A list of all participating insurances can be found under patient resources section of this web portal
Please bring your insurance cards, a photo identification card, such as a driver's license, and any referrals, or authorizations that are required by your insurance company. You can upload a copy at the time you fill the new patient registration form on this web portal
Please complete : Patient Registration form, HIPPA information and consent form and medication list form. Completing it online on this web portal will streamline your experience with your physician at the office. It is important that wait time in the lobby of the office is kept to a minimum during the COVID 19 pandemic. The forms are posted under patient resources.
Co-payments or any other payments not covered by insurance, including deductibles or out-of pocket expenses, need be paid at the time of service.
We do accept checks. We also accept Visa and Master cards.
A nephrologist is a physician who specializes in the diagnosis, treatment and management of kidney disease, hypertension, and kidney stones. Some nephrologists also subspecialize in kidney transplant. In addition to completing a residency in internal medicine, nephrologists must complete several years of additional training.
A nephrologist is a medical doctor who focuses on the treatment of diseases of the kidney. A urologist is medical doctor (surgeon) who focuses on the treatment of the diseases of the urinary tract and prostate.
Most people think the kidneys are only responsible for producing urine, but they have many important functions in your body:
They remove waste products from the body
They balance the body’s fluids and electrolytes
They release hormones that regulate blood pressure and control calcium metabolism
They stimulate and control the production of red blood cells
They produce an active form of Vitamin D that promotes healthy bones
They provide critical regulation of the body’s salt, potassium and acid content
Some people with severe kidney disease make urine that has a lot of water, but does not contain much waste products. This means the blood has a high level of waste products, including potassium.
The good news is that there are a lot of things you can do to reduce the risk of developing or worsening kidney disease. There are some ways you can help slow or diminish the loss of kidney function. You should:
Keep fit and active – exercise regularly
Maintain good control over your blood sugar levels
Monitor and control your blood pressure
Eat healthy and maintain a healthy weight
Maintain a healthy intake of water
Avoid excessive salt intake
Don’t smoke or drink too much alcohol
Do not take over-the-counter medications on a regular basis
Get your kidney function tested regularly
Most patients have no symptoms until they have severe loss of kidney function, generally less than 10-20% of normal. Symptoms may be vague and nonspecific and may include:
● Fatigue or loss of energy
● Loss of appetite
● Trouble sleeping
● Itching or hiccups
● Swelling in the legs and/or the face
● Diabetes and high blood pressure are the most common causes of chronic kidney disease. There is no specific treatment that reverses diabetic kidney disease or high blood pressure related kidney damage.. Good control of diabetes and high blood pressure as well as the use of medicines which protect the kidneys often stabilizes or slows down these forms of kidney damage especially if they are caught early. Therefore early referral to a nephrologist is key to management
● Polycystic kidney disease (PKD) is the most common inherited kidney disease and affects men and women equally. Hundreds of cysts typically replace normal kidney tissue over many years, resulting in loss of kidney function. The main treatments consist of good blood pressure control and medicines to protect the kidneys and close monitoring.
● Vasculitis is a disease in which blood vessels through out the body become inflamed and damaged by the immune system. When this happens in the blood vessels in the kidneys, they may leak blood or protein in the urine or not clean the blood well. Treatment usually consists of drugs which reduce immune system activity and inflammation.
● Glomerulonephritis refers to inflammation in the filters (or blood vessels or glomeruli) in the kidneys. Treatment consists of drugs which reduce immune system activity and inflammation.
A blood test called the Creatinine is the most common lab test used to indicate kidney function. Creatinine in the body is mostly made in muscles and is typically in the blood in very small and stable amounts throughout a lifetime. The creatinine rises when kidneys do not clean the blood well and therefore it can be used as an indicator of kidney function. The creatinine indicates the total function of BOTH KIDNEYS.
● The urine is another indicator of kidney health and in certain diseases may show protein, microscopic blood and /or allergic or inflammatory cells. If protein is present in the urine, it may be helpful to follow the amount of protein over time.
● 24-hour urine collections were done frequently in the past but are less commonly needed today to follow urine protein or amount of kidney function due to other testing alternatives. 24-hour collections are still helpful in certain diseases such as kidney stone evaluation and management.
● Pictures of the kidneys often reveal clues to the causes of kidney disease or damage and so an ultrasound (the test with a wand and cold jelly on the abdomen and back, no needles) is often requested. Depending on an individual's case, a CT scan, MRI or angiogram may also be recommended.
● Occasionally if a certain kidney disease is suspected or if the cause of kidney disease is unknown despite other testing, a kidney biopsy may be recommended.
There are five stages of kidney disease, defined by the level of kidney cleaning (or GFR):
● Stage 1-Kidneys clean the blood normally but other indicators of kidney damage or stress are found, such as protein in the urine or scars on the kidneys or loss of one kidney.
● Stage 2-Kidneys cleaning at 60-90% of normal
● Stage 3-Kidneys cleaning at 30-60% of normal
● Stage 4-Kidneys cleaning at 15-30% of normal. At this level of function, an individual may start to experience symptoms of poor kidney function (such as fatigue or poor appetite) or may start to notice fluid build up in the ankles or higher blood pressure or have more problems with the build up of potassium or acid in the blood or become anemic (have a low blood count).
● Stage 5-Kidneys cleaning less than 15% of normal. This is also called End Stage Kidney Disease and generally indicates a person who needs dialysis or a kidney transplant in the near future.