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The Department of Renal Medicine comprising senior
and junior doctors and is supported by fellows dialysis,
renal and transplant coordinators, renal educator and
psychologists.
The department is a premier referral centre for the
evaluation and management of a range of renal diseases.
It comprises 3 sub-specialty clinical services - clinical
nephrology, dialysis, including haemodialysis and peritoneal
dialysis, and renal transplantation.
The Clinical Nephrology Service provides for the evaluation
and management of all types of renal diseases including
glomerulonephritis, diabetic nephropathy, chronic renal
failure and hypertension. Referral clinics in this sub-specialty
also provide for renal retardation, evaluation of urinary
abnormalities, urinary tract infections, polycystic
kidney disease, lupus nephritis and other renal conditions.
The Service provides real-time ultrasound-guided renal
biopsy and 24 hour ambulatory blood pressure monitoring
as indicated for management of patients. The renal laboratories
provide clinical support for the performance and processing
of renal tissues for biopsy and histopathology.
The Dialysis Section provides services in both haemodialysis
and peritoneal dialysis. End stage kidney failure patients
admitted to the hospital with complications from haemodialysis
are evaluated and managed for these conditions. In addition,
patients with acute renal failure are evaluated and
treated with acute haemodialysis or Continuous Renal
Replacement Therapy, including Slow Continuous Ultrafiltration,
Haemodialfiltration, Haemofiltration and its variants
as required. Facilities for charcoal hemoperfusion are
also available for cases of poisoning.
A state of the art Haemodialysis Centre, comprising
of a 20-station unit, running at 3 shifts a day, with
additional stations for isolation, caters to standard
bicarbonate haemodialysis as well as heparin free haemodialysis,
dialysis with sodium modeling and isolated ultrafiltration
for inpatients with special needs.
The Continuous Peritoneal Dialysis (PD) service provides
training and education for patients with end stage kidney
failure accepted into the PD program and is the regional
referral centre for training in both Continuous Ambulatory
Peritoneal Dialysis (CAPD) and Automated Peritoneal
Dialysis (APD). PD patients receive prescribed dialysis
suited for their needs and lifestyle. Modified dialysis
regimens including amino acid-based or Icodextrin-based
dialysates are offered to meet unique needs of patients.
The CAPD Day Unit caters to the training needs of PD
patients and provides for the evaluation and management
of patients with complications of Continuous Peritoneal
Dialysis.
The Renal Transplantation Section provides a comprehensive
service for the management of patients undergoing kidney
transplantation. It evaluates kidney failure patients
for suitability for living donor or cadaveric kidney
transplantation and assesses suitability of potential
donors for kidney donation. The program coordinates
the preparation of patients for transplantation and
provides full investigation and management of patients
after transplantation. A Transplant Resource Centre
serves as a Help Centre for transplant patients to access
information regarding their care. The Centre also provides
for ongoing educational programs for transplant patients
to help prevent complications after transplant and to
optimize outcomes.
Teaching is an important area of endeavor in the department.
Departmental staff participate actively in teaching
medical and nursing students as well as training house
officers, medical officers, advanced trainees, post
graduate fellows and general practitioners in all aspects
of nephrology. Due to the nature of the specialty, the
department also undertakes the training of nurses and
other paraprofessionals in various aspects of nephrology,
dialysis and transplantation.
The department has been recognized for clinical training
in Renal Medicine for up to 1 year by the Australasian
College of Physicians and is also recognized as a sister
renal unit to Ripas Hospital, Brunei under the International
Society of Nephrology. The Department is also recognized
for training by the Specialist Accreditation Board.
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