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Publications (323)
Rationale
Melioidosis is a serious opportunistic infection caused by Burkholderia (B.) pseudomallei, primarily affecting immunocompromised individuals, particularly in endemic regions. Timely diagnosis and appropriate treatment are crucial to prevent fatal outcomes.
Patient concerns
Case 1 was a 34-year-old male kidney transplant recipient who pre...
To study the clinical profile and outcomes of rare mycobacterial infections such as nontuberculous mycobacteria (NTM) and Mycobacterium leprae kidney transplant recipients. This is a retrospective analysis of clinical outcomes of the uncommon infections in renal allograft recipients over 22 years during 2000–2022 from a tertiary care center in sout...
Background
IgA nephropathy (IgAN) is the most common form of glomerulonephritis globally, and a leading cause of end-stage kidney disease (ESKD). In India, IgAN accounts for 10-15% of kidney biopsies, often with nephrotic syndrome and renal impairment. Steroids are the mainstay of treatment, though the role of mycophenolate (MPA) is less explored....
This is an article the delves into the intricacies of kidney donation from both diabetics and pre-diabetics
Introduction
The aim of the study was to study the clinical profile and outcomes of nocardiosis in renal allograft recipients.
Methods
This was a retrospective study of clinical outcomes in consecutive renal allograft recipients with Nocardia infection over a 22-year period (2000–2022) from a tertiary care center in Southern India. The clinical da...
Opportunistic infections or pathogens that reactivate from latent infection in the renal transplant recipients often arise during the peak immunosuppression period and infections such as Pneumocystis jirovecii may arise in the late period of posttransplant. In developing countries, tuberculosis (TB) is a major concern among transplant patients. Her...
To study the clinical presentation, diagnostic methods, treatment and outcomes of Invasive Aspergillosis Cryptococcal infection, Mucormycosis and Histoplasmosis in renal transplant recipients.
: We performed a retrospective analysis of renal transplant recipients with four major fungal infections from January 2000 until December 2022 at a tertiary...
Diabetic kidney disease (DKD) is a leading cause of chronic kidney disease (CKD) worldwide and the disease is often relentless and progresses to end-stage kidney disease (ESKD). It is incumbent upon the treating team to prepare patients early, for future renal replacement therapy (RRT), helping them to choose their preferred modality of RRT, thus a...
Background
Fatigue is a pervasive and debilitating symptom among hemodialysis patients, severely impacting their quality of life and ability to participate in social activities. Dialysis nurses are pivotal in alleviating these effects through physical exercise. This study aims to evaluate the effectiveness of an integrated dialysis nursing interven...
Introduction: Acute kidney injury (AKI) is no longer considered a single hit disease but part of a spectrum that culminates in adverse renal and cardiovascular outcomes. What are the renal biopsy findings of patient with persistent AKI/AKD (acute kidney disease)? Are there renal biopsy characteristics which predict renal recovery. These are the que...
Background
Proliferative glomerulonephritis with monoclonal immunoglobulin deposits (PGNMID) is a rare entity classified under the umbrella of monoclonal gammopathy of renal significance. The clinical implications of circulating monoclonal immunoglobulin (MIg), light chain restriction on immunofluorescence (IF) microscopy, histopathological pattern...
The simultaneous occurrence of vasculitic glomerulonephritis and membranous nephropathy is unusual. We report two cases that presented to our outpatient department with rapidly progressive renal failure. On evaluation, in one patient, anti-myeloperoxidase (MPO) titers were high, and renal biopsy was suggestive of concurrent necrotizing and diffuse...
Plasma exchange (PLEX) improves survival in patients with rodenticidal hepatotoxicity. However, predictors of treatment response are unknown. We aimed at assessing predictors of response to PLEX treatment in these patients.
Patients with rodenticidal hepatotoxicity from 2014 to 2023 managed in our department were included in this study. Kochi crite...
Background
The job profile of security officers in tropical countries involves prolonged standing in hot conditions causing heat stress as well as complications of sedentary lifestyle. The objectives of this study were to estimate the prevalence of noncommunicable diseases and heat stress in security officers and analyze factors affecting heat stre...
