Diagnosis – finding out what the problem is
Diagnostic tests are tests used to find out what the problem is. Various diagnostic tests are used. Different problems need different tests. These diagnostic tests are done in the labs (biochemistry, microbiology, Clinical Pathology etc). After a kidney transplant, they are on the lookout for certain viral infections. This test is done in the molecular diagnostic and research lab of Nephrology. CMV is Cytomegalovirus – this bug can infect the kidney and cause problems. Thus “Monitoring” patients for infectious after transplants is a standard procedure.
The levels of immunosuppressive medicines in the blood of transplant patients are looked at. Immunosuppressive drugs are used after transplants to ensure the kidney keeps working. The tablets suppress body’s immune system. However, too much of the drug makes the patient sick. Not enough, and the kidney may stop working. The Clinical Pharmacology department tests the amount of medicine in the blood. And depending on the concentration of medicine in the blood, the dosage of the tablets is adjusted.
The Nephrology Department is equipped for conducting kidney biopsies. On average, about 1200 biopsies are done every year. The biopsies are done on both native, ie the patient’s own kidney, and on transplanted kidneys.
Some problems can be controlled by medicines, diet and life style changes. Life style encompasses physical activity/inactivity, as well as type of work done by the patient. But, if the kidney is working very poorly, the patient has to have kidney dialysis or a transplant.
For dialysis, the patient is connected to a machine. His blood is made to flow through the machine (like flowing through the kidney). The machine removes the wastes and returns the cleaner blood back to the patient. So, these machines, called dialysers, are like artificial kidneys. The Nephrology Department has a dialysis lab called the Artificial Kidney lab or AK lab. The dialysis of the blood (Haemodialysis) is done in the AK lab. Another form of dialysis uses the space within the abdomen. This peritoneal cavity is where the stomach, liver, gut, colon and kidneys are. This space is used for dialysis and so it is called peritoneal dialysis. Both forms of dialysis are done in the AK Lab.
There are about 26 haemodialysis machines. Dialysis is carried out by trained haemodialysis technologists. There are also nurses and all are supervised by nephrologists. Minor surgical procedures (small operations) are also done in the AK lab.
Dr. K. VENKATARAMANAN M.D, DM,