10 results on '"Patel, R. D."'
Search Results
2. Collapsing Glomerulopathy- A Troublemaker for the Renal Allograft: Lessons Learnt.
- Author
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Kanodia KV, Vanikar AV, Nigam LK, Patel RD, Suthar KS, Patel HV, and Trivedi HL
- Abstract
Collapsing glomerulopathy (CG) is a well-recognized distinct morphological pattern of proliferative parenchymal injury leading to rapid graft failure. We conducted a single-center retrospective study to evaluate the prevalence, clinicopathological features, and prognosis of CG in renal transplant recepient. We analyzed 2518 renal allograft biopsies performed from 2007 to 2015 and correlated their clinicopathological features. The prevalence of CG was 0.83% (21 out of 2518) of allograft biopsies with a higher prevalence of 1.4% during the period from 2012 to 2015. Out of 21 patients, 18 (85.71%) patients had undergone live donor and 3 (14.28%) patients had undergone deceased donor renal transplant. Hypertension was observed in 3 (14.28%) patients. The mean duration of diagnosis for CG was 1.85 ± 1.91 years. Urinalysis revealed microhematuria in 5 (23.8%) patients. The mean 24 h urinary protein excretion was 4.77 ± 5.3 g and serum creatinine was 2.12 ± 1.5 mg/dl. The predominant native kidney diseases in recipients were chronic glomerulonephritis of unknown etiology in 12 (57.14%) patients and hypertensive nephropathy in 3 (14.28%) patients. CG was associated with rejection in 9 (42.85%), calcineurin-inhibitor toxicity in 2 (9.5%), and BK virus nephropathy in 1 patient. All patients received standard triple immunosuppression. Eleven (52.38%) patients developed graft failure over a mean period of 2.2 ± 1.7 years and 6 (28.57%) patients recovered with stable graft function. CG can coexist with viral infection, drug toxicity, rejection, microvascular injury, etc. CG usually presents with moderate to severe proteinuria and may lead to rapid graft dysfunction and subsequent graft failure in most of the patients., Competing Interests: There are no conflicts of interest.
- Published
- 2017
- Full Text
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3. C1q nephropathy in India: a single-center study.
- Author
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Kanodia KV, Vanikar AV, Patel RD, Suthar KS, Patel HV, Gumber MA, Shah PR, and Trivedi HL
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- Adolescent, Adult, Aged, Biomarkers analysis, Biomarkers blood, Biopsy, Child, Complement C3 analysis, Creatinine blood, Female, Fluorescent Antibody Technique, Glomerulonephritis, Membranoproliferative diagnosis, Glomerulonephritis, Membranoproliferative epidemiology, Glomerulosclerosis, Focal Segmental diagnosis, Glomerulosclerosis, Focal Segmental epidemiology, Hematuria diagnosis, Hematuria epidemiology, Hematuria immunology, Humans, Immunoglobulin M analysis, India epidemiology, Kidney Glomerulus pathology, Male, Nephrotic Syndrome diagnosis, Nephrotic Syndrome epidemiology, Nephrotic Syndrome immunology, Predictive Value of Tests, Prognosis, Time Factors, Young Adult, Complement C1q analysis, Glomerulonephritis, Membranoproliferative immunology, Glomerulosclerosis, Focal Segmental immunology, Kidney Glomerulus immunology
- Abstract
C1q nephropathy (C1qN) is defined by conspicuous C1q deposits in the glomerular mesangial regions of patients who do not have any evidence of systemic lupus erythematosus (SLE). We present our experience with C1qN over the last three years. In total, 1775 native renal biopsies were reviewed and dominant/co-dominant C1q mesangial deposits in patients with absence of clinical and/or serological evidence of SLE were considered as C1qN. Their clinical profile and renal function status were studied and correlated. C1qN was observed in 11 patients (0.61%), and included eight males and three females; the mean age was 36.6 years. The most common presentation was nephrotic syndrome. Hematuria was noted in eight patients (72%). The mean serum creatinine was 2.78 mg/dL. Hypertension was seen in two patients (18%). Mesangial proliferative glomerulonephritis (MePGN) was the most common histological pattern, followed by focal and segmental glomerulosclerosis and other lesions. The common codeposits along with C1q were IgM, followed by C3 and others. MePGN had better prognosis than others. To conclude, C1qN was noted in 0.61% of all renal biopsies with bimodal age distribution and may present as podocytopathy or non-podocytopathy. The prognosis depends on the morphological pattern and C1q deposits per se are not prognostic indicators.
- Published
- 2015
- Full Text
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4. Primary renal carcinoid tumor.
