Overview

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Nephrology is the branch of internal medicine’s subspecialty that deals with the diagnosis and treatment of kidney-related diseases. A human body has two kidneys; they are the bean-shaped organs located on either side in the retroperitoneal space. Kidneys are responsible for removing waste products and excess fluid from the body. They are also critical for retaining fluid intake and maintaining electrolyte concentrations that may be subjected to change due to numerous conditions or medicines.

Several kidney complications are systematic disorders, i.e. they are not only confined to the organ itself. These conditions need specialized treatment and medical care.

The Nephrology Division at Shivam Hospital offers comprehensive care to patients suffering from a spectrum of chronic and acute kidney diseases. We are one of the best kidney hospitals in Churu renowned for using advanced facilities and treatment options. The Nephrology experts at NH consistently invest time, effort, and expertise to help people maintain their kidney health through various non-invasive procedures.

Our team of experienced Nephrologists is acclaimed for its rare clinical skills and for providing top-notch treatment to all classes of people ranging from children to adults. We at NH boast an adroit team of professionals including kidney transplant specialists, nephrologists, urologists, and other nursing staff.

Diseases Treated Under the Branch of Nephrology

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Nephrology focuses on ensuring the normal functioning of kidneys by treating conditions that hinder its processes. The various conditions that fall under the scope of nephrology include:

• Urine abnormalities such as excess excretion of protein, sugar, blood, casts, and crystals
• Glomerular complications that affect the tiny filtering systems of the kidneys known the glomerulus
• Cancers of the kidneys, bladder, and urethra
• Acute, sudden, long-term or chronic Renal failure
• Kidney infections
• Effects of diseases like diabetes and hypertension on the kidneys
• Acid-base fluctuations.
• Kidney and bladder stones
• Ill effects of toxins and drugs on the kidneys
• Nephrotic syndrome and nephritis
• Renal vascular diseases that disturb the blood vessel networks within the kidneys.
• Tubulointerstitial diseases affecting the kidneys tubules
• Autoimmune diseases including lupus and autoimmune vasculitis
• Hydronephrosis
• Dialysis and its associated long-term complications – hemodialysis as well as peritoneal dialysis
• Renal Transplantations
• Polycystic kidneys diseases in which large cysts or fluid-filled sacs grow within the kidney damaging its normal functioning – this may be congenital, inherited or genetic.
• Anemia related to kidney disease.
• Bone disease related to kidney disease

Additional Conditions

The Nephrology team at Shivam Hospital specializes in offering evaluation and treatment for a wide range of kidney-related complications including:-

• Amyloidosis: This disease is characterized by abnormal growth of protein known as amyloids in different parts of the body.
• Diabetic kidney disorder: The long-standing complications of diabetes contribute to kidney diseases. It is one of the prominent causes of kidney failure. Around one-third of people having diabetes are exposed to the risk of developing diabetic nephropathy.
• Electrolyte disorders: This condition results from an abnormal imbalance of minerals in the body that results in potentially harmful damage to vital organs including the brain and muscles.
• Glomerulonephritis: This is a kind of disease that develops due to inflammation in tiny kidney organs called glomeruli. The glomeruli are important structures that are responsible for removing extra fluid and waste from your bloodstream.
• Hypertension (chronic hypertension): This refers to high blood pressure, a condition wherein arteries are exposed to a consistent increase in blood pressure levels. This condition affects different body organs and results in illnesses involving kidney failures, heart failure, aneurysm, and stroke.
• Kidney disease: Kidney diseases comprise a wide range of damages to the organ that results in its system failure. These complications make kidneys inefficient to remove waste and excess fluid from the body.
• Kidney failure: Also referred to as a renal failure, this is a medical condition in which kidneys become incapable of filtering out waste products from the blood.
• Lupus nephritis: This is a condition in which inflammation of kidneys occurs due to systemic lupus erythematosus (SLE), an autoimmune disease.
• Nephrotic syndrome: This is a kind of kidney disorder that occurs due to damage in small blood cells of the kidney. This syndrome results in excretion of excessive protein in your urine.
• Pyelonephritis: This is a kind of bacterial infection that leads to inflammation of substances of the kidney.
• Polycystic kidney disorder: It is a genetic disorder that leads to the development of a cluster of cysts within kidneys and results in high blood pressure and kidney failure.
• Renal insufficiency: This is a medical condition in which blood flow to kidneys reduces significantly due to renal artery diseases and leads to poor kidney functioning.

Signs and symptoms of Nephrology Diseases

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Some common signs and symptoms that indicate the risk of severe kidney complication include:-

• Frequent swelling in the legs, ankles, or feet
• Consistent headaches
• Dry and itchiness in the skin
• Nausea
• Reduced sense of taste and appetite
• Less energy and trouble concentrating
• Unexplained confusion, memory problems, or trouble focusing
• Pain, fluid in the joints, or stiffness
• Unexplained blood pressure problems
• Muscle cramps, numbness, or weakness
• Exhaustion during the day but problems sleeping at night
• Blood in the urine (hematuria)
• Reduced urine output not related to dehydration
• Abnormal weight loss

Treatments Available for Nephrology Diseases

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The state-of-the-art dialysis units with modern equipment and facilities for nephrology treatment operates 24/7 at full capacity at Shivam Hospital. Different services offered by the Nephrology department include-

• Continuous Renal Replacement Therapy (CRRT)
• Peritoneal Dialysis (CPD)
• Plasma Dialysis (Plasmapheresis)
• Liver Dialysis (MARS Therapy)
• Kidney Transplant
• Combined Kidney & Liver Transplant and Kidney Biopsy

Continuous Renal Replacement Therapy (CRRT)

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Patients who are critically ill tend to have a high metabolic rate as their bodies are trying to recover from the disease. They need vasoactive drugs and continuous waste elimination while also simultaneously receiving large volumes of fluid in the form of nutritional and inotropic agents and drug infusions. Therefore, CRRT or continuous renal replacement therapy is followed so that wastes and water can be gently removed without causing hypotension.

CRRT is a slow form of haemodialysis, where the blood is removed and pumped through a hemofilter.

Peritoneal Dialysis (CPD)

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During peritoneal dialysis, a fluid known as dialysate is put into the peritoneal or abdominal cavity with the help of a catheter. The dialysate is allowed to sit there for several hours while waste products pass from the capillaries into the liquid. The dialysate is then drained out.

Liver Dialysis (MARS Therapy)

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The Molecular Adsorbent Recirculating System or MARS therapy is based on the concept of albumin dialysis and quite effectively eliminates the protein-bound and water-soluble toxins. The treatment procedure could facilitate liver regeneration and stabilisation of vital organ functions.

Kidney Transplant

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Patients with kidney failure have to go for dialysis or a kidney transplant. Dialysis takes time, and patients have to visit a dialysis centre frequently for treatments. But with a liver transplantation, they don’t have to depend on a dialysis machine and can have a chance at leading a better quality of life.

Combined Kidney & Liver Transplant and Kidney Biopsy

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Combined kidney and liver transplantation are usually done in patients with cirrhosis and other kidney diseases associated with it.

During a kidney biopsy, the doctor will collect samples of the kidney to check them in great detail under special microscopes. It can be done either through percutaneous biopsy or open biopsy. In a percutaneous biopsy, a needle is advanced through the skin over the kidney and guided to the required place by ultrasound.

In an open biopsy, the sample is taken from the kidney during surgery.

Other treatment options available are:

• Full range dialysis services and chronic dialysis on an outpatient basis.
• Chronic peritoneal dialysis care, including continuous cycling peritoneal dialysis (CCPD) or continuous ambulatory peritoneal dialysis (CAPD).
• Real-time ultrasound guidance for Percutaneous needle biopsy of native kidneys and kidney transplants.
• Percutaneous cannula placement through ultrasound guidance
• Dialysis and transplant services for patients with end-stage renal complications.
• Therapies to all end-stage renal disease, including kidney transplantation, hemodialysis, and peritoneal dialysis.
• Continuous renal replacement therapy, including citrate anticoagulation for critically ill patients.

Common Medical Procedures Used in Nephrology

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There are several medical procedures that your Nephrologists may use for diagnosing, monitoring, and treating kidney diseases. Some of the most common ones are:

Ultrasound: Ultrasound is an imaging test that uses high-frequency sound waves to capture internal images of your kidneys. This test helps in the identification of abnormalities in kidneys such as a change in size and position. Moreover, it can detect the presence of obstructions involving the formation of cysts or tumors.

CT scan: As known as computed tomography, a CT scan allows doctors to capture cross-sectional images of kidneys. Sometimes the process may also be performed using intravenous contrast dye. This test can identify obstruction in organs in a more precise manner.

Biopsy: A biopsy involves removing tiny samples of tissues by inserting a thin needle. These cells from your body help healthcare professionals examine the condition in laboratories.

You doctor may conduct a biopsy for some specific reasons including:

• Assessing kidney damage
• Identifying disease processes and checking its response to treatment
• Analyzing the complications associated with transplantation

Hemodialysis: Hemodialysis is a specialized process that uses an artificial kidney machine called hemodialyzer for extracting extra waste, fluid, and chemicals from the blood before returning it to the body. After purification blood is returned to the body through a catheter or port, in leg, arm, or neck.

This procedure is usually used for patients who have reached the end stage of kidney failure. At this stage, 85–90% functioning of kidneys is lost and during this a patient requires around 4 hours of hemodialysis sessions three times a week.