Clinical & Critical Nephrology

Clinical and Critical Nephrology is a specialized field of medicine that deals with the diagnosis and management of kidney diseases in a clinical setting, often involving critically ill patients. The focus is on the kidneys' functions, including fluid and electrolyte balance, toxins removal, blood pressure regulation, and the maintenance of acid-base balance. It encompasses a wide range of disorders, from chronic kidney disease (CKD) to acute kidney injury (AKI), electrolyte disturbances, glomerular diseases, renal replacement therapy, and management of comorbid conditions in patients with kidney disease.

Conditions Treated

  • Chronic Kidney Disease (CKD): A progressive condition characterized by a gradual loss of kidney function over time. Clinical nephrologists play a crucial role in managing CKD, providing personalized treatment plans to slow its progression and alleviate symptoms.
  • Acute Kidney Injury (AKI): Sudden and rapid loss of kidney function, often occurring in response to severe illness, trauma, or certain medications. Early intervention by critical nephrologists is vital in reversing or managing AKI.
  • Hypertension (High Blood Pressure): Nephrologists are skilled in diagnosing and managing hypertension, which can lead to kidney damage if left untreated.
  • Diabetic Nephropathy: Kidney damage caused by diabetes is a common concern. Nephrologists work closely with endocrinologists to provide specialized care for patients with diabetes-related kidney complications.
  • Glomerular Diseases: These conditions affect the glomeruli, tiny filters within the kidneys. Nephrologists conduct thorough assessments and implement targeted treatment strategies.
  • Polycystic Kidney Disease (PKD): A genetic disorder characterized by the growth of cysts within the kidneys. Nephrologists are skilled in managing PKD and addressing associated complications.
  • Kidney Stones: Nephrologists provide expert guidance on dietary and lifestyle modifications to prevent recurrent kidney stones.
  • Nephrotic Syndrome: A group of symptoms indicating kidney damage, often associated with conditions like diabetes or autoimmune diseases.
  • Electrolyte Disorders: Nephrologists monitor and treat imbalances in essential minerals like sodium, potassium, calcium, and phosphorus.

Key Procedures

The Department of Clinical and Critical Nephrology offers a range of advanced interventions to address complex kidney issues:

  • Renal Replacement Therapy (RRT): This includes hemodialysis, hemodiafiltration, peritoneal dialysis, and continuous renal replacement therapy (CRRT) for patients with severe kidney failure.
  • Plasmapheresis: A specialized procedure used to remove harmful substances from the blood, often employed in autoimmune kidney diseases.
  • Kidney Biopsies: These procedures help diagnose the underlying cause of kidney disease by examining a small sample of kidney tissue.
  • Peritoneal Dialysis (PD): In select cases, peritoneal dialysis may be used in critically ill patients. It involves using the peritoneal membrane in the abdomen as a natural filter for waste removal.
  • Vascular Access Management: Ensuring proper access to hemodialysis is crucial. Nephrologists are skilled in creating and maintaining arteriovenous fistulas or grafts.

Key Advantages

  • Expert Care for Kidney Diseases: Nephrologists are experts in diagnosing and managing a range of kidney diseases, from chronic conditions like CKD to acute issues like AKI. Their specialized knowledge is crucial in providing the most effective treatments.
  • Management of Chronic Kidney Disease (CKD): Clinical nephrology focuses on the long-term management of CKD, aiming to slow disease progression and improve quality of life. This includes optimizing medication regimens, dietary advice, and monitoring for complications.
  • Acute Kidney Injury (AKI) Intervention: In critical nephrology, nephrologists provide life-saving interventions for AKI. This includes rapid assessment and treatment, which can significantly reduce the risk of long-term kidney damage.
  • Advanced Treatment Options: Nephrologists are trained in the latest renal replacement therapies, including hemodialysis, peritoneal dialysis, and continuous renal replacement therapy (CRRT). These treatments are vital for patients with severe kidney dysfunction.
  • Electrolyte and Fluid Balance Management: Nephrologists expertly manage complex fluid and electrolyte disorders, which are common in kidney disease and can be life-threatening if not correctly addressed.
  • Renal Transplantation Management: Clinical nephrologists play a crucial role in both pre-and post-transplant care, including managing immunosuppressive therapy and monitoring for transplant rejection.

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Disease & Treatment

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Diabetic Nephropathy

Diabetic nephropathy is a common complication of diabetes that affects the kidneys. Our team provides specialized care to manage and slow the progression of this condition through blood sugar control, blood pressure management, and medication.

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Chronic Kidney Disease (CKD)

Chronic Kidney Disease (CKD) is a progressive condition that can lead to kidney failure. Our nephrologists specialize in early detection and comprehensive management of CKD. We provide individualized treatment plans to slow its progression, including dietary guidance, medication, and dialysis when needed.

