| Detail | For this role |
|---|---|
| Department | Clinical and Medical |
| Level | Mid level |
| Reports to | Head of Department (Clinical) |
| Direct reports | Dialysis Technician |
| Experience | 2 to 8 years after DM, including running a dialysis unit |
Nephrologist job description template
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Job title: Nephrologist
Department: Clinical and Medical
Reports to: Head of Department (Clinical)
Location: [City], [office, branch or site]
About the role
A Nephrologist treats kidney disease: acute kidney injury, chronic kidney disease, nephrotic syndrome and blood pressure problems linked to the kidneys. They run the dialysis unit, prescribe haemodialysis and peritoneal dialysis, manage kidney transplant patients before and after surgery, and give opinions across the hospital. A good nephrologist slows kidney disease, keeps dialysis safe and adequate, prevents access infections and prepares suitable patients for transplant.
Key responsibilities
- See OPD patients with raised creatinine, protein in urine, swelling, uncontrolled blood pressure or repeated stones, and plan the work-up.
- Stage chronic kidney disease, set targets for blood pressure, sugar and diet, and slow progression with medicines.
- Write and review each patient's haemodialysis prescription, including frequency, duration, dialyser and fluid removal target.
- Oversee dialysis unit water quality, machine disinfection, dialyser reuse rules and infection screening of patients.
- Plan fistula or graft creation with the vascular surgeon, and treat catheter and fistula infections and blockages.
- Manage acute kidney injury in wards and ICU, deciding whether and when to start dialysis or CRRT.
- Perform kidney biopsies and insert dialysis catheters, and read biopsy results with the pathologist.
- Evaluate donors and recipients for kidney transplant, and follow transplant patients on immunosuppression for rejection and infection.
- Offer peritoneal dialysis where suitable, train patients and families, and treat peritonitis.
- Counsel patients and families on dialysis costs, government schemes, diet, fluid limits and transplant options.
Requirements
- DM or DrNB in Nephrology after MD in General Medicine or Paediatrics
- Valid registration with the National Medical Commission or a State Medical Council
- Training in transplant nephrology is an advantage
- 2 to 8 years after DM, including running a dialysis unit
KRAs and KPIs for a Nephrologist
Key result areas for the appraisal form, each with a KPI you can measure every month or quarter.
| Key result area | How to measure it |
|---|---|
| Dialysis adequacy | At least 80 percent of haemodialysis patients meet the target Kt/V on monthly tests |
| Access infection | Catheter bloodstream infections within the unit target per 1,000 catheter days |
| Water and machine safety | Monthly water culture and endotoxin within limits, with machine disinfection logged every time |
| Fistula use | At least 70 percent of long-term dialysis patients dialysing through a fistula or graft |
| Opinion response | Opinions for acute kidney injury in ICU given within 4 hours of request |
| Transplant follow-up | Every transplant patient reviewed on the planned schedule with drug levels checked as advised |
Skills and tools
Tools used day to day: Haemodialysis machines, RO water treatment plant, CRRT machine, Ultrasound for biopsy and catheter insertion, Dialysis unit software, Peritoneal dialysis sets.
Reporting line and career path
Next roles: Head of Department (Clinical), Clinical Director
Interview questions for a Nephrologist
- A patient's creatinine doubled after a contrast CT. What do you do next?
- Your dialysis unit's water culture has failed. What steps do you take today?
- How do you decide when to start dialysis in chronic kidney disease?
- A young patient's mother wants to donate a kidney. How do you begin the evaluation?
- How do you persuade a patient to get a fistula made before dialysis is needed?
- Tell me about a transplant rejection episode you managed.
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Book a free demoSee pricingFrequently asked questions
What does a nephrologist do?
A nephrologist treats diseases of the kidneys such as chronic kidney disease, acute kidney injury, nephrotic syndrome and kidney-related high blood pressure. They prescribe and supervise dialysis, perform kidney biopsies, manage kidney transplant patients and advise other doctors on kidney problems in admitted patients.
What is the difference between a nephrologist and a urologist?
A nephrologist is a physician who treats kidney function problems with medicines and dialysis. A urologist is a surgeon who operates on the kidneys, bladder, prostate and urinary tract, for example removing stones or tumours. In a kidney transplant the surgeon operates and the nephrologist manages medicines and follow-up.
When should someone see a nephrologist?
Someone should see a nephrologist when blood tests show rising creatinine, urine shows protein or blood, swelling appears without a clear cause, blood pressure is hard to control, or diabetes starts to affect the kidneys. Early referral helps slow kidney damage and plan dialysis or transplant if it becomes necessary.