Nephrology (Renal)

The KEM Hospital pioneered the development of specialized Nephrology in Pune in 1969, with the establishment of the first dialysis unit in Maharashtra, after Mumbai. Initially dependent on peritoneal dialysis, it was the first in the city to start haemodialysis in 1972. Kidney transplantation followed in 1990. Today, our unit offers a complete range of investigations and treatments for kidney patients and our full-time staff is committed to patient care based on a team approach.

Services Include:

  • Dialysis facilities span acute and maintenance haemodialysis (HD); all variants of HD including CRRT and SLED; peritoneal dialysis - both intermittent (IPD) and continuous (CAPD); and extra-corporeal therapies like plasma exchange. A particular feature is the provision of dialytic therapies in the Critical Care Units, with 16 beds equipped for point-of-care haemodialysis. These include special treatments for critical septic / shock patients, even those not in renal failure (e.g. hemoperfusion therapies with Oxiris for cytokine storm in COVID-19 or severe sepsis, plasma exchange for ACLF, charcoal hemoperfusion for poisoning, etc). All dialysis areas are equipped with RO plants producing ultra-pure water meeting stringent EU standards.
     
  • Kidney Transplantation: the department has an active program, which began in 1990 and was based mainly on living related donors. It was also one of the first to enter the field of deceased donor transplantation in 1997.
     
  • Paediatric Nephrology: we offer a comprehensive Paediatric Nephrology Service - both indoor (IPD) and outdoor (OPD) - backed up by renal replacement therapies and a much-needed specialized bladder clinic.  This service has received a grant from the Indian Society of Nephrology under the auspices of the Sister Renal Program to collaborate with the Paediatric Nephrology Service of the Great Ormond Street Hospital for Children NHS Foundation Trust, UK as level C pair. 
     
  • Interventional Nephrology: Our department performs insertion and salvage of cuffed tunnelled catheters, fibrin sheath balloon disruption, angioplasty of AV fistulae and central veins as needed.
     
  • Academics: the department has an active super-speciality teaching program. It is recognized for the DNB (Nephrology) of the National Board of Examinations, as well as the FNB in Paediatric Nephrology and Fellowship Courses of the Indian Society of Paediatric Nephrology.
     
  • Research: Our research includes single centre studies in haemodialysis, acute kidney injury, and genetic and functional studies in haemolytic uremic syndrome (HUS). We have also collaborated and participated in multicentre studies nationally and internationally in maintenance haemodialysis, acute kidney injury biomarkers with the AKIN network and on genetic studies with KEM Hospital Mumbai and MPUH Nadiad. Specific research areas in Paediatric Nephrology cover: renal involvement in Wilson’s Disease, ambulatory blood pressure monitoring (ABPM) in diagnosis of hypertension in children with solitary functioning kidney, and prevalence of haematological abnormalities in distal RTA. Recently, our department also completed participating in a Multicentric Trial: Optimal dose of Cholecalciferol Supplementation in Children with Chronic Kidney Disease - An Open Label Randomized Control Trial.
     
  • Dialysis and Transplant Coordination: A trained Dialysis and Transplant Coordinator counsels patients to help them adopt the most suitable treatment modality (i.e. dialysis or transplantation) for their condition. She facilitates compliance with treatment, follow-up and finding ways to overcome their financial and social difficulties. An extension of this work peculiar to our Unit is the Coordinator’s HR activities, in educating, updating, and effecting continued progress in staff attitudes. These activities are very relevant in promoting a cohesive team essential for good patient care.   

Special Clinics and Camps

  • OPD Clinics: Adult General Nephrology OPDs are held twice a week, and Paediatric Nephrology OPDs are held thrice a week.
     
  • A special Dialysis and Transplant Clinic is held once a week, which includes counselling for potential transplants.
     
  • We are on the verge of opening a specialized Bladder Clinic which will be a cross-disciplinary feature manned by the Nephrology Service (principally Paediatric), Urology and Paediatric Surgery. It is equipped with state-of-the-art urodynamic equipment and has dedicated OPD / counselling areas.
     
  • Stone Clinic is planned for the special investigation and management of urinary tract stones, backed up by more detailed stone analysis than presently available anywhere in the city.
     
  • Preventive Nephrology: the Paediatric Nephrology Service has conducted a School Screening Program for hypertension in adolescent children (Classes VIII & IX) in 2018 - 2019 in 4 schools in Pune District and 900 school children were screened. This is of great importance as up to 25% of adult chronic kidney disease may arise from undiagnosed and untreated paediatric kidney disease and hypertension.

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