Preserve kidney function
The kidneys are “silent” until the later stages - the numbers speak early: the doctor assesses the trend of creatinine/GFR, albuminuria (the main early marker), urine sediment, kidney size by ultrasound and puts the picture together into a diagnosis. Modern regimens (SHLT2 inhibitors work even without diabetes) + blood pressure <130/80 + reasonable protein in the diet - a program that really changes the function curve. Control - by stage, from once a year to quarterly.
Indications
- increased creatinine, decreased GFR - assessment and management of CKD;
- protein/blood in the urine when a urological cause has been excluded;
- diabetic and hypertensive nephropathy - nephroprotection;
- edema, suspicion of glomerulonephritis;
- single kidney, polycystic disease - observation of function.
Nephrologist and urologist: who does what?
The urologist treats “surgical” causes (stones, obstruction, tumors), the nephrologist treats “therapeutic” diseases of the renal tissue and chronic kidney disease: his task is to slow down the decline in function with nephroprotective regimens (SGLT2 inhibitors, RAS blockers), control of pressure and metabolism. In a urology clinic, a nephrologist covers an important interface: assessment of function before/after operations, contrast studies, management of patients with a solitary kidney. Early nephroprotection delays dialysis for years - the key is timely treatment in case of “silent” test changes.
