CMC | Paediatric Nephrology

Paediatric Nephrology

The Pediatric Nephrology subspeciality in Christian Medical College, as a subdivision of Pediatrics, was established in 2002. We provide outpatient and inpatient services and have facilities for diagnosis and management of complicated renal diseases. Support is given to Intensive care unit, Pediatric urology and other subspecialties of Pediatrics. For critically ill children with renal failure, haemodialysis, peritoneal dialysis, plasmapheresis and CRRT are provided. Maintenance dialysis programmes- both CAPD and Haemodialysis are available and we have a growing renal transplant program. A 2-year Post-Doctoral Fellowship training program is the focal point of our academic activities. We are involved in both clinical and translational research in collaboration with the Nephrology department and our Lab services.

We also have collaborative projects with other centres in India. A Biorepository and Registry of children with Nephrotic Syndrome (through Department of Biotechnology-MOHFW) and Pediatric Chronic Kidney disease Registry (by the Indian Society of Pediatric Nephrology (ISPN) have been initiated and guidelines for various common kidney diseases have been formulated (through ISPN). We have international collaborations through the International Society of Nephrology (ISN) with University of California, Los Angeles (Sister Renal Centre Program), Emory Children Hospital, Atlanta (Sister Transplant Program) and Children’s Hospital Maputo (Sister Trio program). There almost 50 publications from the division on research related to Pediatric Nephrology and several presentations have been made in national and international conferences.

Conference Website

COLLABORATIONS

Several collaborative projects have been initiated with other institutes in the country as well as with centres abroad. Intramural research projects include those with postgraduate students and Fellows on a regular basis. Publication in journals and participation in national and international conferences is part of the curriculum.

SISTER RENAL CENTRE PROGRAMME: Pediatric Nephrology Division was selected for the “ISN Sister Renal Centre Programme” in 2012. This was a 3 tiered programme sponsored and funded by the International Society of Nephrology involving a partnership with the University of California, Los Angeles (UCLA) as the Supporting centre and the Pediatric Nephrology Division, Christian Medical College, Vellore as the Emerging centre. Development of this sub-specialty through faculty exchange for training and joint research projects was the major focus of this programme.

The main goal of initiating renal transplant was realised in 2017. A presentation on this successful programme was made at the World Congress of Nephrology in Melbourne in April 2019.

ISN-TTS SISTER TRANSPLANT CENTER PROGRAMME – In partnership with Emory and Children’s Transplant Centre/Emory University, this collaboration provides funding for exchange between 2 centres and focuses on further development of transplant at our centre.

SISTER RENAL CENTRE TRIO Programme with Hospital Central De Maputo, Mozambique, Christian Medical College, Vellore and University of California Los Angeles, USA. This partnership also provides funding primarily for the Emerging centre in Mozambique. The focus is to help the Pediatric Nephrology Division develop as a centre of providing service to needy children of their region.

MEMBERSHIPS

Dr Indira Agarwal: Member – Scientific Advisory Committee (SAC) for ICMR Advanced Centre for Pediatric Kidney Diseases

Dr Indira Agarwal: Member- DBT Steering Committee in the project Pediatric Renal Biology Program Research on Nephrotic Syndrome

Dr Indira Agarwal: Member Specialty Board of Pediatric Nephrology- National Board of Examinations

CONFERENCE ORGANISED

The First Primer on Pediatric Renal Transplant and Immunology Workshop- 5th to 7th March 2020 at CMC, Vellore organized by Dr. Indira Agarwal. It was well attended by 125 delegates.

WORLD KIDNEY DAY 2020

The World Kidney Day was celebrated on 12th March 2020. The theme for this year was “Kidney Health for Everyone Everywhere – from Prevention to Detection and Equitable Access to Care.

AREA OF RESEARCH

i) Glomerular Disease

ii) Critical care nephrology

iii) Chronic kidney disease

iv) Ambulatory Blood pressure monitoring

v) Community Pediatrics- Screening for renal disease

vi) Pharmacokinetics and Pharmacogenetics

vii) Genetic basis of Renal disease

viii) Hemolytic Uremic syndrome

GENERAL OVERVIEW OF SERVICES

Outpatient and Inpatient Clinic: The Pediatric Nephrology outpatient clinic continues to attract huge number of patient from all over the country. Almost 10,000 patients are seen every year and include a wide variety of nephrourological problems.

