423 results match your criteria: "Medanta Kidney & Urology Institute[Affiliation]"

Efficacy and safety of daprodustat in patients on peritoneal dialysis in the ASCEND-D trial.

Nephrol Dial Transplant

November 2024

Department of Medicine and Nephrology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Background And Hypothesis: Daprodustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor, is approved for treatment of anemia in dialysis patients with CKD in some parts of the world. This subgroup analysis examined the efficacy and safety of daprodustat versus darbepoetin alfa in patients with anemia of CKD undergoing peritoneal dialysis (PD).

Methods: ASCEND-D (NCT02879305) was an open-label, Phase 3 trial; patients with CKD were randomized to daprodustat daily and epoetin alfa (HD patients) or darbepoetin alfa (PD patients).

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IPNA clinical practice recommendations on care of pediatric patients with pre-existing kidney disease during seasonal outbreak of COVID-19.

Pediatr Nephrol

December 2024

Pediatric Nephrology, Dialysis and Transplant Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico, Milan, Italy.

The coronavirus disease 2019 (COVID-19) pandemic, instigated by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has profoundly impacted healthcare infrastructures around the globe. While children are usually asymptomatic or have mild symptoms, children with pre-existing kidney conditions require specialized attention. This pivotal report, championed by the International Pediatric Nephrology Association (IPNA), delivers precise and actionable recommendations tailored for pediatric patients with kidney ailments in this pandemic landscape.

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ABO-incompatible transplantations are increasingly gaining relevance with advancements in therapeutic modalities, thus allowing patients to receive timely solid organ transplants. Therapeutic apheresis (TA) procedures remain instrumental as a preconditioning measure to enable such transplants. This survey was undertaken to find out current trends and practices of TA across major transplant centers in India.

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Reninoma: an unusual cause of growth failure.

J Pediatr Endocrinol Metab

January 2025

Department of Endocrinology and Diabetes, Max Super Speciality Hospital, Saket, Delhi, India.

Objectives: Growth failure can result from various underlying causes, necessitating a thorough evaluation. Reninoma, a rare renin-secreting tumor, is an uncommon cause of hypertension, especially in paediatric patients, and has not been associated with growth failure until now.

Case Presentation: An 11-year-old girl presented with complaints of poor height gain, headaches, increased thirst, and vomiting.

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Heart failure (HF) is a significant public health concern characterized by notable rates of morbidity and mortality. Multimorbidity, ranging from 43% to 98% among HF patients, significantly impacts prognosis and treatment response. HF management requires a holistic approach, including guideline-directed medical therapy.

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Complement in Kidney Transplantation.

Transplant Rev (Orlando)

January 2025

Department of Nephrology and Kidney Transplantation, Medanta Medicity, Sector 38, Gurgaon 122001, India. Electronic address:

Article Synopsis
  • Transplantation is the preferred treatment for most patients with kidney failure, and the complement system is crucial to this process.
  • Dysregulation of the complement system leads to various kidney-related diseases and impacts post-transplant issues such as rejection and graft function.
  • Understanding the complement cascade can guide strategies for preventing complications during kidney transplantation, with new therapeutic options being developed to enhance graft survival.
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POCUS in Critically-ill Children with Acute Kidney Injury.

Indian Pediatr

December 2024

Akron Nephrology Associates and Cleveland Clinic, Akron General Medical Center, Akron, Ohio, United States of America.

Acute kidney injury (AKI) in children is associated with increased mortality and morbidity including the need for prolonged stay in pediatric intensive care unit (PICU) and longer duration of mechanical ventilation. Technological advancements have expanded the array of bedside tools available to clinicians for patient evaluation beyond the traditional physical examination. Point-of-care ultrasound (POCUS) has emerged as a crucial tool for clinicians to quickly diagnose kidney pathology and assess the volume status.

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Background: Patients with chronic kidney disease (CKD) undergoing maintenance haemodialysis (MHD) develop several abnormalities of left ventricular (LV) structure and function. Speckle-tracking echocardiography permits compressive assessment of LV myocardial deformation. Previous studies involving CKD patients have shown a significant reduction in LV global longitudinal strain (GLS) with strong prognostic implications.

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Point-of-care ultrasonography (POCUS) has rapidly evolved from a niche technology to an indispensable tool across medical specialties, including nephrology. This evolution is driven by advancements in technology and the visionary efforts of clinicians in emergency medicine and beyond. Recognizing its potential, medical schools are increasingly integrating POCUS into training curricula, emphasizing its role in enhancing diagnostic accuracy and patient care.

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CRB2 Depletion Induces YAP Signaling and Disrupts Mechanosensing in Podocytes.

bioRxiv

October 2024

Humboldt Centre for Nano- and Biophotonics, Department of Chemistry, University of Cologne, Cologne, Germany.

