Comprehensive Kidney Care
Backed by Evidence

Chronic kidney disease affects millions of Americans and can progress silently for years. At AKSNB, we provide meticulous, personalized management of CKD from the earliest detected stages through advanced kidney disease. Our approach centers on identifying and addressing the root causes of kidney decline — whether diabetes, hypertension, or autoimmune conditions — while simultaneously protecting residual kidney function and your overall health.

Our CKD management protocols are based on the most current KDIGO (Kidney Disease: Improving Global Outcomes) guidelines and incorporate the latest disease-modifying therapies, including SGLT2 inhibitors and other evidence-based treatments. We work closely with your primary care physician, endocrinologist, and other specialists to coordinate a holistic care plan that addresses all contributing factors.

Regular monitoring, medication optimization, dietary counseling, and proactive management of complications like anemia, bone disease, and cardiovascular risk are all part of your CKD care at AKSNB.

Hypertension is both a cause and a consequence of kidney disease, and managing it expertly requires the combined expertise of nephrology and cardiovascular medicine. Our nephrologists are specially trained to evaluate and treat resistant, complex, and secondary hypertension — including forms related to kidney artery disease, adrenal tumors, or other underlying conditions that primary care providers may not detect.

We provide thorough ambulatory blood pressure monitoring, 24-hour assessments, and comprehensive evaluations to identify any secondary causes. Our individualized treatment plans combine optimized pharmacotherapy, lifestyle modification, and close monitoring to achieve and maintain target blood pressure — protecting both your kidneys and your heart long-term.

Electrolyte and acid-base disorders can have serious and sometimes life-threatening consequences if not recognized and treated promptly. Conditions like hyponatremia, hyperkalemia, metabolic acidosis, and hypercalcemia require specialized knowledge to evaluate accurately and manage safely.

Our nephrologists bring deep expertise to the diagnosis and management of the full spectrum of electrolyte and acid-base abnormalities — both in acutely ill hospital patients and in those with chronic conditions requiring long-term electrolyte management. We work systematically to identify underlying causes and implement targeted therapies that correct imbalances safely while addressing the root problem.

Kidney stones are among the most painful conditions a person can experience — and without proper evaluation and prevention, they frequently recur. At AKSNB, we offer comprehensive metabolic stone evaluations to identify the specific type of stone and its underlying cause, enabling us to design a targeted prevention strategy unique to each patient.

For patients with a single stone episode, we provide guidance on dietary modifications and hydration. For recurrent stone formers, we conduct a thorough 24-hour urine analysis, blood chemistries, and imaging to uncover metabolic abnormalities such as hypercalciuria, hyperuricosuria, or cystinuria — and we prescribe the evidence-based medical therapies that reduce recurrence rates significantly.

Glomerular diseases — conditions affecting the kidney's filtering units — represent some of the most complex and challenging disorders in nephrology. These include IgA nephropathy, membranous nephropathy, focal segmental glomerulosclerosis (FSGS), lupus nephritis, ANCA vasculitis, and many other rare conditions.

At AKSNB, our nephrologists have deep expertise in evaluating patients with proteinuria, hematuria, and unexplained kidney dysfunction. We coordinate kidney biopsies, interpret complex pathology, and design tailored immunosuppressive and supportive therapy regimens consistent with the most current international guidelines. Our goal is to achieve remission, protect kidney function, and minimize the burden of treatment side effects.

Acute kidney injury is a serious medical event requiring prompt nephrology input to prevent permanent kidney damage and life-threatening complications. Our nephrologists are available for urgent hospital consultations and provide timely, expert evaluation of patients with AKI across the facilities we cover in Napa, Solano, Sonoma, and Lake counties.

We assess the cause of AKI systematically — differentiating prerenal, intrinsic renal, and postrenal etiologies — and implement targeted interventions to restore kidney function. For patients who develop severe AKI requiring renal replacement therapy, we oversee acute dialysis and guide decisions about short-term vs. long-term dialysis needs with careful attention to the patient's overall clinical trajectory.

When kidney failure requires dialysis, having an experienced and accessible nephrology team is essential. AKSNB provides comprehensive management of both hemodialysis (HD) and peritoneal dialysis (PD), coordinating care between outpatient dialysis centers, home dialysis programs, and hospital settings seamlessly.

Our nephrologists manage dialysis prescriptions, access (fistulas, grafts, catheters), adequacy monitoring, and the complex metabolic issues that arise during dialysis treatment. We also oversee the transition to dialysis with careful timing, access planning, and patient education — ensuring that this significant transition is handled with clarity, support, and clinical precision. For peritoneal dialysis patients, we provide hands-on training, troubleshoot complications, and monitor outcomes closely.

Facing the possibility of dialysis or transplant is a major life transition, and we believe patients make better decisions when they are thoroughly informed and empowered. AKSNB provides structured pre-dialysis education for patients with advanced chronic kidney disease (Stages 4 and 5), helping them understand what dialysis involves, the differences between hemodialysis and peritoneal dialysis, the option of conservative management, and the path toward kidney transplant.

Our education program includes individualized consultations, educational materials, and facilitated discussions with patients and their families. We work collaboratively with dialysis centers, transplant programs, social workers, and dietitians to ensure that the RRT planning process is comprehensive, unhurried, and truly patient-centered.

Kidney transplant is the best available treatment for end-stage kidney disease, offering superior quality of life and longevity compared to dialysis. At AKSNB, we identify appropriate transplant candidates early in the course of CKD, initiate the evaluation process, and coordinate closely with transplant centers to streamline the workup and listing process.

For patients who have already received a kidney transplant, we provide dedicated post-transplant nephrology follow-up — monitoring for rejection, managing immunosuppressive medications, addressing post-transplant complications, and optimizing long-term graft survival. Our goal is to help transplant recipients maintain their gift of a kidney for as long as possible.