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Urology

Urologist vs. Nephrologist – Which Kidney Specialist Should I See?

Dr. Joe Pazona

I’ll be honest. When I was starting medical school, I had no idea what a urologist did. Therefore, I can empathize with a patient who mistakenly makes an appointment with me instead of a nephrologist. 

So what’s the difference? How do you decide which “kidney specialist” to see? At VirtuCare we are here to help. 

What are the normal functions of the kidney?

Before we can understand how urologists and nephrologists work with the kidney, let’s first examine how the kidney works. 

The kidneys are the main filtration system of the body. They filter extra fluid and minerals out of our body in the form of urine. Kidneys also play an important role in regulating our blood pressure. Lastly they are involved in vitamin D metabolism and the production of erythropoietin, which stimulates red blood cell growth. 

What’s the difference between a urologist and a nephrologist?

  • A urologist is a surgeon who treats blockages, infections and cancers of the kidney.
  • A nephrologist treats kidney diseases that lead to decreased kidney function. 

What is a urologist?

Urologists are specialists of the male and female urinary tract. If the urinary tract is blocked, has cancer or is infected then we are your guy or gal. We also treat diseases of the male genital or reproductive system. For now though let’s focus on the urinary tract.

What is a nephrologist?

A nephrologist is a kidney specialist who cares for conditions that affect the function of the kidney. Nephrologists only treat the kidney and related conditions.

What medical training do urologists and nephrologists complete?

After medical school, urologists complete a urologicsurgical residency of 5-6 years. They are then able to go into practice or undergo further training in a fellowship. In addition to learning how to perform operations on the kidney, urologists also manage other conditions of the urinary tract (more to come).

In contrast, a nephrologist must first complete an internal medicine or family practice residency. These are 3 years, non-surgical training programs. Rather than entering primary care, a nephrologist then chooses to complete a nephrology fellowship (extra training after residency) to specialize in treating disorders of the kidneys. 

What do nephrologists treat?

As a general rule, if the kidneys are not working properly then you need a nephrologist. These conditions would include:

  • Acute kidney failure (kidneys shut down all of a sudden)
  • Chronic kidney disease (kidneys are not filtering your blood normally)
  • End-stage kidney disease or failure requiring dialysis
  • High blood pressure (difficult to control hypertension may be due to the kidneys)
  • Protein in the urine
  • Narrowing of the renal/kidney blood vessels 
  • Electrolyte abnormalities

If your doctor is concerned about your kidney function (creatinine level or GFR) you may be referred to see a nephrologist. When high blood pressure is difficult to manage, a nephrologist can often help. 

What Do Urologists Treat?

On the other hand, urologists are like the “plumbers” of the kidneys. They treat the following kidney conditions:

  • Obstruction or blockage
  • Kidney cancer (renal cell carcinoma)
  • Kidney stones (removal)
  • Kidney infections (pyelonephritis)

Urologists also diagnose and treat:

  • Bladder infections
  • BPH and enlarged prostate symptoms in men
  • Overactive bladder and bladder leakage in women
  • Prostate, testicular and bladder cancer
  • Swellings, aches and pains of the testicles
  • Erectile dysfunction
  • Premature ejaculation

If there’s something physically wrong with the urinary tract or a man has a concern with his “private area” then a urologist is the right doctor for you.

Is There Some Overlap Between a Urologist and Nephrologist?

Yes. Both specialists can help with the following conditions depending on their training and level of expertise:

  • Prevention of kidney stones
  • Acute kidney failure due to a blockage 
  • Evaluation of blood in the urine (hematuria)

It is not unusual for a urologist and nephrologist to get on the phone together to brainstorm a care plan for a challenging condition.

What If I’m Still Not Sure If I Need a Urologist vs. Nephrologist?

No need to worry! Our mission at VirtuCare is to get you the care you deserve. Feel free to email us at hello@myvirtucare.com and we’ll help you find the right specialist.

If you need a urologist, then our compassionate, board-certified urologists are ready to help you from the comfort of your home.

Tired of dealing with kidney stones? We can discuss a plan to prevent future stones so you can avoid painful trips to the emergency room.

Have you been treated for kidney cancer and are tired of tedious in-person visits to be told “you’re fine”? Our VirtuCare urologists can order imaging studies and bloodwork.

Do you need a second opinion for a kidney blockage? We offer extended visits for a deep dive into your medical records so you can feel more comfortable with your options. 

Lucky for you, our plumbers make house calls too! And we’re a lot less expensive.

<a href=”https://www.freepik.com/photos/background”>Background photo created by Iaros – www.freepik.com</a>

ABOUT THE AUTHOR

Dr. Joe Pazona

Dr. Joseph Pazona is the founder and President of VirtuCare, a telemedicine solution for connecting patients with physician experts. He can be reached at joe@myvirtucare.com.
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We’re here to help.

At VirtuCare, we believe that patients deserve direct access to the experts. There should be no gatekeeper standing between you and a healthcare specialist. VirtuCare puts you in control.

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