Public Service

Auckland DHB Renal

Auckland District Health Board (ADHB)

Description

What is Renal Medicine?

Renal medicine, or nephrology, is the branch of medicine that involves the diagnosis and management of people with diseases and conditions of the kidneys.

The kidneys are two bean-shaped organs about 12 centimetres long, found at the back of your abdominal cavity, that filter out wastes and excess fluid from your blood and excrete them as urine.

Renal medicine includes the urgent care of acutely ill patients as well as those with chronic illness who require long term care.

A doctor who specialises in disorders of the kidneys is called a nephrologist. Conditions seen by a nephrologist may include:

Acute renal failure – the sudden loss of kidney function (also called acute kidney injury)
Chronic, or long term, renal failure – gradual worsening of kidney function
Haematuria – blood loss in the urine
Proteinuria – protein loss in the urine
Kidney stones
Chronic or frequent urinary tract infections
Hypertension – that has not responded to antihypertensive therapy.

Many kidney disorders can be treated with medications but if kidney function starts to fail and the condition becomes severe, dialysis (using a machine to filter the blood) and later, kidney transplantation, may be required.

The Auckland District Health Board (ADHB) Renal Service manages patients in the ADHB region. It also provides transplant services for the northern half of the North Island.

Referral Expectations

If you have an urgent problem requiring immediate renal assessment you are referred acutely to the Renal Department where you will initially be seen by the Registrar (trainee specialist) who will decide whether you need to be admitted to hospital. Investigations will be performed as required, and the more senior members of the team involved where necessary.

If the problem is not urgent, the GP will write a letter to the Renal Department requesting an appointment in the outpatient clinic.

Most renal outpatient clinics are held at Greenlane Clinical Centre, but a small number are held at Auckland City Hospital and some follow-up clinics are held in community settings.

Most months the Department receives more referrals than can be seen in clinic. One of the consultant nephrologists (kidney doctors) working in the Department reviews these letters to determine who should be seen first, based on the information provided by the GP. Very urgent cases are usually seen within a couple of weeks, but other cases may have to wait a longer time. Sometimes the nephrologist will contact your GP to discuss your case and give advice rather than arranging a clinic appointment.

When you come to the Renal Outpatient Department you will be seen by a member of the renal team who will ask questions about your illness and examine you to try to determine or confirm the diagnosis. This process may also require a number of tests (e.g. blood tests, x-rays, scans etc). Sometimes this can all be done during one clinic visit, but for some conditions this will take several follow-up appointments. Occasionally some tests are arranged even before you are seen at the hospital to try to speed up the process.

Once a diagnosis has been made, the medical staff will discuss treatment with you. They will write to your GP with advice and may or may not arrange for you to attend a follow-up clinic.

You will receive a copy of the letter to your GP.

Procedures / Treatments

Kidney Failure

This is when a patient’s kidneys are unable to remove wastes and excess fluid from the blood... More
Haemodialysis

Haemodialysis is a treatment that cleans and filters your blood by removing the waste products and extra fluid that your kidneys can no longer eliminate... More
Peritoneal Dialysis

Peritoneal dialysis is a treatment where the peritoneal membrane (lining around the inside of your abdominal wall and the outside of your intestines) is used to filter and cleanse the impurities, waste products and extra fluid from your body... More
Transplantation

Transplantation places one healthy kidney into your abdomen. This one kidney is sufficient to replace the work of your two failed kidneys... More
Kidney Stones

This term refers to stones in the urinary system. They form in the kidneys but can be found anywhere in the urinary system... More
Urinary Tract Infections (UTIs)

A UTI is caused by an infection in the urinary tract... More