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    - UROLOGY, NEPHROLOGY AND ANDROLOGY (156 journals)

UROLOGY, NEPHROLOGY AND ANDROLOGY (156 journals)                     

Showing 1 - 156 of 156 Journals sorted alphabetically
Acta Urológica Portuguesa     Open Access   (Followers: 1)
Actas Urológicas Españolas     Full-text available via subscription   (Followers: 3)
Actas Urológicas Españolas (English Edition)     Full-text available via subscription   (Followers: 1)
Advances in Chronic Kidney Disease     Full-text available via subscription   (Followers: 11)
Advances in Urology     Open Access   (Followers: 13)
African Journal of Nephrology     Open Access  
African Journal of Urology     Open Access   (Followers: 7)
AJP Renal Physiology     Hybrid Journal   (Followers: 8)
Aktuelle Urologie     Hybrid Journal   (Followers: 4)
American Journal of Kidney Diseases     Hybrid Journal   (Followers: 43)
American Journal of Men's Health     Open Access   (Followers: 9)
American Journal of Nephrology     Full-text available via subscription   (Followers: 37)
Andrologia     Hybrid Journal   (Followers: 2)
Andrology     Hybrid Journal   (Followers: 4)
Andrology & Gynecology : Current Research     Hybrid Journal   (Followers: 4)
Andrology and Genital Surgery     Open Access   (Followers: 7)
Andrology-Open Access     Open Access  
Annales d'Urologie     Full-text available via subscription  
Arab Journal of Nephrology and Transplantation     Open Access   (Followers: 1)
Arab Journal of Urology     Open Access   (Followers: 7)
Archives of Clinical Nephrology     Open Access   (Followers: 2)
Archivio Italiano di Urologia e Andrologia     Open Access   (Followers: 1)
Archivos Españoles de Urología     Open Access  
Asian Journal of Andrology     Open Access   (Followers: 1)
Asian Journal of Urology     Open Access   (Followers: 3)
Bangladesh Journal of Urology     Open Access   (Followers: 5)
BANTAO Journal     Open Access  
Basic and Clinical Andrology     Open Access  
BJU International     Hybrid Journal   (Followers: 34)
BMC Nephrology     Open Access   (Followers: 10)
BMC Urology     Open Access   (Followers: 14)
Canadian Journal of Kidney Health and Disease     Open Access   (Followers: 7)
Canadian Urological Association Journal     Open Access   (Followers: 2)
Cancer Urology     Open Access   (Followers: 2)
Cardiorenal Medicine     Full-text available via subscription   (Followers: 1)
Case Reports in Nephrology     Open Access   (Followers: 5)
Case Reports in Nephrology and Dialysis     Open Access   (Followers: 9)
Case Reports in Urology     Open Access   (Followers: 12)
Clinical and Experimental Nephrology     Hybrid Journal   (Followers: 4)
Clinical Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 20)
Clinical Kidney Journal     Open Access   (Followers: 4)
Clinical Medicine Insights : Urology     Open Access   (Followers: 3)
Clinical Nephrology     Full-text available via subscription   (Followers: 8)
Clinical Nephrology and Urology Science     Open Access   (Followers: 6)
Clinical Queries: Nephrology     Hybrid Journal   (Followers: 1)
Cuadernos de Cirugía     Open Access   (Followers: 3)
Current Opinion in Nephrology & Hypertension     Hybrid Journal   (Followers: 10)
Current Opinion in Urology     Hybrid Journal   (Followers: 12)
Current Urology     Open Access   (Followers: 10)
Current Urology Reports     Hybrid Journal   (Followers: 5)
Der Nephrologe     Hybrid Journal  
Der Urologe     Hybrid Journal   (Followers: 1)
EMC - Urología     Full-text available via subscription  
Enfermería Nefrológica     Open Access   (Followers: 1)
European Urology     Full-text available via subscription   (Followers: 34)
European Urology Focus     Hybrid Journal   (Followers: 4)
European Urology Supplements     Full-text available via subscription   (Followers: 10)
Forum Nefrologiczne     Full-text available via subscription  
Geriatric Nephrology and Urology     Hybrid Journal   (Followers: 7)
Giornale di Clinica Nefrologica e Dialisi     Open Access  
Herald Urology     Open Access   (Followers: 2)
Hong Kong Journal of Nephrology     Open Access   (Followers: 3)
Human Andrology     Partially Free   (Followers: 2)
IJU Case Reports     Open Access  
Indian Journal of Nephrology     Open Access   (Followers: 2)
Indian Journal of Urology     Open Access   (Followers: 5)
International Brazilian Journal of Urology     Open Access   (Followers: 5)
International Journal of Nephrology     Open Access   (Followers: 2)
International Journal of Nephrology and Renovascular Disease     Open Access   (Followers: 2)
International Journal of Urology     Hybrid Journal   (Followers: 12)
International Urology and Nephrology     Hybrid Journal   (Followers: 7)
Jornal Brasileiro de Nefrologia     Open Access  
Journal für Urologie und Urogynäkologie/Österreich     Hybrid Journal  
Journal of Clinical Nephrology     Open Access   (Followers: 1)
Journal of Clinical Urology     Hybrid Journal   (Followers: 14)
Journal of Endoluminal Endourology     Open Access  
Journal of Endourology     Hybrid Journal   (Followers: 2)
Journal of Endourology Case Reports     Hybrid Journal  
Journal of Genital System & Disorders     Hybrid Journal   (Followers: 3)
Journal of Integrative Nephrology and Andrology     Open Access   (Followers: 2)
Journal of Kidney Cancer and VHL     Open Access  
Journal of Lower Genital Tract Disease     Hybrid Journal  
Journal of Nephrology     Hybrid Journal   (Followers: 4)
Journal of Nephrology Research     Open Access   (Followers: 3)
Journal of Pediatric Nephrology     Open Access   (Followers: 4)
Journal of Renal Care     Hybrid Journal   (Followers: 8)
Journal of Renal Nursing     Full-text available via subscription   (Followers: 12)
Journal of Renal Nutrition     Hybrid Journal   (Followers: 28)
Journal of Renal Nutrition and Metabolism     Open Access   (Followers: 1)
Journal of the American Society of Nephrology     Full-text available via subscription   (Followers: 29)
Journal of The Egyptian Society of Nephrology and Transplantation     Open Access  
Journal of Translational Neurosciences     Open Access  
Journal of Urology     Full-text available via subscription   (Followers: 45)
Journal of Urology & Nephrology     Open Access   (Followers: 2)
Kidney Disease and Transplantation     Open Access   (Followers: 4)
Kidney Diseases     Open Access   (Followers: 3)
Kidney International     Hybrid Journal   (Followers: 46)
Kidney International Reports     Open Access   (Followers: 3)
Kidney Medicine     Open Access  
Kidney Research Journal     Open Access   (Followers: 6)
Kidneys (Počki)     Open Access   (Followers: 1)
Nature Reviews Nephrology     Full-text available via subscription   (Followers: 21)
Nature Reviews Urology     Full-text available via subscription   (Followers: 12)
Nefrología (English Edition)     Open Access  
Nefrología (Madrid)     Open Access  
Nephro-Urology Monthly     Open Access   (Followers: 1)
Nephrology     Hybrid Journal   (Followers: 13)
Nephrology Dialysis Transplantation     Hybrid Journal   (Followers: 26)
Nephron     Hybrid Journal   (Followers: 4)
Nephron Clinical Practice     Full-text available via subscription   (Followers: 4)
Nephron Experimental Nephrology     Full-text available via subscription   (Followers: 4)
Nephron Extra     Open Access   (Followers: 1)
Nephron Physiology     Full-text available via subscription   (Followers: 4)
Neurourology and Urodynamics     Hybrid Journal   (Followers: 1)
OA Nephrology     Open Access   (Followers: 2)
Open Access Journal of Urology     Open Access   (Followers: 6)
Open Journal of Nephrology     Open Access   (Followers: 5)
Open Journal of Urology     Open Access   (Followers: 6)
Open Urology & Nephrology Journal     Open Access  
Pediatric Urology Case Reports     Open Access   (Followers: 7)
Portuguese Journal of Nephrology & Hypertension     Open Access   (Followers: 1)
Progrès en Urologie     Full-text available via subscription  
Progrès en Urologie - FMC     Full-text available via subscription  
Prostate Cancer and Prostatic Diseases     Hybrid Journal   (Followers: 6)
Renal Failure     Open Access   (Followers: 12)
Renal Replacement Therapy     Open Access   (Followers: 4)
Research and Reports in Urology     Open Access   (Followers: 4)
Revista de Nefrología, Diálisis y Trasplante     Open Access   (Followers: 1)
Revista Mexicana de Urología     Open Access   (Followers: 1)
Revista Urologia Colombiana     Open Access  
Saudi Journal of Kidney Diseases and Transplantation     Open Access   (Followers: 2)
Scandinavian Journal of Urology     Hybrid Journal   (Followers: 7)
Seminars in Nephrology     Hybrid Journal   (Followers: 11)
The Prostate     Hybrid Journal   (Followers: 8)
Therapeutic Advances in Urology     Open Access   (Followers: 4)
Trends in Urology & Men's Health     Partially Free   (Followers: 1)
Ukrainian Journal of Nephrology and Dialysis     Open Access   (Followers: 1)
Uro-News     Hybrid Journal   (Followers: 1)
Urolithiasis     Hybrid Journal   (Followers: 2)
Urologia Internationalis     Full-text available via subscription   (Followers: 2)
Urologia Journal     Hybrid Journal  
Urologic Clinics of North America     Full-text available via subscription   (Followers: 4)
Urologic Nursing     Full-text available via subscription   (Followers: 4)
Urologic Radiology     Hybrid Journal  
Urological Science     Open Access  
Urologicheskie Vedomosti     Open Access  
Urologie in der Praxis     Hybrid Journal  
Urologie Scan     Hybrid Journal  
Urology     Hybrid Journal   (Followers: 33)
Urology Annals     Open Access   (Followers: 4)
Urology Case Reports     Open Access   (Followers: 3)
Urology Practice     Full-text available via subscription   (Followers: 2)
Urology Times     Free   (Followers: 3)
Urology Video Journal     Open Access   (Followers: 1)
World Journal of Nephrology and Urology     Open Access   (Followers: 15)
World Journal of Urology     Hybrid Journal   (Followers: 11)

