Advertisment
About us
|
Subscription
|
e-Alerts
|
Feedback
|
Reader Login
Home
|
Current Issue
|
Archives
|
Ahead of print
|
Search
|
Instructions
|
Editorial Board
Users Online:
4493
Official publication of the Indian Society of Nephrology
~
Site Statistics
~
Addresses
~
Search
~
My Preferences
~
Online Submission
Export selected to
Endnote
Reference Manager
Procite
Medlars Format
RefWorks Format
BibTex Format
Citation statistics : Table of Contents
2021| March-April | Volume 31 | Issue 2
Online since
April 20, 2021
Archives
Previous Issue
Next Issue
Most popular articles
Most cited articles
Show all abstracts
Show selected abstracts
Export selected to
Cited
Viewed
PDF
SPECIAL ARTICLES
NOTTO COVID-19 vaccine guidelines for transplant recipients
Vivek B Kute, Sanjay K Agarwal, Jai Prakash, Sandeep Guleria, Sunil Shroff, Ashish Sharma, Prem Varma, Narayan Prasad, Manisha Sahay, Subhash Gupta, S Sudhindran, Kewal Krishan, Vasanthi Ramesh, Sunil Kumar
March-April 2021, 31(2):89-91
DOI
:10.4103/ijn.IJN_64_21
In December 2019, novel coronavirus (SARS-CoV-2) infection started in Wuhan and resulted in a pandemic within a few weeks' time. Organ transplant recipients being at a risk for more severe COVID-19 if they get SARS CoV-2 viral infection, COVID-19 vaccine has a significant role in these patients. The vaccine is a safer way to help build protection and would either prevent COVID-19 infection or at least diminish the severity of the disease. It would also reduce the risk of the continuing transmission and enhance herd immunity. Immuno-compromised patients should not receive live vaccines as they can cause vaccine-related disease and hence the guidelines suggest that all transplant recipients should receive age-appropriate 'inactivated vaccine' as recommended for general population. Though trials have not been undertaken on transplant recipients, efficacy and safety of COVID-19 vaccine have been scientifically documented for few vaccines among the general population.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
7
6,137
377
REVIEW ARTICLE
The nitty-gritties of Kt/V
urea
calculations in hemodialysis and peritoneal dialysis
Brian Mark Churchill, Pallavi Patri
March-April 2021, 31(2):97-110
DOI
:10.4103/ijn.IJN_245_19
In advanced Chronic Kidney Disease, patients require renal replacement therapy (dialysis or transplantation) for clearance of toxins, electrolyte and acid-base balance and removal of excess fluid. Dialysis adequacy should be taken into consideration in the adjustment of the dialysis prescription. Kt/V
urea
is one method of measuring dialysis adequacy that is commonly used in clinical practice. Different formulae for calculating Kt/V are available. The appropriate Kt/V formula to be used depends on the clinical scenario, as well as parameters such as gender and size of patient, frequency of dialysis, mode of dialysis (ie hemodialysis vs, peritoneal dialysis), inter-dialysis weight gain, clinical symptoms, complications (fluid overload, hyperkalemia, intolerance to dialysis, etc), and residual kidney function. Nutrition parameters including serum protein and albumin levels, vitamin B12 and β2-microglobulin levels should be factored into the assessment of dialysis adequacy. In this review, we have described how Kt/V
urea
is calculated in hemodialysis and peritoneal dialysis with examples. We reviewed the available literature by searching for papers related to calculating Kt/V
urea,
single pool Kt/V, double pool Kt/V, weekly Kt/V, standard Kt/V, surface area normalized Kt/V, and various equations commonly practiced in clinical practice. We found several original articles, some review articles along with detailed information from manufacturers of different dialyzers published on their websites or as package inserts. Understanding the different equations available for calculating Kt/V
urea
and the application of these results in the clinical setting is important for refining patient care and for designing clinical studies.
[ABSTRACT]
[FULL TEXT]
[PDF]
[CITATIONS]
5
8,875
1,551
ORIGINAL ARTICLES
A study of association of urinary nephrin with albuminuria in patients with diabetic nephropathy
Kishore Kondapi, N Lakshmana Kumar, Swathi Moorthy, Santhi Silambanan
March-April 2021, 31(2):142-148
DOI
:10.4103/ijn.IJN_305_19
Background and Aims:
Diabetes mellitus and its complications are associated with high mortality and morbidity. Early detection is mandatory to improve quality of life years in patients with diabetic nephropathy. Hyperglycaemia disrupts podocytes, both structurally and functionally, leading to excretion of nephrin which is present in the glomerular filtration barrier. This study was undertaken to find out whether urinary nephrin is a better indicator of podocyte injury than albuminuria in patients with diabetic nephropathy.
