Nephrology

Nephrology evaluates kidney function, urine abnormalities, fluid and electrolyte balance, and medical treatment of kidney disease. Early disease may cause few symptoms, so trends in blood and urine results matter. The priorities are identifying the cause, protecting remaining function and planning suitable long-term care.
MPGCARE coordinates nephrology review at Medical Park and Liv Hospital in Türkiye. The hospital confirms the specialist, investigations and available services. We support records, communication, appointments and travel. Procedures, dialysis arrangements and transplantation suitability require individual clinical confirmation.

Kidney diseases and consultation topics

The following overview does not establish a diagnosis or mean every condition requires dialysis or a biopsy. Treatment depends on cause, severity, change over time and the patient’s overall health.

Disease / condition	Assessment	Management approach
Chronic kidney disease (CKD)	Persistent structural or functional problems; review eGFR and urine albumin trends.	Cause-specific kidney protection and monitoring of complications.
Acute kidney injury (AKI)	A sudden deterioration may relate to dehydration, illness, medicines or obstruction.	Prompt cause assessment and treatment; temporary dialysis may be needed in severe cases.
Diabetic kidney disease	Diabetes can damage kidney filters, often without early symptoms.	Glucose and blood-pressure management, appropriate kidney-protective therapy and follow-up.
Hypertension-related kidney disease	High pressure and kidney disease can worsen one another.	Individual pressure targets, medicine review and relevant secondary-cause assessment.
Proteinuria or albuminuria	Protein in urine requires confirmation and context.	Quantify, identify cause and protect kidney function; biopsy only where indicated.
Haematuria	Blood in urine can arise from kidney filters or urinary tract causes.	Urine and imaging review with urology collaboration where appropriate.
IgA nephropathy and other glomerulonephritis	Filter inflammation has several distinct causes.	Targeted blood/urine tests and selected biopsy; diagnosis-specific treatment.
Nephrotic syndrome	Heavy protein loss can cause swelling and low blood albumin.	Find the underlying disease and manage oedema and relevant complications.
FSGS, membranous nephropathy and minimal-change disease	Different filter disorders cannot be treated as one diagnosis.	Specialist interpretation of biopsy where needed; individual supportive or immune-directed therapy.
Lupus nephritis and systemic immune disease	Systemic inflammation may involve kidneys.	Nephrology/rheumatology coordination, selected biopsy and close treatment monitoring.
Polycystic and inherited kidney disease	Genetic disorders may cause cysts or other abnormalities.	Family history, imaging and selected genetic counselling; individual risk and treatment review.
Interstitial and medicine-related kidney injury	Medicines or other triggers may affect kidney tissue.	Review exposures and renal function; changes only under medical guidance.
Fluid, potassium and acid-base disorders	Imbalance may cause swelling, weakness or serious complications.	Assess severity and correct the cause; severe abnormalities require urgent care.
Kidney-related anaemia and mineral/bone disorders	Reduced function can affect blood production and mineral balance.	Targeted laboratory review and appropriate prescribed treatment.
Recurrent stones and metabolic risk	Repeated stones may need prevention beyond the immediate procedure.	Metabolic evaluation with urology; tailored nutrition and prevention.
Advanced kidney failure and dialysis care	Treatment choice depends on symptoms, function and personal circumstances.	Haemodialysis, peritoneal dialysis, transplantation assessment or conservative kidney care.
Kidney transplant follow-up	A transplanted kidney needs ongoing monitoring.	Transplant-team coordination, medicine levels, infection/rejection assessment and continuing care.

What should I bring to the consultation?
Bring dated creatinine/eGFR and urine results, ultrasound or other imaging, biopsy reports, discharge records, blood-pressure readings and a complete medicine list. Include painkillers, supplements, dialysis prescriptions and transplant details if relevant. The nephrologist reviews the pattern over time, not only the latest isolated number.

What do eGFR and urine albumin show?
eGFR estimates filtration; urine albumin-to-creatinine ratio helps assess protein leakage. Both contribute to risk assessment and follow-up. Results may need repeat testing and interpretation against recent illness, medicines and previous values. One abnormal test does not by itself define chronic disease, and a normal-looking scan does not exclude a kidney-function problem.

