Welcome to National Kidney & Prostate Clinic
The kidneys are the blood filtration organs of the body, which purify the blood of all the impurities in it. These impurities are then excreted in the urine, in a concentrated form. Kidneys are also an important organ which controls the blood pressure and the hemoglobin production by the bone marrow and the liver. The kidneys also maintain the amount of water retained inside the body, therefore when the individual is dehydrated the kidneys conserve the water, while when the patient has more water in the body, the kidney help in excreting the excess water from the body in the form if urine.Therefore, the kidneys are vital organ essential for life. When the kidney become weak then the patient has excess impurities like creatinine in the blood. Also, the water excretion and management suffers therefore they may have water overload, or dehydration. Also they often have, difficult to control, high blood pressure. And they have very low hemoglobin. Which results in the patient becoming weak and having very less appetite.At this point a nephrologist will often advise to start Hemodialysis. Hemodialysis is the process of purification of the blood. This is generally performed twice or thrice weekly. The patient is admitted in day care. Then blood is drawn into a dialysis machine then purified and filtered and then returned to the patient. This process is lifesaving in end stage renal disease patients.These patients need specialized nephrological care too since these patients also have low hemoglobin, excessively high blood pressure. And also deficit in calcium and iron metabolism.Since the kidney produces erythropoietin, a hormone which stimulates hemoglobin production therefore this is often needed to be replaced by weekly subcutaneous injections.Please do not delay nephrology care and dialysis when needed, since these patients can have functional and active life on dialysis and care
1 Nephrology is the medical management of renal disorders
2 These doctors are MD in medicine and then DNB or DM in nephrology
3 We have DR Smartya Pulai MD DM and DR Tanmoy Mukhopadhyay MD DNB as our nephrologist at NKPC
4 At Baghajatin NKPC diagnostics we have Dr Sandip Bhattacharya MD DM and Dr Arunangshu Banerjee MD DM as our senior Nephrologists
5 These physicians mostly manage medical renal disease, wherein the kidney has shrunken and shows altered echotexture.
6 When chronic renal disease progresses then these doctors advise the initiation of hemodialysis or peritoneal dialysis as deemed suitable for the case.
7 In case the patient needs maintenance hemodialysis then the nephrologist may counsel the patient regarding kidney transplantation.
8 kidney transplantation means, the donation of a kidney from another individual to the recipient, a person whose both kidneys are non-functional.
9 Nephrologist also has a role in acute kidney injury caused by sepsis or toxins or drug induced kidney damage.
10 Nephropathys are a wide range of disorders which can be initiated by auto-immune reaction. The immune system is the defense system of the body, but if it hyper-reacts then it can attack these individual’s own kidneys, resulting in renal damage. These individuals are also treated by the nephrologist.
1 when the kidneys are terminally damaged by a disease process it is called end stage renal disease
2 the commonest reason for this is diabetes and hypertension
3 but other autoimmune diseases can also cause glomerular damage and permanent renal damage
4 in this stage the patient cannot survive without renal replacement therapy
5 one therapy is maintenance hemodialysis, which is performed twice weekly or thrice weekly lifelong
6 the other method is renal transplantation
7 renal transplantation means another individual donates a living kidney to the renal impaired recipient
8 the donation is only possible if the T cell and B cell crossmatch of the donor and the recipient are matched, also the ABO blood group also has to be matched.
9 in the absence of a match the transplantation is not possible
10 when the transplant Is performed the donor surgical team harvests the kidney from the patient, generally the left kidney is harvested.
11 then the recipient team attaches this kidney to the artery and vein of the patient who receives the kidney and the ureter is attached to the bladder so that the urine can be drained naturally
12 these patients however are kept under immune suppression since the recipient body should not reject the new grafted kidney
13 this immune suppression means medication to suppress the defense system of the body, therefore these patients have to be kept under protected environment to prevent infections
14 transplants have good survival over ten years and we expect 19 out of 20 cases to have good dialysis free lives even after ten years of transplantation
Hemodialysis is needed permanently in some patients, this is called maintenance hemodialysis
2 this is performed generally twice or three times per week
3 for dialysis atleast two needle punctures are needed every time, one to draw the blood into the machine and the other to return the purified blood black to the patient
4 therefore the need for a vein access which can withstand so many puncture and also provide a channel for flow of large volumes of blood
5 therefore the surgeon creates a arterio-venous fistula.
6 this means joining a vein to an artery, therefore the high pressure and volume of flow from the artery dilates and strengthens the vein, this creating a channel for permanent dialysis.
7 generally the left hand is preferred since it is the non-dominant hand of most people
8 this surgery needs about two hours to perform and is a day care procedure
9 the patient is advised forearm exercises to generate better blood flow to develop the fistula better.
10 this AVF is the best dialysis permanent access