Dr. Jay K. Chu, a nephrologist at Kidney Specialists of Southern Nevada since 2009, earned his medical degree at Oregon Health & Science University School of Medicine in Portland, Oregon. His training also includes an internal medicine residency at University of California, Los Angeles, VA Greater Los Angeles. The Shanghai-born doctor, who grew up in Southern California, spent a couple of years in France with his family and completed a fellowship at Montefiore Medical Center and Albert Einstein College of Medicine in New York. Here are the highlights of his recent interview with Jessi C. Acuña.
Nephrology is one of the few medical specialties that still enables the practitioner to foster long-term relationships with patients. The majority of our patients have chronic disease that starts off mild to moderate. Eventually it progresses into severe levels, [until] the end stage. Over the course [of treatment], the [doctor-patient] relationship can last five or 10 years.
The most common long-term kidney diseases in this country are either caused through diabetes or high blood pressure. These diseases are not curable, but we can control them. These are the types of patients I manage chronically. Our goal is to not cure the disease but to intervene early enough so that we can prolong the lifespan of the kidneys. As we age, we lose kidney function. Eventually all organs fail.
The most important thing for the general population is for healthy individuals to regularly see a primary care physician. Most kidney disease—more than 90 percent—can be picked up through routine blood and urine tests. As long as labs are normal, there is nothing to worry about.
One of the bigger misconceptions for patients is that when they come to us for the first time and they say, “Doctor, I feel [fine]. Why do I have to see you?” I try to explain to them that you won’t feel something wrong until it might be too late. We have scales to measure kidney functions. In a young person, the function is more than 100; in an older person, a 70-year-old, it could be in the 40s. Unless it’s close to 30 or below, we do not usually feel symptoms. But once it gets to that point, it’s very hard to reverse.
When we transplant a kidney, we put it in a different place than the original kidneys. We do not take the original kidney out. Patients will very commonly have three kidneys after transplants. The kidneys are in the back; we put the transplant in by the pelvis. Some patients have four kidneys. It’s less of an operative risk, and the other kidneys may still serve small functions.