Publications by authors named "Dharmendra S Bhadauria"

Background And Objectives: Hepatitis B virus (HBV) infection is common in people with chronic kidney diseases (CKD). The guidelines recommend four doses, 2.0 mL each, of HBV vaccine, given at zero, one, two and six months in these patients.

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Background: Chronic kidney disease (CKD) patients are at a high risk of tuberculosis (TB), with a relative risk of developing active TB of 10%-25%. Similarly, glomerular disease increases the risk of TB due to diminished glomerular filtration rate, proteinuria, and immunosuppression use. Further, the first-line anti-TB drugs are associated with acute kidney injury (AKI) even in patients with normal kidney functions.

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Objective: To describe the incidence, risk factors, and outcomes associated with serious infections in patients with Takayasu arteritis (TA).

Methods: Serious infections, defined as infections resulting in hospitalization or death or unusual infections like tuberculosis, were identified from a cohort of patients with TA. Corticosteroid and disease-modifying antirheumatic drug (DMARD) use at the time of serious infection was noted.

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Article Synopsis
  • The study aimed to compare the characteristics and outcomes of patients with prepulseless Takayasu arteritis (TAK) against those with pulse loss due to the condition.
  • Findings showed that prepulseless TAK patients often had worse renal function and higher rates of Hata's type IV disease, while experiencing fewer symptoms like claudication and asymmetric blood pressure.
  • Despite differences at presentation, both groups had similar long-term disease activity and survival rates, indicating that prepulseless TAK has a generally favorable prognosis.
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  • A study analyzed the differences in presentation and survival rates of Takayasu arteritis (TAK) patients based on whether they had renal artery involvement (RAI).
  • Among 215 TAK patients, over half had RAI, with those affected experiencing earlier disease onset and higher rates of complications like chronic renal failure and hypertension.
  • Despite these increased health issues related to RAI, the study found that RAI did not significantly increase mortality risk compared to TAK without RAI.
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Objectives: To analyze the risk, causes, and predictors of mortality in Takayasu arteritis (TAK).

Methods: Survival was assessed in a cohort of patients with TAK using Kaplan-Meier curves. Age- and sex-standardized mortality ratio (SMR = observed: expected deaths) for TAK were calculated by applying age- and sex-specific mortality rates for the local population to calculate expected deaths.

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Article Synopsis
  • - The study investigated the loss of Wilms tumor-1 (WT1) protein in urine exosomes as an early marker for kidney injury in individuals without chronic kidney disease (CKD), analyzing it alongside other urine injury markers.
  • - Researchers assessed kidney function using the albumin-to-creatinine ratio (ACR) and estimated glomerular filtration rate (eGFR) while comparing WT1 levels in human and diabetic rat urine samples through statistical tests.
  • - Results showed that urine WT1 (uE-WT1) had a stronger correlation with kidney function than other markers like KIM-1 and NGAL, indicating its potential as a reliable early indicator of kidney injury in those without CKD.
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Background: Posterior urethral valve (PUV) is obstructive uropathy that may lead to chronic kidney disease (CKD) and end-stage renal disease (ESRD) in children. Glomerular filtration rate (GFR) measurement remains the gold standard for renal function measurement. However, due to its less availability and cumbersome, it is not commonly used, and GFR is estimated utilizing various endogenous filtration markers.

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Objectives: A subset of Takayasu's arteritis (TAK) begins in the paediatric age group (≤18 years). Differences in prognosis between paediatric-onset and adult-onset TAK are unclear. We compared the differences in the presentation and survival between paediatric-onset and adult-onset TAK in our cohort of TAK.

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Introduction: People on renal replacement therapy (RRT) have a high risk of COVID-19 infection and subsequent death. COVID-19 vaccination is strongly recommended for those on RRT. Data are limited on the immune response of the ChAdOx1 nCoV-19/AZD1222 (Covishield®) vaccine in patients on RRT.

