When to see a nephrologist
Common reasons people book a consultation.
- A creatinine or eGFR result outside the normal range
- Protein or blood found in a urine test
- Blood pressure that stays high on several drugs
- Swelling of the legs or face
- Planning for dialysis or a transplant
What a nephrologist does
A nephrologist is a physician who specialises in the kidneys: how well they filter the blood, balance salts and fluids, and help control blood pressure. In India the usual route is an MBBS, a postgraduate degree in general medicine or paediatrics, and then a super-speciality degree such as DM Nephrology or DrNB Nephrology. Nephrologists treat with medicines, diet and dialysis; they do not operate.
Kidney disease is often silent until it is advanced, so many people first hear of it through a routine blood test showing a raised creatinine, or a urine test showing protein. Diabetes and high blood pressure are the commonest causes, which is why people with these conditions are advised to have their kidneys checked regularly. Nephrologists also treat inflammation of the kidneys, inherited kidney disease, and sudden kidney injury in hospital.
When the kidneys fail, a nephrologist plans and supervises dialysis, either haemodialysis at a centre or peritoneal dialysis at home, and prepares patients for a kidney transplant, looking after them afterwards alongside the transplant surgeon. Because kidney disease is usually long-term, continuity matters: a nephrologist who follows your results over years can spot a change early.
- Passing very little or no urine, especially with swelling or breathlessness
- Severe breathlessness or chest pain in someone with kidney failure or on dialysis: call 108
- Confusion, extreme drowsiness, severe weakness or palpitations in someone with kidney disease, which can mean dangerous salt levels
- Fever, pain or redness at a dialysis catheter or access site, or pain and reduced urine over a transplanted kidney
Conditions nephrologists treat
Chronic kidney disease (CKD)
A gradual loss of kidney function over months or years, often from diabetes or high blood pressure.
Acute kidney injury
A sudden drop in kidney function, often during another illness, dehydration or after certain medicines.
Diabetic kidney disease
Kidney damage from long-standing diabetes, often first seen as protein in the urine.
High blood pressure related to the kidneys
Blood pressure that is hard to control, or that is caused or worsened by kidney disease.
Glomerulonephritis and nephrotic syndrome
Inflammation or leakiness of the kidney filters, causing protein or blood in the urine and swelling.
Polycystic kidney disease
An inherited condition in which cysts grow in the kidneys; family members may be offered screening.
Electrolyte disorders
Abnormal sodium, potassium or other salt levels in the blood.
Kidney failure
When the kidneys can no longer keep the body in balance and dialysis or a transplant is needed.
Care after kidney transplant
Long-term monitoring of the transplanted kidney and the medicines that protect it.
Tests and procedures you may come across
Serum creatinine and eGFR
Blood tests that estimate how well the kidneys are filtering.
Urine tests for protein and blood
Including a urine albumin or protein ratio, an early marker of kidney damage.
Electrolytes
Blood levels of sodium, potassium and other salts that the kidneys control.
Ultrasound of the kidneys
Shows kidney size, cysts, stones and blockage.
Kidney biopsy
A small sample of kidney taken with a needle to find the exact cause of some kidney diseases.
Blood pressure monitoring
Regular or 24-hour readings, since blood pressure control protects the kidneys.
Haemodialysis
Blood is cleaned by a machine, usually several times a week at a dialysis centre.
Peritoneal dialysis
Dialysis done at home using fluid placed in the abdomen through a soft tube.
Nephrologist or another specialist?
The nearest neighbouring specialities, and when each is the right door.
Before your first visit
- Bring every creatinine, urine and ultrasound report you have, with dates; the trend over time matters more than any single result.
- Bring a list of all medicines, including painkillers, supplements and traditional remedies, since some can affect the kidneys.
- Bring home blood pressure readings and, if you have diabetes, recent sugar and HbA1c reports.
- Mention any family history of kidney disease or dialysis.
- Expect blood and urine tests on the day, and advice on salt, fluids and diet that may be adjusted as results come in.
Qualifications and registration to check
Registered with the National Medical Commission or a state medical council. The number can be searched on the NMC's Indian Medical Register. Every profile on The Doctor Index shows the registration number and says whether it has been checked against the register.
Degrees you will see on nephrologists' profilesHow to check a registrationQuestions about seeing a nephrologist
My creatinine is slightly high. Should I worry?
A single result can be affected by dehydration, muscle mass and other factors. A nephrologist or physician will usually repeat it, check urine tests and look at the trend before deciding what it means.
Does kidney disease always lead to dialysis?
No. Many people with chronic kidney disease never need dialysis, especially when blood pressure, diabetes and other risks are well controlled and the disease is found early.
What is the difference between a nephrologist and a urologist?
A nephrologist is a physician who treats kidney function and kidney disease and manages dialysis. A urologist is a surgeon who treats stones, blockages, the prostate and other structural problems of the urinary tract.
What qualifications should a nephrologist have?
An MBBS, a postgraduate degree usually in general medicine, and then a super-speciality degree such as DM Nephrology or DrNB Nephrology. Registration can be checked with the NMC or a state medical council.
Should people with diabetes see a nephrologist?
Not routinely, but they should have kidney blood and urine tests regularly. A nephrologist is usually involved when these show declining function or rising protein in the urine.
Also searched as: kidney specialist, kidney doctor, dialysis.
Written by The Doctor Index on 27 Sep 2026, and has not yet been reviewed by a clinician. General information, not advice about your own situation.