UofL Physicians includes one of Louisville’s most experienced teams of kidney disease specialists. Serving more than 5,000 patients annually, our compassionate and caring multidisciplinary team of nephrologists, nurses, dieticians and social workers are dedicated to educating and treating the community of patients living with kidney disease.
Kidney disease is a widespread problem afflicting many individuals with common issues such as hypertension and diabetes. Genetic or immune system disorders and a variety of other conditions may also affect the kidneys. Each patient should be screened regularly by a primary care provider with a simple blood and urine test. Patients with a family history of kidney disease, diabetes or hypertension are at greater risk and need to be more closely monitored. Kidney damage resulting from these conditions may cause the kidneys to be ineffective in removing wastes from the body and eventually may cause permanent kidney failure.
Our UofL Physicians have been committed to physician education as well as training medical students, general physicians and kidney specialists who continue to care for patients in the region and nationwide. Through leading-edge medical research and the latest technologies, we are dedicated to finding better ways to understand and treat kidney disease, and are recognized nationally for our efforts and research.
Diseases and conditions
UofL Physicians provide state-of-the-art outpatient care for a wide range of kidney diseases and serves patients across the state of Kentucky and neighboring regions with conditions including:
- Protein and/or blood in the urine
- Sudden onset kidney failure
- Chronic kidney disease
- Hypertension (high blood pressure)
- Kidney stones
- Osteoporosis and bone mineral diseases
- Glomerulonephritis and autoimmune or inflammatory disorders of the kidney
- Inherited diseases including polycystic kidney disease
- Disorders of body fluid chemistries
- End-stage kidney disease
- Kidney transplantation
Services we provide include:
- In-center dialysis
- Home dialysis including peritoneal and home hemodialysis
- Kidney transplantation and immunosuppression
- Hemodialysis access procedures
- Education in chronic kidney disease and controlling risk factors for kidney disease
- Symptoms of kidney disease might include:
- Urinating less often than normal
- Extreme tiredness
- Loss of appetite or unexplained weight loss
- Nausea or vomiting
Treatments and services
Chronic kidney disease is caused by a decrease in the ability of the kidneys to carry on usual functions such as eliminating waste products and urine from the body. Some important risk factors for chronic kidney disease include diabetes, high blood pressure, liver disease, cardiovascular disease, recurrent urinary tract infections and a family history of kidney disease. The number of people in the United States with kidney disease is increasing every year. Patients can live well with chronic kidney disease through patient education, nutrition, medications and a collaborative partnership between physician and patient. Specialists at UofL Physicians use a variety of state-of-the-art diagnostic tools and personalized treatments that take into account individual patient needs and medical conditions.
High blood pressure (Hypertension)
Good control of blood pressure is important for preventing kidney disease, heart disease, stroke and decline in brain function in patients of all ages, even in patients over the age of 80. High blood pressure is often a silent disease with no symptoms until damage to important body systems has occurred. Routine monitoring in a health care setting is a key part of diagnosis and treatment. Treatments for high blood pressure include improving lifestyle factors such as reducing excess body weight, reducing or discontinuing tobacco and alcohol use, and consuming a diet low in salt and high in fruits and vegetables. Sometimes, a correctable cause for high blood pressure may be found. There is a broad range of medications available to help patients reach their blood pressure goals. UofL Physicians kidney specialists tailor a specific medical plan to the individual patient to minimize risks of side effects while achieving blood pressure goals. Hypertension specialists, certified by the American Society of Hypertension, are available to diagnose and treat resistant hypertension, as well as hypertension complicating other medical illnesses.
End-stage renal disease
When kidneys stop functioning, fluid and waste products build up in the blood and body. This advanced kidney failure is termed end-stage renal disease (ESRD) and eventually leads to life-threatening levels of toxins and fluid in the body. There are several important treatment options for patients with ESRD that include dialysis and kidney transplantation. Dialysis may be performed through the blood, either at home or at a dialysis facility, termed hemodialysis; or through the abdominal cavity, termed peritoneal dialysis. Many patients receive a kidney transplant as a treatment for ESRD. Our providers discuss the risk and benefits of each treatment option in detail with patients and families, utilizing shared decision-making to decide on the treatment of choice for each patient.
Dialysis is necessary for kidney failure patients. The procedure helps the kidneys remove wastes from the body when they can no longer do the job effectively themselves. We offer the most advanced dialysis services at our Louisville locations.
We offer the most advanced dialyzers available to maximize blood purification. We use online bicarbonate preparation and extra water purification steps to prepare very high-quality dialysate.
