Outline of the Department of Nephrology
In this department, we treat both acute and chronic renal conditions, hypertension, electrolyte imbalance and undertake dialysis. As part of a comprehensive hospital, we liaison with specialists from departments such as gastroenterology, cardiology, hematology and rheumatology to assist in the treatment of patients experiencing renal complications. Our Nutritional Support Team, consisting of nutritionists, nurses, pharmacists and medical social workers, responds to instances of chronic kidney disease through lifestyle and nutritional guidance. We also conduct renal replacement therapy, continuous ambulatory peritoneal dialysis, continuous blood purification therapy in the intensive care unit and both plasmapheresis and adsorption in the blood transfusion unit. We generally treat patients from the west of Okayama Prefecture; however patients are referred to us from other prefectures in instances of multiple complications or renal failure.

The main conditions treated in this department are chronic kidney disease; nephritis, nephrotic syndrome and other renal conditions related to systemic diseases; acute renal failure; non-dialysis dependent chronic kidney disease (NDD-CKD); and hemodialysis and continuous ambulatory peritoneal dialysis (CAPD). Kidney transplants are not performed in this hospital.

1. Chronic Kidney Disease

Chronic kidney disease often accompanies lifestyle diseases such as obesity, diabetes and dyslipidemia (such as high cholesterol) and results in an increased risk of cardiovascular disease developing. If the disease is not diagnosed by a specialist doctor at the point in which proteinuria (protein in urine) is evident, the disease will progress and result in renal failure and cardiovascular disease. At this hospital, we work in liaison with other facilities in the region to treat and diagnose chronic kidney disease.

2. Nephritis, Nephrotic Syndrome and other Renal Conditions Related to Systemic Diseases

We treat to varying extents conditions such as nephrotic syndrome and renal dysfunction which often start with the discovery of blood (hematuria) or protein (proteinuria) in a urine test. We perform renal biopsies and administer treatment accordingly to the results of a histological examination, for not only glomerulonephritis, but also kidney disease complicated as a result of systemic disease. Over a period of five days, a specialist conducts tests such as microscopy, immunohistochemistry and electron microscopy, with the results of the histology determined through liaison with pathologists. Concerning treatments, steroid therapy and immunosuppressive agents are administered according to guidelines, with apheresis also used in certain instances. We are actively administering steroid pulse therapy following tonsillectomy as a result of immunoglobin A nephropathy.

3. Acute Renal Failure

From cases of acute renal failure coming from Emergency and Critical Care Center, to critical cases of multiple organ failure involving successive bouts of severe infection and surgery, we administer treatment in liaison with physicians in other departments. In severe instances, continuous hemodiafiltration is conducted as part of intensive care treatment. The precise diagnosis of the cause of acute renal failure and the treatment of the primary disease is also essential. In cases where blood purification therapy is performed, this is done with the aim of separating this from the blood.

4. Non-Dialysis Dependent Chronic Kidney Disease (NDD-CKD)

For patients with Non-Dialysis Dependent Chronic Kidney Disease (NDD-CKD), we administer treatment with the aim of preserving remaining renal function, thus extending the period until dialysis is required. At the same time, we also work towards the prevention of any cardiovascular complications. Through either scheduled outpatient visits, or in liaison with the patient’s regular physician, the patient’s renal function is evaluated every 3 to 6 months. Patients are also hospitalized for the purpose of education concerning adjustment to a new diet and the taking of medication.

5. Hemodialysis, Continuous Ambulatory Peritoneal Dialysis（CAPD）

When the deterioration of chronic kidney disease necessitates dialysis, either surgery for a cardiac shunt will be performed by the cardiothoracic surgery department (hemodialysis) or a catheter will be inserted into abdomen for dialysis (continuous ambulatory peritoneal dialysis: CAPD), with attention paid in assisting the patient to adjust their lifestyle in order for the smooth uptake of dialysis. We also administer dialysis for patients who previously were under dialysis at a different hospital and have been referred due to complications (surgical, chemotherapy, diseases such as pneumonia, etc.) Whether undertaken in the dialysis unit or in the CAPD clinic, doctors work closely together with experienced medical support staff, offering both therapeutic treatment and guidance to patients.