34 results on '"Sethi, Sidharth Kumar"'
Search Results
2. Management of Intoxication via Extracorporeal Therapy in Pediatrics.
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Raina R, Sethi SK, and Bunchman T
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- Child, Continuous Renal Replacement Therapy, Humans, Renal Replacement Therapy, Extracorporeal Membrane Oxygenation, Pediatrics
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- 2020
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3. Challenges of Vascular Access in the Pediatric Population.
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Raina R, Mittal A, Sethi SK, and Chakraborty R
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- Child, Humans, Arteriovenous Shunt, Surgical instrumentation, Arteriovenous Shunt, Surgical methods, Catheterization, Central Venous instrumentation, Catheterization, Central Venous methods, Kidney Failure, Chronic therapy, Pediatrics methods, Pediatrics trends, Renal Dialysis methods, Vascular Access Devices adverse effects, Vascular Access Devices classification, Vascular Access Devices trends
- Abstract
The incidence and prevalence of renal replacement therapy has continued to increase in the pediatric population. Recent data have shown that hemodialysis was the most frequently used dialysis modality, especially in pediatric ESRD patients (age 0-21 years). A well-functioning vascular access is required for effective hemodialysis and choosing the best vascular access option for pediatric patients can be difficult. Pediatric vascular options include arteriovenous fistula, arteriovenous graft, and central venous catheters (CVCs). There is a national initiative for fistula first-catheter last approach; however, CVCs have been reported as the most conventionally utilized vascular access option in pediatric patients. The use of CVCs should be minimized or avoided as they are associated with high risk of infections, thrombosis, and other complications. Thus, it is important for practitioners to plan appropriately in advance, practice good clinical judgment, and assure that the best vascular access is placed according to the patient's needs. Therefore, this article reviews the different types of pediatric vascular access and the associated benefits and potential complications of each., (Copyright © 2020 National Kidney Foundation, Inc. Published by Elsevier Inc. All rights reserved.)
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- 2020
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4. Survey on health care transition services in pediatric nephrology.
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Raina R, Wang J, Sethi SK, and Ferris M
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- Adolescent, Adult, Health Care Surveys, Healthcare Disparities organization & administration, Humans, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic epidemiology, Patient Care Team organization & administration, Practice Patterns, Physicians' organization & administration, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic epidemiology, United States epidemiology, Young Adult, Delivery of Health Care, Integrated organization & administration, Kidney Failure, Chronic therapy, Nephrology organization & administration, Pediatrics organization & administration, Renal Insufficiency, Chronic therapy, Transition to Adult Care organization & administration
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- 2018
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5. Invited manuscript poster on renal-related education American Society of Nephrology, Nov. 16-21, 2010. E-pediatric nephrology in India.
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Sethi SK
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- Child, Humans, India, Internet, Nephrology education, Pediatrics
- Abstract
New tools such as blogs, social media networks, and audio and video podcasts in Web 2.0 have allowed better exchange of information among physicians across distances. The medical world has started embracing this new technology as it emerges. Wikis, blogs, and podcasts carry the potential of complementing, improving, and adding new collaborative dimensions to the health education currently in existence. There is a need for physicians in all specialities to adopt the new Web 2.0 technologies. This review features the innovative use of internet in disseminating renal education in Pediatric Nephrology in India.
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- 2011
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6. Earthquakes and pediatric nephrology: are we prepared?
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Sethi SK, Bunchman T, and Srivastava RN
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- Delivery of Health Care, Integrated organization & administration, Haiti, Health Services Accessibility organization & administration, Humans, Triage organization & administration, Civil Defense organization & administration, Disaster Planning organization & administration, Earthquakes, Mass Casualty Incidents, Nephrology organization & administration, Pediatrics organization & administration
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- 2010
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7. E-learning and pediatric nephrology: time to embrace the new technology.
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Sethi SK
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- Child, Educational Technology, Humans, Internet, Learning, Nephrology education, Pediatrics education
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- 2010
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8. When google wave hits the pediatricians!
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Sethi SK
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- Humans, Social Support, Documentation methods, Internet, Pediatrics methods, Software, Writing
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- 2010
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9. Medical calculators: online tool for pediatricians.