Methods:
The study included 125 type 2 diabetes mellitus patients as cases categorized into three groups, depending upon albumin excretion. Age and sex matched 45 individuals without diabetes mellitus were chosen as the control group. The study protocol was approved by Institutional Ethics committee. Microalbumin was estimated by immunoturbidometry and urinary nephrin by ELISA. ANOVA and Tukey post-hoc tests were done to compare the data between the groups. Correlation studies were done. Odds ratio for nephrin was calculated.
P
value less than 0.05 was considered statistically significant. The statistical analyses were performed with SPSS software version 13.0.
Results:
The urinary nephrin was found to be proportionately increased from normoalbuminuria to macroalbuminuria and it was statistically significant, with sensitivity of 92.5% and specificity of 76.7%, the cut-off value of urinary nephrin was 97.5ng/mL.
Conclusion:
Albuminuria has been used as an independent predictor of diabetic nephropathy. The statistical significant difference between the groups inferred that urinary nephrin excretion increased even in the stage of normoalbuminuria. Nephrin expression and its phosphorylation get altered by hyperglycaemia, contributing to renal damage. Nephrin was found to be a sensitive marker of early kidney dysfunction in diabetic patients.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
3
2,318
187
The Effect of Synbiotic and Probiotic Supplementation on Mental Health Parameters in Patients Undergoing Hemodialysis: A Double-blind, Randomized, Placebo-controlled Trial
Neda Haghighat, Majid Mohammadshahi, Shokouh Shayanpour, Mohammad Hossein Haghighizadeh, Samaneh Rahmdel, Majdadin Rajaei
March-April 2021, 31(2):149-156
DOI
:10.4103/ijn.IJN_341_19
Introduction:
The purpose of this double-blind clinical trial, was to examine the effect of supplementation with the synbiotic and probiotic on the mental health, quality of life, and anemia in HD patients.
Methods:
Seventy-five HD patients were randomly assigned to receive the synbiotic (
n
= 23) as 15 g of prebiotics, 5 g of probiotic powder containing
Lactobacillus acidophilus, Bifidobacterium bifidum, Bifidobacterium lactis
, and
Bifidobacterium longum
(2.7 × 107 CFU/g each); probiotics (
n
= 23) as 5 g probiotics similar to the synbiotic group with 15 g of maltodextrin as placebo; and placebo (
n
= 19) as 20 g of maltodextrin. Serum hemoglobin (Hb) and albumin (Alb) were measured. Beck depression and anxiety index (BDI/BAI) was used to assess symptoms of depression and anxiety. The health-related quality of life (HRQoL) was assessed using the questionnaire SF-36.
Results:
From baseline to 12 weeks, synbiotic and probiotic supplementation resulted in a significant decrease in BDI and BAI score in comparison to the placebo (
P
< 0.05). Between and intergroup comparison showed no significant changes between the groups in terms of HRQoL. However, the serum Hb level increased significantly in the synbiotic and probiotic group compared to the placebo group (
P
< 0.001).
