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Renal Critical Care

The renal critical care unit provides advanced treatment and care facilities for acute and chronic renal disease patients. The experts at the renal critical care unit have hands-on experience with the latest innovations related to renal replacement methods and delivering dialysis to critically ill patients. In addition, patients with severe fluid and electrolyte imbalances and acid-base disorders are also treated at the renal critical care unit.

"Critical Care Medicine"

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Diseases and Conditions

  • Acute Renal Failure: This is a condition characterized by a sudden inability of the kidneys to filter waste materials from the blood. It results in the accumulation of waste in the blood. Patients experience nausea, reduced urine output, shortness of breath, fluid retention, chest pain, an irregular heartbeat, and weakness.
  • Chronic Renal Failure: Patients suffering from chronic renal failure have a progressive loss of the kidney's ability to filter blood over several months or years. The severity of the symptoms depends upon the extent of the loss of kidney function.
  • Renal Transplantation: It is a surgical procedure that involves the replacement of the failed kidney with a new, healthy donor kidney. The doctor recommends a renal transplant when other non-invasive and invasive treatment methods cannot provide relief from the symptoms.
  • Severe Urinary Tract Infections: Urinary tract infections involve infection in one or more parts of the urinary tract. The urinary tract includes the kidney, ureters, bladder, and urethra. The symptoms of urinary tract infections are a strong urge to urinate, pain and burning sensation during urination, strong smelling urine, increased urination frequency, cloudy urine, and pain in the pelvic region.

Procedures and treatment

  • Conventional Hemodialysis: Hemodialysis is a renal replacement therapy that involves filtering the blood through an external device in patients with reduced kidney function. Conventional hemodialysis is generally done thrice a week and requires 3-4 hours per session.
  • Sustained Low-Efficiency Dialysis (SLED): It is a type of dialysis performed in the intensive care unit on patients with acute renal failure and hemodynamic instability. The advantages of SLED include excellent hemodynamic tolerability, effective small solute clearance, and flexibility in the treatment schedule.
  • Continuous Renal Replacement Therapy (CRRT): This slow and continuous renal replacement therapy ensures fluid and solute homeostasis. It is used in patients with volume overload, hyponatremia, hyperkalemia, uremia, hyperphosphatemia, metabolic acidosis, encephalopathy, electrolyte abnormalities, pericarditis, and drug and chemical toxicity. The techniques for CRRT are continuous venovenous hemofiltration, continuous venovenous hemodiafiltration, and continuous venovenous hemodialysis.
  • Plasma Exchange Therapy: Plasma exchange therapy, also known as plasmapheresis, is used to eliminate molecular substances of higher weight, such as immune complexes and immunoglobulins, from plasma. It is indicated as adjuvant therapy, with hemodialysis, in patients with severe acute kidney injury. Some important therapeutic plasma exchange modifications are immune adsorption, double membrane filtration, and microfiltration.
  • Renal Infections Management: Antibiotics are considered first-line therapy in kidney infections. It is important to take the complete course of antibiotics even if the patient experiences reduction in symptoms within the first few days of treatment. If the patient has a severe kidney infection, hospitalization is recommended, and the management involves antibiotics and fluid resuscitation. In cases of recurrent kidney infections, the patient undergoes a comprehensive anatomical examination, and surgery may be required to correct the anatomical abnormality causing repeated infections.
  • Dyselectrolytemia Management: Hemodialysis may be followed by several acute and chronic complications. Dyselectrolytemia is a condition that involves alteration in the levels of electrolytes in the blood when it comes in contact with the dialysate during dialysis. It results in cardiovascular complications and increases mortality and morbidity in patients undergoing dialysis. The treatment depends on the ionic profile of the patient and is customized accordingly.

Faq's

Acute Renal Failure, also known as acute kidney injury (AKI), refers to a sudden loss of kidney function. It can occur due to various factors such as dehydration, severe infection, medication side effects, or underlying health conditions.

The treatment for Acute Renal Failure depends on the underlying cause and severity of the condition. It may involve fluid resuscitation, medications to support kidney function, addressing any infections or blockages, and sometimes dialysis in severe cases.

Chronic Renal Failure refers to the gradual and irreversible loss of kidney function over time. This condition often develops as a result of long-standing health issues like diabetes, high blood pressure, or other chronic diseases affecting the kidneys.

While there is no cure for Chronic Renal Failure once it reaches an advanced stage called End-Stage Kidney Disease (ESKD), early detection and management can help slow down its progression and preserve kidney function through lifestyle changes, medication management, and possibly renal replacement therapy such as dialysis or renal transplantation.

Eligibility criteria for renal transplantation include having End-Stage Kidney Disease with significant decline in kidney function that requires regular dialysis treatments or has severely impacted daily life activities. Additionally, individuals must undergo thorough medical evaluations to assess their overall health status before being considered suitable candidates for transplantation.

Renal transplantation offers excellent outcomes in terms of both improved quality of life and long-term survival rates compared to ongoing dialysis treatments alone.

Severe Urinary Tract Infections (UTIs) refer to infections that affect the urinary system, including the kidneys, bladder, ureters, and urethra. These infections can lead to significant discomfort and complications if left untreated.

Treatment for severe UTIs typically involves a course of antibiotics specific to the type of bacteria causing the infection. It is important to seek medical attention promptly as untreated or recurrent UTIs may result in kidney damage or other complications.

  • Do not delay or skip the dialysis sessions.
  • Undergo complete blood checkups, especially hemoglobin, at least once a month.
  • Incorporate an adequate amount of protein into the diet.
  • Counter anxiety and depression, and maintain a positive attitude.
  • Take all medications as prescribed. Do not discontinue any medication without consulting your doctor.

The causes of chronic renal failure are high blood pressure, type 1 and type 2 diabetes, polycystic kidney disease, glomerulonephritis, prolonged urinary tract obstruction, interstitial nephritis, recurrent kidney infection, and vesicoureteral reflux.