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Sethi SK
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- Humans, Computers, Internet, Online Systems, Pediatrics methods
- Published
- 2009
10. Artificial intelligence in early detection and prediction of pediatric/neonatal acute kidney injury: current status and future directions
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Raina, Rupesh, Nada, Arwa, Shah, Raghav, Aly, Hany, Kadatane, Saurav, Abitbol, Carolyn, Aggarwal, Mihika, Koyner, Jay, Neyra, Javier, and Sethi, Sidharth Kumar
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- 2024
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11. Concurrent use of continuous kidney replacement therapy during extracorporeal membrane oxygenation: what pediatric nephrologists need to know—PCRRT-ICONIC practice points
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Raina, Rupesh, Nair, Nikhil, Pelletier, Jonathan, Nied, Matthew, Whitham, Tarik, Doshi, Kush, Beck, Tara, Dantes, Goeto, Sethi, Sidharth Kumar, Kim, Yap Hui, Bunchman, Timothy, Alhasan, Kahild, Lima, Lisa, Guzzo, Isabella, Fuhrman, Dana, and Paden, Matthew
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- 2024
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12. Point-of-care ultrasound in pediatric nephrology
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Sethi, Sidharth Kumar, Raina, Rupesh, Koratala, Abhilash, Rad, Afagh Hassanzadeh, Vadhera, Ananya, and Badeli, Hamidreza
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- 2023
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13. Prevention of dialysis disequilibrium syndrome in children with advanced uremia with a structured hemodialysis protocol: A quality improvement initiative study.
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Sethi, Sidharth Kumar, Luyckx, Valerie, Bunchman, Timothy, Nair, Aishwarya, Bansal, Shyam Bihari, Pember, Bryce, Soni, Kritika, Savita, Yadav, Dinesh Kumar, Sharma, Vivek, Alhasan, Khalid, and Raina, Rupesh
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SYNDROMES in children , *DIALYSIS (Chemistry) , *HEMODIALYSIS , *UREMIA , *CHILD patients - Abstract
Background: Dialysis disequilibrium syndrome (DDS) is a rare but significant concern in adult and pediatric patients undergoing dialysis initiation with advanced uremia or if done after an interval. It is imperative to gain insights into the epidemiological patterns, pathophysiological mechanisms, and preventive strategies aimed at averting the onset of this ailment. Design: Prospective observational quality improvement initiative cohort study. Setting and Participants: A prospective single‐center study involving 50 pediatric patients under 18 years recently diagnosed with chronic kidney disease stage V with blood urea ≥200 mg/dL, admitted to our tertiary care center for dialysis initiation from January 2017 to October 2023. Quality Improvement Plan: A standardized protocol was developed and followed for hemodialysis in pediatric patients with advanced uremia. This protocol included measures such as lower urea reduction ratios (targeted at 20%–30%) with shorter dialysis sessions and linear dialysate sodium profiling. Prophylactic administration of mannitol and 25% dextrose was also done to prevent the incidence of dialysis disequilibrium syndrome. Measures: Incidence of dialysis disequilibrium syndrome and severe dialysis disequilibrium syndrome, mortality, urea reduction ratios (URRs), neurological outcome at discharge, and development of complications such as infection and hypotension. Long‐term outcomes were assessed at the 1‐year follow‐up including adherence to dialysis, renal transplantation, death, and loss to follow‐up. Results: The median serum creatinine and urea levels at presentation were 7.93 and 224 mg/dL, respectively. A total of 20% of patients had neurological symptoms attributable to advanced uremia at the time of presentation. The incidence of dialysis disequilibrium syndrome was 4% (n = 2) with severe dialysis disequilibrium syndrome only 2% (n = 1). Overall mortality was 8% (n = 4) but none of the deaths were attributed to dialysis disequilibrium syndrome. The mean urea reduction ratios for the first, second, and third dialysis sessions were 23.45%, 34.56%, and 33.50%, respectively. The patients with dialysis disequilibrium syndrome were discharged with normal neurological status. Long‐term outcomes showed 88% adherence to dialysis and 38% renal transplantation. Limitations: This study is characterized by a single‐center design, nonrandomized approach, and limited sample size. Conclusions: Our structured protocol served as a framework for standardizing procedures contributing to low incidence rates of dialysis disequilibrium syndrome. [ABSTRACT FROM AUTHOR]
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- 2024
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14. A young child with fever and unexplained acute kidney injury: Answers
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Sethi, Sidharth Kumar, Nautiyal, Arushi, Rana, Alka, Duggal, Rajan, Nandwani, Ashish, Yadav, Dinesh, Mahapatra, Amit, Dhaliwal, Maninder, Raghunathan, Veena, and Bansal, Shyam Bihari
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- 2018
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15. Switching from continuous veno‐venous hemodiafiltration to intermittent sustained low‐efficiency daily hemodiafiltration (SLED‐f) in pediatric acute kidney injury: A prospective cohort study.