Conclusion:
Overall, 12 weeks of synbiotic and probiotic supplementation resulted in an improvement in mental health and anemia compared with the placebo, whereas they failed to enhance the quality of life in HD patients.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
3
3,669
240
CASE REPORTS
First reported case of rhabdomyolysis associated with concomitant use of cyclosporin, diltiazem, and simvastatin
Kar Wah Fuah, Christopher Lim
March-April 2021, 31(2):173-175
DOI
:10.4103/ijn.IJN_5_20
Rhabdomyolysis is a syndrome with a wide range of symptoms ranging from asymptomatic raised serum creatinine kinase to life-threatening metabolic disturbances and acute kidney injury. A careful history taking and high clinical suspicion on drug-drug interaction are crucial to identify the etiology of rhabdomyolysis. Here, we present a case of rhabdomyolysis due to a rare drug-to-drug interaction of simvastatin, diltiazem, and cyclosporin in a patient with IgA nephropathy. Early renal replacement therapy was initiated, and the insulting agents were withheld. Despite the metabolic disturbances were corrected, the patient succumbed to possible venous thromboembolism event during the prolonged hospital stay. Therefore, heightened awareness is required in dealing with patients with glomerulonephritis who are frequently prescribed on polypharmacy, in order to reduce unwarranted adverse events.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
3,112
171
Arterial thrombosis associated with factor V leiden mutation in a child with nephrotic syndrome
March-April 2021, 31(2):187-189
DOI
:10.4103/ijn.IJN_32_18
Thromboembolism remains a common complication of nephrotic syndrome (NS) in adults and a less common complication in children. Venous thrombosis is well recognized, but arterial thrombosis occurs less frequently and is seen primarily in children. We report a case of arterial thrombosis associated with factor V Leiden (FVL) mutation in a young girl with NS. Screening for inherited thrombophilias such as FVL mutation may be beneficial for NS patients with thromboembolic vascular events not explained by conventional risk factors.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
1,704
108
Rosuvastatin-induced rhabdomyolysis: A case report
Ravindra Nikalji, Suvadeep Sen
March-April 2021, 31(2):190-193
DOI
:10.4103/ijn.IJN_388_19
Rosuvastatin is a recently approved statin and used widely across the globe for primary and secondary prevention of atherosclerotic cardiovascular heart disease. It has the highest lipid-lowering property among all statins and relatively well tolerated. Rhabdomyolysis is a rare but potentially serious adverse effect. The present report highlights the case of a patient admitted with proximal myopathy with severe rhabdomyolysis and acute kidney injury associated with life-threatening hyperkalemia. The symptoms appeared within 1 month of starting rosuvastatin. He required temporary dialysis to overcome the crisis. His myopathy and kidney injury were completely reversible after a few months of stopping the drug. In this report, we have also discussed the various risk factors for developing myopathy with statins and the importance of strict pharmacovigilance, and a greater caution among physicians while using this drug.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
3,301
200
LETTERS TO EDITOR
Jugular Venous Catheter related
Stenotrophomonas maltophilia
Bacteremia
Jude James, Joel J Joseph, Stelvin Sebastian, Edwin Antony, Jobin K Vilapurathu
March-April 2021, 31(2):205-206
DOI
:10.4103/ijn.IJN_193_20
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
1,342
75
Discolouration of plasma in therapeutic plasma exchange
S S Deepak Bala Kumar, Edwin M Fernando, ND Srinivasaprasad, K Thirumal Valavan, S Sujit
March-April 2021, 31(2):207-208
DOI
:10.4103/ijn.IJN_223_20
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
2,359
106
ORIGINAL ARTICLES
A novel glomerular C4d scoring system: A tool to prognosticate proliferative exudative pattern of glomerular injury
Shubada Bansode, Swarnalata Gowrishankar
March-April 2021, 31(2):111-115
DOI
:10.4103/ijn.IJN_284_19
Aim:
Proliferative exudative pattern of glomerular injury is usually a manifestation of an infection related or a post-infectious glomerulonephritis (PIGN). Rarely, it may represent a C3 glomerulopathy, which is a dysfunction of the alternative pathway of complement activation, and is then termed an atypical PIGN (aPIGN). C4d deposits in the glomerulus are footprints of the classical and/or lectin pathway of complement activation and hence is expected to be positive in immune-mediated glomerulonephritis (GN) like classical infection-related GN, and could be used to differentiate classical PIGN from atypical PIGN. Materials and
Methods:
We report a novel C4d scoring system based on the intensity and the proportion of glomerular tuft staining, in a series of 104 biopsies with the proliferative exudative pattern of glomerular injury. Using a statistically derived cut-off score of 1.45, the cases were divided into C4d positive and C4d negative groups and compared to IF findings and the follow-up, available in 36 cases.
Results:
The C4d positive group had a significantly greater proportion of cases with immune complexes compared to the group with C3 deposits alone. In the follow-up, C4d negative group had also a greater number with partial/incomplete response compared to the C4d positive group.
Conclusions:
We recommend that the C4d stain be done in all cases with a proliferative exudative pattern of glomerular injury to identify patients who would need a close follow up and further assays of complement function.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
2,283
175
Peritoneal dialysis catheter insertion by nephrologist using minilaparotomy: Do survival and complications vary in obese?
Pavitra Manu Dogra, Ranjith K Nair, Amit Katyal, G Shanmugraj, Ashok K Hooda, Anantharam Jairam, Satish Mendonca, Parikshit Singh Chauhan
March-April 2021, 31(2):124-129
DOI
:10.4103/ijn.IJN_341_20
Introduction:
Peritoneal dialysis catheter (PDC) placement for chronic kidney disease (CKD) amongst overweight and obese patients is difficult owing to deeper operating field. Literature being discordant on survival and complications in this patient subset, we attempted to analyse this research question in Indian population.
