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327 results on '"Kohli, H. S."'

1. Consensus in the Management of Multiple Myeloma in India at Myeloma State of the Art 2016 Conference

Author

Yanamandra, Uday, Khattry, Navin, Kumar, Shaji, Raje, Noopur, Jain, Arihant, Jagannath, Sundar, Menon, Hari, Kumar, Lalit, Varma, Neelam, Varma, Subhash, Saikia, Tapan, Malhotra, Pankaj, Bhave, Abhay, Sharma, Ajay, Tripathi, A. K., Khadwal, Alka, Aribandi, Anil, Ramesh, Anita, Dixit, Ashish, Devasia, Anup J., Batra, Charu, Subash, Chezhian, Choudhary, Dharma, Bhurani, Dinesh, Lad, Deepesh, Jijina, Farah, Prakash, Gaurav, Jaishetwar, Ganesh, Khurana, Harshit, Malhotra, Hemant, Kohli, H. S., Pinto, Ian, Rasool, Javid, Sarin, Jatin, Bhattacharyya, Jina, Singh, Col Jasjit, Babu, K. Govind, Pavithran, K., Subramanian, Kannan, John, M. Joseph, Sachdeva, Man Updesh Singh, Bhattacharyya, Maitreyee, Agarwal, M. B., Sengar, Manju, Kumar, Narender, Sood, Nitin, Chakravarti, Prantar, Subramanian, P. G., Sharma, Prashant, Tembhare, Prashant, Mishra, Pravas, Ganesan, Prasanth, Naithani, Rahul, Ahmed, Rayaz, Gupta, Ritu, Bansal, Ritu, Nada, R. Itambhra, Arora, Raman, Kapoor, Rajan, Das, Reena, Nair, Reena, Shah, Sandeep, Kumari, Savita, Damodar, Sharat, Gupta, Sachin, Melinkeri, Sameer, Naseem, Shano, Sreedharanunni, Sreejesh, Chakrabarti, Suparno, Gundeti, Sadashivudu, Das, S. R., Nityanand, Soniya, Bhatwadekar, Seema, Prinja, Shankar, Singh, Tejinder, Suri, Vikas, Nair, Velu, and for IMAGe Group

Published
2017
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6. The Utility of 1- and 3-Month Protocol Biopsies on Renal Allograft Function: A Randomized Controlled Study: This prospective randomized study carried out in 102 living-related renal transplant recipients show that early protocol biopsies detect subclinical histological changes in the graft, and the biopsied group had lower 6-month and 1-year serum creatinine values.

Author

Kurtkoti, J., Sakhuja, V., Sud, K., Minz, M., Nada, R., Kohli, H. S., Gupta, K. L., Joshi, K., and Jha, V.

Published
2008

11. Utility of determining autoantibodies to M-type phospholipase A2 receptor in diagnosing primary membranous nephropathy: An ideal setting

Author

Ramachandran, R., Kumar, V., Singh, N., Kataruka, M., Rathi, M., Kohli, H. S., Jha, V., and Gupta, K. L.

Subjects
Pathology, medicine.medical_specialty, business.industry, 030232 urology & nephrology, Autoantibody, 030204 cardiovascular system & hematology, medicine.disease, lcsh:Diseases of the genitourinary system. Urology, lcsh:RC870-923, 03 medical and health sciences, 0302 clinical medicine, Membranous nephropathy, Nephrology, Immunology, medicine, business, Letters to Editor, Phospholipase A2 receptor
Published
2017

15. Loss of Subpodocytic Space Predicts Poor Response to Tacrolimus in Steroid-Resistant Calcineurin Inhibitor-Naïve Adult-Onset Primary Focal Segmental Glomerulosclerosis.

Author

Agrawal, P., Nada, R., Ramachandran, R., Rayat, C. S., Kumar, A., and Kohli, H. S.

Subjects
TACROLIMUS, COMPARATIVE studies, DRUG resistance, IMMUNOSUPPRESSIVE agents, KIDNEY glomerulus, STEROIDS, RETROSPECTIVE studies, FOCAL segmental glomerulosclerosis, THERAPEUTICS
Abstract

Focal segmental glomerulosclerosis (FSGS) is the most common cause of adult-onset nephrotic syndrome, but its pathophysiology is poorly understood. The question as to why only a subset of patients responds to treatment in unanswered. In the past few years, change of podocytic phenotype from stationary type in health to migratory type in disease has been described, of which loss of subpodocytic space is a surrogate marker. Diagnostic biopsies of adult-onset steroid-resistant calcineurin inhibitor-naïve primary FSGS cases, which were subsequently treated with tacrolimus were included in this retrospective study conducted from 2011 to 2013. The ultrastructure of all cases was studied in detail, especially in context to the presence or absence of subpodocytic space. In the present study, we have compared presence or absence of subpodocytic space in tacrolimus-responsive versus tacrolimus-resistant cases to identify potential electron microscopic features predictive of response to treatment, of which loss of subpodocytic space indicating migratory phenotype is the most important and consistent feature. The present series included 7 tacrolimus responsive cases (includes two cases with partial response) and seven tacrolimus-resistant cases. The tacrolimus-resistant patients were of older age, had a longer duration of illness, and a lower eGFR as compared to tacrolimus responsive cases. The subpodocytic space was preserved in patients on tacrolimus with complete remission and lost in patients with partial response and tacrolimus-resistant cases. [ABSTRACT FROM AUTHOR]

Published
2019
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16. A prospective study of collapsing focal segmental glomerulosclerosis

Author

Raja, Ramachandran, primary, Nada, Ritambhra, additional, Yadav, Ashok K., additional, Kumar, Ashwani, additional, Goyal, Ajay, additional, Kumar, Vivek, additional, Rathi, Manish, additional, Kohli, H. S., additional, Gupta, K. L., additional, Sakhuja, Vinay, additional, and Jha, Vivekanand, additional

Published
2016
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17. Infection Prevention and Control Guidelines for COVID.

Author

Mahajan, Sandeep, Kohli, H. S., Gupta, K. L., Prasad, Narayan, and Agarwal, Sanjay K.

Subjects
*TREATMENT of chronic kidney failure, *CHEMOPREVENTION, *PREVENTION of communicable diseases, *HAND washing, *KIDNEY transplantation, *MEDICAL protocols, *PERSONAL protective equipment, *SANITATION, *TRANSPLANTATION of organs, tissues, etc., *COVID-19
Published
2020
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18. Missed Monoclonal Disease Manifesting in Early Post-renal Transplant Period.

Author

Singh, N., Pattanashetti, N., Joshi, K., Kohli, H. S., Gupta, K. L., and Ramachandran, R.

