Acute kidney failure, also known as acute kidney injury (AKI), is a sudden decline in kidney function that occurs within a week. It happens when the kidneys are no longer able to filter waste products from the blood, or to balance fluids and electrolytes. 

Causes include severe illness, major surgery, or certain medications. 
AKI causes kidney damage or failure within a short period of time. AKI may damage other organs as well, such as the heart, lungs, and brain. In severe cases, temporary dialysis may be required. AKI can be reversible if caught early but may lead to chronic kidney disease if not promptly addressed.

Symptoms:

• Decreased urine output
• Fluid retention causing swelling in legs, ankles, or feet
• Shortness of breath
• Fatigue
• Confusion
• Nausea
• Chest pain or pressure
• Seizures in severe cases

Diagnostic Approaches:

• Blood tests to measure creatinine and blood urea nitrogen (BUN)
• Urine output monitoring
• Urinalysis to check for blood or abnormal cells
• Imaging studies like ultrasound to check for obstruction
• Kidney biopsy in some cases

Treatment Options:

• Treating the underlying cause (e.g., sepsis, dehydration)
• Stopping medications that may be causing kidney damage
• Intravenous fluids to maintain proper hydration
• Medications to control blood potassium levels
• Dialysis in severe cases

Follow-up Care:

• Regular monitoring of kidney function through blood tests
• Follow-up with a nephrologist, especially if kidney function doesn't fully recover
• Monitoring for development of chronic kidney disease
• Avoiding nephrotoxic medications
• Education on maintaining kidney health

Treatment for AKI depends on the cause and aims to restore normal kidney function. Treatment would include  restricting  fluids and diet, medications, or  dialysis.

 Read to know more 

Chronic Kidney Disease is a progressive condition characterized by gradual loss of kidney function over time. Often caused by diabetes or high blood pressure, CKD can lead to complications like anemia and cardiovascular problems. Early stages of CKD may have no symptoms or mild symptoms, but as the condition worsens, symptoms may become more severe.

Causes of Chronic kidney disease

A gradual loss of kidney function is caused by long-term conditions, such as:

• Diabetes
• High blood pressure
• Inflammation in the kidney
• Polycystic kidney disease
• Autoimmune diseases
• Defects present at birth
• Long-term use of certain medications, such as NSAIDs
• Exposure to toxins, such as lead poisoning 

Symptoms:

• Fatigue
• Swelling in legs and ankles
• Changes in urination patterns
• High blood pressure
• Anemia
• Poor appetite
• Nausea
• Trouble concentrating
• Numbness in hands or feet

Diagnostic Approaches:

• Blood tests to measure urea , creatinine and calculate estimated glomerular filtration rate (eGFR)
• Urine tests to check for protein (albumin) and calculate urine albumin-to-creatinine ratio (UACR)
• Imaging tests like ultrasound or CT scan to assess kidney structure
• Kidney biopsy in some cases

Treatment Options:

• Medications to control underlying conditions like diabetes and high blood pressure
• ACE inhibitors or ARBs to protect kidney function
• Dietary changes to limit sodium, potassium, and phosphorus intake
• Treatment for anemia, if present
• In advanced stages, dialysis or kidney transplant

Follow-up Care:

• Regular monitoring of kidney function through blood and urine tests
• Blood pressure checks
• Adjustment of medications as needed
• Referral to a nephrologist
• Education on lifestyle modifications and diet

Read to know more about CKD

Kidney stones are hard deposits of minerals and salts inside the kidneys. They can range from tiny grains to large stones. Kidney stones usually come out of the body during urination. Passing kidney stones can be extremely painful, but they rarely cause significant problems.

Symptoms:

• Severe pain in the side, back, lower abdomen, or groin
• Pain that comes in waves and fluctuates in intensity
• Pink, red, or brown urine
• Cloudy or foul-smelling urine
• Nausea and vomiting
• Frequent urination
• Urinating small amounts

Diagnostic Approaches:

• Urinalysis to check for blood and crystals
• Blood tests to assess kidney function and look for high levels of calcium or uric acid
• Imaging studies such as CT scan, ultrasound, or X-ray to visualize stones

Treatment Options:

• Pain management with prescription medications
• Increased fluid intake to help pass small stones
• Medical expulsive therapy using alpha-blockers
• Extracorporeal shock wave lithotripsy (ESWL) to break up larger stones
• Ureteroscopy to remove or break up stones
• Percutaneous nephrolithotomy for larger  stones

Follow-up Care:

• Follow-up imaging to ensure all stones have passed
• 24-hour urine collection to identify risk factors for stone formation
• Dietary modifications based on stone composition
• Increased fluid intake to prevent recurrence
• Medications to prevent stone formation in high-risk individuals

Glomerulonephritis is inflammation of the kidney's filtering units (glomeruli). Glomeruli are extremely small filtering units inside the kidneys that filter the blood. Glomerulonephritis can be caused by infections, drugs, or disorders that occur during or shortly after birth (congenital abnormalities). It often gets better on its own. Some forms respond well to treatment, while others may progress to chronic kidney disease. Regular monitoring is essential for managing the condition effectively.

