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J Prakash
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ABSTRACT: Acute renal failure (ARF) complicating epidemic dropsy is reported in three patients. In this study, ARF resolved in two patients over a period of 4-6 weeks with conservative and dialytic support. One patient died of refractory heart failure. To the best of our knowledge ARF in association with epidemic dropsy has not been reported before in the literature from India.
Renal Failure 12/1999; 21(6):707-11. · 0.82 Impact Factor
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The Journal of the Association of Physicians of India 06/1998; 46(5):491.
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ABSTRACT: A total of 638 patients with acute renal failure (ARF) of diverse etiology were studied over a period of 9 years (July 1985-Dec, 1994) of which 96 (15%) patients were classified as elderly ARF with mean age of 72.5 years. Medical causes accounted for 80% of geriatric ARF while 20% patients, had ARF of surgical origin. Decreased renal perfusion resulting from gastroenteritis was the predominant (52.8%) cause of ARF in the medical group. Nephrotoxic ARF and ARF due to F. malaria were seen in 10 and 7 patients respectively. Obstructive uropathy was observed in 12 patients in surgical group and in remaining 8 patients ARF developed following various surgical procedures. ARF in association with multiorgan failure was not observed in our study. Mortality was seen in 24 patients (25%). The causes of mortality were GI bleed (6), peripheral circulatory failure (5), hyperkalemia (4) and sepsis (4). Thus medical ARF remains the major cause of acute renal failure in elderly patients in our study in contrast to ARF associated with multiorgan failure and surgery in developed countries.
Geriatric Nephrology and Urology 02/1997; 7(2):67-72.
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ABSTRACT: Twenty-six cases (4.8%) from a total of 540 patients with acute renal failure (ARF) of diverse aetiology had ARF in association with falciparum malaria. Their ages ranged from 15 to 85 years (mean 31.2). Urinary sediment abnormalities and proteinuria (less than 1 g/24 h) were observed in 15 (57.7%) cases. The probable underlying factors leading to ARF were: volume depletion 17 (65.3%), intravascular haemolysis 8 (30.8%), hyperparasitaemia 8 (30.8%), cholestatic jaundice 6 (23%), and hypotension 5 (19.2%). Dialysis therapy was required in 15 patients (57.7%) as they had severe renal failure, and the remaining 11 patients improved with supportive measures. All patients received antimalarial therapy. The clinical course of ARF was consistent with acute tubular necrosis in 20 patients. Six cases were subjected to percutaneous renal biopsy. One patient showed histological features of necrotizing glomerulonephritis along with acute tubulointerstitial nephritis. The biopsies in the other five patients showed features of acute tubular necrosis in three, and acute interstitial oedema with patchy tubular necrosis in two. The mortality rate was 30.8%. Thus falciparum malaria, which has been an important cause of ARF in certain highly endemic zones of India, is showing an increasing prevalence in other parts such as Eastern Uttar Pradesh due to an imbalance between the increasing population and inadequate sanitary facilities, which further worsen during floods.
Nephrology Dialysis Transplantation 01/1997; 11(12):2414-6. · 3.40 Impact Factor
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ABSTRACT: Of 63 patients of obstetrical acute renal failure, 15 cases (23.8%) had biopsy proven bilateral renal cortical necrosis. Remaining 48 patients (76.2%) had acute tubular necrosis. Eight of 39 cases in early pregnancy had cortical necrosis (postabortum) and 7 of 24 patients in late pregnancy revealed cortical necrosis. Diffuse and patchy cortical necroses were seen in 12 and 3 patients respectively. The incidence of cortical necrosis was almost equal in both early as well as late pregnancies. The high incidence (20.5%) of cortical necrosis following septic abortion remains the interesting feature of the present study in contrast to very low incidence (1.5%) of cortical necrosis in postabortum group in developed countries. The death occurred in most patients (14 ie, 93.3%) of cortical necrosis because of uraemic complications and sepsis.
Journal of the Indian Medical Association 07/1996; 94(6):227-9.
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Indian pediatrics 05/1996; 33(4):329-31. · 1.05 Impact Factor
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ABSTRACT: The present study included 426 patients with acute renal failure age range 7 months to 85 years, during 8-year period (1984-1992). Medical, surgical and obstetric causes were responsible for ARF in 68.3, 17.8, and 14% of cases respectively. The main aetiological factors encountered were volume depletion secondary to gastrointestinal fluid loss (35.2%), acute glomerulonephritis (10.3%), nephrotoxin (8.6%), falciparum malaria (4.2%), obstructive uropathy (13%), post-abortal (10.5%), and miscellaneous factors (1.4%) of patients. The overall mortality was 19.2%. Thus our observation revealed that diarrhoeal diseases (35.2%), obstructive uropathy (13.3%), and septic abortion (10.5%) were the main causes for ARF in medical, surgical, and obstetric groups respectively. In contrast to our studies, acute renal failure associated with diarrhoeal diseases, septicaemia, falciparum malaria and septic abortion are rare in European countries.
