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  Citation statistics : Table of Contents
   2011| January-March  | Volume 21 | Issue 1  
    Online since March 25, 2011

 
 
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ORIGINAL ARTICLES
Oxidative stress and its association with cardiovascular disease in chronic renal failure patients
Z Hambali, Z Ahmad, S Arab, H Khazaai
January-March 2011, 21(1):21-25
DOI:10.4103/0971-4065.75218  PMID:21655165
Cardiovascular disease (CVD) is responsible for the majority of deaths in chronic renal failure (CRF). Oxidative stress plays a key role in pathogenesis of atherosclerosis and CVD, which is promoted by the production of reactive oxygen species (ROS) and impaired antioxidant enzymes. These ROS react with nitric oxide (NO) to produce cytotoxic reactive nitrogen species that cause oxidative injury to the endothelium. This study evaluated biomarkers of oxidative stress, NOx (total NO 2 and NO 3 ), and superoxide dismutase (SOD) enzyme in normal control and CRF patients as case group and correlated their association with CVD. This cross sectional study involved 173 CRF patients on different modes of treatment (hemodialysis, continuous ambulatory peritoneal dialysis (CAPD), and predialysis). Of these, 74 had CVD. The control group consisted of 33 healthy subjects who had no history of CRF and CVD. Both NOx and SOD levels were significantly lower (P<0.05, P<0.001, respectively) in the case group. Comparing between CRF patients with and without CVD, SOD level was found to be significantly lower in CRF patients with CVD (P<0.05). Logistic regression analysis showed significant association of CVD event with age, male gender, diabetes, SOD level, and lipid profile in CRF patients. Oxidative stress occurs in the CRF patients with or without CVD. This study found that NOx and SOD levels were reduced in all CRF patients with or without CVD. However, it was noted that the levels of these biomarkers of oxidative stress were significantly lower in CRF patients with CVD compared with CRF patients without CVD. Therefore, these oxidative stress markers maybe contributing factors in the pathogenesis of CVD in patients with CRF.
  12 5,018 308
Clinico-microbiological profile of urinary tract infection in South India
M Eshwarappa, R Dosegowda, I Vrithmani Aprameya, MW Khan, P Shiva Kumar, P Kempegowda
January-March 2011, 21(1):30-36
DOI:10.4103/0971-4065.75226  PMID:21655167
The knowledge of etiology and antibiotic resistance pattern of the organisms causing urinary tract infection is essential. This study was taken up to determine the presentation and risk factors associated with community-acquired urinary tract infection (CA-UTI). The distribution of bacterial strains isolated from these patients and their resistance pattern were also studied. This multidisciplinary prospective observational study was conducted in M. S. Ramaiah Hospital, Bangalore, between January and December, 2008. Patients who had CA-UTI confirmed by positive urine culture reports were included in the study. Statistical analysis was done using the SPSS version 16. Symptomatology and others risk factors for CA-UTI were studied in these patients and the causative organisms and their resistance patterns were recorded. Of the total 510 patients included, 57% belonged to the elderly age group (50-79 years). Fever and dysuria were the most common clinical presentation, but were not specific in predicting CA-UTI. Escherichia coli (66.9%) was the most common organism causing CA-UTIs with extended spectrum beta lactamase (ESBL) resistance seen in nearly two-thirds of these cases (42.2%). The organisms recorded least resistance against carbapenems (3.9%). A high resistance rate was seen for fluoroquinolones (74.1%). In conclusion, a high rate of ESBL-positive organisms and their resistance to commonly used antibiotics brings a concern for future options in treating these conditions.
  12 8,365 815
CASE REPORTS
Collagenofibrotic glomerulopathy - Case report with review of literature
KC Patro, R Jha, M Sahay, G Swarnalatha
January-March 2011, 21(1):52-55
DOI:10.4103/0971-4065.78080  PMID:21655172
Collagenofibrotic glomerulopathy is a rare, idiopathic glomerular disease characterized by abnormal accumulation of type III collagen fibrils within the mesangial matrix and subendothelial space and a marked increase in serum type III procollagen peptide levels. Proteinuria (commonest feature), edema, hypertension, and occasional progression to end-stage renal disease are the various features of this disease. The etiology and pathogenesis remain elusive. There have been reports of the disease running in the family, suggesting the possibility of genetic transmission. We report two cases of this rare entity.