Symptoms:

• Blood in urine (hematuria)
• Foamy urine due to excess protein (proteinuria)
• High blood pressure
• Fluid retention causing swelling (edema)
• Fatigue
• Decreased urine output in severe cases

Diagnostic Approaches:

• Urinalysis to check for blood and protein
• Blood tests to assess kidney function and look for signs of inflammation
• Imaging studies like ultrasound to evaluate kidney size and structure
• Kidney biopsy to determine the specific type of glomerulonephritis

Treatment Options:

• Corticosteroids to reduce inflammation
• Immunosuppressive medications in some cases
• Blood pressure medications, especially ACE inhibitors or ARBs
• Diuretics to reduce fluid retention
• Treatment of underlying conditions (e.g., infections, autoimmune diseases)

Follow-up Care:

• Regular monitoring of kidney function and urine protein levels
• Blood pressure management
• Adjustment of medications as needed
• Monitoring for side effects of immunosuppressive medications
• Dietary modifications, such as limiting salt intake

Polycystic kidney disease is a genetic disorder that causes numerous cysts (small sacs of fluid) to grow in the kidneys. These cysts can interfere with kidney function and cause kidney failure. It can lead to enlarged kidneys and impaired function over time. It’s important to note that individual kidney cysts are fairly common and almost always harmless. Polycystic kidney disease is a distinct more serious condition. As the disease advances, dialysis or kidney transplantation may be necessary.

Symptoms:

• High blood pressure
• Back or side pain
• Blood in urine
• Kidney stones
• Enlarged abdomen
• Headaches
• Urinary tract infections

Diagnostic Approaches:

• Imaging studies such as ultrasound, CT scan, or MRI to visualize kidney cysts
• Genetic testing to confirm the diagnosis and determine the type of PKD
• Blood tests to assess kidney function
• Urinalysis to check for blood or protein in urine

Treatment Options:

• Blood pressure control with ACE inhibitors or ARBs
• Pain management
• Treatment of urinary tract infections
• Tolvaptan to slow cyst growth in some patients
• Dialysis or kidney transplant in advanced stages

Follow-up Care:

• Regular monitoring of kidney function and cyst growth
• Blood pressure management
• Screening for complications such as aneurysms
• Genetic counseling for family members
• Lifestyle modifications, including a low-salt diet and adequate hydration

Kidney infections, also known as pyelonephritis, are a type of urinary tract infection (UTI) that occurs when bacteria, and sometimes fungi or viruses, infect one or both kidneys. This condition can be serious and may require immediate medical attention, especially if it spreads to the bloodstream.

Causes:

Infections: Most commonly caused by Escherichia coli (E. coli), which originates in the gastrointestinal tract and travels up the urinary tract.

Spread from Lower UTIs: Often starts as a bladder infection (cystitis) and progresses to the kidneys.

Blockage or Obstruction: Kidney stones, enlarged prostate, or other obstructions in the urinary tract can increase the risk.

Catheters or Medical Devices: Increases the likelihood of infections.

Weakened Immune System: Conditions like diabetes, or use of immunosuppressive drugs, can raise susceptibility.

Symptoms:

High fever and chills.

Pain in the back, side (flank), or lower abdomen.

Frequent or painful urination (dysuria).

Cloudy, foul-smelling, or bloody urine.

Nausea or vomiting.

Fatigue or malaise.

The elderly may present with confusion or altered mental status instead of typical symptoms.

Women are more prone as they have a shorter urethra, making it easier for bacteria to reach the bladder and kidneys.Pregnancy causes hormonal and anatomical changes that increase vulnerability.Obstructions such as Stones, tumors, or anatomical abnormalities lead to increase in risk.Poor glycemic control in diabetics can fuel bacterial growth.

Complications:

Sepsis: A life-threatening condition if the infection spreads to the bloodstream.

Kidney Abscess: Pockets of pus can form in or around the kidney.

Chronic Kidney Disease (CKD):Prolonged or repeated infections may lead to scarring and long-term damage.

Pregnancy Complications: Can lead to preterm labor or low birth weight if untreated.