           

Similar Journals
Journal Cover
Clinical Queries: Nephrology
Number of Followers: 1  
 
  Hybrid Journal Hybrid journal (It can contain Open Access articles)
ISSN (Print) 2211-9477
Published by Elsevier Homepage  [3203 journals]
  • Tubular ectasia of rete testis – A diagnostic dilemma
    • Authors: Vaidehi K. Pandya; Harsh C. Sutariya; Kajal M. Patel
      Pages: 33 - 34
      Abstract: Publication date: October–November 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 2
      Author(s): Vaidehi K. Pandya, Harsh C. Sutariya, Kajal M. Patel
      Tubular ectasia of rete testis is a rare benign condition often confused with testicular neoplasm. Though not thought of clinically, it is usually an incidental finding on ultrasound. Here, we report a case of bilateral rete testis associated with multiple epididymal cysts in otherwise normal patients.

      PubDate: 2016-11-20T10:32:12Z
      DOI: 10.1016/j.cqn.2016.07.001
      Issue No: Vol. 5, No. 2 (2016)
       
  • Imaging of forgotten indwelling D.J. stent with encrustment
    • Authors: Harsh Sutariya; Vaidehi Pandya
      Pages: 35 - 36
      Abstract: Publication date: October–November 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 2
      Author(s): Harsh Sutariya, Vaidehi Pandya
      A poor, uneducated male patient from a remote rural place had undergone Right open pyelolithotomy with Double J (D.J. stent) stenting for obstructive uropathy 15 years ago. He presented with the following prevailing conditions: right flank pain, interrupted urinary stream and burning micturition. Ultrasound showed Gross Hydronephrosis with multiple calculi and D.J. stent in the right kidney. Urinary bladder also showed presence of D.J. stent with encrustment around the tip of the stent. The mid part of D.J. stent was not visualized. Later, on X-ray, broken parts of the stent with encrustment were seen in the right renal pelvis and bladder, which were removed, and cystolithotomy was done. Imaging plays a pivotal role in detection of such broken or forgotten stents and can direct early and prompt management to prevent complications.

      PubDate: 2016-11-20T10:32:12Z
      DOI: 10.1016/j.cqn.2016.07.002
      Issue No: Vol. 5, No. 2 (2016)
       
  • Duplex Doppler ultrasound for detection of significant renal artery
           stenosis in transplant kidney with end to side arterial anastomosis
    • Authors: Shruti Gandhi; Kajal Patel; Vivek Kute; Maulik Mehta
      Pages: 37 - 39
      Abstract: Publication date: October–November 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 2
      Author(s): Shruti Gandhi, Kajal Patel, Vivek Kute, Maulik Mehta
      Objective To evaluate the accuracy of velocity parameters and to define optimum threshold values of these parameters in detection of >60% renal artery stenosis in patients with end to side arterial anastomosis. Methods The study group composed of 17 patients of transplant renal artery stenosis confirmed by CT angiography; and 25 control patients with normal Doppler study. Doppler parameters like PSV in main transplanted renal artery, PSV in interlobar artery, PSV in iliac artery, acceleration time, and resistive index were evaluated. Pre-PSV ratio and Post-PSV ratio were calculated. Patients were divided into group A (>60% stenosis) and B (<60% stenosis) according to CT angiography reports. Control group assigned as group C. Difference between Doppler parameters were evaluated by individual t test. Receiver operating curve was performed to determine optimal parameter for diagnosis of >60% stenosis. Results Considering better sensitivity and specificity for diagnosis of >60% stenosis the best threshold for Intrarenal RI, acceleration time, PSV, Pre-PSV ratio and Post-PSV ratio were determined to be 0.058, 0.071s, 3.1m/s, 2 and 10 respectively. P value of acceleration time between group B and C; and P value of PSV in main renal artery, Pre-PSV ratio and Intrarenal RI between group A and B is >0.05. Conclusion Post-PSV ratio is the best parameter for diagnosis of significant stenosis and its optimum threshold value is 10.

      PubDate: 2016-11-20T10:32:12Z
      DOI: 10.1016/j.cqn.2016.07.004
      Issue No: Vol. 5, No. 2 (2016)
       
  • Renal recovery after dengue induced acute kidney injury (DAKI): A future
           perspective
    • Authors: Tauqeer Hussain Mallhi; Amer Hayat Khan; Azmi Sarriff; Azreen Syazril Adnan; Yusra Habib Khan
      Pages: 40 - 41
      Abstract: Publication date: October–November 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 2
      Author(s): Tauqeer Hussain Mallhi, Amer Hayat Khan, Azmi Sarriff, Azreen Syazril Adnan, Yusra Habib Khan


      PubDate: 2016-11-20T10:32:12Z
      DOI: 10.1016/j.cqn.2016.08.001
      Issue No: Vol. 5, No. 2 (2016)
       
  • A rare cause of low back pain: A report of presacral schwannoma
    • Authors: Shruti P. Gandhi; Syed Jamal Rizvi; Kamlesh S. Suthar; Kajal N. Patel
      Pages: 42 - 45
      Abstract: Publication date: October–November 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 2
      Author(s): Shruti P. Gandhi, Syed Jamal Rizvi, Kamlesh S. Suthar, Kajal N. Patel
      The presacral space is the site of a group of heterogeneous and rare tumors that are often indolent and produce nonspecific symptoms. Here we report a case of large multiloculated cystic mass in 53-year-old male presented with right-sided low backache. Provisional diagnosis of presacral schwannoma was made with the help computed tomography (CT) study and diagnosis was confirmed by histopathology.

      PubDate: 2016-11-20T10:32:12Z
      DOI: 10.1016/j.cqn.2016.07.003
      Issue No: Vol. 5, No. 2 (2016)
       
  • Distal renal tubular acidosis with hypokalemic paralysis as primary
           presentation of Sjogren's syndrome without sicca symptoms: An unusual case
           presentation
    • Authors: Umesh T. Varyani; Pankaj R. Shah; Vivek B. Kute; Aruna V. Vanikar; H.L. Trivedi
      Pages: 46 - 48
      Abstract: Publication date: October–November 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 2
      Author(s): Umesh T. Varyani, Pankaj R. Shah, Vivek B. Kute, Aruna V. Vanikar, H.L. Trivedi
      Sjogren's syndrome is a systemic autoimmune disorder characterized by chronic inflammation of the exocrine glands with extra-glandular manifestations. Renal involvement occurs in 18–67% of cases, with chronic tubulo-interstitial nephritis being the most frequent pathology which can lead to distal renal tubular acidosis characterized by normal anion gap acidosis with hypokalemia and alkaline urinary pH. Hypokalemic periodic paralysis can be primary or secondary to potassium deficiency which can arise from several causes. Primary Sjogren's syndrome is a rare cause which can lead to renal involvement producing distal renal tubular acidosis with hypokalemic paralysis.

