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Introduction: Ocular manifestations of Haemodialysis (HD) are one of the important causes of morbidity in End-stage Renal Disease (ESRD) patients. According to studies, the incidence rate of glaucoma in the dialysis group was higher than that in the non dialysis group. Angle-closure glaucoma was found to be more common, which depends on anterior chamber morphology. Aim: To assess the effect of HD on Intraocular Pressure (IOP), Anterior Chamber Depth (ACD), and Lens Thickness (LT) in patients with ESRD. Materials and Methods: This was a single-centre crosssectional observational study conducted in the Department of Ophthalmology on 170 eyes of 87 patients undergoing HD for at least three months. The study was conducted between October 2020 and October 2022 at the Dialysis Centre of Bharati Vidyapeeth (DTU) Medical College and Hospital, Pune, Maharashtra, India. These patients underwent ophthalmological evaluation pre- and postdialysis. IOP, ACD, and LT were measured 30 minutes prior to and 30 minutes after the HD session. The paired t-test was used to compare differences in means, and a p-value of <0.05 was considered significant. Results: The mean age of the study participants was 57.63±11.95 years. There was a decrease in mean ACD by 0.08±0.29 mm (p=0.0001) and an increase in mean LT by 0.06±0.42 mm (p-value=0.0001) postdialysis. The changes in IOP were variable and not statistically significant (p=0.45). Conclusion: Postdialysis, a significant increase in LT was observed corresponding to a decrease in ACD. Although the change in IOP was variable, this change might be more significant in pre-existing narrow-angle patients undergoing dialysis. As a result, the present study underscores the urgency of refining screening protocols for HD patients to effectively address these identified ocular changes and associated risks. [ABSTRACT FROM AUTHOR]

Introduction: Nutritional status is compromised in End-Stage Renal Disease (ESRD) patients on dialysis. In order to predict the clinical outcomes of these patients, the diagnosis of nutritional status becomes extremely important. However, data related to parameters assessing nutritional status are limited. Aim: The aim of this study was to assess the nutritional status of dialysis patients with ESRD at the renal care unit of a tertiary care hospital. Materials and Methods: A cross-sectional study was conducted at the renal care unit of a tertiary care hospital from January 2016 to July 2016. Fifty individuals were divided into two groups: 30 stable ESRD patients on Haemodialysis (HD) and 20 stable ESRD patients on Continuous Ambulatory Peritoneal Dialysis (CAPD). Data were collected using a questionnaire regarding nutritional assessment, which comprised medical history, food intake history, anthropometry, biochemical investigations, and Subjective Global Assessment (SGA). Based on the SGA analysis of nutritional status, the patients were divided into Categories A, B, and C. Data were analysed using the Statistical Package for Social Sciences (SPSS) version 22.0. Results: A total of 50 subjects were included in the final analysis - 30 patients in the renal dialysis group and 20 patients in the CAPD group. Body Mass Index (BMI) was significantly higher in the HD group (21.78±2.86 kg/m²) than in the CAPD group (20.87±2.63 kg/m²). In the HD group, the majority were in Category B (60%). In the CAPD group, the majority were in Category B (70%). The mean anthropometric measurements were significantly higher in Category A, followed by B and C (p<0.001). There was no significant difference across groups in biochemical parameters, except for serum albumin levels, which were significant. Serum albumin levels were highest in Category A, followed by Category B, and Category C in reverse for S. Prealbumin (mg/dl). Conclusion: There is a significant number of ESRD patients who have malnutrition as an additional burden. These results suggest that low BMI and low calorie intake are harmful to ESRD patients on HD, causing severe malnutrition. Optimal calorie intake could reduce malnutrition in these patients. [ABSTRACT FROM AUTHOR]