Diagnostic Approaches:

• Urinalysis to check for bacteria and white blood cells
• Urine culture to identify the specific bacteria causing the infection
• Imaging studies like CT or ultrasound if recurrent infections occur

Treatment Options:

• Antibiotics tailored to the specific bacteria
• Pain relievers for discomfort
• Increased fluid intake to help flush out bacteria
• In recurrent cases, low-dose antibiotics for prevention

Follow-up Care:

• Completion of prescribed antibiotic course
• Follow-up urine tests to ensure the infection has cleared
• Lifestyle changes to prevent recurrence (e.g., proper hygiene, staying hydrated)
• Investigation of underlying causes in recurrent cases
   

Kidney cancer is an abnormal  growth of cells in the kidneys. It occurs when cells in the kidneys grow out of control, forming a tumour. It's most common in people over 65 and is twice as likely to affect men than women.

Symptoms:

• Blood in urine (hematuria)
• Persistent pain in the side or lower back
• Unexplained weight loss
• Fatigue
• Fever not caused by infection
• High blood pressure that's difficult to control

Diagnostic Approaches:

• Physical examination and medical history review
• Blood and urine tests to check kidney function
• Imaging studies like CT scans, MRI, or ultrasound
• Kidney biopsy in some cases to confirm diagnosis

Treatment Options:

• Surgery (partial or radical nephrectomy)
• Ablation therapies for small tumours
• Targeted drug therapies
• Immunotherapy
• Radiation therapy in certain cases

Follow-up Care:

• Regular imaging scans to monitor for recurrence
• Blood tests to check kidney function
• Management of side effects from treatment
• Lifestyle modifications to reduce risk factors

Read to know more about Kidney Cancer

1. Kidney Function Tests (KFTs): Kidney Function Tests are a group of blood and urine tests that evaluate how well your kidneys are working. These tests are crucial for detecting kidney problems early and monitoring kidney disease progression. These include :
 

Blood Urea Nitrogen (BUN) Test: The Blood Urea Nitrogen (BUN) test is a crucial diagnostic tool for evaluating kidney function. This test measures the amount of urea  in your blood, which is a waste product normally filtered out by healthy kidneys. When kidney function declines, BUN levels in the blood tend to rise.

Read more

 Serum Creatinine Test: The Serum Creatinine Test is a vital diagnostic tool used to evaluate kidney function. Creatinine is a waste product produced by muscle metabolism and is normally filtered out of the blood by the kidneys. When kidney function declines, creatinine levels in the blood tend to increase.

Read more

Glomerular Filtration Rate (GFR): The Glomerular Filtration Rate (GFR) calculation is a crucial tool in assessing overall kidney function. It provides an estimate of how much blood passes through the glomeruli (tiny filters in the kidneys) each minute, offering a comprehensive view of kidney health. GFR is calculated using the serum creatinine level, age, gender, and other factors to estimate kidney function.

Read more

Creatinine Clearance Test: Measures how well the kidneys clear creatinine from the blood over a 24-hour period. Requires both blood and urine samples. A low clearance indicates impaired kidney filtration.

Read more

Electrolyte Levels: Measures key electrolytes such as sodium, potassium, chloride, and bicarbonate. Imbalances may indicate kidney dysfunction, as the kidneys regulate electrolyte levels.

Read more

Urinalysis: Urinalysis is a series of tests performed on a urine sample to detect various kidney and urinary tract issues. This test can detect a wide range of conditions, from urinary tract infections to kidney disease.

What This Test Shows:

• Protein in Urine: Can indicate kidney damage
• Blood in Urine: May suggest kidney stones or other problems
• Urinary Tract Infections: Detects the presence of bacteria or white blood cells
• Glucose Levels: Can indicate diabetes

• Urine culture and sensitivity can detect the organism that has caused the infection and determine which antibiotics would the organism respond to.
  
   

  What to Expect:

• Requires a urine sample
• No special preparation needed
• Results usually available within a day

1. Renal Ultrasound: Renal ultrasound is a non-invasive imaging technique that uses high-frequency sound waves to create detailed images of the kidneys and surrounding structures. This safe and painless procedure is a valuable tool in diagnosing and monitoring various kidney conditions. Ultrasound uses sound waves to create images of your kidneys and urinary tract.

Read more

2. CT Scan: A Computerized Tomography (CT) scan, also known as a CAT scan, is an advanced imaging technique that uses X-rays and computer processing to create detailed cross-sectional images of the body. For kidney diagnostics, a CT scan provides highly detailed images of the kidneys, ureters, and bladder, making it an invaluable tool in nephrology.

Read more

3. Magnetic Resonance Imaging (MRI): Magnetic Resonance Imaging (MRI) is a sophisticated imaging technique that uses powerful magnets and radio waves to create detailed images of the body's internal structures. For kidney diagnostics, MRI provides high-resolution images of the kidneys and surrounding tissues without using ionizing radiation.

Read more

4. Kidney Biopsy: A kidney biopsy is a procedure in which a small sample of kidney tissue is removed for microscopic examination. This advanced diagnostic technique provides detailed information about kidney structure and function at the cellular level, making it an invaluable tool in nephrology.