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Sethi, Sidharth Kumar, Raina, Rupesh, Bansal, Shyam Bihari, Soundararajan, Anvitha, Dhaliwal, Maninder, Raghunathan, Veena, Kalra, Meenal, Soni, Kritika, Mahato, Samit Kumar, Vadhera, Ananya, Yadav, Dinesh Kumar, and Bunchman, Timothy
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HEMODIAFILTRATION , *ACUTE kidney failure , *RENAL replacement therapy , *CRITICALLY ill children , *HEPATIC veno-occlusive disease , *PEDIATRIC intensive care , *COHORT analysis - Abstract
Introduction: Continuous kidney replacement therapy (CKRT) is the preferred modality in critically ill children with acute kidney injury. Upon improvement, intermittent hemodialysis is usually initiated as a step‐down therapy, which can be associated with several adverse events. Hybrid therapies such as Sustained low‐efficiency daily dialysis with pre‐filter replacement (SLED‐f) combines the slow sustained features of a continuous treatment, ensuring hemodynamic stability, with similar solute clearance along with the cost effectiveness of conventional intermittent hemodialysis. We examined the feasibility of using SLED‐f as a transition step‐down therapy after CKRT in critically ill pediatric patients with acute kidney injury. Methods: A prospective cohort study was conducted in children admitted to our tertiary care pediatric intensive care units with multi‐organ dysfunction syndrome including acute kidney injury who received CKRT for management. Those patients receiving fewer than two inotropes to maintain perfusion and failed a diuretic challenge were switched to SLED‐f. Results: Eleven patients underwent 105 SLED‐f sessions (mean of 9.55 +/− 4.90 sessions per patient), as a part of step‐down therapy from continuous hemodiafiltration. All (100%) our patients had sepsis associated acute kidney injury with multiorgan dysfunction and required ventilation. During SLED‐f, urea reduction ratio was 64.1 +/− 5.3%, Kt/V was 1.13 +/− 0.1, and beta‐2 microglobulin reduction was 42.5 +/−4%. Incidence of hypotension and requirement of escalation of inotropes during SLED‐f was 18.18%. Filter clotting occurred twice in one patient. Conclusion: SLED‐f is a safe and effective modality for use as a transition therapy between CKRT and intermittent hemodialysis in children in the PICU. [ABSTRACT FROM AUTHOR]
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- 2023
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16. A young child with fever and unexplained acute kidney injury: Questions
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Sethi, Sidharth Kumar, Nautiyal, Arushi, Rana, Alka, Duggal, Rajan, Nandwani, Ashish, Yadav, Dinesh, Mahapatra, Amit, Dhaliwal, Maninder, Raghunathan, Veena, and Bansal, Shyam Bihari
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- 2018
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17. Literature Review of the Efficacy of High-Volume Hemofiltration in Critically Ill Pediatric Patients.
