Answers to the questions patients most commonly ask before their first visit.
What is a nephrologist, and when should I see one?
A nephrologist is a specialist in kidney diseases. You should see one if you have been told your kidneys are not functioning normally, if your creatinine or eGFR is abnormal, if you have persistent protein or blood in your urine, or if you have diabetes or hypertension and have not had a kidney function check in the past year. Your family doctor or internist can refer you, but you may also book directly.
Do you accept PhilHealth? What about HMOs?
Yes —
PhilHealth is accepted at all clinic locations. For HMO coverage, please contact your HMO provider directly and ask for an LOA (Letter of Authorization) before your appointment, as accepted HMOs vary by clinic location. When in doubt, call the clinic directly or message via
SeriousMD.
What is the difference between an internist and a nephrologist?
An internist (specialist in Internal Medicine) manages a wide range of adult diseases — diabetes, hypertension, infections, heart disease, and more. A nephrologist is an internist who completed additional subspecialty training specifically in kidney diseases, dialysis, and electrolyte disorders. Dr. Rivero is both — he completed his Internal Medicine residency and Nephrology fellowship at St. Luke's Medical Center, and manages patients across both disciplines.
I have diabetes. Should I be seeing a nephrologist?
If you have had diabetes for more than 5 years, or if your doctor has found protein in your urine or a rising creatinine, a nephrology consultation is strongly recommended. Diabetic kidney disease is the leading cause of kidney failure in the Philippines and is often silent until significantly advanced. Early detection and treatment can slow or stop progression entirely.
What should I bring to my first consultation?
Bring all recent laboratory results (blood tests, urine tests, imaging), a list of current medications with doses, your PhilHealth MDR card, any previous medical records or discharge summaries, and your HMO LOA if applicable. If you have had a kidney ultrasound or CT scan, bring the actual images (CD/film), not just the report.
Can I consult online?
Yes. Online consultations are available through
SeriousMD — bookable 24/7. Online consultations are suitable for follow-up visits, medication adjustments, result interpretations, and second opinions. Initial consultations for new, complex, or undiagnosed conditions are best done in person so that a physical examination can be performed.
How often do I need to see a nephrologist once I'm diagnosed with CKD?
Visit frequency depends on your CKD stage: Stage 1–2: every 6–12 months. Stage 3: every 3–6 months. Stage 4: every 1–3 months. Stage 5 / dialysis: monthly or more frequently. More frequent visits may be needed when starting new medications, adjusting doses, or managing acute changes. Regular monitoring is what protects your kidneys — do not skip follow-ups even when you feel well.
My creatinine is slightly elevated but I feel fine. Is that a problem?
Yes — and this is exactly why CKD is called a "silent disease." Symptoms of kidney disease typically don't appear until 60–70% of kidney function is already lost. A mildly elevated creatinine may represent Stage 2–3 CKD with no symptoms at all. The earlier it is evaluated and managed, the better the long-term outcome. Please do not wait for symptoms before seeking evaluation.
