50 not out: Institute of Nephrology at Chennai’s Rajiv Gandhi GH has carved a niche for itself

6 days ago 35

Inside a hospital ward stands 11-year-old Madhumitha (name changed), looking forward to the day when she can go home. Weeks earlier, the girl underwent kidney transplantation, with her mother being the donor, and is recovering at the post-transplant unit of the Institute of Nephrology, Rajiv Gandhi Government General Hospital (RGGGH), Chennai. She is among three children to have undergone kidney transplants in recent months after the department decided to take up paediatric patients as well.

In the thick of the COVID-19 pandemic, when the complete lockdown was in force, patients on dialysis and having tested positive for novel coronavirus disease walked into an exclusive unit set up by RGGGH’s Institute of Nephrology for dialysis. Since the first wave of the pandemic, 1,750 persons with COVID-19 have undergone dialysis at the unit.

Small set-up

What began as a small set-up 50 years ago is a full-fledged facility now. One of the earliest renal disease treatment centres to be established in the country, the nephrology department has grown by leaps and bounds over the years. Established as a separate department in 1972, it now offers services such as clinical nephrology, haemodialysis, peritoneal dialysis, kidney transplants, plasmapheresis and continuous renal replacement therapy.

“The department has seen tremendous changes in all aspects of nephrology over the years. It has, in fact, been a trendsetter too,” says N. Gopalakrishnan, the institute’s Director.

Dialysis is one of the key services offered by the department. In 2013, for the first time in the government sector in the State, a maintenance haemodialysis unit was started here. Now, with 65 dialysis machines, the department accounts for nearly 3,300 dialysis sessions per month, roughly 110 dialysis a day.

“During the pandemic, many private hospitals were unable to handle patients who were on dialysis and tested positive for COVID-19. At RGGGH, a team of dialysis technicians, postgraduates and doctors took care of more than a thousand patients round the clock after setting up a unit with 10 dialysis machines in Tower 3 where the COVID-19 wards were located,” of RGGGH Dean E. Theranirajan recalled.

Dr. Gopalakrishnan added they received patients from 75 other hospitals during the pandemic. “Starting with the first wave of the pandemic, we have catered to a total of 1,750 patients with COVID-19,” he said.

Transplant is a key component of the institute. It was in 1987 that the regular renal transplant programme was started at RGGGH. Though the first cadaver (deceased donor) transplant was done in 1996 itself, the cadaver transplant programme became well-established in 2008. So far, 1,590 transplants have been performed — 1,289 living donors and 301 deceased donors.

The launch of Continuous Ambulatory Peritoneal Dialysis (CAPD), which has so far benefited 100 to 120 patients at RGGGH, was a “dream come true”, according to Dr. Gopalakrishnan. This was now included in the State government’s flagship scheme Makkalai Thedi Maruthuvam, through which 231 beneficiaries receive dialysis bags at their homes.

Doctors pointed out that a government hospital performing nearly 3,000 dialysis sessions every month free of cost and providing life-long drugs for patients who had undergone transplants was a progressive step in the State’s healthcare system.

Research activities 

The institute is among the earliest to offer a higher speciality course — DM Nephrology. So far, 138 nephrologists have qualified from the centre.

It has been part of a number of research activities, and has nearly 150 publications to its credit in the last 10 years, Dr. Gopalakrishnan said. Recently, the institute was sanctioned a grant from the Indian Council of Medical Research for a multi-centre study on the follow-up of patients who had sustained acute kidney injury and recovered.

The department, along with the Institute of Community Medicine, has completed a study on the prevalence of chronic kidney disease across the State.

The department plans to establish a separate obstetric clinic at the Institute of Obstetrics and Gynaecology. It also plans to pick up hotspots for kidney diseases in the State and lay down guidelines for the management of renal diseases, doctors said.

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