Publications by authors named "Attur Ravindra Prabhu"

Background: Adenovirus nephritis is an increasingly recognized complication in adult kidney transplant recipients, characterized by its diverse clinical presentations and diagnostic challenges. This systematic review summarises the clinical profiles and outcomes of adenoviral nephritis in kidney allograft recipients.

Methods: We conducted a systematic search of PubMed, Embase, and Web of Science for studies (case reports or series) with individual patient data on adult kidney transplant recipients with confirmed or presumptive adenoviral nephritis up to October 2, 2024.

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Background: Dipeptidyl peptidase-4 (DPP-4) inhibitors are oral hypoglycemic agents widely prescribed in India despite safety concerns. However, studies focused on their safety profile are scarce, especially in South India.

Objective: To evaluate the prevalence and predictors of adverse events (AEs) with DPP-4 inhibitors in patients with type 2 diabetes mellitus (T2DM).

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Article Synopsis
  • Chloride levels, often overlooked in critically ill patients, can indicate serious outcomes, such as acute kidney injury (AKI) and major adverse kidney events (MAKE30) in those with sepsis.
  • In a study involving 400 sepsis patients, hypochloremia was found to be a significant risk factor for adverse kidney outcomes, with 32.3% of patients showing low chloride levels within 72 hours of ICU admission.
  • Conversely, hyperchloremia did not demonstrate any significant association with MAKE30 or worsening AKI, suggesting that low chloride levels are more critical to monitor in sepsis patients.
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Article Synopsis
  • Haematological abnormalities, particularly post-transplant anemia (PTA), are common among renal transplant recipients, with a peak prevalence of 98% in the first week post-surgery.
  • Other issues included leukopenia, thrombocytopenia, and pancytopenia, often caused by medications and infections.
  • Despite the high incidence of PTA initially, graft function was stable and similar among patients with and without anemia at six and 12 months post-transplant.
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Objectives: The existing biomarkers used to promptly identify graft dysfunction after kidney transplantation lack consistency. Neutrophil gelatinase-associated lipocalin (NGAL) appears to be a promising biomarker but its levels measured from serum and urine have demonstrated varying predictive values. Our study aimed to explore the potential of NGAL as a biomarker in predicting graft dysfunction in kidney transplant patients, including live and deceased donor recipients.

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Introduction: Patients with chronic kidney disease (CKD) are at increased risk of developing tuberculosis (TB). These patients may also be at higher risk of developing antitubercular treatment (ATT)-associated adverse drug reactions (ADRs). Although dose modification has been recommended, data regarding the impact of impaired kidney function on ATT-associated ADRs is sparse.

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Background: Dialysis dysequilibrium syndrome (DDS) refers to neurological symptoms usually seen during or after new initiation or following reinitiation of haemodialysis (HD) after missing multiple sessions. DDS is associated with death and morbidity. We studied interventions aimed at preventing DDS.

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Purpose Of The Study: The purpose of this study was to assess the association of measured glomerular filtration rate (mGFR) using camera-based method with early transplant outcomes.

Methodology: Diethylenetriamine pentaacetate renograms of all voluntary kidney donors between January 2016 and December 2022 at Kasturba Hospital, Manipal, India, were retrieved for the study. Recipients' posttransplant biochemical parameters were collected and compared against donors with scaled mGFR >80 ml/min/1.

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Diabetic kidney disease (DKD) is the most devastating complication of diabetes mellitus. Identification of patients at the early stages of progression may reduce the disease burden. The limitation of conventional markers such as serum creatinine and proteinuria intensify the need for novel biomarkers.

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Background: A significant proportion of diabetic kidney disease (DKD) experience a rapid decline in eGFR, leading to end-stage kidney disease (ESKD) within months. This single-centered retrospective cohort study aimed to assess the prevalence, clinical profile, and predictors for rapid progression in type 2 diabetes mellitus (T2DM) patients with DKD.

Method: Three hundred fifty-nine T2DM patients with DKD between January 2018 and 2022 were included and those with superimposed non-diabetic kidney disease, chronic kidney disease 5, and < 6 months follow-up were excluded.

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Background: Uremic pruritus has an impact on the quality of life and sleep of hemodialysis patients, but the majority of cases go unreported and untreated unless severe, due to a lack of awareness. The purpose of this study is to determine the prevalence, associated factors, and impact on health-related quality of life (HR-QOL) and sleep in hemodialysis patients.

Methodology: A single-center observational study of 3 months wherein 120 adults on maintenance hemodialysis were included.

