Nephrology

Welcome to Kern Medical’s division of Nephrology, offering Internal Medicine residents training in Nephrology an exciting academic environment committed to excellence, innovation, and diversity. Kern Medical is committed to treating patients struggling with kidney diseases and educating the community on the importance of healthy lifestyle choices.

According to a California Health Interview Survey, about 11.5% of adults in Kern County have diabetes. Kern County also has one of the highest numbers of dialysis patients in the country. Chronic Kidney Disease (CKD) is a growing problem in this area, and limited resources lead to limited options for local patients. At Kern Medical, doctors are hoping to change perspectives: The best way to treat kidney problems may be to do more to make sure patients don’t have them in the first place.

What Is Nephrology?

Nephrology is a branch of Internal Medicine devoted to the physiology and study, diagnosis, and treatment of kidney disease. The kidneys help to control blood pressure by removing excess water and waste from the body. These organs can cause many issues when they do not function as they should, which is why the Nephrology Division is actively working to prevent kidney problems for optimal kidney health.

Conditions Treated

Chronic Kidney Diseases
Acute Renal Failure
Kidney Stones
Hypertension (High Blood Pressure)
Urinary Tract Infections
Fluid and Electrolyte Abnormalities
Acid-Base Disorders
Cystic Diseases of the Kidney
Gout
Pre and Post Kidney Transplant Management
Acute and Chronic dialysis care (Home hemodialysis, peritoneal and In-center Hemodialysis)

Nephrology: Frequently Asked Questions

What is Chronic Kidney Disease (CKD)?
How to Recognize Chronic Kidney Disease (CKD)
How to prevent CKD
What is Acute Renal Failure?
What are kidney stones?
What is hypertension (high blood pressure)?
What is a urinary tract infection (UTI)?
What are electrolyte abnormalities?
What are acid-base disorders?
What are cystic diseases of the kidney?
What is gout?

What is Chronic Kidney Disease (CKD)?

CKD is a progressive disease that, when caught early, can be managed and treated to inhibit critical damage to the organs

How to Recognize Chronic Kidney Disease (CKD)

CKD can be difficult to detect. Sometimes, initial kidney failure symptoms simply include fatigue and exhaustion, which often go unnoticed. If this is the only symptom in the beginning, the disease may go undiagnosed until more serious care is required, such as a kidney transplant. By recognizing kidney problems early on, especially those with diabetes, you have the best chance at an optimal outcome. Kern Medical Nephrologist, Dr. Eppanapally recommends people with diabetes should see a kidney specialist once a year as a preventative measure. “If you don’t have diabetes, however, you should still know the signs. For some people, it’s a genetic issue, and the only way to prevent damage is to be aware,” he said.

How to prevent CKD

CKD may be a growing problem in our community, but fortunately, there are everyday things we can do to help prevent it for ourselves and our loved ones.

Stay hydrated
Maintain a healthy weight
Don’t smoke or use tobacco
Limit alcohol consumption
Exercise for at least 30 minutes per day
Follow a low-salt, low-fat diet
Make sure your blood pressure is normal
Have regular check-ups with your doctor

What is Acute Renal Failure?

Acute renal failure is a malfunction of the kidneys so that they are unable to perform the vital function of filtering out waste from the blood. Acute renal failure may be caused by decreased blood supply to the kidneys from drugs or infection, damage to the kidneys, or by blockage in the urinary system.

What are kidney stones?

Kidney stones are the presence of stones in the kidney due to a decrease in urine volume or excess of stone-forming substances in the urine. They are formed due to dehydration, changes in diet, hormonal changes, and infections in the kidney.

Symptoms include:

Renal pain which is intermittent and severe radiating to the groin, and testes in males
Pain worsens during movement
Blood in urine
Pus in urine
Fever
Difficulty in urination, feeling of urgency, frequent, painful, burning
Nausea, vomiting, chills, and fever

Some kidney stones pass on their own when they are small before causing any symptoms. Larger stones block urine flow and cause painful symptoms.

What is hypertension (high blood pressure)?

Hypertension is high pressure in the arteries (vessels that carry blood from the heart to the rest of the body). There is no exact cause for hypertension but there are many factors that increase the risk such as sedentary lifestyle, age, and other medical conditions. Most people are symptomless, others may include:

Severe headache
Severe anxiety
Shortness of breath
Nosebleed
The feeling of pulsations in the neck or head
Exact causes of high blood pressure are not known, but several factors include risk:
High salt intake or salt sensitivity
Smoking
Overweight or obesity
Lack of physical activity
Too much of alcohol consumption
Stress
Age above 40
Genetics

Simple lifestyle changes can lower high blood pressure, but when blood pressure is very high, or lifestyle measures fail, treatment is necessary.

What is a urinary tract infection (UTI)?

UTIs are an infection of any part of the urinary system, including kidneys, ureters, bladder, and urethra. They are generally caused by bacteria but can also result from certain viruses and fungi. Mainly noted symptoms include:

Burning sensation during urination
Frequent urination
Frequent urge to urinate, but incomplete voiding
Pain or pressure in the back or lower abdomen
Cloudy, dark, or strange or strong-smelling urine, mixed with blood in some cases
Tiredness
Fever and/or chills
Nausea and/or vomiting

What are electrolyte abnormalities?

An electrolyte disorder occurs when the levels of electrolytes in your body are either too high or too low. Electrolytes are naturally occurring elements and compounds int he body. They control important physiologic functions.

Examples of electrolytes include:

Calcium
Chloride
Magnesium
Phosphate
Potassium
Sodium

These substances are present in your blood, bodily fluids, and urine. They’re also ingested with food, drinks, and supplements. Electrolytes need to be maintained in an even balance for your body to function properly. Otherwise, vital body systems can be affected.

Common symptoms of an electrolyte disorder may include:

Irregular heartbeat
Fast heart rate
Fatigue
Lethargy
Convulsions or seizures
Nausea
Vomiting
Diarrhea or constipation
abdominal cramping
Muscle weakness
Muscle cramping
Irritability
Confusion
Headaches
Numbness and tingling

What are acid-base disorders?

An acid-base disorder is an abnormality in the balance of acids and bases in the body. If there’s too much acidity in the blood, the imbalance is called acidosis. If the blood is too alkaline (base), the imbalance is called alkalosis. This can exist in varying levels of severity.

What are cystic diseases of the kidney?

Cystic kidney disease refers to a wide range of hereditary, developmental, and acquired conditions. With the inclusion of neoplasms with cystic changes, over 40 classifications and subtypes have been identified. Depending on the disease classification, the presentation of disease may be from birth, or much later into adult life. The cystic disease may involve one or both kidneys and may or may not occur in the presence of other anomalies. A higher incidence of cystic kidney disease is found in the male population and prevalence increases with age. Renal cysts have been reported in more than 50% of patients over the age of 50. Typically, cysts grow up to 2.88 mm annually and cause related pain and/or hemorrhage.

What is gout?

Gout is a type of arthritis that causes inflammation of joints due to excess uric acid. The main symptoms include a sudden attack of severe pain in joints, mainly the big toe. The risk factors which causes excess uric acid include: