Nephrology
Hospital in Bangalore

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 retro peritoneal 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 concentration that may be subjected to change due to numerous conditions or medicines. The Department of Nephrology at SPARSH Hospitals, provides comprehensive and benevolent care to patients across the spectrum of acute and chronic kidney diseases. The department’s transplantation facilities are engineered to deliver quality care and successful outcomes even in ABO incompatible transplantation. Our team of experienced doctors are recognized for their superior clinical skills and for treating all categories of patients ranging from children to adults. We have an eminent team of kidney transplantation specialists, nephrologists, urologists and the technical expertise needed to meet the challenges in conducting multiple lifesaving procedures. We offer the most advanced diagnostics, comprehensive preoperative evaluation and dialysis support, the latest facilities available in surgical procedures, and complete post-operative care to minimize chances of infection. We also provide dialysis services driven by an efficient team of nephrologists, nurses, and certified haemodialysis technicians along with registered dieticians. Peritoneal, nocturnal and short daily dialysis and haemodialysis are provided to both children and adults. The patients suffering from kidney diseases need superior quality care, hope and guidance and we take pride in our team efforts to achieve successful outcomes for our patients. We ensure patients comfort and satisfaction through our services. Suffering from kidney diseases need superior quality care, hope and guidance and we take pride in our team efforts to achieve successful outcomes for our patients. We ensure patients comfort and satisfaction through our services. Several kidney complications are systemic disorders, i.e. they are not only confined to the organ itself. These conditions need specialized treatment and medical care. The Nephrology Division at SPARSH Hospitals, offers comprehensive care to patients suffering from a spectrum of chronic and acute kidney diseases. We are one of the best kidney hospitals in India renowned for using advanced facilities and treatment options. The Nephrology experts at SPARSH consistently invest time, effort, and expertise to help people maintain their kidney health through various non-invasive interventions.

DISEASES TREATED UNDER THE BRANCH OF NEPHROLOGY

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: 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 as the glomerulus – Cancers of the kidneys, bladder, and urethra
• Acute, kidney injury or 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 – haemodialysis as well as peritoneal dialysis – Renal Transplantations
• Polycystic kidney disease 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 SPARSH Hospitals, specializes in offering evaluation and treatment for a wide range of kidney-related complications including: Amyloidosis: This disease is characterized by abnormal production of protein known as amyloidosis 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 damage to the organ that results in its system failure. These complications make kidneys in efficient 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

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 or itchy skin – Nausea – Reduced sense of taste and appetite
• Less energy and trouble concentrating
• Unexplained confusion, memory problems, or trouble focussing
• Pain, fluid in the joints, or stiffness.

TREATMENTS AVAILABLE FOR NEPHROLOGY DISEASES

The state-of-the-art dialysis units with modern equipment and facilities for nephrology treatment operates 24/7 at full capacity across all multispecialty hospitals of SPARSH. Different services offered by the nephrology department include:

• Continuous Renal Replacement Therapy (CRRT) – Peritoneal Dialysis (CPD)
• Plasma Dialysis (Plasmapheresis) | Liver Dialysis (MARSTherapy) | Kidney Transplantation
• Combined Kidney & Liver Transplantation and Kidney Biopsy
• Continuous Renal Replacement Therapy (CRRT)

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 waste 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) 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) 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 stabilization of vital organ functions. Kidney Transplantation: Patients with kidney failure have to go for dialysis or a kidney transplantation. Dialysis takes time, and patients have to visit a dialysis center frequently for treatments. With a kidney 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 Transplantation and Kidney Biopsy: 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 transplantation.
• Percutaneous cannula placement through ultrasound guidance
• Dialysis and transplantation services for patients with end-stage renal complications.
• Therapies to all end-stage renal disease, including kidney transplantation, haemodialysis, and peritoneal dialysis.
• Continuous renal replacement therapy, including citrate anticoagulation for critically ill patients.

Common Medical Procedures Used in Nephrology:- There are several medical procedures that your Nephrologist 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: Commonly 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

Haemodialysis: Haemodialysis is a specialized process that uses an artificial kidney machine called hem dialyzer 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 haemodialysis sessions three times a week. Kidney transplantation: Transplantation is a surgical procedure that involves removing a particular section or the entire damaged kidney and replacing it with a matching donor organ.

When should you see a Nephrologist?

If your kidneys are in the early stages of a disease, a general care doctor may be able to help to prevent and treat them. However, in many cases, kidney diseases occur without any or non-specific symptoms that are hard to detect. Some of them include fatigue, changes in the quantity of urine, and sleep troubles. Therefore, people who are at a higher risk for kidney diseases must go through regular tests to monitor their kidney health and functioning. Individuals with diabetes, heart disease, high blood pressure, and a family history of kidney problems should be cautious. Some of the common reasons why your doctor may refer you to a nephrologist:

• Sudden loss of kidney functions or acute renal failure
• CKD (chronic kidney disease) with long-term decline in kidney functions
• Cystitis or bladder infections and Pyelonephritis or kidney infection
• Recurring kidney stone formation
• Presence of blood, crystals, proteins or casts in the urine
• Acid-base imbalance or electrolyte disorders
• Chronic Diabetes
• Hypertensive nephrosclerosis (kidney damage from high blood pressure)
• Atheroembolic kidney disease (kidney damage from atherosclerosis)
• Autoimmune diseases such as lupus, autoimmune vasculitis, etc.
• Drugs or toxins that may have caused kidney damage