Introduction
Hemodialysis is the standard treatment for end-stage renal disease. However, patients receiving hemodialysis can become less active as a result of treatment, resulting in the accumulation of waste products. Intradialytic exercise improves the clearance of urea and creatinine by opening up vascular beds.
Materials and methods
We conduct...
Background
Up to 20% of lupus nephritis diagnosed within 1 year of lupus diagnosis ends up in end-stage kidney disease (ESKD). Increasing evidence suggests that findings from a second biopsy provide more information regarding the risk of lupus nephritis flare, treatment response, and the development of ESKD.
Objectives
Our study aimed to investiga...
Low-volume plasma exchange (PLEX) and low-dose steroid improve survival in severe alcoholic hepatitis. We aimed to compare one-year survival of very severe alcoholic hepatitis (VSAH) patients treated with centrifugal PLEX (cPLEX), membrane PLEX (mPLEX) or standard medical treatment (SMT).
We retrospectively analyzed survival in consecutive VSAH pat...
Background
With significant advances in the understanding of transplant immunology and a reduction in rejection rates, significant improvements in kidney allograft survival have been seen. The problem of recurrent and denovo glomerular diseases after transplantation affecting graft outcomes remains and is poorly characterized. This study aimed to a...
Aim:
Diabetic patients are prone to infections, thus making them a unique cohort at risk of developing bacterial infection-related glomerulonephritis (IRGN).
Methods:
In total, 1693 adult diabetic patients underwent kidney biopsy between 2005 and 2021 at our tertiary care hospital in South India. Of these, 121 consecutive cases which met criteri...
Refer to Abstract no: TNISGCON2023 - 50
In this case report, we present a renal transplant recipient who developed an infection due to a plant pathogen – Pantoea agglomerans . This pathogen is a rare organism with no case reports in a renal transplant recipient from India so far. A 50-year-old renal transplant recipient presented with fever for 20 days associated with productive cough an...
Background and Aims
Infections are the most common cause of mortality in solid organ transplant patients. Kidney transplant is the most common organ transplantation worldwide. Since its successful outcomes and longevity of patients, wide literature is available about the long term outcomes and infections. They are more susceptible to infections in...
Introduction
There is a paucity of studies on asymptomatic bacteriuria (ASB) among kidney transplant recipients (KTR) in developing countries. This study assessed the clinical profile, risk factors, outcomes, and impact of treatment of ASB in KTRs with a normal genitourinary tract.
Methods
Consecutive KTRs from 2009 to 2018 with no clinical or rad...
Kidney disease is prevalent in diabetes. Urinary exosomes (uE) from animal models and patients with Diabetic nephropathy (DN) showed increased levels of miRs with reno-protective potential. We examined whether urinary loss of such miRs is associated with their reduced renal levels in DN patients. We also tested whether injecting uE can leverage kid...
The landscape of posttransplant diabetes mellitus (PTDM) has transformed drastically over the past 20 years witnessing changes ranging from the definition and pathophysiology to the use of newer agents such as sodium-glucose cotransporter-2 inhibitors and dipeptidyl peptidase-4 inhibitors in the treatment of PTDM. Its unique pathophysiology leads t...
Parvovirus B19 is a small (26 nm), nonenveloped, single-stranded DNA (5.6-kb) virus. The only known host for parvovirus B19 is humans. Parvovirus B19 is directly cytotoxic to erythroid precursor cells of the colony- and burst-forming units. Human parvovirus B19 is the etiologic agent of erythema infectiosum and chronic pure red cell aplasia in immu...
Introduction: Post hematopoietic stem cell transplant (HSCT), kidney can be subjected to injury by various causes. Of these, Graft versus Host Disease (GvHD) affecting the kidney is an under-recognized entity with no clear guidelines on its diagnosis, clinicopathological manifestations and outcomes.
Material and Methods: Out of 2930 patients who un...
