Nephrology

Location

The Department of Nephrology is located on the second and third floor of the Old building of the KEM Hospital.It has a single patient care unit.The Hemodialysis Unit is located on the Second Floor of the building. Part of the dialysis unit was recently renovated by the American Jewish Joint Distribution Committee in association with the State of Israel. The Third floor houses the Dr.MD Motashaw Memorial Renal Transplant Unit and the Aditya Textile Renal Research Laboratories. In addition to the Intensive Care unit for transplant patients, the Department has an intensive care area devoted to patients with nephrology problems. In addition to these areas, the Department admits patients to beds in the general wards for male and female patients located on the second and ground floor of the same building.

The dialysis Unit :
The Hemodialysis unit is located on the 2nd floor of the old hospital building. It is in close proximity to a six bedded ICU area which forms part of the Nephrology department.

The dialysis unit has two designated areas 
       1. For patients who are HbsAg negative (measuring about 1000 sq. feet) and  
       2. For patients who require isolation dialysis (measuring about 700 sq.feet). 

The dialysis unit has an allocated area measuring 200 sq ft. wherein the Water Treatment Plant is housed. The Water Treatment
Plant has been designed to provide AAMI Standard quality water for dialysis. The water supply to this plant comes from the
Municipal Corporation of Greater Mumbai (filtered and chlorinated water).

The Water Treatment Plant consists of an Up-flow sand filter followed by an activated carbon filter. Just proximate to the reverse osmosis module there is a 10 micron cartridge filter. The treated water is circulated with the help of a circulation pump through a Stainless Steel SS-316 Pipeline. There is on-line a 0.2 micron size filter and an ultraviolet sterilizer. In addition, there is a storage
tank (SS316) with a 200 liter capacity.

A Store room exists for storing chemicals required for the cleansing and sterilization of the dialysis system and the circulating water pipeline. In addition, there are also chemicals stored for the reprocessing of hemodialysis. The reprocessing of hemodialyzers is
carried out in non Hepatitis B positive, non HIV positive patients who do not have reuse programme. The patients with Hepatitis C
have their dialysis processed in a separate area. There are thus designated separate areas for processing patients with Hepatitis C
and for patients who are not positive for hepatitis viral markers.

An on-duty doctor room is located near the dialysis area so as to provide immediate emergency care if required.

The present complement of Single Patient Dialysis systems number eight. They include 3 Nipro Surdial SPS, System 1000 DW,
480 BUF (2) and 480A (2). In addition, 2 other SPS are to be purchased in the near future. The dialysis area has been planned so
that 14 such Single Patient Systems can be used. The patients who are hepatitis B positive are managed on dedicated machines.
All machines are sanitized and sterilized after use, adopting the approved machines.

Separate dialysis room personnel (technical, nursing and house keeping staff) are posted in the dialysis area (clean and isolation).

The drainage of spent dialysate and the water etc used for reprocessing of dialyzers is separately drained. Dirty linen and dirty instruments are handled in a separate area located outside the dialysis area. Biomedical waste (sharps and other contaminated equipments) are handled as per the guidelines of the Hospital Infection Committee and the government.

The Nephrology Intensive Care Unit comprises of 6 beds wherein patients requiring dialytic intervention and a close watch on their clinical condition are accommodated in this area.

A pantry-cum-diet education area is located near the dialysis and Intensive Care area. In this area, preparation/distribution of patients food items as well as diet counseling is performed by a renal dietician.

The dialysis Unit is supplied with water from the Municipal Corporation which is treated and fulfills the standards set out by AAMI.
This treated water is used for both dialysis as well as reprocessing of dialyzers. The dialysis unit has electric supply from the electric company and also has provision for emergency electric supply through a generator lodged on the ground floor of the hospital building. In addition, three of the units have battery backup. The dialysis unit has Central air-conditioning. The Air Handling Unit is located near the dialysis theatres. Presently, the air-conditioning has not been extended to the ICU area. Entry of personnel to the dialysis area is restricted to staff of the unit and requires change of footwear and use of a mask. Thus, the areas are clearly demarcated as 'sterile' and 'semi sterile' with a separate 'dirty' area.

The Intensive Care Area as well the Dialysis Unit have central suction and central oxygen facilities. The air-conditioned areas are provided with a false ceiling and the walls have ceramic tiles which facilitates cleaning and sterilization.