Subjects
TREATMENT of chronic kidney failure, BIOPSY, BLOOD transfusion, CARDIAC arrest, CHRONIC kidney failure, DIABETIC nephropathies, GRAFT rejection, HEMODIALYSIS, KIDNEY transplantation, MULTIPLE myeloma, PLASMAPHERESIS, POSTOPERATIVE period, SURGICAL complications, ACUTE kidney tubular necrosis, DISEASE complications, SURGERY
Abstract

A 63-year-old diabetic gentleman with microvascular complications presented with advanced azotemia and anemia. He was stabilized with blood transfusion and hemodialysis. With the probable diagnosis of diabetic nephropathy-related end-stage renal disease, he underwent kidney transplantation. He had delayed graft function. Graft biopsy done on the 2nd postoperative day showed acute tubular necrosis. Graft biopsy repeated after 2 weeks for persistent graft dysfunction showed myeloma cast nephropathy (MCN) and light chain proximal tubulopathy. Work-up for multiple myeloma was positive. He was started on plasmapheresis and chemotherapy. However, he suffered sudden cardiac death during dialysis after 1 week. The presence of MCN in the early graft biopsy implies that it must have been the cause for his native kidney failure. Thus, renal failure in a diabetic should not always be presumed to be due to diabetic nephropathy, and kidney biopsy should be done in diabetics with atypical features. [ABSTRACT FROM AUTHOR]

Published
2019
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19. Spectrum of IgG4-related Kidney Disease at a Tertiary Care Center.

Author

Singh, N., Nada, R., Rawat, A., Sharma, A., Sinha, S. K., Ramachandran, R., Kumar, V., Kohli, H. S., Gupta, K. L., and Rathi, M.

Subjects
HEMATURIA diagnosis, KIDNEY disease diagnosis, PROTEINURIA diagnosis, STEROID drugs, KIDNEY failure, INTERSTITIAL nephritis, BIOPSY, GLOMERULONEPHRITIS, IMMUNOGLOBULINS, KIDNEY function tests, KIDNEY diseases, TERTIARY care, HEMODIAFILTRATION, DIAGNOSIS
Abstract

IgG4-related kidney disease (IgG4 RKD) is increasingly reported with varied manifestations. The present study was carried out to study the spectrum of IgG4 RKD. All patients with renal manifestation associated with conditions known to be associated with IgG4-related diseases (IgG4 RDs), or renal imaging or histology suggestive of IgG4 RKD were included and evaluated further. Patients with known extrarenal IgG4RD were also screened for renal involvement. Out of 40 patients screened over a period of 15 months, IgG4 RKD was diagnosed in 8. Majority were male (87.5%) with mean age being 56 years. Disease spectrum ranged from normal renal function in one to renal failure requiring dialysis in another two patients. Significant proteinuria was uncommon (12.5%) while hematuria was not seen in any patient. Tubulointerstitial nephritis was seen in all four patients who underwent kidney biopsy. Two patients had associated glomerular lesions in the form of immune complex crescentic glomerulonephritis. The most common imaging abnormality was hypodense renal lesions seen in 2 patients. Elevated IgG4 levels had 87.5% sensitivity and 78.3% specificity for IgG4 RKD and levels did not correlate with disease severity. Of 4 patients treated with steroids, 3 showed improvement in renal function. IgG4 RKD is an uncommon disease even at a referral tertiary care center. Elevated IgG4 levels alone are neither sensitive nor specific for the diagnosis of IgG4 RKD, and a combination of clinical, imaging, serological, and histological features are required for diagnosis. [ABSTRACT FROM AUTHOR]

Published
2018
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20. Clinicopathological Spectrum of Glomerular Diseases in Adolescents: A Single-center Experience over 4 Years.

Author

Muthu, V., Ramachandran, R., Nada, R., Kumar, V., Rathi, M., Kohli, H. S., Jha, V., Gupta, K. L., and Sakhuja, V.

Subjects
BIOPSY, CHI-squared test, ELECTRON microscopy, FLUORESCENT antibody technique, GLOMERULONEPHRITIS, KIDNEY diseases, NEPHROTIC syndrome, LUPUS nephritis, DESCRIPTIVE statistics
Abstract

The spectrum of biopsy-proven glomerular disease was studied from a single center in Northwestern India, among adolescents aged 13-19 years. From January 2009 to December 2012, a total of 177 patients with biopsy-proven glomerular disease were studied. The same pathologist reported all the biopsy specimens after subjecting to light, immunofluorescence, and electron microscopy. The clinical profile and laboratory findings of the patients were correlated with the histopathological spectrum of glomerular diseases. Males formed 71.19% (n = 126) and the remaining 28.81% (n = 51) were females. Lupus nephritis had a strong female predominance, whereas minimal change disease (MCD) and focal segmental glomerulosclerosis (FSGS) had a male predominance. Nephrotic syndrome was the indication for biopsy in 65% of the cases. Rapidly progressive renal failure and acute nephritis were the next common indications accounting for 14% and 7%, respectively. FSGS was the most common glomerular disease in adolescents (n = 45, 25.4%). The next common were MCD and lupus nephritis each contributing 21.6% and 10.7%, respectively. Primary glomerular diseases accounted for 84.75% (n = 150) of the total. The remaining 15.25% (n = 27) were attributed to secondary glomerular diseases, of which lupus nephritis was the most common, i.e., in 70.4% patients (n = 19). FSGS was the most common histology in adolescent nephrotic participants (37%). MCD was the next common, found in 31% of nephrotic patients. Electron microscopy changed the diagnosis made by light microscopy and immunofluorescence in 5.6% cases only, and it confirmed the diagnosis in another 21.6%. Kidney biopsy in adolescents is a safe procedure. The spectrum of glomerular diseases in adolescents is different from that seen in adults and smaller children. [ABSTRACT FROM AUTHOR]

Published
2018
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21. A Single-center Experience of Kidney Transplantation from Donation after Circulatory Death: Challenges and Scope in India.

Author

Singh, S., Kumar, S., Dasgupta, S., Kenwar, D. B., Rathi, M., Sharma, A., Kohli, H. S., Jha, V., Gupta, K. L., and Minz, M.

