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Conditions We Treat & Services We Provide

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Chronic Kidney Disease (CKD)

Chronic Kidney Disease (CKD)

Permanent damage to the kidneys is called chronic kidney disease (CKD). Some common medical conditions that can cause CKD are diabetes, hypertension (high blood pressure), inherited kidney diseases, chronic obstruction of the bladder and diseases of the kidney tissue itself.

5 Stages of Chronic Kidney Disease

  • Stage 1   eGFR 90+Kidney damage considered to be normal or high kidney function
  • Stage 2   eGFR 60-89Kidney damage considered to have mildly lessened kidney function
  • Stage 3   eGFR 30-59Kidney damage considered to have moderately lessened kidney function
  • Stage 4   eGFR 15-29Kidney damage considered to have severely lessened kidney function
  • Stage 5   eGFR less than 15Complete loss of kidney function, also known as end-stage renal disease (ESRD), which could require dialysis or a kidney (renal) transplant.

What is eGFR?The estimated glomerular filtration rate (eGFR) is the best way to get an idea of your overall kidney function. As kidney disease worsens, the eGFR will go down.

Kidney Transplant

Kidney Transplant

Chronic kidney disease (CKD) could progress to complete loss of kidney function, known as end-stage renal disease (ESRD), which could require dialysis or a kidney transplant. A kidney transplant is used to treat kidney failure.

Nephrology Associates is proud to have cemented an exclusive partnership with Saint Thomas West Hospital, a member of Ascension Saint Thomas, to expand the Kidney Transplant Program, offering increased access for kidney transplant patients throughout the greater Middle Tennessee area.

If you’ve decided you wish to be considered for a kidney transplant, you may work with your nephrologist and care team to determine if a kidney transplant is an option for you.

Ashish Soni

Dr. Ashish Soni, President, Nephrology Associates

“The decision to partner with Ascension Saint Thomas is a progression of Nephrology Associates’ long-standing commitment to meeting this growing public health need. With this alignment, we are positioning ourselves to fight for the improved kidney health of all Middle Tennesseans.”Dr. Ashish Soni, President, Nephrology Associates

Chronic Kidney Disease (CKD)

Kidney Stones

A kidney stone is like a small rock that forms in the kidney. Kidney stones could form when certain chemicals in the body clump together. A stone can either stay in the kidney or travel through the urinary system.

Your doctor will be able to determine the best treatment option for your kidney stones, depending on many factors, such as:

  • Size of kidney stone
  • Location of kidney stone
  • Type of kidney stone
Kidney Transplant

Kidney Failure: Acute & Chronic

Acute Kidney Failure happens when there is an abrupt loss of kidney function, preventing your kidneys from properly filtering waste from your body.

Acute kidney failure could be caused by:

  • Illness
  • Injury
  • Toxins

Chronic Kidney Failure is the complete loss of kidney function, also known as end-stage renal disease (ESRD), which could require dialysis or a kidney (renal) transplant.

Chronic kidney disease could be caused by:

  • Diabetes
  • High blood pressure (hypertension)
  • Race
  • Obesity
  • Inherited kidney diseases
  • Age 60 or older
Chronic Kidney Disease (CKD)

Lupus Nephritis

Inflammation of the kidneys caused by the autoimmune disease Systemic Lupus Erythematosus (SLE) is called lupus nephritis. This complex condition prevents the kidneys from properly removing waste from the blood and regulating the amount of fluid in the body.

Symptoms of lupus nephritis could include:

  • High blood pressure (hypertension)
  • Exhaustion
  • Increase in weight
  • Foamy or frothy urine
  • Swelling of the lower extremities (legs, feet and ankles)
Kidney Transplant


Hemodialysis & Peritoneal Dialysis

Dialysis is the artificial process of washing or cleansing of the blood to remove toxins and waste products when your kidneys have lost the ability to naturally filter waste from your body and regulate fluids properly.

Hemodialysis is the process of cycling of the blood through an artificial kidney that is exposed to a cleaning solution (dialysate) for a prescribed period of time, as ordered by your nephrologist. Blood is then removed from and returned to the body through needles and tubing in a closed circuit with the artificial kidney and dialysis machine.

Hemodialysis requires the surgical creation of a vascular access (usually in the arm) and can take place either at home or in a dialysis center.

  • Home hemodialysis (HHD) may be completed at home
  • In-center hemodialysis (ICHD) may be completed in a dialysis center

Peritoneal dialysis uses the vascular membrane (peritoneum) surrounding the abdominal organs as a filter. A small catheter is surgically implanted in the abdomen to allow exchanges of a solution designed to “clean” the blood.

This cleaning solution (dialysate) is drained into the abdomen and remains for a prescribed (dwell) time. The process allows wastes and fluids to filter out of the blood. The dialysate then drains from the abdomen and is replaced by fresh solution to repeat the process (overnight/daytime) as prescribed by your nephrologist.

Work closely with your nephrologist and care team to determine which dialysis treatment option is right for you.