Materials and Methods:
We retrospectively analysed PDC inserted by nephrologist using surgical minilaparotomy for survivals and complications amongst 'overweight and obese' cohort ('O') at two tertiary care government hospitals in India, and compared results with normo-weight cohort ('N'), with 12−36 months follow-up.
Results:
245 PDCs were inserted by surgical minilaparotomy and 'N' to 'O' ratio was 169:76. 'O' group were more rural residing (
P
= 0.003) and post-abdominal surgery (
P
= 0.008) patients. The 1, 2, and 3-year death censored catheter survival rate was 98.6%, 95.8%, and 88.2% respectively in 'O' group, and 97.6%, 94.5% and 91.8% in 'N' group respectively (
P
= 0.52). Patient survival (
P
= 0.63), mechanical complications (
P
= 0.09) and infective complications (
P
= 0.93) were comparable despite technically challenging surgery in 'O' group. Refractory peritonitis related PDC removal was comparable (
P
= 0.54). Prior haemodialysis or catheter related blood stream infections or diabetes were non-contributory to results.
Conclusions:
Catheter survival and patient survival amongst obese and overweight CAPD patients was non-inferior to normal weight patients. Mechanical, and infective complications were comparable despite technically challenging abdominal terrain in 'O' group. The overall CAPD performance was good amongst obese and overweight.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
2,034
142
Comparative Assessment of Peritoneal Membrane Characteristics in Patients on Continuous Ambulatory Peritoneal Dialysis Using Standard Peritoneal Equilibration Test and Fast Peritoneal Equilibration Test
Aman Gupta, Pradeep Deshpande, G Sridhar, J Ramashankar
March-April 2021, 31(2):130-134
DOI
:10.4103/ijn.IJN_386_19
Background:
Evaluation of peritoneal membrane permeability in patients on continuous ambulatory peritoneal dialysis (CAPD) is crucial in prescribing treatment regimens. This study evaluated peritoneal membrane characteristics in patients on CAPD using standard peritoneal equilibration test (PET) and fast PET.
Methods:
A prospective observational longitudinal study included patients on CAPD with no symptoms of peritonitis for at least 4 weeks before the PET. Both, standard and fast PET were performed using 2.5% glucose-containing dialysate. The dialysate and plasma (D/P) creatinine ratios at each time point (i.e., 0 h, 2
nd
h, and 4
th
h) in standard and at 4
th
hour only in fast PET were determined. Patients were classified according to D/P creatinine value as high, high-average, low-average, low transporter. The follow-up period was 6 months and changes in membrane characteristics were compared again to revalidate the efficacy of fast PET.
Results:
A total of 50 patients between 41 and 70 years of age were enrolled. The majority had diabetic nephropathy (40%) and chronic glomerulonephritis (28%). Based on transport type, a significant positive correlation was observed between the D/P creatinine ratio of baseline standard PET I and fast PET I (r = 0.992,
P
≤ 0.05) and standard PET II and fast PET II (r = 0.969,
P
≤ 0.05) done after 6 months. The results of the PET and transport category after 6 months were similar in 82% cases determined by fast PET and 98% cases determined by the standard pet. There was significant agreement between both the methods of PET (K value = 0.872,
P
< 0.001). A significant (
P
≤ 0.001) correlation was observed between standard PET I and standard PET II transport status.
Conclusion:
Fast PET is a good alternative for assessing peritoneal membrane characteristics especially in the setting of less availability of resources and is a less cumbersome procedure as compared to standard PET.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
2,053
133
Delayed gastric emptying among Indian patients with non-diabetic chronic kidney disease
Madapathi Sampath Kumar, Kolar Vishwanath Vinod, Nandini Pandit, Vivek Kumar Sharma, Halanaik Dhanapathi, Sreejith Parameswaran
March-April 2021, 31(2):135-141
DOI
:10.4103/ijn.IJN_331_19
Introduction:
Upper gastrointestinal symptoms such as nausea, vomiting, abdominal bloating, and poor appetite are more frequent among chronic kidney disease (CKD) patients and may contribute to poor nutritional intake and malnutrition. Delayed gastric emptying (GE), one of the important contributors to these symptoms, has not been evaluated systematically in different stages of non-diabetic CKD, among Indian patients. Materials and
Methods:
This hospital-based, cross-sectional analytical study aimed to find out the frequency of delayed GE in non-diabetic CKD (stages: 3,4,5) patients and also to study the correlation between delayed GE and symptoms of gastroparesis, autonomic neuropathy and nutritional parameters. Patients were subjected to evaluation of symptoms of gastroparesis by standardized questionnaire (gastroparesis cardinal symptom index), nutritional status (by anthropometric measures and serum albumin), autonomic function by heart rate variability (HRV) and GE by gastric scintigraphy with a standardized solid rice idli (savory cake) meal labeled with technetium-99m sulfur colloid.
