Aditya Birla Institute of Nephrology

 Key Consultants of the Department

Full Time Consultants
	Dr. Tarun Jeloka
	Dr. Manish Mali

Aditya Birla Memorial Hospital (ABMH) has a world class Institute of Nephrology with latest technology and experienced staffs. It has 10 haemodialysis stations, including an isolation room for infected and hepatitis positive patients. We have "online" RO system for best water quality for the dialysis patients. We also have "portable" RO for doing bedside dialysis across any bed in the hospital.

We have 3 NIBPs for continuous blood pressure monitoring and 2 cardiac monitors for continuous cardiac monitoring of patients during haemodialysis. We have automated dialyzer-reprocessing machine for better cleaning and life of dialyzer.

There is a separate room for peritoneal dialysis, caring for aseptic and antiseptic precautions required for this subset of patients.

In transplant unit, we have separate transplant suite for individual patients equivalent to a deluxe room. Transplant ORs are dedicated operating rooms.

Our unit in ABMH vows to provide best and "evidence based" management to all the nephrology patients

•  What is the Institute of Nephrology?

This department deals with medical diseases of the kidneys, ureter and bladder. It also manages patients requiring kidney transplantation. It also helps in medical management of patients needing surgery for KUB.

•  What are the "medical" diseases of Kidney, Ureter and Bladder? 

The diseases of kidneys are

1. Acute Renal Failure
2. Chronic Renal Failure
3. Nephrotic Syndrome
4. Nephritic Syndrome
5. Urinary Tract Infections
6. Urinary Tract Stones
7. Asymptomatic Urinary abnormalities Hematuria (blood in urine), Proteinuria (protein in urine), etc
8. Rapidly Progressive Renal Failure including Vasculitis
9. Other Congenital or hereditary kidney diseases like polycystic kidney diseases, horse shoe kidneys, etc

•  How do they manifest?

•  Kidney diseases can manifest with various symptoms/signs

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

•  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 glomerulonephritis, diabetes, 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.

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•  What are the procedures done in nephrology department?

1. Haemodialysis
2. Peritoneal dialysis
3. Kidney transplantation
4. CRRT
5. 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, SCUF, etc. 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.

•  What are the requirements for kidney transplantation?

A matched donor, fit ESRD patient, financial support, and the transplant team.

•  Does donor have any risk of life or kidney failure?

Usually donors are selected after a battery of tests to rule out any disease in them. They are "healthy" persons and it has been shown that they live longer than other "healthy" individuals (not because of donation). They certainly have the risk of anesthesia.

•  How long does the transplant patient need to continue on drugs?

Life long.

•  Are there restrictions for transplant patient, can they work?

Initially there are few restrictions to avoid acquiring infections but later after 3-6 months, the risk of infections are low and yes, they can continue with their jobs.

•  Whom should we contact for any queries?

Queries are welcome to the department and will be attended in person by the qualified person or on telephone at 30717792/7698/7820 in working hours. For emergencies, contact 30717500 or come to the hospital 24 x 7.

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