About KEM Hospital - KING EDWARD MEMORIAL HOSPITALKING EDWARD MEMORIAL HOSPITAL

Nephrology

Background

History

The Division of Nephrology had its origin in the early 60’s due to the foresight of the late Dr. P. Raghavan who could be deemed responsible for the establishment of an independent branch of Nephrology today. The Department of Medicine had received a gift of an Alwall’s hemodialysis machine through the Swedish philanthropist Mr.Alex Axison Johnsonin 1962. Over the years and under the guidance and efforts of Dr.Smt.V. N. Acharya and her band of dedicated workers which included Mr.Claud Lobo and Sr. Bagayatkar. The Division had many achievements that placed it among the premier divisions of the country.The dialysis unit was among the first to provide this facility in the country and the first in the western India. The first cadaver renal transplant of the country was performed here from a non-beating heart donor. The division provided training for the postgraduate course in Nephrology of the National Academy of Medical Sciences .The division matured and became a full-fledged Department of the Seth GS Medical College providing training for the DM postgraduate course in Nephrology in the early 80’s. Since then, the Department has been training young nephrologists to provide service for the ailing renal patients.

The Birth & the Growth of the Division of Nephrology

The Division of Nephrology, conceived in 1962, came into being in the following year with the introduction of the Dialysis Unit. This brain-child of Prof. P. Raghavan, the then Professor & Head of the Department of Medicine has thenceforth not looked back. From humble beginnings, the division grew over the years with the introduction of newer dialysis systems to supplement the original Alwall’s kidney. The growth of the department was ensured through the induction of generous aid received from Rockefeller Foundation, N.M. Wadia Charities and the Dr. P. V. Cherian Trust.

This division was headed by Dr. Ms. V.N. Acharya who had been hand-picked by Dr.Raghavan himself. She had trained in the United Kingdom before she shouldered the responsibility of setting up the dialysis unit. The dialysis set up which had humble beginnings was equipped periodically with state-of- the-art dialysis systems. The provision of dialysis services soon led to the possibility of renal transplantation. In May 1965, the first ever kidney transplant (a Cadaver kidney transplant) was performed at these institutions. Over the years, the department has progressed and has an active live related donor transplant programme and a newly established Cadaver Donor Transplant programme.

Realising the need for an academic programme that would cater to the growing needs of the ailing renal population, the division sought and obtained the status of recognized training institute for the National Board of Examination in the sub-speciality of Nephrology (1977). Thereafter, with the introduction of the D.M. degree in Nephrology in the University of Mumbai in 1986, this division was recognized as a department which thereafter obtained the recognition of the Medical Council of India. As of date, the institution has produced and continues to produce nephrologists that have earned a name for themselves, both on the national scene and abroad.

Sections Units Branches

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 wasrenovated by the American Jewish Joint Distribution Committee in association with the State of Israel. The Third floor houses the Dr.M.D. Motashaw Memorial Renal Transplant Unit and the Aditya Textile Renal Research Laboratories. There is also Dr. Vidya N. Acharya Interventional Nephrology unit which has state-of-art operation theatre to facilitate surgical procedures.In addition to the Intensive Care unit for transplant patients, the Department has an intensive care area devoted to patients with nephrology problems. There is space designated for departmental office and record keeping. Department also houses a state of art museum which embraces antiquities from 1962 and help us understand the history of nephrology as it evolved. Department also has a library which houses all the recent books on the subject. There is a computer room and a full time CCT which also caters to the ongoing research activities in the department.

Hemodialysis Unit

The Hemodialysis unit is located on the 2nd floor of the old hospital building. Currently it houses 17 hemodialysis stations It is in close proximity to a seven bedded ICU area which forms part of the Nephrology department. Dialysis services are working 24*7 and emergency dialysis is provided to all patients including patients with HIV, HBV, and HCV infection.

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 dialysis unit has two designated areas:

For patients who are HbsAg negative (measuring about 1000 sq. feet).
For patients who require isolation dialysis (measuring about 700 sq.feet).

The department is also equipped with portable RO plants which facilitates bedside dialysis for critical patients in ICUs (Medical and surgical ICUs). Department also has facility for bedside dialysis for COVID-19 positive patients in ward 12 and in COVID-ICU.

Dr. Vidya N. Acharya Interventional Nephrology unit

Department houses an interventional nephrology wing which has C- Arm and USG machine. It facilitates tunneled hemodialysis catheter insertion, cuffed peritoneal dialysis catheter insertion, and kidney biopsies. We are also planning to extend the facilities to create AV fistulas.

Aditya Textile Renal Research Laboratories

Department embodies state of the art laboratory services which in equipped with latest technology to conduct all hematological, microbiological, and urinary investigations required in the care of kidney patients. Laboratory staff includes 1 senior scientific officer (Dr Anand Naigaonkar, PhD in Science- stem cell research), 5 technicians, 5 support staff. The laboratory has fully automated biochemistry analyzer, fully automated hematology analyzer, osmometer, electrolyte analyzer, pH Meter.

