Nephrology and dialysis in Israel
Nephrology is a branch of modern medicine that studies kidney diseases, methods of their diagnosis and treatment. Typically, kidney disease begins and remains asymptomatic until the development of end-stage renal failure. According to modern medical data, kidneys can lose up to 90% of their function without any symptoms. Therefore, it is important to regularly check the functioning of this vital paired organ, and in case of any pathological changes, contact nephrologists.
Nephrology Department of Tel Aviv Medical Clinic is a modern medical facility where patients can receive all the necessary care, regardless of diagnosis: be it a common disease or an extremely rare pathology. Clinic is equipped with only modern medical and diagnostic equipment, conditions for patient’s stay are very comfortable, medical staff is qualified and caring, doctors have excellent theoretical and practical training.
The main goal of Nephrology Department doctors and hemodialysis at TAMC is the effective treatment of patients with renal pathologies. If it is impossible to get rid of the disease completely, specialists select a set of therapeutic and preventive measures so that a person can live a full life without suffering from kidney disorders.
Also, a priority in patients treatment is the application of complex techniques in order to delay the need for constant renal replacement therapy (hemodialysis) as far as possible. And if it already happens that patient needs chronic dialysis, he is immediately put on the waiting list for a kidney transplant, and as soon as a suitable donor is found, the person gets a second chance to live a long and healthy life.
Israeli medicine has achieved great success in kidney diseases treatment. Depending on clinical situation, patient may be prescribed conservative or surgical treatment methods. All diagnostic tests and treatment procedures are performed directly at Tel Aviv Medical Clinic, where all necessary equipment and highly qualified specialists are available.
Departments
On the basis of Nephrology Department of Tel Aviv Medical Clinic, several highly specialized clinics operate simultaneously:
- General nephrology – specialists in this area are engaged in diagnosis and treatment of the most common kidney diseases (pyelonephritis, glomerulonephritis, urolithiasis, chronic renal failure, diabetic and hypertensive nephropathy, polycystic kidney disease, etc.).
- Dialysis department – specialists in this profile treat patients who require emergency and permanent dialysis (renal replacement therapy) in case of acute and chronic renal failure.
- Kidney Biopsy Center – a very important procedure for diagnosing renal lesions is performed here – a biopsy followed by the study of tissue samples in the best pathological laboratories in Israel.
- Clinic for treatment of kidneys urolithiasis – specialists in this area use modern conservative and surgical (including minimally invasive techniques) to effectively treat kidney stones.
- Oncology nephrology – specialists in this area are engaged in the study, diagnostics and treatment of benign and malignant kidney diseases.
Diagnostic department – all necessary diagnostic examinations are performed here, including invasive ones, for example, kidney biopsy.
What diseases does Nephrology and dialysis Department treat?
Diagnostic methods in nephrology
A modern diagnostic unit operates on the basis of Nephrology Department. The entire diagnostic process takes approximately 3-4 days and consists of three stages. At the first stage, patient is examined by one of leading nephrologists at TAMC. Doctor collects and systematizes complaints, studies medical history and life history, examines patient in detail, and gets acquainted with medical documents that person brought with him. Next, specialist makes up an individual follow-up examination plan, from which the second stage of diagnosis begins.
Stage 2 lasts 2-3 days. Patient undergoes all diagnostic procedures prescribed by specialist. If diagnostics is invasive, it is performed under anesthesia to minimize any pain. All this time, patient is accompanied by employees of medical tourism department and an interpreter.
Stage 3 includes a second consultation with nephrologist and establishment of final diagnosis, always with a detailed description. Specialist makes up a treatment plan, according to diagnosis and modern global treatment protocols, and, if necessary, a rehabilitation program, for example, after surgery or kidney transplantation.
Important!
The main goal of the doctors of the Department of Nephrology and Hemodialysis at TAMS is the effective treatment of patients with renal pathologies.
If it is impossible to get rid of the disease completely, specialists select a set of therapeutic and preventive measures so that a person can live a full life without suffering from kidney disorders.
Modern diagnostic methods in nephrology:
- Various blood and urine tests.
- Methods of medical kidneys imaging – ultrasound, CT, MRI, PET-CT, MSCT, plain radiography, excretory urography, scintigraphy.
- Angiography of renal arteries.
- Kidney biopsy and subsequent pathological examination.
- DMSA and MAG3 kidney scan.
- Genetic diagnosis for hereditary kidney diseases.
Percutaneous fine-needle biopsy of kidney is a highly informative invasive procedure that allows us to establish a true diagnosis and prescribe correct treatment. Biopsy is performed under the control of a modern ultrasound machine. The procedure is carried out for:
- Determination of the pathological process nature in chronic kidney disease (glomerulonephritis and its type, diabetic or hypertensive nephropathy, renal amyloidosis, other changes).
- Diagnosis and verification of diagnosis for suspected malignant kidney tumors.
- Determination of kidney transplant condition and timely diagnosis of rejection.
Kidney biopsy procedure at TAMC is as safe and painless as possible. Patient must be given anesthesia; the procedure itself is carried out under visual control of an ultrasound machine. Thanks to modern equipment and well-coordinated work of pathohistology laboratory, we obtain accurate results in the shortest possible time.
