Nephrology

The birth and growth of the department

The Division of Nephrology, conceived in 1962, originated in the early 60s due to the foresight of the late Dr. P. Raghavan, who could be deemed responsible for establishing 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 Johnson in 1962. From humble beginnings, the division grew over the years by introducing newer dialysis systems to supplement the original Alwall’s kidney. This was possible due to 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 growth of the department's occurred through the induction of generous aid received from Rockefeller Foundation, N.M. Wadia Trust and the Dr. P. V. Cherian Trust. The provision of dialysis services soon led to the possibility of renal transplantation. In May 1965, the first-ever transplant (a Cadaver kidney transplant) was performed at these institutions. Realizing the need for an academic program that would cater to the growing needs of the ailing renal population, the division sought and obtained the status of rea cognized training institute for the National Board of Examination in the sub-specialty of Nephrology (1977). After that, with the introduction of the D.M. degree in nephrology by the University of Mumbai in 1986, this division was recognized as a department that then obtained the recognition of the Medical Council of India. To date, the institution has produced and continues to make nephrologists who have earned a name for themselves, both nationally and abroad.

Achievements and milestones:

The Division had many achievements that placed it among the premier divisions of the country.

Dialysis: The dialysis unit was among the first to provide this facility in the country and the first in Western India. All modalities of dialysis, including hemodialysis (slow low-efficiency dialysis, hemodiafiltration, and CRRT) and peritoneal dialysis, are provided by the department. Our center performs more than 12000 sessions every year. It is one of the very few centers providing emergency dialysis (24*7) to patients living with HIV/AIDS. We have a bedside dialysis facility for critically ill patients in all medical, surgical, and pediatric ICUs.
Peritoneal Dialysis – The department runs a state-of-the-art peritoneal dialysis program catering to more than 50 underprivileged patients who are provided PD fluid free of charge. We have percutaneous and laparoscopic PD catheter insertion facilities and round-the-clock support for managing PD complications.

Kidney Transplantation: The first cadaver renal transplant in the country was performed here from a non-beating heart donor by Dr V N Acharya. Since then, the department has successfully completed more than 775 transplants with living and deceased donors. These transplants are done at minimal out-of-pocket expense. Our transplant OPD every week caters to 80+ patients.
ABO-incompatible transplant: Department has successfully conducted ABO-incompatible transplants at minimal expense to the patients.
Swap transplant: Department has to its credit the nation’s first pediatric pre-emptive swap transplant. We have also successfully conducted swap transplants for adults across various blood groups.
Dr. Vidya N. Acharya Interventional Nephrology unit: The department runs a state-of-art interventional nephrology unit with C-Arm and ultrasonography machines. Here all procedures like temporary catheter insertion, tunneled catheter insertion, kidney biopsy, percutaneous PD catheter insertion, and acute PD catheter insertion are performed by skilled nephrologists. Soon our unit is planning to start A-V fistula surgeries.
Dr. Vidya N. Acharya Glomerulonephritis registry: In 2020, a registry was instituted to facilitate long-term longitudinal follow-up with optimal clinical and genetic evaluations. The vision of this registry is the generation of prospective outcome data, which will translate to meaningful improvement in patient care.
Training and education: Since its inception, the division provided training for the postgraduate course in Nephrology of the National Academy of Medical Sciences. Now the department is recognized for two seats in DM nephrology and four seats for fellowship under the aegis of the Maharashtra University of Health Sciences. A certificate course is also started for critical care dialysis for dialysis nurses and technicians.
Hand transplantation: As KEM hospital accomplished its first “Hand Transplant” in 2021, the department of nephrology was involved in pre-transplant assessment and post-transplant medical management, including immunosuppression regimen.

Future vision:
The department of nephrology plans to start the following services in the near future –

To establish a fully functional operation theatre with a training facility for AV fistula creation and other nephrology-related procedures.
To establish onco-nephrology wing of the department
To expand the CAPD program specifically catering to patients living with HIV/AIDS
To establish a dedicated Paediatric Nephrology clinic
To computerize the records of the nephrology department with the glomerulonephritis registry facility.
To start certificate courses in “Interventional Nephrology” and “Critical Care Nephrology”

Location:
The Department of Nephrology is located on the second and third floor of the Old building of the KEM Hospital. The American Jewish Joint Distribution Committee renovated part of the dialysis unit 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 a 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. The department also houses a state of art museum that embraces antiquities from 1962 and helps us understand the history of nephrology as it evolved. The department also has a library which houses all the recent books on the subject. A computer room and a full-time CCT also cater to the department's ongoing research activities. There is a seminar room (seating capacity = 70) equipped with high-tech audio-visual facilities to aid in the department's educational activities. The Hemodialysis unit is on the 2nd floor of the old hospital building. Currently, it houses 17 hemodialysis stations. It is close to a seven-bed 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 infections.
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 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 (approx. 1000 sq. feet).
For patients requiring isolation dialysis (approximately 700 sq. feet).

