Critical Care & CRRT

Critical Care Nephrology

Expert multi-organ and ICU renal management — continuous renal replacement therapy (CVVHD/CVVHDF), sepsis-AKI, and electrolyte emergencies.

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Critical Care Nephrology - Dr. Vishal Singh Swasth Kidney Clinic

31+

Years Experience

24/7

ICU CRRT Coverage

Director

Nephrology & Transplant

Advanced

CVVHDF & SLED Technology

Overview

Comprehensive Care & Management

Critical Care Nephrology addresses the complex, high-stakes intersection of kidney failure and severe acute critical illness. Up to 50–60% of patients in intensive care units (ICUs) develop acute kidney injury secondary to severe sepsis, septic shock, major cardiac surgery, polytrauma, or multi-organ failure.

As Director & Unit Head of Nephrology at Max Super Specialty Hospital and founder of Swasth Kidney Clinic, Dr. Vishal Singh brings 31+ years of advanced intensive care nephrology expertise. We deliver cutting-edge continuous renal replacement therapy (CRRT), Slow Low-Efficiency Dialysis (SLED), precision fluid balance management, and rapid resolution of life-threatening electrolyte crises.

What We Treat

Severe AKI in Multi-Organ Dysfunction Syndrome (MODS)
Septic Shock Associated Renal Failure
Continuous Renal Replacement Therapy (CVVHD / CVVHDF / SCUF)
Slow Low-Efficiency Daily Dialysis (SLED)
Refractory Fluid Overload & Acute Pulmonary Oedema
Life-Threatening Hyperkalaemia, Acidosis & Electrolyte Crises
Cardiorenal & Hepatorenal Syndrome in ICU

Who Should Consult Us

Critically ill ICU patients with rising creatinine and falling urine output
Hemodynamically unstable patients in shock unable to tolerate standard HD
Post-cardiac surgery patients with acute renal impairment
Patients with acute respiratory distress syndrome (ARDS) and fluid overload
Patients with severe metabolic acidosis or refractory hyperkalaemia

Care Pathway

How We Care For You

A structured, compassionate approach from initial consultation through diagnosis, specialized therapy, and long-term surveillance.

Immediate ICU Consultation

Bedside evaluation of hemodynamics, vasopressor requirements, oxygenation, and renal functional decline.

CRRT Prescription

Custom selection of CRRT mode (CVVHDF), blood flow rate, dialysate/replacement fluid chemistry, and anticoagulation (Citrate/Heparin).

24-Hour Continuous Filtration

Continuous gentle removal of uraemic toxins, inflammatory mediators, and fluid without dropping blood pressure.

Renal Recovery & Step-Down

Transitioning from CRRT to SLED and intermittent dialysis as hemodynamics stabilize, followed by renal recovery monitoring.

Conditions & Stages

Conditions We Manage

Personalized diagnostic and treatment pathways addressing specific stages and variations of kidney disease.

Continuous Veno-Venous Hemodiafiltration (CVVHDF)

The most comprehensive continuous blood purification modality combining diffusive and convective clearance.

Slow Continuous Ultrafiltration (SCUF)

Continuous fluid removal without replacement fluid for refractory diuretic-resistant fluid overload.

Sepsis-Associated AKI

Managing the microcirculatory and inflammatory cytokine storm damaging kidney tubules during sepsis.

Cardiorenal Syndrome Type 1

Acute cardiac failure triggering secondary renal hypoperfusion and rapid functional failure.

Hepatorenal Syndrome (HRS)

Severe functional renal failure secondary to advanced cirrhosis; managed with vasopressors and albumin.

Severe Electrolyte Emergencies

Emergency correction of life-threatening hyperkalaemia (>6.5 mmol/L), severe hyponatraemia, and metabolic acidosis.

Why Dr. Vishal Singh

Renowned Clinical Leadership

With 31+ years of nephrology practice, military leadership, and academic fellowships, Dr. Vishal Singh delivers world-class, compassionate kidney care.

Academic & Clinical Authority

MBBS (AFMC Pune), MD, DNB, DrNB Nephrology, FASN (USA), FRCP (Edinburgh), FISN. Former Professor & HOD at Army Hospital (R&R), Delhi.

Pioneering Transplant Expertise

Over 1,000 kidney transplants performed — including blood group incompatible (ABOi), sensitized host, paediatric, and deceased donor transplants.

Evidence-Based Protocols

Implementation of modern guideline-directed therapies (SGLT2i, Finerenone, online HDF) backed by clinical evidence to maximize kidney longevity.

Full Procedural Suite

Access to complete interventional nephrology: ultrasound-guided renal biopsies, AV fistula creation, permcath insertion, and PD catheter placement.

Director & Unit Head at Max Hospital

Seamless continuity between outpatient clinic care at Greater Noida and advanced tertiary hospital facilities at Max Super Specialty Hospital, Vaishali.

Patient-Centred Philosophy

Transparent counselling, dietary and lifestyle education, and compassionate support tailored to every patient and their family.

FAQ

Frequently Asked Questions

Get clear, medically verified answers about diagnosis, treatment options, and disease progression.

Why is CRRT better than standard dialysis in the ICU?

Standard haemodialysis removes fluid and toxins very rapidly over 4 hours, which can cause sudden blood pressure drops in critically ill patients. CRRT runs continuously over 24 hours at gentle rates, providing optimal blood purification without compromising hemodynamic stability.

What is regional citrate anticoagulation in CRRT?

Regional citrate anticoagulation prevents the blood from clotting inside the dialysis filter without thinning the patient's blood in the rest of the body. This significantly reduces bleeding risks in critically ill surgical or trauma patients.

Can kidneys recover after requiring CRRT in the ICU?

Yes. A significant percentage of patients who require CRRT for acute kidney injury achieve partial or complete recovery of kidney function once the underlying infection or critical illness resolves.

What is the role of the nephrologist in multi-organ failure?

The critical care nephrologist manages precise fluid removal, acid-base balance, drug dosing adjustments for failing kidneys, electrolyte control, and extracorporeal organ support, working seamlessly with ICU intensivists.

Take the first step toward better kidney health today.

Consult Dr. Vishal Singh at Swasth Kidney Clinic, Greater Noida or Max Hospital, Vaishali.

Book Appointment

Swasth Kidney Clinic is dedicated to delivering expert, compassionate, and advanced nephrology care to help every patient achieve the best possible kidney health.

Critical Care Nephrology

Comprehensive Care & Management

How We Care For You

Conditions We Manage

Renowned Clinical Leadership

Frequently Asked Questions

Related Nephrology Services

Your best kidney health starts here—make your appointment today.

Your best kidney health starts here
—make your appointment today.