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Acute Kidney Injury (AKI)

Acute Kidney Injury (AKI): AKI can be caused by various factors, including infections, medications, or traumatic events. Our experts are experienced in diagnosing and treating AKI promptly to prevent further damage and promote kidney recovery.

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Renal Transplant

Our kidney transplant program is renowned for its success rates and comprehensive care. We offer kidney transplantation as a life-saving option for those with end-stage renal disease. Our multidisciplinary team guides patients through the entire transplant process, from evaluation to post-transplant care.

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Glomerular Diseases

Glomerular diseases, such as nephrotic syndrome and glomerulonephritis, can have complex presentations. Our nephrologists specialize in the diagnosis and management of these conditions, offering treatment plans tailored to each patient's unique needs.

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Hypertensive Nephropathy

High blood pressure can damage the kidneys over time, leading to hypertensive nephropathy. Our nephrologists focus on blood pressure control and lifestyle modifications to prevent kidney damage and provide comprehensive care for those affected.

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Hemodialysis

We offer advanced hemodialysis services to effectively filter and cleanse your blood when your kidneys are unable to do so. Our well-equipped dialysis units and skilled staff ensure your comfort and safety during the procedure. The Hemodialysis services are available round the clock for 24 hours at the institute.

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Hemodiafiltration

For patients who require advanced filtration, our hemodiafiltration treatments combine hemodialysis with additional filtration techniques, offering improved toxin removal and a better overall outcome.

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Kidney Transplantation

Our institute specializes in kidney transplantation, offering hope and a new lease on life to those with end-stage kidney disease. Our experienced transplant team ensures a successful and smooth procedure, followed by comprehensive post-transplant care.

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Kidney Biopsy

Accurate diagnosis is essential in kidney disease management. We perform kidney biopsies to provide insight into the underlying causes of kidney problems, guiding our treatment decisions.

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Peritoneal Dialysis (CAPD)

When hemodialysis isn't the best option, we provide peritoneal dialysis, a home-based treatment that uses the peritoneal membrane to filter waste and excess fluids. Continuous Ambulatory Peritoneal Dialysis (CAPD) offers the flexibility to manage your treatment at home.

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AV Fistula Formation

For patients requiring long-term hemodialysis access, our specialists are skilled in creating arteriovenous (AV) fistulas. These connections between arteries and veins enable effective hemodialysis sessions.

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Permcath Insertion

In situations where AV fistula formation is not possible, we offer Permcath insertion, a temporary access point for hemodialysis. Our team ensures the safe and efficient placement of the catheter.

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Meet Our Doctor

Dr. Rajesh Aggarwal

Director

Clinical & Critical Nephrology, Kidney Transplant, Hemodialysis, Transplant Intensive Care, Chronic Kidney Disease, Renal Intensive Care, Institute of Nephrology

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Dr. Rajesh Aggarwal

Director

Dr. Umesh Nautiyal

Principal Consultant

Clinical & Critical Nephrology, Kidney Transplant, Hemodialysis, Transplant Intensive Care, Chronic Kidney Disease, Renal Intensive Care, Institute of Nephrology

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Dr. Umesh Nautiyal

Principal Consultant

Dr. Blessy Sehgal

Sr. Consultant

Clinical & Critical Nephrology, Kidney Transplant, Hemodialysis, Transplant Intensive Care, Chronic Kidney Disease, Renal Intensive Care, Institute of Nephrology

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Dr. Blessy Sehgal

Sr. Consultant

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Health Tips

How Common is Chronic Kidney Disease? Which Hospital is best to get the right treatment?

Overview Of Chronic Kidney Disease Diabetes and hypertension account for the majority (60%) of all the cases of CKD. (Chronic Kidney Disease) It is defined as a structural and /or functional abnormality of the kidney for more than three months with implications on the health of the patient. CKD has five stages depending on the […]

10th Jan, 2020

FAQ

Dialysis is a life-saving treatment for individuals with advanced kidney failure. It involves using a machine to filter waste products and excess fluids from the blood when the kidneys are no longer able to do so effectively. Dialysis helps maintain the body's balance of electrolytes and fluids, providing a crucial lifeline for those awaiting a kidney transplant.

Risk factors for kidney disease include diabetes, high blood pressure, a family history of kidney disease, older age, smoking, obesity, and certain ethnic backgrounds. Additionally, conditions like heart disease and autoimmune disorders can contribute to kidney problems.

Maintaining kidney health involves adopting a healthy lifestyle. This includes staying hydrated by drinking an adequate amount of water, managing blood pressure through a balanced diet and regular exercise, avoiding excessive salt intake, and refraining from smoking. It's also crucial to monitor and manage conditions like diabetes, which can impact kidney function.

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