      PubDate: 2016-11-27T13:54:05Z
      DOI: 10.1016/j.cqn.2016.09.001
      Issue No: Vol. 5, No. 2 (2016)
       
  • De-novo donor-specific antibody (DSA) against HLA-DQ antigens resulting in
           acute antibody mediated rejection in a renal transplant patient
    • Authors: Sonia Mehrotra; Raj K. Sharma; Narayan Prasad; Amit Gupta; Dharmendra S. Bhadauria; Anupama Kaul
      Pages: 1 - 3
      Abstract: Publication date: January–March 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 1
      Author(s): Sonia Mehrotra, Raj K. Sharma, Narayan Prasad, Amit Gupta, Dharmendra S. Bhadauria, Anupama Kaul
      A highly sensitive single antigen bead assay (SAB) by luminex is a very useful tool for post-transplant monitoring of HLA antibodies for diagnosing antibody-mediated rejection ABMR. Donor-specific anti-HLA antibodies that arise de-novo (de-novo DSA) after transplantation, indicate the highest risk for acute antibody-mediated rejection (AMR) and graft loss. The return of pre-existing antibodies after transplantation or the development of new de-novo anti-HLA or non-HLA DSA may also confer an increased risk for graft loss. A case with de-novo donor-specific antibody (DSA) against HLA-DQ antigens resulting in acute antibody-mediated rejection (ABMR) in a renal transplant patient is presented along with review of literature.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.04.002
      Issue No: Vol. 5, No. 1 (2016)
       
  • Synchronous bilateral Wilms tumour: A case report with review of
           literature
    • Authors: Kajal Patel
      Pages: 4 - 7
      Abstract: Publication date: January–March 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 1
      Author(s): Kajal Patel
      Wilms tumour is the most common malignant renal tumour in childhood. Approximately 5–7% of Wilms tumour patients present with bilateral disease, either synchronously or metachronously. However, its association with hypospadias is seen in only 1.8% cases. Synchronous bilateral Wilms tumour poses the special challenge of establishing local tumour control while preserving renal function. We describe the case of synchronous bilateral Wilms tumour associated with hypospadias in a 1-year-old male child. A review of the aetiology, demographics, diagnosis and imaging, staging and treatment of Wilms tumour with emphasis on bilateral disease will be presented.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.04.001
      Issue No: Vol. 5, No. 1 (2016)
       
  • Acute kidney injury in pregnancy
    • Authors: C. Praveen; Anupama Kaul; R.K. Sharma
      Pages: 8 - 15
      Abstract: Publication date: January–March 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 1
      Author(s): C. Praveen, Anupama Kaul, R.K. Sharma
      Pregnancy-related acute kidney injury (P-AKI) incidence has reduced over the recent years with better accessibility and advances in health care. It is still a concern in developing countries where septic abortions and puerperal sepsis persist due to lack of health facilities. Recent advances have helped in a better understanding of pathogenesis of disorders like pre-eclampsia, acute fatty liver of pregnancy, and thrombotic microangiopathy which has helped the physicians to solve the enigma in both diagnosis and management of these conditions. Diagnosis of P-AKI is challenging due to normal maternal physiological changes. Usual definitions of AKI are not very accurate in pregnancy and newer markers for diagnosis of AKI are not well studied in pregnancy. Early identification of the cause of P-AKI and its prompt treatment holds the key in the management of P-AKI. It is of utmost importance to maintain the hemodynamics and acid base balance for ensuring proper utero-placental blood flow and fetal well being in P-AKI. There is neither particular modality of RRT which is better than other nor a preset dialysis prescription for P-AKI, and renal replacement therapy should be individualized to provide optimal care.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.04.003
      Issue No: Vol. 5, No. 1 (2016)
       
  • Management of acute kidney injury in sepsis
    • Authors: B Karthikeyan; R Sharma
      Pages: 16 - 20
      Abstract: Publication date: January–March 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 1
      Author(s): B Karthikeyan, R Sharma
      Acute kidney injury and multiorgan dysfunction due to sepsis and septic shock increase the morbidity and mortality among critically ill patients. It remains an important challenge in critically ill patients. In this review, management of septic AKI in terms of prevention, medical therapies, and extracorporeal therapies is discussed. Stabilizing the hemodynamic parameters by fluid resuscitation and inotropic support are important strategies to prevent acute kidney injury in the initial stages. Controversies exist in the timing of initiating renal replacement therapy although some studies showed improved outcomes with early initiation. The recommended dose of renal replacement therapy (25ml/kg/hr) had not shown to be associated with improved survival in randomized studies. The clinical benefit of other therapies, like hemoadsorption, and alkaline phosphatase use is still uncertain. Mesenchymal stem cell therapies are in phase I trials.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.04.006
      Issue No: Vol. 5, No. 1 (2016)
       
  • Pathophysiology of sepsis-associated AKI [SA-AKI]
    • Authors: L.P. Saikumar Doradla; Narayan Prasad
      Pages: 21 - 25
      Abstract: Publication date: January–March 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 1
      Author(s): L.P. Saikumar Doradla, Narayan Prasad
      Sepsis often leads to widespread injury causing multiple organ dysfunction and the development of AKI in sepsis often portends poor prognosis. The pathophysiology of sepsis induced AKI is complex and multifactorial. Initially it was thought that hypotension causing hypoperfusion of kidneys as the major cause of AKI in sepsis. Recent work has been shown that rather than hypoperfusion, microvascular dysfunction with release of inflammatory mediators, cytokines, microparticles with adaptation of tubular cells as the major contributor of sepsis induced AKI. The aim of this review is to focus on the recent advances in pathophysiology of sepsis induced AKI and understanding these complex mechanisms which may pave the way for newer treatments in the future which are directed against the specific pathophysiological mechanisms.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.04.005
      Issue No: Vol. 5, No. 1 (2016)
       
  • Acute kidney injury in malaria: An update
    • Authors: Anand Chellappan; D.S. Bhadauria
      Pages: 26 - 32
      Abstract: Publication date: January–March 2016
      Source:Clinical Queries: Nephrology, Volume 5, Issue 1
      Author(s): Anand Chellappan, D.S. Bhadauria
      Malaria is a mosquito-borne infectious disease with active transmission in the tropics. Malaria is becoming a global threat with the increasing number of cases of ‘imported malaria’. According to the World Health Organization, half of the world's population is at the risk of malaria. Severe malaria is associated with high mortality. There has been a change in the spectrum of manifestations of severe malaria over the past two decades. Acute kidney injury (AKI) in malaria is being frequently reported. AKI is commonly caused by Plasmodium falciparum. However, Plasmodium vivax and Plasmodium knowlesi are also shown to cause AKI. A combination of hemorheological, inflammatory and humoral responses has been implicated in the pathogenesis. AKI in malaria is frequently oliguric and hyper-catabolic. Cerebral malaria and jaundice are often associated with acute kidney injury and portend a poor prognosis. The KDIGO criteria enable earlier detection of acute kidney injury in malaria. Acute tubular necrosis is the most consistent histological feature. A lot of uncertainty surrounds fluid management in severe malaria. A conservative approach to fluid replacement is recommended. Artesunate is the recommended first choice antimalarial for the treatment of severe malaria. Prompt recognition and early institution of renal replacement therapy reduces the mortality.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.04.004
      Issue No: Vol. 5, No. 1 (2016)
       
  • Malnutrition and hyperphosphatemia in dialysis patients
    • Authors: S. Mehrotra; P. Rishishwar; R.K. Sharma
      Pages: 25 - 27
      Abstract: Publication date: October–December 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 3–4
      Author(s): S. Mehrotra, P. Rishishwar, R.K. Sharma
      This study aims to document the incidence of hyperphosphatemia in dialysis patients and correlate it with malnutrition. The incidence and severity of malnutrition (low serum albumin) and hyperphosphatemia (increased serum phosphorus level) were correlated with serum calcium, serum alkaline phosphate, and serum parathyroid hormone levels in patients on dialysis. In India, approximately on an average, every 10th person has evidence of early stage of chronic kidney disease. There is high incidence of malnutrition in chronic kidney disease (CKD) patients on dialysis (stage 5D). There have been varying reports of incidence of hyperphosphatemia in dialysis patients in India. Patients on maintenance hemodialysis (MHD) also have high incidence of malnutrition. Indian patients on dialysis have been reported to have less incidence and severity of hyperphosphatemia. A total of 500 patients on MHD (122 female and 378 male patients, age range 9–89 years, and mean age 47.0±15.25 years) were evaluated for hyperphosphatemia, malnutrition, and degree of renal failure. There was trend of more hyperphosphatemia in the group of patients with serum albumin level ≥3.0g/dl, because these patients were taking adequate dietary protein intake. Patients with malnutrition (serum albumin level <3.0g/dl) had less incidence and severity of hyperphosphatemia as compared to the group with serum albumin level ≥3.0g/dl. Chronic kidney disease (CKD) patients on dialysis had high incidence of malnutrition. Hyperphosphatemia was seen even in patients with malnutrition despite lower dietary protein intake and low serum albumin levels.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.11.008
      Issue No: Vol. 4, No. 3-4 (2016)
       