Results:
Of the 89 non-diabetic CKD (stages-3,4,5) patients evaluated, 22 (≈25%) had delayed GE and 8 (≈9%) rapid GE. Prevalence of delayed GE was higher among stage 5 (15/49, 31%) compared to stages 3 and 4 (7/40, 17.5%), though the difference was statistically insignificant. There was no association between delayed GE and symptoms of gastroparesis and autonomic neuropathy. Though not statistically significant, nutritional parameters (body mass index, skinfold thickness, and serum albumin) were poorer in the delayed GE group compared to the rest.
Conclusion:
Delayed GE, irrespective of symptoms, may contribute to malnutrition and hence should be looked for in non-diabetic CKD patients with unexplained malnutrition.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
[CITATIONS]
1
2,589
167
CASE REPORTS
Encapsulating peritoneal sclerosis after kidney transplantation: Success of medical treatment
Hanene Gaied, Mohamed Mongi Bacha, Fatima Jaziri, Mondher Ounissi, Raja Aoudia, Mouna Jerbi, Hafedh Hedri, Rim Goucha, Taieb Benabdallah
March-April 2021, 31(2):194-196
DOI
:10.4103/ijn.IJN_329_19
Encapsulating peritoneal sclerosis (EPS) is an infrequent but serious complication of long-term peritoneal dialysis (PD). EPS may become clinically apparent when patients are on PD (classical EPS) or after undergoing kidney transplantation (post-transplantation EPS). This presentation of EPS seems to occur shortly after kidney transplantation in former PD patients. In this report, we present our experience in our first case of patient diagnosed with EPS after kidney transplantation.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,051
126
A rare genetic mutation in a stone former
T Yashwanth Raj, Periandavan Kalaiselvi, Pugazhendhi Kannan, Sujit Suren, M Edwin Fernando
March-April 2021, 31(2):197-200
DOI
:10.4103/ijn.IJN_366_19
A 30-year-old woman with history of passage of stones since childhood presented with oliguria and pedal edema for 10 days. She had hypertension with a creatinine of 4.1 mg/dL. Evaluation showed presence of bilateral multiple renal calculi with features of chronicity of kidney disease. Metabolic work-up for nephrolithiasis turned out to be negative and eventually renal biopsy revealed features of chronic interstitial nephritis with greenish brown refractile crystals in the tubular lumen and interstitium. The possibility of dihydroxy adenine crystalline nephropathy was considered. Spectrophotometry of RBC lysates revealed decreased activity of Adenine phosphoribosyl-transferase enzyme. Gene amplification by PCR and sequential analysis identified a missense mutation in exon 3 region of APRT gene in the patient and her family members. This case report highlights the need to contemplate the diagnosis of DHA crystalline nephropathy in young patients with nephrolithiasis and the identification of a rare genetic mutation, which is being reported for the first time in India.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,195
121
Treatment of post-biopsy arteriovenous fistula of a renal graft by selective embolization
Lina M Serna-Higuita, Monica Zuluaga-Quintero, Jose M Hidalgo-Oviedo, Sergio Alvarez Vallejo, Arbey Aristizabal-Alzate, Gustavo A Zuluaga-Valencia, John F Nieto-Ríos
March-April 2021, 31(2):201-204
DOI
:10.4103/ijn.IJN_351_19
The development of an arteriovenous fistula (AVF) after renal graft biopsy is a rare complication, it is associated in most cases with spontaneous resolution. However, interventional therapies are required in some cases, to prevent graft loss. Selective embolization has been described as an alternative treatment. In the present study, we describes our experience on AVF after biopsy in kidney transplant patients, which was managed with selective embolization. From 2005 to 2015, a total of 452 kidney transplant biopsies were performed, 12 had an AVF requiring embolization. In 92% of cases, this was successful. Beforehand, mean serum creatinine levels were 2.45 mg/dL, after the procedure, that increased to 3.05, however, 3 months later, mean creatinine levels dropped to 1.85 mg/dL. Graft survival after 2 follow-up years was 72%. Our experience demonstrates that selective embolization of the AVF after kidney transplant biopsy is a safe procedure, and that transplant function can be maintained in patients with this complication.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
1,956
103