Abstract

Donation after circulatory death (DCD) has never been attempted in India because of legal constraints and lack of guidelines for the withdrawal of life support in end-of-life situations. The present report describes the initial experience of transplantation of organs from DCD donors in a tertiary care center in India. Between 2011 and 2015, five donors had kidneys retrieved after cardiac arrest. These patients were declared dead after waiting for 5 min with no electrocardiographic signal on monitor following cardiopulmonary resuscitation (CPR), which was restarted in three patients till organ retrieval. All donors received heparin and underwent rapid cannulation of aorta, infusion of preservative cold solution, and immediate surface cooling of organs during retrieval surgery. 9/10 kidneys were utilized. Mean donor age was 29.6 ± 16.3 years, M:F 4:1 and mean age of recipients was 38.7 ± 10.8 years, M:F 7:2. Seven patients required dialysis in postoperative period. Mean postoperative day 0 urine output was 1.9 ± 2.6 L. Baseline creatinine achieved was 1.38 ± 0.35 mg/dl after a mean duration of 26.12 ± 15.4 days. Kidneys from donors where CPR was continued after the declaration of death (n = 3) had better recovery of renal function (time to reach baseline creatinine 21.2 ± 7.2 vs. 34.3 ± 23.7 days, baseline creatinine 1.36 ± 0.25 vs. 1.52 ± 0.45 mg%). In donors without CPR, one kidney never functioned and others had patchy cortical necrosis on protocol biopsy, which was not seen in the kidneys from donors with CPR. Kidneys from DCD donors can serve as a useful adjunct in deceased donor program. Continuing CPR after the declaration of death seems to help in improving outcomes. [ABSTRACT FROM AUTHOR]

Published
2017
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22. Anti-glomerular basement membrane disease: Case series from a tertiary center in North India.

Author

Prabhakar, D., Rathi, M., Nada, R., Minz, R. W., Kumar, V., Kohli, H. S., Jha, V., and Gupta, K. L.

Abstract

Anti-glomerular basement (anti-GBM) disease is an uncommon disorder with a bimodal age of presentation. Patients presenting with dialysis-dependent renal failure have poor renal outcomes. There is limited data regarding the clinical presentation and outcomes of anti-GBM disease from India. We conducted this prospective study to analyze the clinical presentation and outcomes of anti-GBM disease at a large tertiary care hospital in North India over 1 1/2 years. Subjects with a biopsy proven anti-GBM disease (light microscopic examination showing crescents and immunofluorescence examination showing linear deposition of IgG) with or without positive anti-GBM antibodies in serum were included in the study and followed-up for at least 12 months. All the patients were treated with steroids, cyclophosphamide, and plasma exchange. A total of 17 patients (nine males) were included. The mean age at presentation was 39.11 ± 16.58 (range 11-72) years. Twelve patients (70%) presented with rapidly progressive glomerulonephritis (RPGN), 4 (23.5%) presented with Goodpasture syndrome, while 1 (5.8%) had nephritic syndrome, 7 (41%) were hypertensive, and 14 (82.3%) required dialysis at the time of presentation. Four patients (23.5%) had associated anti-neutrophil cytoplasmic antibody positivity (anti-myeloperoxidase antibodies in all). Fourteen (87.5%) patients had crescentic glomerulonephritis, while 5 (31.25%) showed necrotizing (n = 4) or granulomatous (n = 1) in the vasculitis. Of 16 patients who received treatment, four (23.25%) achieved complete remission. In this single-center study, the majority of anti-GBM disease patients presented with RPGN and had crescentic glomerulonephritis on biopsy with poor treatment outcome. [ABSTRACT FROM AUTHOR]

Published
2017
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24. Intestinal Tuberculosis: A Rare Case of Massive Gastrointestinal Bleed in a Post-Renal Transplant Recipient.

Author

Pattanashetti, N., Gupta, S., Rana, S., Dahiya, D., Das, A., Kumar, V., Rathi, M., Kohli, H. S., Gupta, K. L., and Ramachandran, R.

Subjects
ANEMIA, ENDOSCOPY, GASTROINTESTINAL hemorrhage, ILEUM, KIDNEY transplantation, RECTUM, TECHNETIUM
Abstract

Massive rectal bleeding is an uncommon presentation of ileal tuberculosis (TB). We report an uncommon cause of anemia in a post-renal transplant patient due to massive lower gastrointestinal (LGI) bleed. The index case had a normal upper and LGI endoscopy, but the 99technetium labeled red blood cell scan showed active bleeding from terminal ileum and caecum. Microscopic examination of the resected specimen revealed tubercular granuloma with acid-fast bacilli. Intestinal TB should be a differential diagnosis for massive LGI bleed in immunosuppressed patients in developing country. [ABSTRACT FROM AUTHOR]

Published
2019
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25. GLOMERULONEPHRITIDES

Author

Jayne, D. R. W., primary, Bruchfeld, A., additional, Schaier, M., additional, Ciechanowski, K., additional, Harper, L., additional, Jadoul, M., additional, Segelmark, M., additional, Selga, D., additional, Szombati, I., additional, Venning, M., additional, Hamilton, P., additional, Hugo, C., additional, Van Daele, P. L. A., additional, Viklicky, O., additional, Potarca, A., additional, Schall, T. J., additional, Bekker, P., additional, Loirat, C., additional, Legendre, C. M., additional, Ogawa, M., additional, Bedrosian, C. L., additional, Kincaid, J. F., additional, Fakhouri, F., additional, Guillevin, L., additional, Karras, A., additional, Pagnoux, C., additional, Carron, P.-L., additional, Quemeneur, T., additional, Gobert, P., additional, Daugas, E., additional, Mouthon, L., additional, Whatmough, S., additional, Fernandez, S., additional, Sweeney, N., additional, Dhaygude, A., additional, Rathi, M., additional, Goyal, A., additional, Gupta, P. K., additional, Jaryal, A., additional, Sharma, A., additional, Jha, V., additional, Ramachandran, R., additional, Kumar, V., additional, Kohli, H. S., additional, Gupta, K. L., additional, and Sakhuja, V., additional

Published
2014
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28. Clinical nephrology - miscellaneous