Read more

Apollo Institute of Nephrology offers comprehensive clinical nephrology services, providing expert care for patients with various kidney-related conditions. 

1. Management of All Kidney Disorders

The clinical nephrology team at Apollo specializes in diagnosing and treating a wide range of kidney disorders, including:

• Acute kidney injury
• Chronic kidney disease (CKD)
• Glomerulonephritis
• Diabetic nephropathy
• Hypertensive kidney disease
• Polycystic kidney disease
• Lupus nephritis
• Kidney stones

The team employs a multidisciplinary approach, utilizing advanced diagnostic tools such as kidney biopsies and specialized imaging techniques to accurately diagnose and stage kidney diseases. Treatment plans are tailored to each patient's specific condition and may include medication management, dietary modifications, and when necessary, renal replacement therapies.

Benefits:

• Early detection and intervention to slow disease progression
• Personalized treatment plans based on individual patient needs
• Access to cutting-edge therapies and clinical trials
• Comprehensive care from a team of specialists

2. Counseling for Kidney Diseases

Apollo Institute of Nephrology places a strong emphasis on patient education and counseling. Dedicated counselors work closely with patients and their families to provide:

• Detailed information about kidney diseases and their management
• Guidance on lifestyle modifications to support kidney health
• Emotional support and coping strategies
• Education on treatment options and their implications

Benefits:

• Improved patient understanding and adherence to treatment plans
• Enhanced quality of life through better disease management
• Reduced anxiety and improved mental well-being
• Empowerment of patients to actively participate in their care

3. Treatment of Associated Conditions

Kidney diseases often coexist with or lead to other health complications. The clinical nephrology team at Apollo provides comprehensive care for these associated conditions, including:

• Hypertension management
• Diabetes care and prevention of diabetic nephropathy
• Anemia treatment
• Bone and mineral disorders
• Cardiovascular complications
• Electrolyte imbalances

Benefits:

• Comprehensive care addressing all aspects of kidney-related health
• Reduced risk of complications through proactive management
• Improved overall health and quality of life
• Coordinated care across multiple specialties for complex cases

Apollo Institute of Nephrology offers comprehensive Renal Replacement Therapies (RRT) for patients with end-stage renal disease (ESRD) or severe acute kidney injury. These advanced treatments are designed to replace the normal blood-filtering function of the kidneys when they can no longer perform adequately. The institute provides a range of RRT options to suit individual patient needs, ensuring optimal care and improved quality of life for those with kidney failure.

1. 24-hour Dialysis Unit

Apollo's 24-hour Dialysis Unit is a state-of-the-art facility that provides round-the-clock dialysis services to patients with acute and chronic kidney failure. This unit is equipped with modern dialysis machines and staffed by experienced nephrologists, dialysis technicians, and nurses.

Key features:

• Continuous availability for emergency dialysis needs
• Flexible scheduling to accommodate patient lifestyles
• Strict infection control protocols
• Regular monitoring and adjustment of treatment plans

Benefits:

• Immediate access to life-saving treatment for acute kidney injury
• Reduced hospitalization rates for chronic dialysis patients
• Improved patient comfort and convenience
• Enhanced ability to manage dialysis-related complications promptly
  
   

Types of dialysis 

1] Hemodialysis

Hemodialysis is a common form of RRT where blood is filtered outside the body using a dialysis machine. Apollo's hemodialysis service utilizes advanced technology to provide efficient and comfortable treatments.

Process:

• Blood is drawn from the patient through a vascular access point
• The blood passes through a dialyzer (artificial kidney) that removes waste and excess fluids
• The cleaned blood is returned to the patient's body

Features:

• High-flux dialyzers for improved toxin removal
• Ultrapure dialysis water systems
• Individualized dialysis prescriptions
• Regular vascular access care and monitoring

Benefits:

• Effective removal of waste products and excess fluids
• Better control of blood pressure and anemia
• Improved overall health and quality of life
• Reduced risk of dialysis-related complications

2. Peritoneal Dialysis

Peritoneal Dialysis (PD) is a home-based dialysis option that uses the patient's peritoneum as a natural filter. Apollo provides comprehensive training and support for patients opting for PD.

Types offered:

• Continuous Ambulatory Peritoneal Dialysis (CAPD)
• Automated Peritoneal Dialysis (APD)

Key components:

• Personalized PD prescription and monitoring
• Patient and caregiver training programs
• Regular home visits by PD nurses
• 24/7 support for PD-related issues

Benefits:

• Greater independence and flexibility in daily life
• Preservation of residual kidney function
• Reduced dietary and fluid restrictions compared to hemodialysis
• Lower risk of bloodstream infections

3. Hemodiafiltration

Hemodiafiltration (HDF) is an advanced form of hemodialysis that combines diffusion and convection principles for enhanced waste removal. Apollo offers online HDF,  where the replacement used in the procedure is generated in real time during the dialysis session. 