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Article Synopsis
  • The study focused on the antibody response and durability of the Covishield® vaccine among Indian health care workers who received two doses four weeks apart.
  • Blood samples were collected at various intervals post-vaccination to measure anti-spike antibody (ASAb) and neutralizing antibody (NAb) levels, revealing significant differences based on pre-existing antibodies.
  • Results indicated that individuals with pre-existing ASAb had higher antibody titres throughout the study, and overall, antibody levels began to decline approximately five months after vaccination.
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  • The study analyzes and compares the disease characteristics and treatment approaches for Takayasu arteritis (TAK) in patients from Italy and India, focusing on imaging methods and immunosuppressive therapies.
  • A total of 318 patients were examined, revealing that ultrasound was primarily used in Italy while CT angiography was favored in India; corticosteroids were more commonly prescribed and for longer in Italy compared to India.
  • The findings suggest significant differences in treatment modalities, likely influenced by socio-economic factors, highlighting the need for tailored treatment guidelines for TAK based on regional practices.
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Takayasu arteritis (TAK) could cause a stroke or transient ischemic attack (TIA) in young individuals due to inflammatory vascular occlusion or intracerebral hemorrhage. We compared the clinical presentation, angiographic features, longitudinal patterns of disease activity, medical treatments, and survival in 34 TAK patients with stroke/TIA and 157 without stroke/TIA from a single-center retrospective cohort. TAK patients with stroke/TIA were older ( = 0.

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Background: Liver stiffness (LS) may be falsely elevated in patients on maintenance hemodialysis (MHD) due to fluid overload. We measured LS change by transient elastography (TE) in MHD patients before and after successful renal transplantation.

Method: Adults on ≥2 years of MHD, without additional risk factors for liver fibrosis or fluid overload, and planned for renal transplantation were prospectively recruited.

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Kidney transplant recipients (KTRs) are at a much higher risk of complications and death following COVID-19 and are poor vaccine responders. The data are limited on the immune response to Covishield® in KTRs. We prospectively recruited a cohort of 67 KTRs aged >18 between April 2021 and December 2021.

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Background: Acute kidney injury (AKI) is associated with morbidity and mortality in COVID-19 patients. The incidence of AKI and its outcomes vary in different parts of the world. We aimed to analyze the AKI incidence, predictors of AKI, mortality, and renal function outcomes on follow-up in hospitalized patients with COVID-19.

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Introduction: Asymptomatic maintenance hemodialysis patients with acute respiratory corona virus-2 (SARS-COV-2) are missed with pre-dialysis screening without testing. The possible ideal strategy of testing each patient before each shift with reverse transcription polymerase chain reaction (RT-PCR) is not feasible. We aimed to study the effectiveness of fortnightly screening with RT-PCR for SARS-CoV-2 in curbing transmission.

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Background: Sofosbuvir is not recommended in persons with estimated glomerular filtration rate (eGFR) <30 mL/min. We report the results of treatment with an off-label 8-week regimen of daclatasvir and half-dose sofosbuvir in patients with acute infection with hepatitis C virus ( HCV) and eGFR <30 mL/min.

Methods: Clinic records were searched to identify treatment-naïve, noncirrhotic adults with acute hepatitis C (HCV viremia and a ≥10-fold elevation of serum alanine aminotransferase activity) and eGFR <30 mL/min, who had been treated with a sofosbuvir-based regimen.

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The outcomes of the elderly population on peritoneal dialysis (PD) in developing countries are less known. In this study, we intended to study the clinical characteristics and patient and technique survival of elderly patients on PD. In this study, data of 148 elderly patients with end-stage renal disease who initiated PD between January 2001 and December 2015 were collected.

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Hepatitis C virus (HCV) is a parenterally-transmitted hepatotropic virus that often causes chronic infection, which can progress to cirrhosis and hepatocellular carcinoma. Development of highly effective direct-acting anti-viral agents (DAAs) has led to a paradigm change in the treatment of HCV infection over the last 4-5 years. Patients with chronic kidney disease (CKD) are at a higher risk of acquiring HCV infection.

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Aim: Sofosbuvir is a key agent for HCV treatment. It is not recommended for patients with chronic kidney disease (CKD) and estimated glomerular filtration rate (eGFR) <30 mL/min. We report real-life experience of treating a cohort of CKD patients with eGFR <30 mL/min using daclatasvir and half-daily dose of sofosbuvir.

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Objectives: There are no reports of de novo donor-specific antibody monitoring by a low-cost solid-phase crossmatch assay using donor lysate after renal transplant.

Materials And Methods: We prospectively evaluated 121 complement-dependant cytotoxicity crossmatch-negative living-donor kidney transplant recipients for development of de novo donor-specific antibodies (class I and II HLA) by solid-phase crossmatch Luminex assay after transplant.

Results: Of 121 recipients in our study group, 26 (21.

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In recent past, direct-acting anti-viral drugs (DAAs) have become the standard of care for the treatment of hepatitis C virus (HCV) infection. However, the experience with the use of these drugs in Indian renal transplant recipients is limited. We retrospectively reviewed our experience with DAA-based treatment for HCV infection in such patients.

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