Focal Segmental Glomerulosclerosis (FSGS) is a histologic lesion caused by a variety of injurious stimuli that lead to dysfunction/loss of glomerular visceral epithelial cells (i.e. podocytes).

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Article Synopsis
  • Sudden death is a significant concern for hemodialysis patients, accounting for about 25% of their deaths, with more incidents occurring on the days they receive treatment.
  • A study analyzed data from 66 patients using implantable loop recorders over 12 months to examine how higher levels of dialysate bicarbonate (DBIC) affected the occurrence of serious heart arrhythmias.
  • The results showed that while fewer episodes of clinically significant arrhythmia were linked to DBIC levels over 35 mEq/L, this finding lost significance when factoring in potassium levels, highlighting the need for further research with larger sample sizes.
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Importance: Racial disparities have been identified in pediatric community-acquired acute kidney injury (CA-AKI), and they are associated with increased risk of child mortality, morbidity, and progression of kidney disease.

Objective: To assess clinical outcomes at 1 year among children with CA-AKI, stratified by age, race, and ethnicity.

Design, Setting, And Participants: This retrospective cohort study is a population-based analysis of deidentified, aggregated electronic health record data collected by 61 large health care organizations from 2003 to 2023 and accessed through the TriNetX platform.

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Background: Acute kidney injury (AKI) is common after coronavirus 2 infection (COVID-19), leading to higher morbidity and mortality. There is little prospective data from India regarding the incidence, risk factors, and outcome of AKI in COVID-19.

Materials And Methods: This study was conducted prospectively in adult patients between September and December 2020 in a tertiary care hospital in the national capital region of Delhi.

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Background: Regional citrate anticoagulation (RCA) has emerged as a treatment modality that reduces bleeding risk and filter clotting. With initial experience of using RCA with continuous renal replacement therapy (CRRT), we have formulated a working protocol based on published literature.

Objective: The study aimed to evaluate the protocol for routine use of RCA during CRRT requiring anticoagulation and evaluation of filter life.

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Article Synopsis
  • Researchers studied strokes from 1990 to 2021 to understand how many people get them and how they are affected around the world.
  • In 2021, strokes caused about 7.3 million deaths and were a major cause of health problems, especially in specific regions like Southeast Asia and Oceania.
  • There are differences in stroke risks based on where people live and their age, and some areas actually saw more strokes happening since 2015.
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Article Synopsis
  • * Current guidelines recommend early combination therapy using four drug classes, especially ARNI, which significantly reduces morbidity and mortality in patients with heart failure with reduced ejection fraction (HFrEF).
  • * A national consensus by Indian cardiology experts emphasizes that ARNI should be initiated early in HFrEF patients, including those hospitalized, and can also benefit patients with preserved and mildly reduced ejection fractions.
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Gender Disparities in Kidney Transplantation: A Nationwide Survey of Nephrologists in India.

Transplantation

February 2025

Transplant and Immunocompromised Host Infectious Diseases, Infectious Diseases Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA.

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Background: Despite the burden of pyelonephritis after kidney transplantation, there is no consensus on initial empirical antibiotic management.

Methods: We surveyed clinicians throughout the world on their practice and opinions about the initial empirical therapy of post-transplant pyelonephritis, using clinical vignettes. A panel of experts from 19 countries on six continents designed this survey, and invited 2145 clinicians to participate.

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Background: Acute kidney injury (AKI) is prevalent in patients with acute stroke. Although AKI is linked to poor clinical outcomes, data about its incidence and effect on stroke outcomes is limited.

Methods: This was a prospective observational study carried out at a single tertiary care center that analyzed the data of 204 consecutive subjects with acute ischemic stroke and intracerebral hemorrhage.

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A Boy with End-Stage Kidney Disease and Hypertriglyceridemia.

Indian J Nephrol

November 2023

Pediatric Nephrology, Kidney Institute, Medanta, The Medicity, Gurgaon, Haryana, India.

Mutations in the HNF-1β gene have been found to be associated with renal cysts and diabetes syndrome (RCAD), also known as MODY5. The mutation is inherited in an autosomal dominant fashion, although sporadic mutations can be seen. Pediatric cases of HNF - 1β mutations are more likely to present with renal involvement like renal failure or renal hypoplasia.

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Background: The role of induction in low-risk, living-donor kidney transplants being treated with tacrolimus, mycophenolate mofetil, and prednisolone is debatable.

Materials And Methods: This was a retrospective study that consisted of patients undergoing living kidney transplantation between February 2010 and June 2021 with a related haplomatch donor, with maintenance immunosuppression of tacrolimus, mycophenolate mofetil, and prednisolone. High-risk transplants, such as second or more transplants, immunologically incompatible transplants, and steroid-free transplants, were excluded.

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Scrub Typhus in a Kidney Transplant Patient.

Indian J Nephrol

May 2024

Department of Nephrology and Kidney Transplant, Medanta-Medicity, Gurugram, Haryana, India.

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