1. DIALYSIS

Dialysis is a major technological advance in modern medicine that makes it possible for people to survive despite complete and permanent kidney failure. In HAEMODIALYIS, your blood is drawn out of the body and flows through a combination of filters and fluid mixtures that removes toxins from the blood. The dialysis machine can be set to remove fluid from the blood stream with minimal damage to blood cells or loss of other important blood components. Haemodialysis needs to be done three times weekly and each session lasts 4 hours.

In PERITONEAL DIALYSIS, fluid is infused into the space surrounding your bowels and abdominal organs. The fluid then "mixes" with the surrounding blood across vessels with the effect of drawing toxins and excess fluid out when the fluid is drained. Peritoneal dialysis exchanges must be performed 4 times daily. Each exchange generally lasts for approximately 15-20 minutes.

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2. KIDNEY TRANSPLANT

A successful Kidney Transplant in Noida is the most desirable outcome for any patient living with kidney failure. The transplant operation itself can only be performed on patients who are medically fit to undergo high risk surgery. Your nephrologist will collaborate with your other physicians, cardiologists, and the transplant surgeon to assess this risk. 

A transplant can be done between the patient and a related or unrelated person who chooses to altruistically donate a single kidney. If no live donor is available the patient can choose to go onto a waiting list for a cadaver donor. A successful transplant depends mainly on very strict compliance with anti-rejection medication which prevents the transplant from failing. The average lifespan of a kidney transplant could be as long as 25 years.Our Kidney Transplant in Noida ranks as one of the most prestigious transplant programs in the country. Our team of specialists are highly skilled in the care of kidney transplant patients and living donors and will work with you every step of the way to ensure superior health care and service.

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3. MANAGEMENT OF ACUTE AND CHRONIC RENAL FAILURE

Chronic Kidney Disease(CKD) is a condition where the body suffers from weak kidneys. Your kidneys clean and purify the blood by removing waste products and extra fluid. When the kidneys are weak, waste and toxins remain in the blood and cause disease. In the most extreme form of CKD, patients require dialysis or a Kidney Transplant in Noida. Most patients have milder disease that can be treated with medications and diet. Risk factors for CKD include:
 

• Diabetes

• High blood pressure

• Heart disease

• Family history of kidney disease

 

CHRONIC KIDNEY DISEASE (CKD)

Chronic Kidney Disease can be managed with early detection and treatment. Dr. Anuja Porwal will explain how lifestyle changes and medication can help to slow the progression of the disease and improve your quality of life. Often-times people are frightened by the thought of damaged kidneys, and if they do not have visible symptoms they ignore the problem. One of Dr. Anuja´s main objectives in working with patients is to educate them on the realities of kidney disease. It is a disease that you can have an impact on and halt progression. Being proactive, managing your disease, and monitoring the patient while advocating preventive measures is Dr. Anuja´s philosophy that results in much better outcomes overall.

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ACUTE RENAL FAILURE (ARF)

Acute renal failure is the rapid breakdown of renal (kidney) function that occurs when high levels of uremic toxins (waste products of the body's metabolism) accumulate in the blood. ARF occurs when the kidneys are unable to excrete (discharge) the daily load of toxins in the urine

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Patients with acute kidney injury generally should be hospitalized unless the condition is mild and clearly resulting from an easily reversible cause. The key to management is assuring adequate renal perfusion by achieving and maintaining hemodynamic stability and avoiding hypovolemia. In some patients, clinical assessment of intravascular volume status and avoidance of volume overload may be difficult, in which case measurement of central venous pressures in an intensive care setting may be helpful.

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In some patients, the metabolic consequences of acute kidney injury cannot be adequately controlled with conservative management, and renal replacement therapy will be required. The indications for initiation of renal replacement therapy include refractory hyperkalemia, volume overload refractory to medical management, uremic pericarditis or pleuritis, uremic encephalopathy, intractable acidosis, and certain poisonings and intoxications.

Patients with acute kidney injury are more likely to develop chronic kidney disease in the future. They are also at higher risk of end-stage renal disease and premature death. Patients who have an episode of acute kidney injury should be monitored for the development or worsening of chronic kidney disease.

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4. USG GUIDED RENAL BIOPSY

A percutaneous (through the skin) renal (kidney) biopsy is a procedure where, under local anaesthetic (LA), a needle is passed through the skin into the kidney to obtain a piece of kidney tissue. The piece of kidney tissue can then be examined under the microscope to ascertain what is causing your kidney problem. The kidney is identified with ultrasound equipment in the radiology department, and the ultrasound scan used to guide the needle into the kidney for the biopsy. .

Why is the biopsy necessary? 
Investigation of kidney disease includes a combination of history, examination, and both radiology and laboratory tests. Sometimes these tests do not complete the picture of the condition affecting the kidneys. The kidney biopsy is required in order to both guide in the treatment of the condition, and give information about the prognosis (outlook, or what the future may bring). 

The main reasons for a biopsy are: abnormal kidney function (elevated plasma creatinine), and / or proteinuria (protein in the urine), and / or haematuria (blood in the urine).

How long does the biopsy take?
The actual procedure takes about 30 to 45 minutes. Often the biopsy can be performed as a day case. This means no overnight stay. After the biopsy you will need to remain for observation for several hours. 

When may I return to work?
Most retired people, sedentary people, home and office workers usually can return to normal activities after two (2) days rest. No heavy lifting or moving of heavy items (eg. furniture, baskets of wet-washing, or heavy bags of grocery items) for two days. Physically active people (e.g. manual labouring occupations, long-haul drivers, and sports people) should not return to their normal activities for three to four days. This is to minimise the risk of bleeding late after the biopsy.

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5. COMPLICATED URINARY TRACT INFECTION

Urinary tract infections happen when bacteria get into the urethra and travel up into the bladder. If the infection stays just in the bladder, it is a called a bladder infection, or "cystitis." If the infection travels up past the bladder and into the kidneys, it is called a kidney infection or " pyelonephritis."

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Bladder infections are one of the most common infections, causing symptoms of burning with urination and needing to urinate frequently. Kidney infections are less common than bladder infections, and they can cause similar symptoms, but the can also cause fever, back pain, and nausea or vomiting.

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Management of patients with recurrent urinary tract infections and also identify the risk factors which has led to UTI (e.g. structural kidney problems like vesicoureteric reflux, posterior urethral valve etc, bladder dysfunction, stones). If not recognized and treated early it may lead to renal deterioration on long term.

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6. RESISTANT HYPERTENSION

High blood pressure, also called hypertension, is extremely common and contributes to heart disease, strokes and chronic kidney disease. It is also an important cause of dementia. Normal blood pressure is less than 120/80. 
 

• Risk factors for hypertension include: 

• Obesity

• Smoking

• Lack of physical activity

• Too much salt in the diet

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Evaluation and management of hypertension in majority of young hypertensive patients, cause of hypertension is due to the kidney related problems like renal artery stenosis. evalution of such diseases require special imaging tests like renal doppler and angiography.

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