Inpatient beds

Department is allotted 42 beds for indoor patients in the following wards – ward 34 [22 beds], 34A [14 beds], ward 12 [4 beds], ward 4 [2 beds].

Human Resource –

Following full time faculty are present in the department –

Faculty	Designation	Teaching experience
Dr. Tukaram Jamale	Professor and head	10 years
Dr. Divya Bajpai	Associate Professor	7 years
Dr. Atim Pajai	Associate Professor	7 years
Dr Nikhil Saxena	Assistant professor	3 years
Dr Ankita Patil	Assistant Professor (Bonded)	3 years
Dr Abhinav Katyal	Assistant Professor (Bonded)	3 years

Resident Doctors	6
House officer	2
Nursing Staff	25
Senior scientific officer (Lab)	1
Laboratory Technicians	17
Laboratory assistant	1
Laboratory cleaning staff	1
Dietician	1
Medical Social Worker	1
Administrative Staff	4
Clinical research coordinator	1
Cleanliness staff	15

Services

Outpatient care – Five OPDs per week cater to approximately 15,000 patients per year. OPD schedule of the department is as follows –

Monday – Chronic kidney disease clinic

Tuesday – New patient clinic

Thursday – Morning- Transplant clinic

Afternoon–Glomerulonephritis clinic

Friday – 1^st : Tubulopathy clinic & Pediatric Nephrology clinic

2^nd : Lupus nephritis clinic

3^rd : Hemodialysis &Peritonial Dialysis clinic

4^th : Hemodialysis &Transplant workup clinic

Inpatient care – Catering to approximately 1200 inpatient consultations per month. About 1000 patients per year are admitted under the department of nephrology in the 4 allotted wards. More than 9000 dialysis sessions are performed per year for indoor patients.
Interventional nephrology – Department houses an interventional nephrology wing which has facilities for tunneled hemodialysis catheter insertion, cuffed peritoneal dialysis catheter insertion, and kidney biopsies. We are also planning to extend the facilities to create AV fistulas.
Critical care nephrology – Department caters to critically ill kidney patients with kidney involvement in various medical and surgical ICUs. We have facility to provide bedside hemodialysis in MICU, EMSICU, COVID-1CU, SICU and CVTS ICU. We also provide bedside acute peritoneal dialysis to critically ill unstable adult and especially pediatric patients.
Transplant program – Department runs a successful kidney transplant program conducting living related transplants, deceased donor transplants, and paired kidney transplant. Department has to its credit the successful performance of 1^st ever pediatric pre-emptive paired kidney transplant. Department has state of art transplant recovery room for recipients. All the transplant recipients are in regular OPD follow-up in the transplant clinic which has an attendance of 60 – 70 every Thursday.
Pediatric nephrology services– Department provides inpatient consultation, critical nephrology care and outpatient services to pediatric and neonatal kidney patients. This includes hemodialysis and peritoneal dialysis (acute and chronic).
Dietician support – Department has a team of dieticians dedicated to care for nephrology patients. They regularly visit the indoor patients and are also available for OPD patients.
Patient education program – Department hosts regular counselling sessions for patient and caregiver education and support. We also have a medical social worker dedicated to care of kidney patients.

Academic

The Department is recognized for the DM Course of the Maharashtra University of Health Sciences, Nashik addition, and students are enrolled for M.Sc / Ph.D in Applied Biology.

The Seth GS Medical College enrolls 2 students per year for the DM course. The selection is based on an All-India Entrance examination conducted by the Directorate of Medical Education and Research of the Government of Maharashtra . This 3 year course prepares students for the practice of Nephrology. The students are also eligible to appear for the qualifying examination, Diplomat of the National Board in Nephrology, conducted by the National Board of Examinations, New Delhi.

Enrollment for the M.Sc/Ph.D course by research in Applied Biology is through the University of Mumbai.

Observership & Training

Observer-ship for Medical Practitioners for periods varying from 1 to 3 months is possible in the department.
The applications for observer-ship should be addressed to :

TheDean ,
Seth GS Medical College & KEM Hospital,
Acharya Donde Marg,Parel, Mumbai 400 012
India

An Observership fee is Rs.3200/- per month.

Training for Dialysis Technicians is also provided .The training period is for 3 months. A certificate will be provided after successful completion of the training programme. Applications should be made to the Dean at the aforementioned address. Eligibility: – Bsc, D.M.L.T. / 12th with science.

