Publications by authors named "Ravindra P Attur"

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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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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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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Hepatitis C virus (HCV) is a significant problem among hemodialysis population, especially in India where renal transplant often gets delayed in the presence of live-related donors. An acceleration of liver cirrhosis and poor renal allograft outcomes are often witnessed in allograft recipients with high viral load. Use of interferon in the postrenal transplant setting for the treatment of hepatitis C viral infection was limited to a few grave situations, fearing the precipitation of allograft rejection and poor efficacy for sustained virological remission.

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Paraneoplastic glomerulopathy has been described in established cases of the solid tumors of lung, gastrointestinal system, breast, etc., and rarely in patients with Renal Cell Carcinoma (RCC). Studies on secondary glomerular diseases have described a higher incidence of IgA nephropathy in patients with RCC compared to membranous glomerulopathy, which are commonly reported in malignancies of the lung and gastrointestinal tract.

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Cerebral venous thrombosis (CVT) and polycythemia are considered as rare and life threatening complications of nephrotic syndrome. We report an unusual combination of both these complications in a case of nephrotic syndrome due to minimal change disease that was treated successfully. There was prompt and complete remission of nephrotic syndrome with steroid therapy, concurrent with complete resolution of polycythemia and CVT.

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Hepatitis B virus (HBV) infection presenting as crescentic glomerulonephritis in the absence of cryoglobulinemia is an extremely rare phenomenon. We report a case of a 44-year-old male with HBV infection, who underwent kidney biopsy for rapidly progressive renal failure and nephrotic range proteinuria. Histopathological evaluation of the kidney biopsy was consistent with immune complex mediated crescentic membranoproliferative glomerulonephritis (MPGN).

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Background: Patient information leaflets are universally-accepted resources to educate the patients/users about their medications, disease and lifestyle modification.

Objectives: The objective of the study was to prepare, validate and perform user-testing of pictogram-based patient information leaflets (P-PILs) among hemodialysis (HD) patients.

Methods: The P-PILs are prepared by referring to the primary, secondary and tertiary resources.

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Health-related quality of life is an essential aspect concerned with the treatment outcomes. The main objective of the study is to evaluate the validity and reliability of the South Indian (Kannada) version of the Kidney Disease and Quality of Life-36 (KDQOL-36) instrument for hemodialysis (HD) patients. The KDQOL-36 instrument was validated by the committee of experts consisting of healthcare providers such as nephrologists (three), senior HD staff nurse (one) and clinical pharmacist (one).

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Background: The progression of chronic kidney disease (CKD) can be attributed to various factors, including lack of medical services, delayed referral, lack of awareness about the disease, drugs, and financial support.

Aims: To compare the pharmacoeconomic-related direct medical and non-medical costs among hospitalised pre-dialysis and dialysis patients.

Methods: A prospective observational study was conducted on the inpatients admitted to the Department of Nephrology.

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Toxic epidermal necrolysis (TEN) is a rare and life-threatening allergic drug reaction. We report a 26-year-old young female with end-stage renal disease on maintenance hemodialysis developing TEN while on filgrastim and phenytoin. It was successfully treated with intravenous immunoglobulins and steroids.

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Background: We studied the urinary abnormalities and acute kidney injury (AKI) as per RIFLE criteria in scrub typhus.

Methods: A prospective case record-based study of scrub typhus was carried out from January 2009 to December 2010 in a tertiary hospital in South India. Patients were followed up until renal recovery or for at least 3 months after discharge.

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