CORRELATION OF SERUM ALBUMIN AND CREATININE WITH OXIDATIVE STRESS MARKERS IN PATIENTS HAVING NEPHROTIC SYNDROME

Objective: Children with nephrotic syndrome (NS) have a stressful condition, and oxidative damage may impair their treatment response. This study aims to gain a better understanding of the relationship between oxidative stress and NS to lay the basis for further research into improved diagnostic options, treatment, and prevention of the disease. Methods: We took a blood sample from 100 Indian patients aged 2-14 y. Each patient was tested for oxidative stress. The buege method was used to assess MDA levels in patients. The pyrogallol method was used to measure SOD activity in blood serum, and the jollow method was used to measure glutathione levels. Results: The levels of oxidative stress markers (MDA, SOD, and GSH) were compared between NS patients and the control. SOD and GSH concentrations were significantly decreased in the NS group when compared to the control. In contrast, MDA level was significantly higher in the NS group than in the control. In the correlation analysis, we found that the serum SOD activity was significantly positively correlated with serum albumin and creatinine level in patients with NS. Thus, oxidative stress in children with NS is indicated by reduced antioxidant potential because of low albumin. Therefore, it is thought that oxidative stress is implicated in the development of NS in Indian children. Conclusion: We concluded that oxidative stress was intensified in children with NS due to decreased antioxidant levels caused by hypoalbuminemia

PREDICTION OF FUNCTIONAL, STRUCTURAL AND STABILITY CHANGES IN PMM2 GENE ASSOCIATED WITH NEPHROTIC SYNDROME USING COMPUTATIONAL ANALYSIS

Objective: Nephrotic syndrome defines as a disorder with a group of symptoms like proteinuria, hypoalbuminemia, hyperlipidemia, and edema. PMM2 encodes phosphomannosemutase protein enzyme involved in the synthesis of N-glycan. Methods: Different Insilico analysis tools: SIFT, PolyPhen, PROVEAN, SNPandGO, MetaSNP, PhDSNP, MutPred, I-Mutant, STRUM, PROCHECK-Ramachandran, COACH and ConSurf, were used to check the effect of nsSNP on protein structure and function. Results: The genetic polymorphism in the PMM2 gene was retrieved from NCBI ClinVar and UniProtKB. Total 20 SNPs were predicted most significant and responsible for disease-causing and decrease protein stability. Conclusion: This study helps to discover disease-causing deleterious SNPs with different computational tools and gives information about potent SNPs

What do we know about chronic kidney disease in India: first report of the Indian CKD registry

<p>Abstract</p> <p>Background</p> <p>There are no national data on the magnitude and pattern of chronic kidney disease (CKD) in India. The Indian CKD Registry documents the demographics, etiological spectrum, practice patterns, variations and special characteristics.</p> <p>Methods</p> <p>Data was collected for this cross-sectional study in a standardized format according to predetermined criteria. Of the 52,273 adult patients, 35.5%, 27.9%, 25.6% and 11% patients came from South, North, West and East zones respectively.</p> <p>Results</p> <p>The mean age was 50.1 ± 14.6 years, with M:F ratio of 70:30. Patients from North Zone were younger and those from the East Zone older. Diabetic nephropathy was the commonest cause (31%), followed by CKD of undetermined etiology (16%), chronic glomerulonephritis (14%) and hypertensive nephrosclerosis (13%). About 48% cases presented in Stage V; they were younger than those in Stages III-IV. Diabetic nephropathy patients were older, more likely to present in earlier stages of CKD and had a higher frequency of males; whereas those with CKD of unexplained etiology were younger, had more females and more frequently presented in Stage V. Patients in lower income groups had more advanced CKD at presentation. Patients presenting to public sector hospitals were poorer, younger, and more frequently had CKD of unknown etiology.</p> <p>Conclusions</p> <p>This report confirms the emergence of diabetic nephropathy as the pre-eminent cause in India. Patients with CKD of unknown etiology are younger, poorer and more likely to present with advanced CKD. There were some geographic variations.</p

Clinical outcome of type 2 diabetic patients after kidney transplantation: Systematic review