Academic and Research Activities

Academic:

The Department teaching activities are as follows:

Monday : symposium/case discussion
Tuesday : Nephro-urology Discussion
Wednesday : Review guideline/Teaching Rounds /Journal Review / Mumbai Nephrology Group meeting
Friday : Rounds with Residents / Nephrology forum/Case discussion
Saturday : Case Discussion/Renal Biopsy Conference with renal pathology

Department of Nephrology, Teaching programme: January 2012

Time	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
7 – 8.30	Ward Round Resident	Ward Round Resident	Ward Round Resident	Ward Round Resident	Ward Round Resident	Ward Round Resident	Ward Round Resident
8.30 – 9.00	Ward Round by faculty	O.P.D. 8.30 – 3.00	Ward Round by faculty	Ward Round by faculty	Ward Round by faculty	Ward Round by faculty	Ward Round by faculty
9.00 – 10.00	Apprasial of New cases / Symposium		Apprasial of New cases / Guide lines		Sub-speciality OPD	Nephro /Path Meeting CPC 9 – 11.00	Apprasial of Ward cases to Consultant
10– 12.30	Symposium	New Cases/ followup	Teaching grand rounds	Transplant clinic	Sub-speciality OPD	Round/ WARD Consultant 11 – 12.30	Emergency on Calls onwards
1.30 – 4.00	Renal Clinic / Case discussion CKD	Reports / Followup OPD Patients & Rounds	1^st Journal Club 2^nd Journal Club 3^rd Journal Club 4^th Mumbai Nephro. Group meeting	Renal clinic follow up Glomerular Disease Vasculitis SLE /	1.Case presentation 2.Nephro. meet. 3 Death Audit Dialysis/ Transplant Meeting 4.Case presentations	1.Theory paper 2.Question writing 3.Mumbai Nephro. Teaching Web Cast
4.30 – 5.00	Reports & Evening rounds	Evening rounds	Reports & Evening rounds	Reports & Evening rounds	Evening rounds Reports discussion
7.00 p.m.	Emergency on Call	Emergency on Call	Emergency on Call	Emergency on Call	Emergency on Call	Emergency on Call

Research activities –

The department actively participates in both sponsored and investigator initiated research trials. Currently there are 2 sponsored and 15 investigator initiated research studies going on in the department.

Publications

Publications by the department in last two years –

Bajpai D, Deb S, Bose S, et al. Recovery of kidney function after AKI due to COVID-19 in kidney transplant recipients [published online ahead of print, 2021 Apr 21]. Transpl Int. 2021;10.1111/tri.13886. doi:10.1111/tri.13886
Bajpai D, Shah D, Bose S, et al. Development and longevity of antibodies against SARS-CoV-2 in kidney transplant recipients after symptomatic COVID-19 [published online ahead of print, 2021 May 24]. Transpl Infect Dis. 2021;e13646. doi:10.1111/tid.13646
Rao, S. R., Vallath, N., Siddini, V., Jamale, T., Bajpai, D., Sancheti, N. N., & Rangaswamy, D. (2021). Symptom management among patients with chronic kidney disease. Indian Journal of Palliative Care, 27(5), 14.
Thakare S, Gandhi C, Modi T, Bose S, Deb S, Saxena N, Katyal A, Patil A, Patil S, Pajai A, Bajpai D, Jamale T. Safety of Remdesivir in Patients with Acute Kidney Injury or CKD. Kidney International Reports. 2020 Oct 10.
Gaudry, Stéphane, et al. “Delayed versus early initiation of renal replacement therapy for severe acute kidney injury: a systematic review and individual patient data meta-analysis of randomised clinical trials.” The Lancet (2020).
Jamale, T. (2020). Progression of diabetic kidney disease: Who is at risk?. Journal of Postgraduate Medicine, 66(4), 182.
Bajpai D, Shah S. COVID-19 pandemic and pregnancy in kidney disease. Advances in Chronic Kidney Disease. 2020 Aug 7.
Anandh, U., Basu, G., Bajpai, D., Shingada, A. K., Lerma, E. V., Bek, S. G., … & Conjeevaram, A. (2020). Social Media Coverage of the International Society of Nephrology World Congress of Nephrology 2019: Exploring Novel Strategies. Kidney international reports, 5(10), 1615-1619.
Bajpai D. Preeclampsia for the Nephrologist: Current Understanding in Diagnosis, Management, and Long-term Outcomes. Advances in Chronic Kidney Disease. 2020 Nov 1;27(6):540-50.
Bajpai D et al. Haemodialysis Unit Preparedness Checklist developed to deliver safe dialysis during and after COVID-19 pandemic. April 2020

https://www.georgeinstitute.org/media-releases/haemodialysis-unit-preparedness-checklist-developed-to-deliver-safe-dialysis-during

Nigwekar SU, Negri AL, Bajpai D, ET AL. Chronic prolonged hyponatremia and risk of hip fracture in elderly patients with chronic kidney disease. Bone. 2019; 127:556-562.

Book Chapters –

PREVENTING CHRONIC KIDNEY DISEASE – IN WHOM, WHEN, AND HOW?

Bajpai D, Modi G 2021, Postgraduate Medicine

CONTRAST ASSOCIATED ACUTE KIDNEY INJURY-

Bajpai D. 2021 India Point-of-Care tool, Elsevier.

For Patient

Photo Gallery

Visit on 29 May 23 by Professor Joseph Muenzer, Pediatric Geneticist , University of North Carolina

Workshop on “Principles of Scientific Writing” 12, 13 October 2017, conducted for Pfizer Ltd

Mr Ashnik Chauhan at the DIA meeting in Chicago in June 2017

90 years of Seth GS Medical College and KEM Hospital, January 2016