Plasmablastic Lymphoma Involving Kidney in an HIV Positive Patient: A Case Report with Review of the Literature
Sulav Sapkota, Mona Priyadarshini, Diganta Hazarika, Shivakumar Swamy, Radheshyam Naik
March-April 2021, 31(2):176-178
DOI
:10.4103/ijn.IJN_277_18
Plasmablastic lymphoma (PBL) is an aggressive lymphoma commonly associated with HIV infection. It most commonly presents in the oral cavity and rarely involves the kidney. Herein, we report a case of HIV positive male with renal involvement of PBL. The patient presented with unilateral severe hydronephrosis with unaltered renal functions. Despite aggressive management, there was an early relapse and the patient died within 2 years of the diagnosis. Despite the recent advances in the therapy of HIV-associated aggressive lymphomas, patients with PBL have a poor prognosis. Multimodal treatment with chemotherapy, newer targeted and biological agents, along with hematopoietic stem cell transplantation is essential for the treatment of PBL.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,335
108
Nephrotic Syndrome with Central Retinal Artery Occlusion: A Unique Presentation
Anika Agrawal, Shipra Agrwal, Mukta Mantan, Vineeta Vijay Batra
March-April 2021, 31(2):179-181
DOI
:10.4103/ijn.IJN_367_19
Childhood nephrotic syndrome is associated with significant morbidity because of recurrent relapses, infections, and episodes of thromboembolism. Thromboembolism in nephrotic syndrome may involve any major blood vessel. Timely recognition of symptoms and early initiation of anticoagulation therapy are important to avoid end-organ damage. We present here a case of a child with steroid-resistant nephrotic syndrome (SRNS) with bilateral central retinal artery occlusion (CRAO), whose vision improved with anticoagulation therapy.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
1,788
123
Novel mutations in the
DGKE
gene in two indian patients with early-onset atypical haemolytic uraemic syndrome
Jyoti Sharma, Valentine Lobo, Jyoti Singhal, Siddharth Anand, Sandeep Kadam, Shatakshi Ranade, Priyanka Gangodkar, Karthik Ganesan, Nikhil Phadke, Meenal Agarwal
March-April 2021, 31(2):182-186
DOI
:10.4103/ijn.IJN_336_19
Atypical haemolytic uremic syndrome (aHUS) is a clinically and genetically heterogeneous condition caused by a complex interplay between genomic susceptibility factors and environmental influences. Pathogenic variants in the
DGKE
gene are recently identified in cases with infantile-onset autosomal recessive aHUS. The presence of low serum C3 levels, however, has rarely been described in cases of
DGKE-
associated aHUS. Molecular genetic testing was performed by a commercial next-generation sequencing (NGS) panel as well and by an in-house developed targeted NGS for
DGKE
gene. Copy number variations (CNVs) were computed from NGS data by calculating a normalised copy number ratio of aligned number of reads at targeted genomic regions against multiple reference regions of the same sample and multiple controls. We report here two such novel clinically relevant variants (c.727_730delTTGT and c.251_259delGCGCCTTC) in the
DGKE
gene, in two families of infantile aHUS with low serum C3 levels.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,107
126
First successful three-way kidney exchange transplantation in North India
Irfan Ahmad, Sanjiv Saxena, Ravi Bansal, Rajesh Goel, Prit P Singh, Jagdeep Balyan, Amit S Malhotra, Bhaskar Borah
March-April 2021, 31(2):169-172
DOI
:10.4103/ijn.IJN_116_19
Kidney paired donation is the most cost-effective approach in incompatible donor-recipient pairs. Incompatibility may be due to blood group, human leucocyte antigen crossmatch or both. In many cases of a living donor kidney transplant, there is only one potential donor who becomes unsuitable due to any of the above mentioned factors. In kidney paired donation, donor-recipient pairs are exchanged to sort out the incompatibility. We report our first successful three-way kidney exchange transplantation from North India. As deceased donor program is still in evolving stage in most parts of our country and transplant with desensitization protocol is associated with financial constraints, infections, and lack of availability in many centers, kidney paired donation is a valuable approach to expand the donor pool.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,317
163
COMMENTARY
From the president's pen
Chakko Korula Jacob
