Nephrology

The kidneys are filtering units of the body. A bean-shaped kidney has one million tiny filters, or nephrons, that separates the nutrients and other important substances and entities of the body needs from waste products and excess fluid; commonly thrown out of the body as urine.

Common kidney diseases range from minor kidney stones to chronic kidney disease to kidney failure. Kidney or renal conditions are on the rise globally including India.

Causes for kidney diseases include:

  • 1)High blood sugar and high blood pressure damage the kidney's nephrons and impair blood vessel function, making it more difficult for waste to be removed leading to either temporary or permanent kidney failure.
  • Other reasons like excessive and long-term intake of pain killers, alternative medicine, and genetic factors contribute to kidney failure

Our Nephrology department is regarded, as one of the centres for excellence.  Our clinical expertise and infrastructure support the treatment of health conditions, related to all kidney disorders.

At Wockhardt Hospitals, Our philosophy is to serve and enrich the quality of life of our patients giving them a winning edge to live life to the fullest. The gift of saving a human life is probably the most compassionate deed of all, where you can give or receive a second chance to normal and healthy life. As part of this endeavour the Renal Replacement therapy program has been initiated where, Haemodialysis Peritoneal Dialyses, Renal Transplantation form part of treatment modalities for kidney disease in chronic renal failure patients.

We have already achieved many successful transplants already and provided a better quality of life to patients suffering from terminal kidney diseases. Our hospitals have a full-fledged dialysis unit, intensive care facility and full integrated operation theatre with advanced equipped to carry out super speciality surgery like renal transplantation.

 All infection control protocols, quality nursing care, advanced clinical acumen, Facilities and services are as per international standards and help to facilitate treatment and recuperation of our transplant patients.

Speciality Areas
  • PCNL Surgery

    Percutaneous nephrolithotomy (PNL) is the procedure of choice for the treatment of large or complex” renal calculi” commonly known as “renal stones”. This technique is well established, with high rates of success and accepted morbidity. Percutaneous nephrolithotomy technique is in constant evolution. Supine position has been proved as an acceptable option. ...

     

  • Shock Wave Lithotripsy

    Lithotripsy is a procedure that uses shock waves to break up stones in the kidney, bladder, or ureter (tube that carries urine from kidneys to the bladder. After the procedure, the tiny pieces of stones pass out of your body in your urine The lithotripsy attempts to break up the stone with minimal collateral damage by using an externally applied, focused, high...

     

  • Kidney Dialysis

    The kidneys are responsible for filtering waste products from the blood. Dialysis is a procedure that is a substitute for many of the normal duties of the kidneys. The kidneys are two organs located on either side of the back of the abdominal cavity. Dialysis can allow individuals to live productive and useful lives, even though their kidneys no longer work...

     

Doctors

FAQs

Who is a specialist that looks at kidney disease?

A nephrologist is a doctor who look at kidney disease.

What is the importance of the Kidney and its functions?
  • The kidneys are two bean-shaped organs situated in the back muscles (on either side of the spine) of the upper abdominal cavity in our body.
  • The main function of the kidney is to filter the blood circulating through your body by removing waste and excess salts and regulate the water fluid levels.
  • They are also responsible for regulating pH, salt, and potassium levels in the body.
  • Produce hormones that regulate blood pressure and control the production of red blood cells.
  • Activate a form of vitamin D that helps the body absorb calcium.
What are some of the kidney diseases?

Chronic Kidney Disease.

  • The most common form of kidney disease is chronic kidney disease caused by high blood pressure and diabetes.
  • Kidney failure is the last (most severe) stage of chronic kidney disease. This called end-stage renal disease or ESRD for short.
  • Other causes include, autoimmune diseases, such as lupus and IgA nephropathy, Genetic diseases, polycystic kidney disease, Nephrotic syndrome and Urinary tract problems
What is kidney failure?

Acute Renal Failure:
• This type of kidney failure is called acute kidney injury or acute renal failure and is of sudden onset. .
• Common causes of acute renal failure include Heart attack, Illegal drug use and drug abuse, not enough blood flowing to the kidneys, Urinary tract problems. However this type of kidney failure is not always permanent.

What is chronic renal failure?

Chronic kidney disease, also known as chronic renal failure, is a slow progressive loss of kidney function over a period of several years. Eventually the patient has permanent kidney failure. It is staged as per based on the patient's level of glomerular filtration rate (GFR) which is a measure of filtering capacity of the kidneys.

What are the common symptoms of kidney failure?
  • Nausea
  • vomiting
  • Loss of appetite
  • Changes in urine output
  • Fluid retention
  • Anaemia (a decrease in red blood cells)
  • decreased sex drive
  • Sudden rise in potassium levels (hyperkalaemia)
  • Inflammation of the pericardium (fluid-filled sac that covers the heart
What is kidney stone?