Author

Bantis, C., primary, Heering, P., additional, Kouri, N.-M., additional, Siekierka-Harreis, M., additional, Stangou, M., additional, Schwandt, C., additional, Efstratiadis, G., additional, Rump, L.-C., additional, Ivens, K., additional, Haddiya, I., additional, Houssaini Squalli, T., additional, Laouad, I., additional, Ramdani, B., additional, Bayahia, R., additional, Dimas, G. G., additional, Tegos, T. J., additional, Spiroglou, S. G., additional, Pitsalidis, C. G., additional, Sioulis, A. S., additional, Karamouzis, I. M., additional, Savopoulos, C. G., additional, Karamouzis, M. I., additional, Orologas, A. G., additional, Hatzitolios, A. I., additional, Grekas, D. M., additional, Maixnerova, D., additional, Jancova, E., additional, Rychlik, I., additional, Rysava, R., additional, Merta, M., additional, Reiterova, J., additional, Kolsky, A., additional, Honsova, E., additional, Skibova, J., additional, Tesar, V., additional, Kendi Celebi, Z., additional, Calayoglu, R., additional, Keven, K., additional, Kurultak, I., additional, Mescigil, P., additional, Erbay, B., additional, Karatan, O., additional, Duman, N., additional, Erturk, S., additional, Nergizoglu, G., additional, Kutlay, S., additional, Sengul, S., additional, Ates, K., additional, Marino, F., additional, Martorano, C., additional, Bellantoni, M., additional, Tripepi, R., additional, Zoccali, C., additional, Ishizuka, K., additional, Harita, Y., additional, Kajiho, Y., additional, Tsurumi, H., additional, Asano, T., additional, Nishiyama, K., additional, Sugawara, N., additional, Chikamoto, H., additional, Akioka, Y., additional, Yamaguchi, Y., additional, Igarashi, T., additional, Hattori, M., additional, Bantis, C., additional, Heering, P. J., additional, Sahay, M., additional, Monova, D. V., additional, Monov, S. V., additional, Wang, Y.-y., additional, Cheng, H., additional, Wang, G.-q., additional, Dong, H.-r., additional, Chen, Y.-p., additional, Wang, C.-j., additional, Tang, Y.-l., additional, Buti, E., additional, Dervishi, E., additional, Bergesio, F., additional, Ghiandai, G., additional, Mjeshtri, A., additional, Paudice, N., additional, Caldini, A. L., additional, Nozzoli, C., additional, Minetti, E. E., additional, Sun, L., additional, Feng, J., additional, Yao, L., additional, Fan, Q., additional, Ma, J., additional, Wang, L., additional, Kirsanova, T., additional, Merkusheva, L., additional, Ruinihina, N., additional, Kozlovskaya, N., additional, Elenshleger, G., additional, Turgutalp, K., additional, Karabulut, U., additional, Ozcan, T., additional, Helvaci, I., additional, Kiykim, A., additional, Kaul, A., additional, Bhadhuaria, D., additional, sharma, R., additional, Prasad, N., additional, Gupta, A., additional, Clajus, C., additional, Schmidt, J., additional, Haller, H., additional, Kumpers, P., additional, David, S., additional, Sevillano, A. M., additional, Molina, M., additional, Gutierrez, E., additional, Morales, E., additional, Gonzalez, E., additional, Hernandez, E., additional, Praga, M., additional, Conde Olasagasti, J. L., additional, Vozmediano Poyatos, C., additional, Illescas, M. L., additional, Tallon, S., additional, Uson Carrasco, J. J., additional, Roca Munoz, A., additional, Rivera Hernandez, F., additional, Ismail, G., additional, Jurubita, R., additional, Andronesi, A., additional, Bobeica, R., additional, Zilisteanu, D., additional, Rusu, E., additional, Achim, C., additional, Huerta, A., additional, Caro, J., additional, Gutierrez-Solis, E., additional, Pasquariello, A., additional, Pasquariello, G., additional, Innocenti, M., additional, Grassi, G., additional, Egidi, M. F., additional, Ozturk, O., additional, Yildiz, A., additional, Gul, C. B., additional, Dilek, K., additional, Tylicki, L., additional, Jakubowska, A., additional, Weber, E., additional, Lizakowski, S., additional, Swietlik, D., additional, Rutkowski, B., additional, Postorino, A., additional, Costa, S., additional, Cristadoro, S., additional, Magazzu, G., additional, Bellinghieri, G., additional, Savica, V., additional, Buemi, M., additional, Santoro, D., additional, Lu, Y., additional, Shen, P., additional, Li, X., additional, Xu, Y., additional, Pan, X., additional, Wang, W., additional, Chen, X., additional, Zhang, W., additional, Ren, H., additional, Chen, N., additional, Mitic, B. P., additional, Cvetkovic, T., additional, Vlahovic, P., additional, Velickovic Radovanovic, R., additional, Stefanovic, V., additional, Kostic, S., additional, Djordjevic, V., additional, Ao, Q., additional, Ma, Q., additional, Cheng, Q., additional, Wang, X., additional, Liu, S., additional, Zhang, R., additional, Ozturk, S., additional, Ozmen, S., additional, Akin, D., additional, Danis, R., additional, Yilmaz, M., additional, Hajri, S., additional, Barbouche, S., additional, Okpa, H., additional, Oviasu, E., additional, Ojogwu, L., additional, Fotouhi, N., additional, Ghaffari, A., additional, Hamzavi, F., additional, Nasri, H., additional, Ardalan, M., additional, Stott, A., additional, Ullah, A., additional, Anijeet, H., additional, Ahmed, S., additional, Kohli, H. S., additional, Rajachandran, R., additional, Rathi, M., additional, Jha, V., additional, Sakhuja, V., additional, Yenigun, E., additional, Dede, F., additional, Turgut, D., additional, Koc, E., additional, Akoglu, H., additional, Piskinpasa, S., additional, Ozturk, R., additional, Odabas, A., additional, Bajcsi, D., additional, Abraham, G., additional, Kemeny, E., additional, Sonkodi, S., additional, Legrady, P., additional, Letoha, A., additional, Constantinou, K., additional, Ondrik, Z., additional, Ivanyi, B., additional, Lucisano, G., additional, Comi, N., additional, Cianfrone, P., additional, Summaria, C., additional, Piraina, V., additional, Talarico, R., additional, Camastra, C., additional, Fuiano, G., additional, Proletov, I., additional, Saganova, E., additional, Galkina, O., additional, Bogdanova, E., additional, Zubina, I., additional, Sipovskii, V., additional, Smirnov, A., additional, Bailly, E., additional, Pierre, D., additional, Kerdraon, R., additional, Grezard, O., additional, Gnappi, E., additional, Delsante, M., additional, Galetti, M., additional, Maggiore, U., additional, Manenti, L., additional, Hasan, M. J., additional, Muqueet, M. A., additional, Mostafi, M., additional, Chowdhury, I., additional, Haque, W., additional, Khan, T., additional, Kang, Y.-J., additional, Bae, E. J., additional, Cho, H. S., additional, Chang, S.-H., additional, Park, D. J., additional, Xu, G., additional, Lin, H., additional, Hu, Z., additional, Yu, X., additional, Xing, C., additional, Mei, C., additional, Zuo, L., additional, Ni, Z., additional, Ding, X., additional, Li, D., additional, Zhang, Q., additional, Feng, X., additional, and Lin, L., additional

Published
2013
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29. Transplantation - clinical studies II

