The Nephrology department looks after patients with kidney problems. It gives them the treatment they need through medicines, tablets, dialysis or kidney transplantation.
What They Do
Everybody normally has 2 kidneys. The kidneys remove waste, like urea, from the blood. They also control the amount of water in our bodies. If the kidneys do not work properly these things are not removed and people get sick. The urea levels go up and making people feel sick. Water also builds up in the body and causes more problems. People with kidneys that do not work come to Nephrology department for treatment.
Diagnosis - finding out what the problem is
Diagnostic tests are tests used to give a diagnosis. These tests find out what the problem is. The nephrologists will ask for various diagnostic tests. Different problems need different tests. These diagnostic tests are done in the labs (biochemistry, microbiology, Clinical Pathology etc). After a kidney transplant they look for certain viral infections. This test is done in the molecular diagnostic and research lab of Nephrology. CMV is Cytomegalovirus that can infect the kidney and so cause problems. This “monitoring” looks for problems eg after the transplants.
The levels of immunosuppressive medicines in the blood of transplant patients are looked at. For this, the Nephrology department works with the department of Clinical Pharmacology. These immunosuppressive drugs are used after transplants to keep the kidney working. The tablets suppress body’s immune system. Too much drug makes the patient sick. Not enough tablets and the kidney may stop working. Clinical Pharmacology department tests the amount of medicine in the blood. Depending on the concentration of medicine in the blood the dosage of the tablets is changed.
The Nephrology Department has good equipment to do kidney biopsies. On an average about 1200 biopsies are done every year. The biopsies are done on both native, ie the patient's own kidney, and transplanted kidney.
Some problems are controlled by medicines, diet and life style changes. Life style includes exercising, resting, type of work etc. But, if the kidney is working very poorly, the patient has to have kidney dialysis or a transplant.
In dialysis, the patient is connected to a machine. His blood flows through the machine (like flowing through the kidney). The machine removes the wastes and returns the cleaner blood back to the patient. So, these machines, called dialysers, are like artificial kidneys. The Nephrology Department has a dialysis lab called the Artificial Kidney lab or AK lab. The dialysis of the blood (Haemodialysis) is done in the AK lab. Another form of dialysis uses the space inside our abdomen. This peritoneal cavity is where the stomach, liver, gut, colon, kidneys are. This space is used for dialysis and so it is called peritoneal dialysis. Both forms of dialysis are done in the AK Lab.
There are about 26 haemodialysis machines. Dialysis is done by trained haemodialysis technologists. There are also nurses and all are supervised by nephrologists. Minor surgical procedures (small operations) are also done in the AK lab.
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