ABC OF

NEPHROLOGY

KEEP YOUR
KIDNEY
INFORMED

WRITTEN BY
DR. SAMBASHIVA A. C
MEDICAL DIRECTOR
 ABC OF
NEPHROLOGY

KEEP YOUR
KIDNEY
INFORMED

WRITTEN BY
DR. SAMBASHIVA A. C
MEDICAL DIRECTOR
GENERAL
NEPHROLOGY
The objective of General Nephrology is to deal with the treatment of
acute renal failure and chronic renal failure, nephritic syndrome and
acute nephritic syndrome. Sree Lakshmi hospital is the best once it
come for nephrology treatment and is well equipped to deal with all
types of renal failure

Below are the treatment options in the field of Nephrology

Nephritic Syndrome:
The condition where the patient has developed swelling in legs and
face. There are several protein excretions in the urine. Kidney Biopsy
is important test to know the exact cause of the condition in adults

Acute Nephritic Syndrome:

C h i l d r e n s a r e m o s t l y a f f e c t e d a n d u s u a l l y t h e c h i l d c o m p l a i n s o f s o r e
throat or a skin infection, the child develops red urine, swelling in legs
and face with increase in BP. It usually goes away within few days or in
a few weeks times

Acute Renal Failure:

The most common reason is due to dehydration (lose motions or
vomiting), infections, certain drugs side effect and urine blockage
GENERAL
NEPHROLOGY
Chronic Renal Failure:
It is one of the main reasons for Kidney failure and it is irreversible.
The most common causes are Diabetes, Hypertensions, painkillers uses
(long term), genetic, frequent urinary tract infections and other
primary kidney diseases

Pediatric Nephrology
Kidney problems are rare in pediatric age but still significant number
o f c h i l d r e n s d e v e l o p s r e n a l p r o b l e m s . M o s t o f t h e m a r e e a s i l y t r e a t e d
condition like post-infectious glomerulonephritis & steroid sensitive
nephritic syndrome. These diseases are more common in child hood

M o s t U n i q u e R e n a l c o n d i t i o n ( C h i l d r e n s )
Congenital anomalies of the kidneys & urinary tract (CAKUT)
Posterior urethral valves
Vesico-ureteric reflux
Voiding dysfunction
Recurrent urinary tract infections
Rickets,
Recurrent renal stones
Electrolyte abnormalities & hypertension

If left untreated it may lead to renal failure or sever morbidity

GENERAL
NEPHROLOGY

Sree Lakshmi hospital specialized in Pediatric Nephrology and

can treat varieties of acute and chronic kidney problems
PREVENTIVE
NEPHROLOGY
In order to identify the early kidney disease and to prevent damage
Shree Laksmi Hospital conduct several diabetic, hypertension
awareness camp among common and elderly public
How to protect

Six ways to protectkidney

1-Say no to OTC drugs
2-Avoid painkillers
3-Say no to smoking
4-Control the blood sugar
5-Regular screening for high risk patient (kidney functions test)
6-Children with UTI adequate medical attention is required

Renal (Kidney) Biopsy

It is a diagnostic procedure where a small piece of renal tissue is
taken to understand the exact cause of proteinuria and the severity of
diseases like lupus nephritis.
Local Anesthesia is used for Ultrasound-renal biopsy , in adults for
both native kidneys or that of the transplant kidney. In children
general anesthesia is needed
For sick people renal biopsies is done in ICU and in the ward
For the procedure the patient has to be admitted in the morning and is
advised for bed rest for couple of days. He can resume their daily
activity after few days of the procedure.
PREVENTIVE
NEPHROLOGY
Hemodialysis
There are two options for an End stage renal failure condition, dialysis
or a kidney transplant. Usually there are two types of Dialysis

Hemodialysis
Peritoneal dialysis
We will discuss about hemodialysis.
h a e m o = B l o o d

It is the process that balance blood chemistry and filters fluid and
waste from the blood

In terms of hemodialysis, two needles are inserted in the arm of

patient. One needle will withdraws the blood and the other will return
the filter blood into the patient body
The blood from the first needle goes out of the body through tubing
and goes to a filter called dialyzer.
Dialyzer will filter and return the purified blood to patient body
through second needle. Dialyzer is the replacement of damaged kidney,
hence it is called artificial kidney. This process is usually done in
dialysis center
PREVENTIVE
NEPHROLOGY
Plasmapheresis
For the patient who is very sick with some specific kidney problem, a
specialized procedure is performed called as Plasmapheresis in the ICU.
Here a large quantity of plasma is taken out from the patient and is
replaced by frozen plasma (Albumin or Saline)
Plasma filter is used for the procedure and Hemodialysis instrument
with blood line and blood pump is used .In the blood line replacement
fluid is infused. Anticoagulation is used during the procedure

CRRT
Continuous Renal Replacement Therapy (CRRT)- A special dialysis for
few patient who are very sick and admitted in ICU. They are usually
sick, multiple organ damage, including renal failure. For such patient a
specialized dialysis is performed called CRRT
For this procedure a separate dialysis machine is dedicated and round
the clock patient condition is monitored. It is carried out continuously
for 24 to 48 hours
PREVENTIVE
NEPHROLOGY
Peritoneal Dialysis
In the condition of End stage renal failure, there are two options
available:
Dialysis
Kidney transplant (renal transplant)
Usually there are two types of dialysis known as hemodialysis and
peritoneal dialysis. We will discuss about peritoneal dialysis
Peritoneal dialysis: Here the patient peritoneum (membrane present
inside the abdomen) is used for the procedure
In this procedure a tube called catheter is inserted into the patient
abdomen as a permanent access for dialysis. The catheter is placed by
the side of navel and about 2 to 4 inch is extends out of the body.
Peritoneal dialysate, a chemical used to remove waste from the body is
filled into the peritoneum. This dialysate usually absorb the waste
product and excess water. Dwell time is the period when dialysate
remains in the peritoneum. After this period the waste and solution is
drained out and collected in a sterile collecting bag
PREVENTIVE
NEPHROLOGY
Types of Peritoneal Dialysis
Intermittent Peritoneal Dialysis (IPD) :It a short period dialysis (24-48
hours) and is performed for the patient as a temporary procedure. It is
performed on patient with low BP or in children with acute renal
failure
Continuous Ambulatory Peritoneal Dialysis (CAPD): In CAPD there are
no dry periods and the patient peritoneum is filled by hand as a manual
procedure
Automated Peritoneal Dialysis (APD): This procedure is usually done at
night when the patient is sleep and is performed through a machine
called as cycler machine
Continuous Cyclic Peritoneal Dialysis (CCPD): This is usually carried
out night where the patient peritoneum is filled with dialysate by the
help of a machine. The exchange usually done throughout night. This
is more patient friendly as the machine is not attached at day, it helps
patient to be more active in day time
Daytime Ambulatory Peritoneal Dialysis (DAPD): In this procedure it is
dry at night and the patient peritoneum is filed with dialysate during
day
N i g h t - T i m e I n t e r m i t t e n t P e r i t o n e a l D i a l y s i s ( N I P D ) : p a t i e n t s p e r i t o n e a l
cavity of the patient is filled manually at night and is usually dry
during the day
 Dr. Sambashiva A. C
Medical Director

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