Chronic Kidney Disease (CKD)


Diabetic Nephropathy

Diabetes is a disease of elevated blood sugar(glucose). Glucose is a large molecule in the blood that causes damage to tiny blood vessels all over the body- including the kidneys’ smallest filtering units – the glomeruli.

This filter damage creates holes that allow abnormal leaking of protein (albumin) in the urine. Your primary care provider or nephrologist has likely checked for protein in your urine. Protein in the urine is an indicator of decline in kidney health.

Kidney Transplant


Blood in the urine is called hematuria. While blood in the urine can be caused by many issues, it is not normal and should be seen by a doctor in order to determine the best treatment option.

Hematuria could be caused by:

  • Infection
  • Cancer
  • Kidney Stones
  • Inflammation of the kidneys
Chronic Kidney Disease (CKD)


Protein in the urine is called proteinuria, but may also be referred to as albuminuria or microalbuminuria. Your kidneys make urine by cleaning waste and extra fluid from your blood. Your kidneys also help prevent the loss of things that your body needs, like protein.

Proteinuria happens when your kidneys let protein leak into your urine. If proteinuria goes untreated, it can worsen the kidney function by damaging the kidney’s filtering system.

Symptoms of proteinuria could include:

  • Foamy or frothy urine
  • Increase in weight
  • High blood pressure (hypertension)
Kidney Transplant


Inflammation of the kidney’s smallest filtering units (glomeruli) is called glomerulonephritis, but may also be referred to as nephritis or nephrotic
. The inflammation and damage within the kidneys, as a result of glomerulonephritis, is often seen as a result of an autoimmune disease.

Common autoimmune diseases include Lupus, Goodpasture’s Syndrome, and Wegener’s Syndrome. These disorders can contribute to loss of kidney function via disease-specific damage within the kidney.

Symptoms of glomerulonephritis could include:

  • High blood pressure (hypertension)
  • Hematuria (blood in the urine)
  • Foamy or frothy urine
  • Proteinuria (protein in the urine)
Chronic Kidney Disease (CKD)


Elevated pressure on the insides of the arteries in your body is called hypertension, but may also be referred to as high blood pressure. Over time, this elevated pressure on delicate renal vessels can cause damage to the kidneys blood flow and filtering units (glomeruli).

Uncontrolled hypertension has been known as the silent killer because organ damage could occur without any symptoms being present. Controlling blood pressure can help to prevent kidney failure, cardiac failure, stroke and death.

Treatment of hypertension could include:

  • Medication
  • Increased physical activity
  • Diet modification
  • Shift in tobacco usage
Kidney Transplant

Polycystic Kidney Disease

The genetic disorder that replaces normal kidney tissue with multiple fluidfilled cysts is called polycystic kidney disease (PKD). This disease affects kidney function by decreasing the number of functioning filters available. PKD is the 4th leading cause of chronic kidney disease (CKD), which could progress to the complete loss of kidney function, also known as end-stage renal disease (ESRD).

Symptoms of polycystic kidney disease could include:

  • High blood pressure (hypertension)
  • Hematuria (blood in the urine)
  • Pain in the back and/or side
  • Recurrent urinary tract infections (UTI’s)
Chronic Kidney Disease (CKD)


Metabolic Syndrome

Metabolic syndrome is a term used to describe a combination of the following conditions which affect the heart or blood vessels:

Symptoms of polycystic kidney disease could include:

  • High blood pressure (hypertension)
  • High blood sugar (hyperglycemia)
  • Obesity
  • Abnormal cholesterol (dyslipidemia)

Controlling these risk factors is important in order to minimize the possibility of developing chronic kidney disease, as well as other healthrelated complications.

Kidney Transplant

Pregnancy-related Kidney Issues

Pregnancy-related kidney issues describe various disorders that might arise due to profound prenatal bodily changes, such as:

  • Acute kidney injury (AKI)
  • Pyelonephritis (bacterial infection of the kidneys)
  • Recurrent urinary tract infections (UTIs)

During pregnancy it is important to work closely with your nephrologist and care team to determine the best way to monitor and treat any irregular conditions for the health of you and your baby.

Chronic Kidney Disease (CKD)

Electrolyte Disorders

An imbalance of essential minerals in the body is called an electrolyte disorder. One of the primary functions of the kidneys is to balance out these important minerals in order for the body to function properly.

Examples of electrolyte disorders include:

  • Hypercalcemia (excess calcium)
  • Hypokalemia (low potassium)
  • Hyperphosphatemia (excess phosphate)
  • Hyponatremia (low sodium)
  • Hyperchloremia (excess chloride)

Symptoms of an electrolyte disorder could include:

  • Exhaustion
  • Elevated heart rate
  • Nausea
  • Headaches
  • Muscle spasms
Kidney Transplant


We stand by our commitment to delivering first-in-class care to our patients in the greater Middle Tennessee area which is why we recently expanded our patient services to include Telehealth.

Benefits of Telehealth:

  • Flexible
  • Convenient
  • User-friendly
  • Secure

Download our Telehealth app, AnywhereCare, to your mobile device of choice.

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