  4 3,857 215
An unusual case of bilateral renal enlargement due to primary renal lymphoma
SC Dash, K Purohit, SK Mohanty, AK Dinda
January-March 2011, 21(1):56-58
DOI:10.4103/0971-4065.78081  PMID:21655173
Primary renal lymphoma is an uncommon variant of extranodal non-Hodgkin's lymphoma. Manifestations are usually nonspecific hematuria, fever, flank pain, and renal insufficiency. Pathological data are scanty; few reports indicate it has a very poor prognosis. We describe a child with bilateral symmetrically palpable kidneys, low-grade pyrexia, and arthralgia. Clinically, diagnosis was missed partly due to the fact that bilateral large renal tumors commonly produce asymmetric renal swelling, renal dysfunction, and hematuria which were absent in this case and partly due to rarity of the condition. However, radiological investigations combined with renal histology helped in establishing diagnosis in the present case.
  4 2,955 169
ORIGINAL ARTICLES
Role of free radicals and antioxidant status in childhood nephrotic syndrome
SR Ghodake, AN Suryakar, RD Ankush, RV Katkam, K Shaikh, AV Katta
January-March 2011, 21(1):37-40
DOI:10.4103/0971-4065.78062  PMID:21655168
Nephrotic syndrome (NS) is characterized by heavy proteinuria and hypoalbuminuria. Reactive oxygen species (ROS) seem to play an important role in the etiopathogenesis of proteinuria in NS. This study aims to evaluate the potential role of reactive oxygen species in pathogenesis of NS by estimating the levels of oxidants and antioxidants in children with NS. Thirty patients of NS and thirty age, sex-matched healthy subjects, were selected for the study. As compared to healthy controls, the levels of serum lipid peroxide were significantly elevated while levels of nitric oxide, erythrocyte-superoxide dismutase activity, levels of vitamin C, albumin and total antioxidant capacity were significantly reduced in nephrotic patients.The levels of uric acid and bilirubin were significantly increased in children with NS as compared to controls. There was no significant difference in vitamin E level between patients and controls. It can be concluded that increased ROS generation and decreased antioxidant defense may be related to the pathogenesis of proteinuria in NS.
  4 2,918 236
Association of angiotensin-converting enzyme gene I/D polymorphism with steroid responsiveness in childhood nephrotic syndrome
P Prasun, N Prasad, G Tripathi, T Jafar, S Sharda, S Gulati, S Agrawal
January-March 2011, 21(1):26-29
DOI:10.4103/0971-4065.75215  PMID:21655166
The aim of the study was to study the distribution of angiotensin-converting enzyme (ACE) gene insertion/deletion (I/D) polymorphism, and its association with steroid responsiveness in children with idiopathic nephrotic syndrome (INS). One hundred twenty-five children with INS were classified into two groups: steroid-sensitive nephrotic syndrome (SSNS: n = 90) and steroid-resistant nephrotic syndrome (SRNS: n=35). The control group consisted of 150 unrelated healthy children. Genomic DNA was extracted from peripheral leucocytes by the standard salting-out method. ACE genotyping was performed and ACE genotypes DD, ID, and II were compared between different groups. The frequency distribution of the DD genotype was significantly increased in children with INS compared to control subjects (P = 0.0012) while the difference was not significant (P = 0.071) between SSNS and control subjects. The frequency distribution of the DD genotype was significantly high in the SRNS group compared to control subjects (P < 0.0001). The distribution of the DD genotype was high in SRNS compared to SSNS group patients (P = 0.016). In conclusion, the presence of the DD genotype may predict risk for steroid resistance in childhood INS.
  4 2,898 204
Collapsing glomerulopathy in renal allograft biopsies: A study of nine cases
R Gupta, A Sharma, SK Agarwal, AK Dinda
January-March 2011, 21(1):10-13
DOI:10.4103/0971-4065.75220  PMID:21655163
Collapsing glomerulopathy (CG) is considered to be a distinct clinicopathologic pattern of proliferative podocyte injury. The clinical significance of CG in renal allograft biopsies is yet not clear due to the scant data on the occurrence of CG in renal transplant recipients. We identified nine cases of CG in allograft biopsies over a period of 2 years. Detailed clinical information, including follow-up data, was collected and histopathological analysis performed. All the nine patients were males with a mean age at diagnosis of 32.4±11.2 years. The median posttransplantation duration at diagnosis of CG as 52 (range 12-98) months. All the patients presented with severe proteinuria and graft dysfunction. Histological analysis showed a median number of 8 glomeruli. The collapse of the glomerular tuft with visceral epithelial cell hyperplasia involved median of 2 glomeruli (range 1-4). At the last follow-up (mean duration 6 months), four patients had graft failure (return to dialysis) while four had functioning grafts. One patient was lost to follow-up. This series emphasizes the importance of this rare glomerular pathology as an important cause of graft dysfunction that may lead to allograft failure.
