Nephrology

The Department of Nephrology at Sir Run Run Shaw Hospital is a key medical specialty in Zhejiang Province, a clinical medicine doctoral degree-granting site of Zhejiang University School of Medicine, and a core member institution of the National Clinical Research Center for Chronic Kidney Disease. The Sir Run Run Shaw Integrated Kidney Disease Treatment Center is committed to providing comprehensive diagnostic and treatment services, including specialized outpatient clinics for specific diseases, a hemodialysis vascular access center, an acute and chronic kidney disease treatment center, a blood purification center, a peritoneal dialysis center, a kidney transplant center, and a renal disease laboratory. It has 60 specialized beds and 70 hemodialysis machines; more than 4,000 patients are discharged annually, more than 3,000 vascular access surgeries are performed annually, more than 600 renal biopsies are performed annually, and more than 30,000 dialysis sessions are performed annually. The establishment and maintenance of hemodialysis vascular access are at a leading level in China. The department is the birthplace and a leader of ultrasound-guided interventional vascular access technology in China. As a key national health technology promotion project, it receives more than 60 visiting physicians for further training each year and has trained more than 500 vascular access physicians in total, supplying a large number of professionals to the field of vascular access nationwide.

Technical Advantages

Hemodialysis Vascular Access Subspecialty

Hemodialysis vascular access is a distinctive discipline of the Department of Nephrology. It has been developed for more than 20 years and is one of the earliest departments in China to conduct the diagnosis, treatment, and research of this specialty. It is the birthplace and a leader of ultrasound-guided interventional vascular access technology in China. The department enjoys a high reputation nationwide and also has a certain influence in the Asia-Pacific region. After the department as a whole moved to the Qiantang Campus, the development of the vascular access subspecialty reached an even higher level and entered a new stage, with an annual surgical volume of nearly 4,000 procedures. It has distinctive technical features and extensive clinical diagnostic and treatment experience.

Integrated Diagnosis and Treatment of Chronic Kidney Disease

In 2014, the inpatient ward of the Department of Nephrology at Sir Run Run Shaw Hospital completed its relocation as a whole to the Qiantang Campus, and a chronic kidney disease subspecialty was established. The discipline now has more advanced diagnostic and treatment capabilities and extensive experience in diagnosis and treatment, enabling it to effectively manage various diseases, including acute and chronic renal failure, primary glomerular diseases, lupus nephritis, ANCA (antineutrophil cytoplasmic antibody)-associated vasculitis, and metabolic kidney disease. In addition, the subspecialty can provide diagnosis and treatment according to standardized procedures for various difficult and rare diseases, including IgG4-related disease (IgG4-RD), thrombotic microangiopathy, monoclonal gammopathy-associated renal injury, and Fabry disease. The Department of Nephrology was also among the earlier departments to apply biologic agents, such as rituximab and belimumab, to the treatment of kidney diseases, reducing patients’ use of glucocorticoids and achieving excellent therapeutic outcomes. At the same time, comprehensive management of chronic kidney disease has enabled integrated treatment of kidney diseases and effectively delayed progression to end-stage kidney disease.

The number of renal biopsy procedures has increased year by year. More than 600 renal biopsies are currently performed annually, and both the total number of biopsies and the number of IgA nephropathy (immunoglobulin A nephropathy) cases rank among the highest in Zhejiang Province. The department routinely performs pathological examinations including light microscopy, electron microscopy, immunofluorescence, special stains such as Congo red, and light-chain immunohistochemistry, providing strong support for clinical diagnosis and prognostic assessment.

Hemodialysis and Peritoneal Dialysis

The Blood Purification Center at the Qiantang Campus is equipped with an internationally advanced German Lauer dual-stage reverse-osmosis water treatment system and has 47 hemodialysis machines and an Asahi Kasei plasma exchange machine, thereby establishing a comprehensive information management system. It performs more than 30,000 dialysis sessions annually, with dialysis quality ranking among the best in Zhejiang Province. In addition to routine hemodialysis, the Qiantang Blood Purification Center also performs a range of blood purification techniques, including hemoperfusion, single plasma exchange, double plasma exchange, plasma adsorption, and artificial liver treatment, providing support for the treatment of critical conditions such as poisoning, hyperlipidemic pancreatitis, severe immune diseases, transplant rejection, and liver failure. In addition, in cooperation with the Vascular Access Center, it explores ultrasound-guided puncture of difficult vascular access.

The center performs open surgical peritoneal dialysis catheter placement and percutaneous peritoneal dialysis catheter placement, and was the first in China to perform relatively complex procedures such as laparoscopic tunnelled peritoneal dialysis catheter placement and peritoneal dialysis catheter placement by puncture with pelvic fixation. It has the techniques required for the prevention and treatment of various complications, including peritoneal dialysis catheter migration, obstruction, and peritonitis. At present, more than 400 patients have undergone peritoneal dialysis catheter placement, nearly 100 patients are under follow-up, and more than 10 patients are receiving APD (automated peritoneal dialysis). Patient survival and technique survival, among other measures, have reached leading levels in Zhejiang Province. Nurses and physicians from the Peritoneal Dialysis Center have received further training at peritoneal dialysis centers in the United Kingdom and China and maintain close cooperation and exchanges with leading hospitals in China.

Academic Standing

The Department of Nephrology currently has a highly qualified medical and nursing team. All physicians have postgraduate-level or higher qualifications, including six with senior professional titles. Nurses in the hemodialysis unit have undergone specialized hemodialysis staff training at Loma Linda University in the United States and possess a high level of professional competence. The department serves as the chairing institution of the Zhejiang Provincial Association of Mathematics and Physics, as a vascular access training base in Zhejiang Province, and as a national-level validation institution for new drugs for kidney diseases. Each year, it organizes continuing education programs on topics including new advances in hemodialysis vascular access and in the diagnosis and treatment of chronic kidney disease mineral and bone disorders, sharing new concepts and methods for dialysis access and chronic kidney disease with peers.

Research Achievements

The Department of Nephrology conducts research and analysis on new mechanisms in the pathogenesis of chronic kidney disease, new diagnostic and treatment technologies for vascular access, and risk factors for death among patients undergoing peritoneal dialysis. The team has led 1 project under the National Key R&D Program of the Ministry of Science and Technology—the Young Scientists Project—6 National Natural Science Foundation of China projects, and 10 Natural Science Foundation of Zhejiang Province projects. The team has published nearly 100 research papers in high-level academic journals, including the renowned journals Immunity, Nature Immunology, JCI, and JASN. More than 20 of these papers are indexed by SCI, and the highest impact factor for a single paper is 43.75.