This large multicentre study of peritonitis offers insights into the aetiology and outcomes of infectious complications of chronic PD in India that are germane to clinical decision-making.
Introduction: Acute Kidney Injury is commonly present in Covid-19 hospitalised patients whereas chronic kidney disease and end-stage renal disease are also common comorbidities in patients who develop severe COVID-19. These patients require antiviral medication as early as possible but there is no current guidelines for use of Remdesivir therapy in these patents and drug is not used initially in these patients. Antiviral strategies are desperately needed in this population to treat these patients as early as possible. Material And Methods: We conducted an observational, retrospective cohort study of adults with COVID-19 conrmed by RT-PCR who had eGFR < 30mL/min/1.73m2 or received RRT prior to receiving at least one dose of Remdesivir. eGFR was estimated from the serum creatinine value just prior to the rst dose of Remdesivir using the Chronic Kidney Disease Epidemiology Collaboration calculator. The majority of patients requiring supplemental oxygen were offered Remdesivir; eGFR cut-offs were not used as a strict exclusion criteria. All patients with eGFR < 30mL/min/1.73m2 who received at least one dose of Remdesivir in hospital were included in the study. AKI was dened as at least a 1.5- fold rise in creatinine from baseline per KDIGO criteria. CKD was dened as eGFR < 60mL/min/1.73m2 between 7-365 days prior to admission. Patients with “stable CKD” did not meet criteria for AKI at the time of starting Remdesivir. ESRD was dened as requiring RRT > 3 months prior to hospitalization. The primary objectives were to describe changes in ALT, AST, and Bilirubin and serum creatinine during Remdesivir therapy, and to report adverse effects attributed to Remdesivir. A Results: total of 41 patients with eGFR <30 ml/min per 1.73 m2 at the time of Remdesivir initiation were included in the study. 27 patients were in intensive care, and 14 patients were mechanically ventilated at the time of Remdesivir initiation. At the time of Remdesivir initiation, 30 patients were receiving RRT. 11 patients with eGFR <30 ml/min per 1.73 m2 were not on RRT at the time of starting Remdesivir. Four patients developed ALT more than the upper limit of normal and only two patients developed ALT more than 5 times, that may be contributory to other factor also. In general, limited information is available Conclusion: on the impact of SARS-CoV-2 infection in patients with eGFR less than 30. Impact of Remdesivir on these patients and their liver and kidney functions are not well studied. Although the available clinical data are limited, but it shows that impact of Remdesivir on liver and kidney function in patients of eGFR less than 30 is limited. However further studies are needed.
Aim: To determine QOL standards in patients with ESRD undergoing twice/week hemodialysis. Methods: This was a multicenter cross-sectional study conducted in patients of either sex, aged above 18 years diagnosed with ESRD who were undergoing hemodialysis for at least three months in three hemodialysis centers. For QOL assessment, patients underwent KDQOL questionnaire survey. KDQOL is a disease-specic QOL questionnaire. Results: Total of 74 patients with ESRD (mean age: 54.7 years; men: 67.6%) undergoing hemodialysis enrolled. Overall, 53 (71.6%) patients had improvement in their life in comparison to last year. Majority of patients reported no bodily pain (66.2%). Majority of patients (68.9%) did not feel frustrated due to kidney disease. Total of 75.7% of patients did not feel like a burden on their family. More than half of the patients reported they did not bother about dry skin (55.4%), sleep disturbance (66.2%), and problem with access site (75.7%). Most of the patients reported that dialysis staff encouraged them to be as independent as possible (93.7%) and support them in coping their kidney disease (93.3%). Conclusion: The present study was done to throw a light on the status of QOL of Indian patients undergoing hemodialysis and might inspire the healthcare providers to endeavor for quality in delivery of dialysis in the future.
Background: This study aimed to evaluate the prevalence of depressive symptoms among the patients with end-stage renal disease (ESRD) on hemodialysis and to explore associated risk factors.Methods: A prospective observational study of patients with ESRD undergoing hemodialysis were included in the study. Data was collected based on questionnaire created by the study team, and by verbal interviews with patients. The questionnaire consisted of two parts, which included demographic data (gender, age, sleep quality, duration of sleep, appetite pattern, and duration of dialysis) and evaluation of the severity of depressive symptoms by using the depression, anxiety and stress scale-21.Results: Out of total 93 patients with ESRD on hemodialysis majority of patients belonged to the age group of >60 to ≤80 years (47.8%) and age group >40 to ≤60 years (40.0%). Patients had a higher incidence of severe anxiety (38.7%) than depression (34.4%), and stress (22.6%). The proportion of patients diagnosed with depression (50.0%) and stress (57.1%) was higher in the older age group (>60 to ≤80 years); while the proportion of patients having severe anxiety was similar in both adult (>40 to ≤60 years) and older (>60 to ≤80 years) age group (38.9%). More than 50% of patients with depressive, anxiety, and stress symptoms had insufficient sleep (≤1 to ≤4 h). The present study could not predict the risk factors of depressive symptoms in patients with ESRD on hemodialysis. Conclusions: Depression and anxiety symptoms were more frequent among patients with ESRD undergoing hemodialysis in Indian settings.
Diabetic nephropathy (DN) is a major cause of renal failure globally including chronic kidney disease and end-stage renal disease (ESRD). Using comprehensive linkage disequilibrium mapping, we genotyped five polymorphisms from engulfment and cell motility 1 (ELMO1) gene (rs741301, rs7799004, rs1882080, rs11769038 and rs1345365) to evaluate its association with DN. BMI was observed to be low in DN cases as compared to the control groups, which is the result of haemodialysis and high doses of medication. Physical inactivity, lipid profile, urea and creatinine were observed to be the confounding factors correlated with DN. This study comprehensively evaluated ELMO1 in DN patients, T2D without Nephropathy and healthy controls from North Indian population and revealed significant association with DN. Haplotypes G-G-C-C and G-A-T-T provided ~2-fold risk towards DN development. In conclusion, the present study suggests the significant role of ELMO1 gene polymorphisms in the pathophysiology of DN in North-Indian population.
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