Nephrologist Career Overview

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A nephrologist, also called a renal physician, is a medical doctor who specialized in diseases of the kidneys. Nephrology is a subspecialty both of internal medicine, the branch of medicine involved in diagnosing diseases mainly in adults, and of pediatrics.

Nephrologist Training Requirements

To become a renal physician in the United States, a person must first graduate from medical school, then become board-certified in internal medicine by completing a 3+ year internal medicine residency program. After completing this “apprenticeship” training, the doctor must pass the American Board of Internal Medicine (ABIM) board certification examination. At this point, the doctor becomes a board-certified internal medicine specialist, also called an internist, and can obtain a license to practice internal medicine.

Most internists go on to specialize further, as in the case of nephrologists. The subspecialty training is called a fellowship and typically takes 2-3 additional years. During the fellowship, the aspiring kidney doctor will learn specialized information about the physiology and diseases of the kidneys; practice in clinical diagnosis and management of kidney patients; and learn all the kidney-related procedures needed for practice in nephrology, such as how to perform a kidney biopsy and insert a dialysis catheter. On completion of the nephrology fellowship, the physician can take the ABIM examination for nephrologists to become a board certified nephrologist.

The process for becoming a pediatric nephrologist, competent to treat children with kidney disorders, is similar to the above, but the initial specialization and residency must be in pediatrics instead of internal medicine.

Salary and Work Environment for Nephrologists

The salary of renal physicians in the United States ranges from less than $182,982 (25th percentile) to over $250,120 (75th percentile), with a median of $211,910 ( This salary is well above the median of $166,420 for experienced general internists, though it is by no means the highest-paying medical subspecialty (BLS).

Nephrologists work in hospitals, kidney and dialysis centers, and general medical centers. Excluding procedures such as kidney biopsies and catheter placements, they do not do surgery, though they often work closely with urologists, surgeons who specialize in the urinary tracts of both sexes and the reproductive system of males. Other procedures that renal physicians perform or supervise include continuous renal replacement therapy, done in hospital ICUs; kidney ultrasound; and plasmapheresis, in which blood plasma is removed from the body, treated, and returned.