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.

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.

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.

Read More About Management of Electrolyte and acid base disorders 

d] 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.

4. 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.

5. 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.

6. 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.

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.