A DMSA kidney scan is an examination of kidneys using dimercaptosuccinic acid (DMSA) radioisotopes. The technique allows not only to evaluate anatomical characteristics of organ, but also to check its function. Patient is injected with radioisotopes of dimercaptosuccinic acid, which accumulate in kidney tissue. From taken photographs, one can evaluate kidneys function and their anatomical structure, identify pathological changes (renal failure, traumatic injuries, abnormalities in kidneys position, developmental defects, cysts, tumors and other neoplasms).
Dynamic kidney scintigraphy (renal scintigraphy) with MAG-3 allows us to study kidney function in detail. Patient is preliminarily administered radiopharmaceutical 99mTc-MAG-3, which accumulates in kidney tissue. Then they take pictures and draw conclusions about the functional state of organs.
CT angiography of renal vessels is a modern method for kidneys examining. Kidneys are literally riddled with blood vessels. Their study using a tomograph allows us to see vessels in volumetric form, track their work, identify damage, anomalies, inflammation, as well as blood clots, stenoses, aneurysms in renal veins and arteries. CT angiography procedure of renal vessels is carried out using modern equipment, which guarantees maximum safety and minimal radiation exposure; all stages of study are supervised by highly qualified doctors.
Modern treatment methods in nephrology
The main differences in treatment of kidney diseases in Israel:
- TAMC clinic quickly implements all innovations in the field of diagnostics and treatment of kidney diseases, so you don’t have to wait for years to take advantage of all the benefits of modern medicine.
- Specialists in Israel undergo a long course of theoretical and practical training before starting independent activities. Therefore, you can be 100% confident in qualifications of your doctor.
- Department is equipped with only modern diagnostic and treatment equipment, which is at same time not only effective, but also completely safe for patient.
All this, together with generous government funding for medical field of nephrology, allows TAMC patients to receive only high-quality, effective and safe treatment for renal diseases.
Minimally invasive treatment of urolithiasis is carried out by laser lithotripsy, when, using a ureteroscope, a holmium laser is applied to stone without a single incision in patient’s tissue. Stone is destroyed by laser radiation, without leaving any small fragments. Studies have proven that this is an effective and safe procedure for urolithiasis treatment and its relapses.
An effective treatment for renal hypertension, renal artery deneuration, is used to treat hypertension that is resistant to drug treatment. During this minimally invasive surgical procedure, doctor uses radiofrequency ablation (RFA) to destroy nerve fibers that regulate the activity of renal arteries, resulting in a significant reduction in blood pressure and patient no longer requiring regular use of medications to control blood pressure.
If patient needs kidney surgery (most often for malignant neoplasms), depending on the type of tumor, its spread, and size, surgeons choose different methods of accessing diseased kidney. In most cases, surgery can be performed laparoscopically without large skin incisions and significant tissue trauma. Sometimes it is still necessary to perform open surgery when tumor has reached a significant size.
The main part of interventions performed by our surgeons is organ-preserving. That is, doctors manage to remove tumor from its bed with the help of modern equipment, while preserving person’s entire kidney. Sometimes it is necessary to perform a nephrectomy (complete removal of kidney along with tumor). As a rule, even after such surgery, patient’s complete recovery occurs, since another healthy kidney fully compensates for the work of the lost organ.
If two kidneys are affected by tumor process and they need to be removed to save patient’s life, such complex surgeries are performed simultaneously with preparing the patient for replacement therapy – program hemodialysis. In future, these people will be offered a kidney transplant from a related or unrelated donor, which will allow them to return to normal lifestyle and not depend on “artificial kidney” apparatus.
Hemodialysis is one of renal replacement therapy methods in patients with end-stage chronic or acute renal failure, which removes the end products of metabolism – creatinine and urea, as well as free water. Hemodialysis is carried out using an “artificial kidney” machine.
The procedure is performed in inpatient TAMC unit at Nephrology Department. Typically, dialysis lasts 6-8 hours, 3 times a week. To carry out hemodialysis at TAMC, only modern and safe equipment is used, which allows us to monitor the patient’s condition constantly in real time. The hemodialysis department is equipped with comfortable transformable chairs, and medical staff offers patients hot drinks and snacks during the procedure. Each patient is assigned a personal nurse who monitors the procedure and helps person in everything.
Kidney transplantation in Israel is allowed only from a related donor. In the case of end-stage renal failure, patient is prepared for an organ transplant from a suitable related donor. Surgery is possible if donor and recipient are fully compatible. Occures at TAMC transplant center. Statistics show that more than 90% of transplantations are successful, kidney takes root in its new location and begins to function perfectly.
Our Nephrology Department constantly conducts clinical studies to study the effectiveness of experimental drugs or innovative treatment methods. All our patients can participate in these studies completely free of charge. For some, this is a real chance for recovery, especially for those patients for whom all standard treatment methods have been ineffective or the disease has relapsed.
Specialist in the treatment of kidney diseases, head of the department of nephrology and dialysis
Head of the Department of Nephrology and Hypertension Control at the Medical Center
Senior physician, nephrology and dialysis department
Head of the Department of Pediatric Nephrology at the Children’s Hospital. Pediatric Specialist