The department is also equipped with portable RO plants, which facilitate bedside dialysis for critical patients in ICUs. Dr. Vidya N. Acharya Interventional Nephrology unit is situated on the third floor in ward 34A. This hones a C- Arm and USG machine. 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 equipped with the latest technology to conduct all hematological, microbiological, and urinary investigations required in the care of kidney patients. Laboratory staff includes one senior scientific officer (Dr Anand Naigaonkar, PhD in Science- stem cell research), five technicians, and five support staff. The laboratory has a fully automated biochemistry analyzer, fully automated hematology analyzer, osmometer, electrolyte analyzer, pH Meter.

Research wing
Department owns a fully functional research wing that is well staffed with 3 clinical research coordinators and has cold storage facilities for samples and a digital storage facility.
Inpatient beds
Department is allotted 43 beds for indoor patients in the following wards – Ward 34 [22 beds], 34A [15 beds], ward 12 [4 beds], ward 4 [2 beds].

Faculty	Designation	Qualification	Teaching experience	Email ID	Photos
Dr. Tukaram Jamale	Professor and head	MD, DM (Nephrology)	11 years	tukaramjamale@yahoo.co.in
Dr. Divya Bajpai	Professor (Addl)	MD, DM (Nephrology)	9 years	divyaa24@gmail.com
Dr. Sayali Thakare	Assistant professor	MD, DM (Nephrology)	7 years	thakare.sayali@gmail.com
Dr Sreyashi Bose	Assistant professor	MD, DM (Nephrology)	4 years	sreyashi.bose@gmail.com
Dr Chintan Gandhi	Assistant Professor (Bonded)	MD, DM (Nephrology)	3 years	dr.chintanpgandhi@yahoo.in
Dr Tulsi Modi	Assistant Professor (Bonded)	MD, DM (Nephrology)	3 years	tulsimodi02@gmail.com

Non-teaching staff of the department

Resident Doctors	6
House officer/fellows	3
Nursing Staff	25
Senior scientific officer (Lab)	1
Laboratory Technicians	14
Laboratory Assistant	4
Laboratory cleaning staff	1
Dietician	1
Medical Social Worker	1
Administrative Staff	2
Clinical research coordinator	3
Cleanliness staff	15

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 – 1st : Tubulopathy clinic & Pediatric Nephrology clinic
2nd : Lupus nephritis clinic
3rd : Hemodialysis &Peritonial Dialysis clinic
4th : 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 12000 dialysis sessions are performed per year for indoor patients.
Interventional nephrology services– 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, EMS ICU, COVID-19 ICU, SICU, and CVTS ICU. We also offer bedside acute peritoneal dialysis to critically ill unstable adults, and especially pediatric patients.
Transplant program – The 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 1st 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).
Onconephrology services – Department caters to all patients with malignancy and kidney diseases referred from TMH and other institutes.
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 every Wednesday at 11am. We also have a medical social worker dedicated to care of kidney patients.
Laboratory services- The in house nephrology lab supports the department with timely conduct of all the tests which are needed for optimum care of patients with kidney diseases
Telemedicine and outreach activities: Department of nephrology is associated with the telemedicine cell of Seth G.S.M.C. and K.E.M. Hospital, where we give consults to patients with kidney disease who can’t physically attend our outpatient services.

Community activities: Department participates in regular camps for patient education and health screening. Faculty members are actively involved in patient advocacy and community awareness on various media platforms.

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.
The department is also recognized for 2 MUHS fellowships with an intake of 2 candidates each in the Dialysis Technology and Clinical Nephrology.
Certificate course in critical care dialysis for dialysis technicians under the aegis of Seth G.S.M.C. and K.E.M. Hospital, Mumbai
Observership - Observership 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 :
The Dean,
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.

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

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	1st Journal Club 2nd Journal Club 3rd Journal Club 4th 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

Workshop/CME: Department conducts regular programmes for the training and education of nephrologists and primary care physicians. These are conducted in both physical and hybrid modes and are MMC accredited.

