Nephrology

Specialized Care for Kidney & Renal Diseases

The Nephrology Department at AS Medical Complex provides specialized evaluation, diagnosis, treatment, and ongoing management for conditions affecting the kidneys and related body functions.

The kidneys perform several essential functions, including removing waste and excess fluid from the blood, maintaining fluid and mineral balance, and contributing to the regulation of blood pressure and other important processes.

Kidney problems can develop gradually without obvious symptoms or occur suddenly because of illness, dehydration, medications, infection, obstruction, or other medical conditions.

Our nephrology services focus on identifying kidney problems early, protecting remaining kidney function, managing complications, and providing appropriate long-term care according to each patient's condition.

Our Nephrology Services

The Nephrology Department at AS Medical Complex may provide assessment and management for:

• Chronic Kidney Disease (CKD)

• Acute Kidney Injury (AKI)

• Reduced kidney function

• Abnormal creatinine levels

• Abnormal eGFR results

• Protein in the urine

• Blood in the urine requiring renal assessment

• Diabetic kidney disease

• Hypertensive kidney disease

• Difficult-to-control hypertension associated with kidney disease

• Nephrotic syndrome

• Glomerular diseases

• Electrolyte disorders

• Sodium abnormalities

• Potassium abnormalities

• Calcium and mineral disturbances related to kidney disease

• Fluid retention and edema

• Kidney-related anemia

• Kidney stones and recurrent stone evaluation

• Kidney disease associated with other medical conditions

• Medication-related kidney problems

• Dialysis assessment and ongoing renal care

• Kidney failure management

• Evaluation related to kidney transplantation

• Long-term monitoring of chronic kidney conditions

Chronic Kidney Disease – CKD

Chronic Kidney Disease (CKD) occurs when the kidneys remain damaged or lose function over time. Early kidney disease may produce few or no obvious symptoms, which is why laboratory testing can be important in people at increased risk.

CKD may be associated with conditions such as:

• Diabetes

• High blood pressure

• Glomerular diseases

• Inherited kidney conditions

• Recurrent kidney problems

• Other chronic medical diseases

Patients with CKD may require regular monitoring of:

• Kidney function

• Creatinine

• Estimated Glomerular Filtration Rate (eGFR)

• Urine protein

• Blood pressure

• Electrolytes

• Hemoglobin

• Calcium and other minerals

• Fluid status

• Medications

Treatment focuses on addressing the underlying cause, slowing progression when possible, managing complications, and planning appropriate care if kidney function becomes severely reduced.

Acute Kidney Injury – AKI

Acute Kidney Injury (AKI) is a sudden deterioration in kidney function that can develop during serious illness, hospitalization, surgery, infection, dehydration, exposure to certain medicines or toxins, or other medical problems.

Patients with AKI may require close monitoring of:

• Urine output

• Creatinine levels

• Blood pressure

• Fluid balance

• Potassium

• Sodium

• Acid-base balance

• Current medicines

• Underlying illness

Some patients recover kidney function after the underlying cause is treated, while others may develop persistent kidney impairment and require continued nephrology follow-up.

Severe AKI may require hospitalization and, in selected cases, temporary dialysis.

Diabetic Kidney Disease

Diabetes is an important cause of chronic kidney disease.

People living with diabetes may require regular kidney assessment, particularly when they have:

• Persistent high blood glucose

• Protein or albumin in the urine

• Reduced eGFR

• Increasing creatinine

• High blood pressure

• Swelling

• Other evidence of kidney impairment

Kidney care in patients with diabetes may involve coordination between Nephrology, Endocrinology, General Medicine, and other relevant specialties.

Management focuses on protecting kidney function, controlling contributing risk factors, reviewing medications, and monitoring for complications.

High Blood Pressure & Kidney Disease

High blood pressure and kidney disease are closely connected. Kidney disease can contribute to hypertension, while uncontrolled hypertension can further damage the kidneys.

Nephrology assessment may be appropriate for patients with:

• Difficult-to-control blood pressure

• Hypertension associated with reduced kidney function

• Abnormal urine protein

• Abnormal creatinine

• Suspected secondary causes of hypertension

• Fluid retention associated with kidney disease

Treatment depends on the patient's kidney function, overall cardiovascular health, electrolyte levels, and other medical conditions.

Protein in the Urine – Proteinuria

Healthy kidneys normally prevent large amounts of protein from passing into the urine.

Persistent protein in the urine can indicate kidney damage and may require further assessment.

Depending on the patient's condition, evaluation may include:

• Urinalysis

• Urine protein measurement

• Urine albumin testing

• Kidney function tests

• Blood pressure assessment

• Blood tests

• Ultrasound

• Additional renal investigations

The significance of proteinuria depends on the amount of protein present, kidney function, associated medical conditions, and other clinical findings.

