Sir Ganga Ram Hospital, New Delhi, India

Nephrology

Introduction

The department of Nephrology India was started in 1981 at Sir Ganga Ram Hospital, and was the first hospital to provide maintenance haemodialysis services in non government sector in north India. Our H.O.D. has pioneered the art of vascular access by nephrologists in India, which is now being taken over by nephrologists all over the world. In 1987, kidney transplantation service was established with joining of a leading transplant surgeon. Another young and dynamic nephrologist joined the team in 1987 and was instrumental in realizing the dream of chronic peritoneal dialysis (CAPD) and was first to present data on CAPD with indigenous material available at various conferences in 1989. Later in 1991 and in 1997 two very competent and energetic nephrologists joined to strengthen the department. One of our nephrologist India has taken the challenge of providing dialytic care to critically sick patients and added state-of-the-art continuous renal replacement therapy (CRRT) service in the department. The latest to join the team is "our own grown product" and we admire his sincerity, hard work and honesty. All these faculty members work in unison and the hospital is proud of their exemplary team work. The department is always focussed to provide high quality medical care with a human touch. The department is one of the first few centres in India to be accredited by the National Board of Examinations for training in post-doctoral courses in nephrology and our trained doctors and are much sought after and holding key positions in major hospitals in India. 

Facilities Available

a) Clinical Nephrology: A leading centre for the management of all renal problems. State-of-the-art facilities for renal pathology, with complete biochemical, immunological, microbiological and histological (including immunoflorescence and immuno-histo-chemistry) - back up available under one roof. Angiographic, genetic and HLA studies are available in-house for organ transplantation & diagnosis of other diseases.Dialysis: Established in 1981, it is one of the first centre in India and first of its kind in North India to provide maintenance haemodialysis facilities to the patients of chronic renal failure.

b) Dialysis Unit

  • Latest generation, fully computerised bicarbonate haemodialysis machines with volumetric ultrafiltration and adjustable sodium facility, provide betterpatient safety profile.
  • First centre in north India to provide R.O. (Reverse Osmosis) water for the dialysis, to ensure patient safety and prevent long term complications on haemodialysis.
  • We are first to have world's best, state-of-the-art computerized dialyzer re-use system in North India which ensures safety & adequacy of dialysis and also economise dialysis for the patient.
  • Facility for continuous monitoring of sick patient on dialysis through highly sophisticated monitors throughout the dialytic procedure is available.
  • First centre to have separate units for Hepatitis B & C positive patients.
  • Heat-clean disinfection of haemodialysis machines after every shift is practiced for patient safety.
  • Regular dialysis facilities are available in the centre from 7.00 AM to 12 midnight, besides emergency dialysis round the clock.
  • More than 1200 haemodialyses are performed per month (four dialysis shifts of 4 hrs) by highly trained technical and nursing staff under supervision of two dialysis medical officers under the overall supervision and guidance of consultants round the clock is available.

c) Continuous Renal Replacement Therapy

One of the few centres 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 Ultrafiltration)
  • CVVH (Continuous Veno-Venous hemofiltration)
  • CVVHD (Continuous Veno-Venous haemodialysis)
  • CVVHDF (Continuous Veno-Venous hemodiafiltration)
  • Plasmapheresis

d) 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 Peritoneal Dialysis: One of the leading centres in India and perhaps the first centre in north India (since 1993) to provide continuous ambulatory peritoneal dialysis (CAPD) for patients of CRF, who are otherwise not suitable for kidney transplant or maintenance haemodialysis. CAPD is also suitable for patients who are living in far flung areas where facility of haemodialysis is not available. We have the largest number of patients having been initiated and surviving on CAPD in the country. Our centre has one of the largest series of patients on automated peritoneal dialysis.

We have one of the largest experience in India of having done CABG (Coronary Artery Bypass Surgery) in patients with advanced chronic renal failure under cover of CAPD.

e) Renal Transplantation

This is one of the leading renal transplant centres in India, having done around twelve hundred live related transplants since 1987 with results comparable to the best centres in the world. Ours is the leading centre for laparoscopic donor nephrectomy in India having done more than 100 laparoscopic nephrectomies. A state-of-the-art transplant unit for immediate post transplant case and subsequent management has been specially built.

f) Vascular Access for Haemodialysis

This centre has been pioneer in making A.V. Fistula and A.V. Shunts for use in haemodialysis. This centre is the nursery for training people from Delhi and neighboring states in the art of making vascular access. Having performed a few thousand successful surgeries, this unit is among the centres with largest experience in vascular access surgery anywhere in the world. 

g) Post-doctoral course (DNB) in nephrology

This is one of the first few private centres to be accredited by the National Board of Examinations for training post-graduates for the DNB course in Nephrology. Since 1991, we have produced 14 qualified Nephrologists who are running independent Nephrology Centres in Delhi India as well as in neighboring states. 

CASUALTY SERVICES

24 hours casualty services are available. All patients are seen by a senior resident on duty and admitted if needed. A consultant supervises all these services round the clock.

Academic Programme

The DNB students attend morning meetings, journal clubs, bed side case discussions, seminars, histo-pathology rounds and nephro-radiology rounds. They are also involved in transplant clinics and in carrying out various procedures under the supervision of consultants. 

Conferences / Workshops:

  • 7th Congress of Asian Society of Transplantation held in 2001.
  • 1st Conference of Indian Society of Haemodialysis in 2004.
  • 10th Annual Conference of North Zone Chapter of Indian Society of Nephrology.
  • Dr. D.S. Rana, President - Delhi nephrology Society of India.
  • Dr. A.K. Bhalla, Secretary - Peritoneal Dialysis Society of India.
  • Dr. A.K. Bhalla, Secretary - Delhi Nephrology Society.

Patients and doctors interactive programmes are held at regular intervals to educate about prevention and retardation of progression of renal failure in patients of pre dialysis and rehabilitation and counselling for patients on renal replacement therapy.