  • Biopsy in native kidney diseases
    • Authors: Manish R. Balwani; Charulata Bawankule; Swati Vakil; Rajashri Yadav; Nilima Ambade; Aparna Manjarkhede; Shilpa Pandhare; Himanshu Patel; Vivek B. Kute
      Pages: 28 - 33
      Abstract: Publication date: October–December 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 3–4
      Author(s): Manish R. Balwani, Charulata Bawankule, Swati Vakil, Rajashri Yadav, Nilima Ambade, Aparna Manjarkhede, Shilpa Pandhare, Himanshu Patel, Vivek B. Kute
      Renal biopsy is usually obtained to establish a diagnosis, help guide therapy, and ascertain the degree of active and chronic changes. The routine evaluation of a percutaneous renal biopsy involves examination of the tissue under light, immunofluorescence, and electron microscopy. The indications for performing a renal biopsy vary among concerned physicians, being determined in part by the clinical features, signs, and symptoms. Among patients with the nephrotic syndrome and no evidence of systemic disease, renal biopsy is performed both to determine treatment and to make an unidentified diagnosis. The acute nephritic syndrome is often caused by a systemic disease that requires a renal biopsy to establish the diagnosis and guide treatment. Even in the absence of a systemic disease, the acute nephritic syndrome commonly needs a biopsy to ascertain a diagnosis and guide treatment. Among patients with unexplained acute kidney injury, a biopsy is obtained in those settings, in which the diagnosis is uncertain. Among patients with isolated glomerular hematuria, a renal biopsy is not routinely performed, unless there is evidence of progressive disease such as increasing proteinuria or a rising serum creatinine concentration. A renal biopsy is also generally not obtained in patients, who presents with low-grade proteinuria (less than 500–1000mg/day), the absence of glomerular hematuria, usually normal renal function, and an absence of clinical or serologic evidence of a systemic disease that can cause glomerulonephritis. Prior to a percutaneous renal biopsy, a history, physical examination, and selected laboratory tests should be performed. Recommended laboratory tests include complete blood count, platelet count, prothrombin time, partial thromboplastin time, and bleeding time. Percutaneous renal biopsy is usually performed under real time ultrasonic guidance in local anesthesia with spring-loaded needle. Bleeding is the primary complication of renal biopsy. Nonpercutaneous renal biopsies (open, laparoscopic, and transjugular renal biopsy) are indicated in settings, in which a percutaneous renal biopsy cannot be performed (uncorrectable bleeding diathesis, failed attempts at percutaneous biopsy).

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.01.001
      Issue No: Vol. 4, No. 3-4 (2016)
       
  • Novel presentation of Plasmodium vivax malaria with acute kidney injury
           and hemolytic uremic syndrome
    • Authors: Mohan P. Patel; Prakash P. Ugale; Abhijeet B. Jagtap; Sandip T. Chaudhari; Pitambar N. Dighore
      Pages: 34 - 37
      Abstract: Publication date: October–December 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 3–4
      Author(s): Mohan P. Patel, Prakash P. Ugale, Abhijeet B. Jagtap, Sandip T. Chaudhari, Pitambar N. Dighore
      Background In India, epidemiologically, Plasmodium vivax predominates over Plasmodium falciparum malaria, and this produces a major public health problem due to the recent increase in severe vivax malaria. Malaria-related renal failure is usually ascribed to acute tubular necrosis (ATN) and interstitial nephritis, and rarely to cortical necrosis. Clinical features of hemolytic uremic syndrome (HUS) and thrombotic microangiopathy (TMA) on renal histology have not been described conclusively in relation to malaria. Methods This prospective observational study includes patients of vivax malaria with renal failure admitted to a tertiary care hospital during November 2011 to April 2012 with features of HUS (anemia, thrombocytopenia, and acute kidney injury). The diagnosis of P. vivax malaria monoinfection was established with detection of parasite in peripheral smear and malaria card test. Renal biopsies were performed after three weeks for nonrecovering renal failure and evaluated with light and immune-fluorescence microscopy. Results Five patients (2 males and 3 females) had clinical constellation of HUS associated with vivax malaria. All the patients required dialysis [1 peritoneal dialysis and 4 hemodialysis (HD)]. Renal biopsy performed in all the patients showed characteristic features of TMA like mucointimal proliferation, subintimal fibrin deposits with luminal thrombi along with ATN, and cortical necrosis. Three patients were dependent on dialysis [1 continuous ambulatory peritoneal dialysis (CAPD) and 2 HD]. The rest of the two patients had partial recovery at the end of 3 months. The patient on CAPD died due to pneumonia-related sepsis. Conclusion Clinical association of vivax malaria with TMA leading to HUS is novel and suggests parasite-related severe endothelial injury. Future studies are needed to demonstrate interaction of parasite with endothelium and factors related to it.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.02.001
      Issue No: Vol. 4, No. 3-4 (2016)
       
  • Participation of compatible donor to improve HLA matching can increase
           kidney transplant rate of O blood group patients
    • Authors: U.T. Varyani; V.B. Kute; H.V. Patel; P.R. Shah; A.V. Vanikar; P.R. Modi; V.R. Shah; P.S. Wakhare; S.G. Shinde; V.A. Godhela; P.S. Shah; V.B. Trivedi; H.L. Trivedi
      Pages: 38 - 40
      Abstract: Publication date: October–December 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 3–4
      Author(s): U.T. Varyani, V.B. Kute, H.V. Patel, P.R. Shah, A.V. Vanikar, P.R. Modi, V.R. Shah, P.S. Wakhare, S.G. Shinde, V.A. Godhela, P.S. Shah, V.B. Trivedi, H.L. Trivedi
      Background Infection is the most common cause of hospitalization, morbidity, and mortality in post-transplant recipients in developing countries like India. With the availability of potent immunosuppression the short-term graft outcomes have improved, but the risk of infections has increased, and the long-term graft and patient survival are poor. Infections are the leading cause of death with functioning grafts in the developing countries. By increasing the HLA match, we can decrease the need of more potent immunosuppression, thereby decreasing the risk of infection and improving graft and patient survival. Here we report a case where two-way kidney paired donation (KPD) transplantation was done for better HLA match to improve long-term graft survival. Methods Two-way kidney paired donation (KPD) transplantation was performed, where one compatible pair (patient: AB blood group 48 years male; Donor, 47 year wife) benefitted by better HLA match (9/14) and other pair (patient: O blood group 33 years female; Donor 47 year mother) benefitted by getting ABO compatible O group donor. Both patients had anatomic, functional, and immunologically comparable donors. Kidney transplant was performed simultaneously after legal permission from authorization committee. Results Outcome was similar for both patients. Mean serum creatinine is 0.95mg/dl at 3 months follow-up without any complications. Conclusion National KPD program will expand the donor pool. Long-term outcome of compatible pairs with poor HLA matching can be improved with better HLA matching in KPD, which also increases the transplant rate of KPD program.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2016.02.002
      Issue No: Vol. 4, No. 3-4 (2016)
       
  • Severe hyperuricemia with acute kidney injury: Vigilance needed for
           spontaneous tumor lysis syndrome
    • Authors: Mohan P. Patel; Vivek B. Kute; Himanshu V. Patel; Pankaj R. Shah; Hargovind L. Trivedi; Aruna V. Vanikar
      Pages: 41 - 43
      Abstract: Publication date: October–December 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 3–4
      Author(s): Mohan P. Patel, Vivek B. Kute, Himanshu V. Patel, Pankaj R. Shah, Hargovind L. Trivedi, Aruna V. Vanikar
      Tumor lysis syndrome (TLS) is well described treatment related oncologic emergency with hyperuricemia being a cardinal sign of it leading to acute uric acid nephropathy. But spontaneous occurrence of TLS has occasionally been described in the literature. This spontaneous tumor lysis syndrome (STLS) is unusual cause for acute kidney injury (AKI) and a very uncommon initial presentation of lymphoma. AKI occurring in the setting of STLS has very poor outcome as it was not possible to institute preventive measures leading to very high mortality. We report a case of non-Hodgkin's lymphoma presenting with severe hyperuricemia with AKI. Our case stresses the importance of rapid diagnosis and treatment of AKI due to STLS which helps in early renal recovery. With prompt and timely initiation of hemodialysis and other supportive measures, renal failure and prognosis can be improved.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.12.001
      Issue No: Vol. 4, No. 3-4 (2016)
       
  • Therapeutic drug monitoring of sirolimus
    • Authors: Pankaj R. Shah; Vivek B. Kute; Himanshu V. Patel; Hargovind L. Trivedi
      Pages: 44 - 49
      Abstract: Publication date: October–December 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 3–4
      Author(s): Pankaj R. Shah, Vivek B. Kute, Himanshu V. Patel, Hargovind L. Trivedi
      The pharmacology of the sirolimus and their use in renal transplant recipients are discussed here. In majority of the transplant centers, sirolimus whole-blood concentrations are measured by enzyme-linked immunoassays and high-performance liquid chromatography (HPLC) with ultraviolet or mass spectrometry detection. HPLC measures the parent drug and is very accurate but time-consuming. The recommended time for collection is 1h prior to the next oral dose. Because of metabolic interactions, sirolimus should be given 4h after cyclosporine, whereas sirolimus and Tacrolimus can be given simultaneously. The target sirolimus levels should be 5–15ng/mL depending on immunologic risk, time of conversion and other immunosuppressive drugs. Sirolimus trough concentrations >15ng/mL have been correlated with side effects such as hypertriglyceridemia, thrombocytopenia, and leukopenia. The 2009 Kidney Disease: Improving Global Outcomes (KDIGO) clinical practice guidelines for the care of kidney transplant recipients suggest monitoring sirolimus levels (2C). KDIGO recommend that if sirolimus is used, they should not be started until graft function is established and surgical wounds are healed (1B). KDIGO recommend that the combined use of sirolimus and calcineurin inhibitor (CNI) should be avoided, because they potentiate nephrotoxicity, particularly if used in the early period following transplantation. Conversion from CNI to sirolimus is generally not recommended when proteinuria >800mg/day, acute rejection during the 3 months before conversion, estimated GFR<40mL/min, acute Banff 2A at any time post-transplant and dyslipidemia despite lipid lowering agents.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.11.005
      Issue No: Vol. 4, No. 3-4 (2016)
       