March-April 2021, 31(2):92-92
DOI
:10.4103/ijn.IJN_413_20
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
1,482
71
C4d in Proliferative Glomerulonephritis
Geetika Singh
March-April 2021, 31(2):93-94
DOI
:10.4103/ijn.IJN_224_20
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
1,956
129
Optimum Chain Length in Kidney Exchange Program and the Way Ahead
Vivek B Kute, Himanshu V Patel, Vineet V Mishra, Sanjay K Agarwal
March-April 2021, 31(2):95-96
DOI
:10.4103/ijn.IJN_376_19
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
1,876
94
LETTERS TO EDITOR
COVID-19 pandemic: A perspective from nephrology resident
Priti Meena, Abhishek Singh
March-April 2021, 31(2):209-210
DOI
:10.4103/ijn.IJN_276_20
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,552
131
OBITUARY
Prof. Pratap S Avasthi (1935-2021)
RN Srivastava
March-April 2021, 31(2):0-0
DOI
:10.4103/0971-4065.313991
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
1,320
101
ORIGINAL ARTICLES
Remote ischemic preconditioning for prevention of contrast-induced acute kidney injury in patients of CKD stage III and IV undergoing elective coronary angiography: A randomized controlled trial
Raju Sahu, Dipankar Sircar, Saroj Mondal, Koushik Bhattacharjee, Debabrata Sen, Arpita Raychoudhury, Rajendra Pandey
March-April 2021, 31(2):116-123
DOI
:10.4103/ijn.IJN_416_19
Introduction:
Contrast-induced acute kidney injury (CI-AKI) is a serious complication of coronary angiography (CA). The aim of this randomized, parallel group, single blind, sham-controlled trial was to assess the safety and efficacy of the remote ischemic preconditioning on the prevention of CI-AKI.
Methods:
Patients of 18–80 years of age with CKD 3 and 4, who were admitted for elective coronary angiography in a tertiary care hospital in eastern India were randomized in a 1:1 ratio to standard care with ischemic preconditioning (
n
= 45; intermittent arm ischemia through 4 cycles of 5-min inflation and 5-min deflation of a blood pressure cuff) or with standard care and sham ischemic preconditioning (
n
= 42). Overall, both study groups were at moderate risk of developing CI-AKI according to the Mehran risk score. The primary endpoint was the incidence of CI-AKI, defined as an increase in serum creatinine ≥25' or ≥0.5 mg/dL above baseline at 48 h after contrast medium exposure.
Results
: CI-AKI occurred in 8 patients (19.04') in the control group and 2 (4.4') in the remote ischemic preconditioning group (odds ratio, 0.198, 95' confidence interval, 0.087 to 0.452;
P
= 0.04). No major adverse events were related to remote ischemic preconditioning.
Conclusions:
This study indicates that remote ischemic preconditioning is a simple and well-tolerated procedure, which reduces the incidence of CI-AKI in CKD 3 and 4 patients undergoing coronary angiography.
[ABSTRACT]
[FULL TEXT]
[PDF]
-
2,441
166
Etiological spectrum and clinical features in 215 patients of crescentic glomerulonephritis: Is it different in India?
Anubha Gupta, Vinita Agrawal, Anupma Kaul, Ritu Verma, Manoj Jain, Narayan Prasad, Rakesh Pandey
March-April 2021, 31(2):157-162
DOI
:10.4103/ijn.IJN_237_19
Introduction:
Crescentic glomerulonephritis (CrGN) characterized by the presence of crescents in most (=50%) glomeruli on renal histology clinically presents as rapidly progressive renal failure. It can occur due to diverse etiologies with varying course and renal outcomes. We studied the prognostic significance of its classification as pauci-immune, anti-GBM, and immune-complex mediated CrGN.
Materials and Methods:
Renal biopsies diagnosed as CrGN over 9 years were included. Clinical, biochemical, serological, and histological features of various classes of CrGN were correlated with renal outcome.
Results:
215 biopsies were diagnosed as CrGN during this period. A majority (63%) were immune-complex mediated while 32% were pauci-immune, followed by anti-GBM disease (5%). 85.5% of pauci-immune CrGN were ANCA associated. The levels of proteinuria and serum creatinine were significantly higher in anti-GBM CrGN as compared to the other two classes. The various histological features including Bowman's capsule rupture, peri-glomerular granulomatous reaction, fibrinoid necrosis, and vasculitis were more common in anti-GBM disease and pauci-immune CrGN. The median renal survival was 6.3, 5.3, 2.1 months in immune-complex mediated, pauci-immune, and anti-GBM CrGN, respectively.