Aim: To conduct a systematic review to summarize the outcome of adult patients with history of type II DM after renal transplantation [RTx] in following category of patients: (1) type 2 DM; (2) type 2 DM vs Non-DM; (3) type 2 DM vs Dialysis; (4) Preemptive Kidney Transplant (prekTx) vs non prekTx. Method: MEDLINE, EMBASE, Renal transplant registries were searched for observational/cohort/casecontrol studies from 1980 to 2015. Results: We identified 10 studies reporting outcome of kidney transplantation in patients with type 2 DM[type 2 DM(2), type2 DM vs Non-DM (6), type 2 DMvs Dialysis (1), prekTx vs non-prekTx (1)]. One and five year graft survival ranged from 76% to 100% and 53% to 96% respectively. 8, 4, 8, and 2 studies showed 1, 3, 5 and 10 yr patient survival respectively. Recent study with type 2 DM patients showed at 10 yrs, graft survival did not differ between Non-DM and type 2 DM but Non-DM patient survival was better (p < .001) than type 2 DM patients after RTx. At 5 yrs, patient survival ranged from 29% to 97%. Graft and patient survival did not differ between type 2 DM and Non-DM patients in three and two studies respectively. A study showed at 10 yrs, survival after RTx was significantly (p < .001) better than patients on dialysis. Preemptive transplant study reported lower adjusted graft failure and mortality risk for type 2 DM transplant recipients from living donors compared to deceased donors. Conclusion: Results from these few single center studies demonstrate the need for multicenter rigorous studies to look at long term survival of type 2 diabetes patients after renal transplant

Poststreptococcal glomerulonephritis with atypical hemolytic uremic syndrome: An unusual presentation

A 14-year-old female presented with oliguric dialysis requiring kidney injury due to acute poststreptococcal glomerulonephritis (PSGN) with hypertension strongly suggestive of atypical hemolytic uremic syndrome (aHUS) with microangiopathic hemolytic anemia and elevated factor H antibody levels. Renal biopsy revealed crescentic glomerulonephritis with typical subepithelial, intramembranous and mesangial electron-dense deposits (humps) on electron microscopy. She was treated with glucocorticoids following which she recovered, remained dialysis free and her Factor H antibody levels and depressed complement 3 levels normalized. PSGN-associated HUS has rarely been described, with this patient being the 11th case reported, to the best of our knowledge. This case is unique as we describe the course and management of the first patient with PSGN-associated HUS in the era of eculizumab, without eculizumab, and plasmapheresis. This patient presented with clinical and histological features of PSGN as well as anemia and thrombocytopenia consistent with aHUS. Given that these diseases are both mediated through the alternate complement pathway, it is tempting to speculate that blockade of the terminal complement pathway through the use of eculizumab might improve outcomes. Temporally, the hematological parameters in our patient seemed to improve soon after treatment was initiated; however, none of the prior cases in the literature experienced any long-term hematological issues, suggesting that supportive management can be a reasonable alternative

Postrenal transplant dual viral infection: A double jeopardy

Despite significant advances in the field of renal transplantation, long-term graft survival has not dramatically increased. The reasons for this are varied but include the persistent impact of infectious diseases on transplant recipients. Viral infections continue to be a potential contributor to graft failure, but also a cause of severe mortality and morbidity. We hereby present a case of early posttransplant dual viral infection detected and treated during the initial 2 months and discuss the risk factors which were involved, potential preventive strategies and therapies that could be helpful in treating such patients

Bacteriological Profile and Drug Resistance Patterns of Blood Culture Isolates in a Tertiary Care Nephrourology Teaching Institute

Blood stream infections can lead to life threatening sepsis and require rapid antimicrobial treatment. The organisms implicated in these infections vary with the geographical alteration. Infections caused by MDR organisms are more likely to increase the risk of death in these patients. The present study was aimed to study the profile of organisms causing bacteremia and understand antibiotic resistance patterns in our hospital. 1440 blood samples collected over a year from clinically suspected cases of bacteremia were studied. The isolates were identified by standard biochemical tests and antimicrobial resistance patterns were determined by CLSI guidelines. Positive blood cultures were obtained in 9.2% of cases of which Gram-positive bacteria accounted for 58.3% of cases with staph aureus predominance; gram negative bacteria accounted for 40.2% with enterobactereciea predominence; and 1.5% were fungal isolates. The most sensitive drugs for Gram-positive isolates were vancomycin, teicoplanin, daptomycin, linezolid, and tigecycline and for Gram-negative were carbapenems, colistin, aminoglycosides, and tigecycline. The prevalence of MRSA and vancomycin resistance was 70.6% and 21.6%, respectively. ESBL prevalence was 39.6%. Overall low positive rates of blood culture were observed

Percutaneous endovascular management of recurrent aneurysm of transplant renal artery anastomosed to internal iliac artery

Aneurysm formation constitutes 0.5 to 1% of all vascular complications in transplant patients. Aneurysms may result from infection, injury during procurement or preservation, faulty suture technique or trauma. Transplant renal artery aneurysm presents with hypertension, graft dysfunction and bleeding. We report a case of percutaneous covered stent-graft for recurrent aneurysm with stenosis of transplant renal artery. To our knowledge this is the first report of successful treatment of transplant renal artery aneurysm with covered stent-graft