Author

Marques, I. B., primary, Silva, R. d. M., additional, Moraes, C. E., additional, Azevedo, L. S., additional, Nahas, W. C., additional, David-Neto, E., additional, Furmanczyk-Zawiska, A., additional, Baczkowska, T., additional, Chmura, A., additional, Szmidt, J., additional, Durlik, M., additional, Joslin, J., additional, Blaker, P., additional, White, B., additional, Marinaki, A., additional, Sanderson, J., additional, Goldsmith, D. J., additional, Medani, S., additional, Traynor, C., additional, Mohan, P., additional, Little, D., additional, Conlon, P., additional, Molina, M., additional, Gonzalez, E., additional, Gutierrez, E., additional, Sevillano, A., additional, Polanco, N., additional, Morales, E., additional, Hernandez, A., additional, Praga, M., additional, Morales, J. M., additional, Andres, A., additional, Park, S. J., additional, Kim, T. H., additional, Kim, Y. W., additional, Kim, Y. H., additional, Kang, S. W., additional, Kujawa-Szewieczek, A., additional, Szotowska, M., additional, Kuczera, P., additional, Chudek, J., additional, Wiecek, A., additional, Kolonko, A., additional, Mahrova, A., additional, Svagrova, K., additional, Bunc, V., additional, Stollova, M., additional, Teplan, V., additional, Hundt, F., additional, van Heteren, P., additional, Woitas, R., additional, Cavallo, M. C., additional, Sepe, V., additional, Conte, F., additional, Albrizio, P., additional, Bottazzi, A., additional, Geraci, P. M., additional, Alpay, N., additional, Gumber, M. R., additional, Kute, V. B., additional, Vanikar, A. V., additional, Patel, H. V., additional, Shah, P. R., additional, Engineer, D. P., additional, Trivedi, H. L., additional, Golebiewska, J. E., additional, Debska-Slizien, A., additional, Rutkowski, B., additional, Matias, P., additional, Martins, A. R., additional, Raposo, L., additional, Jorge, C., additional, Weigert, A., additional, Birne, R., additional, Bruges, M., additional, Adragao, T., additional, Almeida, M., additional, Mendes, M., additional, Machado, D., additional, Masin-Spasovska, J., additional, Dohcev, S., additional, Stankov, O., additional, Stavridis, S., additional, Saidi, S., additional, Dejanova, B., additional, Rambabova-Busletic, I., additional, Dejanov, P., additional, Spasovski, G., additional, Nho, K. W., additional, Han, D. J., additional, Park, S.-K., additional, Kim, S. B., additional, Fenoglio, R., additional, Lazzarich, E. E., additional, Cagna, D., additional, Cena, T., additional, Conti, N., additional, Quaglia, M., additional, Radin, E., additional, Izzo, C., additional, Stratta, P., additional, Oh, I. H., additional, Park, J.-S., additional, Lee, C. H., additional, Kang, C. M., additional, Kim, G.-H., additional, Leone, F., additional, Lofaro, D., additional, Gigliotti, P., additional, Lupinacci, S., additional, Toteda, P., additional, Vizza, D., additional, Perri, A., additional, Papalia, T., additional, Bonofiglio, R., additional, di Loreto, P., additional, de Silvestro, L., additional, Montanaro, D., additional, Martino, F., additional, Sandrini, S., additional, Minetti, E., additional, Cabiddu, G., additional, Yildirim, T., additional, Yilmaz, R., additional, Turkmen, E., additional, Abudalal, A., additional, Altindal, M., additional, Ertoy-Baydar, D., additional, Erdem, Y., additional, Panuccio, V., additional, Tripepi, R., additional, Parlongo, G., additional, Versace, M. C., additional, Politi, R., additional, Zoccali, C., additional, Mallamaci, F., additional, Porrini, E., additional, Silva, I., additional, Diaz, J., additional, Ibernon, M., additional, Moreso, F., additional, Benitez, R., additional, Delgado Mallen, P., additional, Osorio, J., additional, Lauzurica, R., additional, Torres, A., additional, Ersoy, A., additional, Koca, N., additional, Gullu Koca, T., additional, Kirhan, E., additional, Sarandol, E., additional, Ersoy, C., additional, Dirican, M., additional, Milne, J., additional, Suter, V., additional, Mikhail, A., additional, Akalin, H., additional, Dizdar, O., additional, Pascual, J., additional, Torio, A., additional, Garcia, C., additional, Hernandez, J., additional, Perez-Saez, M. J., additional, Mir, M., additional, Anna, F., additional, Crespo, M., additional, Carta, P., additional, Zanazzi, M., additional, Antognoli, G., additional, Di Maria, L., additional, Caroti, L., additional, Ray, D. S., additional, Mukherjee, K., additional, Bohidar, N. P., additional, Pattanaik, A., additional, Das, P., additional, Thukral, S., additional, Kimura, T., additional, Yagisawa, T., additional, Ishikawa, N., additional, Sakuma, Y., additional, Fujiwara, T., additional, Nukui, A., additional, Gavela, E. E., additional, Sancho, A. A., additional, Kanter, J. J., additional, Avila, A. A., additional, Beltran, S. S., additional, Pallardo, L. L., additional, Dawoud, F. G., additional, Aithal, V., additional, Majernikova, M., additional, Rosenberger, J., additional, Prihodova, L., additional, Nagyova, I., additional, Jarcuskova, M., additional, Roland, R., additional, Groothoff, J. W., additional, van Dijk, J. P., additional, van Agteren, M., additional, de Weerd, A., additional, van de Wetering, J., additional, IJzermans, J., additional, Betjes, M., additional, Weimar, W., additional, Popoola, J., additional, Reed, A., additional, Tavarro, R., additional, Chryssanthopoulou, C., additional, MacPhee, I., additional, Mayor, M., additional, Franco, S., additional, Jara, P., additional, Ayala, R., additional, Orue, M. G., additional, Martinez, A., additional, Martinez, M., additional, Wasmouth, N., additional, Arik, G., additional, Yasar, A., additional, Yilmaz, S., additional, Arici, M., additional, Bihari Bansal, S., additional, Pokhariyal, S., additional, Jain, S., additional, Sethi, S., additional, Ahlawat, R., additional, Kher, V., additional, Martins, L. S., additional, Aguiar, P., additional, Dias, L., additional, Fonseca, I., additional, Henriques, A. C., additional, Cabrita, A., additional, Davide, J., additional, Sparkes, T. M., additional, Trofe-Clark, J., additional, Reese, P. P., additional, Jakobowski, D., additional, Goral, S., additional, Doll, S. L., additional, Abt, P. L., additional, Sawinski, D., additional, MBloom, R. D., additional, Knap, B., additional, Lukac, J., additional, Lukin, M., additional, Majcen, I., additional, Pavlovec, F., additional, Kandus, A., additional, Bren, A. F., additional, Kong, J. M., additional, Jeong, J. H., additional, Ahn, J., additional, Lee, D. R., additional, Son, S. H., additional, Kim, B. C., additional, Choi, W. Y., additional, Whang, E. J., additional, Czajka, B., additional, Malgorzewicz, S., additional, Panizo, N., additional, Rengel, M. A., additional, Vega, A., additional, Abad, S., additional, Tana, L., additional, Arroyo, D., additional, Rodriguez-Ferrero, M., additional, Perez de Jose, A., additional, Lopez-Gomez, J. M., additional, Koutroutsos, K., additional, Sackey, J., additional, Paolini, L., additional, Ramkhelawon, R., additional, Chowrimootoo, M., additional, Whelan, D., additional, Slatinska, J., additional, Honsova, E., additional, Wohlfahrtova, M., additional, Slimackova, E., additional, Rajnochova, S. B., additional, Viklicky, O., additional, Yankovoy, A., additional, Smith, I. S. J., additional, Wylie, E., additional, Ruiz-Esteban, P., additional, Lopez, V., additional, Garcia-Frias, P., additional, Cabello, M., additional, Gonzalez-Molina, M., additional, Vozmediano, C., additional, Hernandez, D., additional, Pavlovic, J., additional, Radivojevic, D., additional, Lezaic, V., additional, Simic-Ogrizovic, S., additional, Lausevic, M., additional, Naumovic, R., additional, Sakhuja, V., additional, Gundlapalli, S., additional, Rathi, M., additional, Jha, V., additional, Kohli, H. S., additional, Sharma, A., additional, Minz, M., additional, Nimgirova, A., additional, Esayan, A., additional, Kayukov, I., additional, Zuyeva, E., additional, Bilen, Y., additional, Cankaya, E., additional, Keles, M., additional, Gulcan, E., additional, Turkeli, M., additional, Albayrak, B., additional, Uyanik, A., additional, Yildirim, R., additional, Molitor, N., additional, Praktiknjo, M., additional, Abeygunaratne, T. N., additional, Balasubramanian, S., additional, Baker, R., additional, Nicholson, T., additional, Toprak, O., additional, Sari, Y., additional, Keceli, S., additional, Kurt, H., additional, Rocha, A., additional, Malheiro, J., additional, Pedroso, S., additional, Henriques, A., additional, Nihei, C., additional, Bacelar Marques, I., additional, Seguro, C. A., additional, Mate, G., additional, Martin, N., additional, Colon, L., additional, Casellas, L., additional, Garangou, D., additional, de la Torre, M., additional, Torguet, P., additional, Garcia, I., additional, Calabia, J., additional, Valles, M., additional, Pruthi, R., additional, Calestani, M., additional, Leydon, G., additional, Ravanan, R., additional, Roderick, P., additional, Korkmaz, S., additional, and Gulten, S., additional