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Bhatt, Girish Chandra, Sethi, Sidharth Kumar, Mehta, Ira, Nair, Nikhil, Chakraborty, Ronith, Sharma, Bhavya, Singh, Siddhartha, Kumar, Nikhita, Gulati, Kabir, and Raina, Rupesh
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CHILD patients , *RENAL replacement therapy , *CRITICALLY ill , *LITERATURE reviews , *BLOOD filtration - Abstract
Background: Pediatric sepsis is a significant public health issue. This condition is exacerbated by rising serum creatinine and inflammatory cytokines that lead to deleterious effects upon the body. The current standard of care involves the use of continuous kidney replacement therapy to remove harmful cytokines until the body returns to homeostasis. In order to promote faster clearance and reduced stay in the ICU, high-volume hemofiltration (HVHF) has shown promise. However, there is a paucity of studies to fully elucidate its benefits. Methods: A literature search was done using PubMed/ MEDLINE and Embase. The literature was reviewed by two independent reviewers, who independently assessed the quality of randomized controlled trials by using the Cochrane risk of bias tool for RCTs and Newcastle-Ottawa Scale (NOS) for assessing the quality of nonrandomized controlled trials. Data were combined from studies with a similar design. Results: The primary endpoint of all-cause mortality was found to be reduced by 40% across all of the pooled studies. For secondary endpoints, significant reductions of serum creatinine were found. Additionally, duration of ICU stays and treatment course was found to be significantly shorter in HVHF patients than the current standard of care. The rate of adverse effects was analyzed, and there was no difference in the proportion of patients developing hypokalemia, hyperkalemia, hypernatremia, or hyponatremia. The proportion of patients developing hyperglycemia was higher in patients undergoing HVHF, whereas the proportions of patients developing bleeding were significantly less in patients undergoing HVHF. One study reported a total number of adverse events between the two groups which were significantly lesser in patients undergoing HVHF. Conclusion: HVHF shows promise as a modality to treat pediatric patients with sepsis. In order to confirm the benefits of this modality, future studies need significantly more patients for analysis. [ABSTRACT FROM AUTHOR]
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- 2022
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18. Perioperative albuminuria and clinical model to predict acute kidney injury in paediatric cardiac surgery.
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Nautiyal, Arushi, Sethi, Sidharth Kumar, Sharma, Rajesh, Raina, Rupesh, Tibrewal, Abhishek, Akole, Romel, Gupta, Aditi, Bhan, Anil, and Bansal, Shyam Bihari
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CARDIAC surgery , *PERIOPERATIVE care , *SCIENTIFIC observation , *CONFIDENCE intervals , *PEDIATRICS , *PHARMACOKINETICS , *RISK assessment , *CARDIOPULMONARY bypass , *ACUTE kidney failure , *ALBUMINURIA , *LONGITUDINAL method , *DISEASE risk factors - Abstract
Background: AKI is an important complication post cardiac surgery in children. An early diagnosis can help in mitigating complications and allow for prognostication. Urinary albumin:creatinine ratio (ACR) as a biomarker can provide a cheaper and more accessible AKI risk assessment and prediction. There is a paucity of paediatric literature regarding its utility. Methods: This was a prospective observational study, enrolling all children aged 1 month to 18 years, who underwent cardiac surgery, with use of cardiopulmonary bypass. Cohort was divided into groups < 2 years and ≥ 2 years for analyses to account for differences in physiological albumin excretion with age. Results: Of 143 children enrolled in the study, 36 developed AKI. In both age groups, the post-operative ACR was higher than pre-operative ACR among patients with and without AKI. In the group aged ≥ 2 years, the highest first post-operative ACR tertile (> 75.8 mg/g) predicted post-operative AKI after adjusting for clinical variables (adjusted RR, 11.71; 1.85–16.59). In the group aged < 2 years, the highest first post-operative ACR tertile (> 141.3 mg/g) predicted post-operative AKI in unadjusted analysis but not after adjusting for clinical variables (RR, 2.78; 0.70–6.65). For AKI risk prediction, AUC (95% CI) was highest after combining clinical model and pre-operative ACR for groups aged < 2 years [0.805 (0.713-0.896)] and ≥ 2 years [0.872 (0.772–0.973)]. Conclusions: This study provides evidence for use of albuminuria as a feasible biomarker in AKI prediction in children post cardiac surgery, especially when added to a clinical model. A higher resolution version of the Graphical abstract is available as Supplementary information. [ABSTRACT FROM AUTHOR]
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- 2022
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19. Dialysis disequilibrium syndrome (DDS) in pediatric patients on dialysis: systematic review and clinical practice recommendations.
