Indian Journal of Nephrology最新文献

{"title":"Focal Crescentic Glomerulonephritis Superimposed on Myeloproliferative Disease-Related Glomerulopathy in a Case of Myelofibrosis.","authors":"Janmejay Ashvinkumar Kunpara, Bhavya Prakash Darji, Himanshu Arvindbhai Patel, Devang Patwari, Sujit Shaileshbhai Patel, Prakash Ishwarlal Darji","doi":"10.4103/ijn.ijn_218_22","DOIUrl":"https://doi.org/10.4103/ijn.ijn_218_22","url":null,"abstract":"<p><p>Proliferative glomerulonephritis in myelofibrosis is a very rare. Mesangial proliferation and sclerosis with changes of chronic thrombotic microangiopathy have been reported, but pauci-immune focal crescentic glomerulonephritis has not been described so far. Herein, we present a 68-year-old male who was a known case of myelofibrosis and presented with rapidly progressive glomerulonephritis and nephrotic range proteinuria. He was diagnosed as anti-neutrophil cytoplasmic antibody (ANCA)-negative focal crescentic glomerulonephritis, and he responded well to a course of intravenous methylprednisolone and cyclophosphamide. Pauci-immune focal crescentic glomerulonephritis may occur in myelofibrosis without ANCA and may be related to unknown pathogenetic mechanisms in myeloproliferative disorders or suggest any superimposed pathology that might respond well to immunosuppressants.</p>","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"64-66"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140860687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C3 Dominant Collapsing Focal Segmental Glomerulosclerosis - A Report of Two Rare Cases.","authors":"Mythri Shankar, Sreedhara C Gurusiddiah, K S Vinay, Kishan Aralapuram, Ranjitha Siddalingappa, Gouri Satheesh","doi":"10.4103/ijn.ijn_250_22","DOIUrl":"https://doi.org/10.4103/ijn.ijn_250_22","url":null,"abstract":"<p><p>Collapsing focal segmental glomerulosclerosis (FSGS) a heterogeneous group of disorders, rather than a single disease entity. Kidney biopsy shows segmental or globally collapsed, sclerotic glomerular capillaries. There is also hypertrophy and hyperplasia of overlying glomerular epithelial cells. Immuno-fluorescence is negative or has non-specific deposits of immunoglobulins and C3. We present two cases of C3 dominant collapsing FSGS. Both the cases were non-responsive to therapy and had a poor outcome. This calls for research to study the role of the complement pathway in the pathogenesis of FSGS.</p>","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"70-73"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nephrotic Syndrome and Posterior Reversible Encephalopathy Syndrome as Clinical Presentations of Gemcitabine-Induced Thrombotic Micro-Angiopathy.","authors":"Vijoy Kumar Jha, Ramanjit Singh Akal, Debasish Mahapatra, Alok Sharma, Bhanu Pratap Singh, Rahil Arora","doi":"10.4103/ijn.ijn_277_22","DOIUrl":"https://doi.org/10.4103/ijn.ijn_277_22","url":null,"abstract":"<p><p>Gemcitabine-induced thrombotic micro-angiopathy (GiTMA) is a very rare pathology of micro-vascular occlusion with a poor prognosis. In this case report, we present a young male with pancreatic carcinoma who received gemcitabine as adjuvant chemotherapy and developed thrombotic micro-angiopathy (TMA) manifesting as nephrotic syndrome with renal dysfunction and posterior reversible encephalopathy syndrome (PRES). The case was successfully managed with discontinuation of the drug and conservative management. The pathogenesis of GiTMA might be direct endothelial dysfunction with consequent activation of the clotting system. The role of plasma exchanges and monoclonal antibodies is unclear in drug-induced TMA.</p>","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"74-78"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140862699","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Harmony in Healing: The Imperative for Integrating Humanities and Social Sciences in Medical Training.","authors":"Vivekanand Jha","doi":"10.25259/ijn_510_23","DOIUrl":"https://doi.org/10.25259/ijn_510_23","url":null,"abstract":"","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"1-3"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140863323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Tale of Two Pathologies: MIS-C in a Patient with Pediatric Systemic Lupus Erythematosus.","authors":"Amy