Introduction: Diabetes mellitus is the most common single cause of End Stage Renal Disease (ESRD). About 20-30% of patients with Type 1 Diabetes Mellitus (Type 1 DM) develop diabetic nephropathy as a serious complication which is the major cause of morbidity and mortality. Early identification of renal impairment is crucial to prevent the progression of nephropathy to a significant degree, because several interventions have greatest impact if initiated very early in the course of the disease. Aim: To study the correlation of microalbuminuria and serum cystatin C for the early prediction of renal impairment in patients with Type 1 DM. Materials and Methods: This was a cross-sectional study conducted from January 2016 to June 2016 on type 1 DM patients attending Diabetology Out Patient Department (OPD). According to the duration of diabetes, pateints were divided into two groups, Group I with <5 years and Group II with >5 years duration. The patients in each group were categorised as cases and controls, based on the Albumin Creatinine Ratio (ACR), serum urea, Creatinine, cystatin C, glycated haemoglobin (HbA1c), and urine ACR levels were estimated. Student's unpaired t test was used to compare the means between two independent groups. Pearson correlation coefficient was used to estimate the degree of correlation between two quantitative variables. Results: Cystatin C levels in cases (0.89±0.35) when compared to controls (0.67±0.26) in more than five years duration of type 1 DM found to be statistically significant (p <0.05) and positive correlation between cystatin C and ACR (r = 0.4, p<0.05) found to be statistically significant in more than five years duration. It indicates that serum cystatin C levels increases as the values of ACR increases. There was no significant difference in cystatin C levels in patients with less than five years duration of type 1 DM Conclusion: Serum cystatin C may be considered as an early predictor of renal impairment in type 1 DM patients with more than five years duration. However, in this study cystatin C carries no significance in less than five years duration of type 1 DM patients. [ABSTRACT FROM AUTHOR]

Introduction: Chronic Kidney Disease (CKD) has become a major health issue worldwide. CKD patients require Renal Replacement Therapy (RRT) throughout their life. Haemodialysis is one of the options for RRT. Arterio-Venous Fistula (AVF) creation is required for haemodialysis. The radio cephalic fistula is the initial option for creating vascular access. Fistula can be created by anastomosing cephalic vein to radial artery either by End-To-Side (ETS) or Side-To-Side (STS) techniques. Aim: To compare the efficacy rate of radio cephalic AVF using ETS or STS anastomotic methods. Materials and Methods: This was a retrospective analytical study conducted at SDM college of medical sciences and hospital, Dharwad from March 2017 to February 2020. A total of 43 CKD patients were enlisted for the above duration from the hospital records. These patients were included in the study since they underwent radio cephalic AVF creation. AVF creation at other anatomical sites for rest of the CKD patients was excluded. Out of 43 patients, 24 of them underwent ETS technique and 19 STS technique; 15 patients from the former group and 17 from the latter were followed-up for a period of three months. Eleven patients were lost to follow up. Demographic variables were analysed with frequency, mean and standard deviation. Its association with two different operative techniques was analysed using Fisher’s-exact test. Outcome of the two operative procedures was analysed using Student’s t-test. Results: Effectively 15 patients from ETS group and 17 from STS group were compared. Three (20%) in ETS group and 5 (29.41%) in STS group had primary failure. Mean of maturation time in weeks in ETS group was 4.73±2.73 weeks and in STS group was 5.29±3.75 weeks. Three months patency rate in ETS group was 12 (80%) and in STS group was 12 (70.58%). Student’s t-test was performed comparing the above parameters and no statistical significance was noted. Conclusion: Comparison of two techniques of radio cephalic AVF creation proves that both the techniques are beneficial with no superiority of one over other. [ABSTRACT FROM AUTHOR]

