Background: Autosomal dominant polycystic kidney disease (ADPKD) is a monogenic disorder and is a common genetic cause of chronic renal failure in children and adults. The enzyme renin plays a key role in the RAAS cascade and an important role in the development of hypertension and progression of renal disease in ADPKD. The present study is aimed to investigate the potential modifier effect of REN gene polymorphisms on the progression of chronic kidney disease (CKD) in ADPKD. Methods: We analyzed 102 ADPKD patients and 106 healthy controls from the same geographic area. FRET-based KASPar single-nucleotide polymorphism (SNP) genotyping assays for REN gene tag-SNPs (rs2887284, rs2368564, rs1464816, rs7521667, rs10900555, rs6693954, rs6676670 and rs11571078) were performed. Cochran-Armitage trend test was used to assess the potential associations between these polymorphisms and CKD stages. Haplotype frequencies and LD measures were estimated by using the software Haploview. Mantel-Haenszel stratified analysis was used to explore confounding and interaction effects of these polymorphisms. Results: Of the eight tag-SNPs genotyped, the rs10900555 polymorphism deviated from the Hardy-Weinberg equilibrium in controls. The presence of ADPKD in general was not significantly associated with the REN tag-SNPs included in this study. Linkage disequilibrium analysis yielded three haplotype blocks and the haplotypes of the respective blocks are not statistically different between ADPKD and controls. In multivariate analysis, the rs1464816 TG genotype showed a significant association with the advancement of CKD in ADPKD (OR = 4.80; 95 % CI = 1.30-17.82; p = 0.019). Conclusions:The present study provides evidence that the rs1464816 polymorphism in REN is associated with CKD progression in ADPKD.

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Malnutrition is widely prevalent among patients on hemodialysis. Malnutrition can be estimated using a fully quantitative scoring system Subjective Global Assessment-Dialysis Malnutrition Score which is simple, reliable and dynamic. The primary objective of the study was to assess the severity of malnutrition in patients with end stage renal disease and undergoing hemodialysis in a tertiary care teaching hospital in Chennai, using Subjective Global Asses sment-Dialysis Malnutrition Score and correlate it with standard indicators of malnutrition like anthropometric and biochemical parameters of the study population by Pearson's correlation. Anthropometric assessment included height, body weight, triceps skin fold thickness, mid arm circumference, mid arm muscle circumference % and biochemical parameters included serum albumin, transferrin, ferritin, total protein, total cholesterol, blood urea nitrogen and creatinine. Based on the scores, of the 66 patients, 91% were moderately malnourished. There was a significant negative correlation between modified Subjective Global Assessment-Dialysis Malnutrition Score and anthropometric measures such as triceps skin fold thickness, mid arm circumference, mid arm muscle circumference; biochemical markers such as albumin, transferrin and ferritin. The data obtained from this study confirm that a high degree of malnutrition was prevalent in patients on hemodialysis, as shown by anthropometric assessment, biochemical markers of malnutrition and Subjective Global Assessment-Dialysis Malnutrition Score. Nutritional status as determined by Subjective Global Assessment-Dialysis Malnutrition Score is a useful and reliable index for identifying patients at risk for malnutrition and it correlates well with anthropometric and biochemical assessment. may be integrated in regular assessment of malnutrition in patients on maintenance hemodialysis.

Aim:To determine the prevalence and the type of complementary and alternative medicine (CAM) use among chronic kidney disease (CKD) patients on maintenance hemodialysis (MHD).Materials and Methods:The study was conducted in 200 CKD patients who were on MHD. The patients were subjected to a validated interviewer-administered questionnaire adopted from the National Health Interview Survey Adult CAM. The knowledge on CAM and its usage by the patients were assessed based on the responses given by the patients.Results:Of the 200 patients, 52 (26%) patients were identified to be using CAM therapy. The most commonly used CAM modality by these patients was Ayurveda both alone (30.4%) and in combination with other CAM modalities (23.2%), followed by acupuncture in 17.3% patients. CAM usage was high in the age range of 50–64 years (67%). Of the CAM users, 21% of patients were from a rural area; 16.5% of patients were from upper middle class, and 24% were on dialysis for 1–4 years. There was a statistically significant association between CAM usage and age, gender, place of living, socioeconomic status, and duration of dialysis (P < 0.01).Conclusion:The present survey provides the data on the usage of CAM among dialysis patients and adds to the increasing evidence about CAM use. Because many products are at risk to either accumulate or cause interactions with medication, a better education on the risks and benefits of the CAM therapy by the health care providers to the end stage renal disease patients is needed.