A kidney stone is a hard, crystalline mineral material formed within the kidney or urinary tract.

Kidney stones form when there is a decrease in urine volume and/or an excess of stone-forming substances in the urine. Dehydration is a major risk factor for kidney stone formation.

What are the symptoms of kidney stone?

Symptoms of a kidney stone include flank pain and blood in the urine can be present.

What is the diagnosis for kidney stones?

Diagnosis of kidney stones is best accomplished using an ultrasound, intravenous pyelography (IVP), or a CT scan.

What is the treatment of kidney stones?
  • Most kidney stones eventually pass through the urinary tract on their own within 48 hours, with ample fluid intake.
  • Ketorolac (Toradol), an injectable anti-inflammatory drug, and narcotics may be used for pain control when over-the-counter pain control medications are not effective.
  • Lithotripsy is a procedure which can be done to remove stones. Extracorporeal shock wave lithotripsy (ESWL) is a non-invasive treatment of kidney stones and biliary calculi.
Can I take something to dissolve my kidney stone?

The most common stone types (calcium oxalate and calcium phosphate, accounting for 80% of all stones) cannot be dissolved with medications. However, in patients with uric acid stones, medication (potassium citrate) can be successfully given to dissolve the stones, helping them to pass and preventing from re-development.

Do all kidney stones cause pain?

Kidney stones cause pain if they are blocking the ureter and trying to pass down towards the bladder. Stones that are not obstructing are generally not painful.

What are the risks or potential complications of the various treatment?

Each treatment has its own inherent risks. Some risks that can be associated with all surgical procedures are the possibility of bleeding and infection. It is extremely rare for patients undergoing shock wave lithotripsy (SWL) or Ureteroscopy (URS) to have significant problems with blood loss or infection. The probability is higher with more invasive treatments such as percutaneous nephrolithotomy (PNL) or open surgery. Antibiotics are generally given at the time of surgery to help prevent infection.

Will I have significant pain after the procedure?

Some discomfort is inevitable after surgical intervention for stones. The degree of discomfort is directly related to the invasiveness of the procedure. If needed, your urologist will prescribe medication to help control the pain during the recovery period.

What are kidney infections?

Kidney infections are caused when bacteria infects your kidneys. The bacteria are usually a type called E. coli, which live in the intestine. The bacteria get in through the opening of the urethra and move upwards through the urinary tract, first infecting your bladder and then your kidneys.Most urinary tract infections involve only the bladder and urethra (the lower urinary system). Pyelonephritis results when a UTI progresses to involve the upper urinary system (the kidneys and ureters).

What are the signs and symptoms of kidney infections?

Fever, nausea, abdominal pain, vomiting, and confusion.

A Kidney abscesses can occur where pus accumulates inside kidney tissues. Symptoms include blood in urine, weight loss, and abdominal pain.

What are the various investigations carried out for kidney diseases?
  • Urine output measurements. The amount of urine excreted in a day may help to determine the cause of kidney failure.
  • Urine tests: Analysing a sample of urine, a procedure called urinalysis, may reveal abnormalities that suggest kidney failure.
  • Blood tests: A sample of blood may reveal rapidly rising levels of urea and creatinine — two substances used to measure kidney function.
  • Imaging tests. Imaging tests such as ultrasound and computerized tomography may be used to help see your kidneys.
  • Kidney biopsy: Removing a sample of kidney tissue for testing, a kidney biopsy to remove a small sample of kidney tissue for lab testing.
What is kidney transplant?
  • A kidney transplant is a surgical procedure which allows a person whose own kidneys have failed to receive a new kidney (recipient) from another person. (Donor)
  • A successful kidney transplant can improve many of the complications of kidney failure and is the best solution to patients whose kidneys have stopped working or are close to failing.
  • The functioning kidney is removed either from a living donor or someone who has recently passed away.
  • A transplanted kidney performs all the functions of a kidney a person has from birth
What is the most common medical indication for kidney transplant?
  • Patient who is diagnosed with end stage kidney diseases is candidates for kidney transplantation. In other words the kidneys are not functioning optimally.
  • The two basic options for treating end-stage kidney failure are dialysis and kidney transplantation.
What are the types of kidney transplants available?

A) Living donor transplant: Become a Donor Today & Save a Life!

A living donor may be someone in your immediate or extended family, or it may be your spouse or a close friend. In some cases, a living donor may even be a stranger who wishes to donate a kidney to someone in need of a transplant.

Advantages of Live Donor Transplant are as follows:

  • Receiving a kidney from a living donor has shown to last longer than a kidney from a deceased donor.
  • The operation can be planned to suit your schedule, since it is not necessary to wait for a kidney to become available from a deceased donor.