Introduction: Chronic Kidney Disease (CKD) has been recognised as a worldwide health threat and understanding its complex patho-physiological mechanisms could go a long way in taking care of patients with CKD. One of the most important causes for mortality in End Stage Renal Disease (ESRD) patients is Cardiovascular Disease (CVD). ESRD is a low grade chronic inflammatory state, suspected to promote atherosclerosis. Aim: To determine if there is any association between elevated High-sensitivity C-Reactive Protein (hs-CRP) and development of future cardiovascular events in stage-5 CKD patients. Materials and Methods: Forty-five CKD stage-5 patients were included in the study, after ruling out patients with established CVD. According to categorisation proposed by the American Heart Association for the cut-off value of hs-CRP-value (3 mg/L), patients were divided into two groups. Those who had hs-CRP more than 3 mg/L were considered to have 'elevated hs-CRP' and those who had a value 3 mg/L and below were considered to have 'normal hs-CRP' levels. These patients were followedup monthly, for a period of one year, to record any occurrence of cardiovascular events (coronary events/cerebrovascular accidents/peripheral occlusive vascular disease). Statistical Package for the Social Sciences (SPSS) 16.0 was used for analysis. Chi-square test and Mann-Whitney U-test were used for statistical comparison between the groups and a p-value of 0.05 or less was considered to be statistically significant. Receiver Operating Characteristic (ROC) curve was also plotted to determine the cut-off value for hs-CRP based on the occurrence of any cardiovascular event. Results: Baseline hs-CRP level was more than 3 mg/L in 42% of patients. Among those who had elevated hs-CRP, 78.9% of patients developed cardiovascular events during the follow-up period. This signifies a strong association between elevated hs- CRP and CVD in ESRD patients. The hs-CRP cut-off point of 3 mg/L was obtained from ROC curve. Conclusion: There was a significant association between elevated hs-CRP and development of cardiovascular events in ESRD patients. Hence, hs-CRP can be used as a marker of future cardiovascular events in CKD stage-5 patients. [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular complications are considered as the main cause of mortality in patients with End-Stage Renal Disease (ESRD). Cardiovascular Disease (CVD) includes disorders of the Left Ventricular Hypertrophy (LVH) of the heart which is the most frequent cardiac alteration in ESRD. Galectin-3 (GAL-3), a ß-galactoside-binding protein has been proposed to be a new clinical biomarker that reflects cardiac fibrosis in patients with Heart Failure (HF). Aim: To evaluate the relationship between GAL-3 and biochemical parameters in Peritoneal Dialysis (PD) patients with and without LVH. Materials and Methods: This cross-sectional study enrolled 45 patients (25 women and 20 men) with ESRD who were categorised as having CVD with (n=12) or without (n=33) LVH. Demographic, biochemical and clinical characteristics of 45 patients were analysed. The relationship of plasma GAL-3 levels was analysed with the biochemical parameters for both the groups of patients. For comparison between groups, Student unpaired t-test was used for the data of normal distribution while Mann-Whitney test was used for data of non- Gaussian distribution. Pearson's correlation test was performed to examine various correlations. Results: Significantly high number (83.3%) of female patients were observed in ESRD with LVH. The groups did not differ significantly in their demographic, and biochemical and clinical parameters. There was significant increase in Left Ventricular End-Diastolic Diameters (LVEDD), Left Ventricular (LV) mass and LV mass index in patients with LVH as compared to the patients without LVH. The levels of GAL-3 showed slight increase (91±23.98 ng/mL) levels in LVH patients as compared to the patients without LVH (83.68±32.8 ng/mL). Exponential positive correlation between serum levels of GAL-3 and creatinine in all ESRD patients (r2=0.5488, p=0.0002). GAL-3 also showed positive correlations with urea (r=0.3825, p=0.011) as well as and uric acid (r=0.347, p=0.021) for ESRD patients without LVH. However, GAL-3 showed no association with uric acid and urea (r=0.04487, p=0.896; r=0.2383, p=0.48) in ESRD patients with LVH. Conclusion: GAL-3 positively correlated to the biochemical parameters in ESRD patients. Patients with LVH only showed positive correlation between GAL-3 and creatinine. Moreover, GAL-3 could not be used as the biomarker because it did not correlate with established diagnostic parameter like LV mass and LV mass index. Hence, in this study GAL-3 is not a potential clinical biomarker for the progression of cardiovascular complications in ESRD patients. Overall, these data reflect the need for further investigation of GAL-3 to HF in patients with ESRD. [ABSTRACT FROM AUTHOR]

