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Dr. Ndugu consulting with Dr. Krause on one of her nephrology patients.
Nephrology is the medical sub-specialty of internal medicine that focuses on the diagnosis and treatment of diseases of the kidney. Because the kidney performs so many critical functions, physicians in this sub-specialty maintain expertise in primary kidney disorders, but also the management of the systemic consequences of kidney dysfunction.
Internists who practice this sub-specialty are called nephrologists. In addition to kidney disorders, their treatment of kidney dysfunction includes high blood pressure, fluid and mineral balance, and dialysis of body wastes pertaining to kidney function. They typically consult with general surgeons about kidney transplantation and dialysis access surgery.
Rashida Flowers (Some Kind of Tomorrow/Hotter Than Hell): Dr. Krause had diagnosed her with chronic kidney failure secondary to diabetes. Kidney dialysis was ordered as the course of treatment, but she kept losing her access port. Additionally, because of a clotting disorder, gaining more traditional access sites were unsuccessful, and Dr. Ndugu consulted on the case as the next and last access site would go through the SVC.
Rashida being evaluated by Dr. Ndugu and Dr. Ortiz
Although her labs and status put her as a prime candidate for kidney transplant, her eGFR score disqualified her, forcing Dr. Ndugu to perform reinsertion at her last access site. Unfortunately, this caused her to develop SVCS and the port had to be removed. As she could no longer receive treatment through dialysis, Dr. Krause agreed with Dr. Ndugu and placed her on the transplant list. A donor kidney became available shortly after, and Dr. Ndugu secured Dr. Hunt to perform the kidney transplantation.
