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Introduction: Focal Segmental Glomerulosclerosis (FSGS) is a nephrotic syndrome with a variety of clinicopathological presentations and varied responses to treatment. Hence, this study attempts to classify FSGS based on clinical presentation and pathological findings on kidney biopsy, which is essential for appropriate treatment and avoidance of inappropriate use of immunosuppressants. Aim: To analyse clinicopathological findings and responses to immunosuppressants in FSGS. Materials and Methods: A retrospective cohort study was conducted at Department of Nephrology, Vydehi Institute of Medical Sciences and Research Centre Bengaluru, Karnataka, India, to analyse clinicopathological parameters such as urine analysis, 24-hour urine protein, serum creatinine, serum albumin, lipid profile, renal biopsy details, and response to treatment in 97 patients. The study was planned, analysed, and executed between January 2023 and February 2023. All variables were expressed as mean±standard deviation or percentage. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) software version 16.0. Results: Among a total of 97 patients, 64% were males. Sudden onset oedema was observed in 90% of the cases, while nephrotic proteinuria was seen in 71%. The Not Otherwise Specified (NOS) variant was noted in 60% of the cases. Complete remission was observed in 61%, suggesting a possible primary FSGS. Persistent nephrotic proteinuria with a poor response to therapy was noted in 32%, indicating a possible secondary/genetic FSGS, despite adequate immunosuppressive therapy. Therefore, differentiating between primary and secondary forms of FSGS has therapeutic and prognostic implications. Accurate diagnosis of each form of FSGS is vital to avoid unnecessary immunosuppressive-based therapy and establish appropriate treatment. Conclusion: Resistance to steroid therapy was observed in one-third of FSGS patients. It is likely that unrecognised genetic FSGS or secondary FSGS were included among the study group of primary FSGS, leading to misinterpretation of treatment responses in primary FSGS. Hence, a clinicopathological approach for correctly differentiating between primary FSGS, secondary (maladaptive, viral, or toxic) FSGS, and genetic FSGS helps in making correct treatment decisions. [ABSTRACT FROM AUTHOR]

Introduction: Acute Kidney Injury (AKI) and Chronic Kidney Disease (CKD) are risk factors for COVID-19 infection. Patients with kidney disease also have other co-morbidities like hypertension, diabetes mellitus, cardiovascular disease that are risk factors for poor outcome in COVID-19 infections. Severe COVID-19 has multiorgan involvement including AKI. Compared to normal population, renal failure patients with COVID-19 have extensive lung involvement, need more ventilator support, and have higher mortality. Aim: To assess outcome (mortality, recovery) and association between factors (age, gender, co-morbidities), biochemical parameters with mortality in COVID-19 patients requiring haemodialysis. Materials and Methods: It was a retrospective observational study wherein, data was collected, entered and analysed with Statistical Package for the Social Sciences (SPSS) version 19.0 using medical records of all COVID-19 patients who had renal failure (AKI or CKD) requiring haemodialysis. The study period was from June-September 2020 at Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India. Results: Out of total 68 COVID-19 positive patients, mean age of presentation was 55.08 years and with 75% of the study population were males. Most patients presented with severe COVID-19 illness with tachypnoea and hypoxia. The AKI occurrence and mortality was noted in 44.1% and 47%, respectively. It was noted that medication usage was higher for corticosteroids, oseltamivir, vitamin C, zinc therapy. Conclusion: In the present single centre study involving COVID-19 patients requiring haemodialysis, it was noticed that severe COVID-19 illness, presence of AKI, chronic respiratory illness and high inflammatory markers were associated with higher mortality. [ABSTRACT FROM AUTHOR]

Chyluria is excreting chyle in urine leading to white urine. It can cause mild proteinuria. It could be parasitic or non parasitic in origin. It is often mistaken as nephrotic syndrome or urinary tract infection. Normal renal biopsy should prompt for further investigation. Lymphangiography or retrograde pyelogram can establish the diagnosis. Non parasitic chyluria is rare, but do occur like the one reported in this case. Hereby, authors discuss a case of chyluria associated with proteinuria in a 49-year-old male patient, due to non parasitic cause which was successfully treated. Treatment was done with installation of povidone iodine into renal pelvis. The resolution of chyluria and proteinuria suggest that abnormal lymphatic-urinary communications was causing chyluria. [ABSTRACT FROM AUTHOR]

Introduction: Renal failure is often seen with Urinary Tract Obstruction (UTO), which could be acute or chronic (obstructive nephropathy). With early diagnosis and treatment, it is often reversible. The data being sparse in literature, hence this study was planned. Aim: The present retrospective study was undertaken to discuss about causes, pathophysiology, site of obstruction, clinical features, diagnostic tests, management and factors affecting renal failure outcomes in cases of obstructive uropathy. Materials and Methods: All outpatient and inpatient cases of obstructive uropathy in 2016 were included and were subjected for renal function tests, radiological investigations. Stenting, diversion surgeries were performed to relieve obstruction. Student's t-test, Levene's test, chi-square/Fisher Exact-test were used for statistical analysis. Results: Of the 107 patients enrolled, bilateral UTO, intrinsic cause, chronic obstruction (>3 months duration), acute on Chronic Kidney Disease (CKD), Acute Kidney Injury (AKI), most common site of obstruction was ureter, seen in 58 (54%), 78 (72%), 71 (66%), 63 (58%), 44 (41%) and 47 (43%) cases respectively. Among co-morbities, history of past Urinary Tract Infection (UTI), past urological surgeries and diabetes mellitus were seen in 70 (65%), 62 (57%), and 62 (57%) cases respectively. Among the aetiology, blood clots, abdomen lymphadenopathy, ureter calculus were seen in 62 (57%), 16 (15%), and 14 (13%) cases respectively. Most common symptom was pain abdomen present in 98 (91%) cases. Among the complications, UTI was seen in 65 (60%). Dialysis therapy and most common urological intervention, ureter stenting was needed in 38 (35%) and 37 (34%) cases respectively. Renal failure recovery, post obstructive diuresis, death were noted in 34 (31%), 25 (23%) and 18 (16%) cases respectively. Conclusion: Comparing with renal failure recovered group, the non recovered group had statistically significant dominant males, were much older, had higher incidence of congenital blocks, acute on CKD, Pelvi-Ureter Junction (PUJ) obstruction, blood clots, abdomen lymphadenopathy, weight loss, abdomen mass, mineral bone disorder, emphysematous Acute Pyelonephritis (APN), lower haemoglobin, leukocytosis, dialysis need and Extracorpeal Shock Wave Lithotripsy (ESWL) therapy. [ABSTRACT FROM AUTHOR]