Experts Speak

Dr Ankit Mody, Nephrologist Explains The Types Of Kidney Diseases

I am Dr Ankit Mody. I am a Consultant Nephrologist and a Renal Transplant Physician at CARE Hospitals, Hi-tech City, Hyderabad.

Nephrology is a subspecialty of medicine which deals with the diagnosis and treatment of kidney diseases. Kidney diseases can be broadly classified into 2 types, primary kidney diseases and secondary kidney diseases. Primary kidney diseases are not very common but they do occur in the general population. This means that the kidney has some problem of itself which needs attention. Secondary kidney diseases means that the kidney is an innocent bystander and is basically affected because of some other disease in the body, most commonly diabetes and high blood pressure.

As you know that the prevalence and incidence of diabetes and high blood pressure in the country has assumed epidemic proportions. We expect that in times to come by, the proportion of patients with kidney failure is going to increase exponentially. These patients might need dialysis and Renal Replacement Therapy in the long term for their survival.

We at CARE Hospitals, Hi-tech City are equipped to handle all types of nephrology cases, right from diagnosis and treatment of different types of kidney diseases.

Let me go through the various aspects and the facilities available at CARE Hospitals, Hi-tech City.

First let me talk about our hemodialysis unit. Our hemodialysis unit is a 6-bedded hemodialysis unit. It provides dialytic support to the patients 24*7. It is open all 365 days of a year. We have 4 dialysis technicians at present to take care of the dialysis unit. Hemodialysis can be provided on an outpatient basis which means that the patients who require long time dialysis come to the hospital 2 times or 3 times a week, stay in the hospital for 4 hours for dialysis and then they can go back home. These patients require dialysis in the long term. We also provide dialysis on an in-patient basis. This means the patients while in the hospital develop kidney failure might require dialysis, which may be temporary or permanent, but we are equipped to provide dialysis in the ICU as well.

Our department is lucky enough to have the latest state-of-the-art Continuous Renal Replacement Therapy machine, also known as the CRRT machine, which is a Prismaflex machine. Not all hospitals are lucky enough to have this type of facilities. The CRRT machine can be used in the ICU setting to provide hemodialysis or hemo-diafilteration to critically sick patients in the ICU. We also provide plasmapheresis which is also known as plasma exchange to patients. This can be done in various settings. Some non kidney diseases patients may also need plasmapheresis and we are well equipped to provide plasmapheresis as well. Another option is renal transplantation. Our tertiary care center is a renal transplantation hub. We provide renal transplantation to dialysis patients.

Mind you that not all dialysis patients are suitable for renal transplantation. But, overall, renal transplantation provides a better quality and better quantity of life as compared to dialysis. Renal transplantation includes a pre and post transplant evaluation which takes around 1 to 2 months before transplantation. Post transplantation, within 6 to 8 weeks, the patient can resume an almost normal life after transplantation.

Transplantation involves the use of specific imunosuppressive drugs. We provide counseling to the patients in terms of side effects and adverse effects of these drugs. Other than dialysis therapies and renal transplantation, we take care of all types of kidney diseases. Kidney diseases are quite varied; they range from congenital kidney diseases — means a small baby can be born with kidney birth defects — or auto immune kidney diseases. Auto immune kidney diseases means that the body’s immune system affects the body and the kidney itself. These types of auto immune kidney diseases require the use of specific immunosuppressive drugs. These immunosuppressive drugs, also known as cytotoxic drugs, are very potent and require careful management.

We are well equipped to use these drugs. Another major aspect of the Department of Nephrology at CARE Hospitals is preventive nephrology.

Most of the times kidney disease is asymptomatic. This means that in early kidney disease the patients do not have any symptoms and are not aware of the kidney problems they have. They come to a doctor’s attention or a hospital’s attention only when the kidney disease is far advanced and the patients develop symptoms only when the kidney disease is far advanced. Our aim is to diagnose a patient at an earlier stage using screening methods. We use various screening methods like early detection of diabetes, early detection of high blood pressure. We use specific tests like urine test and blood test to diagnose them.

Once you are able to diagnose kidney disease at an earlier stage we can use various strategies including drugs and other medications to prevent the progression of kidney disease or even, sometimes, reverse the kidney disease. So prevention is the key in nephrology. So our aim is to prevent kidney diseases by screening and doing regular health check-ups. So we recommend that after a specific age patients should undergo health screening at least once a year.

Particularly high risk populations like patients who have diabetes and hypertension should undergo screening more frequently — 3 to 6 months or at least one yearly.

We at the Nephrology Department at CARE Hospitals, Hi-tech City are dedicated to patient care and are available to take care of your kidney diseases.

 

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