  • Pulmonary renal syndromes: A pulmonologist's view
    • Authors: Alok Nath; Srinivas Rajagopala
      Pages: 1 - 8
      Abstract: Publication date: January–June 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 1–2
      Author(s): Alok Nath, Srinivas Rajagopala
      Background Pulmonary Renal Syndromes are heterogeneous group of disorders characterized by co-occurrence of rapidly progressive glomerulonephritis (RPGN) and alveolar hemorrhage due to an autoimmune etiology. This condition many a times presents as an emergency and can be rapidly fatal. A high index of suspicion is required to identify PRS early because appropriate diagnosis and timely institution of treatment is necessary for favorable results. The most common causes of PRS include anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV), anti-glomerular basement membrane (Anti-GBM) disease and systemic lupus erythematosus (SLE) which are responsible for almost 80% of the cases. All these condition share similar clinical presentation however there are some salient features which differentiate them in terms of prognosis and management. Methods This is a narrative review using the search terms; “pulmonary renal syndrome, granulomatosis with polyangiitis; eosinophilic granulomatosis with polyangiitis; microscopic polyangiitis; anti-GBM disease and systemic lupus erythematosus. Results The most common causes of PRS include anti-neutrophil cytoplasmic antibody (ANCA) associated vasculitis (AAV), anti-glomerular basement membrane (Anti-GBM) disease and systemic lupus erythematosus (SLE) which are responsible for almost 80% of the cases. All these condition share similar clinical presentation however there are some salient features which differentiate them in terms of prognosis and management. The response to immunosuppressive therapy and long term prognosis also differs because of distinguishing features in pathogenesis of these disorders. There is no consensus about the management protocols of pulmonary renal syndromes however, various immunological societies have laid down treatment protocols with variable success rates. Conclusion The syndrome of PRS has a high short-term mortality (20–40%). The rates of remission are >90% with current protocols and effective second line therapies exist for those who don't attain remission. Relapse rates are about 15% at 18 months and are higher with patients having PR3-ANCA and a diagnosis of GPA. A high index of suspicion is required to identify PRS early because treatment delays may be rapidly fatal.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.02.001
      Issue No: Vol. 4, No. 1-2 (2016)
       
  • Updates in the management of diabetic nephropathy
    • Authors: Jai Prakash
      Pages: 9 - 14
      Abstract: Publication date: January–June 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 1–2
      Author(s): Jai Prakash
      Diabetic nephropathy is the most frequent cause of end stage renal disease (ESRD) worldwide. Current treatments consisting of glycaemic and blood pressure control, and efficient anti-proteinuric effects of RAS blockade are not sufficient to prevent progression of ESRD in a substantial proportion of patients. This finding is consistent with the hypothesis that key pathogenic mechanisms leading to progression of renal disease in diabetic patients are not modified or inactivated by current therapeutic approaches. Despite extensive research in molecular signalling mechanism and a number of high-profile clinical trials of potentially nephroprotective agents, the pathogenetic mechanisms underlying the diabetic nephropathy are not fully understood. Currently, only one trial (atrasentan) that seems to have a potentially renoprotective effect is underway. Further research into the potential nephroprotective effects of novel glucose lowering agents is needed.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.11.001
      Issue No: Vol. 4, No. 1-2 (2016)
       
  • Renal replacement therapy in India: Promising future with kidney paired
           donation transplantation
    • Authors: M.K. Shah; V.B. Kute; H.V. Patel; P.R. Shah; A.V. Vanikar; P.R. Modi; V.R. Shah; P.S. Shah; H.L. Trivedi
      Pages: 15 - 18
      Abstract: Publication date: January–June 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 1–2
      Author(s): M.K. Shah, V.B. Kute, H.V. Patel, P.R. Shah, A.V. Vanikar, P.R. Modi, V.R. Shah, P.S. Shah, H.L. Trivedi
      The prevalence of CKD is increasing worldwide. There is tremendous imbalance in organ supply and demand worldwide. India is having mainly living donor (up to 90%) kidney transplantation program. Majority (up to 45%) of the living donors, although healthy and willing, are rejected due to ABO incompatibility. Deceased donation contributes to <10% of KT in India. Kidney paired donation, ABO incompatible KT, desensitization protocols, and marginal living donors are the ways to expand the living donor pool. The age at time of CKD reporting is less as compared to western stand and economic constraints are the most important hurdle in access to renal replacement therapy. The best long-term patient and graft survival is seen in KPD, which is cost effective and can be performed in all transplant centers. KPD has potential to expand the KT rate by 25%. The state and national KPD program will increase the donor pool and it increases the transplant rate in KPD. The harmony and co-ordination in different transplant centers, uniform guidelines to accept donor and patients for transplantation and computer software are required for the national KPD program.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.11.006
      Issue No: Vol. 4, No. 1-2 (2016)
       
  • Synthetic cannabinoids causing acute kidney injury – A rare case
    • Authors: Malagouda R. Patil; Manong Chohwanglim; Arpita Roy Choudhury; R. Pandey
      Pages: 19 - 20
      Abstract: Publication date: January–June 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 1–2
      Author(s): Malagouda R. Patil, Manong Chohwanglim, Arpita Roy Choudhury, R. Pandey
      Cannabis is a collective term referring to the bioactive substances from cannabis sativa or cannabis indica. Ganja is a resinous extract of leaves and bracts of a female plant. Smoking of ganja is very rampant for a very long time in our country. Recently, use of synthetic drugs is increasing as compared to natural psychotropic substances because intensity is much higher than that induced by natural ones, together with easy access, affordability and avoidance of detection by many commonly used urine drug tests. Renal failure after cannabinoid use has never been reported; we here report a case of acute kidney injury after synthetic cannabinoid use.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.11.007
      Issue No: Vol. 4, No. 1-2 (2016)
       
  • Guillain–Barré syndrome post renal transplantation – A
           rare entity
    • Authors: Kundan G. Wadhai; Vivek B. Kute; Vijay A. Ghodela; Maulin K. Shah; Himanshu V. Patel; Dinesh N. Gera; Aruna V. Vanikar; Pankaj R. Shah; Hargovind L. Trivedi
      Pages: 21 - 22
      Abstract: Publication date: January–June 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 1–2
      Author(s): Kundan G. Wadhai, Vivek B. Kute, Vijay A. Ghodela, Maulin K. Shah, Himanshu V. Patel, Dinesh N. Gera, Aruna V. Vanikar, Pankaj R. Shah, Hargovind L. Trivedi
      Guillain–Barré syndrome is acute, frequently severe fulminant polyradiculoneuropathy characterized by areflexic motor paralysis with/without sensory disturbance. We report a rare case of post-renal transplant (RT) Guillain–Barré syndrome (GBS) in a 34-year-old male, who presented with sudden onset of ascending pattern paralysis of lower limbs (LL) without bowel/bladder involvement. The diagnosis was confirmed by neurological examination and nerve conduction velocity (NCV) studies. He was treated with IV immunoglobulin and recovered completely.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.11.004
      Issue No: Vol. 4, No. 1-2 (2016)
       
  • Dilemma of fluid overload and diuretics prescribing in chronic kidney
           disease
    • Authors: Yusra Habib Khan; Azmi Sarriff; Azreen Syazril Adnan; Amer Hayat Khan; Tauqeer Hussain Mallhi
      First page: 23
      Abstract: Publication date: January–June 2015
      Source:Clinical Queries: Nephrology, Volume 4, Issues 1–2
      Author(s): Yusra Habib Khan, Azmi Sarriff, Azreen Syazril Adnan, Amer Hayat Khan, Tauqeer Hussain Mallhi


      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2015.11.003
      Issue No: Vol. 4, No. 1-2 (2016)
       
  • Genetic aspects of familial focal segmental glomerulosclerosis
    • Authors: Suraksha Agrawal; Swayam Prakash; Raj Kumar Sharma
      Pages: 57 - 72
      Abstract: Publication date: April–December 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issues 2–4
      Author(s): Suraksha Agrawal, Swayam Prakash, Raj Kumar Sharma
      Focal Segmental Glomerulosclerosis (FSGS) participates in different clinical presentations therefore involved in underlying pathophysiological etiologies. Numerous reports have proposed that vulnerability to develop FSGS has an important genetic component. These studies comprise familial aggregation, differences in the incidence of FSGS between different ethnic groups, and segregation analysis. Genetic methods have been used to classify genes that contribute towards genetic predisposition. Various studies revealed the precise role of “candidate genes”, which may cause FSGS with different pathogenesis. New studies to assess the role of associated genes have shown contradictory results. These results may be due to the fact that some of the previously reported genes may play only a moderate role. Presently genome wide studies have been carried out and these studies have contributed in finding out the location chromosomal positions. Interestingly novel, unrecognized genes to FSGS have been found. We have focused on different genetic studies including exact role and function of these genes on FSGS and have discussed the strength and weaknesses of these studies. Understanding of the development of FSGS may track future therapies and outcomes.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.06.001
      Issue No: Vol. 3, No. 2-4 (2016)
       