Hemodialysis is one of the most commonly used treatments for patients suffering from irrecoverable kidney damage. In our present work we investigate polyetherimide (PEI) mixed matrix membranes (MMMs) as a potential candidate for hemodialysis applications due to its efficient clearance and high biocompatibility. Graphene oxide (GO) was synthesized by the modified Hummers' method and was then confirmed by X-ray diffraction spectroscopy, Fourier transform infrared spectroscopy, Raman spectroscopy and high resolution transmission electron microscopy. The GO-polyvinylpyrrolidone nano-composite incorporated PEI MMMs were fabricated by a semi-automatic casting unit, using the non-solvent induced phase separation (NIPS) technique. The effect of the nano-composite loading ratio was evaluated by water content; ultrafiltration rate, and porosity; which were all found to increase as the nano-composite content increased. Cross Sectional and top surface morphology was visualized using scanning electron microscopy and atomic force microscopy. The hydrophilicity of these membranes was in consonance with contact angle values. These MMMs demonstrated an increase in biocompatibility -reduced protein adsorption, suppressed platelet adhesion and lower complement activation. Furthermore the prolonged blood clotting time is an indication of the heparin mimic anticoagulant properties of these membranes. The cytocompatibility results by 3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-tetrazolium bromide (MTT) assay and live cell/dead cell staining indicated that there was an increase in cell viability. The membranes with 0.1 wt% GO showed an excellent clearance of the model uremic toxins, namely urea, vitamin B-12 and cytochrome-c in-vitro. The diffusive permeability of these membranes could be comparable to the existing commercial hemodialysis membranes. Thus it can be concluded that these membranes containing a composite of both functional nano-sheets and bioactive polymers have a tremendous potential to be utilized commercially in hemodialysis modules if shown successful in further in-vivo studies with an animal model.

Introduction: Tuberculosis (TB) causes significant morbidity and mortality worldwide as one of the leading infectious diseases. In India, more than 1.8 million new cases occur every year. Rapid and accurate diagnosis of TB would improve patient care and limit its transmission. This study aimed to evaluate a dual target polymerase chain reaction (PCR) diagnostic assay to detect Mycobacterium tuberculosis from pulmonary and extra-pulmonary samples at a tertiary care centre in South India. Methodology: Samples were collected from patients with a low index of suspicion of TB. Acid-fast smears were performed by Auramine O fluorescent microscopy and PCR was performed by using two site-specific primer pairs targeting IS6110 by nested PCR and TRC 4 by conventional PCR. Amplified products for IS6110 and/or TRC 4 were indicative of M. tuberculosis. Results: Among 114 (19 pulmonary and 95 extra-pulmonary) samples tested by PCR assay, 12 (11%) were positive for both IS6110 and TRC 4 , of which 11 (10%) were non-respiratory and one was (1%) respiratory in origin. PCR for TRC 4 alone was positive for eight (7%) nonrespiratory and two (2%) respiratory samples, while IS6110 alone tested positive for six (5%) non-respiratory samples and one (1%) respiratory sample. Of a total of 29 PCR positive samples, 17 (15 %) were acid-fast smear positive. Conclusion: Although the target site of IS6110 is specific for M. tuberculosis, some strains from South India may lack this region. Therefore, the use of an additional target site (TRC 4 ) is required for improved detection of M. tuberculosis.

BackgroundDiabetic nephropathy (DN) is one of the life-threatening disorders characterized by persistent albuminuria, raised arterial blood pressure, a lowered glomerular filtration rate, and high risk of cardiovascular morbidity and mortality. The vascular genes ACE (Angiotensin-converting enzyme), and PPARG (peroxisome proliferator activated receptor gamma) are involved in alterations in vascular endothelium, and are suggested to play a role in the susceptibility of diabetic nephropathy.ObjectivesThe aim of our study was to find out the role of ACE ID and PPARG P12A polymorphisms in genetic susceptibility of diabetic nephropathy in south Indian population.Patients and MethodsA total of 54 cases with diabetic nephropathy and 67 control subjects with diabetes were enrolled for our study. DNA was isolated from peripheral blood leucocytes, and genotyped using PCR-electrophoresis (ACE ID) or PCR-RFLP (PPARG P12A) methods.ResultsACE ID genotypes followed Hardy-Weinberg equilibrium in both cases and controls. But P12A genotypes deviated from Hardy-Weinberg equilibrium in diabetic controls. Chi2 test was applied for the analysis of genotypic distributions in genotypic and dominant models. Odds ratios were also calculated. No significant differences in genotype frequencies of ACE ID and PPARG P12A polymorphisms were found on comparing patients with diabetic nephropathy with diabetic controls. The synergistic role of ACE ID* PPARG P12A interaction, did not show any association in patients with diabetic nephropathy when compared to diabetic controls.ConclusionsIn conclusion, the ACE and PPARG genes do not have a key role in conferring risk for diabetic nephropathy.

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