Nephrology

Nephrology

Overview

In 1978 ,GKNM Hospital, had the distinction of being the first healthcare provider to offer haemodialysis facility in the district. The maintenance dialysis program for patients with chronic renal disease was started in the early 80's.

It currently caters to an average of 100 outpatients on dialysis and offers specialized hybrid dialysis for the inpatients.

It has a staff strength of 30 members including 2 Nephrologists, Physician Assistants, Dialysis Nurses, Dialysis Technicians, Dialysis Assistant, Transplant Manager and Transplant co-ordinators.

Facilities

Infrastructure

Dialysis: Our Dialysis Unit currently has10 machines for the outpatients and 2 machines for regular dialysis of the inpatients and 2 Hybrid Machines (Hemodiafiltration - HDF) for the critically ill and those who are compromised hemodynamically. We currently do close to 1000 dialysis per month including dialysis in critical care units. The water for dialysis is purified by double Reverse Osmosis to enable us perform Hemodiafiltration with Ultra pure water by international standards.

We follow stringent quality control measures by monitoring the nutritional status, AV fistula penetrance, adequacy of dialysis, haemoglobin targets, catheter infection episodes. Currently we have achieved more than 70% of all the quality indices. Our infection control practices are so stringent that we can perhaps at present boast that our unit has ‘zero’ Hepatitis C outbreak! And our dialysis catheter infection episodes are under 1% which is on par with any other international dialysis unit.

Dr. S. Goutham

MD, DNB, MRCP, SCE
Consultant Nephrologist

Dr. P. Ramachandran

MD
Consultant Nephrologist

We currently have 2 Dialysis Reprocessing Machines (and in the process of acquiring the third one) which can reprocess 4 dialyzers at the same time and gives us vital information about the quality of the dialyzers after each wash.

All Intensive Care Units (including the General ICU, Paediatric ICU, Cardiac ICU and Cardio-thoracic ICU) has the facility to dialyse critically ill patients. We currently have the facility to dialyse even critically ill children with compromised hemodynamics. GKNMH’s Isolation Unit has the facility to dialyse patients with Viral infections like Hepatitis C, B and other contagious infections.

We perform regular Plasma Exchange sessions for renal and non-renal indications like GBS with excellent result and safety. And with our recent acquisition of the Body Composition Monitor we are able to do appropriate fluid removal during dialysis and to fix the patients Dry weight with excellent precision.

Transplant

Our Transplant Unit has a negative pressure centrally air-conditioned room with an ante room and can accommodate 2 renal transplant recipients at the same time. We have successfully done more than 50 renal transplants including both live and deceased donor transplants with excellent results. We do offer a less traumatic laparoscopic donor nephrectomy where the donor is ambulated the next day of surgery and discharged home in a few days to resume work at the earliest.

The recipient is cared for by a team of well trained transplant nurses round the clock with strict infection control practice.

The department conducts a monthly Patient Support Club meeting where the transplanted recipients, donors and prospective recipients and donors get together for an interactive session with the Nephrologist, Urologist, Transplant Manager, Co-ordinator, Physiotherapist and Nutritionist.

Procedures

Temporary dialysis catheter insertion with and with out real-time guidance for dialysis initiation Tunnelled Cuffed Dialysis Catheter (Permcath) insertion into the jugular veins (both right and left) and the femoral veins with ‘C’ arm guidance in the Operation Theatre.

Renal Biopsies under real-time guidance for both native kidneys and graft kidneys in both adults and children. We regularly do renal biopsies even in children who are as young as six months old with an excellent support from the Pediatric Anaesthesia team and Department of Radiology.