Kidney Care

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Kidney Care

State of the art Haemodialysis facilities are available at Noble Hospital, Pune; all patients are treated using the latest fully computerized bicarbonate based haemodialysis machines with volumetric ultra-filtration and adjustable sodium facility, that provide better patient safety.

Overview

Kidneys are bean shaped organs about 9 to 11 cm in length situated on either side of the backbone. Each kidney comprises of approximately 1 million nephrons which are the functional unit; not only involved in filtration of wastes but also many other functions.

  • Maintaining fluid balance and electrolyte balance
  • Maintaining haemoglobin by production of erythropoietin
  • Maintaining balance of salt
  • Maintaining blood pressure
  • Maintaining bone Health by producing active Vitamin D
  • Maintains acid-base balance

CKD – Chronic Kidney Disease

CKD is an abnormality in kidney function of more than three months duration. This results in accumulation of waste products and water in the body. It is very often progressive with gradual worsening of the kidney function leading to end stage kidney disease necessitating dialysis or transplantation.

Chronic kidney disease (CKD) develops over a period of time when there is a decrease in the kidneys’ ability to perform their normal functions. If kidney disease gets worse, wastes can build to high levels in your blood and make you feel sick.

Unfortunately most of the times early CKD has no or very vague symptoms like fatigue, poor appetite, increased urination at night. Chronic kidney disease is quite common (some studies estimate that 1 in 10 adults may suffer from kidney disease, and people often have the condition without knowing it.

Complications of CKD like high blood pressure, anaemia, weak bones, poor nutritional health and nerve damage, may develop long before CKD is diagnosed. Kidney disease also increases your risk of having heart and stroke.

Almost 80% of CKD is caused by diabetes and high blood pressure.

Early detection and treatment can often keep chronic kidney disease from getting worse. When kidney disease progresses, it may eventually lead to kidney failure, which requires dialysis or a renal transplant to maintain life.

Services

  • Nephrology outpatient consultation
  • Maintenance Haemodialysis
  • Hemodialysis service for (Hep B, Hep C, H.I.V.)
  • In patient care with 24 hour Emergency Dialysis
  • Critical Care Nephrology; including bed side dialysis in the ICU.
  • Home Haemodialysis
  • Kidney biopsy
  • Vascular Access
  • Peritoneal Dialysis
  • Kidney Transplantation
  • Specialised procedures – S.L.E.D.; Plasmapheresis; Hemoperfusion
  • Diet and Nutrition 

The Noble NephroPlus Advantage

NephroPlus is one of the first centres in South Asia to have networked dialysis machines and the highest specification RO plant to provide India’s Highest Quality Dialysis experience to patients.

Why choose a Noble NephroPlus centre?

  • NephroPlus’ safety protocols & policies
  • Globally recognized NKF KDOQI (National Kidney Foundation Kidney Disease Outcomes Quality Initiative) guidelines
  • Top notch infection control protocols for minimum risk of seroconversions
  • Comprehensive & reliable biochemical monitoring
  • Monthly clinical audit & patient scorecards
  • Travel-friendly dialysis – India’s first online medical record
  • Dedicated nutrition support
  • Regular patient satisfaction survey 

Why Noble NephroPlus?

  • World-class, qualified, experienced team.
  • High-tech centre with top-of-the line equipment.
  • Dialysis in a comfortable, private, spacious environment, with imported medical recliners and beds; individual TV screens.
  • Standards of patient care and safety comparable with the best in the world.
  • State-of-the-art, standards compliant Hospital Information System for instant accurate access to all patient records.

Noble NephroPlus Advantages – Superior Clinical Infrastructure

  • NephroPlus has the necessary resources, support and processes in place to provide the highest quality of care in dialysis. This translates to healthier, happier patients and doctors alike.
  • State-of-the-art facility with the latest machines and highest specification RO Plants.
  • Imported recliners – first and only in India: to give patients the freedom to work, watch TVor be active during dialysis.
  • Highly improved intradialytic tolerance (fewer cramps, Nausea and vomiting)
  • Less post-dialysis fatigue, Cramps and light headedness
  • Decreased risk of access-related infections 

Noble NephroPlus differentiation – The Clinical Aspects

Our endeavour is to provide the highest quality of outcomes at the lowest possible “total cost of care”. We ensure this through

  • Strict and proven clinical protocols and high quality clinical infrastructure.
  • New set of tubing
  • High quality RO plant
  • Reprocessing of dialysers on automated reprocessing machines
  • Strict infection control protocols
  • Regular testing, to provide highest quality R.O. water for Dialysis
  • Highly improved intradialytic tolerance (fewer cramps, Nausea and vomiting)
  • Less post-dialysis fatigue, Cramps and light headedness
  • Highly trained and motivated staff
  • Continuous quality improvement process
    • Monthly patient audit
    • Tracking of outcomes
    • Individualized patient improvement plans

Treatment

Tests for chronic kidney disease

A blood test of serum creatinine can be used to know your eGFR (estimated glomerular filtration rate). This is a measure of how well your kidneys are working.

(Serum Creatinine varies with age, sex and race. It remains within the normal range till more than 50% of kidneys are damaged. Hence it is essential to also know your eGFR to assess kidneys. Several online calculators are available to know your eGFR Click here)

A simple urine sample can detect protein in your urine (proteinuria) or RBCs in your urine (hematuria), which can suggest that the kidneys are not working properly. You should be offered these tests if you are at risk.

Who should get tested?

