What Does a Nephrologist Do? Roles and Career Opportunities
Learn more about nephrologists, including conditions they treat, tests they administer and career opportunities.
Aspiring medical doctors have so much to consider as they plan for a 4-year MD program, USMLE exams and clinical rotations. But what is always top-of-mind are thoughts about what medical specialty they will one day pursue in residency and beyond.
For those who may be wondering about Nephrology, this blog is a wonderful place to begin. We’ll describe the profession, career opportunities, educational requirements and more.
Read on to gain key information that will support your learning and skills-development efforts!
What is Nephrology?
Nephrology is the study of the kidney, one of the most vital organs in the body. Working as a nephrologist requires years of study but can offer many exciting career opportunities.
What is a Nephrologist?
A nephrologist is a doctor who specializes in the care of kidneys. Your kidneys are one of the most important organs in your body. They are part of your urinary system, filtering your blood and removing waste, excess water, and electrolytes. According to the International Society of Nephrology, there is an increasing demand for nephrologists globally. A pediatric nephrologist specializes in kidney treatment for newborns and adolescents.
What Does a Nephrologist Do?
A nephrologist diagnoses and treats kidney conditions and kidney failure, and they also assess how these conditions impact other parts of the body. They can also treat conditions related to kidney function, such as high blood pressure, electrolyte imbalances and fluid retention. They oversee kidney dialysis and transplants, and follow-up care.
What Diseases Does a Nephrologist Treat?
Nephrologists treat several conditions related to the kidneys, ranging from common conditions to more serious issues like kidney failure.
Here are some of the many conditions that a nephrologist may treat:
Acute Kidney Injury (AKI): An AKI occurs when your kidneys cannot filter waste from the blood. This causes harmful levels of waste to build up, which can lead to kidney failure.
Chronic Kidney Disease (CKD): CKD is characterized by a gradual loss of kidney function over time. It is divided into five stages, the first stage being mild and the fifth stage being the most severe, in which the kidneys have lost nearly all function. While there is no cure for CKD, a nephrologist can help manage symptoms through medication, dialysis or arranging a transplant.
Electrolyte Imbalance Disorders: Electrolytes are essential minerals that your body needs to function. Impaired kidneys can lead to electrolyte disorders, which can cause severe damage to your body. Trained nephrologists help manage such imbalance disorders.
Glomerulonephritis: This refers to a group of diseases that damage the glomeruli, the part of the kidney that filters blood, which can lead to serious issues. Treatment typically involves medication and managing the underlying conditions.
Inherited Kidney Disorders: There are over 60 known inherited kidney disorders, which range from common conditions to very rare diseases. The most common inherited kidney disorder in the U.S. is PKD.
Kidney Failure: Occurs when one or both of your kidneys can no longer function on its/their own. It can be caused by several conditions, including diabetes and hemolytic uremic syndrome. It is a serious condition and requires dialysis or a transplant.
Nephrotic Syndrome: This refers to excessive protein leakage in the urine, often caused by kidney damage. It can lead to several complications, including blood clots and high cholesterol levels. Nephrology doctors can prescribe medication to alleviate symptoms or treat the underlying cause.
Polycystic Kidney Disease (PKD): PKD is a genetic disorder that causes clusters of cysts to grow in the kidneys. These cysts can enlarge, damaging the kidneys or causing them to fail. There is no cure, but a nephrology doctor can help manage the symptoms of cystic kidney disease.
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Types of Tests and Procedures a Nephrologist Performs
Nephrologists are trained to perform several tests and procedures, including the following:
Blood Tests: A blood test measures the levels of creatinine, a waste product, in the blood. Nephrologists use blood test results, plus the patient’s age, size and gender, to calculate how many millimeters of waste their kidneys should filter in a minute. This is called a glomerular filtration rate. Kidneys that cannot filter a certain amount of waste in a minute likely have a condition or injury.
Urine Tests: A urine test can measure creatinine levels in the urine, which can also help determine how well the kidneys are performing.
Laboratory Tests: Such tests can give nephrologists a better idea of the state of a patient’s kidneys. They can include imaging tests, such as ultrasounds and X-rays, or a biopsy.
Ultrasounds: An ultrasound is an imaging test that uses sound waves to take pictures of the kidneys. It can help evaluate kidney size and shape, and identify any scarring.
CT Scans: A Computed Tomography scan uses X-rays and technology to create detailed images of the kidneys. These scans last for approximately 30-60 minutes, and can give a nephrologist more detailed information than an ultrasound.
X-Rays: X-rays use beams of energy that pass through the body to create a picture on a special film, to provide pictures of internal organs, bones and tissue. An X-ray can help determine the cause of any pain in the kidneys, ureter or bladder.
Kidney Biopsies: During a kidney biopsy, a nephrologist will remove a small piece of kidney tissue and examine it under a microscope to determine the cause of kidney issues.
Kidney Transplants: For patients with kidney failure, a transplant is recommended. During a transplant, a kidney is removed from one person and given to another. A kidney transplant is a complex procedure, but it can greatly improve the patient’s quality of life.
Connection Between Nephrology and Hypertension
There is a close relationship between nephrology and hypertension, or high blood pressure. Hypertension is a leading cause of kidney disease; it is estimated that one in five adults with hypertension may have chronic kidney disease. Kidney disease can also lead to high blood pressure. Patients with electrolyte imbalance disorders may also have hypertension.
For patients with both kidney disease and hypertension, treatment can become complex. However, highly trained nephrologists can manage both conditions through personalized treatment plans, which can include medication, lifestyle changes and dietary restrictions.
How to Become a Nephrologist: Education Requirements and Training
To become a professional nephrologist, aspiring doctors often complete four years of undergraduate studies, followed by four years of medical school. This is usually followed by three years of residency training and two to three years in a fellowship, with an additional year for transplant nephrology training. All in all, nephrologist education requirements take approximately 12-13 years.
Nephrologist Career Opportunities and Advancement
Becoming a nephrologist is an exciting opportunity that can lead to a long, successful career. According to the American Society of Nephrology, there is a growing demand in the United States, with chronic kidney disease and kidney failure increasing nationally.
According to salary.com, the average Nephrologist salary in the U.S. (in October 2025) was $277,100 USD per year. Doctors who operate a private practice often earn an even higher salary.
Conclusion
Ultimately, nephrology is a rewarding choice for many future medical doctors. With a high projected salary and the opportunity to improve outcomes for many patients, beginning a career in nephrology can be an immensely rewarding experience.
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FAQs About Nephrologists
Nephrologists diagnose and treat conditions related to the kidneys.
You should see a nephrologist if you have any symptoms that could be caused by kidney disease, or if you have a family history of kidney disease.
Nephrologists can prescribe medications and advise on changes to lifestyle or diets.
In the U.S., nephrologists make an average salary of $277,100 (Oct 2025), according to salary.com.
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