22 results on '"Sinha, Aditi"'
Search Results
2. Gastrostomy Tube Feeding in Indian Children with Advanced Chronic Kidney Disease
- Author
-
Sharma, Shally, Sinha, Aditi, Malik, Rohan, and Bagga, Arvind
- Published
- 2023
- Full Text
- View/download PDF
3. Efficacy of rituximab versus tacrolimus in difficult-to-treat steroid-sensitive nephrotic syndrome: an open-label pilot randomized controlled trial
- Author
-
Mathew, Georgie, Sinha, Aditi, Ahmed, Aijaz, Grewal, Neetu, Khandelwal, Priyanka, Hari, Pankaj, and Bagga, Arvind
- Published
- 2022
- Full Text
- View/download PDF
4. SARS-CoV-2 infection in children with chronic kidney disease
- Author
-
Krishnasamy, Sudarsan, Mantan, Mukta, Mishra, Kirtisudha, Kapoor, Kanika, Brijwal, Megha, Kumar, Manish, Sharma, Shobha, Swarnim, Swarnim, Gaind, Rajni, Khandelwal, Priyanka, Hari, Pankaj, Sinha, Aditi, and Bagga, Arvind
- Published
- 2022
- Full Text
- View/download PDF
5. Phenotypic variability in distal acidification defects associated with WDR72 mutations
- Author
-
Khandelwal, Priyanka, Mahesh V, Mathur, Vijay Prakash, Raut, Sumantra, Geetha, Thenral S., Nair, Sandhya, Hari, Pankaj, Sinha, Aditi, and Bagga, Arvind
- Published
- 2021
- Full Text
- View/download PDF
6. Therapy and outcomes of C3 glomerulopathy and immune-complex membranoproliferative glomerulonephritis
- Author
-
Khandelwal, Priyanka, Bhardwaj, Swati, Singh, Geetika, Sinha, Aditi, Hari, Pankaj, and Bagga, Arvind
- Published
- 2021
- Full Text
- View/download PDF
7. Short-term safety and efficacy of escalating doses of atorvastatin for dyslipidemia in children with predialysis chronic kidney disease stage 2–5.
- Author
-
Ramesh, Punitha Lakxmi, Khandelwal, Priyanka, Lakshmy, R., Sinha, Aditi, Bagga, Arvind, and Hari, Pankaj
- Subjects
TREATMENT of chronic kidney failure ,DRUG therapy for hyperlipidemia ,DRUG efficacy ,CONFIDENCE intervals ,ATORVASTATIN ,LOW density lipoproteins ,SEVERITY of illness index ,TREATMENT effectiveness ,DESCRIPTIVE statistics ,HEMODIALYSIS ,HIGH density lipoproteins ,ODDS ratio ,PATIENT safety ,LIPIDS ,CHILDREN - Abstract
Background: Dyslipidemia is a potentially modifiable risk factor in patients with chronic kidney disease (CKD). Information on the safety and efficacy of statins in pediatric CKD is limited. Methods: Patients with CKD stage 2–5 and aged 5–18 years with low-density lipoprotein cholesterol (LDL-C) > 130 mg/dL and/or non-high-density lipoprotein cholesterol (non-HDL-C) > 145 mg/dL were enrolled from September 2019 to February 2021. All patients were administered atorvastatin 10 mg/day, which was escalated to 20 mg/day if LDL-C remained > 100 mg/dL and/or non-HDL-C > 120 mg/dL at 12 weeks. Proportion of patients achieving target lipid levels (LDL-C ≤ 100 mg/dL and non-HDL-C ≤ 120 mg/dL) and adverse events were assessed at 24 weeks. Results: Of 31 patients enrolled, target lipid levels were achieved in 45.2% (95% CI 27.8–63.7%) at 24 weeks; 22 patients required dose escalation to 20 mg at 12 weeks. There was no difference in median lipid level reduction with 10 (n = 9) versus 20 mg/day (n = 22, P = 0.3). Higher baseline LDL-C (OR 1.06, 95% CI 1.00–1.11) and older age (OR 36.5, 95% CI 2.57–519.14) were independent predictors of failure to achieve target lipid levels with 10 mg/day atorvastatin. None had persistent rise in AST/ALT > 3 times upper normal limit (UNL) or CPK > 10 times UNL. No differences were noted in adverse events due to atorvastatin 10 or 20 mg/day. Conclusion: Atorvastatin (10–20 mg/day) administered for 24 weeks was safe and effectively reduced LDL-C and non-HDL-C in children with CKD stages 2–5. Patients with higher baseline LDL-C required higher doses to achieve the target. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
8. Child and caregiver perspectives on access to psychosocial and educational support in pediatric chronic kidney disease: a focus group study.
