Subspecialty Careers: Highlights about Careers in Internal Medicine: Nephrology
The Discipline
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.
Procedures
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.
Training
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.
Certification
The American Board of Internal Medicine, ABIM, offers certification in
nephrology.
Training Positions
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.
Practice
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
(202) 659-0599
http://www.asn-online.org
National Kidney Foundation
30 East 33rd Street, 8th Floor
New York, NY 10016
800-622-9010
http://www.kidney.org
Major Publications
American Journal of Kidney Diseases
Journal of the American Society of Nephrology