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Raina, Rupesh, Davenport, Andrew, Warady, Bradley, Vasistha, Prabhav, Sethi, Sidharth Kumar, Chakraborty, Ronith, Khooblall, Prajit, Agarwal, Nirav, Vij, Manan, Schaefer, Franz, Malhotra, Kunal, and Misra, Madhukar
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DIAGNOSIS of neurological disorders ,NEUROLOGICAL disorder prevention ,ONLINE information services ,COGNITION disorders ,NEUROLOGICAL disorders ,MEDICAL information storage & retrieval systems ,SYSTEMATIC reviews ,PEDIATRICS ,MEDICAL protocols ,NEUROLOGIC manifestations of general diseases ,DESCRIPTIVE statistics ,HEMODIALYSIS ,MEDLINE ,DATA analysis software ,EARLY diagnosis ,SYMPTOMS - Abstract
Background and objectives: Dialysis disequilibrium syndrome (DDS) is a rare neurological complication, most commonly affecting patients undergoing new initiation of hemodialysis (HD), but can also be seen in patients receiving chronic dialysis who miss regular treatments, patients having acute kidney injury (AKI), and in those treated with continuous kidney replacement therapy (CKRT) or peritoneal dialysis (PD). Although the pathogenesis is not well understood, DDS is likely a result of multiple physiological abnormalities. In this systematic review, we provide a synopsis of the data available on DDS that allow for a clear picture of its pathogenesis, preventive measures, and focus on effective management strategies. Methods: We conducted a literature search on PubMed/Medline and Embase from January 1960 to January 2021. Studies were included if the patient developed DDS irrespective of age and gender. A summary table was used to summarize the data from individual studies and included study type, population group, age group, sample size, patient characteristics, blood and dialysate flow rate, and overall outcome. A descriptive analysis calculating the frequency of population size, symptoms, and various treatments was performed using R software version 3.1.0. Results: A total of 49 studies (321 samples) were identified and analyzed. Out of the included 49 studies, a total of 48 studies reported the presence of DSS among patients (1 study reported based on number of dialysis and therefore was not considered for analysis). Among these 48 studies, 74.3% (226/304) patients were reported to have DSS. The most common symptoms were nausea (25.2%), headache (24.8%), vomiting (23.9%), muscle cramps (18.1%), affected level of consciousness (8.8%), confusion (4.4%), and seizure (4.9%) among the 226 DDS patients. Furthermore, 12 studies decided to switch from HD to alternative dialysis modalities including continuous venovenous hemofiltration/hemodiafiltration (CVVH/CVVHDF) or PD which reported no DDS symptoms. Conclusion: Early recognition and timely prevention are crucial for DDS patients. We have provided comprehensive clinical practice points for pediatric, adolescent, and young adult populations. However, it is essential to recognize that DDS was reported more frequently in the early dialysis era, as there was a lack of advanced dialysis technology and limited resources. [ABSTRACT FROM AUTHOR]
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- 2022
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20. A child with chronic kidney disease and hepatic dysfunction: Questions.
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Sethi, Sidharth Kumar, Mohan, Neelam, Rana, Alka, Bagoria, Gaurav, Soni, Kritika, Sharma, Vivek, Nair, Aishwarya, Savita, Savita, Bansal, Shyam Bihari, and Raina, Rupesh
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KIDNEY physiology , *CHRONIC kidney failure , *POLYDIPSIA , *ULTRASONIC imaging , *PEDIATRICS , *DIFFERENTIAL diagnosis , *LIVER diseases , *NEPHROLOGY , *POLYURIA , *FAILURE to thrive syndrome , *CHILDREN - Abstract
A quiz about the case of a 19-month-old girl with chronic kidney disease and hepatic dysfunction is presented.
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- 2023
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21. AGREEing on clinical practice guidelines for idiopathic steroid-sensitive nephrotic syndrome in children.