Introduction: Patients suffering from End Stage Renal Disease (ESRD) are physically less active typically when compared to healthy individuals. Performing regular exercise could improve many attributes indicating the physical functioning of such patients and thus improving their quality of life. Haemodialysis patients can be safely guided to participate in a range of exercise programs to improve their health-related quality of life while restricting adverse effects to a minimum. Aim: To evaluate the efficacy of intradialytic stretching exercise on quality of life among patients undergoing haemodialysis and to find the association between quality of life with selected variables in the experimental and control group. Materials and Methods: A quasi-experimental pre-test and post-test design with a control group was used to assess the effectiveness of intradialytic stretching exercise on Health- Related Quality of Life (HRQOL) among haemodialysis patients. Two hundred patients were selected through purposive sampling technique. The inclusion criteria considered were chronic kidney patients undergoing haemodialysis for a period of one year, whose vital signs were within safe limits for exercise therapy. Patients with femoral catheter and lower limb pathology were excluded from the study. Results: There was no significant difference between experimental and control groups before the intervention in terms of HRQOL. Six months after the intervention, the post-test findings revealed that out of 100 participants in experimental group, 65 (65%) were having good HRQOL, 35 (35%) were having average HRQOL and no one had poor HRQOL. Whereas, in control group, out of 100 participants, pre-test scores were very similar to those of post-test. The pre-test scores showed 83 (83%) were having poor HRQOL, 17 (17%) were having average HRQOL and no one had good HRQOL. Post-test scores showed 84 (84%) were having poor HRQOL, 16 (16%) were having average HRQOL and none had good HRQOL. Conclusion: The study concluded that regular intradialytic stretching exercises among haemodialysis patients help in improving HRQOL. [ABSTRACT FROM AUTHOR]

Introduction: Diabetic Nephropathy (DN) is a micro-vascular complication of Type 2 Diabetes Mellitus (T2DM). It is known that renal tubular damage plays an important role in DN. Liver-Type Fatty Acid Binding Protein (LFABP) is found in liver and proximal tubular cells of kidney and its levels are associated with the structural and functional changes of tubular cells of kidney. Aim: The present study was carried out to estimate the levels of urinary LFABP and its potential role as a clinical biomarker for early diagnosis of nephropathy in T2DM patients with nephropathy. Materials and Methods: A hospital based cross-sectional study was conducted on 84 subjects divided into 3 groups. Group 1: (n=28) healthy controls, Group 2: (n=28) T2DM patients without nephropathy and Group 3: (n=28) T2DM patients with nephropathy. Serum and urine creatinine were carried out by alkaline picrate Jaffe's kinetic method. Urine albumin was estimated by turbidometric method by using nephelometer. Urinary LFABP levels were measured by commercial available ELISA kit. Results: In the present study, a statistically significant difference was found in urinary Albumin Creatinine Ratio (ACR) between the study groups I and III, II and III (p=<0.001). Also, a statistically significant difference was found between the levels of urinary LFABP in groups I and II, I and III (p=0.004 and p=<0.001 respectively). Significantly increased level of urinary LFABP was found in group III as compared to group II. There was a positive correlation observed between urinary LFABP levels with urinary ACR, which indicated that LFABP can predict kidney damage even before micro-albuminuria can be detected. Also a negative correlation was observed between urinary LFABP and estimated Glomerular Filtration Rate (eGFR). Conclusion: The study suggests that the estimation of urinary LFABP could be used as a potential adjunct biomarker along with urinary ACR for early detection of DN and monitoring of progression of DN in clinical practice. This will enable the Institution for preventive strategies that could delay the onset of symptoms of full-blown DM and End Stage Renal Disease (ESRD). [ABSTRACT FROM AUTHOR]

Introduction: Cardiovascular risk factors are prevalent in Haemodialysis (HD) patients. Aim: To assess the effect of HD on lipid peroxidation marker (Malondialdehyde (MDA)), lipid atherogenic ratios, and peripheral inflammatory markers in HD patients. Materials and Methods: A cross-sectional case-control study was conducted on 60 patients on regular HD attending nephrology unit of Luxor general hospital between June 2016 and May 2017, (33 males/27 females) and 30 healthy controls (17 males/13 females) were enrolled. Blood samples were obtained for estimation of lipid profile, MDA, and complete blood counts. One-way analysis of variance (ANOVA) was used for comparisons between groups, receiver operator characteristic curve was performed to obtain the cut-off value of MDA, sensitivity, specificity, and area under the curve was used to discriminate between HD patients and controls. The correlation study was used to measure the relationship between variables. Logistic Regression (Odd's Ratio) was performed for calculation of cardiac risk factors for heart attack in HD cases. Results: HD patients had significantly low WBCs (p=0.010) and lymphocyte counts (p<0.00001); with insignificant difference between pre- and post-HD. HD-patients had significantly higher cholesterol (p=0.019), triglycerides, VLDL-c, MDA (p<0.00001) and non-HDL-c (p=0.002) all increased significantly post-HD. Inversely, HDL-c was significantly lower in HD-patients and decreased significantly in post-HD (p<0.00001). HD-patients had significantly higher indexes for (TC/HDL, LDL/HDL, VLDL/ HDL, TG/HDL, Non-HDL/HDL) (p<0.00001), monocyte: HDL ratio (p=0.003) and Platelet: Lymphocyte Ratio (PLR) (p=0.042) all significantly increased post-HD. Inversely; HD-patients had significant lower LDL/VLDL (p<0.00001) and Lymphocyte: Monocyte Ratio (LMR) (p=0.0003) with insignificant difference between pre- and post-HD. However, Neutrophil: Lymphocyte Ratio (NLR) (p=0.095), monocyte count (p=0.626) showed insignificant difference. MDA was correlated with TG, VLDL, non-HDL/HDL, and TG/HDL; but multivariate regression analysis indicates inter-related variables and none was considered independent risk factor. Conclusion: HD worsens oxidative stress caused by uraemia and accentuates lipid peroxidation and dyslipidemia present in HD patient. Lipid peroxidation and dyslipidemia are probable independent modifiable risk factor that contributes to high morbidity and mortality by promoting cardiovascular complications. [ABSTRACT FROM AUTHOR]

