Nephrology Department

The Nephrology unit is the part of the network dedicated to the kidneys: their function, the diseases that affect them, and the care of people whose kidneys are no longer working as they should. It brings together kidney specialists (nephrologists), specialist nurses, dialysis teams and the laboratory and imaging services that kidney medicine depends on, so that everything needed to investigate and manage kidney disease is gathered in one coordinated team. For an international patient, the unit is the clear place to turn for a rising creatinine, protein or blood in the urine, difficult-to-control blood pressure, recurrent stones or a kidney problem found on a scan — and the team that reviews such cases remotely before any travel is arranged.

What the nephrology unit does

Nephrology is the medical specialty of the kidney. Unlike urology, which is surgical and focuses on the urinary tract and its plumbing, nephrology is a medical discipline concerned with how well the kidneys filter the blood, balance fluids, salts and acidity, control blood pressure and support the bones and the production of red blood cells. The unit’s work runs across the whole spectrum of kidney health: detecting disease early through simple blood and urine tests, slowing the progression of chronic kidney disease, managing the complications that arise when kidney function falls, and delivering or coordinating kidney replacement therapy — dialysis and, with the transplant unit, transplantation — when it is needed.

Much of nephrology is quiet, long-term medicine. Kidney disease often produces no symptoms until it is advanced, which is why the unit places so much weight on screening and monitoring. A small change in a blood test, picked up and acted on early, can change the entire course of a person’s kidney health. Where disease is more advanced, the unit’s role shifts to protecting remaining function, managing blood pressure, fluid and minerals, and preparing — calmly and in good time — for whatever the next stage of care may be.

Conditions the nephrology unit treats

The unit cares for the full range of kidney and related conditions, including:

• Chronic kidney disease (CKD) at every stage, from early changes detected on testing through to advanced disease and the planning of kidney replacement therapy.
• Acute kidney injury — a sudden fall in kidney function caused by illness, dehydration, medication or other insults — where prompt assessment can make a decisive difference.
• Hypertension, including blood pressure that is difficult to control or that has a kidney-related cause, managed in a dedicated hypertension setting.
• Glomerular diseases such as the various forms of glomerulonephritis and nephrotic syndrome, in which the filtering units of the kidney are inflamed or damaged.
• Diabetic kidney disease, one of the most common reasons kidneys fail worldwide, managed alongside the endocrinology team.
• Inherited and cystic kidney diseases, including polycystic kidney disease.
• Electrolyte and acid–base disorders — disturbances of sodium, potassium, calcium and other minerals.
• Kidney involvement in systemic illness, such as autoimmune disease, where the unit works with rheumatology and other specialties.
• Recurrent kidney stones investigated for an underlying metabolic cause, in collaboration with urology.

For each of these, the aim is the same: to find the cause, slow or reverse the damage where possible, and protect the patient’s long-term health and quality of life.

Diagnosis and tests

Kidney medicine is built on careful measurement, and the unit uses a layered set of investigations. The foundation is laboratory testing: blood tests that measure kidney function (creatinine and the estimated filtration rate), together with urine tests that look for protein and blood — often the earliest signs that something is wrong. These simple tests, repeated over time, are what allow the team to detect disease early and track its course.

Imaging adds the anatomical picture. Ultrasound is the usual first step, showing the size, shape and structure of the kidneys and detecting obstruction, cysts or scarring; CT and MRI are used when more detail is needed. Where the diagnosis depends on understanding what is happening inside the filtering tissue itself, the unit performs a kidney biopsy — taking a tiny sample of kidney tissue under imaging guidance for examination by specialist pathologists. The biopsy is often the key that unlocks the precise diagnosis in glomerular and unexplained kidney disease, and it is performed within a unit experienced in doing it safely.

Because kidney disease rarely exists in isolation, assessment also includes a search for its causes and consequences — blood pressure, blood sugar, the heart, the bones and the blood count — so that the plan addresses the whole picture rather than a single number.

Treatments and procedures

The unit’s treatments span the full range of kidney care. For most patients, the work is medical: controlling blood pressure with the right combination of medicines, protecting the kidneys in diabetes, treating inflammation in glomerular disease, correcting mineral and acid–base disturbances, and adjusting other medications so they are safe for the kidneys. This careful, individualised medicine is what slows progression and keeps patients well for as long as possible.

When kidney function falls to the point that the kidneys can no longer sustain the body, the unit provides and coordinates kidney replacement therapy:

• Haemodialysis, in which the blood is filtered by a machine, delivered in a dedicated dialysis setting by experienced teams.
• Peritoneal dialysis, a home-based form of dialysis using the lining of the abdomen, with training and support from the unit.
• Kidney transplantation, the best long-term option for suitable patients, delivered together with the organ transplantation unit, which runs the regulated transplant programme and the lifelong follow-up that protects a transplanted kidney.