- Author
-
Zhang, Yifan, Gutman, Talia, Tong, Allison, Craig, Jonathan C., Sinha, Aditi, Dart, Allison, Eddy, Allison A., Gipson, Debbie S., Bockenhauer, Detlef, Yap, Hui-Kim, Groothoff, Jaap, Zappitelli, Michael, J.A.Webb, Nicholas, Alexander, Stephen I., Furth, Susan, Samuel, Susan, Blydt-Hansen, Tom D., Dionne, Janis, Michael, Mini, and Wenderfer, Scott E.
- Subjects
TREATMENT of chronic kidney failure ,PARENT attitudes ,CAREGIVER attitudes ,EDUCATION ,SOCIAL support ,HEALTH services accessibility ,FOCUS groups ,EMPATHY ,CHILDREN'S hospitals ,SELF-perception ,ATTITUDE (Psychology) ,GROUP identity ,PATIENTS' attitudes ,HEALTH ,THEMATIC analysis ,EMOTIONS ,PSYCHOLOGICAL resilience ,CHILDREN - Abstract
Background: Children with chronic kidney disease (CKD) generally have worse educational and psychosocial outcomes compared with their healthy peers. This can impair their ability to manage their treatment, which in turn can have long-term health consequences through to adulthood. We attempted to capture the experiences of children with CKD and to describe the perspectives of their parents and caregivers on access to educational and psychosocial support. Methods: Children with CKD (n = 34) and their caregivers (n = 62) were sampled via focus groups from pediatric hospitals in Australia, Canada, and the USA. Sixteen focus groups were convened and the transcripts were analyzed thematically. Results: We identified four themes: disruption to self-esteem and identity (emotional turmoil of adolescence, wrestling with the sick self, powerlessness to alleviate child's suffering, balancing normality and protection); disadvantaged by lack of empathy and acceptance (alienated by ignorance, bearing the burden alone); a hidden and inaccessible support system (excluded from formal psychological support, falling behind due to being denied special considerations); and building resilience (finding partners in the journey, moving towards acceptance of the illness, re-establishing childhood). Conclusions: Children with CKD and their caregivers encountered many barriers in accessing psychosocial and educational support and felt extremely disempowered and isolated as a consequence. Improved availability and access to psychosocial and educational interventions are needed to improve the wellbeing and educational advancement of children with CKD. A higher resolution version of the Graphical abstract is available as Supplementary information. [ABSTRACT FROM AUTHOR]
- Published
- 2023
- Full Text
- View/download PDF
9. IPNA Clinical Practice Recommendations for the Diagnosis and Management of Children with Steroid-resistant Nephrotic Syndrome
- Author
-
Trautmann, Agnes, Vivarelli, Marina, Samuel, Susan, Gipson, Debbie, Sinha, Aditi, Schaefer, Franz, Hui, Ng Kar, Boyer, Olivia, Saleem, Moin A, Feltran, Luciana, Müller-Deile, Janina, Becker, Jan Ulrich, Cano, Francisco, Xu, Hong, Lim, Yam Ngo, Smoyer, William, Anochie, Ifeoma, Nakanishi, Koichi, Hodson, Elisabeth, Haffner, Dieter, and International Pediatric Nephrology Association
- Subjects
Male ,Nephrology ,Pediatrics ,medicine.medical_specialty ,Nephrotic Syndrome ,Adolescent ,Population ,Drug Resistance ,Guidelines ,Prednisone ,Internal medicine ,Chronic kidney disease ,Genetics ,medicine ,Humans ,ddc:610 ,Child ,education ,Glucocorticoids ,Congenital nephrotic syndrome ,Children ,Steroid-resistant nephrotic syndrome ,Outcome ,education.field_of_study ,business.industry ,Remission Induction ,Infant, Newborn ,Infant ,medicine.disease ,Immunosuppressive treatment ,Transplantation ,Clinical Practice ,Proteinuria ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,Female ,business ,Nephrotic syndrome ,Immunosuppressive Agents ,medicine.drug ,Kidney disease - Abstract