Samson, Shaegan Irusen","doi":"10.4103/ijn.ijn_239_22","DOIUrl":"https://doi.org/10.4103/ijn.ijn_239_22","url":null,"abstract":"<p><p>An HIV-negative 9-year-old female was admitted to the pediatric ward at a tertiary hospital in Johannesburg, South Africa for investigation of a suspected rheumatic disorder complicated by proteinuria. She was subsequently diagnosed with pediatric systemic lupus erythematosus complicated by class IV lupus nephritis. Further into her admission, the patient developed hospital-acquired SARS-CoV-2 infection with mild clinical symptoms. Three weeks after her initial COVID-19 diagnosis, the patient developed multisystemic inflammatory syndrome. She was successfully treated with intravenous immunoglobulin therapy, intravenous corticosteroids, and thromboprophylaxis.</p>","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"84-87"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003592/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140874636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Timely Hemodialysis for Successful Treatment of Acute Salicylate Overdose in a Young Adult Female - A Case Report.","authors":"Amitabh Kulkarni, Pavan Shrivastava, Rajesh Kumar Phulara","doi":"10.4103/ijn.ijn_141_22","DOIUrl":"https://doi.org/10.4103/ijn.ijn_141_22","url":null,"abstract":"<p><p>Salicylates are often used in clinical practice as antiplatelets as well as analgesics. Its overdose is not uncommon due to its easy availability over the counter. Mortality is high in severe cases when a lethal dose is consumed. Treatment of overdose is difficult due to the non-availability of an antidote. Hemodialysis is an underutilized treatment modality in such cases. We discuss here a case of a young female who presented to us 2.5 h after the consumption of a lethal dose of salicylate with symptoms of only tinnitus. She was successfully treated with two sessions of hemodialysis. Her drug levels on admission were remarkably high, and early hemodialysis was justified in view of high-dose consumption with minimal symptoms.</p>","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"67-69"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003594/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140851368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Journey of Indian Journal of Nephrology.","authors":"Sunny Duttagupta","doi":"10.25259/IJN_48_2024","DOIUrl":"https://doi.org/10.25259/IJN_48_2024","url":null,"abstract":"","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"4-5"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003600/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864038","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of Dietary Acid Load in Children with Chronic Kidney Disease: An Observational Study.","authors":"Madhileti Sravani, Sheeba Collins, Arpana Iyengar","doi":"10.4103/ijn.ijn_29_23","DOIUrl":"https://doi.org/10.4103/ijn.ijn_29_23","url":null,"abstract":"<p><strong>Introduction: </strong>Dietary acid load (DAL), which reflects the balance between acid- and alkaline-forming foods, is a modifiable risk factor for metabolic acidosis in CKD. Owing to the paucity of data in the Indian context, we undertook this cross-sectional study to estimate DAL and assess acid and alkaline food consumption in children with CKD2-5D (Chronic kidney disease stage 2 to 5 and 5D-those on hemodialysis).</p><p><strong>Methods: </strong>Clinical profile, dietary assessment of energy, protein intake/deficits, and macronutrients were noted and computed using software created by the division of nutrition, St John's research institute based on Kidney Disease Outcomes Quality Initiative (KDOQI) guidelines in clinically stable children with CKD2-5D. DAL was estimated using potential renal acid load (PRAL in mEq/day) = (0.49 × protein intake in g/day) + (0.037 × phosphorus-intake in mg/day) - (0.02 × potassium intake in mg/day) - (0.013 × calcium intake in mg/day) - (0.027 × magnesium intake in mg/day). A positive dietary PRAL (>0) favors acidic content and negative (<0) favors alkaline content. PRAL was stratified into quartiles for analysis. The association of various clinical and dietary parameters were analysed across these quartiles.