Conclusion:
Immune-complex mediated is the commonest etiology of CrGN in India. Anti-GBM disease has the worst prognosis followed by pauci-immune and immune-complex mediated CrGN. Raised serum creatinine levels (>5mg%) and the degree of glomerulosclerosis at diagnosis were predictors of poor renal survival. High index of suspicion and prompt diagnosis can improve the outcome in these patients.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,324
148
Relation between vitamin d level and cyclin-dependent kinase-1 gene expression in egyptian patients with lupus nephritis and their impact on disease activity
Eman M. A. Osman, Salma Y Abu El Nazar, Dalia A Maharem, Dhargam M Al-Jebouri, Iman S Naga
March-April 2021, 31(2):163-168
DOI
:10.4103/ijn.IJN_359_19
Introduction:
Lupus nephritis (LN) is a common complication of systemic lupus erythematosus. Vitamin D and cycline-dependent kinase-1 (CDK1) have been implicated in its pathogenesis. The aim of this study was to determine the relation between vitamin D level and CDK-1 in lupus nephritis patients and their impact on disease activity.
Patients and Methods:
The current study was conducted on 50 LN patients and 20 control subjects from Egyptian population using ELISA to assess vitamin D level in serum and TaqMan assay for CDK1 gene expression.
Results:
Serum vitamin D level was significantly lower in LN patients and
CDK-1
gene was down expressed in the majority of LN patients. A significant inverse correlation was found between vitamin D level and 24 h protein in urine, ANA, anti-dsDNA, CRP, with a significant positive correlation with renal biopsy indices, eGFR. There was a non-significant inverse correlation between vitamin D and
CDK-1
(before RO-3306 addition) and a positive correlation after RO-3306. A significant positive correlation was found between
CDK-1
gene expressions with urinary albumin/creatinine ratio. However, a significant positive correlation was found between
CDK-1
(after RO-3306 addition) and proteinuria. While a significant positive correlation was found between
CDK-1
expression (after RO-3306 addition) and ANA, a significant positive correlation was found between
CDK-1
expression (before RO-3306 addition) and anti-dsDNA but CDK-1 is not associated with renal biopsy indices nor with activity indices of SLE. There was a positive correlation between
CDK-1
gene expression and CRP before and after RO-3306 addition.
Conclusions:
Vitamin D deficiency acts as a risk factor for developing LN.
CDK-1
may have an association with the diagnosis of LN but its association with the progression of staging of LN is still confusing
[ABSTRACT]
[FULL TEXT]
[PDF]
-
1,988
157
SPECIAL ARTICLES
Living well with kidney disease by patient and care-partner empowerment: Kidney health for everyone everywhere
Kamyar Kalantar-Zadeh, Philip Kam-Tao Li, Ekamol Tantisattamo, Latha Kumaraswami, Vassilios Liakopoulos, Siu-Fai Lui, Ifeoma Ulasi, Sharon Andreoli, Alessandro Balducci, Sophie Dupuis, Tess Harris, Anne Hradsky, Richard Knight, Sajay Kumar, Maggie Ng, Alice Poidevin, Gamal Saadi, Allison Tong, for the World Kidney Day Steering Committee
March-April 2021, 31(2):83-88
DOI
:10.4103/ijn.IJN_59_21
Living with chronic kidney disease (CKD) is associated with hardships for patients and their care-partners. Empowering patients and their care-partners, including family members or friends involved in their care, may help minimize the burden and consequences of CKD-related symptoms to enable life participation. There is a need to broaden the focus on living well with kidney disease and re-engagement in life, including an emphasis on patients being in control. The World Kidney Day (WKD) Joint Steering Committee has declared 2021 the year of “Living Well with Kidney Disease” in an effort to increase education and awareness on the important goal of patient empowerment and life participation. This calls for the development and implementation of validated patient-reported outcome measures to assess and address areas of life participation in routine care. It could be supported by regulatory agencies as a metric for quality care or to support labeling claims for medicines and devices. Funding agencies could establish targeted calls for research that address the priorities of patients. Patients with kidney disease and their care-partners should feel supported to live well through concerted efforts by kidney care communities including during pandemics. In the overall wellness program for kidney disease patients, the need for prevention should be reiterated. Early detection with a prolonged course of wellness despite kidney disease, after effective secondary and tertiary prevention programs, should be promoted. WKD 2021 continues to call for increased awareness of the importance of preventive measures throughout populations, professionals, and policy makers, applicable to both developed and developing countries.
[ABSTRACT]
[FULL TEXT]
[PDF]
[Mobile Full text]
[EPub]
-
2,139
153
Contact us
|
Sitemap
|
Advertise
|
What's New
|
Copyright and Disclaimer
|
Privacy Notice
© Indian Journal of Nephrology
Published by Wolters Kluwer -
Medknow
Online since 20
th
Sept '07