Background
Universal access to safe drinking water and sanitation facilities is an essential human right, recognised in the Sustainable Development Goals as crucial for preventing disease and improving human wellbeing. Comprehensive, high-resolution estimates are important to inform progress towards achieving this goal. We aimed to produce high-res...
These guidelines discuss the epidemiology, screening, diagnosis, posttransplant prophylaxis, monitoring, and management of endemic infections in solid organ transplant (SOT) candidates, recipients, and donors in South Asia. The guidelines also provide recommendations for SOT recipients traveling to this region. These guidelines are based on literat...
Introduction
Angiotensin-converting enzyme inhibitors (ACEI) and angiotensin receptor blockers (ARB) are the antihypertensive drug class of choice in patients with chronic kidney disease (CKD). Head-to-head comparisons of the renal or non-renal outcomes between ACEI/ARB users and nonusers have not been conducted in all population groups. We examine...
Aim:
To study the additional utility of pre-nephrectomy whole and cortical kidney volumes (WKV, CKV) in predicting long-term post-nephrectomy kidney function in Indian living kidney donors (LKDs).
Methods:
This retrospective cohort study included all LKDs who underwent nephrectomy between 1st January 2006 and 31st December 2015 at our centre, ha...
Background
Difficulty in cannulation of arteriovenous fistula (AVF) can lead to inadequate dialysis, transient to permanent loss of access and increases dependency on bridging catheters. This study aimed to analyze the causes for difficult fistula cannulation, using various imaging modalities.
Methodology
This was a retrospective single-center obs...
Background
In a prior report, no patient with rodenticidal hepatotoxicity who met Kochi criteria (MELD score ≥36 or baseline INR ≥6 with hepatic encephalopathy) (PMID: 26310868) for urgent liver transplantation survived with medical management alone. Plasma exchange (PLEX) may improve survival in these patients.
Objectives
We describe our experien...
Background
More than 3 billion people do not have access to clean energy and primarily use solid fuels to cook. Use of solid fuels generates household air pollution, which was associated with more than 2 million deaths in 2019. Although local patterns in cooking vary systematically, subnational trends in use of solid fuels have yet to be comprehens...
Both tubercular and non-tubercular mycobacterial infections are common in South Asia. These are important pathogens in solid organ transplant recipients and hence prevention (when possible), prompt diagnosis, and early and optimum treatment is critical to reduce morbidity and prevent mortality. This article reviews available data to portray a possi...
The diagnosis of non-diabetic kidney disease (NDKD) in a diabetic patient has significant therapeutic and prognostic implications. There are certain proven clinical predictors of NDKD, which, when present in an appropriate clinical setting, would warrant a kidney biopsy. Herein, we describe four cases of NDKD diagnosed in rather unusual clinical se...
Dual anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV) characterized by the presence of both anti-proteinase-3 (PR3-ANCA) and anti-myeloperoxidase (MPO-ANCA) antibodies is a rare clinical entity. Only few cases have been reported previously, most of which were associated with infections, drugs, autoimmune diseases and malignancies. H...
Aims:
The mass quarantine measures adopted to control the COVID-19 pandemic greatly impacted the lives of patients on haemodialysis in India. We used a mixed methods approach to study its effect on dialysis outcomes and the lived experience of haemodialysis patients during the lockdown.
Methods:
Quantitative data was collected from 141 subjects...
Background:
Serial monitoring of tacrolimus and serum creatinine after renal transplantation is of vital importance. In this study, a liquid chromatography-tandem mass spectrometry (LC-MS/MS) assay for the estimation of tacrolimus and creatinine, obtained from dried blood spots (DBS) or by volumetric absorptive microsampling (VAMS) was validated a...
Graft loss and rejections (acute/chronic) continue to remain important concerns in long-term outcomes in kidney transplant despite newer immunosuppressive regimens and increased use of induction agents. Global guidelines identify the risk factors and suggest a framework for management of patients at different risk levels for rejection; however, the...
