CENTER OF EXCELLENCE - Dialysis

The department of Nephrology at Primus provides comprehensive and high quality services. It has state of art Advanced Kidney Dialysis (AKD) unit. The department focuses to provide highest quality medical care with a human touch. The department is one of the first few centers in India to provide state of Art Renal Replacement Therapy.

Dialysis Unit

Latest generation, state of art fifteen bicarbonate haemodialysis machines with volumetric ultrafiltration and adjustable sodium facility, provide better patient safety profile.

We provide state of Art R.O.(Reverse Osmosis) water for the dialysis, to ensure patient safety and prevent long term complications on haemodialysis. Facility for continuous monitoring of sick patient on dialysis through highly sophisticated monitors throughout the dialysis procedure is available. Each haemodialysis session is for four hours duration. We make sure that adequate dialysis is given to the patients without compromising on duration of dialysis sessions. As, some of the hospitals are giving, only three hours of dialysis in each sessions, in which patients have to take more than twice or thrice weekly dialysis in order to get adequate dialysis. Supported by highly trained Medical, Technical and Nursing staff, our dialysis unit provides the best quality care to all patients.

Continuous Renal Replacement Therapy

One of the few centers in India to provide highly sophisticated dialysis for critically ill patients in ICU/ICCU with multi-organ failure, where peritoneal or routine haemodialysis are not possible for various reasons Various procedures done with this technique are

  • SCUF (Slow Continuous Ultra filtration)
  • CVVH (Continuous Veno-Venous hemofiltration)
  • CVVHD (Continuous Veno-Venous haemodialysis)
  • CVVHDF (Continuous Veno-Venous hemodiafiltration)

Plasmapheresis & Plasma Exchange

These facilities of Plasmapheresis & Therapeutic Plasma Exchange (TPE) are available for renal and non-renal patients such as LGB syndrome and myasthenia gravis. Chronic Peritoneal Dialysis/Automated

Hemodialysis

Blood is pumped outside the body to an artificial kidney machine. The machine cleanses the blood and returns it to the body. Only a small amount of blood is out of the body at any time.

A “istula (the surgical linking of an artery to a vein) provides access to blood vessels. So does a graft (tubing surgically placed under the skin, linking an artery to a vein).

Two needles are placed into the fistula or graft. The needles are then attached by plastic tubing to a special filter. This filter is an artificial kidney called a dialyzer. One needle withdraws blood for cleansing. The other needle returns filtered blood to the body.

A pump pushes blood through the dialyzer. Blood passes on one side of the filter. Solution made by the dialysis machine passes on the other side. The solution draws excess fluid and waste out of the blood. A filter is used with pores large enough to allow waste to leave. Larger molecules like blood cells cannot pass through the filter. The average person receives three treatments per week. Each treatment lasts three to four hours.

Peritoneal dialysis

Continuous Ambulatory Peritoneal Dialysis (CAPD)Autonomic Peritoneal Dialysis (APD)Peritoneal dialysis occurs inside the body. It uses your peritoneal membrane (the lining of your abdomen) as the filter. For this treatment, a tube called a catheter is surgically placed through the wall of your abdomen. Special dialysis solution will flow into the peritoneum through the catheter. Waste products and excess fluids pass from the blood. They move through the peritoneal membrane, into the dialysis solution. Then, they are drained from the peritoneal cavity. Peritoneal dialysis can be performed by hand or by using a machine. Tubing and bags are worn only during the solution exchange.

Continuous Ambulatory Peritoneal Dialysis (CAPD)

CAPD allows gravity to draw dialysis solution in and out of the peritoneal cavity, using system of tubing and bags. With CAPD, you connect tubing and a bag of sterile dialysis solution to the peritoneal catheter. By raising the bag to shoulder level or higher, the solution flows into the peritoneum. When empty, simply remove and throw away the tubing and solution bag.

During daily activities, the peritoneal membrane acts as a filter for your blood. Waste products and excess water transfer to the dialysis solution. After a few hours, you attach new tubing and an empty bag to the catheter. Then, lower the bag to drain the waste-filled filled fluid from the peritoneum.

Connect the tubing set to the catheter. Drain out the used solution. Fill with the new solution. Disconnect the tubing set from the catheter. Throw away the used solution, disposable tubing and bags.

The Advantages of Peritoneal Dialysis

  • Patient very involved in self-care
  • Control over schedule/freedom
  • Less restricted diet
  • Typically, once a month clinic visits
  • No needles
  • More steady physical condition
  • Typically, no daytime exchange (APD)

The Disadvantages of Peritoneal Dialysis

  • Four exchanges per day
  • Nightly machine exchange (APD)
  • Permanent external catheter.
  • Some risk of infections
  • Potential weights gain
  • Store supplies at home
  • Body image change

AV graft procedures with AVF

An AV graft is done when a patient does not have a suitable superficial vein for the creation of an AV fistula. It is similar to an AV fistula, except an artificial graft (a tube made out of Teflon) is used to connect an artery to a vein. The graft is tunneled underneath the skin, so nothing sticks out of the patient AV grafts are inserted much like AV fistulas are created. Instead of one small incision, usually two small incisions are made. It is still usually done under local anesthesia and patients usually go home the same day.

An AV graft can be used approximately three weeks after it inserted. As with an AV fistula, hemodialysis access is achieved by way of two inserted needles. One needle drains blood out of the patient and into the dialysis machine so the blood can be filtered. The second needle returns the filtered blood back to the patient.

Procedures

  • Renal Biopsies
  • Central venous catheterizations
  • Hemodialysis catheter
  • PD Catheter insertios
  • Perm cath / Tunneled cuffed catheter insertions
  • AV Fistula and Graft placements
  • Cystoscopy and lithotripsy

Why Choose Primus

If you have advanced kidney disease, or you’re on dialysis, you may be hoping a kidney transplant will improve the quality and quantity of your life. We want those outcomes for you as well. Unfortunately, not everyone is a candidate for transplant. Thanks to our transplant specialists’ extensive experience, we are often able to accept into our kidney transplant program people who have been turned away elsewhere due to their complex medical conditions.

Options if You've Had a Prior Transplant

If you’ve had a prior transplant, we have multiple anti-rejection regimens to offer you. These options can make it more likely you’ll find a match among potential living donors and more likely we can waitlist you for a deceased donor transplant. If your immune system is highly sensitized, our innovative, newly available approaches are proving better at overcoming this problem.

We Perform Multi-Organ Transplants

Our colleagues in the other Primus organ transplant teams share our commitment to providing you the life-changing transplant you need with the best possible outcome. We regularly partner with them to help you and your caregivers throughout each step of the process.

Fast Evaluation

We offer a comprehensive, one-day evaluation. You’ll be seen by all the necessary specialists - a nephrologist, transplant surgeon.

Nephrologists and Kidney transplant surgeons
pict

Dr. M.S.Jha

Director & HOD - Advanced Urology, Uro-Oncology & Kidney Transplant
OPD Timings
Monday - Saturday
9 A.M to 5 P.M
pict

Dr. ​Prem​ ​Prakash​ ​Varma

Senior Consultant in Department​ ​of​ ​Nephrology
OPD Timings
Monday - Saturday
9 A.M to 5 P.M