Nephrology is a medical discipline that covers the diagnosis, treatment and management of kidney diseases. Commonly treated disorders include kidney stones and kidney failure. Nephrology also involves comprehensive care for kidney diseases associated with other illnesses and conditions, such as hypertension and diabetes.

Renal Transplant

The Centres of Nephrology and Urology have a sizeable and comprehensive renal transplant program, having performed both autologous and cadaveric transplants. It has the first organ transplant registry in India. The Centres also perform minimally invasive surgery for renal donors thereby minimising post-operative recovery time and hospitalisation.

The stringent infection control practices, immunosuppressive protocols and proactive vigil for complications and their prompt management make the service a huge success. The Transplant unit also integrates, analyzes and addresses the health needs of the transplant patient and his or her family. The Apollo Hospitals group has performed more than 10,000 kidney transplants till date. We perform nearly 400 Kidney transplants each year.

State-of-the-art procedures for kidney transplantation include:

• Cadaveric renal transplantation
• Cadaver-donor kidney transplantation
• Living donor kidney transplants (from both related and unrelated donors)
• Laparoscopic donor Nephrectomy

Dialysis

Dialysis is the process of removing wastes and impurities from the blood and is done when a person's kidney doesn't function properly, due to kidney failure, severe diabetes, a congenital kidney disease, hypertension or other health problems.

Dialysis is a form of renal replacement therapy. Dialysis can be done for a short period, in case the patient is waiting for a kidney transplant. If the patient doesn't qualify for the transplant, life-long dialysis will be needed.

There are two types of dialysis:

Hemodialysis

In hemodialysis, a machine called a dialyser is used to filter the blood. A catheter is placed in a vein in the arm, and a needle inserted into this catheter is connected to a tube that carries blood into the dialyser. In the dialyser, a semi-permeable membrane separates the blood from a dialysis fluid. The wastes in the blood pass through the membrane into the fluid, and the clean blood is sent into the body.

Peritoneal Dialysis

In peritoneal dialysis, the abdomen is filled with a glucose-based liquid through a small hole created in the peritoneal membrane (lining of the abdominal cavity). This solution cleans the blood of wastes.

Peritoneal dialysis can be done when the patient is performing regular activities. Such dialysis is called Continuous Ambulatory Peritoneal Dialysis. The patient will be trained to infuse and drain out the fluid a few times every day. Peritoneal dialysis can also be done with the help of a machine, at night, when the patient is sleeping.

Plasma exchange may be done along with dialysis, to filter clotting factors and unwanted proteins. Charcoal hemofiltration in which a charcoal layer is used to remove wastes from blood, a process similar to dialysis, may sometimes be used.

Urology is the branch of medicine that focuses on diagnosing, treating and managing disorders of the urinary and male and femalegenital tracts. Commonly treated problems include bladder and kidney stones, diseases of the prostate gland, male infertility, erectile dysfunction and urinary incontinence.

The Centers of Urology at Apollo Hospitals provide diagnostic and surgical services for all genitourinary disorders. Areas of expertise include Renal Transplantation, Uro-oncology (urological cancers), Reconstructive Urology, Endo-urology for stone diseases (including Flexible Ureteroscopy, Percutaneous Nephrolithotomy and Laparoscopic Nephrectomy), Neuro-Urology with urodynamic facility, Andrology for treatment of male infertility and erectile dysfunction (including prosthetic surgery), Female Urology and Paediatric Urology.

The team of Urologists at Apollo Hospitals, continuously seek to develop ways to improve surgical results while reducing recovery time and side effects. They practise advanced surgical techniques including those for bladder preservation and diseases of the prostate, treatment of benign inflammatory and infectious disorders, diagnosis and treatment of kidney stones, all types of voiding dysfunction (including incontinence, obstruction and reconstruction of the upper and lower urinary tract), male infertility, and impotence. Surgical diseases of the adrenal gland are also treated.

Key Procedures

Urologic Oncology

The Centers offer specialized treatment of urologic malignancy with emphasis on the management of patients with cancers of the Kidney (radical nephrectomy), bladder (radical cystectomy), prostate (radical prostatectomy), testis and penis. Patients benefit from innovative surgical techniques for treatment of pelvic and retroperitoneal malignancy as well as reconstructive efforts including "neo bladder". A multidisciplinary approach is used with all cancer patients, with regular interactions with faculty from both Medical Oncology and Radiation Therapy.

Reconstructive Surgery

We have expertise in all areas of urinary tract, pelvic and genital reconstruction, including treatment of abnormalities resulting from injury, disease or surgical therapy. Faculty surgeons have extensive experience in both upper and lower urinary tract reconstruction including treating complex urethral strictures using buccal mucosa.

Laparoscopy (Surgery through a "Keyhole")

Apollo Hospitals has a rapidly developing program in Laparoscopic Urologic surgery ranging from ablative and reconstructive renal surgery. Traditional surgery usually requires long, deep incisions and a lengthy recovery period. Minimally invasive surgery uses a thin, telescope-like instrument called an endoscope, which is inserted through a small incision. Laparoscopic nephrectomy (Removal of kidney through key hole) is replacing open nephrectomy throughout the world and is routinely performed here as well.

Endourology

Patients have access to a full spectrum of urologic endoscopic equipment and techniques including both flexible and rigid instrumentation. Techniques include trans-urethral surgery of the urethra, prostate, bladder, ureter and kidney, and percutaneous renal surgery. Kidney stones are removed through keyhole (percutaneous nephrolithotomy) and ureteric stones are removed through "microsurgery" (telescopic surgery). The latest methods of minimally invasive stone surgery are also available, with instrumentation for Ultrasonic Lithotripsy and Pneumatic lithotripsy.

Andrology

The Urologists at Apollo Hospitals specialize in the diagnosis of impotence, reconstructive microvascular surgery, and pharmacological treatment for sexual dysfunction. A variety of treatment options, such as oral agents, Caverject (an injectable therapy), and a prosthetic inflatable penile implant, are used and tailored to fit both the patient's underlying patho-physiology and lifestyle. Assessment and treatment for male infertility is also provided, and microsurgical procedures (reverse vasectomy), vasectomy and epididymal aspiration are performed. The hospital offers the most advanced treatment available for Benign Prostatic Hyperplasia, commonly called BPH or enlarged prostate.

Neuro-urology

Neuropathic bladders secondary to trauma (Spinal cord trauma) and neurologic diseases like stroke and Parkinson's disease are evaluated and managed. Assessment may include complex neuro-urodynamic evaluation to better characterize the urinary continence dysfunction. Treatment options include medical, surgical and/or prosthetic alternatives.

Uro-Gynecology

The subspecialty of Urogynecology is concerned with the diagnosis and treatment of those urinary tract disorders most prevalent in women. These include urinary incontinence and pelvic floor prolapse, voiding dysfunction, recurrent urinary tract infection, urethral syndrome and interstitial cystitis.

Pediatric Urology

The Pediatric Urology Service treats congenital abnormalities of the genitourinary system in children. Reconstructive surgery for hypospadias, cryptorchidism, and other genital abnormalities is usually performed on an ambulatory surgery or short-stay basis.