Duke University School of Medicine MD 1995 and ABIM board-certified nephrologist Dr. Dylan L. Steer practices from 4060 Fourth Avenue Suite 700 in Hillcrest 92103 as part of Balboa Nephrology Medical Group, which he joined in 2003 after completing a nephrology and hypertension fellowship at UC San Diego. Clinical focus covers chronic kidney disease staging, end-stage renal disease management, hemodialysis oversight at FMC and DaVita dialysis units, and pre-transplant kidney workups, with vascular access surgery for arteriovenous fistula and graft placement coordinated through surgical groups including Pacific Coast Surgical Group. Office visits are split with hospital rounding and in-center dialysis rounds, meaning the same nephrologist managing clinic-based CKD also handles inpatient acute kidney injury consults on hospitalized patients. Inpatient nephrology consults for acute kidney injury and dialysis initiation connect to Hillcrest Medical Center at UC San Diego Health and Scripps Mercy admissions through the Balboa Nephrology call schedule. Insurance panels include most commercial PPO networks, and new-patient referrals from primary-care physicians typically arrive with baseline eGFR, urine albumin-creatinine ratio, and renal ultrasound results already in hand. The most complex cases manage stage 5 CKD patients approaching dialysis initiation through simultaneous vascular access planning, transplant evaluation referral to UCSD or Scripps Green, and uremia symptom management until renal replacement therapy begins.