  4 3,642 253
CASE REPORTS
Bilateral quadriceps tendon rupture as the presenting manifestation of chronic kidney disease
NA Wani, HA Malla, T Kosar, IM Dar
January-March 2011, 21(1):48-51
DOI:10.4103/0971-4065.78079  PMID:21655171
Bilateral painful knees with loss of extension in a patient with chronic kidney disease (CKD) may be due to spontaneous quadriceps tendon rupture. This rare complication is usually seen in patients on long term dialysis. We present a case of bilateral spontaneous quadriceps tendon rupture demonstrated by magnetic resonance imaging in a 20-year-old woman who on evaluation was found to have CKD.
  3 6,690 151
ORIGINAL ARTICLES
Medical and non-medical factors that affect voluntary living-related kidney donation: A single-center study
I Veerappan, N Neelakantan, V Tamilarasi, GT John
January-March 2011, 21(1):14-20
DOI:10.4103/0971-4065.75223  PMID:21655164
The aim was to evaluate the patients with chronic kidney disease stage 5 (CKD 5) and their prospective renal transplant donors with regard to their renal replacement choices, and to assess the medical and non-medical factors that affect living-related renal donor selection. Over 24 months, consecutive patients with CKD 5 and their relatives were interviewed at presentation. Reasons for the choice of modality were analyzed; the prospective recipients and their donors were again interviewed separately and the medical and nonmedical factors that affected the donor selection were determined. A total of 1257 patients were enrolled. Conservative therapy, maintenance dialysis, and renal transplantation were chosen by 513 (40.8%), 320 (25.5%), and 424 (33.7%) patients, respectively. Only socioeconomic status affected the modality chosen. The age, gender, and donor availability did not emerge as significant factors. Patients or donors were likely to withdraw from transplant evaluation due to the absence of a voluntary donor, presence of a male donor, coercion not to donate, and the absence of reimbursement. The commonest cause of rejection of a donor was blood group incompatibility (45.8%), followed by diabetes mellitus (DM) or risk of DM (24%), renal disease (5.9%), hypertension (5.5%), and persistent cross-match positivity (5.1%). To improve donation rates, the donor's spouse should be involved in the early stages of donor evaluation, financial support for the recipient has to be improved, and the apprehensions about complications of nephrectomy among the donors need to be alleyed. Male donors are at increased risk of leaving the program in the evaluation phase.
  3 3,203 233
CASE REPORTS
NK/T-cell lymphoma in a renal transplant recipient and review of literature
A Mohapatra, A Viswabandya, R Samuel, AN Deepti, S Madhivanan, GT John
January-March 2011, 21(1):44-47
DOI:10.4103/0971-4065.78078  PMID:21655170
T-cell lymphomas, particularly NK/T-cell lymphomas are rare post transplantation malignancies. Only a few cases have been described. These tumors behave aggressively and the outcome is poor. We present here a case of NK/T-cell lymphoma who presented to us with an orbital swelling 9 years after renal transplantation, along with the review of literature. To the best of our knowledge, this is the first case of NK/T-cell lymphoma post-renal transplantation reported from India.
  2 2,503 129
LETTERS TO EDITOR
Percutaneous nephrostomy under ultrasound guidance
RK Baishya, DR Dhawan, J Jagtap, R Sabnis, MR Desai
January-March 2011, 21(1):67-67
DOI:10.4103/0971-4065.78086  PMID:21655177
  2 1,939 121
Hypokalemia induced rhabdomyolysis
VV Jain, OP Gupta, SU Jajoo, B Khiangate
January-March 2011, 21(1):66-66
DOI:10.4103/0971-4065.78085  PMID:21655176
  1 2,358 167
Chronic kidney disease, immunosuppression and tuberculin test sensitivity
SA Zaki
January-March 2011, 21(1):68-68
DOI:10.4103/0971-4065.78088  PMID:21655179
  1 1,946 153
CASE REPORTS
Successful treatment of critically ill chronic kidney disease patient with multi-organ dysfunction associated with H1N1 infection
VB Kute, PR Shah, KR Goplani, AV Vanikar, HL Trivedi
January-March 2011, 21(1):59-61
DOI:10.4103/0971-4065.78082  PMID:21655174
Chronic kidney disease (CKD) patients are at higher risk of H1N1 influenza A infection and associated complications. To our knowledge, this is the first case report of a febrile CKD patient with multi-organ dysfunction and associated H1N1 virus infection successfully treated with oseltamivir, hemodialysis, and mechanical ventilation. Oseltamivir is safe, effective, and well tolerated in our CKD patient.
