Nephrology Centre

The department of Nephrology is dedicated to the understanding of Kidney diseases, their development, progression, treatment and prevention. The faculty is at the forefront of patient care in the field of kidney diseases. Pursuit of excellence in patient care through the improvement of the understanding of disease processes and the development of new strategies in the treatment of individuals with kidney disease is our primary goal.

BASIC NEPHROLOGY CARE
 

We offer both inpatient and OPD care to all nephrology patients round the clock. This includes counseling, management of kidney disorders, procedures and the support of systems affected by kidney diseases. Services for kidney biopsies, dialysis is also available under one roof. It is a close knit, which includes highly specialized Nephrologist, Urologist.

BASIC CARE FOR CKD (CHRONIC KIDNEY DISEASE)

Know About your Kidney!!!

The kidneys perform a variety of functions:

• Filter the Blood to remove toxic waste products
• Regulate the water and electrolyte balance (sodium, potassium, calcium etc)
• Maintain healthy bones by producing an active form of Vitamin D
• Release a hormone that produces Red blood cells
• Regulate Blood Pressure

Causes of CKD?
The two major causes of CKD are Hypertension (high BP) and Diabetes mellitus.

Who is at risk for CKD??
You are at an increased risk for developing CKD if you:

• Have diabetes
• Have high blood pressure
• Have Cardiovascular disease
• Have a family history of chronic kidney disease

What are the symptoms of CKD?
Most people with early CKD have no symptoms. As the Disease progresses, following symptoms may appear:

• Swelling over face, legs or entire body
• Urinary abnormalities like red colored urine, burning while passing urine, decreased urine output, increased frequency of urine especially at bedtime
• Shortness of breath
• Pain in flanks or in the groin
• Unexplained loss of appetite, nausea, vomiting
• Weakness, fatigue, bone pains

Are Kidney diseases curable / treatable?

Yes, many of the kidney diseases are curable and many are treatable.

• Acute renal failure: Kidney failure appearing over hours to days, if managed in time can be completely cured.
• Chronic renal failure: Chronic kidney diseases common causes in India are Glomerular nephritis, diabetes, and hypertension. If kidney involvement is managed appropriately, advanced failure can be either avoided or delayed.
• Nephrotic/Nephritic Syndromes: Many of these can be cured.
• UTIs and UT stones can be treated and recurrence avoided.

How can we screen for CKD?
Persons who are at risk for CKD must get their Kidney Function tested by the following very simple tests. This will help detect CKD at an early stage so that corrective measures can be taken.


Simple tests to Screen for Kidney Disease:

• Check BP
• Urine Routine
• Urine for Micro albumin. Micro albumin in urine in an early sign of CKD
• Blood test for Serum Creatinine: Creatinine is a waste product derived from muscles. Serum Creatinine test is used to calculate the GFR (Glomerular Filtration Rate) which gives an accurate indication of Kidney function.

What are some healthy measures to adopt to decrease chances of getting CKD?
These include:

• Eat a balanced diet
• Exercise regularly
• Keep weight in check
• Stop smoking
• Monitor Cholesterol levels
• Annual physical examination

What are the procedures done in nephrology department?

• Haemodialysis
• Peritoneal dialysis
• Kidney transplantation
• CRRT
• Kidney biopsy
   

Does initiation of dialysis mean life long treatment?

No, Dialysis does not determine life long treatment. If kidney failure is irreversible (chronic kidney disease), then only treatment is life long. Many acute renal failure patients may require dialysis for a short time and then once their kidneys recover, they are off dialysis.

What does dialysis do?

Dialysis removes the toxins and excess water accumulated in the body as a result of kidney failure. These toxins, if not removed can cause end-organ damage and even death.

What is the frequency of haemodialysis?

As our kidneys work 24 hours X 7 days, nowadays, the concept is coming for daily dialysis. However, conventionally, 3 times a week for 4 hours each time is considered good dialysis.

What is Peritoneal dialysis?

It is an alternative form of dialysis where patient fills in his/her belly with dialysate (special solution) through a tube in their belly and empties it after some time. They do this 3-4 times in a day. Each cycle takes about 30-45 minutes.

Which dialysis is better, haemodialysis or peritoneal dialysis?

Some patients are more suited for haemo and some for peritoneal. Nephrologist can help in this regard. Most of the patients are fit for either and have a choice between the two.

What is CRRT?

It is Continuous Renal Replacement Therapy. It includes CVVHD, CVVHDF. This form of dialysis is special form, which is done for critically sick patients in ICUs who cannot tolerate conventional dialysis.

Does patients on dialysis have food and fluid restrictions?

Generally dialysis patients are advised low potassium and low phosphate containing diet with adequate protein. Fluid (water) restrictions are depending on patients' urine output. However, these restrictions are individual and many patients may not require these restrictions. So, the restrictions are individualized for best health of patients.

Which form of treatment is best for end-stage renal disease (ESRD)?

Best treatment for patients having ESRD is kidney transplantation. It gives better survival and best quality of life. If this is not possible for some reason, then patients can be managed with dialysis.

CONSULTANTS ATTENDING NEPHROLOGY CASES

• Dr. Atul Ingle
• Dr. Vishwanath Billa
• Dr. Nitin Bhosale

PEDIATRIC NEPHROLOGY DEPARTMENT

Pediatric Nephrology offers a full range of inpatient and OPD renal services including diagnostic support for prenatal urological malformation
on and management of renal diseases and hypertension.
The pediatric Nephrologist also works closely with the pediatric urologist in medical care of patient with complex urological problems.

Common Pediatric Nephrological problems

• Nephrotic syndrome especially with multiple relapses (swelling due to protein loss in urine)
• Nephritis
• Blood in the urine (haematuria)
• Urine infections
• Special tubular disorders like Renal Tubular Acidosis, Bartter�s syndrome etc
• Acute kidney failure needing/not needing dialysis
• Chronic (irreversible) kidney failure, including the stage where chronic dialysis is required
• Hypertension (high blood pressure) in children
• Renal dysplasia (abnormal formation of kidneys at birth)
• Antenatal ultrasound showing abnormality in kidneys
• Polycytic kidneys/other cystic problems in kidneys
• Daytime and/or night wetting
• Endocrine (hormonal) problems with effects on kidneys
• Conditions like posterior urethral valves, obstruction in urinary tract to maintain kidney function

Services available at M.G.M New Bombay Hospital

1. Management of conditions like nephrotic syndrome with relapses, nephritis, blood in the urine
2. Dialysis for acute kidney failure (Peritoneal, Haemodialysis)
3. Dialysis for chronic (end stage kidney disease) (Haemodialysis). Progressing to kidney transplant soon.
4. KIDNEY BIOPSIES
5. INSERTION OF DIALYSIS CATHETERS
6. Detection and management of conditions like Renal tubular acidosis, bartter�s syndrome etc
7. Management of kidney function in conditions like posterior urethral valves, cysts in the kidneys
8. Daytime/Night wetting
9. Counseling and management for kidney abnormalities seen on antenatal ultrasound (ultrasound done in pregnancy)
10. Diagnosis, detection of cause and treatment of hypertension (high blood pressure) in children

CONSULTANT ATTENDING PEDIATRIC NEPHROLOGY CASES

• Dr. Pankaj Deshpande