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Nephrology & Hypertension

Nephrology & Hypertension

The Hypertension Clinic was founded by Dr. Maurice Nellen, one of the original members of the Cardiac Clinic, in about 1960. In 1968 Prof Willem Lubbe together with Coenie Marais, father of Prof. David Marais, further developed the clinic, but in 1978 Prof. Lubbe left for New Zealand. Prof. Lionel Opie ran the clinic until 1998 when Prof. Brian Rayner took over the reins.

Professor Lennox Eales stimulated initial interest in renal medicine at Groote Schuur Hospital. Owing to his interest in porphyria, the renal/porphyria laboratory was a prominent feature and supported the clinical service as well as much of the early research.

Dr Geoff Thatcher (1972-1976) carried this work forward, and stimulus for the early development of the Groote Schuur Renal Unit was provided by an active transplant and dialysis service. His successors were Dr Martin Gregory (1977-1979), Prof Roal van Zyl Smit (1979-1998), Dr Michael Pascoe (1999-2008), and Prof Brian Rayner (2008-present).

Prof Rayner has combined the Renal and Hypertension Clinics under one division of Nephrology and Hypertension. He is assisted by 3 other full-time consultants, A/Prof Ikechi Okpechi, Dr Zunaid Barday and Dr Nicola Wearne, and one part-time consultant, Dr Erika Jones.

Teaching

Although there is currently only one permanent sub-specialist training post for a senior registrar/fellow, the division is fortunate to be able to access regular funding for 2 or 3 other trainees at most times, as well as providing training to International Society for Nephrology (ISN) sponsored trainees (1-3 at a time), of whom many have completed there training here. Registrars in internal medicine rotate through the unit every 3 months.

Initially, surgeons of the general surgical service did renal transplants. This included a single kidney transplant carried out by Professor Christiaan Barnard. Since the early 1990s when he returned from the USA after completing his training as a transplant surgeon, till recently, Prof Del Kahn ran the kidney and liver transplant programme. Prof Elmi Muller has now taken over the running of this unit, and is doing pioneering work in HIV positive-to-positive kidney transplantation.

 

Research

As of August 2016, our Division has been officially recognised by the University as a research unit – Kidney and Hypertension Research Unit. See the publications link for a full list of recent publications.

 

Clinical services

  1. Specialist Hypertension Clinic (E17) - Phone 021 404 6102
  2. 24 hour blood pressure monitoring (E17)
  3. Chronic Haemodialysis (E12/E13)
  4. Acute haemodialysis (intermittent, SLED, CVVHD), plasma exchange and charcoal haemoperfusion
  5. CAPD (E12)
  6. Renal Transplantation (E12 Transplant Unit) 
  7. Renal Transplant Clinic (E13 Clinic on Mon/Wed/Fri AM) - Phone 021 404 3311
  8. Living Donor Workup/Transplant Coordinators - Phone 021 404 4300/3316
  9. Under 10 clinic ie. low clearance/immunosuppression clinic (E13 Clinic Tue AM)
  10. Nephritic Clinic ie. general nephrology (OPD building Wed PM)
  11. In patient nephrology consultation
  12. Adolescent Clinic (E13 Clinic Thurs PM)
  13. HIV associated nephropathy clinic (E13 Clinic Thur AM)
  14. Private practice nephrology services at UCT Academic Hospital - call 021 442 1816/1966
  15. University of Cape Town Private Hypertension Clinic. Contact: 0214066490  or Yvonne.Trinder@uct.ac.za

The Division provides a very active outpatient and consultative service, running busy outpatient clinics in hypertension (E17), "Under-10" (low clearance and immunosuppression) clinic, transplant follow up clinics, new renal patient clinic, HIV kidney disease clinics, adolescent clinic (E13), and general nephrology "nephritic" clinics in the OPD building.

Dialysis makes up a big part of our service. Besides for dialysing all patients with acute renal failure/kidney injury who require dialysis in hospital, we maintain about 150 patients on chronic outpatient dialysis - around 100 on haemodialysis and 50 on peritoneal dialysis. This would be impossible without our dedicated nursing and technologist staff.

The only way to get patients off dialysis is to transplant them, so the transplant team are critical in the ability of the service to accept new patients onto dialysis, which has a fixed maximum number of places available. They are involved in performing around 50 kidney transplants per year, about one third of them from living donors. Follow up takes place at the Renal Transplant Clinic in E13.