Introduction: Globally, incidence of Chronic Kidney Disease (CKD) is rapidly rising with huge burden on the life expectancy of the patients. Regular haemodialysis improves the quality of life in these patients. They get treatment at either Government run or private sector hospitals. A difference in disease pattern, co morbidity, patient management and number of access failures can be observed in these set ups. Aim: The present study was carried out to find out selection, management and disease pattern of CKD patients admitted for dialysis to Government run and private hospital. Materials and Methods: A cross-sectional study on patients (18-90 years) admitted and undergoing dialysis at Government run (N=129) and private hospital (N=182) was undertaken in Karnataka, India. Parameters like co morbidities, number of dialysis per week, number of access failures, and follow up visits were compared between these patients. Chi-squared test was used to compare the data. All tests were two-tailed and p< 0.05 was considered as significant. Results: More number of younger patients and co morbidity were seen in Government run hospital (p<0.001) with no gender bias in selection of patients for dialysis between the two hospitals. Similarly, follow-ups with nephrologist, number of dialysis done per week and erythropoietin supplements administered were significantly more among private hospital patients (p<0.001). Number of dialysis sessions in Government run hospital and mean haemoglobin levels of patients was less compared with those in private. No statistical difference was seen with access failure in both these setups. Conclusion: No bias in management of CKD patient was seen among the two sets of hospitals though treatment options seemed to vary. [ABSTRACT FROM AUTHOR]

Introduction: The global prevalence of chronic kidney disease (CKD) is estimated to be 8-16%. Studies have shown that the increased mortality in patients with CKD is due to anemia that leads to cardiovascular disease (CVD), also known as "Cardio renal anemia syndrome". The present study was undertaken to look into the laboratory profiles of end stage renal disease (ESRD) patients. Aim: To study the laboratory profiles of End stage renal disease (ESRD) patients coming for hemodialysis. Materials and Methods: The study was a retrospective, crosssectional study done by collecting data from the medical case records of all patients during a period of one year from January 1st 2014 to December 31st 2014. Records of a total of 140 patients who underwent hemodialysis during this period were taken. The laboratory profiles that was recorded included haemoglobin, serum sodium, potassium, chloride, fasting glucose, calcium and phosphorus. Results: The mean age of the subjects was 53.5±14.5 yrs. All the patients had moderate anaemia. There was a significant difference in the mean systolic and diastolic blood pressure, serum creatinine and serum urea values between males and females. The mean serum calcium levels were low. Conclusion: The present study is the first such study in this rural area and shows evidence of a relatively young population with ESRD having moderate anaemia and hypertension. There is evidence of hypocalcaemia and serum phosphorus is on the higher end of the normal range. These findings are usually associated with a higher risk of mortality. With the explosion of diabetes and hypertension in India, chronic kidney disease should be diagnosed and managed as early as possible if not prevented. [ABSTRACT FROM AUTHOR]