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Background: Hepatitis C virus (HCV) infection is common in chronic kidney disease (CKD) patients on dialysis, causes chronic liver disease, may increase the risk of death, and impacts kidney transplant outcomes. Direct-acting antivirals have replaced interferons because of better efficacy and tolerability. This is an update of a review first published in 2015.

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The global burden of diabetic kidney disease (DKD) is escalating, and it remains as a predominant cause of the end-stage renal disease (ESRD). DKD is associated with increased cardiovascular disease and morbidity in all types of diabetes. Prediction of progression with albuminuria and eGFR is challenging in DKD, especially in non-proteinuric DKD patients.

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Accordion or concertina effect is the angiographic appearance of pseudostenosis caused by interaction of a stiff guidewire with a tortuous vessel during endovascular procedures. This phenomenon may often mislead the interventionist into performing unnecessary and potentially harmful procedures in a bid to treat the 'stenotic' lesion. The resolution of 'stenosis' on withdrawal of the guidewire clinches the diagnosis.

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Introduction: Thrombotic microangiopathy (TMA) as a cause of snake-bite-induced acute kidney injury (AKI) is rarely reported. Very little is known about the clinical course, optimal management, and prognosis of this entity. We describe a series of snake-bite-induced TMA and compare their outcomes with those without TMA.

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Introduction: Acute kidney injury (AKI) is an independent risk factor for adverse clinical outcomes in patients with hemorrhagic stroke. There is limited data regarding the occurrence and impact of AKI in the setting of spontaneous intracerebral hemorrhage (SICH). Considering this, we sought to determine the incidence and risk factors for AKI in patients with SICH and to determine the role of AKI on SICH mortality in our population.

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Paroxysmal nocturnal hemoglobinuria (PNH) is characterized by episodes of intravascular hemolysis, infections, and thromboembolic complications. Renal abnormalities are rare which occur either due to hemolytic crisis or repeated thrombotic episodes involving small venules. Acute kidney injury (AKI) requiring hemodialysis due to toxic effects of hemoglobinuria, with a stable disease is exceptional.

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The aim of this study is to assess the impact of pharmaceutical care on medication adherence, hemoglobin (Hb) levels, blood pressure (BP), and interdialytic weight gain (IDW) among hemodialysis (HD) patients. An open-label randomized controlled study has been conducted at three different hospitals of HD centers. The patients have been randomized into two groups [usual care group (UCG) and pharmaceutical care group (PCG)] by block design.

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Objectives: The aim of the study is to assess the cost-effectiveness of pharmaceutical care versus usual care on the treatment costs in patients undergoing maintenance hemodialysis (HD) in the outpatient HD centers of academic, government, and corporate hospitals.

Methods: An open-labeled randomized controlled study was registered under clinical trial registry of India (Ref. no.

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Background: Acute kidney injury (AKI) is a common complication of liver cirrhosis and is associated with poor survival. We studied the clinical profile and predictors of in-hospital mortality in patients with cirrhosis of the liver with AKI.

Methods: This retrospective cohort study examined patients at a tertiary care hospital.

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The role of obesity in the progression of primary glomerular diseases is controversial. A few studies report overweight/obesity as a risk factor for disease progression in immunoglobulin A nephropathy (IgAN), and the real impact of it still remains unclear. The aim of this study was to elucidate the effect of body mass index (BMI) on disease progression and proteinuria in patients with IgAN in Indian population.

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The present study was planned to assess the impact of pharmaceutical care on the health-related quality of life (HRQoL) among hemodialysis (HD) patients. An open-label, randomized control study was carried out at three different HD centers of teaching, government, and corporate hospitals in South India. The patients were randomized into two groups (Usual Care Group [UC] and Pharmaceutical Care Group [PC]) by block design method.

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Introduction: Diffuse Crescentic glomerulonephritis (CrGN) is characterized by rapidly progressive renal failure and has grave prognosis. There is significant regional and temporal variation in aetiology, prevalence and prognosis of diffuse crescentic glomerulonephritis (CrGN) with limited data available in adult Indian population.

Aim: This study aims to identify the aetiology, clinico-pathological features and outcomes of diffuse CrGN in south Indian population.

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Nephrotic syndrome is associated with an increased risk of thromboembolism. Pulmonary thromboembolism has been described in nephrotic syndrome with or without deep vein thrombosis. In this case report, we describe an unusual first presentation of childhood membranous nephropathy with massive pulmonary thrombus with pulmonary infarction with right renal vein thrombosis.

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