Methods: Objectives: 1.To study time trend, geographic distribution by zone, cities and centres of COVID-19 infection in HD patients , 2.To study age and gender distribution of COVID patients, 3.To study outcome of COVID-19 infection Methods: From March 15, 2020 to November 15, 2020, consecutive MHD patients who acquired COVID-19 infection in a large dialysis network across India in 235 centres across 25 states were reviewed for date of infection, centre city and zone. Threshold for testing was locally determined and was mostly symptom based. The type of test was determined by state regulatory practices and was either RT-PCR or Antigen test. Incidence of infection zone wise and centre wise infection burden was reviewed. Age, gender and disposition of patients: hospitalisation or home-based care were noted. Survival status is reported. Results are described as numbers and percentage Results: n=883 (4.85%)/18200 patients tested positive for COVID-19
On gestational day (GD) 12, mini-osmotic pumps infusing sFlt-1 and sEng were placed into rats to induce HELLP. A subset of HELLP and NP rats underwent bilateral renal ischemiareperfusion surgery for 45 minutes on GD18 to create AKI. After rats had recovered, all rats were placed in metabolic cages for 24hrs. Mean arterial pressure was measured on GD19 followed by Evan's blue infusion to assess blood brain barrier permeability, or tissue collection and euthanization. RESULTS: During pregnancy HELLP+AKI rats had a significant decrease in urine output compared to NP rats (1.4+0.28 vs. 0.48+ 0.12mL/hr; p¼0.01). MAP was significantly increased in HELLP rats (p<0.0001) and HELLP+AKI rats (p¼0.03) compared to NP rats. Kidney weight was also significantly increased in NP+AKI compared to NP rats (p¼0.005) and in HELLP+AKI compared to HELLP rats (p¼0.003). Urine creatinine levels were significantly lower in all groups of rats compared to NP rats (p¼0.01). NP pups were significantly larger compared to HELLP (p¼0.006), NP+AKI (p¼0.0002) and HELLP+AKI (p¼0.0005) pups. Rats with HELLP had increased blood brain barrier permeability in the brainstem/ cerebellum compared to NP rats (p¼0.04). Similar results were seen in NP+AKI (p¼0.04) and HELLP+AKI (p¼0.01) rats compared to NP rats. Whole brain water weight was significantly increased in HELLP+AKI rats compared to NP rats (p¼0.03). CONCLUSION: The results from the current study suggest that AKI during pregnancy contributes to oliguria, hypertension, decreased urine creatinine, maternal brain injury and reduced pup size. In the setting of HELLP+AKI brain injury was worsened compared to rats with just AKI or HELLP syndrome. Studies are currently ongoing to examine the progression to chronic kidney disease and cognitive failure in rats with a history of sPE/HELLP with and without AKI during pregnancy.
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