Nephrology
Introduction
Nephrology
Nephrology is specialty of medicine concerned with kidney physiology, kidney disease, the treatment of kidney problems and renal replacement therapy. Systemic conditions that affect the kidneys (e.g. diabetes and autoimmune disease) and systemic problems that occur as a result of kidney problems (e.g. metabolic bone disease and hypertension) are also studied in nephrology.
The Department of Nephrology provides comprehensive care across the spectrum of kidney diseases. The department’s transplant facilities are engineered to deliver quality care and successful outcomes even in ABO-incompatible transplants. Our team of experienced doctors is recognised for their superior clinical skills and treats all categories of patients from children to elders. We have an eminent team of kidney transplant specialists, nephrologists, urologists and the technical expertise needed to meet the challenges of this life-saving procedure.
Treatments in nephrology can include medications, blood products, surgical interventions (urology, vascular or surgical procedures), renal replacement therapy (dialysis or kidney transplantation) and plasma exchange. Kidney problems can have significant impact on quality and length of life, and so psychological support, health education and advanced care planning play key roles in nephrology.
Chronic kidney disease is typically managed with treatment of causative conditions (such as diabetes), avoidance of substances toxic to the kidneys (nephrotoxins like radiologic contrast and non-steroidal anti-inflammatory drugs), antihypertensives, diet and weight modification and planning for end-stage kidney failure. Impaired kidney function has systemic effects on the body. An erythropoetin stimulating agent may be required to ensure adequate production of red blood cells, activated vitamin D supplements and phosphate binders may be required to counteract the effects of kidney failure on bone metabolism, and blood volume and electrolyte disturbance may need correction.
Auto-immune and inflammatory kidney disease, such as vasculitis or transplant rejection, may be treated with immunosuppression. Commonly used agents are prednisone, mycophenolate, cyclophosphamide, ciclosporin, tacrolimus, everolimus, thymoglobulin and sirolimus. Newer, so-called “biologic drugs” or monoclonal antibodies, are also used in these conditions and include rituximab, basiliximab and eculizumab. Blood products including intravenous immunoglobulin and a process known as plasma exchange can also be employed.
When the kidneys are no longer able to sustain the demands of the body, end-stage kidney failure is said to have occurred. Without renal replacement therapy, death from kidney failure will eventually result. Dialysis is an artificial method of replacing some kidney function to prolong life. Renal transplantation replaces kidney function by inserting into the body a healthier kidney from an organ donor and inducing immunologic tolerance of that organ with immunosuppression. At present, renal transplantation is the most effective treatment for end-stage kidney failure although its worldwide availability is limited by lack of availability of donor organs.
Medical Procedure
- Blood urea nitrogen (BUN) test
- Creatinine test
- Hemodialysis
- Hormone therapy for breast cancer
- Intravenous pyelogram
- Kidney biopsy
- Kidney transplant
- Microalbumin test
- Nephrectomy (kidney removal)
- Open prostatectomy
- Penile implants
- Percutaneous nephrolithotomy
- Peritoneal dialysis
- Prostate biopsy
- Prostate laser surgery
- Testicular exam
- Transurethral incision of the prostate (TUIP)
- Transurethral microwave therapy (TUMT)
- Transurethral resection of the prostate (TURP)
- Urinalysis