Idiopathic nephrotic syndrome newly affects 1–3 per 100,000 children per year. Approximately 85% of cases show complete remission of proteinuria following glucocorticoid treatment. Patients who do not achieve complete remission within 4–6 weeks of glucocorticoid treatment have steroid-resistant nephrotic syndrome (SRNS). In 10–30% of steroid-resistant patients, mutations in podocyte-associated genes can be detected, whereas an undefined circulating factor of immune origin is assumed in the remaining ones. Diagnosis and management of SRNS is a great challenge due to its heterogeneous etiology, frequent lack of remission by further immunosuppressive treatment, and severe complications including the development of end-stage kidney disease and recurrence after renal transplantation. A team of experts including pediatric nephrologists and renal geneticists from the International Pediatric Nephrology Association (IPNA), a renal pathologist, and an adult nephrologist have now developed comprehensive clinical practice recommendations on the diagnosis and management of SRNS in children. The team performed a systematic literature review on 9 clinically relevant PICO (Patient or Population covered, Intervention, Comparator, Outcome) questions, formulated recommendations and formally graded them at a consensus meeting, with input from patient representatives and a dietician acting as external advisors and a voting panel of pediatric nephrologists. Research recommendations are also given., 論文
- Published
- 2020
10. Patient and caregiver perspectives on blood pressure in children with chronic kidney disease.
- Author
-
Wu, Justin Guang-Ao, Tong, Allison, Evangelidis, Nicole, Manera, Karine E, Hanson, Camilla S, Baumgart, Amanda, Amir, Noa, Sinha, Aditi, Dart, Allison, Eddy, Allison A, Guha, Chandana, Gipson, Debbie S, Bockenhauer, Detlef, Yap, Hui-Kim, Groothoff, Jaap, Zappitelli, Michael, Alexander, Stephen I, Furth, Susan L, Samuel, Susan, and Carter, Simon A
- Subjects
BLOOD pressure ,PEDIATRIC nephrology ,CHRONIC kidney failure ,PATIENTS' attitudes ,PATIENT-centered care ,CARDIOVASCULAR diseases ,KIDNEY failure - Abstract
Background More than 50% of children with chronic kidney disease (CKD) have uncontrolled hypertension, increasing their long-term risk of cardiovascular disease and progression to kidney failure. Children receiving medications or dialysis may also experience acute blood pressure fluctuations accompanied by debilitating symptoms. We aimed to describe the perspectives of children with CKD and their parental caregivers on blood pressure to inform patient-centered care. Methods Secondary thematic analysis was conducted on qualitative data from the Standardized Outcomes in Nephrology—Children and Adolescents initiative, encompassing 16 focus groups, an international Delphi survey and two consensus workshops. We analyzed responses from children with CKD (ages 8–21 years) and caregivers (of children ages 0–21 years) pertaining to blood pressure. Results Overall, 120 patients and 250 caregivers from 22 countries participated. We identified five themes: invisibility and normalization (reassured by apparent normotension, absence of symptoms and expected links with CKD), confused by ambiguity (hypertension indistinguishable from cardiovascular disease, questioning the need for prophylactic intervention, frustrated by inconsistent messages and struggling with technical skills in measurement), enabling monitoring and maintaining health (gaging well-being and preventing vascular complications), debilitating and constraining daily living (provoking anxiety and agitation, helpless and powerless and limiting life activities) and burden of medications (overwhelmed by the quantity of tablets and distress from unexpected side effects). Conclusions For children with CKD and their caregivers, blood pressure was an important heath indicator, but uncertainty around its implications and treatment hampered management. Providing educational resources to track blood pressure and minimizing symptoms and treatment burden may improve outcomes in children with CKD. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
