Clinical nephrology is the branch of medicine dedicated to diagnosing, managing, and treating diseases of the kidneys and related systemic conditions. It focuses on the prevention, detection, and management of kidney dysfunction, electrolyte imbalances, and associated complications
Key Areas of Clinical Nephrology

1. Chronic Kidney Disease (CKD)

• Definition: Progressive decline in kidney function lasting 3 months, characterized by reduced glomerular filtration rate (GFR) and/or evidence of kidney damage (eg, proteinuria)

2. Acute Kidney Injury (AKI)

• Definition: Sudden decline in kidney function over hours to days, often reversible
• Courses:
• Prarenal (e.g., hypovolemia, shock).
• Intrinsic (eg. acute tubular necrosis, glomerulonephritis).
• Postrenal (eg, obstruction).

3. Glomerular Diseases

• Examples:
• Nephrotic Syndrome: Proteinuria >3.5 g/day, hypoalbuminemia, edema (eg, minimal change disease, FSGS, membranous nephropathy).
• Nephritic Syndrome: Hematuria, proteinuria, hypertension, renal dysfunction (e.g., post-
  streptococcal glomerulonephritis, IgA nephropathy, autoimmune disorders).

4. Hypertension

• Primary Hypertension:Often managed with nephrology input if resistant to treatment.
• Secondary Hypertension: Related to kidney diseases (eg, renovascular hypertension, CKD),

5. Electrolyte and Acid-Base Disorders.

• Common Issues
  Hyperkalemia: Managed with potassium binders, insulin, or dialysis
• Hyponatremia: Fluid restriction, hypertonic saline in severe cases).
• Metabolic Acidosis: Sodium bicarbonate or dialysis.
• Hyperphosphatemia and Hypocalcemia: Dietary phosphate restriction, phosphate binders, and vitamin D.

6. Systemic Diseases with Renal Involvement

• Lupus Nephritis:
• Multiple Myeloma:
• Vasculitis (e.g., ANCA-associated) and on GBMdisease.

7. Other kidney disorders.

• Diabetic kidney disease/diabetic nephropathy
• Renal stone disease
• Polycystic kidney disease
• Obstructive nephropathy

8. Renal Transplantation

• Indications: End-stage renal disease (ESRD)
• Post-Transplant Core:
  • Lifelong immunosuppressive therapy (eg, tacrolimus, mycophenolate mofetil).
  • Monitoring for rejection, infections, and malignancies