 I am Dr. Shilpa Shetty, nephrologist in Manipal Hospital, Bangalore. As you are all aware, the common causes of kidney failure are diabetes, uncontrolled hypertension, some immunologically mediated systemic diseases and genetic diseases. When the kidneys are not functioning optimally or patient has chronic kidney disease or end-stage kidney disease, all the waste products, water and salt tend to retain in the body. So at this point of time, some form of renal replacement therapy is required. So there are two types of renal replacement therapy. One is dialysis, the other being transplantation, which is always a better option. Dialysis can be of two types. One is the commonly known hemodialysis, the other being peritoneal dialysis. Hemodialysis is usually done in a hospital setting. Patient has to come to the hospital and it is done as maintenance dialysis three times a week. For this, we need a vascular axis like the AV fistula or an AV graft. Or if both are not feasible, then we place a permanent catheter in the neck. Peritoneal dialysis is another form of dialysis which we offer to the patients. This is well planned, well in advance. A catheter or a tube-like structure is placed surgically into the abdomen and the patient's own peritone membrane acts like a filter and dialysis exchanges can be done in the comfort of the home. We train the patient or any of his family members well in advance. Whenever a patient comes to us for medical advice, we assist the patient as a whole. We look into their other associated medical conditions and offer both these modalities of treatment. We also suggest what is better for them and we also to some extent give the choice to the patient. Apart from routine adult dialysis, we do a large number of pediatric as well as neonatal dialysis that is dialysis on the newborn. We have well qualified pediatric nephrologist as well as pediatric intensivist in our hospital. There are other slow continuous therapies also called popularly as CRRT or continuous renal replacement therapies which are usually done for critically ill patients in the ICU. We do a large number of these dialysis sessions or CRRTs. We do around 15 to 20 sessions a day in our ICU. We have another form of dialysis called as hemodial filtration which is very popular in European countries. It is a combination of hemo filtration and hemodialysis. It is an excellent mode of dialysis for people with fluctuating blood pressures or what we call hemodynamically unstable patients and older people and it gives a better clearance of larger molecules and patients feel overall much better. In fact many of our patients tell us that they don't feel that they have just undergone a dialysis. Apart from routine hemodialysis we also do liver dialysis otherwise called as mass as a bridge to liver transplantation. We do a large number of other therapies like plasmapheresis, immuno adsorption and hemo perfusions. We do quite a number of plasmapheresis in our hospital. Now what is plasmapheresis? Plasmapheresis is a therapy which is done by blood separator technology wherein we remove abnormal blood constituents or abnormal antibodies which contribute to certain diseases. These diseases are usually immunologically mediated diseases like SLE or certain kidney diseases and some neurological diseases. We also do double filtration plasmapheresis which is not commonly done in most places. We also do hemo perfusion. Hemo perfusion is a therapy wherein we remove the drugs which are in overdose like poisoning and other drug overdose situations. Patients are acutely ill, they are critical and most often in the ICU. It's a very good form to remove these and make the patient feel better. So in our hospital we have all these modalities of treatment under one roof. We have post-MD doctors and nephrology trained doctors covering our dialysis unit 24 hours a day. We handle emergency situations with the help of ICU team and done in a very efficient way. So in our unit we do a large number of dialysis usually about 3500 to 3700 dialysis per month. We have a state of the art water treatment unit. We have ultra pure water which abides by international standards. We also provide home hemo dialysis wherein our technical staff and nurse go to the patient's home and dialysis is done in the comfort of their home. We have had many national and international patients who come here for transit while during their vacation here for dialysis. In general I would like to emphasize here that we have a very kind efficient team of doctors, nurses, technical staff and other supportive staff. And we ensure the safety of the patient as well as we make them feel at home during their dialysis session. In fact many of our dialysis patients have crossed about 15 to 20 years on dialysis. This itself speaks about the quality of care in our department. Do not panic when you are told that you have a kidney disease or kidney failure. There are many options available. You can still lead a normal healthy active life while on dialysis or any kind of renal replacement therapy.