11. Vascular neoplasia masquerading as cellulitis and persistent hemorrhagic pericardial effusion.
- Author
-
Thangaraju, Sharan, Relan, Jay, Sinha, Aditi, Arava, Sudheer, Khanna, Neena, and Raju, Sreenivasa
- Subjects
BLOOD-vessel tumors ,PERICARDITIS ,PREDNISOLONE ,RAPAMYCIN ,PERICARDIAL effusion ,CELLULITIS ,DIFFERENTIAL diagnosis ,TREATMENT effectiveness ,BLOOD-vessel abnormalities ,HEMORRHAGE ,HEMANGIOMAS ,DISEASE complications ,CHILDREN - Abstract
Tufted angioma and kaposiform hemangioendothelioma are considered to represent two ends of the spectrum of benign vascular neoplasms that predominantly present during infancy or early childhood. We report a rare case of a 5-month-old infant with complicated vascular neoplasm involving the pericardial cavity and skin over cervical region, masquerading as infective pericarditis with cellulitis. The patient responded dramatically to therapy with oral prednisolone and sirolimus, with a significant reduction of size of skin lesions and complete resolution of pericardial effusion over 8 weeks. The report also highlights the importance of a multidisciplinary team in managing such complicated cases. [ABSTRACT FROM AUTHOR]
- Published
- 2022
- Full Text
- View/download PDF
12. Post obstructive pulmonary edema in a child who attempted suicidal hanging
- Author
-
Sinha, Aditi, Sivanandan, Sindhu, Ramesh, P., Lodha, Rakesh, and Kabra, S.K.
- Published
- 2008
- Full Text
- View/download PDF
13. Quality of life of children with Nephrotic syndrome and Chronic kidney disease: parents' and children's perspectives.
- Author
-
Gahalain, Savita, Sharma, Kamlesh Kumari, Manju, Bagga, Arvind, and Sinha, Aditi
- Subjects
QUALITY of life ,CHILD behavior ,CHRONIC kidney failure in children ,COMPARATIVE studies ,MEDICAL protocols ,NEPHROTIC syndrome in children ,HEALTH outcome assessment ,SELF-evaluation ,QUALITATIVE research ,PARENT attitudes ,CROSS-sectional method ,DATA analysis software ,DESCRIPTIVE statistics ,INFERENTIAL statistics - Abstract
Nephrotic syndrome (NS) represents a common disease in children characterized by a relapsing and remitting course associated with edema that can significantly affect their quality of life (QOL). Chronic Kidney Disease (CKD) has a major impact on a child's development. However, there is little information on the QOL of children with Nephrotic Syndrome and Chronic Kidney Disease from patient's and parents' perspective. Hence we examined the comparative QOL of children having steroid sensitive nephrotic syndrome (SSNS), steroid resistant nephrotic syndrome (SRNS), CKD and healthy siblings. Materials and methods: A comparative, cross-sectional study on 109 children using consecutive sampling was done. QOL of children was assessed by two methods: child self report and parent proxy report using Peds QL 4.0. Data was analyzed using STATA 11.2. Results: There was no significant difference in total QOL scores of children in all the four groups. However, on domain specific analysis, we found that absenteeism from school due to sickness or hospital visits was a common problem as per children with NS and CKD and their parents but not in siblings (p < 0.05). Children with SRNS reported more difficulty in running than siblings (p=0.01). Parents reported significantly less self care ability in CKD group as compared to SSNS group (p=0.04). Conclusion: The total QOL scores of children having SSNS, SRNS, CKD and siblings were similar as reported by child's self report and parent's proxy report. However, a few differences were found in some items of individual domains. [ABSTRACT FROM AUTHOR]