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Alhasan, Khalid Abdulaziz, Al Khalifah, Reem, Aloufi, Majed, Almaiman, Weiam, Hamad, Muddathir, Abdulmajeed, Naif, Al Salloum, Abdullah, Kari, Jameela A., AlJelaify, Muneera, Bassrawi, Rolan K., Al Hussain, Turki, Alherbish, Adi, Al Talhi, Abdulhadi, Temsah, Mohamad-Hani, Sethi, Sidharth Kumar, Raina, Rupesh, Joseph, Reny, and Amer, Yasser Sami
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NEPHROTIC syndrome ,PEDIATRIC nephrology ,SYNDROMES in children ,BIBLIOGRAPHIC databases ,KIDNEY diseases - Abstract
Background: Nephrotic syndrome is the most common kidney disease in children worldwide. Our aim was to critically appraise the quality of recent Clinical Practice Guidelines (CPGs) for idiopathic steroid-sensitive nephrotic syndrome (SSNS) in children in addition to summarize and compare their recommendations. Methods: Systematic review of CPGs. We identified clinical questions and eligibility criteria and searched and screened for CPGs using bibliographic and CPG databases. Each included CPG was assessed by four independent appraisers using the Appraisal of Guidelines for REsearch & Evaluation II (AGREE-II) instrument. We summarized the recommendations in a comparison practical table. Results: Our search retrieved 282 citations, of which three CPGs were eligible and appraised: Kidney Disease: Improving Global Outcomes (KDIGO) 2012, Japan Society for Pediatric Nephrology (JSPN) 2014, and American Academy of Pediatrics (AAP) 2009. Among these, the overall assessment of two evidence-based CPGs scored > 70% (KDIGO and JSPN), which was consistent with their higher scores in the six domains of the AGREE II Instrument. In domain 3 (rigor of development), KDIGO, JSPN, and AAP scored 84%, 74%, and 41%, respectively. In domain 5 (applicability), they scored 22%, 16%, and 19%, respectively, and in domain 6 (editorial independence), they scored 94%, 65%, and 88%, respectively. Conclusions: The methodological quality of the KDIGO CPG was superior, followed by JSPN and AAP CPGs with the relevant recommendations for use in practice. Systematic review registration: The protocol was registered in the Center for Open Science (OSF) DOI: 10.17605/OSF.IO/6QTMD and in the International prospective register of systematic reviews PROSPERO 2020 CRD42020197511. [ABSTRACT FROM AUTHOR]
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- 2021
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22. Challenges of long‐term vascular access in pediatric hemodialysis: Recommendations for practitioners.
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Raina, Rupesh, Joshi, Hirva, Chakraborty, Ronith, and Sethi, Sidharth Kumar
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SURGICAL arteriovenous shunts ,HOME hemodialysis ,CENTRAL venous catheters ,CHRONIC kidney failure ,HEMODIALYSIS ,ARTERIOVENOUS fistula - Abstract
Kidney transplantation is the preferred treatment of end‐stage renal disease in children. However, time to transplant varies, making a well‐functioning long‐term vascular access essential for performing hemodialysis efficiently and without disruption until a kidney becomes available. However, establishing long‐term vascular access in pediatric patients can present distinct challenges due to this population's unique characteristics, such as smaller body size and lower‐diameter blood vessels. There are three main pediatric long‐term vascular access options, which include central venous catheters (CVC), arteriovenous fistula (AVF), and arteriovenous graft (AVG). CVC are currently the most widely used modality, although various studies and guidelines recommend AVF or AVG as the preferred option. Although AVF should be used whenever possible, it is crucial that clinicians consider factors such as patient size, physical exam findings, comorbidities, predicted duration of treatment to decide on the most optimal long‐term vascular access modality. This article reviews the three long‐term vascular access methods in children and the benefits and complications of each. [ABSTRACT FROM AUTHOR]
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- 2021
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23. Renal replacement therapy in the management of intoxications in children: recommendations from the Pediatric Continuous Renal Replacement Therapy (PCRRT) workgroup.
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Raina, Rupesh, Grewal, Manpreet K, Blackford, Martha, Symons, Jordan M., Somers, Michael J. G., Licht, Christoph, Basu, Rajit K, Sethi, Sidharth Kumar, Chand, Deepa, Kapur, Gaurav, McCulloch, Mignon, Bagga, Arvind, Krishnappa, Vinod, Yap, Hui-Kim, de Sousa Tavares, Marcelo, Bunchman, Timothy E, Bestic, Michelle, Warady, Bradley A, and de Ferris, Maria Díaz-González
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ACETAMINOPHEN ,AMINOGLYCOSIDES ,BARBITURATES ,CARBAMAZEPINE ,INFORMATION storage & retrieval systems ,MEDICAL databases ,MEDICAL information storage & retrieval systems ,KIDNEY diseases ,MEDICAL protocols ,MEDLINE ,METHOTREXATE ,NEPHROTOXICOLOGY ,ONLINE information services ,PEDIATRICS ,PHENYTOIN ,POISONING ,SALICYLATES ,THEOPHYLLINE ,THERAPEUTICS ,VALPROIC acid ,VANCOMYCIN ,SYSTEMATIC reviews ,LITHIUM compounds ,METFORMIN - Abstract
Background: Intentional or unintentional ingestions among children and adolescents are common. There are a number of ingestions amenable to renal replacement therapy (RRT). Methods: We systematically searched PubMed/Medline, Embase, and Cochrane databases for literature regarding drugs/intoxicants and treatment with RRT in pediatric populations. Two experts from the PCRRT (Pediatric Continuous Renal Replacement Therapy) workgroup assessed titles, abstracts, and full-text articles for extraction of data. The data from the literature search was shared with the PCRRT workgroup and two expert toxicologists, and expert panel recommendations were developed. Results and Conclusions: We have presented the recommendations concerning the use of RRTs for treatment of intoxications with toxic alcohols, lithium, vancomycin, theophylline, barbiturates, metformin, carbamazepine, methotrexate, phenytoin, acetaminophen, salicylates, valproic acid, and aminoglycosides. [ABSTRACT FROM AUTHOR]
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- 2019
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24. Prolonged intermittent renal replacement therapy in children.
