NEPHROLOGY
Nephrology
About Nephrology: Nephrology is a branch of medicine that deals with the diagnosis and treatment of kidney diseases, including hypertension and electrolyte imbalance and also deals with the treatment of patients who require Renal Replacement Therapy in the form of Dialysis & Renal Transplant.
Nephrology department
Comprehensive nephrology services are offered to diagnose and treat various diseases. This includes, but is not limited to:
- Hypertension
- Diabetic Kidney Disease
- Inherited Kidney Disease
- Kidney Stones
- Nephritis and Nephrotic Syndrome
- Vasculitis
- Polycystic Kidney Disease
- Critical Care Nephrology
- Acute and Chronic Renal Failure
What are Kidneys?
Kidneys are bean-shaped organs around 10-12 cm in length, 2 in number situated on either side of the backbone. Each kidney comprises of approximately 1 million nephrons, the functioning units- the filtration units. The kidneys function to purify the blood and to remove toxins from blood.
Common causes of Kidney Diseases
- Diabetes Mellitus
- Hypertension (High Blood Pressure)
- Hereditary Kidney Disease
- Inflammation of kidneys (Glomerulonephritis)
Common symptoms of Kidney Diseases
- Swelling of face and legs
- Decrease in urine output
- Increased urination at night
- Blood in urine
- Decreased appetite vomiting
- Breathlessness
Common Signs:
- Rise in BP (Hypertension)
- Anaemia (fall in haemoglobin)
- Dry skin
Are you at risk of Kidney Disease?
If you have diabetes, high blood pressure or family history of kidney diseases, you may be at risk of developing kidney disease. Periodic screening in the form of simple blood and urine test is helpful in detecting early kidney disease and preventing deterioration of kidney function.
Precautions to be taken for Healthy Kidneys
- Adequate fluid intake
- Healthy diet
- Blood Pressure control
- Diabetes control
Clinical Services/Procedures offered are:
- Inpatient/outpatient Haemodialysis
- Continuous Renal Replacement Therapy (CRRT)
- Renal Biopsy
- Plasmapheresis
- Chronic Ambulatory Peritoneal Dialysis
- Renal Transplantation
Nephrology Department at CIMS Hospital has seven dialysis machines. The department functions round the clock.
- Being an international level hospital, complicated cases are referred to this department from various other centers.
- Facility for CRRT (continuous renal replacement therapy)for critically ill patients requiring dialysis is also available.
Haemodialysis
- Haemodialysis is a method, wherein blood is purified through a machine known as “hemodialyser”. Blood flows through a dialyser and is returned to the body after purification.
- Haemodialysis requires AV-Fistula or dialysis catheter. Dialysis catheter could be of short term or long term duration.
- Haemodialysis should be performed twice or thrice a week as per advice by nephrologist for patients whose kidneys are permanently impaired.
- Haemodialysis is also required and performed in patients having severe, but temporary reduction in kidney function.
- It can be performed at hospital only under observation of skilled nephrologists and technical staff.
Haemodialysis is done for:
- Acute as well as chronic renal failure patients
- In case of drug overdose
- Plasmapheresis for renal as well as non-renal cases
- Reducing incidence of Hepatitis B and C, rigorous precautions are taken and such patients are dialysed on separate machines.
Dialysis
When kidney function drops below minimum requirement to sustain body and maintain normal parameters, the solution is to replace the kidney function with either another artificial technology or transplant of healthy kidney. Purification of blood via artificial means is called “Dialysis”.
Type of Dialysis:
- Haemodialysis
- Peritoneal Dialysis
Peritoneal Dialysis
- Peritoneal dialysis is another modality for dialysis, which is equally effective as haemodialysis.
- Peritoneal dialysis, which is done as a long term therapy for the patient having permanent loss of renal function is called Continuous Ambulatory Peritoneal Dialysis (CAPD).
- In this process, a rubber tube is inserted in the abdomen and fixed there.
- A peritoneal dialysis solution is infused through tube 3-4 times a day as per advised by the nephrologist.
- The solution remains in abdomen for about 6 hours, removes toxin from blood and after 6 hours, dialysis solution with toxin inside is drained out of abdomen.
- Infusion and drainage of peritoneal fluid should be done for 3-4 times a day.
- It is extremely useful in patients without vascular access (AV fistula or long term dialysis catheter).
- It is not suitable for patients who have undergone multiple abdominal surgeries.
CIMS Hospital has 7 dialysis machines and 1 CRRT machine and has performed 3322 haemodialysis procedures including 1895 (OPD) and 1427 (IPD) in the last year (2017).
Renal Transplant
- Renal Transplant (RT) is the best possible option for patient suffering from end-stage Renal-Disease. Legally, near relative that include (father-mother, grandfather-grandmother, brother-sister, son-daughter, grandson-granddaughter and husband-wife) can donate kidneys to one another.
- Such transplant is called “live related renal transplantation”.
- For patients who don’t have well-matched relative for donation, they can opt for deceased/ cadaveric renal transplantation. In deceased donor/cadaveric renal transplantation, kidneys are harvested from brain-dead donors and implanted in recipients.
- The 3rd option for Renal Transplant is swap Renal Transplant for unrelated patients.
- Renal Transplant requires extensive work-up for both recipients and donors before transplantation.
- Patients need to continue necessary medications for rest of his or her life to ensure proper kidney graft function.
- They require lifetime follow-up with the nephrologist.
- Under a Renal Transplant operation, new kidney allograft is placed in right lower abdomen without removing original kidney.
CIMS Hospital is well-equipped with all necessary resources for a successful renal transplantation which include but not limited to:
- Highly experienced and qualified team of doctors.
- Renal Transplant Program Coordinator for counselling sessions for patient and relatives.
- Renal Transplant Committee constituted by subject matter experts and key opinion leaders for transparent, non-objectionable ethical review.
- Best infection control practices while harvesting kidney to be transplanted and also throughout the procedure.
- Renal transplant ICU.
- CIMS has an active cadaveric renal transplant program & we enroll & maintain a cadaveric waiting list.
CIMS Kidney Transplant Center
Anaesthesiology
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Dr. Deepak Joshi
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CIMS Hospital
Care Institute of Medical Sciences
Off Science City Road, Sola, Ahmedabad – 380060
Gujarat, INDIA
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