Dr Alvin Ng
Senior Consultant Nephrologist
MBChB (Auckland), FRACP (Aus), FAMS (Renal Medicine)
What Is Nephrology?
Nephrology is a subspeciality of internal medicine that focuses on diagnosing and managing conditions that affect kidney function. Nephrologists are medical specialists who treat diseases that impair how the kidneys work, rather than the physical structures of the urinary tract. Their work often involves the long-term management of chronic conditions.
To diagnose kidney problems, nephrologists may order blood and urine tests, imaging scans or sometimes a kidney biopsy. They manage care through lifestyle guidance, medication and dialysis for kidney failure, and they prepare patients for kidney transplantation when needed.
Common conditions treated by nephrologists include:
- Chronic kidney disease (CKD)
- Acute kidney injury
- Hypertension that affects kidney function
- Diabetic kidney disease (DKD)
- Kidney Inflammation (Glomerulonephritis)
- Inherited conditions such as polycystic kidney disease
- Electrolyte and acid-base imbalances
What Is Urology?
Urology is a surgical specialty that focuses on the urinary tract and the male reproductive system. Urologists are trained to diagnose and treat structural or anatomical problems that affect urine flow and storage, as well as conditions involving the kidneys, bladder, ureters and urethra.
To identify these conditions, urologists may use diagnostic tools such as imaging scans, cystoscopy or urine flow studies. Treatment often involves surgical or minimally invasive procedures to remove stones, treat tumours or relieve blockages. Medical therapy may also be prescribed for conditions such as urinary tract infections or prostate disorders.
Kidney-related conditions commonly managed by urologists include:
- Kidney stones
- Obstructions in the urinary tract
- Kidney and bladder cancers
- Congenital abnormalities of the urinary system
Key Differences Between Nephrology and Urology
The main distinction between nephrology and urology lies in their areas of focus, medical training, and approaches to treatment. While the two specialties often overlap, they address kidney-related conditions from different perspectives and patients may sometimes need care from both.
- Focus: Nephrology is concerned with how the kidneys function and how diseases affect their ability to filter waste and regulate body balance. Urology, on the other hand, deals with the structural or anatomical aspects of the urinary tract and the male reproductive system.
- Expertise: Nephrologists are physicians trained in internal medicine with advanced expertise in kidney-specific disorders. Urologists are surgeons who specialise in operative techniques for conditions affecting the urinary tract and male reproductive organs.
- Conditions Treated: Nephrologists commonly manage long-term or systemic conditions such as chronic kidney disease, hypertension-related kidney damage and diabetic kidney disease. Urologists focus on structural or obstructive problems such as kidney stones, tumours or blockages that may require surgical intervention.
- Treatment: Nephrology primarily involves medical management, including medication, diet and dialysis to preserve kidney function. On the other hand, urology often involves surgical or minimally invasive procedures to restore normal urinary flow or remove diseased tissue.
When Should You See a Nephrologist?
Doctors often refer patients to nephrologists for ongoing monitoring and management of kidney-related conditions. Because kidney disease can progress silently, early consultation with a nephrologist may help slow its progression and preserve kidney function.
A referral to a nephrologist is usually recommended when there are signs of impaired kidney function. In other words, you should see a specialist if you experience symptoms or medical findings that suggest your kidneys may not be working properly. These include:
- Abnormal kidney blood tests, such as elevated creatinine
- High protein in the urine (Proteinuria)
- Blood in the urine (Hematuria)
- Uncontrolled high blood pressure
- Swelling of the legs, ankles or around the eyes
- Persistent fatigue or unexplained nausea that may relate to kidney function
- Family history of chronic kidney disease
When Should You See a Urologist?
Doctors typically refer patients to urology specialists when a condition may require surgical or procedural treatment. In particular, urologists play a vital role in managing urinary tract cancers, kidney and bladder stones that do not pass naturally, and obstructions that disrupt normal urine flow.
A urologist is the right specialist to consult when there are signs of structural abnormalities or symptoms involving the urinary tract. For instance, you may be referred to a urologist if you experience:
- Sudden severe flank or abdominal pain, often linked to kidney stones
- Recurrent urinary tract infections
- Difficulty urinating or a weak urine stream
- Suspected or diagnosed tumours of the kidney or bladder
Because many urinary issues can worsen without treatment, prompt evaluation by a urologist helps identify the cause early and guide effective management before complications arise.
How Nephrologists and Urologists Work Together
Effective kidney care often relies on close collaboration between nephrologists and urologists. For instance, a patient with recurrent kidney stones may need a urologist to remove or break down the stones, while a nephrologist investigates the underlying metabolic cause to prevent future recurrence. In another example, a person diagnosed with kidney cancer may have a urologist perform surgery, while a nephrologist helps monitor kidney function after treatment.
This coordinated approach ensures patients receive care that addresses both the functional and structural aspects of their condition. By working together, nephrologists and urologists provide comprehensive, long-term support. This helps patients protect and maintain kidney health across the full spectrum of medical and surgical needs.
Get Comprehensive Kidney Care at Our Nephrology Clinic
Understanding the difference between nephrology and urology helps you make informed choices about your care. Whether you are managing a chronic kidney condition or seeking evaluation for new symptoms, early consultation can make a meaningful difference in preserving kidney function and preventing complications.
At The Kidney Health Care Clinic, we provide comprehensive, patient-focused care for a wide range of kidney conditions. With expertise in renal medicine and a commitment to personalised treatment, our nephrologist, Dr Alvin Ng, works closely with each patient to identify the cause of kidney problems and develop a plan that supports lasting kidney health. Schedule a consultation with The Kidney Health Care Clinic today to take an active step toward understanding and protecting your kidney health.