Subspecialty Careers: Highlights about Careers in Internal Medicine: Nephrology
The word nephrology comes from the word nephros, the Greek word for kidney. Nephrology involves the diagnosis and management of diseases of the kidneys, the contiguous collecting system, and the associated vasculature.
The commonly encountered conditions in nephrology include disorders of fluid, electrolyte, and acid-base balance. Other problems include disorders involving the glomerulus, asymptomatic urine abnormalities, tubulointerstitial disorders, renal vascular diseases, renal failure, nephrolithiasis, tubular defects, and infections and neoplasms of the kidney, collecting system, and bladder. The nephrologist must understand how systemic diseases affect the kidneys, and recognize the potential toxicities of various therapeutic and diagnostic agents.
Important procedural skills for the nephrologist include peritoneal dialysis, percutaneous kidney biopsy, and temporary placement of vascular access for hemodialysis. In addition, the nephrologist is expert at interpreting 24-hour urine excretion of minerals and electrolytes, serological tests for evaluating glomerulopathies, acid-base studies, and studies of sodium and water balance.
Nephrology fellowship training requires two years of accredited training beyond general internal medicine residency. Of the two years, a minimum of 12 months must include clinical training in the diagnosis and management of a broad spectrum of renal diseases.
The American Board of Internal Medicine, ABIM, offers certification in nephrology.
As of December 2009, there were 141 ACGME-accredited training programs with 911 active positions in nephrology. A little over one third of the trainees were female and 40% were U.S. medical graduates.
Approximately 61% of the graduates enter clinical practice in nephrology in the United States and 29% enter academic medicine.
Major Professional Societies
American Society of Nephrology
1725 I Street, NW, Suite 510
Washington, DC 20006
National Kidney Foundation
30 East 33rd Street, 8th Floor
New York, NY 10016