The center for nephrology provides intensive care (ICU) to patients with acute renal failure, volume disturbances, or electrolyte ad acid-base disorder. We have several techniques for treating acute renal failures such as Continuous Veno-Venous Hemofiltration (CVVH), Hemadsorption, Plasmapheresis and others depending on the patient requirement and underlying disease. ICU work majorly involves active procedures like IV CONTRAST for Angioplasty/ Post CABG, acute renal failures following polytrauma and multiorgan failure of any origin. We have equipped the department for all kind of extracorporeal therapies, including MARS and other therapies.

Many kidney conditions are treated by dialysis to eliminate toxins, mineral buildup, and excess fluid from the body if there is renal failure. Globally, around 2.5 million people rely on regular dialysis treatment. This is often to stop the further damage of organs that toxins cause once they accumulate within the blood. Dialysis is performed when you are suffering from a kidney-based illness, at dialysis clinics chosen by your nephrologist and insurance provider, and sometimes at the comfort of your home.

Hemodialysis
During dialysis, special vascular access in your lower arm allows the 'Dialyzer' — the "artificial kidney" machine—to pump blood out of your body where it's filtered externally to get rid of the waste products and excess fluid. The Dialyzer machine cleans the blood, monitors the circulation of your blood outside the body, and controls the composition of the dialysis fluid. This fluid is used for flushing out the metabolic waste products before the filtered blood is returned to your body. Anticoagulants can also be added to the dialysis solution to stop blood coagulation. Hemodialysis is usually performed for a minimum of four hours, three times every week, often during a dialysis unit. Some people receive training to perform hemodialysis at home, often with the assistance of a partner.

Peritoneal Dialysis
The lining of your abdomen or peritoneal cavity can act as a filter for cleaning blood as its characteristics are similar to a dialyzer machine. The pores within the peritoneal membrane allow specific substances to undergo while retaining others. Blood is filtered in the body through a tube or 'catheter' inserted into the greater peritoneal sac in the abdomen. The dialysis solution containing glucose is fed through the catheter and left to soak up the impurities in your blood. Later, the fluid containing the toxic impurities and excess water is drained into a bag, then replaced with a fresh solution. This process of replacing the fluids is often done manually during the day or at night by employing a cycler. There are two types of peritoneal dialysis: continuous ambulatory peritoneal dialysis and automatic peritoneal dialysis using a cycler.

Continuous Renal Replacement Therapy
For critically ill people with acute kidney failure or end-stage renal disease who cannot tolerate regular hemodialysis, continuous renal replacement therapy is suggested. This is often a slower sort of blood filtration that lightly removes extra fluid and waste products, which is best tolerated by people who could also be unstable due to shock or severe fluid overload. Both average and smaller-sized people can undergo continuous renal replacement therapy.

A kidney transplant is a life-saving procedure of placing a healthy and working kidney from a donor to a patient with kidneys not functioning properly. The transplanted kidney now takes over the work of the two failed kidneys, and procedures like dialysis are no longer needed.

Your surgeon will place the new kidney in the lower abdomen and connect it to the respective artery and vein of the body. In most cases, the new kidney will start working right after the blood starts flowing through it or may take few weeks to begin filtering waste normally.

When the kidney functioning capacity comes down to 10-15%, we refer to this as the last stage, stage five, or end-stage kidney disease. In this condition of end-stage renal disease, dialysis treatment becomes necessary.

Various functions affected by stage five renal disease include the following:
• Normal Production of Urine
• Imbalance in Electrolyte levels
• Hormone production
• Enzyme production, which results in high blood pressure

Along with following a suggested diet and taking prescribed medication, regular dialysis is needed to manage the end-stage renal disease for an extended period with ease. You need to follow your healthcare team’s renal treatment if you are diagnosed with stage five of renal disease.

The treatment of Kidney infection is based on the severity and type of the condition. The first stage of treatment includes oral antibiotics. Based on your urine culture, the doctor will prescribe and change specific antibiotics. The course of antibiotics usually lasts for 2-3 weeks. After your treatment, the doctor may prescribe follow-up urine cultures to make sure the infection is gone and has not returned. A new course of antibiotics may be prescribed if needed. For a more severe condition, the doctor may keep you in the hospital to receive intravenous antibiotics and fluids. If the condition is highly severe, like a blockage or a complex shape in your urinary tract, the patient may require surgery. Surgery will also ensure that new kidney infections do not return.

The kidneys filter blood and separate wastes in the form of urine. There are salts and minerals in the urine which sometimes stick together, forming kidney stones. Their size can range from a sugar crystal to as big as a ping pong ball. If the kidney stones break loose and enter the ureters (narrow ducts leading to the bladder), the patient can experience intense pain.

The treatment for a kidney stone depends on various factors like size, composition, pain, and whether the urinary tracts are getting blocked. To understand a suitable treatment, the patient must undergo a urine test, blood test, X-ray, and/ or a CT scan.

If the stone size is tiny, your doctor may suggest pain killers and plenty of fluids to help push the stone through the urinary tract. If the kidney stone is large and is blocking your urinary tract, you may require additional treatment.

Treatments for Kidney Stone:

1. Shock Wave Lithotripsy
Shock waves are used to break up kidney stones into small bits. These bits will enter the urinary tract and pass out of the body along with urine. Shock Wave Lithotripsy usually lasts for 45 minutes to an hour and maybe done under general anesthesia, which means the patient will be asleep and will not feel the pain.

2.Ureteroscopy
Ureteroscopy is performed under anesthesia. The doctor uses a tube-shaped tool to remove the stone or to break it into smaller bits. If the stone is small, the doctor may remove it directly or break it into pieces using a laser. In this case, the smaller pieces will move down the patient’s urinary tract. In rare cases, a procedure called ‘percutaneous nephrolithotomy’ might be required. A tube will be inserted directly into the patient’s kidney during this surgery to remove the stone. The patient may be hospitalised for 2-3 days to undergo and recover from this treatment.