  • Nutritional management of diabetic nephropathy
    • Authors: Anita Saxena
      Pages: 73 - 81
      Abstract: Publication date: April–December 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issues 2–4
      Author(s): Anita Saxena
      Diabetic nephropathy (DN) is characterized by albuminuria, which is usually accompanied by hypertension, progressive rise in proteinuria. There are several approaches to delay progression of diabetic nephropathy towards end stage renal failure (ESRD). Current approaches include a) control of blood glucose; b) low-protein diet; c) control of hypertension; restriction of dietary salt, phosphorus and potassium in advanced cases d) control of hyperfiltration, usually through angiotensin-converting enzyme inhibitors or angiotensin-receptor blocking agents. Nutrition management is fundamental for the prevention of diabetic nephropathy to ESRD.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.06.002
      Issue No: Vol. 3, No. 2-4 (2016)
       
  • Pauciimmune vasculitis
    • Authors: Durga Prasanna Misra; Narayan Prasad; Anupam Wakhlu; Vikas Agarwal
      Pages: 82 - 89
      Abstract: Publication date: April–December 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issues 2–4
      Author(s): Durga Prasanna Misra, Narayan Prasad, Anupam Wakhlu, Vikas Agarwal
      Pauciimmune vasculitis encompasses a group of systemic necrotizing vasculitis with paucity of immune complex deposition on microscopic examination. All these diseases have anti-neutrophil cytoplasmic antibody (ANCA) positivity, hence, also termed as ANCA associated vasculitides. It encompasses a spectrum of small vessel vasculitis; granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). Activated neutrophils (and eosinophils in EGPA) resulting from known and unknown environmental influences on a susceptible genetic background cause vascular injury in various organ systems. The spectrum of disease extends from involvement of upper and lower respiratory tracts to life threatening renal and nervous system involvement. High index of suspicion and early diagnosis and initiation of immunosuppression therapy is crucial for minimizing the risk of morbidity and mortality.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.08.001
      Issue No: Vol. 3, No. 2-4 (2016)
       
  • Update on the management of IgA nephropathy
    • Authors: J.P. Tiwari
      Pages: 90 - 96
      Abstract: Publication date: April–December 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issues 2–4
      Author(s): J.P. Tiwari
      IgA nephropathy is the commonest primary glomerular disease worldwide. A high prevalence has been noted in Asia including India. The clinical course has a wide spectrum of presentation varies from isolated microscopic hematuria to crescentic glomerulonephritis. The approach of the treatment has to be decided as per the clinical and histopathological manifestation of the disease. Risk assessment is important to determine management and also to balance between the risks of therapy by the selection of patients. Clinical features appear to be the stronger prognostic indicators however certain renal histopathological findings have been associated with an increased risk of progressive disease. There is no definitive therapeutic approach despite of better understanding of pathogenic mechanism of the disease. The expected outcome of therapy is slowing the deterioration in kidney function as well as a reduction in proteinuria and control of blood pressure by suppression of angiotensin II with ACE inhibitors or angiotensin II-receptor blockers (ARBs). The indications for the use of corticosteroid alone or in combination with other immunosuppressive agents e.g. Azathioprine or cyclophosphamide are not well defined. Different regimens have been used, consisting of corticosteroids alone or in combination with other immunosuppressive agents. Despite retrospective studies in IgA nephropathy supporting the use of immunosuppressive therapy other than corticosteroid, few randomized control trials have demonstrated a benefit. Corticosteroid combined with cyclophosphamide or azathioprine can be considered in patients with rapidly progressive disease with crescentic IgA nephropathy. Fish oil can be used in the treatment of IgA nephropathy with proteinuria above 1 g/day despite 3–6 months of optimized therapy with ACE inhibitors or ARBs and blood pressure control.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.11.001
      Issue No: Vol. 3, No. 2-4 (2016)
       
  • Zebrafish (Danio rerio): A potential model for nephroprotective drug
           screening
    • Authors: Pallavi Sharma; Supriya Sharma; Vikram Patial; Damanpreet Singh; Yogendra Shantaram Padwad
      Pages: 97 - 105
      Abstract: Publication date: April–December 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issues 2–4
      Author(s): Pallavi Sharma, Supriya Sharma, Vikram Patial, Damanpreet Singh, Yogendra Shantaram Padwad
      Zebrafish (Danio rerio) has emerged as a potential vertebrate model for high throughput screening in drug discovery and development process. Easy breeding, short maturation time, transparent embryos for easy observation, good regeneration capability, well characterization of developmental stages, low maintenance cost, high productivity, less ethical constrains, etc. are a few unique characteristics which make zebrafish an attractive model for biomedical research. Apart from these, zebrafish possesses many anatomical, physiological and genetical similarities with higher mammals. Many pathological disorders have been successfully studied in zebrafish like cancer, cardiovascular, renal diseases, immunological, hematological disorders, etc. The pronephros of zebrafish imitates mammalian kidney at structural, functional and cellular level and thus allows informative nephrological research. The present review highlights the use of zebrafish as a model to screen nephroprotective molecules, to enable better understanding of nephrotoxicity and thus to target new therapies.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.11.002
      Issue No: Vol. 3, No. 2-4 (2016)
       
  • Treatment of membranous lupus nephritis
    • Authors: Satish Haridasan; Aman Sharma; Manish Rathi
      Pages: 106 - 113
      Abstract: Publication date: April–December 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issues 2–4
      Author(s): Satish Haridasan, Aman Sharma, Manish Rathi
      Systemic lupus erythematosus is associated with renal involvement in almost 50–80% of cases. Although proliferative lupus nephritis is the most common form, isolated membranous lupus nephritis (MLN or class V lupus nephritis) accounts for 11–20% of cases while mixed proliferative and MLN (Class III + V/IV + V) can be seen in another 21–30%. MLN can present as either sub-nephrotic or nephrotic proteinuria with or without microscopic hematuria or renal dysfunction. These patients are at high risk of cardiovascular and cerebrovascular complications due to thrombotic tendency, dyslipidemia and hypertension. Uniform evidence regarding prognostic factors, outcome and therapy of MLN are still elusive. Systematic analysis of several studies have shown that sustained nephrotic proteinuria, failure to achieve complete remission and associated proliferative lesions denotes poor prognosis. In general, the long term renal survival rate is 50–90%, while end stage renal disease occurs in 12–22% cases. Transformation to proliferative nephritis is also well known, thus a close follow up is warranted in all pure MLN cases. Those with persistent nephrotic proteinuria, renal dysfunction and mixed histology should be treated aggressively with immunosuppressive agent while less severe cases can be managed with adjunctive therapies.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.11.003
      Issue No: Vol. 3, No. 2-4 (2016)
       
  • Minimal change disease
    • Authors: Shyam B. Bansal
      Pages: 114 - 123
      Abstract: Publication date: April–December 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issues 2–4
      Author(s): Shyam B. Bansal
      Minimal change disease is the commonest cause of nephrotic syndrome in children and third most common cause in adults. There are new insights in the pathogenesis of disease, and it is now considered a podocyte disorder. New biomarkers have been identified to explain the pathogenesis. The treatment in children is almost standardised, however in adults, the evidence is not so robust and treatment is mostly extrapolated from randomized trials in children and uncontrolled or retrospective studies in adults. The long term prognosis of disease is excellent in children and steroid sensitive patients. Steroid resistance is a marker of poor prognosis. Genetic studies are helpful in detecting patients with mutations, as, they do not respond to immunosuppressive drugs. The therapeutic armamentarium of treatment of MCD has widened with discovery of new immunosuppressive drugs like tacrolimus, mycophenolate mofetil and rituximab, which are helpful in treatment of steroids resistant and steroid dependent nephrotic syndrome.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.11.004
      Issue No: Vol. 3, No. 2-4 (2016)
       
  • Management of hypertension in CKD
    • Authors: Manish Chaturvedy
      Pages: 1 - 4
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Manish Chaturvedy
      Hypertension is a leading cause of morbidity and mortality in clinical practice. It may be either a consequence or a cause of CKD. It is a major factor contributing to the kidney disease and to faster decline in GFR. Management of hypertension is a key component in the treatment of CKD, in preventing the progression of CKD and other target organ damage in the schema of hypertension spectrum.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.03.001
      Issue No: Vol. 3, No. 1 (2016)
       
  • Restless leg syndrome in chronic kidney disease
    • Authors: Amol R. Mahaldar
      Pages: 5 - 8
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Amol R. Mahaldar
      Restless Leg Syndrome and Periodic Limb Movements (RLS/PLM) are a common form of sleep disturbance in Chronic Kidney Disease (CKD) patients. The pathophysiology is related to the iron deficiency, anemia of renal disease, uremic toxin accumulation resulting in encephalopathy and peripheral neuropathy. Diagnosis of the condition is made by clinical criteria and rarely polysomnography. RLS/PLM is associated with poor quality of life and increased morbidity and mortality in CKD. Therapeutic approaches include nonpharmacologic, pharmacologic and specific interventions for CKD patients.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.03.002
      Issue No: Vol. 3, No. 1 (2016)
       
