Derived from the Greek word, nephros, meaning kidney, and combined with the suffix, -logy, meaning the study of, Nephrology is a medical specialty that is concerned with the study, treatment and even replacement of kidneys.

At Naval Medical Center Portsmouth (NMCP), nephrologists treat kidney patients from all walks of life with a diverse age range and ensure they receive consistent and quality care regardless of their illness or specific treatment.

"Generally, when people think about kidney disease and dialysis, they assume we only treat older patients, and that is not the case," said Cmdr. Austin Parker, Nephrology Department head. "While our patients are generally older, we treat anyone over the age of 18 who may have a chronic kidney disease or injury, and our staff ensures that our patients are educated on their treatment and are receiving the care they need."

The clinic offers a variety of services to its patients including the monitoring of blood pressure and kidney functions, a urinalysis lab, infusion and anemia clinics, transplant work-ups, post-transplant care and dialysis.

"We can help our patients in a number of ways, but our most consistent patients are here for dialysis," Parker said. "We have about 12 people who need dialysis and need to be seen every other day. We have them on a clinic schedule of Monday, Wednesday and Friday with each session being three to four hours in the mornings."

Dialysis is a process for removing waste and excess water from the blood and is used primarily as an artificial replacement for lost kidney function in people with kidney failure. It can also be used for those with an acute kidney injury.

There are two main types of dialysis - hemodialysis and peritoneal - and both remove wastes and excess water from the blood, but in different ways.

Hemodialysis circulates blood outside the body through an external filter called a dialyzer, while peritoneal dialysis removes waste and water from the blood inside the body using a special dialysis solution. NMCP's dialysis unit currently uses the hemodialysis method.

"Some conditions that can cause kidney failure are chronic kidney disease, acute injury or auto immune disease," said Ellen Annunziata, Nephrology Clinic manager. "Patients who have or who are at risk for these ailments are generally referred to us from their primary care provider or internal medicine specialty provider, but there are times when an emergency arises and we treat patients here in the Intensive Care Unit."

"A lot of time when we see an acute kidney injury in the military, it is due to a battlefield injury," Parker said. "Sometimes when our patients need dialysis because of an injury, it is just so their kidneys have time to heal. I have seen patients who go back to almost complete kidney functions after these injuries."

Acute kidney injury is an abrupt loss of kidney function that develops within seven days. It generally occurs because of damage to the kidney tissue caused by decreased renal blood flow from any cause, exposure to substances harmful to the kidney, an inflammatory process in the kidney, or an obstruction of the urinary tract which impedes the flow of urine.

Chronic kidney disease is a progressive loss in kidney function over a period of months or years. It is also known as chronic renal disease and is often diagnosed in patients known to be at risk such as those with diabetes or hypertension. According to Parker, for those who don't recover from an injury, "most of our patients are going to need to be put on a wait list for a new kidney."

When patient who will need a new kidney begins dialysis, they meet with a provider and are educated on treatments and potential lifestyle changes. They are added to the wait list if they meet the prerequisites, which include being less than 70 years old and meeting medical guidelines that ensures they are a good candidate. Patients are listed at Walter Reed National Military Medical Center and a local Hampton Roads hospital.

"When we get a patient who is a good fit for transplant, they are treated routinely with dialysis and with some luck, they will hopefully receive a kidney," Parker said. "The average wait time is two to six years, but it could be faster depending on their circumstances."

Patients who undergo a kidney transplant receive immediate post-transplant care at that hospital. Once they are cleared from that facility, they return to NMCP for additional follow-on care.

"It is really nice to see our patients get their care and help they need," Annunziata said. "When a patient starts care here, they tend to become like family because we spend so much time getting to know them and taking care of them. Some patients may even be scared or in denial about their condition, but once we start treatment, they often realize that we are here to give them the best possible care and make them as comfortable and welcomed as we can."

For more news from Naval Medical Center Portsmouth, visit www.navy.mil/.