Nephrologist

A nephrologist is the physician who specialises in the kidneys and their diseases: chronic kidney disease, disorders of the kidney filter, recurrent stones, hard-to-control high blood pressure, and problems with salt and potassium balance. People also call them a kidney specialist or the dialysis doctor, since they supervise patients whose kidneys no longer filter enough and, when needed, prepare them for a transplant. They mainly see people with long-standing diabetes or hypertension, patients whose blood tests show falling kidney function or protein in the urine, and families affected by inherited kidney disease. The consultation is built around your blood and urine results (creatinine, estimated GFR, albuminuria), your full medication list and a physical examination; a kidney ultrasound is often requested, a biopsy more rarely. In Israel, you get there through a referral from your family doctor, to a nephrology clinic in a hospital or in your health fund.

• ✓Your tests show reduced kidney function (estimated GFR below 60, and especially below 30) or a fast drop between two tests.
• ✓Persistent protein or albumin in the urine, especially if you have diabetes or high blood pressure.
• ✓Blood in the urine found more than once with no urological cause identified.
• ✓High blood pressure that stays uncontrolled despite three medicines taken properly.
• ✓Recurrent kidney stones or a family history of kidney disease (polycystic kidneys, Alport syndrome).
• ✓Repeated abnormal potassium, sodium or calcium levels in the blood.
• ✓Long-standing diabetes with the first signs of kidney involvement, to slow the decline.
• ✓Preparation for, or follow-up of, dialysis or a kidney transplant.

In Israel, nephrology is a sub-specialty: the doctor first holds a specialist title in internal medicine, then a second title in nephrology (מומחה ברפואה פנימית ובנפרולוגיה), both issued by the Ministry of Health on the recommendation of the Scientific Council of the Israel Medical Association. A paediatric nephrologist follows the same logic starting from paediatrics. Both titles and the licence to practise (רישיון לעסוק ברפואה) appear on the Ministry's public register of licence holders (מאגר בעלי רישיון), which you can check before booking. A specialist trained abroad must have obtained the Israeli licence and then had the title recognised by the Scientific Council; a European or American diploma alone is not enough. In the UK and France, nephrology is reached by a different route (renal medicine training, or a direct four-year specialty after the national exam in France), so the pathway differs while the final standard is comparable. If dialysis is involved, check that the unit is licensed by the Ministry of Health, which is mandatory in Israel.