  • Antiphospholipid antibody syndrome
    • Authors: Jyoti R. Parida; Durga Prasanna Misra; Anupam Wakhlu; Vikas Agarwal
      Pages: 9 - 14
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Jyoti R. Parida, Durga Prasanna Misra, Anupam Wakhlu, Vikas Agarwal
      Antiphospholipid antibody syndrome (APS) is characterized by recurrent pregnancy losses and/or thrombotic events (both arterial and venous) with persistently positive lupus anticoagulant or antiphospholipid antibodies. Activation of complements, platelets and endothelial cells by the anticardiolipin-β2GP-1 complex plays a major role in pathogenesis of thrombosis. Treatment is with anticoagulation (warfarin/heparin), with steroids needed in the presence of catastrophic APS or cytopenias. Upto a third of patients may have significant long term morbidity.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.03.007
      Issue No: Vol. 3, No. 1 (2016)
       
  • Uremic autonomic neuropathy
    • Authors: Jitendra Kumar; Sushma Sharma
      Pages: 15 - 19
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Jitendra Kumar, Sushma Sharma
      Autonomic symptoms are frequently encountered in chronic renal disease patients, either as a part of distal symmetric polyneuropathy and small fiber sensory polyneuropathy or as primary autonomic polyneuropathy independent of somatic neuropathy. Pathogenesis of latter remains elusive. Sudomotor, gastrointestinal and cardiological involvement is common. Renal replacement therapies are not as efficacious in curing autonomic neuropathy as in somatic polyneuropathy of uremia. A greater awareness of this entity across various disciplines and subsequent multidisciplinary approach involving nephrologists, gastroenterologist and cardiologist, as needed, is probably the best bet at present, to ease the suffering patient.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.03.008
      Issue No: Vol. 3, No. 1 (2016)
       
  • Cardiovascular disease in chronic kidney disease
    • Authors: Shivendra Singh
      Pages: 20 - 29
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Shivendra Singh
      Chronic kidney disease (CKD) is emerging health problem with prevalence of approximately 10% in general population. The incidence and prevalence of cardiovascular disease (CVD) is high in CKD patients, approaching >50% in patients in advance CKD. CVD outcomes are worse in presence of CKD suggesting different pathophysiology compared to general population. Patients with CKD are at increased risk of both atherosclerotic and structural heart disease, stroke and peripheral vascular disease. Congestive heart failure is most common cardiac condition. The increased incidence of CVD is attributed to presence of both traditional and kidney specific risk factors. The kidney specific risk factors include albuminuria, inflammation, hyperparathyroidism, altered calcium phosphate metabolism, homocysteine level and recently recognized coronary artery calcification gene. The preventive and therapeutic strategies for CVD applied to general population are also applicable in patients with CKD but with poor outcomes. The understanding of pathophysiology may provide better insight to develop methods with favorable outcomes in this unique patient population.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.03.006
      Issue No: Vol. 3, No. 1 (2016)
       
  • Cardiorenal syndrome
    • Authors: Sachin S. Soni; Shriganesh R. Barnela; Sonali S. Saboo; Arun B. Chinchiole; Ashish V. Deshpande; Shirish S. Deshmukh; Sudhir G. Kulkarni; Unmesh V. Takalkar
      Pages: 30 - 37
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Sachin S. Soni, Shriganesh R. Barnela, Sonali S. Saboo, Arun B. Chinchiole, Ashish V. Deshpande, Shirish S. Deshmukh, Sudhir G. Kulkarni, Unmesh V. Takalkar
      Cardiorenal syndrome (CRS) is an umbrella term that defines disorders of the heart and kidneys whereby “acute or chronic dysfunction in one organ may induce acute or chronic dysfunction of the other”. The heart and the kidneys are involved in maintaining hemodynamic stability and organ perfusion through an intricate network. Dysfunction of one organ may lead to dysfunction of the other. CRS was recently sub-classified into 5 types primarily based upon the organ that initiated the insult as well as the acuity and chronicity of disease. Development of CRS is associated with increased morbidity, hospital stay, cost of healthcare and mortality. Newer biomarkers have shown potential for early diagnosis of CRS.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.04.001
      Issue No: Vol. 3, No. 1 (2016)
       
  • Dietary management of hyperphosphatemia in chronic kidney disease
    • Authors: Archana Sinha; Narayan Prasad
      Pages: 38 - 45
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Archana Sinha, Narayan Prasad
      Dysregulation of phosphate homeostasis occurs in chronic kidney disease (CKD). Hyperphosphatemia is an ongoing challenge in treating CKD patients. Restriction of dietary proteins remains one of the cornerstones of nutritional management of CKD patients foods from animal sources are rich in organic phosphorus. Foods sources including certain beverages like colas, enhanced meats, frozen meals, snack bars, processed or spreadable cheeses, instant food products, and refrigerated bakery products are rich in inorganic phosphorus. Phosphate additives added to foods further increases the phosphorus burden. It is estimated that the intestinal absorption of inorganic phosphorus is usually more than 90% compared to only 40%–60% from that of the organic phosphorus. Phosphates from animal food are more readily absorbed compared to that present in plant foods sources as majority of it is present in the form of phytate and hence not readily absorbed. Intensive nutritional counseling regarding phosphorus content of foods, their bioavailability with an emphasis on consumption of a mixed diet including foods from animal sources and plant sources high in phytate. While limiting or avoiding the intake from foods very high in phosphorus to protein ratio and foods rich in phosphorus additives but with an adequate protein content to avoid malnutrition, reinforcement on dietary compliance and judicious use of phosphorus binders are important for the better management of hyperphosphatemia in CKD. Methods like soaking foods in water and boiling them helps in reducing the dietary phosphorus content per gram of protein in foods.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.03.003
      Issue No: Vol. 3, No. 1 (2016)
       
  • Arteriovenous fistula (AVF) monitoring and surveillance
    • Authors: Amit Sharma; Priyadarshi Ranjan
      Pages: 46 - 50
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Amit Sharma, Priyadarshi Ranjan
      An arteriovenous fistula (AVF) is created by direct anastomosis between an artery and adjacent vein which leads to flow of blood from artery directly into the vein. A well functioning and patent AVF is essential for optimum delivery of hemodialysis and hence it is important to assess the AVF for any signs of loss of patency (stenosis/thrombosis) on a regular basis. Methods of AVF monitoring include physical examination and other features like difficulty in AVF cannulation due to poor blood flow, clot aspiration or prolonged bleeding from the AVF site post hemodialysis. Methods of AVF surveillance include access blood flow, venous pressure and Doppler ultrasound etc. Both physical examination and investigations have complimentary role in this field and it is necessary that adequate stress is given on monitoring on a continuous basis. Access blood flow and intra-access pressures have role in confirming any abnormal physical examination finding.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.03.004
      Issue No: Vol. 3, No. 1 (2016)
       
  • CMV disease in renal transplantation
    • Authors: Amresh Krishna; Om Kumar; Mritunjay Kumar Singh
      Pages: 51 - 55
      Abstract: Publication date: January–March 2014
      Source:Clinical Queries: Nephrology, Volume 3, Issue 1
      Author(s): Amresh Krishna, Om Kumar, Mritunjay Kumar Singh
      Cytomegalovirus (CMV) is the most important viral pathogen in renal transplant recipient and is associated with considerable morbidity and mortality. Following transplant CMV may lead to a broad spectrum of disease including encephalitis, retinitis, hepatitis, Pneumonitis, gastrointestinal ulcers and graft dysfunction. The risk of developing CMV disease depends on various factors including Serological status of donor and recipient, degree of immunosuppression, episodes of acute rejection and degree of graft function. For diagnosis of CMV disease pp65 antigen assay or molecular assay for nucleic acid test is used. For prevention of CMV disease in renal transplant recipients either antiviral prophylaxis or preemptive therapy is used. Both strategies having own sets of advantages and disadvantages. For treatment of established disease either intravenous ganciclovir or oral valganciclovir is used. In resistant cases foscarnet of cidofovir may be used.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2014.03.005
      Issue No: Vol. 3, No. 1 (2016)
       