Department is actively involved in clinical research in the following areas of nephrology –

Acute kidney injury
Chronic kidney disease progression
Obstetric nephrology
Onco-nephrology
Tubular disorders
Glomerulonephritis: MPGN, Lupus, membranous nephropathy, aHUS
Kidney Transplantation

Following projects are currently approved and on-going –

FLOW - Effect of semaglutide versus placebo on the progression of renal impairment in subjects with type 2 diabetes and chronic kidney disease.
A phase 3 randomized controlled study of renal autologous cell therapy (react) in subjects with type 2 diabetes and chronic kidney disease (REGEN)
A prospective interventional phase IV, open label, single arm study to assess the safety and effectiveness of Finerenone in participants from India with chronic kidney disease associated with type 2 diabetes
Randomized Control Trial to compare effect of Atenolol vs Telmisartan in hemodialysis patients with uncontrolled hypertension.
Randomized control trial of Rituximab versus cyclophosphamide in membranous nephropathy
Study of clinical profile, laboratory parameters and genotype phenotype correlation in patients with Membranoproliferative glomerulonephritis (MPGN) pattern on renal biopsy
To study the long term renal outcome of patients with pregnancy related acute kidney injury.
Ovarian dysfunction in females with Lupus nephritis
A study of clinical features, laboratory parameters and genotype- phenotype correlation in patients of Distal Renal Tubular Acidosis
Long term outcomes of patients with complement mediated HUS.

