When to see a kidney specialist
Jean Robey, MD, is a board certified physician in the fields of Internal Medicine and Nephrology on staff at Banner Estrella Medical Center. Her office can be reached at (623) 974-1763.
Question: I was recently referred to a kidney specialist by my primary care physician but I feel fine. Should I still go?
Answer: Early referral can identify reversible causes of kidney disease, augment contributing factors and address the associated comorbidities such as anemia or bone disease that occur in the setting of chronic kidney disease (CKD).
Routine labs can help identify patients early and initiate referrals to kidney specialist or nephrologists.
Renal function can be “staged” based on calculations made using patient demographics and labs and represents the combined function of both kidneys. The National Kidney Foundation has established five stages of kidney disease.
Usually little to no protein is lost in the urine. Stage 1 denotes normal function but abnormal excretion of protein. The remaining stages may have abnormalities in the urine sediment but also sequentially decreasing function. Stage 2 denotes that the kidneys are functioning at 90 percent or less of normal, healthy levels. Stage 3 denotes functioning at 60 percent or less. Stage 4 denotes functioning of 30 percent or less. Finally, Stage 5 denotes that kidneys are functioning at less than 15 percent of normal, healthy levels.
Many patients may not feel badly in earlier stages and yet have many associated abnormalities found only with blood work. Early referral also can identify reversible causes or help augment risk factors that can accelerate kidney disease. Finally, nephrologists can evaluate a patient’s current medications and help patients avoid toxic drugs.
Chronic kidney disease is in itself a major risk factor for death and disability comparable to heart attack or diabetes. Serious consideration is appropriate.
As CKD can be a silent problem if identified, follow through and seek specialized evaluation to prolonged your life and quality of life.