If you have any of the following you should be tested for chronic kidney disease at least once a year:

  • Age above 40years
  • Diabetes
  • High blood pressure
  • Heart Disease
  • Kidney stones or an enlarged prostate
  • Family history of kidney disease or an inherited kidney disease
  • Blood in your urine (this is called haematuria) or protein in your urine (proteinuria)

Managing Chronic Kidney Disease

Conservative Care:

CKD when detected early, can be slowed, stabilised and sometimes reversed with appropriate management with lifestyle, diet and medicines. Our team of experienced nephrologists can work with you to prepare an optimised plan for you, to delay or prevent End Stage Kidney Disease (ESKD).

Dialysis Treatment

Haemodialysis Unit

State of the art Haemodialysis facilities are available at Noble Hospital, Pune; all patients are treated using the latest fully computerized bicarbonate based haemodialysis machines with volumetric ultra-filtration and adjustable sodium facility, that provide better patient safety.

Infection control practices are strictly adhered to prevent transmission of infections. The latest dialysis machines include various sensors, meters gauges, monitors, blood leak detectors, computerized detection systems that provide for better quality of dialysis. Biocompatible membrane based dialyzers are routinely used with volumetric ultra-filtration.

All water for dialysis is purified using reverse osmosis (R.O.) and the water quality is monitored at regular intervals to ensure patient safety and prevent long term complications on haemodialysis.

Facility for continuous monitoring of the sick patient through highly sophisticated monitors throughout the dialysis procedure is available. Bedside Dialysis facility is available and routinely performed in ICU for critically ill patients.

SLED Therapy

  • We provide highly sophisticated dialysis support for critically ill patients in ICU with multi-organ failure where peritoneal or routine haemodialysis are not possible for various reasons.
  • SLED (Sustained Low Efficiency Dialysis)

Plasmapheresis and Plasma Exchange

These faculties of Plasmapheresis and Therapeutic Plasma Exchange (TPE) are available for renal and non renal patients such as GB syndrome and myasthenia gravis. Various diseases like Good pasture’s syndrome, Haemolytic Uremic syndrome, TTP, cryoglobulinemia, RPGN (SLE, ANCA-related) can be treated with Plasmapheresis. It’s done using Plasma filter and 5% Albumin or fresh Plasma.

Hemoperfusion in Poisoning

This procedure is performed using Charcoal cartridge, with an average treatment time of hours. It is a lifesaving technique for treating overdoses of sleeping pills, drugs and other poisons.

Peritoneal Dialysis

The aim of the peritoneal dialysis is to support patients carrying out their peritoneal dialysis at home. This can be continuous ambulatory peritoneal dialysis (CAPD) or automated peritoneal dialysis (APD) by machine.

CAPD

With CAPD (continuous ambulatory peritoneal dialysis) a thin tube called a catheter is surgically implanted into the abdominal wall. Inside your body the tube goes down into the abdominal cavity. You will need to drain a special  fluid called dialysate through the tube 3 or 4 times a day (having first drained off the used fluid which carries the toxic waste matters away from your body as your kidneys used to do).

CAPD takes place inside the body using the natural lining of the abdomen called the Peritoneum. The Peritoneum acts as the dialysis membrane. In order to do your dialysis by CAPD, you will need to have a small operation (which takes place under a local or general anaesthesia) to insert a catheter into your abdomen, CAPD is done at home usually 4 times every day. It takes less than 30 minutes each time and is a very simple, painless procedure. Because dialysis is carried out at home patients must be able and willing to take major responsibility for their own care.

The patient will receive expert training from your CAPD nurse which will give you all the expertise and confidence you need to be independent. You will always have the support and advice of the Renal Unit when needed. You can lead a normal active, working life.

APD

The Peritoneal dialysis can be performed by a machine during the night by a machine during your sleep this is known as APD or Automated Peritoneal Dialysis. This can be useful for people who cannot perform CAPD during the day to other commitments.

Kidney Transplant

Kidney transplants are regularly done for both; live related donors and deceased donors. In case of a living donor your donor will be counselled and assessed for fitness to donate. Once found acceptable and compatible, the transplant will be evaluated by authorisation committee. After clearance from authorisation committee, transplant will be scheduled.

 

In case of no acceptable living donor in the family, a person can register for a deceased (cadaveric) donor transplant through the centre. Our transplant coordinator will guide you for the same.

Centre for Nephrology, Dialysis and Kidney Transplant

  • The centre provides comprehensive treatments for all forms of renal disease, including Acute (reversible) Renal Failure, Chronic Kidney Disease and End Stage Renal Disease by an experienced team of Nephrologists
  • Patients with ESRD can choose between options of Haemodialysis, Peritoneal Dialysis and Renal Transplantation as per patient’s suitability.

Points of highlight:

  • The unit has spacious interiors and a quality controlled environment to ensure minimal infection.
  • The unit and its well trained staff are imperative to provide successful treatment and care to all our patients.
  • We provide one of its kind recliner dialysis chairs and online monitoring of all patient records.
  • In fact patients have been very positive about conducting dialysis on recliners.
  • We use the first of its kind MX Eco Fresenius R.O. in India.
  • The unit consists of 26 dialysis stations includes recliners and beds.
  • In addition 5 stations are separately available in the ICU for critically ill patients, who can be provided specialized dialysis within the ICU, for better patient safety and monitoring.

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OUR DOCTORS

Dr Avinash Ignatius

Dr. Avinash Ignatius

MD, DM (A.I.I.M.S., New Delhi) (Head)
team-8-1

Dr. Sunil Jawale

MD, DM (K.E.M., Mumbai)
team-8-1

Dr. Govind Kasat

MD, DM (I.K.D.R.C., Ahmedabad)
team-8-1

Dr. Shradhha Lohia

Paediatrics Nephrologist

TESTIMONIALS

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