Nephrology Hospital | Kidney Hospital | BOSH | Bangalore

Nephrology is a specialty of medicine that concerns itself with the kidneys: the study of normal kidney function and kidney problems, the preservation of kidney health, and the treatment of kidney problems, from diet and medication to renal replacement therapy (dialysis and kidney transplantation). Systemic conditions that affect the kidneys (such as diabetes and autoimmune disease) and systemic problems that occur as a result of kidney problems (such as renal osteodystrophy and hypertension).Interventional Nephrology is a new and emerging subspecialty of Nephrology that mainly deals with ultrasonography of kidneys and ultrasound-guided renal biopsy, insertion of peritoneal dialysis catheters, tunneled dialysis catheters as a vascular access for patients undergoing hemodialysis as well as percutaneous endovascular procedures performed to manage dysfunction of arteriovenous fistulas or grafts in end stage renal disease patients.

Dialysis

Chronic kidney disease causes kidneys to lose their ability to filter and remove waste and extra fluids from the body. The hemodialysis process uses a synthetic membrane to:

  • medical Clear wastes, such as urea, from the blood
  • medical Restore the proper balance of minerals called electrolytes in the blood
  • medical Eliminate extra fluid from the body

There are two types of dialysis

Peritoneal dialysis: Peritoneal dialysis can be done at home. But you must be trained first. This method uses the lining of the belly (abdominal) cavity to filter the blood. This cavity is the space that holds organs such as the stomach, intestines, and liver. The lining is called the peritoneum. First, a surgeon places a thin, flexible tube (catheter) into your belly. After the tube is placed, a sterile cleansing fluid (dialysate) is put through the catheter into the peritoneal cavity.
The fluid is left in the belly for a certain period of time. This fluid absorbs the waste products and toxins through the peritoneum. The fluid is then drained from the belly, measured, and discarded. This process of filling and draining fluid is called an exchange.

There are 2 different types of peritoneal dialysis

  • medicalContinuous ambulatory peritoneal dialysis (CAPD). CAPD does not require a machine. The exchanges can be done 3 to 5 times a day, during waking hours.
  • medical Continuous cyclic peritoneal dialysis (CCPD). CCPD requires the use of a special dialysis machine that can be used in the home. This type of dialysis is done automatically, even while your child is asleep.

Hemodialysis:  Hemodialysis is done in a dialysis center or hospital by trained healthcare professionals. A special type of access, called an arteriovenous (AV) fistula, is placed surgically. It is usually done in your arm. This involves joining an artery and a vein together. An external, central, IV (intravenous) catheter may also be inserted. But this is less common for long-term dialysis. You will then be connected to a large hemodialysis machine. Blood is pumped through a tube into the machine to filter out the wastes and extra fluid. The filtered blood then flows through another tube back into your child's body. Hemodialysis is usually done several times a week. Each session lasts for 4 to 5 hours. It may be helpful to bring games or reading materials for your child to keep him or her busy during this procedure.

Access for Dialysis: Before a patient can undergo hemodialysis or peritoneal dialysis, we must surgically create an access point that makes it possible to enter the patient's bloodstream. The different types of access for dialysis include

  • medical Hemodialysis catheter: We insert a catheter into a vein in the neck or chest when the patient requires hemodialysis quickly. For long-term hemodialysis, we create a permanent access point, usually in the lower arm.
  • medical Fistula: We create a large channel called a fistula by connecting an artery to a vein in the patient's lower arm. A fistula allows repeated access for dialysis sessions.
  • medical Man-made fistula or graft: A synthetic channel called a polytetrafluoroethylene (PTFE or Gore-Tex) graft is the most common type of access that we create for hemodialysis.
  • medical Peritoneal dialysis: requires placing a catheter into the patient's abdomen. We do this approximately 10 to 14 days before the start of regularly scheduled dialysis treatments.

Kidney Biospy

During this diagnostic procedure, a small sample of kidney tissue is removed through a needle and examined under a microscope for signs of cancer, infection or other diseases. A renal biopsy is done to remove a small amount of kidney tissue for laboratory examination to aid in diagnosis. Our doctors use fluoroscopy (live X-ray) to guide the needle to the precise location, so the biopsy is quick and accurate. Renal biopsy is a needle-based procedure that our doctors perform. The procedure takes about 30 minutes and does not require an overnight stay.