Introduction

Renal care with a real good track record.

The Department of Nephrology at MMHRC is one of the largest nephrology centers in the country today. Spread across 10,000 sq. ft., it has become a tertiary referral center for the management of high-risk nephrology cases. Under the leadership of Dr. K. Sampath Kumar, the department has taken great strides in diagnosis, treatment, and management of kidney-related ailments. It has been treating the largest number of outpatients in MMHRC for the last four years, with an average of 80 per day. Each year, a 20% increase in growth all areas pertaining to nephrology have been noted.

 

Facilities

  •  A modern hemodialysis unit with a centrally air-conditioned HD unit (unit A & unit B) with 20 new HD machines and one CRRT machine A modern hemodialysis unit with a centrally air-conditioned HD unit (unit A & unit B) with 20 new HD machines and one CRRT machine
  • GE Osmonics RO Systems for ultra-pure water   
  • Surgical procedures performed in the Interventional suite
  • Pre-dialysis counseling and CAPD exchanges given in the CAPD room
  • Renal ICU (RICU) to treat critically ill patients? A post-transplant room with 4 beds and all intensive care facilities
  • 22 general beds, 8 cubicles and 2 special rooms for in-patients
  • 2 bio-medical waste processing rooms
  • Library and classroom
  • Consultant’s room and Nephrology office
  • A team comprising 40 trained medical professionals and technicians

HD Program:

MMHRC today has one of the largest HD units in South India. The unit is installed with modern dialysis machines from Braun, Fresenius, Kawasumi, Gambro, and Cobe. 

  • Treatment areas A, B, C and D with 30 machines; separate washing room and dialyzer locker for viral negative and positive patients; store for consumables, and administrative area
  • Separate machines for HCV and HBsAg infected patients
  • The unit performs around 2000 hemodialyses per month
  • In the 24-hour hemodialysis program is planned a ‘nocturnal long-time hemodialysis’
  • State-of-the-art GE Osmonics Water Treatment System with Homespring that ensures high standards of care in the hemodialysis
  • Plasmapheresis and acute peritoneal dialysis including automated cycler exchanges performed regularly
  • Intensive care dialysis performed in the form of CAVH, CVVH, SCUF, CVVHDF and SLED for patients with liver, heart and kidney failure even if the blood pressure is low
  • Renal dietician to take care of the nutritional aspect of the ESRD patients
  • Maintenance dialysis patients are enrolled in the deceased donor transplantations (cadaver transplantations) list

CAPD Program:

The first CAPD in MMHRC was done in 1996. Since then the department has initiated more than 500 patients with an excellent success rate. The department initiated its first percutaneous CAPD catheter insertion in 2007. Since then the number has grown to 250 percutaneous CAPD catheters. The Baxter PD Center was established in December 2006, with the aim of counseling pre-dialysis patients regarding CKD management, lifestyle modifications, diet, treatment planning, etc. A video CD narrating the CRF treatment choices in the local language (Tamil) was also released. Every six months the department conduct a patients’ meet. This has become a platform for the patients to interact with each other. The department started the Automated PD in 2004. The success of CAPD is measured by the lack of infection. Among MMHRC patients the peritonitis rate is 1 in 36 patient months, which is comparable to international standards.

Renal Transplantations:

The MMHRC Center for Renal Transplantations is one of the leading transplant centers in South India. The first transplant was done in 1991. Till date, the department has performed more than 500 renal transplantations. A separate ICU for post renal transplant care with four beds has been commissioned recently. Latest protocols for postoperative immunosuppression are followed with prompt drug level monitoring which can be done in the MMHRC lab. The surgical team has also performed laparoscopic donor nephrectomy. This ensures shorter hospital stay and less painful surgery for the donor. Renal allograft biopsy is also routinely done here.

The Cadaver transplantation program was given a boost recently and the ABO incompatible live donor Renal Transplantation has been initiated with excellent results. We also conduct regular deceased donor transplants. Furthermore, the department conducted its first ever multiple organ procurement from a deceased donor.

Interventional Nephrology:

MMHRC is one of the premier centers of Interventional Nephrology in India. Here all interventions are done at the Interventional suite, a mini theatre equipped with all modern equipment like:

  • OT Table
  • Twin roof mounted 7+4 lamps
  • C-Arm
  • GE Multipara Monitor
  • L&T Bipolar Cautery
  • Crash trolley
  • Surgical dressing instrument cart, etc.

The department regularly performs Tunnelled Internal Jugular catheters (Permcath) in the Interventional suite.

The first live interactive Interventional Nephrology workshop in India was organized at Kanyakumari under the southern chapter of Indian Society of Nephrology by Dr. K. Sampath Kumar, HOD Nephrology, MMHRC. 

Renal Intensive Care Unit (RICU):

Recently the Department of Nephrology started a new air-conditioned intensive care unit with state-of-the-art monitors in eight beds for treating critically ill patients.

  • The RICU is equipped with sophisticated monitoring devices like GE Multi-Parameter for Swan-Ganz monitoring, GE Cardiac monitors, L&T Pulse Oxymeters and a new generation Gambro CRRT machine for dialyzing critically ill patients
  • It is a challenge to dialyze acute renal failure patients with multisystem involvement, coagulation abnormalities, and low blood pressure; although dialysis is life-saving, conventional hemodialysis is impossible due to its inherent limitations. With the CRRT Machine, RICU conducts dialysis on patients with hypotension
  • Citrate Dialysis is done for those with high bleeding risk
  • RICU is equipped with a continuous supply of RO water for emergency hemodialysis
  • The unit is run by specialist doctors, well-trained renal nurses, physiotherapists and renal dieticians

Kidney donors’ meet:

MMHRC and MOHAN FOUNDATION together conducted a kidney donors’ meet in which 43 donors participated with their families. During this meeting, the donors were honored for their large-heartedness and the families were appreciated for their support and courage. 

Doctors

  • Dr. K. Sampath Kumar, MD., DNB, D.M (Nephro)., - Senior Consultant & HOD
  • Dr. Andrew Deepak Rajiv, MD., (Gen.Med) DM.,(Nepro) DNB., (Neph) - Junior Consultant
  • Dr. Anusha Gopi, MBBS., DNB (Gen. Med), - Registrar