Prof. Dr. Gürkan Sengölge

Kidneys: Two small organs, yet so many functions! While they are commonly known as detoxification organs, that is only a fraction of their functions. They regulate the blood pressure, the Acid-base balance, the water balance, the Electrolyte balance in our body and the Production of red blood cells (erythrocytes); they produce hormones that are involved in various delicate systems within the human body, such as with the regulation of blood sugar; they ensure that important protein molecules are not excreted and lost; even the preservation of bone substance is a direct function of this organ system.

Now one can well imagine what complex clinical pictures arise, when the kidneys fail: discomfort due to the accumulation of toxins, water retention, anemia, uncontrolled blood pressure, acidic blood, disturbed salt concentrations in the blood with serious consequences such as heart arrhythmias or neurological problems, hormonal imbalances, such as excessive production of parathyroid hormone, “porous” bones, and so on.

Moreover, the kidneys are highly exposed organs to diseases. One should simply imagine that approximately 1.2 liters of blood are pumped through these organs every minute. This means that every germ, every toxic substance, reaches there in high concentration.

By filtering this unimaginable volume of blood, about 180 liters of urine are actually produced daily; however, our healthy kidneys manage to reduce this enormous volume to “normal” amounts of urine! The destructive long-term damages of civilization diseases, especially diabetes and high blood pressure, begin right here. But also rarer and devastating diseases target the kidneys: vasculitis, systemic diseases, and many rheumatological conditions.

The tricky part is that, amidst all the complexity of these problems, the kidneys initially give very few to no clear warning signs: no pain, and even many routine laboratory values obtained in general check-ups remain normal for untrained eyes for the longest time.

What happens when the damage has reached a point where a return to “normal” is no longer possible? Then, a renal replacement therapy must be initiated, whether it be hemodialysis, peritoneal dialysis, or a kidney transplant. These are also therapies that need to be discussed in a very individual and thorough manner – both before and after initiation, as they can have considerable side effects.

Patients need time, tranquility, and understandable explanations to comprehend their illness and its consequences. This way, they can act as crucial partners in the teamwork necessary for the often prolonged treatment of kidney diseases.

My task is to support them by providing calm consultation and guidance, precisely at the right time, drawing from the necessary expertise gained through my 20 years of work at the University Hospital / General Hospital in Vienna. This spans from diagnosis to the necessity of renal replacement therapy, which comes with many questions, problems, potential complications, and uncertainties on the part of the patients.

Since the diagnosis of some complex diseases can be quickly achieved with the right expertise, I offer on-site urine analyses, including microscopic examination. When histological processing of kidney tissue becomes necessary, I personally conduct kidney biopsies in various hospitals in Vienna.

In the case of such complex diseases, interdisciplinary collaboration becomes indispensable. Here, my network with specialists from all fields, both nationally and internationally, as well as working in coordination as an optimized team, benefits my patients.