- Published
- 2018
- Full Text
- View/download PDF
14. Stroke as an Initial Manifestation of Thiamine-Responsive Megaloblastic Anemia.
- Author
-
Madaan, Priyanka, Jauhari, Prashant, Michael, Shruthi N., Sinha, Aditi, Chakrabarty, Biswaroop, and Gulati, Sheffali
- Subjects
BLOOD testing ,CEREBRAL arteries ,DEAFNESS ,EPILEPSY ,HEMIPLEGIA ,GENETIC mutation ,STROKE ,VITAMIN B1 ,VITAMIN B1 deficiency ,TREATMENT effectiveness ,MACROCYTIC anemia ,MAGNETIC resonance angiography ,DISEASE complications ,SYMPTOMS ,CHILDREN - Abstract
The article presents a case study of a 10‑month‑old boy who altered sensorium along with right hemiparesis. Topics include considered clinical diagnosis of left middle cerebral artery territory AIS kept and MRI brain confirmed; examines sonography and Doppler of neck vessels, left internal carotid artery are not visualized; and the diagnosis of congenital thrombotic thrombocytopenic purpura, hemolytic uremic syndrome (HUS) considered and clinical exome sequencing are ordered.
- Published
- 2020
- Full Text
- View/download PDF
15. SARS-CoV-2 infection in children with nephrotic syndrome.
- Author
-
Krishnasamy, Sudarsan, Sinha, Aditi, and Bagga, Arvind
- Subjects
- *
COVID-19 , *IMMUNOSUPPRESSION , *SYMPTOMS , *CHRONIC kidney failure in children , *NEPHROTIC syndrome in children , *CHILDREN - Published
- 2022
- Full Text
- View/download PDF
16. Dyslipidemia, carotid intima-media thickness and endothelial dysfunction in children with chronic kidney disease.
- Author
-
Khandelwal, Priyanka, Murugan, Vijaya, Hari, Smriti, Lakshmy, Ramakrishnan, Sinha, Aditi, Hari, Pankaj, and Bagga, Arvind
- Subjects
ATHEROSCLEROSIS risk factors ,CHRONIC kidney failure complications ,ACADEMIC medical centers ,ANALYSIS of covariance ,CONFIDENCE intervals ,GLOMERULAR filtration rate ,HYPERLIPIDEMIA ,HYPERTENSION ,LOW density lipoproteins ,MULTIVARIATE analysis ,PROBABILITY theory ,REGRESSION analysis ,SEX distribution ,T-test (Statistics) ,TRIGLYCERIDES ,LOGISTIC regression analysis ,BRACHIAL artery ,CROSS-sectional method ,DISEASE progression ,DATA analysis software ,DESCRIPTIVE statistics ,CAROTID intima-media thickness ,ODDS ratio ,MANN Whitney U Test ,DISEASE complications ,CHILDREN - Abstract
Background: Chronic kidney disease (CKD) predisposes to accelerated atherosclerosis that is measured by carotid artery intima-media thickness (cIMT) and brachial artery flow-mediated dilation (FMD). Information on the association of these parameters with dyslipidemia in pre-dialysis pediatric CKD is limited. Methods: Eighty patients aged 9.9 ± 3.2 years, with estimated glomerular filtration rate of 38.8 ± 10.8 ml/1.73 m/min, and 42 pediatric controls underwent cross-sectional analysis of lipid profile, cIMT, and brachial artery FMD. Significant differences in these parameters between patients and controls were analyzed using Student's t test. Predictors of cIMT and dyslipidemia were assessed using linear and logistic regression respectively. Results: Patients had elevated blood levels of triglyceride and of total and LDL cholesterol than controls ( P ≤ 0.001); 73.8 % were dyslipidemic. Mean cIMT was higher (0.421 ± 0.054 mm vs 0.388 ± 0.036 mm, P = 0.001) and brachial artery FMD was reduced (10.6 ± 4.9 % vs 18.9 ± 4.1 %, P < 0.0001) in patients compared with controls. On multivariate analysis, hypertension (OR 3.68, P = 0.044) and male gender (OR 10.21, P = 0.004) were associated with dyslipidemia; cIMT was significantly associated with LDL cholesterol (β = 28.36, P = 0.033). Conclusion: Dyslipidemia was prevalent and cIMT significantly elevated in pre-dialysis pediatric CKD, indicating increased cardiovascular risk. Elevated LDL cholesterol predicted increased cIMT, strengthening the association between dyslipidemia and atherosclerosis in early CKD. [ABSTRACT FROM AUTHOR]
- Published
- 2016
- Full Text
- View/download PDF
17. A Comparative Study to Find out the Health Related Quality of Life of Children with End Stage Renal Disease on Various Renal Replacement therapies: Self and Parental Perception.
