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Narrowly defined, nephrology refers to that branch of medicine specializing in the diagnosis, treatment, and prevention of diseases of the kidney (a.k.a., renal diseases), its practitioners calling themselves 'nephrologists'. Medical schools recognize nephrology as a subspecialty of internal medicine and of pediatrics, typically establishing a Division of Nephrology in the Department of Medicine and the Department of Pediatics, each division administered by a Chief or Head of Nephrology and consisting of faculty members whose interests in nephrology may differ in emphasis among research, teaching, and clinical practice. Nephrologists are usually considered the experts on the body's overall fluid balance and electrolyte and acid-base metabolism.

The Department of Surgery may establish a unit dedicated to kidney transplantation (a.k.a., renal transplantation), employing both urologist surgeons and non-surgeon nephrologists supporting practice and research in renal transplantation. Academic nephrologists may have joint appointments in more than one formal division in the school.

Nephrologists with or without formal academic affiliation may establish private practices, alone or with a group of nephrologists, sometimes operating treatment centers performing chronic hemodialysis and peritoneal dialysis.