Published
2013
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30. Collapsing glomerulopathy in a case of anti-neutrophil cytoplasmic antibody associated vasculitis.

Author

Singh, N., Rathi, M., Nada, R., Sharma, A., Goyal, A., Ramachandran, R., Kumar, V., Kohli, H. S., and Gupta, K. L.

Subjects
AUTOIMMUNE disease diagnosis, AUTOIMMUNE diseases, BIOPSY, GLOMERULONEPHRITIS, VASCULITIS, ANTINEUTROPHIL cytoplasmic antibodies, DISEASE complications, DIAGNOSIS
Abstract

Collapsing glomerulopathy (CG) is a pathological entity characterized by collapse and wrinkling of glomerular tuft, podocyte dedifferentiation and hyperplasia. CG may be idiopathic or secondary to other diseases. CG has been described with IgA nephropathy, membranous glomerulopathy, diabetic nephropathy, and lupus nephritis. However, till date there is no report of CG in association with the anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV). Here, we present a case of CG that developed during follow-up in a case of AAV with biopsy proven pauci-immune glomerulonephritis. [ABSTRACT FROM AUTHOR]

Published
2016
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33. Bone disease in CKD 1-5

Author

Yilmaz, M. I., primary, Sonmez, A., additional, Saglam, M., additional, Yaman, H., additional, Kilic, S., additional, Eyileten, T., additional, Caglar, K., additional, Oguz, Y., additional, Vuaral, A., additional, Yenicesu, M., additional, Mallamaci, F., additional, Zoccali, C., additional, Mazzaferro, S., additional, Pasquali, M., additional, Rotondi, S., additional, Tartaglione, L., additional, Pirro, G., additional, Muci, M. L., additional, Conte, C., additional, Mandanici, G., additional, Frasheri, A., additional, Pugliese, F., additional, Fehmi, H., additional, Long, Y., additional, Kono, K., additional, Fujii, H., additional, Nakai, K., additional, Goto, S., additional, Shite, J., additional, Hirata, K.-i., additional, Fukagawa, M., additional, Nishi, S., additional, Wu-Wong, J. R., additional, Nakane, M., additional, Chen, Y.-w., additional, Nikolopoulos, P., additional, Vlachopanou, A., additional, Giannaki, C., additional, Siapera, V., additional, Papachristopoulos, V., additional, Gouva, C., additional, Sakhuja, V., additional, Dheerendra, P., additional, Jha, V., additional, Rathi, M., additional, Kohli, H. S., additional, Hadjiyannakos, D., additional, Trompouki, S., additional, Filiopoulos, V., additional, Sonikian, M., additional, Karatzas, I., additional, Panagiotopoulos, K., additional, Vlassopoulos, D., additional, Taskapan, H., additional, Baysal, O., additional, Karahan, D., additional, Ulutas, O., additional, Mircescu, G., additional, Capusa, C., additional, Stancu, S., additional, Badulescu, M., additional, Barsan, L., additional, Dorobantu, N., additional, Maria, D., additional, Mota, E., additional, Yildiz, I., additional, Sagliker, Y., additional, Demirhan, O., additional, Acharya, V., additional, Zhang, L., additional, Golea, O., additional, Sabry, A., additional, Ookalkar, D., additional, Radulescu, D., additional, Garneata, L., additional, Ben Maiz, H., additional, Hsu Chen, C., additional, Prado Rome, J., additional, Benzegoutta, M., additional, Paylar, N., additional, Eyuboglu, K., additional, Karatepe, E., additional, Esenturk, M., additional, Yavascan, O., additional, Adam, S. M., additional, Emir, I., additional, Grzegorzevska, A., additional, Tunc, E., additional, Ocal, F., additional, Usta, E., additional, Shilo, V., additional, Mazdeh, M. M., additional, Francesco, R. C., additional, Levin-Iaina, N., additional, Malyszko, J., additional, Kozminski, P., additional, Koc-Zorawska, E., additional, Mysliwiec, M., additional, Lipan, M., additional, Reichel, H., additional, Ringel, J., additional, Guggenberger, C., additional, Dellanna, F., additional, Teixeira, C., additional, Almeida, E., additional, Raimundo, M., additional, Neves, F., additional, Santana, A., additional, Fortes, A., additional, Abreu, F., additional, Pinto Abreu, C., additional, El Bouazzaoui, Z., additional, Cortesao Costa, A., additional, Nogueira, E., additional, Gomes da Costa, A., additional, ElShafey, E., additional, Alsahow, A., additional, Saran, K., additional, Attia, M., additional, Di Lullo, L., additional, Gorini, A., additional, Cecilia, A., additional, Comegna, C., additional, Galderisi, C., additional, Iannacci, G. R., additional, Vitale, M., additional, Polito, P., additional, Kyritsis, I., additional, Roumelioti, M.-E., additional, Agroyannis, I., additional, Vrachnis, S., additional, Kapelleris, V., additional, Fituri, O., additional, Ismail, G., additional, Donia, A., additional, Sezer, S., additional, Karakan, S., additional, Atesagaoglu, B., additional, Tutal, E., additional, Ozdemir Acar, N., additional, Ozturk, S., additional, Uzun, S., additional, Kaya, A. H., additional, Gursu, M., additional, Kaya, B., additional, Sarbay Kemik, A., additional, Aydin, Z., additional, Karadag, S., additional, Feyizoglu, H., additional, Kazancioglu, R., additional, and Vlad, I., additional

Published
2011
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39. Proliferative glomerulonephritis with monoclonal immunoglobulin deposition disease: The utility of routine staining with immunoglobulin light chains.