  • Graft function and nutritional parameters in stable post renal transplant
           patients
    • Authors: Anita Saxena; R.K. Sharma; Amit Gupta
      Pages: 141 - 144
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Anita Saxena, R.K. Sharma, Amit Gupta
      Bioelectrical Impedance Analysis (BIA) is a noninvasive and bedside tool for assessment of nutritional status. It is expected that patients who have undergone successful renal transplant will have good nutritional intake and steadily the patient will return to normal health and have good nutritional status. Objective The aim of the study was to evaluate effect of graft function on nutritional status in post renal transplant patients with borderline to good allograft function using BIA. Material and methods For this study, 45 post-renal transplant patients with mean serum creatinine 1.42 ± 0.42 mg% and glomerular filtration rate (GFR) 45.1 ± 14.1 ml/min were subjected to bioimpedance analysis. Several parameters were evaluated. Based on BIA derived GFR, patients were divided into two groups (group 1: borderline graft function GFR < 40 ml/min, X = 27.34 ± 9.1 ml/min and group 2: good graft function GFR ≥ 40 ml/min, X = 51.60 ± 9.16 ml/min). Patient data were compared with 30 healthy individuals. Results There was significant difference between healthy controls and the post transplant patients. Based on GFR, there was significant difference in patient groups in body weight (p = 0.01), serum creatinine (p = 0.005), BMI (p = 0.000), fat free mass (p = 0.003), fat mass (p = 0.003), body cell mass (p = 0.000), dry weight (p = 0.001). Patients with borderline GFR had higher serum creatinine but significantly lower body weight, BMI, FFM, FM, and dry weight, indicating poorer nutritional status as compared to those with good graft function. Based on phase angle, there was significant difference between groups A and B in GFR (p = 0.000), extracellular water (p = 0.015), intracellular water (p = 0.002), plasma fluid (p= 0.016), interstitial fluid (p = 0.016), body cell mass (p = 0.024). SGA scores showed that transplant patients had normal nutritional status, but when compared with healthy individuals, there was significant difference in the fat mass, fat free mass and body cell mass as assessed by BIA. Conclusion Compared to patients with good graft function, patients with borderline GFR showed evidence of early nutritional depletion as picked up by BIA implying nutritional deficiency sets in with reduction in GFR (<40 ml/min) which may not be picked up by subjective global assessment but is objectively detected by BIA.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.010
      Issue No: Vol. 2, No. 4 (2016)
       
  • Online hemodiafiltration – A systematic review
    • Authors: Tarun K. Jeloka
      Pages: 145 - 147
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Tarun K. Jeloka
      The survival of patients on hemodialysis is very poor when compared to kidney transplantation. Several attempts have been made to improve the survival of dialysis patients. Some such attempts are more frequent dialysis, more prolonged dialysis, use of high flux dialyzers, use of ‘ultrapure’ dialysate, and better electrolyte and mineral metabolism. Hemodiafiltration is one such measure, where both diffusive and convective methods of toxin removal are exploited with a view of removing both small molecular weight and larger molecular weight toxins from the body. Over last 2 decades several studies with confronting results regarding hemodiafiltration and survival outcome are published and hence need for a review.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.004
      Issue No: Vol. 2, No. 4 (2016)
       
  • Atheroembolic renal disease
    • Authors: Jacob George
      Pages: 148 - 151
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Jacob George
      Atherosclerotic plaques are prone for thromboembolism with clots and atheroembolisation with cholesterol crystals. Atheroembolism occurs when the atherosclerotic plaque is disrupted causing multiple showers of cholesterol crystal embolization resulting in partial or total occlusion of small arteries of multiple organs. Atheroembolic renal disease (AERD) refers to cholesterol crystal embolization of the renal arteries and is often associated with multiorgan involvement. Diagnosis requires a high degree of suspicion in the clinical setting with renal failure, skin lesions, and sometimes hypocomplementemia and eosinophiluria. Treatment is mainly supportive and overall prognosis is poor.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.003
      Issue No: Vol. 2, No. 4 (2016)
       
  • Cardiovascular disease in peritoneal dialysis: A review
    • Authors: Mayoor V. Prabhu; B.H. Santosh Pai; Sreedhar Reddy; Parul Kodan
      Pages: 152 - 155
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Mayoor V. Prabhu, B.H. Santosh Pai, Sreedhar Reddy, Parul Kodan
      Cardiovascular disease (CVD) continues to account for a very high percentage of deaths in patients with ESRD. An entire gamut of risks factors-some well known, some still being understood and yet more putative are operational in patients with renal disease. CVD assumes enhanced importance in the wake of its disproportionate effect on patients with uremia. Some studies have reported an upto 15 fold higher cardiovascular death rate in patients on PD when compared to non-uremic cohorts. Thus it follows that the longevity of patients on PD is directly related to improvements in the recognition, management and prevention of CVD. While the conventional risk factors like age/diabetes/hypertension/hyperlipidemia/smoking etc need no elaboration, factors unique to renal failure like calcium/phosphorus/Vitamin D abnormalities, anemia, dialysis related chronic inflammation etc add to the burden and pathogenesis of CVD. Specific to PD, certain abnormalities like hypoalbuminemia and attendant malnutrition, metabolic abnormalities and even high transporter status (speculative) are thought to propagate the progression of CVD. A review of CVD in PD is incomplete without a referral to non-atherosclerotic disease-volume overload, congestive heart failure and LVH. This review looks into the spectrum of CVD in PD patients, its pathogenesis, and factors unique to PD, and possible therapeutic and preventative measures.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.001
      Issue No: Vol. 2, No. 4 (2016)
       
  • Congenital anomalies of kidney and urinary tract (CAKUT)
    • Authors: Manisha Sahay
      Pages: 156 - 165
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Manisha Sahay
      Congenital abnormalities of kidney and urinary tract are the leading cause of end-stage kidney disease in children. These result from genetic as well as environmental causes. The embryology of kidney and urinary tract is modified by genetic mutations leading to CAKUT. These anomalies may occur in isolation or as a part of syndrome with renal as well as non-renal manifestations. The phenotype may vary from asymptomatic abnormalities on one hand to renal agenesis on the other. Lower tract abnormalities are frequently associated. Many of the disorders may be diagnosed antenatally on imaging. Proper antenatal and post-natal management may prevent progression to ESKD. The role of genetics in diagnosis remains unclear at present and needs further evaluation.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.005
      Issue No: Vol. 2, No. 4 (2016)
       
  • Renal tubular acidosis
    • Authors: Gopal Basu; Golla Sudhakar; Anjali Mohapatra
      Pages: 166 - 178
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Gopal Basu, Golla Sudhakar, Anjali Mohapatra
      Renal tubular acidosis is a collection of renal tubular disorders of diverse etiopathological states that present with hyperchloremic metabolic acidosis due to failure of net renal acid excretion. This review attempts to simplify the underlying physiological basis, the pathophysiological patterns, and the clinical manifestations. An algorithmic approach to diagnose RTA along with a description of most of the tests used is provided. The clinical approach to RTA is followed by a brief note on its therapy.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.006
      Issue No: Vol. 2, No. 4 (2016)
       
  • Primary hyperoxaluria
    • Authors: Sree Bhushan Raju
      Pages: 179 - 183
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Sree Bhushan Raju


      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.009
      Issue No: Vol. 2, No. 4 (2016)
       
  • Cardiovascular disease: Prevention and treatment in renal transplant
           recipients
    • Authors: Santosh Varughese
      Pages: 184 - 196
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Santosh Varughese
      Despite improved survival, renal transplant recipients remain at a high risk of increased mortality and mortality from cardiovascular disease. Both traditional cardiovascular disease (CVD) risk factors and those unique to this population add to the burden of disease, making their CVD risk 50 times that of the general population. This article discusses our present understanding of cardiovascular disease, the risk factors, including dyslipidemia, hypertension, allograft rejection and dysfunction, anemia, proteinuria and new onset diabetes after transplantation (NODAT), as well as prevention and management of these risk factors. Cardiovascular interventions as well as future considerations are also briefly discussed.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.007
      Issue No: Vol. 2, No. 4 (2016)
       
  • Transplant renal artery stenosis
    • Authors: Shivendra Singh
      Pages: 197 - 204
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Shivendra Singh
      Vascular complications after renal transplant are not common, but important cause of graft loss and graft failure. Transplant renal artery stenosis (TRAS) is the most common vascular complication. It usually occurs 3 months to 2 years after transplant. Stenosis may occur (1) at the anastomosis site, (2) as a focal stenosis either proximal or distal to anastomosis, or (3) as diffuse (narrowing of whole artery), multiple stenosis (simultaneous narrowing at multiple sites). Stenosis at site of anastomosis is common occurring in approximately 50% of cases and end-to-end anastomosis have a threefold greater risk of stenosis than end-to-side anastomosis. Usual clinical presentation of TRAS is resistant/worsening of hypertension with or without renal dysfunction. Color Doppler ultrasound is preferred method for screening and intraarterial angiography is gold standard for diagnosis of TRAS. Percutaneous transluminal renal angioplasty (PTRA) is treatment of choice for TRAS. Surgery is indicated for patients with unsuccessful angioplasty or with very severe stenosis that are inaccessible to PTRA.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.008
      Issue No: Vol. 2, No. 4 (2016)
       
  • Hepatorenal syndrome
    • Authors: Samir Mohindra; Kundan Kumar
      Pages: 205 - 211
      Abstract: Publication date: October–December 2013
      Source:Clinical Queries: Nephrology, Volume 2, Issue 4
      Author(s): Samir Mohindra, Kundan Kumar
      Renal dysfunction is commonly seen in patients with end stage liver disease. Prognosis of patients who develop hepatorenal syndrome (HRS) is dismal with a median survival of around six months without liver transplantation. Advances in understanding of the pathophysiology of HRS has lead to evolving ideas regarding the definition and diagnostic criteria of HRS. In addition, recent pharmacological and other therapeutic innovations provide hope to patients of HRS. This is a review of diagnostic criteria, etio-pathogenesis and therapeutic options for patients of HRS based on the available evidence in literature.

      PubDate: 2016-09-14T16:17:08Z
      DOI: 10.1016/j.cqn.2013.11.002
      Issue No: Vol. 2, No. 4 (2016)
       
 
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