- Author
-
Tiwari, Anand Narain, Bansal, Minakshi, Manju V. M., Joshi, Poonam, Sinha, Aditi, Hari, Pankaj, and Bagga, Arvind
- Subjects
CHRONIC kidney failure in children ,COMMUNICATION ,COMPARATIVE studies ,HEMODIALYSIS ,HEMODIALYSIS patients ,KIDNEY diseases ,RESEARCH methodology ,PERITONEAL dialysis ,QUALITY of life ,SELF-evaluation ,STATISTICS ,THERAPEUTICS ,TRANSPLANTATION of organs, tissues, etc. ,DATA analysis ,PARENT attitudes ,CROSS-sectional method ,PATIENTS' attitudes ,DESCRIPTIVE statistics ,INFERENTIAL statistics ,MANN Whitney U Test ,CHILDREN - Published
- 2015
- Full Text
- View/download PDF
18. Antibiotic prophylaxis in the management of vesicoureteric reflux: a randomized double-blind placebo-controlled trial.
- Author
-
Hari, Pankaj, Hari, Smriti, Sinha, Aditi, Kumar, Rakesh, Kapil, Arti, Pandey, Ravindra, and Bagga, Arvind
- Subjects
KIDNEY disease prevention ,URINARY tract infection prevention ,ANTIBIOTICS ,PLACEBOS ,CONFIDENCE intervals ,RESEARCH funding ,SURVIVAL analysis (Biometry) ,VESICO-ureteral reflux ,DISEASE management ,RANDOMIZED controlled trials ,BLIND experiment ,DESCRIPTIVE statistics ,DISEASE complications ,CHILDREN - Abstract
Background: The benefits of long-term low-dose antibiotics in preventing urinary tract infection (UTI) and renal damage in children with primary vesicoureteric reflux (VUR) are unclear. Methods: Children aged between 1 and 12 years with VUR grade I-IV and a microbiologically proven UTI were randomized into two groups to receive either antibiotic prophylaxis [2 mg/kg trimethoprim + sulfamethoxazole (TMP-SMX)] daily or placebo, respectively, for 12 months. Primary outcome was microbiologically confirmed symptomatic UTI. Intention-to-treat analysis using time-to-event data was performed. Results: A total of 93 children (66.7 % boys) with a median age of 4.6 years were enrolled in this study; VUR grade III-IV was present in 73.1 % of these children. At least one symptomatic UTI occurred in ten (21.3 %) patients receiving antibiotic prophylaxis and in three (6.5 %) patients receiving placebo [hazard ratio in antibiotic group 3.9; 95 % confidence interval (CI) 1- 14; log rank test P = 0.02). Compared to the group receiving placebo, the antibiotic group had a 14.8 % increased risk for developing UTI (95 % CI 1-28; P = 0.03). Of the total number of episodes of UTI, 58.3 % of those in the antibiotic group were caused by TMP-SMX-resistant bacteria compared to 20 % in the placebo group ( P = 0.15). A renal scan at 12 months revealed that six of 37 (16.2 %) patients in the antibiotic group and seven of 43 (16.3 %) patients in the placebo group had new or worsening of pre-existing scar. Conclusions: Long-term antibiotic prophylaxis with TMP-SMX is associated with increased risk of symptomatic UTI compared to placebo in children with grade I-IV VUR. [ABSTRACT FROM AUTHOR]