Author

Gowda, K. K., Nada, R., Ramachandran, R., Joshi, K., Tewari, R., Kohli, H. S., Jha, V., and Gupta, K. L.

Subjects
STAINS & staining (Microscopy), ACADEMIC medical centers, ACQUISITION of data methodology, BIOPSY, MONOCLONAL antibodies, ELECTRON microscopy, IMMUNOGLOBULIN light chains, MEDICAL records, DESCRIPTIVE statistics, FLUORESCENT antibody technique, GLOMERULONEPHRITIS, BLOOD testing
Abstract

Proliferative glomerulonephritis occurring as a consequence of monoclonal glomerular deposits of IgG is uncommon. It is a form of renal involvement in monoclonal gammopathy that mimics immune complex glomerulonephritis. Here, we report the first series of proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) from the Indian subcontinent highlighting use of light chain immunofluorescence (IF) in routine renal biopsy interpretation. We retrieved 6 patients diagnosed as proliferative glomerulonephritis with monoclonal IgG deposits (PGNMID) out of 160 biopsies (3.7%) with membranoproliferative patterns over 5 1/2 years (2009-2014), one of whom had recurrence 6 months post-renal transplant. Four (67%) patients presented with rapidly progressive renal failure and two (33%) with nephrotic syndrome. None of these patients had overt multiple myeloma. The predominant histologic pattern was membranoproliferative with all the biopsies showing IgG3 Kappa deposits on IF. The deposits were primarily subendothelial on electron microscopy. [ABSTRACT FROM AUTHOR]

Published
2015
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40. Drug-induced acute interstitial nephritis: A clinicopathological study and comparative trial of steroid regimens.

Author

Ramachandran, R., Kumar, K., Nada, R., Jha, V., Gupta, K. L., and Kohli, H. S.

Subjects
THERAPEUTIC use of glucocorticoids, METHYLPREDNISOLONE, PREDNISOLONE, BETA lactam antibiotics, BIOPSY, CHI-squared test, COMPARATIVE studies, INTRAVENOUS injections, BOTANIC medicine, INTERSTITIAL nephritis, NONSTEROIDAL anti-inflammatory agents, OMEPRAZOLE, ORAL drug administration, T-test (Statistics), RANDOMIZED controlled trials, TREATMENT effectiveness, SEVERITY of illness index, DESCRIPTIVE statistics, THERAPEUTICS
Abstract

Steroids are used in the management of drug-induced acute interstitial nephritis (AIN). The present study was undertaken to compare the efficacy of pulse methyl prednisolone with oral prednisolone in the treatment of drug-induced AIN. Patients with biopsy-proven AIN with a history of drug intake were randomized to oral prednisolone (Group 1) 1 mg/kg for 3 weeks or a pulse methyl prednisolone (Group II) 30 mg/kg for 3 days followed by oral prednisolone 1 mg/kg for 2 weeks, tapered over 3 weeks. Kidney biopsy scoring was done for interstitial edema, infiltration and tubular damage. The response was reported as complete remission (CR) (improvement in estimated glomerular filtration rate [eGFR]to ≥60 ml/min/1.73 m²), partial remission (PR) (improvement but eGFR <60 ml/min/1.73 m#178;) or resistance (no CR/PR). Atotal of 29 patients, Group I: 16 and Group II: 13 were studied. Offending drugs included nonsteroidal anti-inflammatory drugs, herbal drugs, antibiotics, diuretic, rifampicin and omeprazole. There was no difference in the baseline parameters between the two groups. The biopsy score in Groups I and II was 5.9 ± 1.1 and 5.1 ± 1.2, respectively. At 3 months in Group I, eight patients each (50%) achieved CR and PR. In Group II, 8 (61%) achieved CR and 5 (39%) PR. This was not significantly different. Percentage fall in serum creatinine at 1 week (56%) was higher in CR as compared to (42%) those with PR. (P 0.14). Patients with neutrophil infiltration had higher CR compared to patients with no neutrophil infiltration (P = 0.01). Early steroid therapy, both oral and pulse steroid, is equally effective in achieving remission in drug-induced AIN. [ABSTRACT FROM AUTHOR]

Published
2015
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41. Successful induction of granulomatosis with polyangiitis with tacrolimus.

Author

Ramachandran, R., Tiwana, S., Prabhakar, D., Gowda, K., Nada, R., Kumar, V., Rathi, M., Kohli, H. S., Jha, V., Gupta, K. L., and Sakhuja, V.

Subjects
TACROLIMUS, AUTOANTIBODIES, BIOPSY, ENZYME-linked immunosorbent assay, VASCULITIS, GRANULOMATOSIS with polyangiitis, SOCIAL services case management, TREATMENT effectiveness, THERAPEUTICS
Abstract

We report a 50‑year‑old female who presented with inflammatory arthritis, upper respiratory tract symptoms, and microscopic hematuria with nephrotic range proteinuria. Antineutrophil cytoplasmic antibodies (ANCA) were detectable and kidney biopsy showed pauci‑immune focal necrotizing crescentic glomerulonephritis. She was treated with pulse intravenous cyclophosphamide (CYC) and prednisolone. Patient developed severe leucopenia after the first dose and subsequently had leucopenia to low dose CYC, mycophenolate mofetil and azathioprine were also tried. However, patient developed leukopenia with all the above agents. Initiation of tacrolimus (TAC) was followed by dramatic response: Proteinuria decreased, serum albumin normalized and C‑ANCA and anti‑PR3 ANCA assays became negative. This is the first successful case of TAC as an induction agent in a patient with GPA (ANCA associated vasculitis with renal involvement). [ABSTRACT FROM AUTHOR]

Published
2015
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42. Study of hypothalamic pituitary adrenal axis in patients of membranous nephropathy receiving modified Ponticelli regimen.

Author

Ramachandran, R., Jairam, A., Bhansali, A., Jha, V., Gupta, K. L., Sakhuja, V., and Kohli, H. S.