Process:

• Combines standard hemodialysis with hemofiltration
• Uses high-flux membranes and increased fluid exchange
• Removes both small and large molecular-weight toxins

Features:

• Real time production of ultrapure replacement fluid
• High-volume HDF for maximum efficiency
• Advanced monitoring systems for treatment optimization

Benefits:

• Superior removal of middle and large molecular weight toxins
• Improved cardiovascular stability during treatment
• Better phosphate control and reduced medication needs
• Potential for improved long-term survival rates compared to standard hemodialysis

Kidney transplantation at Apollo Institute of Nephrology represents the gold standard treatment for end-stage renal disease (ESRD). This surgical procedure involves transplanting a healthy kidney from a donor into a patient with kidney failure. Apollo's transplant program is renowned for its excellence, combining surgical expertise with comprehensive pre- and post-transplant care to ensure optimal outcomes for patients.

1. Living Donor Transplantation

Living donor transplantation involves the transplantation of a kidney from a living donor, typically a close relative or a compatible volunteer, to the recipient.

Key aspects:

• Extensive donor evaluation to ensure suitability and safety
• Advanced tissue typing and cross-matching for optimal donor-recipient compatibility
• Minimally invasive laparoscopic donor nephrectomy when possible
• Comprehensive donor and recipient education programs
• Long-term follow-up care for both donor and recipient

Benefits:

• Shorter waiting times compared to cadaveric transplantation
• Better long-term graft survival rates
• Ability to schedule the transplant surgery in advance
• Opportunity for pre-emptive transplantation before dialysis becomes necessary
• Excellent kidney function immediately after transplantation in most cases

2. Cadaveric Transplantation

Cadaveric transplantation, also known as deceased donor transplantation, involves transplanting a kidney from a recently deceased donor to a recipient on the waiting list.

Key features:

• Collaboration with government committees and networks for efficient allocation
• 24/7 transplant team availability for organ retrieval and transplantation
• Rigorous organ quality assessment protocols
• Advanced preservation techniques to maintain organ viability
• Comprehensive recipient evaluation and preparation

Benefits:

• Provides hope for patients without a suitable living donor
• Allows for a larger pool of potential donors
• Opportunity for patients with rare tissue types to find a match
• Contributes to the broader organ donation ecosystem
• Can lead to successful outcomes comparable to living donor transplants with proper management

Post-transplant care at Apollo includes:

• Tailored immunosuppression regimens
• Regular follow-up appointments and monitoring
• Comprehensive patient education on medication adherence and lifestyle modifications
• Prompt management of any complications or rejection episodes

The Apollo Institute of Nephrology offers a range of advanced interventional procedures to diagnose and treat various kidney conditions. These minimally invasive techniques allow for precise diagnosis, improved treatment outcomes, and reduced recovery times compared to traditional open surgeries. 

1. Kidney Biopsies

Kidney biopsies are diagnostic procedures used to obtain small samples of kidney tissue for microscopic examination. This procedure is crucial for accurate diagnosis and treatment planning for various kidney diseases.

Read More About Kidney Biopsies

2. Long-term Vascular Access

Establishing and maintaining long-term vascular access is essential for patients requiring regular hemodialysis. Apollo's interventional nephrology team specializes in creating and managing various types of vascular access.

Types of access:

• Arteriovenous (AV) fistulas
• AV grafts
• Central venous catheters

Procedures offered:

Vascular Access

Vascular access refers to creating a connection between blood vessels for hemodialysis or other medical treatments. Two common types of vascular access are mentioned:

1.Arteriovenous (AV) Grafts:

A synthetic tube is surgically implanted to connect an artery and a vein. Used when a patient’s veins are not suitable for an arteriovenous fistula (AV fistula).Provides reliable access for dialysis.

2.Central Venous Catheters:

A temporary or semi-permanent catheter inserted into a large vein (e.g., neck, chest, or groin).Used for immediate or short-term dialysis access when other options are unavailable.

Procedures Offered:

1.Fistula or Graft Creation Surgery:

AV Fistula: Directly connects an artery and vein, providing long-term access for hemodialysis.

AV Graft: Uses a synthetic tube to create a connection for patients with unsuitable veins.

2.Angioplasty for Stenosis:

A minimally invasive procedure to widen narrowed blood vessels. Restores blood flow in a narrowed AV fistula or graft.

3.Thrombectomy for Clotted Access:

Removal of blood clots that block vascular access points. Ensures continued use of the access for dialysis.

4.Stent Placement for Recurrent Stenosis:

A stent (a small mesh tube) is placed in a blood vessel to keep it open. Used for cases where narrowing (stenosis) recurs despite angioplasty.

