Clinical nephrology

Clinical nephrology deals with the medical management of various acute and chronic renal disorders. Acute Kidney Injury [AKI] now has become rampant in the recent past owing to the outbreak of sporadic infections, usage of alternative medicine across the globe more so in the developing country like India. AKI if not treated promptly progresses to chronic kidney disease. Nephrologists at AIG Hospitals have wide expertise in managing acute and chronic renal disorders. They also have vast experience in managing various glomerular disorders which basically deals with abnormal filtration barrier of kidney

Lupus nephritis remains one of the leading causes of renal failure in females, which is managed appropriately here by the nephrologists according to the standard guidelines.

Type 2 DM is the leading cause of end-stage renal disease in India. Nephrologists here treat Diabetic kidney disease and measures to prevent the same.

Critical care nephrology which deals with fluid electrolyte disturbances in ICUs is one of the key skills of the Nephrologists here.

Nephrologists at AIG Hospitals evaluate and manage Urinary tract infections, renal and urinary tract stone disorders, cystic diseases of the kidneys.

COMMON RENAL DISORDERS

Chronic Kidney Disease: CKD has a varied etiology which will be evaluated and managed accordingly. Renal transplantation will be the most viable option for such patients

Diabetic Kidney Disease: Type 2 DM and type 1 DM, in the long run, has the potential capability of affecting kidneys and can lead to end-stage renal disease if not identified in the early stages. Prompt referral of a diabetic patient to a nephrologist would help curb the nephropathy at the earliest stage possible.

Nephrotic Syndrome: Patients with nephrotic syndrome present with proteinuria which implies a disruption of the filtration barrier. These patients have to be evaluated by renal biopsy which will guide the treatment strategy. Relentless proteinuria can impose significant damage to the kidneys leading to end-stage renal disease.

Lupus Nephritis: Lupus nephritis is one the common autoimmune renal disorder in females. Patients usually have recurrent abortions, unexplained hair loss, butterfly rash on the cheeks and renal symptoms like facial puffiness, swelling of the feet. Such patients need to undergo renal biopsy for effective management.

Urinary Tract Infections: Recurrent UTI s if neglected can lead to pyelonephritis and lead to permanent scarring of the kidney which can lead to renal failure.UTI s need a special attention, need evaluation to find out the etiology.

Nephrourolithiasis: Stone disorders have become more common in the recent past owing to the lifestyle changes. Metabolic evaluation of the stone has to be done to prevent the recurrence. The dietary modification needs to be addressed in case of uric acid and oxalate stones.

SPECIALISED RENAL CLINICS

• AKI Follow-Up Clinic
• CKD Clinic
• Diabetic Nephropathy Clinic
• Glomerular Disorders Clinic
• Lupus Nephritis Clinic
• Vasculitis Clinic
• UTI’s & Renal Stone Clinic
• ADPKD & Cystic Disease Clinic
• Renal Transplant Clinic

DIAGNOSTIC FACILITIES

• Testing for Autoimmune Renal Disorders
• Screening for Diabetic Renal Disease
• Screening and Evaluation of Cystic Renal Diseases
• Metabolic Evaluation for Renal Stone Disorders
• Evaluation of Renal Tubular Acidosis (RTA)
• Percutaneous Renal Biopsy
• MCUG [Micturating Cystourethrogram]
• DTPA & DMSA Scans

INTERVENTIONAL NEPHROLOGY

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, tunnelled dialysis catheters as a vascular access for patients undergoing hemodialysis as well as percutaneous endovascular procedures performed to manage dysfunction of arteriovenous fistulas in end-stage renal disease patients. Interventional Nephrologists work to improve vascular access for hemodialysis and, thus, the delivery of care to their dialysis patients. In addition, Interventional Nephrologists create and maintain vascular access for hemodialysis.

The common procedures performed include:

• Insertion and removal of tunnelled hemodialysis catheters
• Insertion and removal of peritoneal dialysis catheters
• Fibrin sheath removal from chronically indwelling central catheters
• Mechanical thrombectomies of clotted hemodialysis catheters
• Angiograms
• Angioplasties
• Mechanical thrombectomies of clotted AVFs
• Diagnostic sonography
• Renal biopsies.
• Peritoneal dialysis catheter insertion/manipulation