Admissions in the inpatient unit for both diagnosis and treatment include 300-400 patients per year. Renal biopsies are regularly performed supported by specially trained renal pathologists from the Pathology department. The special facility of electron microscopy is also present, present in very few labs across the country. All radiology procedures required for nephrourological evaluation are available within the hospital, including interventional radiology, DSA, MRU and Nuclear medicine scans.

ACUTE DIALYSIS

1. Acute peritoneal dialysis: This is a procedure more suitable for young children where access is a problem – or in critically ill children who are hemodynamically unstable. This is regularly performed by the nephrologists and monitored by specially trained pediatric renal nurses.

2. Hemodialysis– emodialysis- Almost 600 dialysis sessions (for both outpatients and inpatients) on 100 patients were performed in the last year. A dedicated dialysis room, equipped with 2 NIKKISO machines and three technicians with years of experience in pediatric dialysis along with a centralized RO facility helped to provide uninterrupted dialysis to our patients. Hemodialysis services are provided to critically ill children in the pediatric ICU round the clock.

3. Sustained Low Efficiency Dialysis (SLED) : This remains as a successful alternative to CRRT in patients who are hemodynamically unstable and are not sick enough to require CRRT. This is regularly performed in the PICU for children with sepsis with multiorgan dysfunction.

4. Continuous Renal Replacement Therapy (CRRT): This was a new modality recently initiated in PICU with GAMBRO CRRT machine. These children are critically ill and hemodynamically unstable; it has proven to be the best choice of therapy in these children.

5. Plasmapheresis – This procedure is particularly useful in children with haemolytic uremic syndrome and many critically ill patients with acute liver failure regularly undergo plasmapheresis.

MAINTENANCE DIALYSIS

Short Stay Day Care Dialysis: A “Short Stay Day Care Dialysis” for Hemodialysis patients who are being worked up for transplant is available. It is also useful for those who require dialysis in the short term until complete recovery occurs after acute kidney injury.

Continuous Ambulatory peritoneal Dialysis –The program is supported by Baxter Company We have 4 dedicated CAPD nurses who are also in involved in monitoring of these patients and are the first point of contact if any trouble shooting occurs ensuring the topmost quality of care. They are being ably assisted by the Clinical coordinator from Baxter.

PEDIATRIC CHRONIC RENAL FAILURE CLINIC (PCRF)

Started with a view to give a little more time and attention to these children who would otherwise likely present to the regular Pediatric Nephrology OPD. In this clinic, three renal nurses and one transplant nurse help in counselling and education of these children with chronic renal failure, under the supervision of a trained senior renal clinical nurse.

RENAL TRANSPLANT

The year 2017-2018 was a landmark year for Pediatric Nephrology Division as we were able to initiate pediatric renal transplantation. The team included Nephrology-Urology, Pediatric Anaesthesia, Pediatric Intensive Care and Pediatric Nursing departments. So far 6 children successfully underwent live related transplant and 3 underwent cadaveric transplant.

We also are indebted to the support provided by other centres and friends from overseas, including Mattel Children’s Hospital UCLA, Cedar Sinai Children’s Hospital LA, Nemours Children’s Hospital Delaware and Emory Children’s Hospital Atlanta who made a major contribution to the development of the transplant program.

Post Doctoral Pediatric Nephrology Fellowship

The Speciality has been running a 2-year Post-Doctoral Fellowship, covering basic pediatric nephrology as well as advanced care since 2012. This has resulted in providing state of the art training and skills to a large number of paediatric nephrologists, who now practice in different parts of the country, helping to fill the gaps in care in these areas.

Contact Information

Address :

The Head,

Department of Paediatric Nephrology,

CMC Vellore Town Campus,

Ida Scudder Road, Vellore – 632004,

Tamil Nadu.

Email us :

Reach us :

04162283259

Working hours :

Mon-Fri: 8 am to 4.30 pm

( Sat : 8 am to 12:30 pm)