Department of Nephrology, Rheumatology and Pulmonology - Municipal Hospital Karlsruhe

About the Department of Nephrology, Rheumatology and Pulmonology at Municipal Hospital Karlsruhe

The Department of Nephrology, Rheumatology and Pulmonology at the Municipal Hospital Karlsruhe provides the widest range of services for the prevention, diagnostics and treatment of kidney diseases, arterial hypertension, inflammatory diseases of the joints and blood vessels, diseases of the lungs, bronchi and upper respiratory tract. To provide inpatient treatment, the department has 77 beds for general care, as well as 19 beds in the Intensive Care Unit. The department also includes a Dialysis Unit with 17 places, in which doctors carry out various types of renal replacement therapy. The department operates specialized outpatient clinics, within which doctors hold consultations for the patients with kidney diseases and arterial hypertension, rheumatic pathologies, lung diseases and conditions after kidney transplant surgery. In general, about 2,500 inpatients and more than 1,800 outpatients are treated in the department annually. The health of the patients is in safe hands of a highly qualified team of doctors with rich practical experience and deep theoretical knowledge. The Head Physician of the department is Prof. Dr. med. Martin Hausberg.

One of the priority focuses of the department's work is the conduction of various types of dialysis for kidney diseases. Dialysis procedures are carried out in a specially equipped room with 17 beds. The department's specialists perform about 11,500 hemodialysis procedures on an inpatient and semi-inpatient basis. The service range is complemented by ultrafiltration, hemofiltration and hemodiafiltration procedures. The tasks of the specialists also include the performance of continuous veno-venous hemodialysis and continuous veno-venous hemodiafiltration. With special indications, plasmapheresis or immunoadsorption techniques can be used as well (for example, for autoimmune diseases). The department is one of the best in the region in the field of dialysis procedures and has gained a reputation as a supraregional Peritoneal Dialysis Center. In addition, the department's doctors deal with the treatment of arterial hypertension of any severity (primary and secondary forms), which can lead to severe lesions of the kidneys and other vital organs. In the case of arterial hypertension, the department's doctors usually resort to drug therapy with lifestyle modifications.

An equally important area of ​​clinical practice is rheumatology. The experts of this profile provide qualified medical care to the patients with inflammatory joint diseases (arthritis), systemic diseases (vasculitis) and connective tissue diseases (collagenosis). Doctors have a unique experience in the treatment of inflammatory rheumatic diseases with kidney lesions. Rheumatic pathologies can be detected with various diagnostic methods, in particular, diagnostic joint punctures with a synovial fluid analysis, arthrosonography (joint ultrasound scanning) and color-coded duplex ultrasonography of the blood vessels, as well as the latest imaging tests (PET, MRI, and CT). The treatment is mostly based on the intake of various modern medicines, which are individually prescribed by the patient's attending physician.

The department's pulmonologists specialize in the treatment of pneumonia, chronic inflammatory diseases of the respiratory tract (bronchial asthma, chronic bronchitis, and chronic obstructive pulmonary disease), pulmonary emphysema, bronchiectasis, interstitial lung diseases, pulmonary hypertension, pulmonary embolism, lung cancer, pleural effusion, and occupational pulmonary diseases. The specialists use many high-precision examinations to diagnose pulmonary diseases, including imaging, bronchoscopy, and thoracoscopy. The department also specializes in invasive and non-invasive artificial ventilation. The service range is complemented by comprehensive diagnostics of sleep-related breathing disorders (follow-up treatment in cooperation with the Department of Otolaryngology). As for the treatment, the specialists most often manage to eliminate pulmonary diseases with the help of well-chosen drug therapies. If the intake of medications does not allow achieving the desired result, low-traumatic interventional (bronchoscopic) procedures can be performed then: for example, to eliminate stenosis in the airways caused by benign and malignant neoplasms, stop bleeding in the airways, remove foreign bodies from the airways, etc.

The department's range of medical services includes:

• Diagnostics and treatment of kidney diseases
  • Diagnostics
    • Laboratory tests
    • Ultrasound examinations, including color-coded duplex ultrasonography
    • Ultrasound-guided kidney biopsy
• Treatment
  • Drug therapy
  • Renal replacement therapy, including dialysis access formation
    • Hemodialysis
    • Ultrafiltration
    • Hemofiltration
    • Hemodiafiltration
    • Continuous veno-venous hemodialysis
    • Continuous veno-venous hemodiafiltration
    • Plasmapheresis
    • Immunoadsorption
• Diagnostics and treatment of arterial hypertension
  • Diagnostics
    • Blood pressure measurement, including 24-hour monitoring
    • Electrocardiography
    • Echocardiography
    • Kidney ultrasound 
    • Laboratory blood tests and urinalysis
  • Treatment
    • Drug therapy
    • Lifestyle modifications
    • Psychosomatic care ("stress management")
• Diagnostics and treatment of rheumatic diseases
  • Diagnostics
    • Joint puncture followed by a synovial fluid analysis
    • Ultrasound examinations (arthrosonography)
    • Color-coded duplex ultrasonography of the blood vessels
    • Imaging tests: PET, MRI, and CT scans
  • Treatment
    • Drug therapy
• Diagnostics and treatment of pulmonary diseases
  • Diagnostics
    • Pulmonary function tests
      • Blood gas analysis at rest and during exercises
      • Spirometry
      • Whole body plethysmography
      • Lung diffusion capacity measurement
      • Spiroergometry
      • Non-specific provocation tests
      • Measurement of fractional exhaled nitric oxide (FeNO)
      • 6 minute walk test
    • Ultrasound examinations, including ultrasound-guided interventions on the chest organs
    • Heart ultrasound (echocardiography) to diagnose pulmonary hypertension
    • Imaging diagnostics (in cooperation with the Department of Radiology and the Department of Nuclear Medicine)
      • CT 
      • MRI
      • X-ray 
      • Ventilation and perfusion scintigraphy
      • PET
    • Bronchoscopy
      • Flexible, rigid and combined bronchoscopy
      • Endobronchial ultrasound
      • Biopsy: endobronchial ultrasound-guided transbronchial needle aspiration, forceps biopsy, and transbronchial lung cryobiopsy
  • Treatment
    • Drug therapy
    • Bronchoscopic interventions
      • Interventional treatment of benign and malignant stenoses of the central airways (cryotherapy, stent implantation, brachytherapy, argon plasma coagulation)
      • Bronchoscopic hemostasis for bleeding from the respiratory tract
      • Foreign body removal
      • Treatment of patients with severe pulmonary emphysema using endoscopic lung volume reduction and endobronchial valves
    • Non-invasive and invasive mechanical ventilation
      • Advanced forms of COPD and emphysema
      • Obesity hypoventilation syndrome
      • Restrictive lung diseases
      • Neuromuscular diseases
      • Prolonged artificial lung ventilation and weaning
• Other medical services