This is an excellent question that I get a lot from my patients. The bad part about having kidney disease is that it is relatively a silent disease. Apart from pain in your flank/groin or frank blood in urine, which are alarming symptoms that prompt someone to seek medical attention, most of kidney disease is silent and one does not notice it unless the kidney function drops to a critically low level, which requires dialysis.
So, when should one see a nephrologist and what is the best way to make an appointment?
A nephrologist deals with kidney/renal failure in addition to other concerns like blood in urine, kidney stones and protein in urine. Generally, those concerns should prompt a nephrology evaluation, as your primary physician deems appropriate. However, in my opinion, anyone with a kidney function (reported as eGFR) at or below 45 percent (cc per minute) should see a nephrologist.
Although, self-referrals are welcome, it is strongly recommended to go through your primary care provider, who is better equipped to do an initial work up before being seen by a nephrologist. This saves a lot of time during a nephrologist’s visit and the visit is more useful.