What is a Nephrologist

A nephrologist , or renal physician, is a physician who specializes in the diagnosis and treatment of disorders or diseases of the kidneys, as well as renal replacement therapy (ie kidney transplants or dialysis). These can include systemic conditions, such a diabetes or autoimmune diseases, as well as renal osteodystrophy and hypertension.

Work Environment

The majority of nephrologists work in hospitals, clinics, and private practices, as well as in specialized kidney and dialysis centers. The rarely engage in surgery other than for kidney biopsies and catheter replacements, though some may specialize in kidney transplant surgery.

Their work environment will tend to be clean and well-lit. There is a great deal of interaction with people, including patients, other physicians, nurses, and administrative staff.

Work Schedule

Nephrologists can end up with very diverse and hectic schedules, and may find requirements of odd hours challenging. While one can attempt to have a regular schedule, emergencies can happen easily, and on-call or overtime hours are the norm. While 60 hours is quite regular for many medical specializations, some nephrologists report working upwards of 80 hours per week on occasion, and their compensation may not properly reflect this longer than average schedule.

Nephrologist Job Outlook and Prospects

The job outlook for nephrologists is reported to be fairly promising, with an expected 14 percent growth rate over the next ten years. However, nephrologists currently seeking employment have been left asking “If there is such a shortage of nephrologists, where are all the jobs?” (nephrologyusa.com). So, while the reported expected growth rate appears good, expectation may not meet reality, and one should be aware of this potentiality in the field.

Nephrologist Salary: Factors and Influences

The salary for a nephrologist is affected by a panoply of factors, including the experience of the nephrologist in question, the geographic location in which they work, and any specializations he or she may have. Those with a specific sub-specialization that is in high demand, for example, can find themselves earning significantly more than a general nephrologist.

The industry in which the nephrologist works also has an impact on his or her salary, though to a lesser extent than other factors. Education can also offer some differences, though these tend to be minor. The average salary for a nephrologist is approximately $212,000.

Education and Specialization 

Nephrologists will require a bachelor’s degree followed by a medical degree, totaling eight years of schooling. This will be followed by a residency in internal medicine typically lasting three to four years, and finished with a two- to four-year fellowship focusing on nephrology.

While the education undertaken can offer minor influences on a nephrologist’s salary, this is primarily due to the renown of the program in which they study, as well as the institute in which they undertake their residency and/or fellowship training.

Specializations are a significantly more important factor for wage increases, with those holding a sub-specialty in kidney transplantation, onconephrology (cancer of the kidney), and chronic kidney disease being the most likely to receive a higher wage. A specialization in dialysis can also bring a higher wage than general nephrology, though to a lesser extent than the aforementioned.

Experience and Position 

Experience is another major factor affecting a nephrologist’s salary, with those just beginning their career earning around $150,000, while those who have been working for ten or more years earning closer to $265,000, depending on their geographic location and hours worked.

Position can also offer some moderately significant improvements to the nephrologist’s salary, though this is dependent on both their experience and their status in the field.


Industry can offer some potential differences for nephrologists, though it will not affect their salary as greatly as location and experience. The average salary in a general medical hospital, for example, is around $204,000, while in a private office it will be closer to $218,000. An outpatient care center or dialysis center will average around $216,000.


The location worked will have a significant impact on a nephrologist’s salary. The Bureau of Labor and Statistics doesn’t have data specific to the field, however independent nephrologists in Ohio and other mid-western states report wages averaging around $150,000-$200,000, while those in the southwest region report averages closer to $220,000-$250,000. Those who have been working longer in the southwest have reported even higher wages, above $300,000, and in some cases, as high as $600,000.