NEPHROLOGY
Dr. T. Saravanan MD.,(Gen Med), DM.,(Nephrology)
Medical Director & CEO
Consultant Nephrologist and Transplant Physician
Nephrology is a division of medicine that deals with Kidney diseases and disorders. The
main Kidney diseases are Acute Renal Failure and Chronic Renal Failure.
Nephrology is the branch of medical science that deals with the diseases of kidneys. It
is concerned with normal kidney function, Kidneys are very vital organ of the body with
a network of blood vessels and tubes. The function of kidney is to filter blood of its
impurities and excess water.
Kidney disease is termed as “silent” disease because it is often unnoticed by many of them as
no symptoms appear in the beginning before they get diagnosed. When both kidneys fail to
work they cannot filter the wastes which results in vomiting, nausea, fatigue and itching
leading to complete weakness.
Nephrology is headed by Dr. T. Saravanan and assisted by 3 duty doctors.
ACUTE RENAL FAILURE
Acute Renal Failure means decrease in Kidney function or Kidney failure that happens suddenly.
CHRONIC RENAL FAILURE
Chronic Renal Failure means decrement in kidney function happening over 3 to 4 months.
Various diseases of kidney are Glomerulonephritis, Diabetic Nephropathy, Urolithiasis or
kidney Stone disease, Genetic Kidney disease, etc., The treatment that we give for kidney
failure are Hemodialysis, continuous Ambulatory Peritoneal Dialysis, Kidney Transplantation.
Kidney Biopsy is a minimally invasive investigation done for to know the Ethiopia
Pathogenesis that is what is the type of kidney failure that the patient has. That is very
useful investigation to know the exact type of kidney injuring.
DISEASES UNDER NEPHROLOGY
Nephrology concerns itself with study of the working of the kidneys and its diseases. The diseases that come under nephrology are:-
- Acid base imbalances
- Autoimmune diseases including autoimmune vacuities, lupus, etc.
- Dialysis and its long term complications – dialysis includes hemodialysis as well as peritoneal dialysis
- Effects of diseases like diabetes and high blood pressure on kidneys
- Hydronephrosis
- Ill effects of drugs and toxins on the kidneys
- Kidney Stone and Bladder Stone
- Kidney infections
- Nephritic syndrome and nephritis
- Polycystic kidney diseases where large cysts or fluid filled sacs are formed within the kidney impairing its functions – this is a congenital and inherited or genetic condition
- Renal failure that can be sudden or acute or long term or chronic
- Renal vascular diseases affecting the blood vessel networks within the kidneys
- Tubulointerstitial diseases affecting the tubules in the kidney
- Urine abnormalities (urinary infection) such as excess excretion of protein, sugar, blood, casts, crystals etc.
- The Department of Nephrology provides comprehensive care across the spectrum of kidney diseases.
RENAL BIOPSY
During a kidney biopsy — also called renal biopsy — your doctor removes a small piece of
kidney tissue to examine under a microscope for signs of damage or disease.
Your doctor may recommend a kidney biopsy to diagnose a suspected kidney problem, determine
the severity of kidney disease or monitor treatment for kidney disease. You also may need a
kidney biopsy if you’ve had a kidney transplant that’s not working properly.
Most often, a doctor performs a kidney biopsy by inserting a thin needle through the skin —
a procedure known as percutaneous kidney biopsy. An imaging device helps the doctor guide
the needle into the kidney to remove tissue
A kidney biopsy may be done to:
- • Diagnose a kidney problem that can’t otherwise be identified
- • Help develop treatment plans based on the kidney’s condition
- • Determine how quickly kidney disease is progressing
- • Determine the extent of damage from kidney disease or another disease
- • Evaluate how well treatment for kidney disease is working
- • Monitor the health of a transplanted kidney or find out why a transplanted kidney isn’t working properly Your doctor may recommend a kidney biopsy based on the results of blood or urine tests that show:
- • Blood in the urine (hematuria) originating from the kidney
- • Protein in the urine (proteinuria) that’s excessive, rising or accompanied by other signs of kidney disease
- • Problems with kidney function, leading to excessive waste products in the blood
Not everyone with these problems needs a kidney biopsy. The decision is based on your signs and symptoms, test results, and overall health.
In general, percutaneous kidney biopsy is a safe procedure. Possible risks include:
- • Bleeding: The most common complication of a kidney biopsy is blood in the urine (hematuria). The bleeding usually stops within a few days. Bleeding that’s serious enough to require a blood transfusion affects a very small percentage of people who have a kidney biopsy. Rarely, surgery is needed to control bleeding.
- • Pain: Pain at the biopsy site is common after a kidney biopsy, but it usually lasts only a few hours.
- • Arteriovenous fistula: If the biopsy needle accidentally damages the walls of a nearby artery and vein, an abnormal connection (fistula) can form between the two blood vessels. This type of fistula usually causes no symptoms and closes on its own.
- • Others: Rarely, a collection of blood (hematoma) around the kidney becomes infected. This complication is treated with antibiotics and surgical drainage. Another uncommon risk is development of high blood pressure related to a large hematoma.
Before your kidney biopsy, you’ll meet with your doctor to talk about what to expect. This is a good time to ask questions about the procedure and make sure you understand the benefits and risks.
Medications
When you meet with your doctor, bring a list of all medications you take, including over-the-counter medications, vitamins and herbal supplements. Before your kidney biopsy, you’ll be asked to stop taking medications and supplements that can increase the risk of bleeding.
After the procedure
After the biopsy, you can expect to:
- • Spend time in a recovery room where your blood pressure, pulse and breathing will be monitored.
- • Have urinalysis and complete blood count tests done to check for bleeding and other complications.
- • Rest quietly for several hours.
- • Receive written instructions about your recovery.
- • Feel some soreness or pain at the biopsy site for a few hours. You’ll be given medications to relieve pain.
You may need to rest in bed for 12 to 24 hours after the biopsy, as directed
by your doctor. Your health care team will let you know about any activity
restrictions, such as avoiding heavy lifting and strenuous exercise.
Your kidney tissue goes to a lab to be examined by a doctor who specializes
in diagnosing disease (pathologist). The pathologist uses microscopes and
dyes to look for unusual deposits, scarring, infection or other
abnormalities in the kidney tissue.
Call your doctor if you experience:
- • Significant bright red blood or clots in your urine more than 24 hours after the biopsy
- • Inability to pass urine
- • Worsening pain at the biopsy site
- • Fever over 100.4 F (38 C)
- • Faintness or weakness
Expect your biopsy report from the pathology lab within about a week. In urgent situations, a full or partial report may be available in less than 24 hours. At a follow-up visit, your doctor will discuss the results. The results may further explain what’s causing your kidney problem, or they may be used to plan or change your treatment.