Introduction: The diagnostic validity of urinalysis in asymptomatic Hemodialysis (HD) patients is low and there is limited data on the diagnostic value of urinalysis in HD patients with fever, sepsis, or suspected Urinary Tract Infection (UTI). Aim: The aim of this study was to assess the sensitivity, specificity, positive and negative predictive value of pyuria, bacteriuria, Leukocyte Esterase (LE) and nitrite positivity in symptomatic, febrile or/and septic HD patients. Materials and Methods: A single-center, retrospective study was performed at New York University Lutheran Medical Center, Brooklyn, New York City, USA, in order to investigate the diagnostic validity of pyuria, bacteriuria, LE and nitrite positivity in HD patients with admitting diagnosis of fever, sepsis or UTI from September 2008 to August 2015. Results: A total of 275 HD patients were included in the study. There was significant association between pyuria of different cut-offs (>5,>10,>50 WBC/HPF) and urine culture positivity (p<0.001) and growth of ≥100,000 CFU/mL (p=0.039), but there was no association with fever or sepsis. The sensitivity and specificity of pyuria >10 WBC/HPF for positive urine culture with >100,000 CFU/mL was 86% and 35% respectively (p=0.025). Pyuria >50 WBC/HPF showed a sensitivity of 66% and a specificity of 58% (p=0.032). There was also association between bacteriuria, LE positivity and positive urine cultures but not with =100,000 CFU/mL. Conclusion: Our study results suggest that urinalysis is not a reliable diagnostic tool in febrile and/or septic HD patients and a urine culture is needed. In such patients, physicians should also maintain a high level of clinical suspicion for other potential sources of infection, which may not be initially evident. [ABSTRACT FROM AUTHOR]

Introduction: Proteinuria is always associated with intrinsic kidney disese and is a strong predictor of later development of End Stage Renal Disease (ESRD). As Renin Angiotensin Aldosterone System (RAAS) has a role in mediating proteinuria, inhibitors of this system are renoprotective and patients with refractory proteinuria are put on a combination of these agents. The routinely employed triple blockade of RAAS with Angiotensin Converting Enzyme (ACE) inhibitor, ARB and Aldosterone antagonist has many limitations. Addition of Aliskiren to this combination suppresses the RAAS at the earliest stage and can offset many of these limitations. Aim: This study was conducted to assess the safety and efficacy of complete RAAS blockade by the addition of Aliskiren in those patients with refractory proteinuria who were already on triple blockade with ACE inhibitor, ARB and Aldosterone antagonist. Settings: This study was conducted in Nephrology Department, Calicut Medical College. Materials and Methods: A total of 36 patients with refractory proteinuria who were already on ACE inhibitor, ARB and Aldosterone antagonist were divided in to two groups A and B. Group A received Aliskiren in addition to the above combination whereas group B continued the same treatment for 12 weeks. Efficacy of the treatment was assessed by recording 24hr urine protein and safety by S.Creatinine, S.Potassium every 2 weeks of the treatment period. Statistical Analysis: Statistical analysis of the lab values was done using SPSS software. Unpaired t-test, Paired t-test and Chi-square test were done for data analysis. Results: Statistical analysis revealed that addition of Aliskiren to the combination therapy with ACE inhibitor+ ARB+ Aldosterone antagonist offers no advantage. But mean reduction in proteinuria was more with Group A than Group B. There is no statistically significant change in S.Creatinine and S.Potassium at the end of treatment. Conclusion: As proteinuria is a strong risk factor for progression to ESRD, even a mild decrease in proteinuria by treatment is renoprotective. Hence treatment with group A may be considered clinically superior to group B with no alteration in safety and tolerability. But further multicentre studies with larger sample size and dose escalation are required for confirmation. [ABSTRACT FROM AUTHOR]

Introduction: As a chronic disease, End Stage Renal Disease (ESRD) changes the patients' body and affects their body image negatively. Although the changes in body image are expected in all types of renal replacement therapies, different renal replacement therapy methods could represent different levels of impact on body image. Aim: Present study was conducted to examine and compare the level of body-image disturbance between haemodialysis and kidney transplant patients. Materials and Methods: This descriptive study was conducted in two teaching hospitals in Tehran, Iran. Using convenient sampling, 84 patients (42 patients under haemodialysis and 42 patients with transplant) were invited to participate in the study. A self-designed questionnaire was developed to examine the level of body-image disturbance. Results: Out of 42 haemodialysis patients, 64.3%, 19% and 16.7% of patients reported low, moderate and high level of body-image disturbance respectively. The mean score of bodyimage disturbance was 21.1±18.3(rang=1-71) in haemodialysis patients. Of 42 transplant patients, 69%, 26.2% and 4.8% reported low, moderate and high level of body-image disturbance respectively. The mean score of body-image disturbance was 17.1±13.3 (rang=1-48). According to the results of independent t-test, difference between mean score of body-image disturbance in two groups was statistically significant (p < 0.05). Conclusion: The findings of the present study showed that both haemodialysis and renal transplant patients experienced some levels of body-image disturbance. This problem was more prevalent among haemodialysis patients in compared to kidney transplant ones. We recommend more studies may be conducted in this regard. [ABSTRACT FROM AUTHOR]

