The SRRSH Department of Nephrology is a key medical specialty in Zhejiang province, responsible for a doctoral degree program in clinical medicine at Zhejiang University School of Medicine. It is a core member of the National Clinical Research Center for Chronic Kidney Diseases. The SRRSH Integrated Kidney Disease Centre is committed to providing a comprehensive range of diagnostic and therapeutic services, including specialized outpatient clinics, haemodialysis vascular access centers, acute and chronic kidney disease centers, blood purification centers, peritoneal dialysis centers, kidney transplant centers and nephrology laboratories. It has 60 specialized beds, and 70 hemodialysis machines, with more than 4,000 patients discharged per year, more than 3,000 vascular access surgeries and over 600 kidney biopsies performed per year, and more than 30,000 dialysis done annually. The department's establishment and maintenance of hemodialysis vascular access is at the leading level in China, and it is the cradle to and leader of ultrasound interventional technology for vascular access in China. As a key promotion project of national health technology, it receives more than 60 doctors for advanced training every year and has trained more than 500 vascular access doctors, providing a large number of professionals in the field of vascular access across the country.

Hemodialysis vascular access subspecialty

Hemodialysis vascular access is a characteristic discipline of nephrology, which has developed for more than 20 years, and is one of the earliest departments to carry out this diagnosis, treatment and research in China. It is the cradle to and leader of ultrasound interventional technology for vascular access in China, which not only enjoys a high reputation in the country, but also has a certain influence in the Asia-Pacific region. After the department was relocated to Qiantang Campus, the development of vascular access subspecialties has reached a new level and entered a new stage, with an annual operation volume of nearly 4,000. The department distinguishes itself by its distinctive technical characteristics and rich clinical diagnosis and treatment experience.

 Integrated diagnosis and treatment of chronic kidney disease

In 2014, the Nephrology wards of SRRSH were relocated to Qiantang Campus and a subspecialty of chronic kidney disease was established, with a more advanced level and rich experience in diagnosis and treatment, which can enable the team to effectively deal with acute and chronic renal failure, primary glomerular disease, lupus nephritis, ANCA (antineutrophil cytoplasmic antibody)-associated vasculitis, metabolic kidney disease and other diseases. In addition, subspecialties can also follow standardized procedures for diagnosis and treatment, including IgG4-related diseases (IgG4-RD), thrombotic microangiopathy, monoclonal gammaglobulin-associated renal damage, Fabry disease and other difficult and rare diseases. The Department of Nephrology also applied biologics to treat kidney diseases earlier, such as rituximab and belimumab, which reduced the use of glucocorticoids in patients and achieved excellent efficacy. At the same time, for the comprehensive management of chronic kidney disease, the integrated treatment of kidney disease has been realized, which has effectively delayed the progression of end-stage renal diseases.

The number of renal puncture surgeries is increasing year by year and the annual renal puncture volume exceeds 600 cases. The total number of punctures and the number of IgA nephropathy (immunoglobulin A nephropathy) are in the forefront of Zhejiang Province. The department routinely carries out pathological examination items such as light microscopy, electron microscopy, immunofluorescence, special staining such as Congo red, and light chain immunohistochemistry, which provides strong support for clinical diagnosis and prognosis judgment.

Hemodialysis

The Qiantang Blood Purification Center campus is equipped with the internationally advanced German Raul two-stage reverse osmosis water treatment system, with 47 hemodialysis machines and Asahi Kasei plasmapheresis machines, and a complete set of information management system has been built. The annual dialysis is more than 30,000 cases and the quality of dialysis is leading in the province. In addition to routine hemodialysis, the Qiantang Blood Purification Center also carries out a variety of blood purification technologies such as hemoperfusion, primary plasma exchange, double plasma exchange, plasma adsorption, and artificial liver to provide support for the treatment of critical diseases such as poisoning, hyperlipidemia pancreatitis, critical immune diseases, organ transplant rejection, and liver failure. In addition, in cooperation with the vascular access center, ultrasound-guided access puncture exploration was carried out.

The center carries out surgical open peritoneal dialysis catheterization, percutaneous puncture peritoneal dialysis catheterization, and takes the lead in carrying out more complex surgeries such as laparoscopic sneak peritoneal dialysis catheterization, puncture plus pelvic fixed peritoneal dialysis catheterization, etc. It boasts the technology to deal with various complications such as peritoneal dialysis catheter displacement, blockage, and peritonitis. At present, there are more than 400 patients with peritoneal dialysis catheterization, nearly 100 follow-up patients, and more than 10 patients with APD (automated peritoneal dialysis). The survival rate and technical survival rate of patients have been in the forefront in Zhejiang province. The medical staff of the DTS Centre have studied at DTs in the UK and China and have maintained close cooperation and exchanges with top hospitals in China.

The Department of Nephrology has a highly qualified medical team, with all physicians holding postgraduate degrees or above, including six with senior professional titles. The nurses in the hemodialysis room have received training from specialized hemodialysis personnel at Loma Linda University in the United States and possess high professional competence. The department serves as the Chairman Unit of the Zhejiang Mathematical and Physical Association, Zhejiang Vascular Access Training Base, and National Verification Unit for New Kidney Disease Drugs. Every year, the department hosts continuing education programs on new developments in the diagnosis and treatment of blood dialysis vascular pathways, minerals and bone abnormalities in chronic kidney disease, and shares new concepts and methods of dialysis pathways and chronic kidney disease with peers.

The Department of Nephrology conducts research and analysis on new mechanisms of chronic kidney disease, new technologies for vascular access diagnosis and treatment, and risk factors for death in peritoneal dialysis patients. The team has led one National Key R&D Program for Young Scientists of the Ministry of Science and Technology, six projects funded by the National Natural Science Foundation, and ten projects supported by the Natural Science Foundation of Zhejiang Province. The team has published nearly a hundred research papers in high-level academic journals, including well-known journals such as Immunity, Nature Immunology, JCI, and JASN. Among them, more than 20 papers are included in SCI, with the highest single impact factor of 43.75.