Last reviewed by Dr. Leena Joshi, MD, September 2026
Chronic kidney disease is a progressive condition in which the kidneys gradually lose their ability to filter waste and excess fluids from the blood. Dr. Leena Joshi, a board-certified nephrologist serving San Mateo County, treats chronic kidney disease through comprehensive evaluation, medication management, dietary counseling, and coordination with primary care physicians. Dr. Joshi develops individualized treatment plans to slow disease progression and manage complications in patients throughout Burlingame, Daly City, and surrounding communities.
What is chronic kidney disease?
Chronic kidney disease occurs when the kidneys become damaged and cannot filter blood as effectively as they should. The kidneys are responsible for removing waste products, balancing fluids, and regulating important minerals in the body. When chronic kidney disease develops, waste and fluid can build up to harmful levels. The condition progresses through five stages, with stage 1 being mild damage and stage 5 representing kidney failure. Common causes include diabetes, high blood pressure, and inflammatory conditions affecting the kidneys. Many people with early chronic kidney disease have no symptoms, which is why regular screening is important for those at risk. Dr. Joshi helps patients in San Mateo County understand their kidney function and what steps can preserve remaining kidney health.
Signs and symptoms
- Fatigue and decreased energy levels
- Swelling in the ankles, feet, or hands
- Changes in urination frequency or appearance
- Persistent itching or dry skin
- Difficulty concentrating or mental fog
- Loss of appetite or nausea
- Muscle cramps, especially at night
How Dr. Joshi manages chronic kidney disease
Dr. Joshi begins with a thorough assessment of kidney function through blood tests, urine analysis, and review of medical history. As a chronic kidney disease specialist in San Mateo County, Dr. Joshi creates personalized treatment plans based on the stage of disease and underlying causes. Treatment may include medications to control blood pressure, manage blood sugar in diabetic patients, and address mineral imbalances. Dr. Joshi provides detailed dietary guidance, as nutrition plays a critical role in slowing disease progression. Patients may need to adjust their intake of protein, sodium, potassium, and phosphorus. Dr. Joshi monitors kidney function regularly through laboratory testing and adjusts treatment as needed. For patients with advanced chronic kidney disease, Dr. Joshi discusses options including dialysis and transplant evaluation. Dr. Joshi works closely with primary care physicians, cardiologists, and other specialists to provide coordinated care. The goal is always to preserve kidney function as long as possible and maintain quality of life.
When to see a nephrologist for chronic kidney disease
- Your primary care physician detects reduced kidney function on routine blood work
- You have diabetes or high blood pressure with early signs of kidney damage
- You experience persistent swelling, fatigue, or changes in urination
- Your kidney function is declining despite treatment from your primary doctor
- You need guidance on advanced treatment options or dialysis preparation
Frequently asked questions
What is the difference between a nephrologist and a primary care doctor?
A nephrologist is a physician who completed additional specialized training in kidney diseases after internal medicine residency. Dr. Joshi has expertise in managing complex kidney conditions, interpreting specialized tests, and guiding treatment for all stages of chronic kidney disease that may require more focused care than a primary care setting can provide.
Can chronic kidney disease be reversed?
In most cases, chronic kidney disease cannot be completely reversed, but its progression can often be slowed or stopped with appropriate treatment. Early intervention by a chronic kidney disease specialist in San Mateo County like Dr. Joshi can help preserve remaining kidney function and prevent complications.
How often will I need to see Dr. Joshi?
Visit frequency depends on the stage of chronic kidney disease and how stable your condition is. Patients with early stage disease may be seen every few months, while those with more advanced disease may need monthly appointments. Dr. Joshi will determine the appropriate schedule for your situation.
Will I need dialysis?
Not all patients with chronic kidney disease will need dialysis. Many people can manage their condition with medication and lifestyle changes for years. Dr. Joshi will monitor your kidney function closely and discuss dialysis only if kidney function declines to a level where it becomes necessary.
Does Dr. Joshi accept Medicare and insurance?
Dr. Joshi works with most major insurance plans in San Mateo County. Contact the office at (650) 355-5551 to verify your specific coverage and benefits before your first appointment.
What should I bring to my first appointment?
Bring a list of current medications, recent lab results if available, medical records from other physicians, your insurance card, and a list of questions. Dr. Joshi will review your complete medical history during the initial consultation.
Dr. Leena Joshi, MD, provides expert care for chronic kidney disease at two convenient San Mateo County locations: 1750 El Camino Real, Suite 301, Burlingame, and 1800 Sullivan Avenue, Suite 507, Daly City. Call (650) 355-5551 to schedule a consultation and begin your personalized treatment plan.
This page is for general education and is not a substitute for medical advice. Always consult your physician about your specific situation.
Medically reviewed by Leena Joshi, MD.