Renal Medicine
Renal medicine, or nephrology, includes the care of patients with all forms of kidney disease, with or without impairment of kidney function. The exceptions are patients with malignancy of the renal tract and other surgical conditions, who are dealt with by urologists. In addition, nephrologists provide the bulk of care for renal transplant recipients, in both the acute post-operative period and in long-term follow-up.
Children with renal disease, usually up to the age of 16 years, are cared for by paediatric nephrologists. In many centres nephrologists also provide a specialist hypertension service.
Renal replacement therapy, by dialysis or transplant, is a major part of the clinical work of nephrologists. The number of patients receiving renal replacement therapy is increasing and treatment is now available to all for whom it is appropriate. Factors affecting this expansion include the increased prevalence of kidney failure in older people and in ethnic minority populations. Nephrology is a specialty with a strong multiprofessional approach - there is close collaboration with transplant surgeons, and team work with specialist nurses and other clinical and laboratory health professionals is a feature of the care of patients with renal failure.
More emphasis is also being placed on the prevention, and early detection of kidney disease to minimise progression to renal failure; this approach requires collaborative working between nephrologists and other hospital specialities (particularly diabetic medicine and hypertension), and also with primary care.