</p><p><strong>Results: </strong>Eighty-one children [of mean age 122 ± 47 months; 56 (69%) boys, 29 (36%) on dialysis, 62 (77%) non-vegetarians] were studied. Twenty-eight (34%) were on bicarbonate supplements. A positive PRAL (9.97 ± 7.7 mEq/day) was observed in 74/81 (91%) children with comparable proportions in those with CKD2-5 and 5D [47/52 (90%) vs. 27/29 (93%) respectively, <i>P</i> > 0.05]. Protein intake was significantly higher in the highest quartile compared to the lowest quartile of PRAL in CKD2-5 (55 ± 16 g/day vs. 40 ± 14 g/day, <i>P</i> < 0.001) and 5D groups (47 ± 15 g/day vs. 25 ± 11 g/day, <i>P</i> = 0.002). A majority of the participants 60/81 (74%) consumed highly acidic and minimal alkali foods.</p><p><strong>Conclusion: </strong>In children with CKD2-5D, PRAL estimation revealed high DAL in the majority with a high consumption of acidic foods. These findings provide implications for appropriate dietary counseling in children with CKD.</p>","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"50-55"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003602/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140852162","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collapsing Glomerulopathy in a Patient with Tuberculosis and Poncet's Disease.","authors":"Tayyibah Shah Alam, Vinod Kumar, Joe Thomas, Nayantara Shenoy, Geetha Philips","doi":"10.4103/ijn.ijn_264_22","DOIUrl":"https://doi.org/10.4103/ijn.ijn_264_22","url":null,"abstract":"<p><p>A 39-year-old woman presented with inflammatory polyarthritis, low-grade fever, progressive pedal edema, and frothy urination of three weeks duration. She had nephrotic range proteinuria and elevated creatinine. Kidney biopsy showed collapse of capillary tuft in the glomeruli and proliferation, hyperplasia, and hypertrophy of the overlying podocytes suggestive of collapsing glomerulopathy. Histology of the cervical lymph node showed necrotizing granulomatous inflammation suggestive of tuberculosis. With all other possible causes of polyarthritis ruled out, a diagnosis of Poncet's disease-a form of polyarthritis observed in patients suffering from an active form of extrapulmonary tuberculosis (TB)-was considered. Association between TB lymphadenitis and collapsing glomerulopathy (CG) is very rare, and the patient had partial remission of the disease after being started on anti-tuberculosis therapy (ATT) along with steroids.</p>","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"88-89"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003589/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867350","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Monoclonal Gammopathy of Renal Significance (MGRS) - Case Series from a Tertiary Center in Kerala.","authors":"Priya Padmanabhan, Jayameena P, Neena Mampilly, Shinto Francis, Ajmal Sherif, Sunil George, Thomas Mathew","doi":"10.4103/ijn.ijn_329_22","DOIUrl":"https://doi.org/10.4103/ijn.ijn_329_22","url":null,"abstract":"<p><p>Monoclonal gammopathy of renal significance (MGRS) has gained importance because identifying the monoclonal deposit and addressing it, rather than treating renal dysfunction as the primary pathology, has salvaged the patients from progressing into end-stage renal disease. Since it affects elderly population, there could be a propensity to misdiagnose them with cardiorenal syndrome. We present four patients of MGRS diagnosed from our center. They presented with proteinuria or unexplained renal dysfunction. Three of the patients were diagnosed to have amyloidosis, of which two had lambda-type and one had kappa amyloidosis. The fourth patient had fibrillary glomerulonephritis with kappa restriction, further evaluation of which led to diagnosis of chronic lymphocytic leukemia. Absence of \"M\" band in protein electrophoresis and a normal bone marrow study should not stop physicians from further evaluation. Quantitative serum immunofixation electrophoresis and electron microscopic examination of renal biopsy have become a comprehensive diagnostic tool in such patients.</p>","PeriodicalId":13359,"journal":{"name":"Indian Journal of Nephrology","volume":"34 1","pages":"59-63"},"PeriodicalIF":0.8,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003595/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140848515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}