Choosing between these paths is a considered, shared decision, and the unit’s role is to prepare patients in good time so that, whichever route is right, it begins under the best possible conditions rather than as an emergency.

The multidisciplinary team

Kidney disease reaches into many parts of the body, so the nephrology unit works closely with other specialties. Diabetes and kidney disease are managed alongside endocrinology; the heart and kidneys are deeply linked, so cardiology is a frequent partner; urology handles the surgical and stone-related aspects of the urinary tract; rheumatology is involved where autoimmune disease affects the kidneys; and the transplantation unit takes the lead when a transplant is the goal. Within the unit itself, specialist nephrology and dialysis nurses, dietitians who tailor nutrition to kidney function, pharmacists and coordinators are central to good outcomes. For complex cases, these specialists meet together, so the plan reflects every relevant perspective at once.

Technology and facilities

The unit is built around the equipment kidney care depends on: modern dialysis systems maintained to strict standards and operated by experienced teams, image-guided biopsy, and the laboratory and pathology services that make accurate diagnosis possible. Imaging — ultrasound, CT and MRI — is interpreted by radiologists who work with the kidney team daily. As elsewhere in the network, the value lies less in any single machine than in the pairing of dependable technology with people who use it every day for exactly these conditions.

What to expect as an international patient

For someone travelling from abroad, the unit is designed to make a complex field feel manageable. Your case is first reviewed remotely on the basis of your existing blood tests, urine results and any imaging, so that the team can advise whether travel is necessary at all and, if it is, what should be arranged. On arrival, you can expect a thorough assessment, a clear explanation of your diagnosis and of the realistic options, and a written plan agreed with you. Throughout, an international patient coordinator remains your single point of contact, helping with scheduling, language and the practical side of your visit, and ensuring that any other units involved in your care are engaged from the start.

Because much of nephrology is long-term, the unit also plans for what happens after you return home: the medications you will need, the tests your local doctor should monitor, and how the team here can stay in contact for follow-up or a further opinion.

Remote review before you travel

You do not need to travel to begin. Kidney disease is unusually well suited to remote assessment, because so much of it is captured in numbers: the trend in your kidney function, the amount of protein in your urine, your blood pressure and your mineral levels. By sharing these results and any imaging, you can have the unit review your case, advise whether further tests are needed, and outline the likely plan, timeline and cost before you make any decision. A remote second opinion from a nephrologist is also available if you would like an expert view on a diagnosis or on whether a proposed treatment — including the timing of dialysis or transplantation — is right for you.

Quality and standards

Kidney care is exacting, and the unit works to defined clinical protocols, draws on accredited laboratory and imaging services, and contributes to the hospital’s overall safety systems, including infection control and medication safety — the latter especially important in kidney disease, where many drugs must be dosed carefully. Accreditation such as JCI applies at the level of the hospital and reflects how well these systems work across its units. When considering care, it is reasonable to ask about a unit’s experience in your specific condition and how it monitors results; an experienced nephrology team will be glad to discuss this.

When to see a nephrologist

It is worth seeking a kidney opinion if a blood test shows reduced kidney function or this has been falling over time; if urine testing repeatedly shows protein or blood; if blood pressure is hard to control despite treatment; if you have diabetes, which steadily threatens the kidneys; if you have a family history of kidney disease; or if a scan has shown an abnormality of the kidneys. Early referral is valuable precisely because kidney disease is often silent — the sooner it is assessed, the more can be done to protect function.

Living with kidney disease and travelling for care

Because kidney disease is usually a long-term condition, planning matters as much as treatment. If you depend on dialysis, the unit can coordinate sessions around a visit so that your treatment is not interrupted while you are away from home; share your current dialysis prescription in advance so it can be matched. For those not yet on dialysis, the priority is protecting the kidneys during travel — staying well hydrated, continuing blood-pressure and other medicines, and avoiding drugs that can harm the kidneys, such as certain anti-inflammatory painkillers. The unit’s dietitians can advise on a kidney-appropriate diet, including the sensible management of salt, potassium, phosphate and protein according to your stage of disease, and adapt that advice to the realities of travelling and eating away from home. Most importantly, the unit plans continuity: a clear list of your medications and their doses, the blood tests your doctor at home should monitor and how often, and a point of contact here for questions after you return. For many international patients, this combination of expert assessment during a focused visit and a well-documented plan to follow at home is exactly what long-term kidney care requires, and it is one of the practical strengths of being looked after within a coordinated unit rather than in isolation.

This page is for general information and does not constitute medical advice, a diagnosis or a treatment recommendation. The units and services available vary between hospitals in the network; please confirm details for the unit proposed for your care, and always consult a qualified clinician about your situation.