THE DEPARTMENT OF NEPHROLOGY


The department of Nephrology takes care of patients with kidney problems, giving them appropriate medical treatment and when required, dialysis or transplantation

Location

The nephrology department is located in the main hospital campus. The department functions as two units: Nephrology I and Nephrology II. The nephrology office and the dialysis/transplant units are located in the “O” Block, third and first floor respectively

Services offered

Out Patient Services

Patients with complaints relating to kidney function are referred to the department. After an initial assessment, the treating nephrologist orders appropriate diagnostic tests such as blood tests, urine tests, ultrasonography, kidney biopsy etc. Based on the test results a diagnosis is made and appropriate care/treatment is given or advised. The outpatient clinic also has nephrology nurse educators to provide counseling regarding life style modification, diet and options of renal replacement therapy

Nephrology out Patient services is located in the third floor of the OPD building. We also have a Child Kidney Care clinic (CKCC) managed by pediatric nephrologists. The timings of the outpatient services are as follows

 

Unit Day Time Consultants
Nephrology I Monday, Thursday 12 noon
to
6 pm
Dr. V Tamilarasi
Dr. Vinoi George David
Dr. Suceena Alexander
Dr. Shibu Jacob
 
Nephrology II Tuesday, Friday 12 noon
to
6 pm
Dr. Santosh Varughese
Dr. Basu G
Dr. Anjali Mohapatra
Dr. Anna T Valson
 
CKCC Monday, Thursday,
Tuesday, Friday
12 noon
to
6 pm
Dr. V Tamilarasi
Dr. Anjali Mohapatra
 
 

Dialysis

While many kidney problems can be treated by medication, diet and life style changes, in some patients the extent of kidney damage may be too severe to allow any improvement through medicines alone. In such cases the treating nephrologist would advise the patient to opt for renal replacement therapy to replace the function of the failing kidneys, namely – hemodialysis, peritoneal dialysis or renal transplantation. The advantages and disadvantages of each dialysis modality are discussed in detail with the patient and his/her family by the nurse educator and the treating nephrologist before a final decision is made

Hemodialysis

In hemodialysis, the patient is connected to a dialysis machine (either through a dialysis catheter inserted into a neck or leg vein or through an AV fistula) and the patient’s blood, after removal of waste products by the machine, is returned back to the patient. Thus, these machines are actually artificial kidneys. CMC was involved in carrying out the first hemodialysis in India, in the year 1962. The nephrology department has a dialysis unit (Artificial Kidney lab or AK lab) which presently houses 40 hemodialysis machines, 4 of which are exclusively used for ICU dialysis. Dialysis is done by trained hemodialysis therapists along with nursing staff under the supervision of a junior nephrologist and a consultant nephrologist.
AK Lab is located on the first floor of “O” Block, near the Main Pharmacy and can be reached by taking stairs No. “6”

Continuous Ambulatory Peritoneal Dialysis (CAPD)

In this form of dialysis, a peritoneal dialysis catheter is inserted into the patient’s abdominal cavity either by a nephrologist in the AK Lab minor operating room, or by a team of urologists in the main operating room complex. Fluid stored in sterile bags is infused through the catheter into the abdomen and waste products from the blood move into the fluid over a period of 3-4 hours, after which the fluid is drained out and fresh fluid is infused. The process is repeated 3-4 times every day. So far, more than 200 patients have been initiated on CAPD at our center. The department has a CAPD room attached to AK Lab where patients and their relatives are intensively trained by our CAPD nurses, so that they can carry out CAPD by themselves at home. Patients are followed up by consultant nephrologists at the CAPD clinic from 2.30-3.30 pm every Wednesday except the first Wednesday of the month. Our CAPD nurses can be contacted via phone round the clock for advice and feedback by patients who live outside Vellore

Transplantation

Transplantation is the most effective form of renal replacement therapy, as the new kidney is able to perform all normal kidney functions. Patients need to identify a suitable related donor of a compatible blood group aged 20-60 years of age, who does not have diabetes or any major medical or surgical illness. CMC accepts first and second degree relatives and spouses. After an extensive workup of the patient and the donor, if both are found medically fit to undergo surgery, and if their tissue matches, transplantation is done. The transplant surgery is performed by transplant surgeons (urologists) and after the surgery; patients are followed up by nephrologists
Outpatient service to patients who have had their kidney transplant at CMC is provided separately at the Transplant OPD, which is located in the first floor (next to P1 ward) of the “O” block. This can be reached by using stairs No. “6”. The OPD timings are between 8 to 10 am on Mondays, Wednesdays and Fridays and are attended by all consultants and transplant registrars

CMC has the distinction of performing the first kidney transplant in India in 1971 and has since then been at the forefront of innovations in transplantation in India. In 1991 CMC performed the first kidney transplant from a deceased donor. In 2009 we performed the first swap donor kidney transplantation and the same year the first successful across-the-blood group kidney transplantation in India without spleenectomy

Diagnosis

Diagnostic Tests: Depending upon the patient’s condition, various tests may be required to arrive at the correct diagnosis. These tests are done in the appropriate labs (biochemistry, microbiology, clinical pathology etc). In collaboration with the department of Clinical Pharmacology, the blood levels of various immunosuppressive drugs in transplant patients are monitored and drug dosage is adjusted to ensure the clinical well being of the patient. HLA and Cross match along with donor specific antibodies assessment is done in collaboration with the department of Transfusion Medicine and HLA Lab

Biopsies: The nephrology department is well equipped to perform kidney biopsies and on an average about 1200 biopsies is done every year (both native and transplanted kidney)

Patient education: In addition to diagnosis and treatment, patients with chronic renal problems who come to the department are also educated on life style changes, the need for compliance with prescribed medications and given training on basic techniques to be self reliant in terms of daily follow-up of their clinical situation. Transplant patients and their relatives are trained by our nurse educators to measure blood pressure and check blood sugar using glucometers which they can then continue to do on their return home

Nephrology Research Laboratory

The diagnostic and research services of the Nephrology Lab are as follows. Kinship testing (using DNA profiling techniques) is offered to ascertain biological relationship between a transplant patient and the prospective organ donor. Our research focus includes Transplant Immune Monitoring; Evaluation of Pharmacogenomic tools to aid individualized immunosuppression; Study of biomarkers such as FGF23 etc in Mineral Bone disorders; Genetic tests for inheritable renal disorders like Fabry’s Disease; clinical utility of novel biomarkers in hemolytic uremic syndrome etc. Individuals seeking training in laboratory techniques are accepted as visitor-observers and oriented and trained on various serological and molecular assays performed in the lab

Education & Training

  • The Department runs a 3 year postgraduate training programme towards the award of a DM in Nephrology for four doctors with MD degree in General Medicine or Pediatrics
  • The B. Sc in Dialysis therapy is 4 year course with 10 students
  • Undergraduate students have lectures and afternoon clinics in the department as part of their training programme
  • Individuals interested in exposure, orientation and training in clinical nephrology or lab-based work undergo training in the nephrology department or nephrology laboratory as visitor observers

Contact Details

 Email:  Phone:

Department Email
nephro1@cmcvellore.ac.in
nephro2@cmcvellore.ac.in
Nephrology Lab Email
nephrolab@cmcvellore.ac.in
 

0416-2282053




 

Address:
Department of Nephrology, Christian Medical College,
Vellore, 632004, Tamil Nadu, India