- Published
- 2015
- Full Text
- View/download PDF
19. Outcome of pediatric renal transplantation in north India.
- Author
-
Sinha, Aditi, Hari, Pankaj, Guleria, Sandeep, Gulati, Ashima, Dinda, Amit K., Mehra, N. K., Srivastava, R. N., and Bagga, Arvind
- Subjects
- *
KIDNEY transplant patients , *TRANSPLANTATION of organs, tissues, etc. in children , *VASCULITIS treatment , *HOMOGRAFTS , *IMMUNOSUPPRESSION - Abstract
Sinha A, Hari P, Guleria S, Gulati A, Dinda AK, Mehra NK, Srivastava RN, Bagga A. Outcome of pediatric renal transplantation in north India. Pediatr Transplantation 2010: 14:836-843. © 2010 John Wiley & Sons A/S. We report our experience and long-term outcome of pediatric renal transplantation at a referral center in New Delhi. During 1995-2008, 45 transplants were performed in 43 patients at a mean age of 13.3 ± 4.0 (range 3.8-18) yr. The chief causes for ESRD were reflux nephropathy, obstructive uropathy, vasculitis, renal dysplasia, and focal segmental glomerulosclerosis. Most (91.1%) donors were living related. Post-transplant immunosuppression comprised prednisolone, a calcineurin inhibitor and azathioprine or MMF. AR and CR were seen in 14 (31.1%) and 12 (26.7%) allografts, respectively. Predictors of CR were unsatisfactory compliance and multiple episodes of AR (p = 0.002 each). Urinary infections (n = 13), septicemia (4), tuberculosis (4), CMV disease (7), viral hepatitis (7), and pneumonia (3) were important causes of morbidity. Two patients each had lymphoproliferative disease and new-onset diabetes. There were eight (17.8%) graft losses and six (14%) deaths. The one-, five- and 10-yr graft survivals were 91.1%, 80.4% and 75.1%, respectively; the mean graft survival was 119.4 ± 8.38 months. The respective patient survivals were 95.3%, 87.9%, and 76.9% at one-, five- and 10 yr. Our results affirm that despite scarcity of resources and frequent infections, long-term outcomes of pediatric renal transplantation are highly satisfactory. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
20. Frasier syndrome: early gonadoblastoma and cyclosporine responsiveness.
- Author
-
Sinha, Aditi, Sharma, Sonika, Gulati, Ashima, Sharma, Alok, Agarwala, Sandeep, Hari, Pankaj, and Bagga, Arvind
- Subjects
- *
CYCLOSPORINE , *NEPHROTIC syndrome , *GLOMERULONEPHRITIS , *INTERSEXUALITY , *GENETIC mutation , *PROTEINURIA , *GENETIC testing , *GONADS , *DISEASE complications , *DRUG therapy , *CHILDREN , *GENETICS , *TUMORS ,GENITOURINARY organ abnormalities - Abstract
Frasier syndrome is characterized by progressive glomerulopathy that is unresponsive to corticosteroids, male pseudohermaphroditism, and an increased risk of genitourinary tumors. Of 21 girls with steroid-resistant nephrotic syndrome secondary to focal segmental glomerulosclerosis (FSGS) who were screened for mutations in the WT1 gene, two showed Frasier syndrome. Both patients had donor splice-site mutations in intron 9 of the WT1 gene and a male karyotype (46, XY). Long-term therapy with cyclosporine resulted in partial remission in both cases. One patient showed foci of gonadoblastoma in the excised dysgenetic gonads. This report highlights the need for screening for mutations in the WT1 gene in girls with steroid-resistant FSGS. Patients with Frasier syndrome might benefit from early gonadectomy. [ABSTRACT FROM AUTHOR]