Subjects
ENDOCRINE gland physiology, METHYLPREDNISOLONE, ACADEMIC medical centers, ADRENOCORTICOTROPIC hormone, NEPHRITIS, ADRENAL insufficiency, THERAPEUTICS
Abstract

Pulse methyl prednisolone followed by oral prednisolone and abrupt switch to chlorambucil/cyclophosphamide (Ponticelli/modified Ponticelli regimen) is used in patients with idiopathic membranous nephropathy. This therapy where steroids are stopped abruptly is unphysiologic and expected to have hypothalamic pituitary adrenal (HPA) axis suppression; however, this has not been evaluated. A total of 13 consecutive adult patients with idiopathic membranous nephropathy who had completed modified Ponticelli regimen were studied. The regimen included administration of pulse methylprednisolone 1 g for 3 days followed by oral prednisolone 0.5 mg/kg/day for 27 days followed by oral cyclophosphamide at a dose of 2 mg/kg/day for the next month. This was repeated for three courses. Patients who had received corticosteroids prior to therapy were excluded. The HPA axis was evaluated after 1 month of completing the last course of steroid therapy. The evaluation was done using a low‑dose adrenocorticotropic hormone stimulation test. A single intravenous bolus dose of synacthen (1 g) was given at 9.00 am and the serum cortisol levels were estimated by radioimmunoassay at 0, 30, and 60 min. A peak cortisol level of 550 nmol/L or higher was considered as normal. Mean baseline cortisol levels was 662.3 ± 294.6 nmol/L and peak cortisol level was 767 ± 304.4 nmol/L. A total of 6 patients (46.2%) had low basal cortisol levels, only 3 (23%) had both basal and peak cortisol levels < 550 nmol/L suggestive of HPA axis suppression. To conclude, 23% of patients had suppression of HPA axis after modified Ponticelli regimen. [ABSTRACT FROM AUTHOR]

Published
2015
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43. Acute pyelonephritis in diabetes mellitus: Single center experience.

Author

Kumar, S., Ramachandran, R., Mete, U., Mittal, T., Dutta, P., Kumar, V., Rathi, M., Jha, V., Gupta, K. L., Sakhuja, V., and Kohli, H. S.

Subjects
ACADEMIC medical centers, BLOOD testing, DIABETES, DIAGNOSTIC imaging, FISHER exact test, LONGITUDINAL method, HEALTH outcome assessment, PYELONEPHRITIS, STATISTICS, COMORBIDITY, DATA analysis, SEVERITY of illness index, EARLY diagnosis, DESCRIPTIVE statistics
Abstract

Diabetes mellitus is a common cause of pyelonephritis. Both emphysematous pyelonephritis (EPN) and non‑EPN (NEPN) are associated with poor outcome. This study was aimed at analyzing the clinical features, microbiological profile, prognostic factors, and treatment outcome of pyelonephritis in diabetic patients. A total of 105 diabetic patients with pyelonephritis were admitted from July 2010 to June 2012. Patients were treated with appropriate antibiotics and percutaneous drainage (PCD) as indicated. Nephrectomy was carried out in patients of EPN who were refractory to conservative measures. NEPN and EPN were seen in 79 (75.2%) and 26 (24.7%) patients, respectively. Escherichia coli was the most common organism. Pyelonephritis was associated with renal abscess and papillary necrosis in 13 (12.4%) and 4 (3.8%) patients with EPN and NEPN, respectively. Worsening of renal functions were seen in 92 and 93% of patients with EPN and NEPN, respectively. Class 1 EPN was seen in 2 (7.7%), Class II in 8 (30.7%), IIIa in 7 (27%), IIIb in 5 (19.3), and IV in 4 (15.4%) patients. Antibiotics alone were sufficient in 38.5% of EPN versus 62% in NEPN; additional PCD was required in 42.3% in EPN and 21.4% in NEPN. Nephrectomy was required in 5 (19.2%) EPN patients with Class IIIB or IV. A total of 13 patients (12.4%) expired, 4 (15.4%) in EPN, and 9 (11.4%) in NEPN group. Patients with EPN had a higher incidence of shock (6% vs. 0; P < 0.05) and poorly controlled blood sugar (26% vs. 50%; P < 0.05) compared with NEPN. Presence of shock and altered sensorium were associated with poor outcome in patients with EPN. Diabetics with pyelonephritis have severe disease. Patients of EPN have poorer treatment outcome compared with those with NEPN. However, there is no difference in the mortality, but a greater need of nephrectomy in EPN compared with NEPN patients. Presence of shock and altered sensorium at presentation were poor prognostic factors in EPN. [ABSTRACT FROM AUTHOR]

Published
2014
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44. Changing histologic spectrum of adult nephrotic syndrome over five decades in north India: A single center experience.

Author

Rathi, M., Bhagat, R. L., Mukhopadhyay, P., Kohli, H. S., Jha, V., Gupta, K. L., Sakhuja, V., and Joshi, K.

Subjects
NEPHROTIC syndrome diagnosis, ACADEMIC medical centers, AGE distribution, BIOPSY, BLOOD testing, CHRONIC kidney failure, ELECTRON microscopy, HISTOLOGY, NEPHROTIC syndrome, PROTEINURIA, SEVERITY of illness index
Abstract

Glomerular diseases are an important cause of chronic renal failure in developing countries. The spectrum of diseases causing nephrotic syndrome is changing globally in the last few decades. The aim of this prospective study was to look at this spectrum at a tertiary care center in North India and to analyze the changing trends over the last five decades. Patients in the age group 18-60 years with nephrotic syndrome were consecutively included in the study. Renal biopsies were performed in all patients and were subjected to light microscopy, immunofluorescence (IF) and electron microscopy (EM). While the IF was performed in 78% of cases, EM was available in one-fourth of cases. During 2002-2007, 364 patients (60.2% males) were included in the study. The mean age was 31.5 years. Primary glomerular diseases accounted for 89% of cases while lupus nephritis was the most common secondary glomerular disease. Focal segmental glomerulosclerosis (FSGS) accounted for 30.6% of primary glomerular diseases making it the most common cause of nephrotic syndrome. It was followed by membranous glomerulonephritis (MGN) in 24.4%, mesangiocapillary glomerulonephritis in 17.9% and minimal change disease in 14.8%. In the age group >40 years, MGN was the most common lesion (32.5%) followed by FSGS (27.7%). Over the last five decades, there was a nearly five-fold increase in the incidence of FSGS, 3-fold increase in MGN and a 10-fold reduction in diffuse proliferative glomerulonephritis while there was no major change in incidence of other diseases. The biopsy diagnosis of FSGS has increased considerably in last few decades and it is now the most common cause of nephrotic syndrome in adults in North India. MGN is the most common lesion in patients over 40 years of age. [ABSTRACT FROM AUTHOR]

Published
2014
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