Nephrology Care - Diagnosis & Treatment At Fortis Hospital Mumbai
Nephrology Care - Diagnosis
Many kidney diseases don’t show any symptoms at their early stages. Getting checked through various types of diagnostic tests, physical and oral examination helps your doctor to better conclude and confirm the presence of any renal disease you might have. The following laboratory tests can help evaluate how well your kidneys are performing their job.
Serum Creatinine Test
This blood test can reveal details about the levels of waste products like creatinine in your blood. The Higher the creatinine level is, the greater the chances of kidney problems.
Glomerular Filtration Rate
A blood test checking for GFR can tell your doctor how well the kidneys are filtering wastes and excess fluid from the blood. GFR is calculated by considering various factors like your age, gender, body size and also the results of your blood creatinine test.
Blood Urea Nitrogen
This blood test measures the amount of Urea nitrogen in the blood. As the BUN level shoots up, the kidney function decreases.
Urinalysis helps to pinpoint the presence of excess levels of protein, albumin, creatinine and other abnormalities like red or white blood cells, pus, bacteria, blood and sugar in the urine. The presence of these abnormalities in the urine makes your doctor understand that your kidneys are not working properly.
Renal ultrasound is a painless test that uses sound waves of high frequency to picture the images of the kidneys and other organs belonging to the urinary system. This diagnostic procedure is highly helpful in detecting the mass, cyst, and size of the kidney. Ultrasound can also detect abnormalities like kidney stones and other obstructions that deter the kidney from doing its functions.
Computed Tomography (CT) Scan/ CT Angiography
CT Angiography is a medical test that uses a combination of CT scan and intravenous injection of a special dye to diagnose and evaluate the blockages, damages or malformations within the blood vessels throughout the body. A CT scan is a non-invasive diagnostic test which uses X-rays to produce 3D images of the blood vessels in your body. When compared with MRI or ultrasound, CT angiography gives a greater amount of detail with precise images of the blood vessels.
Renal MRI Scan
A renal MRI scan produces highly detailed pictures of your kidneys using magnetic field and radio waves. This test helps the doctors to evaluate the function and anatomy of the kidneys and also distinguish between a potentially cancerous mass, a non-cancerous fatty tumor (angiomyolipoma) and a benign growth such as a cyst. Doctors often rely on this scan because it has the capability to reveal unique details that are unattainable using a CT scan or any other imaging technique.
Kidney Biopsy for Microscopic Analysis
This is an informative test that involves the removal of a small piece of tissue from the kidney to analyse under a special microscope looking for signs of infection, disease, damage or unusual deposits. The test results allow the doctors to understand the underlying renal condition and decide the best type of treatment.
Nephrology Care - Treatment Procedure
Kidney Transplant Program
A kidney transplant is a surgical procedure to replace the failed kidney in your body with a healthy one from a deceased donor or a living person. The loss of kidney function due to end-stage renal disease or kidney failure generates the need for a kidney transplant.
Dialysis is an artificial process to remove waste substances and excess fluid from the blood when your kidneys can no longer take care of it. This is carried out routinely on patients who have acute or chronic renal failure or ESRD. It is necessary until the kidneys recover or until you receive a kidney transplant.
Minimally Invasive Surgery
We perform a number of minimally invasive surgeries including Laparoscopic nephrectomy and Lithotripsy, all in a precise manner thereby producing minimal or no blood loss, and also reducing their side effects. The other potential benefits of these techniques are shortened hospital stay and faster postoperative recovery time.
Continuous Renal Replacement Therapy (CRRT)
CRRT is a procedure that provides renal support for a prolonged time in critically ill patients with acute kidney injury. This procedure mimics the functions of the kidneys in the purification of blood by a slow and continuous removal of solutes and fluid. It is performed in patients who meet the criteria for haemodialysis therapy but cannot undergo traditional intermittent haemodialysis due to hemodynamic instability.
Haemodialysis is a treatment procedure to remove waste, extra fluid and toxins from the blood using a dialysis machine, if the kidneys have failed. During this procedure, the blood is allowed to flow into an external machine outside the body, where it is filtered and purified. The clean blood is then returned to the body with the aid of a dialysis machine. Haemodialysis is the most common type of dialysis which is performed 3 times a week, with each session lasting for about 3 to 4 hours.
Peritoneal dialysis is a treatment that uses the lining of the abdomen (peritoneum) and special cleaning fluid (dialysate) to purify the blood, if the kidneys cannot function properly. During this procedure, the dialysate is allowed to flow into the peritoneum through a peritoneal dialysis catheter that is implanted into the abdomen. Once the dialysate absorbs wastes and extra fluid from the body, it is drained out of the abdomen into an empty bag. The entire process takes a few hours and it needs to be repeated 4 to 6 times per day.
Plasma dialysis (plasmapheresis)
Plasmapheresis is a medical procedure to remove antibodies from the plasma portion of the blood. It is performed by inserting one line of a catheter into a vein in the arm for delivering the blood to the machine and a second line of the catheter in the arm or foot for returning the blood. Most often, it is performed before transplant procedures to remove antibodies against the donor blood-type from the recipient, so they can’t invade and damage the donated kidney. It is also performed as a treatment for weakness or any autoimmune disorder.
A surgical procedure to replace the non-functioning (or a little functioning) kidney with a healthy kidney from a living or deceased donor is a Kidney Transplant. Most often, it is performed in patients with end-stage renal disease or chronic kidney disease. The conditions that lead to end-stage kidney disease are diabetes, uncontrolled high blood pressure, polycystic kidney disease and chronic glomerulonephritis. Kidney transplant is also a treatment option for patients who no longer wish to have lifetime dialysis.
Nephrectomy (kidney removal)
Nephrectomy is a surgical procedure to remove the whole or part of a kidney. Most often, it is performed to treat kidney cancer or to remove a noncancerous tumor. It can also be performed to treat other kidney diseases and injuries and to remove a healthy kidney from a living or deceased donor for transplantation. There are two types of Nephrectomy - 1. Partial Nephrectomy - It involves removing only the diseased or injured portion of the kidney. 2. Radical Nephrectomy - It involves removing the entire kidney, along with additional structures such as a section of the tube leading to the bladder (ureter), and other adjacent structures like adrenal gland and lymph nodes.