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What Is a Nephrologist?

Education, Examination & Certification, Training, Subspecialties


A nephrologist is a physician who has been educated and trained in kidney diseases, kidney transplantation, and dialysis therapy. Nephrology is classified as an internal medicine subspecialty. Knowledge of internal medicine is required to obtain certification.

Education in Internal Medicine

  • Graduation from an approved medical school
  • Completion of an Accreditation Council for Graduate Medical Education (ACGME) accredited internal medicine residency program, which is a minimum of 3 years in length
  • A minimum of 2 years of meaningful patient contact and responsibility
  • Of the 2 years, 20 months must be spent in ambulatory settings, inpatient services, and in the services of dermatology or neurology
  • Four months may be taken outside the above areas, subject to program director approval
  • Increased level of responsibility for patients with each year of training

Examination & Certification
After satisfactory completion of graduate education, the physician is allowed to take the American Board of Internal Medicine (ABIM) board certification examination. Once this examination has been passed, the physician is certified in internal medicine. This is a prerequisite to becoming certified in nephrology.

Education and Training in Nephrology
The physician must fulfill the requirements for education and training in nephrology in order to qualify to take the board's examination.

Completion of 2 to 3 years of training (fellowship) in an ACGME-accredited program in nephrology

  • Fluid, acid-base, and electrolyte physiology
  • Medical management of acute and chronic renal failure
  • Glomerular/vascular disorders
  • Tubular/interstitial disorders
  • Mineral metabolism
  • Clinical pharmacology
  • Hypertension
  • Epidemiology, ethics, and nutrition
  • Renal transplantation
  • Dialysis
  • Interpretation of x-rays, sonograms, photomicrographs, and radionuclide studies
  • Twelve months of clinical training in diagnosis and management of kidney diseases
  • Placement of temporary vascular access for hemodialysis and related procedures; acute and chronic hemodialysis; peritoneal dialysis; continuous renal replacement therapy (CRRT); and percutaneous biopsy of both autologous and transplanted kidneys

Nephrology Subspecialties
Nephrologists may further specialize in pediatric nephrology (treatment of kidney diseases in children) or adult nephrology. Certification in these subspecialties requires satisfactory completion of additional education and training and passing an examination.

Why train as a nephrologist?

 A career in renal medicine provides a wealth of rewarding and challenging experiences in a specialty which is highly regarded among your peers. Clinical challenges may be wide and varied, including glomerulonephritis, vasculitis, transplantation, acute and chronic kidney disease, dialysis, and pregnancy-related kidney diseases, to name a few. Interventional nephrology is becoming increasingly popular with some nephrologists performing renal ultrasound, peritoneoscopic insertion of PD catheters and vascular access fistulogram / thrombectomy / angioplasty. Opportunities abound to pursue clinical, academic, research or primary / preventative health care aspects of renal disease. Flexible work-place arrangements (full-time, part-time, public, university and private sector) are encouraged and supported, often in the absence of postgraduate research experience.

What Is Pediatric Nephrology?

 Pediatric nephrologists specialize in treating patients from birth to young adults. Specialists work with children's disorders for many reasons. You may need a specialist because your child may have a problem adults do not or rarely have, or your child had an issue at birth that requires immediate treatment. Additionally, children often respond differently to medications and treatments or require procedures an adult may not require. Pediatric nephrology includes kidney disorders present at birth or acquired later.

A pediatric nephrologist generally treats a child with a pediatric nephrology disorder. A nephrologist has obtained a medical degree and completed additional studies and experiences in the diagnosis and treatment of kidney disorders. A nephrologist specializing in pediatrics obtains further training in the treatment of children with kidney diseases
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