diagnosing and medically managing kidney failure, the urologist plays a critical role in the diagnostic process when a blockage or structural problem is suspected. The urologist will use a variety of imaging tests, such as ultrasounds and CT scans, to identify physical obstructions like kidney stones, tumors, or an enlarged prostate that may be preventing urine from leaving the kidneys. They also perform procedures like cystoscopy to examine the bladder and urethra for any issues. The results of these tests help determine if the kidney failure is a result of a surgical issue that falls within the urologist’s scope of expertise.

Non-Surgical Treatment

In cases of kidney failure, non-surgical treatment is primarily managed by a nephrologist. This involves addressing the underlying medical conditions, such as controlling blood pressure and diabetes, and managing fluid and electrolyte imbalances. Non-surgical treatments also include lifestyle changes like dietary modifications to limit protein, sodium, and potassium, as well as medication to manage symptoms and complications like anemia. The urologist’s non-surgical role in kidney failure is limited to the management of conditions that they treat, such as prescribing medications to dissolve small kidney stones.

Surgical Treatment

The urologist’s most significant contribution to the treatment of kidney failure is through surgical intervention. If a blockage is causing AKI, the urologist will perform a procedure to remove the obstruction. This may involve using a scope to remove or break up a kidney stone or placing a stent to bypass an obstruction. For cases where tumors are causing kidney damage, a urologist who specializes in oncology may perform a nephrectomy, which is the surgical removal of part or all of the kidney.