- Author
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Kanodia KV, Vanikar AV, Patel RD, Suthar KS, Kute VB, Modi PR, and Trivedi HL
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- Adult, Carcinoid Tumor metabolism, Carcinoid Tumor pathology, Humans, Immunohistochemistry, Kidney Neoplasms metabolism, Kidney Neoplasms pathology, Male, Nephrectomy, Carcinoid Tumor surgery, Kidney Neoplasms surgery
- Abstract
Primary renal carcinoid tumor is extremely rare and, therefore, its pathogenesis and prognosis is not well known. We report a primary renal carcinoid in a 26-year-old man treated by radical nephrectomy.
- Published
- 2013
- Full Text
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5. Immunoglobulin M nephropathy nephropathy in adults and adolescents in India: a single-center study of natural history.
- Author
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Singhai AM, Vanikar AV, Goplani KR, Kanodia KV, Patel RD, Suthar KS, Patel HV, Gumber MR, Shah PR, and Trivedi HL
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- Adolescent, Adult, Aged, Biopsy, Female, Humans, In Vitro Techniques, India epidemiology, Male, Middle Aged, Prevalence, Risk Factors, Young Adult, Glomerulonephritis chemically induced, Glomerulonephritis epidemiology, Immunoglobulin M toxicity, Kidney pathology
- Abstract
Background: Immunoglobulin M nephropathy (IgMN) is an idiopathic glomerulonephritis (GN) usually presenting clinically as steroid resistant/dependent nephrotic syndrome (NS) with pathology of mesangial proliferative GN or focal and segmental glomerulosclerosis with diffuse predominant mesangial IgM deposits. Not much information is available about its natural history. This is the first Indian study to our knowledge on IgMN in adults and adolescents., Materials and Methods: We evaluated renal biopsies performed at our center between January,'04 to September,'09. Biopsies of all adolescents and adults were evaluated for IgMN and we studied their age, gender distribution, blood pressure (BP), disease duration, steroid/immunosuppressive management and serial serum creatinine (SCr), urinary proteins, and BP values. Patients with other systemic diseases/infections and children were excluded., Results: IgMN constituted 4.3% of 2702 adult renal biopsies. No significant gender predilection was noted. Males presented at average age of 23.1 years, females at 30 years. Steroid-dependent NS was the commonest presentation noted in 75% followed by steroid-resistant NS. Hypertension was noted in 10% patients. Mesangial proliferative GN (MePGN) was commonest histopathological finding noted in 74.4%, followed by focal segmental glomerulosclerosis (FSGS) in 16.2%, and minimal change disease (MCD) in 9.4% biopsies. Sole IgM deposits were noted in 88.5%. All MCD, 35.6% MePGN reached remission, FSGS progressed to renal failure by 1 year. Hypertension, proteinuria, interstitial fibrosis, and FSGS were bad prognosticators., Conclusions: This is the first Indian study of IgMN in adults and adolescents carried out over a period of 5.8 years, which has shown that hypertension, proteinuria, and interstitial fibrosis at presentation have bad prognosis.
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- 2011
- Full Text
- View/download PDF
6. Modifying cyclosporine associated renal allograft dysfunction.
- Author
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Mohapatra N, Vanikar AV, Patel RD, and Trivedi HL
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- Adolescent, Adult, Azathioprine therapeutic use, Biopsy, Case-Control Studies, Child, Drug Therapy, Combination, Female, Graft Rejection chemically induced, Graft Rejection pathology, Humans, Immunosuppression Therapy methods, Male, Middle Aged, Mycophenolic Acid analogs & derivatives, Mycophenolic Acid therapeutic use, Prednisolone therapeutic use, Prospective Studies, Time Factors, Transplantation, Homologous, Treatment Outcome, Young Adult, Cyclosporine adverse effects, Graft Rejection prevention & control, Graft Survival drug effects, Immunosuppression Therapy adverse effects, Immunosuppressive Agents adverse effects, Kidney Transplantation adverse effects, Transplantation Tolerance drug effects
- Abstract
Transplantation is accepted therapy for chronic kidney disease. However the essential immunosuppressive agents for graft survival have their own side-effects. Renal biopsy is a reliable tool for diagnosing cyclosporine (CsA) nephrotoxicity. To present our observations on CsA toxicity in renal allograft biopsies, we studied prospectively 207 renal allograft biopsies performed for graft dysfunction as per Ahmedabad Tolerance Induction Protocol (ATIP) and compared them to 50 controls from January to October 2007. The ATIP comprised donor specific leucocyte infusions, low dose target specific irradiation; non-myeloablative condi-tioning with Anti-T +/- B cell antibodies followed by intraportal administration of cultured donor bone marrow (BM) +/- adipose tissue derived mesenchymal stem cells. Renal transplantation was performed following negative lymphocytotoxicity cross-matching. The post-transplant immunosuppressive agents included CsA 2.5 +/- 0.5 mg/kg BW/day and prednisone 0.2 mg/kg BW/day. The controls were transplanted using standard triple immunosuppressive agents including CsA 5 +/- 1 mg/Kg BW/day, prednisone 0.6 mg/kg BW/day, and MMF/ Azathioprine. The Institutional Review Board approved the ATIP. The biopsies were categorized into 2 groups; group A (N=97): performed < 6 months, group B (N= 160), > 6 months posttransplant. Acute CsA toxicity was observed in group A: 2.5% ATIP and 11.1% controls; group B: 16.2% ATIP and 8.8% controls. Chronic CsA toxicity was observed in group B: 10.8 % ATIP and 17.6 % controls. Acute toxicity was more in the ATIP, while chronic toxicity was more in the controls. CsA doses were reduced post-biopsy and resulted in improved graft function evaluated by serum creatinine. We conclude that CsA nephrotoxicity evaluated by allograft biopsy resulted in allograft function recovery by decreasing the cyclosporine dose, and the ATIP decreased the incidence of CsA nephrotoxicity.