  - 2,703 142
An unusual case of abdominal wall bleeding after renal allograft biopsy
CG Koshy, BR Chacko, S Babu, G Basu, D Selvaraj, GT John
January-March 2011, 21(1):62-65
DOI:10.4103/0971-4065.78083  PMID:21655175
We report an unusual case of a enlarging anterior abdominal wall hematoma after percutaneous biopsy of a renal allograft. Angiography-directed embolization of the vessels filling the pseudoaneurysm was done and followed up with surgical exploration of the hematoma. In order to avoid this complication, Color Doppler evaluation of the overlying abdominal wall is suggested to look for significant vessels before the biopsy procedure.
  - 3,311 147
Effective use of polymyxin B hemoperfusion in septic shock complicated by urosepsis
P Malleshappa, R Ranganath, AP Chaudhari, P Singhai, M Aghariya, AB Shah
January-March 2011, 21(1):41-43
DOI:10.4103/0971-4065.78077  PMID:21655169
Direct hemoperfusion using polymyxin B-immobilized fiber (PMX-DHP) is an established treatment method for septic shock caused by Gram-negative infections. Here we report one instance in which PMX-DHP therapy has been used successfully in a patient with septic shock from urosepsis. After antibiotic therapy, direct hemoperfusion using polymyxin B helped in cardiovascular stability. The patient recovered from the shock within a few days after treatment with polymyxin-B hemoperfusion. As far as we are aware, this is the first reported case of effective treatment of urosepsis complicated by septic shock using PMX-DHP therapy in India.
  - 3,193 193
IMAGES IN NEPHROLOGY
A case of emphysematous cystitis: Timely recognition is the key
N Relia, K Chhavi
January-March 2011, 21(1):69-70
DOI:10.4103/0971-4065.78084  PMID:21655180
  - 2,081 160
LETTERS TO EDITOR
Iron status in ESRD patients
V Wiwanitkit
January-March 2011, 21(1):67-68
DOI:10.4103/0971-4065.78087  PMID:21655178
  - 1,404 182
RETRACTION NOTICE
Retraction Notice

January-March 2011, 21(1):9-9
PMID:21655162
  - 1,421 170
REVIEW ARTICLE
E-Nephrology
PK Manchanda, HK Bid
January-March 2011, 21(1):1-9
DOI:10.4103/0971-4065.78295  PMID:21655161
Diagnosis of renal diseases is often delayed owing to the scarcity of trained physicians, lack of facilities, and shortage of funds limits effective management, particularly when it comes to the red zone of renal replacement therapy. The Internetis expected to open up a myriad resource of knowledge and applications for academicians, researchers and clinicians alike in all health care professions across the globe. Also, the Internet has grown rapidly over the years and will inevitably expand even more. Evolving technologies offer modern applications for information management, communications with multimedia and virtual reality. Now, these innovative technologies have opened up newer possibilities for nephrologists. As Internet is serving as a backbone for these modern technologies, it is an utmost necessity to use and refine Internet applications for future nephrologists. Increasingly easy access to Internet has dramatically reduced barriers in sharing of information among basic and clinical nephrologists. Considering the growing scope for nephrologists in the use of Internet, it is necessary to understand Internet as a source of information and backbone of modern application. This review illustrates expanding roles of the Internet for the nephrologists and provides ready to use compilation of useful academic, research, clinical resources and is expected to introduce, stimulate and guide nephrologists into the realm of the world wide web. It also investigates how Internet is supporting in growth and development of the field of nephrology and present and future scopes of Internet as a tool for professionals involved in this area as well as information about biological sciences, and it also gives information about societies in various continents working in field of nephrology and the links useful for clinicians and research scientists.
  - 6,621 350
Indian Journal of Nephrology
Published by Wolters Kluwer - Medknow
Online since 20th Sept '07