B) Deceased donor (cadaver donor) is someone who has consented to donating his or her organs upon death. In situations where the wishes of the deceased donor are not known, family members may consent to organ donation.

When is a patient advised for kidney transplant?

A person is advised kidney transplant in the following conditions”
Kidney Failure - Temporary (AKI Acute Kidney Failure)
- Permanent (CKD Chronic Kidney Disease

What is dialysis?

Dialysis is the procedure wherein blood electrolytes are balanced and wastes and fluids are filtered out of the blood.

What are the types of dialysis?

Peritoneal

Haemodialysis

When do you need dialysis?
  • You need dialysis when you develop end stage kidney failure - the time you lose approx. 85 - 90 % of your kidney function.4
  • Dialysis, regardless of the type can restore some functions of your kidneys but not all.
How does haemodialysis work?

The purpose of the dialysis machine acts as a special filter like an artificial kidney and gets the blood cleaned. An access is taken through the blood vessels so that the blood is enters the dialyser.

The dialyser has two parts separated by a thin membrane the blood cells, proteins and large molecules remain in the blood but the waste products are washed away, this is how blood is cleaned.

How long does dialysis take?

It is usually done three times a week for about three to four hours . it can be done at  home frequently 4 to 7 times per week. In kidney failure it has to be done in a shorter time.

What is peritoneal dialysis?

A soft plastic tube is placed in the abdomen and a sterile cleansing fluid is placed through this catheter. After dialysis is complete, the fluid leaves your body through the catheter. There are two types:

  • Continuous Ambulatory Peritoneal Dialysis
  • Automated Peritoneal Dialysis
What do you mean by Continuous Ambulatory Peritoneal Dialysis (CAPD)?

This is 24 hours; patient is not sleeping and can move around when dialysis is going on during peritoneal dialysis.

What is renal biopsy?
  • A renal or kidney biopsy is a diagnostic procedure used to separate and evaluate kidney tissue.
  • It helps doctor to identify and assess kidney disease, its severity, and consequently, decide its treatment.
  • A renal biopsy also helps to monitor the effectiveness of kidney treatments and complications, if any following a kidney transplant.
What are the types of renal biopsy?
  • Percutaneous or a renal needle biopsy
  • Percutaneous or a renal needle biopsy
What is PCNL Surgery

Percutaneous nephrolithotomy (PNL) is the procedure of choice for the treatment of large or complex” renal calculi” commonly known as “renal stones”. This technique is well established, with high rates of success and accepted morbidity. Percutaneous nephrolithotomy technique is in constant evolution. Supine position has been proved as an acceptable option.

PCNL offers effective option for removal of large and complex stones in patients with minimal invasion. Percutaneous nephrolithotomy are safe with very low morbidity.

Does a patient need a follow up treatment following PCNL?

Yes; the follow up treatment is targeted to prevent recurrence of the kidney stones

How long one has to stay in the hospital following PCNL?

The usual hospital stay following successful l PCNL is around 3-4 days. However, the treating doctors shall determine the health status of the patient and shall advice accordingly.

How long one has to stay in the hospital following PCNL?

The usual hospital stay following successful l PCNL is around 3-4 days. However, the treating doctors shall determine the health status of the patient and shall advice accordingly.

What are the symptoms for which PCNL is recommended?

Patients are recommended PCNL when the urine low is blocked, pain due to presence of kidney stones, large size kidney stone unable to pass through urine, urine leakage, recurrent urinary tract infection due to kidney stones etc

How long the stent shall remain following the surgery?

The length of time the stent remains in place is variable. Your doctor will probably request it to be removed within a 1-4 week period. This can be removed in the doctor's office. It is common to feel a slight amount of flank fullness and urgency to void as a result of the stent. These symptoms often improve over time as the body adjusts to the indwelling stent. It is critical that patients return to have their stent removed as instructed by their physician as a prolonged indwelling ureteral stent can result in encrustation by stone debris, infection, and obstruction of the kidney.

What is Lithotripsy?

Lithotripsy is a procedure that uses shock waves to break up stones in the kidney, bladder, or ureter (tube that carries urine from kidneys to the bladder. After the procedure, the tiny pieces of stones pass out of your body in your urine. The lithotripsy attempts to break up the stone with minimal collateral damage by using an externally applied, focused, high-intensity acoustic pulse.

A fluoroscopic x-ray imaging system or an ultrasound imaging system is used to locate the stone and aim the treatment. The patients undergoing this procedure can, in some cases, see for themselves the progress of their treatment with the help of the ultrasound or x-ray monitor.

ESWL is the least invasive and the commonest treatment for kidney stones however it provides very low stone free period for the patient. The passage of stone fragments may take a few days or a week and may cause mild pain. ESWL is not without risks. Overall complication rates of ESWL range from 5–20%.

 

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