Choosing the right nephrologist

@jmr4ever welcome to Mayo Clinic Connect. Could you make a list of “what you are looking for” and “your expectations”? That might help to clarify if the fit between you and the nephrologist is a good one.

You mentioned having lupus. Your rheumatologist is caring for your lupus? Lupus can be related to kidney problems so it would be good if the rheumatologist and nephrologist have some affiliation to make collaboration easier. Are you happy with your rheumatologist?

Who ordered the renal biopsy and why? You should always be able to get biopsy results from the ordering provider in a timely manner. You should also always be able to get your lab results whenever you ask for them. They are your results after all.

I am blessed to have a large health service practice that has all the specialties I could ever need and more. This includes endocrinology, nephrology, rheumatology, neurology, dieticians / nutritionists, cardiology ….. etc. These are all areas you could benefit from. Did you know that diabetes and hypertension (high blood pressure) are the two most common causes of kidney problems?

Before you switch practices find out if they have the specialties you may be needing. Find out if their providers are willing to collaborate with each other to give you the total care that you need.

I really like my rheumatologist and he is part of a large heath system with many resources. My PCP referred me to the first nephrologist in the same health system as the rheumatologist. The biopsy was ordered by the nephrologist but in collaboration with my rheumatologist to rule out Lupus nephritis, which I did not have. That nephrologist is the one I couldn’t see for 8 months after the biopsy. I did however receive the results of the biopsy right away on my patient portal. This system releases information to the patient right away.
Since I’ve had this exposure to different nephrologists and practices I now know what I need, and you are right on about making a list of “must haves”. Thank you for the suggestion. I have one more appointment in a few weeks with the office that “doesn’t release information to patients” and will be setting up meetings with two other practices for consultations who are part of a large integrated health network. I think that was what you were referring to that you have. As you said, and I agree they have more resources and are more accountable to patient satisfaction results also.
The current practice I’m in is not part of a local health system and and is owned by DaVita, a national corporation,

Hello jmr4ever,
I am a kidney transplant recipient completed 5 & 1/2 years,
Prior to a the transplant I was seeing a nephrologist under whom my kidney GFR was in a free fall ( fell from 54 to 15) , On one occasion my wife insisted on tagging along to the Visit to the Nephro. Dr ( my wife is outspoken & no nonsense type). My kidney function under this Nephro dropped from 54 to 15 and, she told this Nephrologist that she wanted to donate a kidney to me.... Nephro. responded ..oh He's not ready for a transplant -- you will not be a match ..(based on his past experiences) Then Nephro had to step out.. at that point my wife pointed out me to a Medicare poster ( if kidney function is 20 or less FIND A DONOR or Get your self on the UNOS list). when Nephro came back ... my wife told .. the Nephro..do you mind reading that medicare poster .. Nephro got embarrassed and walked out.. That's when the real search began nationwide for a Transplant Center which would not have such situations. Any way I found out later that he referred patients for Dialysis ( rest is for any one's guess)
I would seriously stay away from a nephrologist who has affliations with Dialysis setups. (strictly my opinion)
Just to end this msg. ( my wife matched & was my kidney donor)
If you test with Quest - you can request for results on day 1 and at end of 5 days Quest will provide Test reports on your quest account. This way you don't have to wait for the Dr.. just make sure that you go testing at least 6/7 working days prior to the Dr's appointment.
Best

@jmr4ever Let me echo the welcome here!

Different practices have different protocols. That said, my dialysis clinic/nephrologist is aligned with Fresenius Kidney Care, and sends me my results right away. As @l0lag0lag0b3 mentioned, going to an outside lab like Quest will often get you results in a day or two. The practice isn't concerned about your background; they want to follow protocol.

Being clear on what you want to see from your medical care team is crucial to getting the care you want and deserve. Sometimes cobbling this team together takes patience and time!
Ginger

@l0lag0lag0b3, kudos to your wife for being outspoken and for advocating for you. And shame on that nephrologist for pushing you towards dialysis only, and not discussing transplant as an option. And how would he know that your wife wouldn't be a match if she hadn't yet been tested and evaluated? I'm glad that you and your wife didn't just accept that nephrologist's misinformation and negativity, and that your wife was a match and you had a successful transplant.
When my kidney function got down to 20, my nephrologist did begin to familiarize and educate me about dialysis. That was necessary and the right thing to do. However, she also recommend me for transplant evaluation. I had never asked, or even thought about asking, about a transplant. My nephrologist is the one who recommended it. I was evaluated, listed, and received a transplant. So, kudos to my nephrologist!

Thanks yes kudos to my wife ( we are married 44 years.. I shall convey the appreciation)
There a lot of good Doctors nationwide, we just have to be fortunate to come across them - who truly are altruistic & practice medicine as a noble profession.
Best

Absolutely! 👍

I am so thrilled for you that you received your transplant and did not accept what the nephrologist said. I love how your wife challenged him and stood up for you. We have to be our own advocates and if something doesn’t sound or feel right then we must advocate for ourselves and make it feel right. Since I am already feeling apprehension and concern, after reading your caution about a nephrology practice being owned by a dialysis company, I have decided to move on to a different practice, even if it means more searching and reviewing and asking more questions. Thank you for your response it helped reinforce what I was feeling. I wish you all the best in good health.