3. Renal Angioplasty and Stenting

Renal angioplasty and stenting are minimally invasive procedures used to treat renal artery stenosis, a condition where the arteries supplying blood to the kidneys become narrowed.

4. Permacath Insertion

Permacath insertion involves the placement of a tunneled central venous catheter for long-term hemodialysis access, particularly in patients awaiting fistula maturation or those unsuitable for other access types.

Critical Care Nephrology at Apollo Institute of Nephrology provides specialized care for patients with acute kidney injuries and related complications in intensive care settings. The department combines expertise in nephrology and critical care medicine to manage complex renal conditions in critically ill patients. 

1. Management of acute renal failure in ICU

This involves rapid assessment and intervention for acute kidney injury in critically ill patients. Utilizes advanced monitoring techniques and renal replacement therapies as needed. Focuses on preserving residual kidney function and preventing further damage. Customises  treatment to underlying causes while managing associated complications.

Read More About Management of Renal Failure

2. Treatment of volume disturbances

Precise management of fluid balance in critically ill patients with kidney dysfunction. Employs advanced hemodynamic monitoring to guide fluid therapy and diuretic use. Utilizes ultrafiltration techniques when necessary to manage fluid overload. Aims to optimize organ perfusion while preventing pulmonary edema and other complications.

3. Management of electrolyte and acid-base disorders

A comprehensive approach to correcting electrolyte imbalances and acid-base disturbances. Utilizes continuous monitoring and frequent laboratory assessments to guide therapy. Implements targeted interventions, including electrolyte replacement and buffer therapy. Addresses underlying causes while preventing arrhythmias and other associated complications.

4. Continuous Renal Replacement Therapy (CRRT)

Continuous Renal Replacement Therapy (CRRT) is a type of dialysis treatment used primarily for critically ill patients with acute kidney injury (AKI), especially when they are hemodynamically unstable (e.g., low blood pressure). Unlike conventional dialysis, CRRT is performed continuously over 24 hours to provide a slow, gentle process of fluid and waste removal, making it ideal for unstable patients in intensive care settings.

How CRRT Works: CRRT uses an extracorporeal (outside the body) circuit to remove blood, filter it through a dialysis or hemofiltration membrane, and return the cleaned blood to the patient. 

It helps manage:

• Fluid overload
• Electrolyte imbalances (e.g., hyperkalemia)
• Acidosis
• Toxin removal

Types of CRRT:

There are four main types of CRRT, depending on how fluids and solutes are removed:

Continuous Veno-Venous Hemofiltration (CVVH):Removes solutes through convection (solvent drag) and primarily targets middle- and large-molecular-weight toxins. Requires the addition of replacement fluid to maintain balance.

Continuous Veno-Venous Hemodialysis (CVVHD):Removes solutes via diffusion (concentration gradient) to clear smaller molecules like urea and creatinine. Dialysate fluid flows countercurrent to the blood for effective clearance.

Continuous Veno-Venous Hemodiafiltration (CVVHDF):Combines diffusion and convection to maximize the removal of small, middle, and large solutes. Involves both replacement fluid and dialysate.

Slow Continuous Ultrafiltration (SCUF):Focuses on fluid removal without significant solute clearance. Useful for managing fluid overload in patients without severe waste accumulation.

5. Hemaabsorption

Specialized blood purification technique to remove specific toxins or inflammatory mediators. Utilizes adsorbent materials to selectively remove harmful substances from the blood. Particularly useful in managing sepsis, drug overdoses, and certain autoimmune conditions. Can be combined with other extracorporeal therapies for enhanced efficacy.

6. Plasmapheresis

Therapeutic procedure that separates and removes plasma from the blood. Used to treat autoimmune disorders, thrombotic microangiopathies, and certain intoxications. Removes harmful antibodies, immune complexes, and other pathogenic factors from circulation. Can be performed in conjunction with plasma exchange to replace removed plasma with donor plasma or albumin.

7. Extracorporeal therapies (including MARS)

Advanced blood purification techniques for managing liver failure and associated complications. Molecular Adsorbent Recirculating System (MARS) provides liver support by removing albumin-bound toxins. Other therapies include plasma exchange and albumin dialysis for various indications. Aims to bridge patients to liver transplantation or recovery of native liver function.

Apollo Institute of Nephrology provides specialized care for children with kidney and urinary tract disorders. This multidisciplinary team combines expertise in pediatric nephrology and urology to offer comprehensive diagnosis, treatment, and long-term management of congenital and acquired renal conditions in infants, children, and adolescents. 
 

Specialized laboratory for microscopic examination of kidney tissue samples. Utilizes advanced techniques for accurate diagnosis of kidney diseases and transplant rejection. Provides detailed analysis of kidney biopsies to guide treatment decisions. Employs expert pathologists with specific training in renal pathology.
 

