S C Tiwari

All India Institute of Medical Sciences, New Dilli, NCT, India

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Publications (177)430.11 Total impact

  • Article: LBP23
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    ABSTRACT: Background & objectives: HIV/AIDS patients may have renal involvement also, however, Indian data are sparse. The present study was done to find the spectrum of renal diseases in HIV/AIDS patients in north India. Methods: In this prospective pilot study, HIV positive patients aged >18 yr were screened for renal involvement [serum creatinine >1.5 mg% and/or significant proteinuria (>500 mg /day)]. Patients who were positive on screening were followed up prospectively and underwent kidney biopsy if indicated. Results: A total of 526 patients were screened, of these, 91 (17.3%) were found to have renal involvement. Group A (Treatment naïve) comprised 392 patients who were not on antiretroviral treatment (ART) and group B (patients on ART) comprised 134 patients. More patients (74/392, 18.9%) in group A had renal involvement as compared to patients in group B (17/134, 12.7%). Of the 91 patients with renal involvement, 26 were followed up and underwent kidney biopsy. Thirteen patients had only proteinuria and another 13 had renal dysfunction with or without proteinuria. Most common histological diagnosis was mesangioproliferative glomerulonephritis (mes PGN) (10/26). Two patients had collapsing FSGS (focal segmental glomerulosclerosis) and three patients had immune complex glomerulonephritis. Seven patients had acute kidney injury, whom six totally recovered from their renal function. All patients with mesPGN tolerated angiotensin converting enzyme (ACE) inhibitors well. There was mixed response of collapsing FSGS to steroids. Both patients with MPGN (membranoproliferative glomerulonephritis) did well on low dose of steroid and ART. Interpretation & conclusions: Renal involvement was found to be common in HIV positive patients (17.3%). A low occurrence of renal involvement found in patients already on ART suggests some renoprotective effect of ART. Our preliminary results showed that collapsing FSGS was not rare in Indian HIV positive population, but classical HIV associated nephropathy was not seen. Longitudinal studies with robust study design and large sample size need to be done to confirm the findings.
    The Indian Journal of Medical Research 05/2013; 137(5):950-6. · 1.40 Impact Factor
  • Dipankar Bhowmik · Tarun Baveja · Suresh C Tiwari
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    ABSTRACT: The term chronic kidney disease (CKD) signifies permanent reduction in renal function. It consists of 5 stages of increasing severity. CKD replaces the multiple terms like chronic renal failure in vogue earlier. The prevalence of CKD is rapidly increasing in the community and causing a huge burden on the community. Since the current marker of renal function-serum creatinine is not sensitive enough, measurement of estimated glomerular filtration rate (eGFR) has been proposed to quantify the renal function better. The family physician has a vital role to play in preventing the onset and progression of CKD. Prevention starts with maintaining a healthy lifestyle. The groups at risk for developing CKD like diabetics and hypertensives should be effectively treated. Yearly estimation of albuminuria (or microalbuminuria) and estimated GFR should be done. Optimal use of renoprotective drugs can delay the inevitable progression of CKD to end-stage renal disease (ESRD). The family physician is the key person, who can implement these measures at the primary care level. Referral to a nephrologist can be made once initially when the serum creatinine >2 mg% to establish the primary diagnosis; and subsequently the patient can be managed in consultation with the nephrologist. Only such an Integrated approach with the active participation of the family physician can successfully stem the upsurge in the tide of CKD.
    Journal of the Indian Medical Association 10/2012; 110(1):40-2.
  • D. Bhowmik · S.C. Tiwari
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    ABSTRACT: Hemodialysis in India has improved by leaps over the last two decades. However there is a long way to go. There is still late diagnosis, late referral of kidney patients and issues remain of accessibility to hemodialysis centres along with finances. Intensive public, patient and primary care physician education, government backing and induction of more trained personnel will make hemodialysis a successful RRT modality in India.
    Journal International Medical Sciences Academy 04/2012; 25(2):99-100.
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    ABSTRACT: Heroin exposure can cause various complications like seizures, stroke, spongiform encephalopathy, transverse myelopathy, plexopathy, compartment syndrome, rhabdomyolysis and renal failure due to various mechanisms. We report here a young male who smoked heroin for the first time and developed transverse myelitis, rhabdomyolysis and acute kidney injury requiring dialysis. His renal recovery was complete by four weeks, while neurological improvement occurred 8 to 12 weeks later. This case suggests a common pathogenic mechanism of heroin intoxication involving multiple systems of the body.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 11/2011; 22(6):1223-5.
