Nephrology

General Nephrology

The objective of General Nephrology is to deal with the treatment of acute renal failure and chronic renal failure, nephritic syndrome and acute nephritic syndrome. Sree Lakshmi Hospital is the best once it come for nephrology treatment and is well equipped to deal with all types of renal failure. Below are the treatment options in the field of Nephrology

Nephritic Syndrome:

The condition where the patient has developed swelling in legs and face. There are several protein excretions in the urine. Kidney Biopsy is important test to know the exact cause of the condition in adults

Acute Nephritic Syndrome:

Children’s are mostly affected and usually the child complains of sore throat or a skin infection, the child develops red urine, swelling in legs and face with increase in BP. It usually goes away within few days or in a few weeks’ times

Acute Renal Failure:

The most common reason is due to dehydration (lose motions or vomiting), infections, certain drugs side effect and urine blockage

Chronic Renal Failure:

It is one of the main reasons for Kidney failure and it is irreversible. The most common causes are Diabetes, Hypertensions, painkillers uses (long term), genetic, frequent urinary tract infections and other primary kidney diseases

Pediatric Nephrology

Kidney problems are rare in pediatric age but still significant number of children’s develops renal problems. Most of them are easily treated condition like post-infectious glomerulonephritis & steroid sensitive nephritic syndrome. These diseases are more common in child hood Most Unique Renal condition (Children’s)

• Congenital anomalies of the kidneys & urinary tract (CAKUT)
• Posterior urethral valves
• Vesico-ureteric reflux
• Voiding dysfunction
• Recurrent urinary tract infections
• Rickets,
• Recurrent renal stones
• Electrolyte abnormalities & hypertension

If left untreated it may lead to renal failure or sever morbidity Shree Laksmi hospital specialized in Pediatric Nephrology and can treat varieties of acute and chronic kidney problems

Preventive Nephrology

In order to identify the early kidney disease and to prevent damage Shree Laksmi Hospital conduct several diabetic, hypertension awareness camp among common and elderly public How to protect 7 ways to protect kidney

• Say no to OTC drugs
• Avoid painkillers
• Say no to smoking
• Control the blood sugar
• Regular screening for high risk patient (kidney functions test)
• Children with UTI adequate medical attention is required

Renal (Kidney) Biopsy

It is a diagnostic procedure where a small piece of renal tissue is taken to understand the exact cause of proteinuria and the severity of diseases like lupus nephritis. Local Anesthesia is used for Ultrasound-renal biopsy , in adults for both native kidneys or that of the transplant kidney. In children general anesthesia is needed For sick people renal biopsies is done in ICU and in the ward For the procedure the patient has to be admitted in the morning and is advised for bed rest for couple of days. He can resume their daily activity after few days of the procedure.

Haemodialysis

There are two options for an End stage renal failure condition, dialysis or a kidney transplant. Usually there are two types of Dialysis Haemodialysis Peritoneal dialysis We will discuss about haemodialysis. ‘haemo’=Blood It is the process that balance blood chemistry and filters fluid and waste from the blood In terms of hemodialysis, two needles are inserted in the arm of patient. One needle will withdraws the blood and the other will return the filter blood into the patient body The blood from the first needle goes out of the body through tubing and goes to a filter called dialyzer. Dialyzer will filter and return the purified blood to patient body through second needle. Dialyzer is the replacement of damaged kidney, hence it is called “artificial kidney”. This process is usually done in dialysis center

Plasmapheresis

For the patient who is very sick with some specific kidney problem, a specialized procedure is performed called as Plasmapheresis in the ICU. Here a large quantity of plasma is taken out from the patient and is replaced by frozen plasma (Albumin or Saline) Plasma filter is used for the procedure and Hemodialysis instrument with blood line and blood pump is used .In the blood line replacement fluid is infused. Anticoagulation is used during the procedure

CRRT

Continuous Renal Replacement Therapy (CRRT)- A special dialysis for few patient who are very sick and admitted in ICU. They are usually sick, multiple organ damage, including renal failure. For such patient a specialized dialysis is performed called CRRT For this procedure a separate dialysis machine is dedicated and round the clock patient condition is monitored. It is carried out continuously for 24 to 48 hours

Peritoneal Dialysis

In the condition of End stage renal failure, there are two options available: Dialysis Kidney transplant (renal transplant) Usually there are two types of dialysis known as hemodialysis and peritoneal dialysis. We will discuss about peritoneal dialysis Peritoneal dialysis: Here the patient peritoneum (membrane present inside the abdomen) is used for the procedure In this procedure a tube called catheter is inserted into the patient abdomen as a permanent access for dialysis. The catheter is placed by the side of navel and about 2 to 4 inch is extends out of the body. Peritoneal dialysate, a chemical used to remove waste from the body is filled into the peritoneum. This dialysate usually absorb the waste product and excess water. Dwell time is the period when dialysate remains in the peritoneum. After this period the waste and solution is drained out and collected in a sterile collecting bag

Types of Peritoneal Dialysis

Intermittent Peritoneal Dialysis (IPD) :It a short period dialysis (24-48 hours) and is performed for the patient as a temporary procedure. It is performed on patient with low BP or in children with acute renal failure Continuous Ambulatory Peritoneal Dialysis (CAPD): In CAPD there are no dry periods and the patient peritoneum is filled by hand as a manual procedure Automated Peritoneal Dialysis (APD): This procedure is usually done at night when the patient is sleep and is performed through a machine called as cycler machine Continuous Cyclic Peritoneal Dialysis (CCPD): This is usually carried out night where the patient peritoneum is filled with dialysate by the help of a machine. The exchange usually done throughout night. This is more patient friendly as the machine is not attached at day, it helps patient to be more active in day time Daytime Ambulatory Peritoneal Dialysis (DAPD): In this procedure it is dry at night and the patient peritoneum is filed with dialysate during day Night-Time Intermittent Peritoneal Dialysis (NIPD): patient’s peritoneal cavity of the patient is filled manually at night and is usually dry during the day