Hi Beth. In my case, my nephrologist's main focus was on extensive blood testing. There's a lot to see regarding renal health. I also had an ultrasound.

In the office, a focus is on vitals. Blood pressure is particularly important as there is a link between it and kidney health. Most nephrologists even specialize in hypertension. Comprehensive metabolic test results are also important.

He always checked my ankles for any swelling and listened to my heart and other things, thoroughly. He was also always interested in any medication changes. Lithium was weaned off as soon as my kidney damage was discovered. I have stage 3 of 5 kidney disease. It's not great, as this indicates only about 50% kidney functioning. There's no repairing them. The damage is done. It's a matter of not worsening them. I currently have no uncomfortable (or really noticeable) symptoms, but many don't until things get really bad. Sometimes a kidney health diet may be recommended. I think my old nephrologist never emphasized that to me because my relevant blood test results showed those levels as good (i e. sodium, potassium, phosphorus, maybe protein). Avoiding diabetes is also crucial, so I'd better cut down on the sugars. Not sure what other checks are done for higher stage kidney disease.

I will not be donating a kidney.