Indian Journal of Clinical Medicine最新文献

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Cardiac Evaluation and its Correlation with Volume Status in Maintenance Hemodialysis Patients 维持性血液透析患者的心脏评估及其与容量状态的相关性
Indian Journal of Clinical Medicine Pub Date : 2023-12-14 DOI: 10.1177/26339447231209168
Sutanay Bhattacharyya, Himanshu Sekhar Mahapatra, L. Pursnani, Muthu Kumar, Vipul Gupta, Rajesh Tarachandani, Preeti Chaudhary
{"title":"Cardiac Evaluation and its Correlation with Volume Status in Maintenance Hemodialysis Patients","authors":"Sutanay Bhattacharyya, Himanshu Sekhar Mahapatra, L. Pursnani, Muthu Kumar, Vipul Gupta, Rajesh Tarachandani, Preeti Chaudhary","doi":"10.1177/26339447231209168","DOIUrl":"https://doi.org/10.1177/26339447231209168","url":null,"abstract":"Introduction: Fluid overload (FO) in hemodialysis (HD) patients can result in increase in left atrial volume (LAV) and left ventricular mass (LVM). Here, we correlated volume status with cardiac outcome in these patients over a period of 6 months. Methodology: Consecutive clinically euvolumic end stage renal disease (ESRD) patients on thrice weekly maintenance hemodialysis (MHD) for at least 6 months were included. Inferior vena cava (IVC) Collapsibility Index of ≤40% by IVC or B-Line score of ≥15 by lung ultrasound (LUS) or over hydration/extracellular water (OH/ECW) by bioimpedence spectroscopy (BIS) ≥15% were defined as FO. A cut-off of left ventricular mass index (LVMI) ≥115 gm/m2 and LAV index (LAVI) ≥34 mL/m2 on echocardiography were used for defining left ventricular hypertrophy (LVH) and left atrial dilatation (LAD), respectively. The diagnostic value of LUS for OH, considering BIS as the gold standard and correlation between LVMI and LAVI with OH/ECW and LUS score was studied. Results: Among 100 MHD patients, 29% had OH at baseline. Baseline FO was significantly associated with LAD but not LVH. The specificity of LUS in diagnosing FO at 3rd and 6th months was 98% and 95.1%, respectively. OH/ECW on BIS showed a correlation with both LAVI at baseline ( p-value of .03, R2 0.71). B line score determined by LUS did not show a correlation with LAVI at baseline ( p-value of .07, R2 0.49). Conclusion: Routine ultrasound use in HD unit for determining OH and echocardiography screening for LAD would assess and reduce early cardiovascular events.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"194 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139180034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Renal Amyloidosis Secondary to Monoclonal Gammopathy of Renal Significance in a Young Patient: A Case Report 一名年轻患者继发于单克隆肾病的肾淀粉样变性:病例报告
Indian Journal of Clinical Medicine Pub Date : 2023-11-21 DOI: 10.1177/26339447231196686
Shreya Ghosh, Yuvraj Gulati, C. Kala, Akansha Garg, A. Thakur
{"title":"Renal Amyloidosis Secondary to Monoclonal Gammopathy of Renal Significance in a Young Patient: A Case Report","authors":"Shreya Ghosh, Yuvraj Gulati, C. Kala, Akansha Garg, A. Thakur","doi":"10.1177/26339447231196686","DOIUrl":"https://doi.org/10.1177/26339447231196686","url":null,"abstract":"Monoclonal gammopathy of renal significance (MGRS), a subtype of plasma cell disorder, usually occurs in individuals >50 years. Amyloid light chain (AL)-associated primary amyloidosis can occur in both young and elderly individuals. However, the progression of AL amyloidosis is usually reported in aged MGRS patients several years after its onset. Herein, we report the case of a young patient with persistent proteinuria and bilateral edema. Histopathological examination confirmed a differential diagnosis of MGRS. Further, Congo red and immunohistochemical staining of the renal biopsy confirmed the presence of lambda-light-chain-derived amyloid deposits in the affected kidney. We report the predominance of MGRS-associated renal amyloidosis in a young patient, conflicting with the age criteria. This case report highlights age as an independent risk factor, signifying the need to diagnose amyloidosis in young people.","PeriodicalId":503995,"journal":{"name":"Indian Journal of Clinical Medicine","volume":"60 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-11-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139251884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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