- Published
- 2009
7. Airway management in a case of tongue flap division surgery: a case report.
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Sahoo TK, Ambardekar M, Patel RD, and Pandya SH
- Abstract
Summary: This article sums up successful airway management in an 18-year-old male presented for tongue flap division surgery constructed before for a palatal fistula in our hospital. After induction of general anaesthesia, we performed laryngoscopy with right molar approach using miller straight blade, intubated from right side of flap and throat packing done using left molar approach. Tongue flap was divided without any ties and hemostasis checked.
- Published
- 2009
8. De novo collapsing glomerulopathy in a renal allograft recipient.
- Author
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Kanodia KV, Vanikar AV, Patel RD, Shah PR, Nagpal M, Firoz A, Falodia J, Kasat P, and Trivedi HL
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- Adult, Complement C4b analysis, Epithelial Cells pathology, Humans, Hyperplasia, Hypertension complications, Kidney Failure, Chronic etiology, Kidney Tubules pathology, Male, Peptide Fragments analysis, Reoperation, Waiting Lists, Kidney Cortex Necrosis pathology, Kidney Failure, Chronic surgery, Kidney Transplantation pathology
- Abstract
Collapsing glomerulopathy (CG), characterized histologically by segmental/global glomerular capillary collapse, podocyte hypertrophy and hypercellularity and tubulo-interstitial injury; is characterized clinically by massive proteinuria and rapid progressive renal failure. CG is known to recur in renal allograft and rarely de novo. We report de novo CG 3 years post-transplant in a patient who received renal allograft from haplo-identical type donor.
- Published
- 2008
9. Vasoocclusion by sickled RBCs in 5 autopsy cases of sudden death.
- Author
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Patel MM, Modi JP, Patel SM, and Patel RD
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- Adult, Autopsy, Cause of Death, Female, Humans, Male, Anemia, Sickle Cell complications, Death, Sudden etiology, Embolism pathology
- Abstract
Mortality in sickle cell disease is high at young age group. So it is necessary to find out the cause of death in young patients with sickle cell disease. We are presenting 5 cases of sudden death in young adults with undiagnosed sickle cell disease. The provocative factors for those terminal events were vasoocclusive crisis. In our patients crisis was secondary to fever (infection), conductive arrhythmia, cardiovascular collapse, post partum shock and hemorrhage. On microscopic examination of viscera, not a single patient showed signs of chronic organ damage, sequestration crisis or acute chest syndrome, which are the common causes of death in sickle cell disease.
- Published
- 2007
10. Left shoulder region metastasis from hepatocellular carcinoma as an initial presentation--a case report.
- Author
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Patel MM, Patel RD, Mody SR, Jarag M, and Bagla N
- Subjects
- Aged, Carcinoma, Hepatocellular pathology, Female, Humans, Liver Neoplasms, Shoulder, Soft Tissue Neoplasms pathology, Carcinoma, Hepatocellular secondary, Soft Tissue Neoplasms secondary
- Abstract
Hepatocellular carcinoma metastasis as a soft tissue mass is rare; we came across a 65 years old female who presented with a left shoulder region mass. There was no previous history of any liver disease and liver function tests were normal. Histologically, it turned out to be a metastasis from hepatocellular carcinoma.
- Published
- 2004
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