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    ABSTRACT: We evaluated important nontraditional cardiovascular risk factors, endothelial function and oxidative stress (OS) among stable peritoneal dialysis (PD) patients. Their association with carotid intimal medial thickness (CIMT) was also assessed. Thirty-eight adult patients (13 diabetics, 20 males) on PD for >6 months and 15 age and sex-matched controls were studied. Duration of dialysis (DOD), residual urine output (UO), weekly Kt/V urea, detailed biochemical and lipid profile were noted. OS was measured by serum concentration of antioxidants; vitamin C and ferric reducing ability of plasma (FRAP) and pro-oxidant; thiobarbituric acid-reactive substances (TBARS). High-resolution ultrasonography was used to determine CIMT and flow-mediated dilatation of brachial artery [endothelium-dependent dilatation (EDD)] and dilatation subsequent to nitrate spray [endothelium-independent dilatation (EID)]. Mean age, DOD, UO and Kt/V of study population were 49.3 ± 11.6 years, 19.4 ± 11.8 months, 508.2 ± 422.9 ml/day and 1.73 ± 0.24, respectively. As compared to controls PD patients had higher CIMT (0.46 ± 0.05 vs 0.50 ± 0.07 mm, P = 0.003) and TBARS (1.5 ± 0.4 vs 5.1 ± 2.3 nM/ml, P < 0.001) but lower Vitamin C (1.7 ± 0.3 vs 0.6 ± 0.2 mg%, P < 0.001), FRAP (990.8 ± 78.1 vs 328.7 ± 183.5 μM/L, P < 0.001) and EDD (26.2 ± 5.4 vs 9.8 ± 4.6 %, P < 0.001). TBARS correlated positively with DOD and negatively with hemoglobin. Vitamin C and FRAP correlated positively with serum albumin. EDD correlated positively with UO, Kt/V and hemoglobin. CIMT correlated negatively with Kt/V and hemoglobin. Among themselves CIMT correlated negatively with EDD and vitamin C. EDD correlated positively with vitamin C, while FRAP correlated positively with vitamin C and negatively with TBARS. PD patients have higher OS, poorer endothelial function and higher structural atherosclerosis. These parameters are closely linked to each other, hemoglobin, DOD, residual UO, serum albumin and small solute clearances.
    Indian Journal of Nephrology 10/2011; 21(4):264-9. DOI:10.4103/0971-4065.83736
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    ABSTRACT: The cases of hemolytic uremic syndrome (HUS) preceeded by diarrhea are commonly labeled as D+ HUS. However, with severe renal failure or with delayed recovery, such cases should be evaluated for rarer associations like Factor H (FH), I and CD 46 deficiency or mutations. We report such a presentation of a young boy who initially came with diarrhea and had features of HUS with delayed renal recovery. He later turned out to have anti-FH antibody-related HUS.
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 09/2011; 22(5):1017-8.
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    ABSTRACT: Oxidative stress (OS) and endothelial dysfunction are implicated in accelerated atherosclerosis in chronic kidney disease (CKD). We assessed endothelial function, OS, and carotid intimal medial thickness (CIMT) and their correlates in 44 CKD stage 5 patients (group III) before and after hemodialysis (HD), 40 patients of CKD stages 3 and 4 (group II), and 25 matched controls (group I). OS was measured by serum concentration of antioxidants; vitamin C and fractional reducing ability of plasma (FRAP) and pro-oxidant; thiobarbituric acid reactive substances (TBARS). Ultrasonography of carotid artery for CIMT and of brachial artery for flow-mediated dilatation (endothelium-dependent dilatation, EDD) was done. TBARS increased significantly with severity of CKD. Antioxidants FRAP and vitamin C were significantly lower in CKD patients as compared with controls, but there was no significant difference between groups II and III. EDD decreased significantly with severity of CKD, whereas CIMT though higher in CKD patients as compared with controls was not significantly different between groups II and III. After a session of HD as compared with predialysis, levels of TBARS decreased, whereas those of FRAP, vitamin C, and EDD increased. On multivariate analysis, there was negative correlation of TBARS with glomerular filtration rate (GFR), serum albumin, hemoglobin, and EDD. Vitamin C had positive correlations with GFR, serum albumin, hemoglobin, and EDD. EDD had direct correlation with GFR, whereas CIMT correlated negatively with EDD. Endothelial dysfunction and OS occur early in CKD, are closely related to each other and structural atherosclerosis, and are proportional to decline in GFR.
    Renal Failure 05/2011; 33(4):411-7. DOI:10.3109/0886022X.2011.568138 · 0.94 Impact Factor
  • Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 05/2011; 22(3):566-70.
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    ABSTRACT: Rapidly progressive renal failure (RPRF) is an initial clinical diagnosis in patients who present with progressive renal impairment of short duration. The underlying etiology may be a primary renal disease or a systemic disorder. Important differential diagnoses include vasculitis (systemic or renal-limited), systemic lupus erythematosus, multiple myeloma, thrombotic microangiopathy and acute interstitial nephritis. Good history taking, clinical examination and relevant investigations including serology and ultimately kidney biopsy are helpful in clinching the diagnosis. Early definitive diagnosis of RPRF is essential to reverse the otherwise relentless progression to end-stage kidney disease.
    The Journal of the Association of Physicians of India 01/2011; 59:38-41.
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    ABSTRACT: ChemInform is a weekly Abstracting Service, delivering concise information at a glance that was extracted from about 100 leading journals. To access a ChemInform Abstract of an article which was published elsewhere, please select a “Full Text” option. The original article is trackable via the “References” option.
    ChemInform 07/2010; 28(28). DOI:10.1002/chin.199728206
  • Ankur Gupta · Ambar Khaira · Anil P Bhatt · Sheel Jain · Suresh C Tiwari
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 07/2010; 21(4):746-7.
  • Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 03/2010; 21(2):339-41.
  • The Journal of the Association of Physicians of India 03/2010; 58:201.
  • Ankur Gupta · Ambar Khaira · Anil Bhatt · Sheel Jain · Suresh Tiwari
  • Ankur Gupta · Ambar Khaira · Dipankar M Bhowmik · Suresh C Tiwari
    Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 01/2010; 21(1):148-9.
  • Saudi journal of kidney diseases and transplantation: an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia 01/2010; 21(1):155-6.
  • Ankur Gupta · Ambar Khaira · Dipankar Bhowmik · Suresh Tiwari

Publication Stats

847 Citations
430.11 Total Impact Points


  • 1983–2013
    • All India Institute of Medical Sciences
      • • Department of Nephrology
      • • Department of Transplant Immunology and Immunogenetics
      • • Department of Biochemistry
      • • Department of Pathology
      • • Department of Medicine
      New Dilli, NCT, India
  • 1996–2009
    • AIIMS Bhopal All India Institute of Medical Sciences
      Bhopal, Madhya Pradesh, India
  • 2008
    • Panacea Biotec Ltd.
      New Dilli, NCT, India