Last reviewed by Dr. Leena Joshi, MD, September 2026
Dialysis and kidney failure occur when the kidneys can no longer filter waste and excess fluid from the blood effectively. Dr. Leena Joshi provides comprehensive nephrology care for patients in Burlingame and throughout San Mateo County, helping manage chronic kidney disease and coordinating dialysis services when needed. Dr. Joshi works closely with local dialysis centers to ensure continuity of care while providing ongoing medical management in the clinic setting.
What is dialysis and kidney failure?
Kidney failure, also called end-stage renal disease, happens when the kidneys lose about 85 to 90 percent of their ability to work. When kidneys fail, waste products and extra water build up in the blood, which can make a person very sick. Dialysis is a medical treatment that does the work healthy kidneys normally do. The treatment removes waste, salt, and extra water from the blood and helps control blood pressure. There are two main types of dialysis: hemodialysis, which filters blood through a machine, and peritoneal dialysis, which uses the lining of the abdomen to filter blood inside the body. Many patients in Burlingame receive dialysis treatments at specialized dialysis centers while continuing to see their nephrologist for overall kidney care management. Dr. Joshi helps patients understand their options and coordinates with dialysis facilities throughout San Mateo County.
Signs and symptoms
- Severe fatigue and weakness that interferes with daily activities
- Swelling in the legs, ankles, feet, or face from fluid buildup
- Shortness of breath or difficulty breathing
- Nausea, vomiting, or loss of appetite
- Confusion, difficulty concentrating, or changes in mental clarity
- Decreased urine output or changes in urination patterns
- Persistent itching or skin changes
How Dr. Joshi manages dialysis and kidney failure
Dr. Joshi provides comprehensive nephrology care for patients with advanced kidney disease in Burlingame and surrounding communities. When kidney function declines to the point where dialysis may be necessary, Dr. Joshi discusses all available treatment options with patients and their families. Dr. Joshi helps patients understand the differences between a dialysis center and a nephrology clinic. A dialysis center in Burlingame or nearby areas provides the actual dialysis treatments, typically three times per week for hemodialysis patients. The nephrology clinic, where Dr. Joshi practices, focuses on overall kidney disease management, medication adjustments, treatment of complications, and coordination with the dialysis facility. Dr. Joshi works collaboratively with dialysis centers throughout San Mateo County to ensure seamless care. Dr. Joshi monitors lab results, manages anemia and bone disease related to kidney failure, adjusts medications, and addresses any complications that may arise. For patients not yet on dialysis, Dr. Joshi focuses on slowing disease progression and preparing patients for potential future dialysis needs.
When to see a nephrologist for dialysis and kidney failure
- Your primary care doctor has told you that your kidney function is declining
- You have been diagnosed with stage 4 or stage 5 chronic kidney disease
- You are currently on dialysis and need ongoing nephrology management
- You are experiencing symptoms of advanced kidney disease
- You need guidance about dialysis options and preparation
- You require coordination between your dialysis center and medical care team
Frequently asked questions
What is the difference between a dialysis center and a nephrology clinic in Burlingame?
A dialysis center provides the actual dialysis treatments, while a nephrology clinic like Dr. Joshi’s office manages overall kidney disease care, medications, and complications. Most dialysis patients need both services. Dr. Joshi coordinates with local dialysis centers to provide comprehensive care.
How often will I need to visit Dr. Joshi if I am on dialysis?
Visit frequency varies based on individual needs, but most dialysis patients see their nephrologist monthly or more often if complications arise. Dr. Joshi determines the appropriate schedule based on each patient’s condition and monitors progress through regular lab work and communication with the dialysis center.
Can Dr. Joshi help me choose a dialysis center in Burlingame or San Mateo County?
Yes, Dr. Joshi can discuss dialysis center options in the Burlingame area and throughout San Mateo County. Dr. Joshi considers factors like location, treatment schedules, and facility quality when helping patients select an appropriate dialysis center that meets their needs.
Do I still need to see a nephrologist if I am already going to a dialysis center?
Yes, ongoing nephrology care remains essential even when receiving regular dialysis treatments. Dr. Joshi manages medications, treats complications, monitors lab results, and coordinates with your dialysis center to ensure optimal outcomes. Dialysis centers focus on the treatment itself, while nephrologists provide comprehensive medical management.
What should I bring to my first appointment with Dr. Joshi about kidney failure?
Bring recent lab results, a list of all current medications, medical records from other doctors, and any questions about dialysis or treatment options. Dr. Joshi will review your complete medical history and kidney function to develop an appropriate care plan.
Can kidney failure be reversed, or will I need dialysis forever?
Most cases of kidney failure are permanent, though a small number of patients may recover some function depending on the cause. Dr. Joshi evaluates each patient individually to determine whether kidney function may improve or if long-term dialysis or kidney transplant evaluation is appropriate.
Dr. Leena Joshi, MD, serves patients from both Burlingame and Daly City offices. To schedule a consultation for dialysis management or kidney failure care, call (650) 355-5551. The Burlingame office is located at 1750 El Camino Real, Suite 301, Burlingame, and the Daly City office is at 1800 Sullivan Avenue, Suite 507, Daly City. Schedule a consultation to discuss your kidney care needs.
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.