- Published
- 2010
- Full Text
- View/download PDF
21. Acute Kidney Injury in Neonates: A Meta-Analysis.
- Author
-
Meena, Jitendra, Kumar, Jogender, Kocharlakota, Jahnavi Phanidhar, Gupta, Himanshu, Mittal, Piyush, Kumar, Amit, Sinha, Aditi, Hari, Pankaj, and Bagga, Arvind
- Subjects
- *
MEDICAL information storage & retrieval systems , *WORLD Wide Web , *RISK assessment , *ACUTE kidney failure , *META-analysis , *DESCRIPTIVE statistics , *WORLD health , *INFANT care , *SYSTEMATIC reviews , *MEDLINE , *ONLINE information services , *CONFIDENCE intervals , *COMPARATIVE studies , *DISEASE risk factors , *CHILDREN - Abstract
BACKGROUND AND OBJECTIVE: There is a paucity of pooled synthesized data on the epidemiology of neonatal acute kidney injury (AKI). Our objective with this study is to systematically assess the worldwide incidence of AKI in neonates. METHODS: We searched 3 electronic databases (Embase, PubMed, Web of Sciences) from January 2004 to December 2022 without language restrictions. We included cohort and cross-sectional studies that reported the incidence of AKI or associated mortality in neonates. Eligible studies had at least 10 participants and used standard criteria (Acute Kidney Injury Network/Pediatric Risk, Injury, Failure, Loss, End Stage Renal Disease (pRIFLE)/ Kidney Disease Improving Global Outcomes) to define AKI. Two authors independently retrieved data on demographic characteristics, clinical setting, and outcomes (incidence and AKI-associated mortality) using a semi-structured proforma and assessed the risk of bias. We used a random-effects metaanalysis to calculate pooled estimates with 95% confidence intervals. RESULTS: We included 201 studies (98 228 participants) from 45 countries. The incidence of any stage AKI was 30% (95% confidence interval 28-32), and that of severe AKI was 15% (14-16). Overall, AKI-associated mortality was 30% (27-33). The odds of mortality were higher (odds ratio 3.4; 2.9-4.0) in neonates with AKI compared with those without AKI. We found that perinatal asphyxia, sepsis, patent ductus arteriosus, necrotizing enterocolitis, and nephrotoxic medications were significant risk factors for AKI. Significant heterogeneity in the pooled estimates was a limitation of this study. CONCLUSIONS: AKI was observed in one-third of the neonates and was associated with increased risk of mortality. The incidence of AKI was almost similar in neonates with perinatal asphyxia and sepsis, but mortality was higher in the former group. [ABSTRACT FROM AUTHOR]
- Published
- 2024
- Full Text
- View/download PDF
22. Range and Heterogeneity of Outcomes in Randomized Trials of Pediatric Chronic Kidney Disease.
- Author
-
Chong, Lauren S.H., Sautenet, Benedicte, Tong, Allison, Hanson, Camilla S., Samuel, Susan, Zappitelli, Michael, Dart, Allison, Furth, Susan, Eddy, Allison A., Groothoff, Jaap, Webb, Nicholas J.A., Yap, Hui-Kim, Bockenhauer, Detlef, Sinha, Aditi, Alexander, Stephen I., Goldstein, Stuart L., Gipson, Debbie S., Raman, Gayathri, and Craig, Jonathan C.
- Abstract
Objective: To determine the range and heterogeneity of outcomes reported in randomized controlled trials of interventions for children with chronic kidney disease (CKD).Study Design: The Cochrane Kidney and Transplant Specialized Register was searched to March 2016. Randomized trials involving children across all stages of CKD were selected. All outcome domains and measurements were extracted from included trials. The frequency and characteristics of the outcome domains and measures were evaluated.Results: From 205 trials included, 6158 different measurements of 100 different outcome domains were reported, with a median of 22 domains per trial (IQR 13-41). Overall, 52 domains (52%) were surrogate, 38 (38%) were clinical, and 10 (10%) were patient-reported. The 5 most commonly reported domains were blood pressure (76 [37%] trials), relapse/remission (70 [34%]), kidney function (66 [32%]), infection (61 [30%]), and height/pubertal development (51 [25%]). Mortality (14%), cardiovascular disease (4%), and quality of life (1%) were reported infrequently. The 2 most frequently reported outcomes, blood pressure and relapse/remission, had 56 and 81 different outcome measures, respectively.Conclusions: The outcomes reported in clinical trials involving children with CKD are extremely heterogeneous and are most often surrogate outcomes, rather than clinical and patient-centered outcomes such as cardiovascular disease and quality of life. Efforts to ensure consistent reporting of outcomes that are important to patients and clinicians will improve the value of trials to guide clinical decision-making. In our study, non-English articles were excluded. [ABSTRACT FROM AUTHOR]- Published
- 2017
- Full Text
- View/download PDF
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.