Hemodialysis at a dialysis facility usually involves treatment three times each week to remove waste products from the blood. Our dialysis centers are staffed by kidney specialists, dialysis nurse practitioners, nutritionists, social workers, nurses and dialysis technicians who are trained to provide compassionate and effective care of the patient with ESRD. Dialysis facilities are equipped with reclining chairs and televisions for patient comfort and ease in an environment that provides opportunities for interacting with other patients receiving dialysis, as well as rest.
Thanks to home dialysis, many patients with kidney diseases in Louisville who previously had to come to the medical center for treatment can now receive dialysis in the comfort of their own homes or even while they are traveling, offering a greater level of freedom to kidney failure patients.
The UofL Physicians Kidney Disease Program offers training in both peritoneal dialysis, as well as home hemodialysis. We also train the patient’s primary caregiver. We provide patients with continual support through dedicated nurses and physicians as they go through the process of training in-home dialysis.
We are one of the largest providers of home dialysis in the region. We provide both peritoneal dialysis and home hemodialysis.
- CAPD (continuous ambulatory peritoneal dialysis): peritoneal dialysis with treatments done without a machine
- APD (automated peritoneal dialysis): peritoneal dialysis done overnight
Most patients including diabetics with well-controlled blood sugars are eligible for peritoneal dialysis.
UofL Physicians – Kidney Disease Program now offers portable home hemodialysis with the NxStage system, a new technology that gives dialysis patients freedom to travel without sacrificing their own health and to perform their dialysis in the comfort of their own homes.
Kidney transplant patient care is very complex and requires special expertise. Our kidney transplant specialists are certified by the United Network of Organ Sharing, which oversees the nation’s organ transplantation programs. These transplant specialists have experience in managing immunosuppressive medications and complications of transplant. Our innovative program uses steroid-free immunosuppressive regimens when possible after transplantation to avoid side effects of long-term steroid use. Additionally, we participate in paired kidney donations matching “incompatible” donor/patient pairs with another pair from anywhere else in the country.
Hemodialysis access procedures
The mission of the Interventional Nephrology Program at the University of Louisville is to provide prompt, high-quality care in the diagnosis and management of problems associated with hemodialysis vascular access. Dr. Amy Dwyer, an interventional nephrologist, is certified in interventional nephrology. The Interventional Nephrology Center at the University of Louisville is one of the only academic programs in the United States that is accredited by the American Society of Diagnostic and Interventional Nephrology.
The Interventional Nephrology Center provides a broad range of services including:
- Tunneled dialysis catheter placement, removal and exchange
- Stent placement
- Ligation and coiling of accessory vessels in dialysis access
- Venography (vessel mapping)
- Feraheme infusion
- Aranesp injections
- Kidney ultrasound
- Kidney needle biopsy under ultrasound guidance
Patients have a choice where they receive their vascular access care. Functioning vascular access is essential for patients to receive adequate dialysis. We strive to treat the whole patient by providing not only excellent hemodialysis access care but also complementary services for our unique patient population.
Metabolic and genetic disorders
Chronic kidney diseases may result from genetic disorders, medications, diseases in other organ systems such as the liver or lung or pregnancy. Primary care physicians identify these diseases through blood and urine studies which may show evidence of metabolic disorders such as acid-base, mineral, potassium, bicarbonate and sodium imbalances or urinary abnormalities such as blood or protein. Our practice has experts in the fields of fluid and electrolyte disturbances, mineral metabolism, kidney stones, genetic kidney diseases, autoimmune and glomerular diseases and kidney diseases resulting from other conditions such as hepatitis C, liver disease or pregnancy.
Mineral metabolism: kidney stones
Kidney stones are one of the most common disorders of the urinary tract. They are responsible for about three million visits to health care providers and half a million emergency room visits per year in the United States. The main goal in our Kidney Stone Clinic is to prevent the recurrence of this painful disease. Up to 15 percent of patients get a second kidney stone within the first year after an initial episode. We check the patient’s urine composition and correct factors that precipitate stone formation by dietary and lifestyle changes and, if necessary, with medication.
Mineral metabolism: osteoporosis
Weakening of the bones due to osteoporosis and other mineral bone diseases may lead to serious health complications such as falls and fractures. People can get bone diseases for many reasons. We focus on bone diseases due to organ failures such as heart failure, liver failure, kidney failure, or lung diseases and the medications used to treat these diseases. We also specialize in treating people who get bone disease who do not have the usual risk factors for bone disease. The Bone Disease Clinic at UofL Physicians-Kidney Disease Program diagnoses and treats osteoporosis and related bone diseases using advanced tests and medical therapies. Specialists at the Bone Disease Clinic promote excellence in clinical care while engaging in patient-oriented research and education.