Nephrology Dialysis Transplantation 12/1995; 10(11):2009-12. · 3.40 Impact Factor
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ABSTRACT: Renal cortical necrosis is an uncommon cause of acute renal failure. We report 23 cases of biopsy-proven renal cortical necrosis which constituted 6.3% (23/363) of all cases of acute renal failure studied over a period of seven years (1985-92). The patients were divided into two groups: obstetric and non-obstetric. Obstetric complications were responsible for renal cortical necrosis in 15 (65.2%) patients while non-obstetric conditions accounted for the remaining eight (34.8%) cases. The overall incidence of cortical necrosis in obstetric acute renal failure was 15/63 (23.8%) patients, the incidence being nearly equal in early (20.5%) and late (29%) pregnancy. Post-abortum renal failure was the sole cause of cortical necrosis in early pregnancy in the obstetric group. Haemolytic uraemic syndrome (three patients) and septicaemia (two patients) were the main cause of necrosis in the non-obstetric group. The cortical necrosis was diffuse and patchy in 17 and six patients, respectively. The disease had a fatal prognosis in 20 (87%) patients; mortality was due to uraemic complications and infections in the majority of patients. The high frequency of post-abortum renal cortical necrosis in our patients is similar to the experience of other Indian workers.
Postgraduate Medical Journal 05/1995; 71(834):208-10. · 1.94 Impact Factor
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ABSTRACT: Three hundred twenty renal biopsies were done in 305 patients over a period of 5 years. Adequate tissue for pathologic diagnosis was obtained in about 79% of biopsy attempts. The overall morbidity of procedure was 6.8%. Haematuria in 11.8% cases was the commonest complication. Haematuria resolved spontaneously in 63.8% of patients within 4-12 hours. Hypotension due to blood loss occurred in 3 patients (0.98%) who required blood transfusion. Five patients (1.6%) developed perirenal haematoma. Urinary retention requiring single catheterisation was seen in 12 cases (3.9%). Perirenal abscess occurred in one case. Minor complications improving with symptomatic medication included vomiting, abdominal pain and vasovagal attack in 3.6%, 2.6% and 1.6% cases respectively.
Journal of the Indian Medical Association 01/1995; 92(12):395-6.
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Indian pediatrics 11/1994; 31(10):1271-3. · 1.05 Impact Factor
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The Journal of the Association of Physicians of India 10/1993; 41(9):616.
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Nephron 02/1993; 64(4):641-2. · 13.26 Impact Factor
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ABSTRACT: Out of 152 cases of Acute renal failure (ARF) 32 patients (21%) were subjected to kidney biopsy. All patients had intrinsic ARF. Prerenal azotemia and obstructive uropathy were excluded. Histologic observations were: Crescentric glomerulonephritis in 7 (21.9%), acute endocapillary proliferative glomerulonephritis 5 (15.6%), acute interstitial nephritis 7 (21.9%), necrotizing vasculitis 4 (12.5%), acute tubular necrosis in 5 (15.6%) and membrano-proliferative GN with superimposed crescent in 2 (6.2%) while renal cortical necrosis was seen in 6.2% of cases. Prebiopsy diagnosis was correct in only 10 (31.25%) cases. The result of biopsy had altered clinical diagnosis in 22 (68.75%) patients and precise renal biopsy diagnosis resulted in therapeutic changes in 54.8% of patients with ARF.
Indian Journal of Medical Sciences 12/1992; 46(11):328-31.
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Transplantation Proceedings 11/1992; 24(5):1790. · 1.00 Impact Factor
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Transplantation Proceedings 11/1992; 24(5):1943. · 1.00 Impact Factor
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ABSTRACT: Two hundred and ninety three sessions of intermittent peritoneal dialysis were carried in 158 cases of renal failure between 1984 and 1987. The complications encountered during the procedure were grouped as mechanical in 29 (17.9%), circulatory in 26 (15%), neurologic in 21 (13.4%) and biochemical in 54 (34.1%) cases. Unexplained respiratory arrest with spontaneous recovery occurred in 2, infections in 5 and miscellaneous complications in 19 (12%) cases. Bradycardia and cardiac standstill were observed in one patient. Most of the complications were managed uneventfully. There was no mortality.
The Journal of the Association of Physicians of India 01/1991; 38(12):906-8.
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The Journal of the Association of Physicians of India 10/1989; 37(9):595-7.
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Nephron 02/1989; 51(1):122-3. · 13.26 Impact Factor
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Journal of the Indian Medical Association 02/1988; 86(1):3-5.
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The Journal of the Association of Physicians of India 12/1986; 34(11):815-7.