Introduction: Collapsing Glomerulopathy (CG) is recognized as distinct pattern of proliferative parenchymal injury with poor response to empirical therapy. Aim: A single center retrospective study was carried out to find out clinicopathological features of idiopathic CG. Materials and Methods: A total of 3335 native renal biopsies were analyzed retrospectively which were performed from 2008 to 2014 with emphasis on clinicopathological correlation and histopathological presentation. Results: Idiopathic CG constituted 0.75% incidence (25 out of 3335 biopsies) of all biopsies, adults constituting major study part with 88%.The duration of the symptoms at the time of biopsy was 34.12±26.09 days and 35±22.91 days respectively in adults and children. Hypertension was noted in 9(40.9%) and oliguria in 8(36.4%) in adults. Urinalysis revealed microscopic haematuria 12(54.5%) in adults. Nephrotic range proteinuria was reported in 10 (45.5%) adult patients. Glomerular collapse with hyperplasia/ hypertrophy of podocytes was seen in 4.54±3.11 glomeruli. Tubular microcystic dilation was seen in 16(64%) patients. Tubular atrophy involving mild (t1) in 15(60%), moderate (t2) in 4(16%) and severe (t3) in 6(24%) patients. Interstitial fibrosis was mild (i1) in 17(68%), moderate (i2) in 2(8%) and severe (i3) in 6(24%) patients. Conclusion: Idiopathic CG is a morphological pattern of grave podocyte injury with poor prognosis. However, there are chances of remission/ recovery if the tubular atrophy and interstitial fibrosis are of grades ≤ t1 i1. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study is to compare the salivary urea, creatine, sodium, potassium and phosphate in pre dialysis and post dialysis state in end stage renal disease patients and compare with the serum counterpart. Materials and Methods: The study group was selected from patients undergoing hemodialysis due renal failure of any cause, who are undergoing dialysis for at least one year duration in a private hospital in Chennai. The total number of subjects was 30. The venous blood was collected from the study group just prior to the dialysis and after the dialysis from the venous catheter which is placed for the purpose of hemodialysis. The collected samples were immediately (within 15 min) submitted to the laboratory for the biochemical examination of urea, creatinine, sodium, potassium and phosphate by an automated biochemical analyser. Unstimulated whole saliva was collected by spitting method from study group both before and after dialysis. The collected samples were immediately submitted to the laboratory for the biochemical examination of urea, creatinine, sodium, potassium and phosphate by an automated biochemical analyser. Result: The paired t-test analysis was done in pre and post blood urea, creatinine, potassium and phosphate which was significant with a p-value of < 0.0001 and the same analysis was done in salivary urea in pre and post-dialysis state which also gave a significant reduction in the parameters with a p-value of < 0.0001. [ABSTRACT FROM AUTHOR]

Senior Loken Syndrome (SLS) is a rare genetic disorder having juvenile nephronophthisis and retinal degeneration progressing to blindness and end stage renal disease. The present case report is about two sisters who presented with decreased visual acuity and end stage renal disease. Both had decreased vision, pallor, deranged renal function test and chronic malnutrition. Investigations revealed anaemia, uraemia, raised creatinine, low Glomerular Filteration Rate (GFR). Ophthalmology examination revealed nystagmus, retinal examination depicted pale optic disc and pigmentary changes in the retina. Renal ultrasound showed grade III renal parenchymal changes and bilateral cortico-medullary cysts. These cases are presented to highlight the importance of timely recognition of renal derangement in patients with retinal disease to delay end stage renal disease. [ABSTRACT FROM AUTHOR]