Nephrotic Syndrome

Nephrotic syndrome is a group of findings caused by abnormal loss of protein through the kidneys. Typical features include high levels of protein in the urine, low blood albumin, swelling, and elevated blood lipids.

Patients may experience:

• Swelling around the eyes

• Swelling of the feet or ankles

• Generalized body swelling

• Foamy urine

• Weight increase due to retained fluid

• Abnormal urine protein results

Nephrotic syndrome can have several different underlying causes, and appropriate renal evaluation is required to determine treatment.

Swelling & Fluid Retention

Kidney disease can interfere with the body's ability to manage sodium and fluid appropriately.

Patients may develop:

• Swollen feet

• Swollen ankles

• Puffiness around the eyes

• Generalized swelling

• Rapid weight increase from fluid retention

• Shortness of breath in severe fluid overload

Swelling is not always caused by kidney disease. Heart, liver, vascular, medication-related, and other medical problems may produce similar symptoms.

Proper clinical assessment is therefore important before determining the cause.

Electrolyte Disorders

The kidneys play an important role in maintaining appropriate concentrations of minerals and electrolytes in the body.

Kidney disease may contribute to abnormalities involving:

• Potassium

• Sodium

• Calcium

• Bicarbonate

• Phosphate

• Other minerals

Electrolyte disorders can range from mild laboratory abnormalities to serious medical conditions.

Significant abnormalities—particularly severe potassium disturbances—may require urgent treatment and close medical monitoring.

Kidney Stones

Kidney stones are hard deposits that can form when certain minerals become highly concentrated in the urine. They may occur in one or both kidneys.

Possible symptoms include:

• Severe pain in the side or back

• Pain extending toward the lower abdomen or groin

• Blood in the urine

• Nausea or vomiting

• Pain during urination

• Recurrent urinary symptoms

Some kidney stones produce no symptoms until they begin moving through the urinary tract.

Patients with recurrent stones may require evaluation to identify factors contributing to stone formation.

Depending on the type of stone and clinical situation, prevention can involve appropriate fluid intake, dietary changes, medication, and management of underlying metabolic abnormalities.

Procedures to remove or break larger stones are usually coordinated with Urology when required.

Kidney Failure

Kidney failure occurs when kidney function becomes severely reduced and the kidneys can no longer adequately perform their normal functions.

Treatment options for kidney failure can include:

• Hemodialysis

• Peritoneal dialysis

• Kidney transplantation

• Conservative kidney management in selected circumstances

The appropriate option depends on the patient's overall health, kidney function, medical circumstances, and individual preferences.

Early nephrology follow-up can help patients and families understand available treatment options before kidney function reaches an advanced stage.

Hemodialysis

Hemodialysis is a treatment used in kidney failure to remove waste products and excess water from the blood using a dialysis machine and filter.

Patients receiving hemodialysis require ongoing monitoring of:

• Blood pressure

• Fluid balance

• Hemoglobin

• Electrolytes

• Dialysis access

• Kidney function

• Nutrition

• Medications

• Other kidney-related complications

The dialysis schedule and treatment prescription are determined according to the patient's medical condition and nephrology plan.

Peritoneal Dialysis

Peritoneal dialysis is another form of kidney replacement therapy. It uses the lining of the abdomen to help remove waste and excess fluid from the body.

Whether peritoneal dialysis or hemodialysis is more appropriate depends on individual clinical and practical factors.

Patients considering dialysis should discuss their options with their nephrologist before treatment is required whenever possible.

Kidney Transplant Evaluation

Kidney transplantation may be a treatment option for selected patients with kidney failure.

Nephrology care surrounding transplantation may involve:

• Assessment of kidney disease

• Determining suitability for transplant evaluation

• Review of other medical conditions

• Coordination with transplant specialists

• Pre-transplant investigations

• Long-term kidney monitoring

Patients requiring transplantation are referred to an appropriate transplant program for formal evaluation and management.

Kidney Disease & Anemia

Patients with chronic kidney disease may develop anemia as kidney function declines.

Possible symptoms can include:

• Fatigue

• Weakness

• Reduced exercise tolerance

• Shortness of breath

• Dizziness

A nephrologist may assess hemoglobin levels, iron status, kidney function, nutritional factors, and other possible causes before planning treatment.

Diagnostic Tests in Nephrology

Kidney evaluation often involves both blood and urine testing.