Advanced genetic testing to determine human leukocyte antigen (HLA) profiles of donors and recipients. Utilizes molecular techniques for high-resolution HLA typing to optimize donor-recipient matching. Crucial for assessing transplant compatibility and predicting graft survival. Supports both living donor and deceased donor transplant programs.
 

Specialized technique for detecting specific proteins in kidney tissue samples. Aids in precise diagnosis of various kidney diseases and transplant rejection. Allows for visualization of immune cell infiltrates and disease-specific markers. Enhances diagnostic accuracy and helps guide targeted therapies.

Read More About Immunohistochemistry
 

Precise measurement of immunosuppressive drug concentrations in patient blood samples. Ensures optimal dosing to prevent rejection while minimizing side effects. Utilizes advanced analytical techniques for accurate and timely results. Supports personalized immunosuppression regimens for transplant recipients.
 

Imaging is crucial for evaluating the structure and function of the kidneys:

a) Ultrasound (Renal Sonography):

Purpose:

• Non-invasive, first-line imaging for assessing kidney size, shape, and abnormalities.

• Detects cysts, stones, obstructions, and tumors.

Doppler Ultrasound:

• Assesses blood flow to and from the kidneys.

b) Computed Tomography (CT):

• CT KUB (Kidneys, Ureters, Bladder):

Identifies kidney stones, tumors, and structural abnormalities.

• CT Angiography:

Evaluates blood vessels in cases of suspected renal artery stenosis or vascular abnormalities.

c) Magnetic Resonance Imaging (MRI):

Purpose:

• Offers detailed imaging without radiation.

• Used for evaluating complex kidney cysts, tumors, and vascular issues.

• MR Angiography (MRA):

• Non-invasive imaging of renal arteries.

d) Nuclear Medicine Scans:

• Renal Scintigraphy:

Measures kidney perfusion and filtration.

• DMSA Scan:

Evaluates kidney function and scarring, often in pediatric cases

Renal Biopsy:

Purpose: A small tissue sample from the kidney is analyzed under a microscope.

Indications:

• Diagnose glomerulonephritis, lupus nephritis, or nephrotic syndrome.

• Evaluate unexplained kidney failure.

Guided Techniques:

• Performed under ultrasound or CT guidance for accuracy and safety.

a) Blood Pressure Monitoring:

• Continuous monitoring for detecting hypertension, a leading cause and consequence of kidney disease.

• Ambulatory Blood Pressure Monitoring (ABPM):

Tracks blood pressure over 24 hours to diagnose masked or nocturnal hypertension.

b) Renal Angiography:

• Invasive imaging technique using contrast dye to evaluate renal arteries for stenosis or vascular abnormalities.

c) Urodynamic Testing:

• Assesses bladder function in patients with urinary disorders related to kidney function.

d) Cystoscopy:

• Examines the bladder and lower urinary tract for obstructions or abnormalities.

a) Advanced Biomarkers:

• NGAL (Neutrophil Gelatinase-Associated Lipocalin):

Early detection of acute kidney injury (AKI).

• KIM-1 (Kidney Injury Molecule-1):

Marker for tubular injury in AKI.

• Fibroblast Growth Factor 23 (FGF23):

Assesses mineral metabolism in chronic kidney disease (CKD).

b) Genetic Testing:

• Identifies genetic conditions like polycystic kidney disease (PKD) or Alport syndrome.

AI tools are being developed for:

• Predicting progression of CKD and AKI.

• Enhancing interpretation of imaging studies.

• Identifying risk factors from electronic health records.

• Portable devices for quick assessment of kidney function in emergency settings.

• Examples include creatinine meters or electrolyte analyzers.

1. Advanced dialysis units for standard hemodialysis

Advanced dialysis units at Apollo Institute of Nephrology offer state-of-the-art hemodialysis treatment for patients with kidney failure. These units feature high-efficiency dialyzers, precise fluid and electrolyte management systems, and advanced monitoring capabilities. They provide options for high-flux and low-flux dialysis, tailored to individual patient needs. The units are equipped with ultrapure water systems to minimize the risk of contamination and inflammation.

2. Continuous Renal Replacement Therapy (CRRT) systems

CRRT systems provide continuous, gentle dialysis for critically ill patients with acute kidney injury or fluid overload. These systems operate 24/7, slowly removing waste products and excess fluids from the blood. They offer various modalities such as continuous venovenous hemofiltration (CVVH), hemodialysis (CVVHD), and hemodiafiltration (CVVHDF). CRRT is particularly beneficial for hemodynamically unstable patients who cannot tolerate standard intermittent hemodialysis.

