The silent killer

The Silent Killer Salad Dressing: The Silent Killer Written by:

The silent killer

April 25, I often call kidney disease the "Rodney Dangerfield of Medicine". It gets no respect! Well, outside of the medical community, the same could be said for nephrologists to a certain extent!

The silent killer

No one is quite sure what they do, or why does anybody need to see one anyway. For The silent killer, we are just another version of urologists. Nephrologists, as the readers of this blog know are physicians who specialize in the diagnosis and treatment of kidney disease, electrolytes, high blood pressure, dialysis, kidney stones, etc.

My medical assistant, Kristina, spends a good portion of her time calling patients about their upcoming appointments which often have been made by patients' primary doctors. Here is how a typical conversation goes: I am calling from Dr Chauhan's office about your upcoming appointment with us".

Your doctor sent us a referral note saying he talked about this with you. That you need to be seen by a nephrologist for elevated creatinine or protein in the urine, or high blood pressure?

They made an appointment for you". And why do I need to see you again? The conversation goes on for some time till Kristina has worked up a pretty convincing argument about why it might be beneficial for the patient to come in for something that their primary doc recommended. Most patients follow through; a few don't.

Typical responses for refusal are, "I pee fine.

The silent killer

Nothing is wrong with my kidneys", or "my kidneys don't hurt". Or even, "I am already seeing a urologist"! As we know, peeing or not peeing, or pain in the kidneys, are not necessarily the symptoms of kidney disease.

Its partly the nephrologists' fault we haven't been good at educating people of the nephrologist's role; not until someone is already on dialysis. It also has to do with the nature of the disease. Chronic kidney disease CKD is a "silent killer".

It destroys your kidneys slowly and you don't feel a thing. Not until it is almost the time for dialysis, even at which time the symptoms can be very vague like fatigue or insomnia.

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