Depending on the patient's symptoms and medical history, investigations may include:

• Serum creatinine

• Estimated Glomerular Filtration Rate (eGFR)

• Blood urea

• Electrolytes

• Sodium

• Potassium

• Calcium

• Phosphate

• Bicarbonate

• Complete Blood Count (CBC)

• Blood glucose

• HbA1c

• Urinalysis

• Urine protein

• Urine albumin

• Urine Albumin-to-Creatinine Ratio

• 24-hour urine testing when clinically indicated

• Kidney ultrasound

• CT imaging when required

• Additional specialized renal investigations

Not every patient requires all of these tests. Investigations are selected according to the patient's symptoms, medical history, and clinical findings.

Kidney Function Testing

Kidney function is commonly assessed using blood tests such as serum creatinine together with calculations such as eGFR.

Urine testing can provide additional information, particularly when assessing protein or albumin loss.

A single abnormal test does not always establish chronic kidney disease. Results are interpreted together with previous tests, the patient's medical history, medications, and other clinical findings.

Kidney Ultrasound & Imaging

Imaging may be required to assess kidney size, structure, urinary obstruction, stones, cysts, or other abnormalities.

Depending on the clinical situation, investigations may include:

• Kidney ultrasound

• Urinary tract ultrasound

• CT scan

• Other specialized imaging

For kidney stones, healthcare professionals may use clinical history, physical examination, and diagnostic tests to identify the stone and determine possible contributing factors.

Medication Review in Kidney Disease

Kidney function can affect how certain medicines are processed by the body.

Patients with impaired kidney function may require medication review to determine whether:

• Dosage adjustment is necessary

• Certain medicines should be avoided

• Treatment requires closer monitoring

• Electrolytes need to be checked

• Kidney function should be monitored after starting treatment

Patients should not stop prescribed medicines without discussing them with their treating physician.

Protecting Kidney Health

People at increased risk of kidney disease may benefit from regular medical monitoring.

Important areas of kidney health management can include:

• Blood pressure control

• Diabetes management

• Appropriate medication use

• Avoiding unnecessary exposure to kidney-damaging substances

• Following individualized dietary advice

• Maintaining appropriate fluid intake according to medical advice

• Monitoring kidney function when clinically indicated

• Regular follow-up for established kidney disease

Fluid recommendations are not the same for every patient. People with kidney failure or significant fluid-retention problems may require specific restrictions, so fluid intake should follow the treating medical team's advice.

Coordinated Kidney Care

Kidney disorders often occur alongside other medical conditions.

Depending on the patient's diagnosis, nephrology care may be coordinated with:

• General Medicine

• Endocrinology

• Cardiology

• Urology

• Hematology

• Critical Care

• Surgery

• Radiology

• Nutrition services

• Other relevant specialties

This multidisciplinary approach is particularly important for patients with diabetes, hypertension, kidney stones, advanced kidney disease, or multiple chronic medical conditions.

When Should You Visit a Nephrologist?

You may consider nephrology assessment if you have:

• Persistently elevated creatinine

• Reduced eGFR

• Protein in the urine

• Recurrent abnormal kidney function tests

• Chronic kidney disease

• Acute deterioration in kidney function

• Significant unexplained swelling

• Difficult-to-control hypertension

• Electrolyte abnormalities

• Diabetic kidney disease

• Recurrent kidney stones requiring metabolic assessment

• Nephrotic syndrome

• Known kidney disease requiring follow-up

• Advanced kidney disease requiring dialysis planning

• Kidney failure

• A condition requiring transplant evaluation

Your physician may also refer you to Nephrology when blood or urine tests suggest impaired kidney function.

When Is Urgent Medical Attention Required?

Certain kidney-related problems require urgent medical assessment.

Seek prompt or emergency medical care for:

• Very little or no urine output

• Sudden severe reduction in urine

• Severe shortness of breath with swelling

• Severe weakness or altered consciousness

• Severe electrolyte abnormalities

• Severe dehydration

• Persistent vomiting with reduced urine output

• Severe flank pain associated with fever

• Blood in the urine with significant symptoms

• Rapidly worsening swelling

• Serious symptoms in a patient with known kidney failure

These symptoms may represent conditions requiring immediate investigation and treatment.

Long-Term Kidney Care

Many kidney conditions require ongoing monitoring rather than a single consultation.

Regular nephrology follow-up can help physicians:

• Monitor kidney function

• Review creatinine and eGFR

• Monitor urine protein

• Control blood pressure

• Monitor electrolytes

• Review medications

• Assess fluid status

• Monitor anemia and mineral abnormalities

• Identify complications

• Slow kidney disease progression when possible

• Plan dialysis or transplant evaluation when required

At AS Medical Complex, our goal is to provide continuity of renal care from initial assessment through long-term kidney disease management.