What brought you here
Start with what you noticed
You don't need a diagnosis to call us. Most people arrive with a symptom, a flagged lab result, or a sentence from another doctor they didn't fully follow. Here's what each of those usually means.
-
Swelling in your legs, ankles, or face
Shoes that fit in the morning and not by three o'clock. A ring that won't come off. Puffiness around your eyes when you wake up. Swelling has several possible causes, and your kidneys are one of the common ones.
-
Protein or blood in your urine
Sometimes you notice it yourself — urine that foams and won't settle, or a color that isn't right. More often a routine test finds it and nobody explains what it means. Either way, it's worth understanding.
-
Your lab results flagged your kidneys
Most people meet their kidneys through a lab report. A number is highlighted, a note says to follow up with a specialist, and nobody has explained what the number is. Here's what it is.
-
Blood pressure that won't come down
You're taking what you were told to take. You've cut the salt. The readings still come back high. That's a specific situation with specific causes, and most of them are findable.
-
Diabetes and your kidneys
Diabetes is the most common reason kidneys fail in this country. It's also one of the most treatable — provided somebody is watching the right test at the right time.
-
Potassium or sodium out of balance
Potassium and sodium have to stay inside a narrow range for your heart and nerves to work properly. Keeping them there is your kidneys' job — so when a result comes back off, kidneys are one of the first things to check.
Common Questions
Frequently Asked Questions About Symptoms & Appointments
Do I need a referral to be seen?
Many insurance plans require a referral from your primary care physician before seeing a specialist. If your doctor referred you, we've likely already received the paperwork by fax. If you're unsure, call our office at (559) 661-1965 and our staff will check your plan's requirements with you.
What should I bring to my first appointment?
Please bring a valid photo ID, your insurance card(s), a complete list of your current medications with dosages (including over-the-counter drugs and supplements), any referral paperwork from your doctor, and copies of recent lab results or kidney imaging if you have them. Don't worry if you're missing something — our staff can request records from your other doctors.
What happens at a first kidney consultation?
Your nephrologist will review your medical history, medications, blood pressure, and lab work (such as creatinine and eGFR, which measure kidney function). Together you'll discuss what the results mean in plain language and agree on a care plan. First visits are more thorough than routine follow-ups, so allow extra time.
How do I know if I even need a kidney specialist?
The usual reasons are an eGFR below 60, a creatinine above the normal range, protein or blood found in your urine, or blood pressure that stays high on three or more medications. Diabetes with any sign of kidney involvement is another. If you're holding a result and you're not sure whether it counts, call us at (559) 661-1965 and ask — that's a question our staff answers all day, and you don't need a diagnosis first.
Not sure whether you need a kidney specialist?
Call and ask. Our staff will tell you whether this is something we should see, what your plan requires, and what to bring. A real person answers, and the whole staff speaks Spanish.