3. Sustained Low Efficiency Daily Dialysis (SLEDD) equipment

SLEDD is a hybrid renal replacement therapy that combines features of both intermittent hemodialysis and CRRT. It provides extended dialysis sessions (usually 6-12 hours) at lower blood and dialysate flow rates compared to standard hemodialysis. SLEDD equipment at Apollo allows for customizable treatment durations and intensities, making it suitable for a wide range of patients, including those with hemodynamic instability.

4. Molecular Adsorbent Recirculating System (MARS) for combined kidney and liver failure

MARS is an advanced extracorporeal liver support system designed for patients with acute-on-chronic liver failure or acute liver failure, often accompanied by kidney dysfunction. It combines hemodialysis with albumin dialysis to remove both water-soluble and albumin-bound toxins. The system uses a specialized albumin-containing dialysate that is regenerated through multiple adsorbent columns, allowing for efficient removal of liver toxins.

Your kidney care journey begins with a complete evaluation to help us understand your health needs and develop the best plan for you. During this visit, you can expect:

• Review of Medical History: The nephrologist will go over your past health issues, family history of kidney disease, and any symptoms you've been experiencing.
• Physical Examination: A thorough physical check to assess your current health.
• Diagnostic Testing: Initial tests may include blood work, urinalysis, or other tests to understand your kidney health.
• Risk Assessment: Based on your health history and test results, we assess your risk for kidney disease.
• Treatment Planning: After reviewing the findings, the doctor will discuss potential treatment options and answer any questions, helping you understand the next steps.

During your treatment, whether you're undergoing dialysis or preparing for a transplant, our team is here to ensure you're informed, comfortable, and well cared for. This phase includes:

• Detailed Information on Procedures: We explain what to expect from any treatment or procedure so that you feel fully prepared.
• Preparation Guidance: Before any procedure, you'll receive instructions to help you get ready and feel confident.
• Updates During Hospital Stay: While you're in the hospital, we keep you and your family informed of your progress every day.
• Daily Physician Rounds: Your nephrologist visits you daily to check your recovery and make any necessary adjustments to your treatment.

Supportive Care Team: Our nurses, specialists, and support staff work together to ensure you receive the highest quality of care.

After treatment, we focus on helping you heal and adapt to any lifestyle changes through a personalized recovery program:

• Custom Rehabilitation Plans: We create a plan just for you, including activities to improve kidney health and overall well-being.
• Dialysis Support: For patients on dialysis, we provide ongoing support and monitoring to ensure effective treatment.
• Transplant Follow-up: Post-transplant patients receive specialized care to prevent rejection and maintain graft function.
• Psychological Support: We provide emotional support to help you cope with any concerns, ensuring a positive mindset throughout recovery.
• Nutritional Guidance: Our dietitians advise on kidney-friendly foods to support long-term recovery and wellness.

Preparing for Your Visit
We would like  every patient to feel well prepared and comfortable. Following a few steps before your appointment can help us deliver the best care for you.

Before Your Appointment
Please carry with you the following documents and records:

• Medical History
• Previous Test Results
• Medication List
• Insurance Information
• Identification Documents
• Questions or Concerns

Medical Records
If available, bring any relevant health documents, such as:

• Reports from previous kidney procedures
• Recent lab results
• Imaging studies (e.g., ultrasounds) on CD or DVD
• Referral letters from other doctors
• Recent urine test reports
• Any other health documents that may help us understand your needs

During Your Visit
Your first consultation usually includes:

• Discussion with Your Nephrologist
• Physical Examination
• Review of Medical Records
• Diagnostic Tests
• Developing a Treatment Plan

At Apollo Institute of Nephrology, we are committed to providing comprehensive, personalized care throughout your kidney health journey.

Before you arrive, we help you plan and prepare for your visit:

• Medical Documentation Review: Our team reviews your medical records to understand your needs and create a treatment plan.
• Treatment Planning: We design a personalized care plan tailored to your specific kidney condition.
• Cost Estimates: We provide transparent cost estimates to help you plan financially.

Visa Assistance: We assist with visa requirements and provide documentation to support your medical travel.

While you are at Apollo Institute of Nephrology, we make sure you and your family feel fully supported:

• Dedicated Coordinators: You'll have a personal care coordinator to guide you through every step of your stay.
• Language Support: Trained interpreters are available to help you communicate clearly with your healthcare team in your preferred language.
• Cultural Considerations: We respect cultural needs and provide services that align with your preferences.
• Family Accommodation: We assist with finding comfortable accommodation options for your family.

Regular Updates: Our team provides updates on your treatment and recovery to keep both you and your family informed.

After your treatment, we continue to support you to ensure a successful recovery:

• Follow-Up Planning: We arrange follow-up appointments and consultations to monitor your recovery.
• Telemedicine Options: You can stay connected with our nephrologists through virtual consultations.
• Coordination with Home Country Physicians: We collaborate with your local doctor to ensure you receive consistent care.

Digital Health Records: Access your medical records online for easy sharing and future care needs.