Which additional tests are useful?
Electrolytes, blood count, urine microscopy, ultrasound or selected immune tests answer particular questions. Some cases require imaging to investigate obstruction or a hereditary assessment. Not everyone needs every test. The clinical team explains preparation, contrast considerations and medication changes; do not stop prescriptions independently.

When is a kidney biopsy considered?
A biopsy may clarify unexplained kidney dysfunction, significant protein loss or selected immune/transplant problems when the result could change care. It is not routine for every patient. The team reviews blood pressure, blood counts, clotting and medicines, explains bleeding and other risks, and plans observation and activity restrictions. Whether it is suitable cannot be decided from a laboratory number alone.

Can progression be slowed?
Managing blood pressure, diabetes and the underlying disease can help protect function. Appropriate medicines, smoking cessation and individual nutrition may be part of care. Immunosuppressive treatment is only for a relevant diagnosis and requires monitoring. Established scarring may not reverse; treatment response and progression vary, so complete recovery cannot be promised.

How much water and which foods are appropriate?
Fluid, salt, protein, potassium and phosphorus recommendations depend on the disease stage, blood results, urine output and dialysis type. More water is not automatically better, and a generic restrictive diet can be harmful. A renal dietitian may help create a practical plan. Avoid unreviewed herbal or “kidney detox” products and ask before taking anti-inflammatory painkillers.

When does dialysis become necessary?
The decision considers symptoms, fluid overload, electrolyte or acid-base problems, nutritional state and kidney-function trend; it is not based on one number alone. Haemodialysis filters blood through an external system, while peritoneal dialysis uses the abdominal lining and needs a catheter and training. Access, infection prevention, schedule and lifestyle suitability are reviewed in advance. Dialysis supports function but does not cure chronic kidney failure.

Transplantation and conservative kidney care
A transplant programme assesses medical suitability, compatibility and follow-up requirements; living donors need an independent safety evaluation. Donor eligibility, regulatory requirements and timing are confirmed by the programme. No organ or transplant date is promised by MPGCARE. Ongoing anti-rejection treatment and monitoring are essential. Conservative kidney management is active symptom-focused care without dialysis or transplantation and should be discussed individually.

How are dialysis visits and travel arranged?
Do not miss or alter dialysis sessions for travel. The receiving unit must review the prescription, access, infection-screening requirements and clinical stability and confirm capacity before flights are booked. Peritoneal supplies or devices require advance planning. MPGCARE coordinates enquiries; an enquiry alone is not a confirmed dialysis booking. Return travel and ongoing care are agreed with the treating team.

Which symptoms need urgent local assessment?
Very low urine output with illness, severe breathlessness or swelling, confusion, chest pain, collapse or rapidly worsening symptoms need urgent care. Fever or access problems during dialysis, and abdominal pain with cloudy peritoneal fluid, need immediate contact with the treating unit. Transplant recipients should promptly report fever or sudden illness. Do not wait for an overseas appointment or online reply.

Documents, costs and follow-up
Send age, diagnosis, dated tests, imaging, biopsy, medicines and dialysis/transplant records through MPGCARE’s designated channel. The hospital confirms the proposed pathway. Clarify consultation, tests, biopsy/observation, medicines, dialysis sessions and follow-up in an itemised estimate. Obtain a written summary and continuity plan with local nephrology; long-term care may extend beyond the visit.

Patient coordination
Free Sarp–Trabzon transfer is offered for road arrivals and free airport–hospital transfer for air arrivals. Route, time and accompanying-person arrangements are confirmed beforehand. Accommodation and appointments should reflect tests, treatment schedules and clinical stability. MPGCARE supports coordination while the hospital determines medical suitability and travel advice.

Patient information sources: NIDDK: CKD · NIDDK: tests · NHS: AKI · NIDDK: glomerular disease · NIDDK: nephrotic syndrome · NIDDK: biopsy · NIDDK: treatment choices · NIDDK: transplantation

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