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The first visit includes a thorough review of your kidney function labs (creatinine, GFR, urinalysis), blood pressure readings, medications, and medical history. The nephrologist will assess the cause and stage of kidney disease and develop a management plan focused on slowing progression. This often involves medication adjustments, dietary changes, and monitoring. If dialysis is likely in the future, they will discuss access planning and options well in advance.
See a nephrologist if your PCP identifies declining kidney function (elevated creatinine, low GFR), protein in your urine, difficult-to-control high blood pressure despite multiple medications, recurrent kidney stones, electrolyte abnormalities, or if you are approaching the need for dialysis. Your primary care doctor will typically refer you when kidney function drops below a certain threshold.
Office visit copay: $30-75 · Kidney function panel: $50-200 · Dialysis: $250-500 per session · Kidney transplant: $250,000-400,000+
Nephrology visits are covered as specialist visits. Medicare covers dialysis for all patients with end-stage kidney disease regardless of age. Dialysis and transplant are among the most expensive treatments in medicine. If you are approaching dialysis, your nephrologist's office can help navigate insurance and disability benefits. Medications for CKD, especially newer ones like SGLT2 inhibitors, may require prior authorization.