Objectives
To use data from the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 (GBD 2019) to estimate mortality and disability trends for the population aged ≥70 and evaluate patterns in causes of death, disability, and risk factors.
Design
Systematic analysis.
Setting
Participants were aged ≥70 from 204 countries and terri...
Aim: This study was aimed to determine the effect of intradialytic aerobic exercise on blood urea in hemodialysis (HD) patients. Introduction: HD is one way to treat advanced kidney failure and can help to carry on an active life despite failing kidneys. Intradialytic exercise (IDE) is the exercise training performed during the HD session to increa...
Pneumocystis jirovecii pneumonia (PCP) is a life-threatening fungal infection in immunocompromised patients. Traditionally, the laboratory diagnosis of PCP relied on the visualization of organisms by microscopy as Pneumocystis cannot be readily cultured in the laboratory. The polymerase chain reaction (PCR) method is preferred over the conventional...
Introduction
Glomerular Research And Clinical Experiments- IgA Nephropathy in Indians (GRACE-IgANI) is the first prospective South Asian IgAN cohort with prespecified objectives, protocolized longitudinal follow-up and extensive biosample collection. The baseline risk scores predicted high risk of kidney disease progression.
Methods
195/201 patien...
BACKGROUND: Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex a...
Background
Documentation of patterns and long-term trends in mortality in young people, which reflect huge changes in demographic and social determinants of adolescent health, enables identification of global investment priorities for this age group. We aimed to analyse data on the number of deaths, years of life lost, and mortality rates by sex an...
Continuous ambulatory peritoneal dialysis (CAPD) related peritonitis is a major cause of technique failure, morbidity, and mortality in patients on CAPD. Its prevention and management is key to success of CAPD program. Due to variability in practice, microbiological trends and sensitivity towards antibiotics, there is a need for customized guidelin...
Background
Chronic kidney disease (CKD) is an important cause of morbidity and mortality worldwide. There is lack of information on epidemiology and progression of CKD in low-middle income countries. The Indian Chronic Kidney Disease (ICKD) study aims to identify factors that associate with CKD progression, and development of kidney failure and car...
Background
Alcohol-related acute on chronic liver failure (A-ACLF) patients have high short-term mortality and are poor candidates for steroid therapy. Plasma exchange (PLEX) improves survival in ACLF patients. We analyzed our experience with low volume PLEX (50% of plasma volume exchanged per session) and low dose steroid to treat A-ACLF patients....
Background
Peritoneal dialysis (PD) as a modality of kidney replacement therapy (KRT) is largely underutilized globally. We analyzed PD utilization, impact of economic status, projected growth and impact of state policy(s) on PD growth in South Asia & Southeast Asia (SA&SEA) region.
Methods
The National Nephrology Societies of the region responded...
Background and objectives
Bacterial infection-related glomerulonephritis occurs concurrent to or following known or unknown infections. It's important to understand the clinical implications of the bacterial isolates, anti-microbial resistance patterns and impact of latency-based classification on kidney and patient outcomes.
Design, setting, parti...
Background
Significant changes in the epidemiology of methicillin-resistant Staphylococcus aureus (MRSA) were recognised with the emergence of community-associated methicillin-resistant Staphylococcus aureus. However, studies on the molecular epidemiology and the genomic investigation of MRSA are limited in India.
Aim
The study was aims to underst...
Background
The temperature at which filtration takes place has been reported to influence the efficacy of leukoreduction. We aimed to compare the residual leukocyte count (RLC) in red cell units (RCUs) filtered at cold (CT) versus room temperature (RT) and to assess whether this correlates clinically with a difference in the incidence of acute tran...
Introduction
Patients with chronic kidney disease (CKD) require multiple medications. There is no information on prescription patterns or the use of evidence-based therapies for management of CKD from low-middle income countries. Using baseline data from the Indian Chronic Kidney Disease (ICKD) cohort, we describe the drug prescription practices in...
This is a supplementary material for the article entitled "Measuring universal health coverage based on an index of effective coverage of health services in 204 countries and territories, 1990–2019"