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. Transpl Infect Dis. 2021;23(4):e13646.
Bajpai D, Deb S, Bose S, et al. Recovery of kidney function after AKI because of COVID-19 in kidney transplant recipients. Transpl Int. 2021;34(6):1074-1082.
Gaudry S, Hajage D, Benichou N, 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. Lancet. 2020;395(10235):1506-1515.
Thakare, S., Gandhi, C., Modi, T., Bose, S., Deb, S., Saxena, N., Katyal, A., Patil, A., Patil, S., Pajai, A., Bajpai, D. and Jamale, T., 2021. Safety of Remdesivir in Patients With Acute Kidney Injury or CKD. Kidney International Reports, 6(1), pp.206-210.
Rao SR, Vallath N, Siddini V, et al. Symptom Management among Patients with Chronic Kidney Disease. Indian J Palliat Care. 2021;27(Suppl 1):S14-S29.
Kute VB, Hegde U, Das P, et al. A Multicenter Cohort Study of Indian Centers on Reoccurring SARS-CoV-2 Infections in Kidney Transplant Recipients. Exp Clin Transplant. 2021;19(10):1023-1031.
Jamale TE. The AKIKI 2 trial: a case for strategy of initiation instead of timing. Lancet. 2021;398(10307):1215.
Meshram HS, Kute VB, Yadav DK, et al. Impact of COVID-19-associated Mucormycosis in Kidney Transplant Recipients: A Multicenter Cohort Study. Transplant Direct. 2021;8(1):e1255.
Sayali Thakare, Tulsi Modi, Chintan Gandhi et al. High Dependency Renal Unit (HDRU) for the management of COVID-19 in patients with severe acute or chronic kidney disease, 06 August 2021, PREPRINT (Version 2) available at Research Square
Jamale, T. (2020). Progression of diabetic kidney disease: Who is at risk?. Journal of Postgraduate Medicine, 66(4), 182.
Davidson B, Bajpai D, Shah S, et al. Pregnancy-Associated Acute Kidney Injury in Low-Resource Settings: Progress Over the Last Decade [published online ahead of print, 2023 Apr 1]. Semin Nephrol. 2023;42(5):151317.
Tannor EK, Bajpai D, Nlandu YM, Wijewickrama E. COVID-19 and Kidney Disease: Progress in Health Inequity From Low-Income Settings [published online ahead of print, 2023 Jan 16]. Semin Nephrol. 2023;42(5):151318. doi:10.1016/j.semnephrol.2023.151318
Meena P, Anandh U, Bajpai D. Kidney Health for Vulnerable: Challenges and Solutions. Indian J Nephrol. 2023;33(1):2-3. doi:10.4103/ijn.ijn_59_23
Meena P, Parikh N, Mohan K, Bajpai D, Anandh U. Women in Nephrology-India: One-Year-old, Yet Miles to Cover. Kidney Int Rep. 2022;8(3):688-689. Published 2022 Dec 23. doi:10.1016/j.ekir.2022.12.012
Bajpai D, Willows JK, Topf JM, Hiremath S. User-generated social media content in knowledge dissemination. Kidney Int. 2022;102(6):1428-1429.
Geetha, D., Kronbichler, A., Rutter, M. Bajpai, D. et al. Impact of the COVID-19 pandemic on the kidney community: lessons learned and future directions. Nat Rev Nephrol 18, 724–737 (2022).
Priti M., Parikh N, Mohan K, bajpai D, Anandh U. Women in Nephrology-India: One-year-old, yet miles to cover, Dec 2022, Kidney International Reports, https://doi.org/10.1016/j.ekir.2022.12.012.
Bajpai D, Muthukumar T. Post-Transplant Hypotension in Kidney Recipients-Vasopressin to the Rescue? Kidney Int Rep. 2022;7(6):1161-1164. Published 2022 May 7. doi:10.1016/j.ekir.2022.05.001.
Wijewickrama ES, Abdul Hafidz MI, Robinson BM, et al. Availability and prioritisation of COVID-19 vaccines among patients with advanced chronic kidney disease and kidney failure during the height of the pandemic: a global survey by the International Society of Nephrology. BMJ Open. 2022;12(12):e065112. Published 2022 Dec 30. doi:10.1136/bmjopen-2022-065112
Chougule D, Nadkar M, Venkataraman K, et al. Adipokine interactions promote the pathogenesis of systemic lupus erythematosus. Cytokine. 2018;111:20-27.
Jasani R, Hase N, Kumar R, Dedhia P, Jamale T, Bajpai D. Predictors of coronary calcification in Indian hemodialysis patients. Saudi J Kidney Dis Transpl. 2018;29(4):822-827.
Keskar V, Jamale T. Acute Kidney Injury in Critically Ill Children and Young Adults. N Engl J Med. 2017;376(13):1294-1295.
Kulkarni M, Jamale T, Hase N, Ubale M, Keskar V, Jagadish PK. Subcutaneous Phaeohyphomycosis Caused By Pyrenochaeta Romeroi in a Kidney Transplant Recipient: A Case Report. Exp Clin Transplant. 2017;15(2):226-227.
Rathod KR, Popat BA, Pandey A, Jamale TE, Hase NK, Deshmukh HL. Safety and effectiveness of transjugular renal biopsy: A single center study. Indian J Nephrol. 2017;27(2):118-123.
Goroshi M, Khare S, Jamale T, Shah NS. Primary Sjogren's syndrome presenting as hypokalemic paralysis: A case series. J Postgrad Med. 2017;63(2):128-131
Jamale T, Dhokare A, Satpute K, et al. Epidemic of Chemical Peritonitis in Patients on Continuous Ambulatory Peritoneal Dialysis: A Report from Western India. Perit Dial Int. 2016;36(3):347-349.
Kulkarni MJ, Jamale T, Hase NK, et al. A cross-sectional study of dialysis practice-patterns in patients with chronic kidney disease on maintenance hemodialysis. Saudi J Kidney Dis Transpl 2015;26(5):1050-1056.
18. Keskar VS, Imel EA, Kulkarni M, et al. The Case | Ectopic calcifications in a child. Kidney Int. 2015;87(5):1079-1081.
Keskar V, Jamale T, Karegar M, et al. Late-Onset Cytomegalovirus Gastritis in Low-Risk Renal Allograft Recipients. Exp Clin Transplant. 2015;13(3):279-282.
Keskar VS, Wanjare S, Jamale TE, et al. Subcutaneous hyalohyphomycosis caused by Fusarium in a kidney transplant recipient. Ren Fail. 2014;36(7):1129-1132.
Keskar V, Jamale TE, Kulkarni MJ, Kiggal Jagadish P, Fernandes G, Hase N. Minimal-change disease in adolescents and adults: epidemiology and therapeutic response. Clin Kidney J. 2013;6(5):469-472.
Jamale TE, Hase NK, Kulkarni M, et al. Earlier-start versus usual-start dialysis in patients with community-acquired acute kidney injury: a randomized controlled trial. Am J Kidney Dis.2013;62(6):1116-1121.
Jamale TE, Hase NK, Kulkarni M, et al. Earlier-start versus usual-start dialysis in patients with community-acquired acute kidney injury: a randomized controlled trial. Am J Kidney Dis 2013;62(6):1116-1121.
Jamale TE, Hase NK, Kulkarni M, et al. Hereditary ADAMTS 13 deficiency presenting as recurrent acute kidney injury. Indian J Nephrol. 2012;22(4):298-300.
Jamale TE, Hase NK, Iqbal AM. Laparoscopic donor nephrectomy versus open donor nephrectomy:recipient's perspective. Saudi J Kidney Dis Transpl. 2012;23(6):1175-1180
Neild GH, Jamale TE, Hase NK, Fernandez GC. A case of shoulder pain post-renal transplant: an unusual etiology. NDT Plus. 2011;4(2):136-137.

Contact Us

Department of nephrology –
Email ID
Infonephrology@kem.edu
VNAGNR.kemh@gmail.com

Phone no. 02224107100, 022-24107534, 02224107405

Dr Tukaram Jamale
Dept of Nephrology. Wd no 34A, old hospital building,
3rd floor,
KEM Hospital, Parel,
Mumbai 12
tukaramjamale@yahoo.co.in
Dr. Divya Bajpai
Dept of Nephrology. Wd no 34A, old hospital building,
3rd floor,
KEM Hospital, Parel,
Mumbai 12
divyaa24@gmail.com

Nephrology

Faculty list

Departmental Services

For Students

Academic and Research Activities

Research activities

Publications

Contact Us

Photo Gallery