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Sinha, Rajiv, Sethi, Sidharth Kumar, Bunchman, Timothy, Lobo, Valentine, and Raina, Rupesh
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BLOOD filtration , *HEMODIALYSIS , *HEMODYNAMICS , *INTENSIVE care units , *KIDNEY diseases , *PEDIATRICS , *PERITONEAL dialysis , *THERAPEUTICS , *TREATMENT duration ,TREATMENT of acute kidney failure - Abstract
Wide ranges of age and weight in pediatric patients makes renal replacement therapy (RRT) in acute kidney injury (AKI) challenging, particularly in the pediatric intensive care unit (PICU), wherein children are often hemodynamically unstable. Standard hemodialysis (HD) is difficult in this group of children and continuous veno-venous hemofiltration/dialysis (CVVH/D) has been the accepted modality in the developed world. Unfortunately, due to cost constraints, CVVH/D is often not available and peritoneal dialysis (PD) remains the common mode of RRT in resource-poor facilities. Acute PD has its drawbacks, and intermittent HD (IHD) done slowly over a prolonged period has been explored as an alternative. Various modes of slow sustained IHD have been described in the literature with the recently introduced term prolonged intermittent RRT (PIRRT) serving as an umbrella terminology for all of these modes. PIRRT has been widely accepted in adults with studies showing it to be as effective as CVVH/D but with an added advantage of being more cost-effective. Pediatric data, though scanty, has been promising. In this current review, we elaborate on the practical aspects of undertaking PIRRT in children as well as summarize its current status. [ABSTRACT FROM AUTHOR]
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- 2018
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25. Pediatric ABO‐incompatible kidney transplantation: Evolving with the advancing apheresis technology: A single‐center experience.
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Sethi, Sidharth Kumar, Bansal, Shyam Bihari, Wadhwani, Nikita, Tiwari, Aseem, Arora, Dinesh, Sharma, Reetesh, Nandwani, Ashish, Yadav, Dinesh Kumar, Mahapatra, Amit Kumar, Jain, Manish, Jha, Pranaw, Ghosh, Prasun, Bhan, Anil, Dhaliwal, Maninder, Raghunathan, Veena, and Kher, Vijay
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BLOOD group incompatibility , *ABO blood group system , *HEMAPHERESIS , *GRAFT rejection - Abstract
Abstract: Recent literature has endorsed favorable outcomes following ABOi kidney transplantation in pediatric population. Nevertheless, reluctance to pursue an ABOi still remains pervasive. This could be ascribed to various legitimate reasons, namely less extensive pediatric ABOi data, technical difficulties encountered during PP, cost restraints, and concerns regarding higher rates of antibody‐mediated rejection, infectious complications, and post‐transplant lymphoproliferative disorder as compared to adults. However, given the similar excellent outcomes of both ABOi and ABOc kidney transplantation, clinicians should consider this option sooner if a compatible donor or swap is not available. Here, we describe the outcomes of three pediatric ABOi performed at our institute in India (from 2014 till now), wherein distinct apheresis modalities had been employed in each desensitization protocol, and our techniques evolved with advancing science in apheresis. This case series includes India's first published pediatric ABO‐incompatible transplant (Case 2) and the youngest child to undergo ABO‐incompatible renal transplant in SAARC nations (Case 3). [ABSTRACT FROM AUTHOR]
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- 2018
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26. Heparin free dialysis in critically sick children using sustained low efficiency dialysis (SLEDD-f): A new hybrid therapy for dialysis in developing world.
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Sethi, Sidharth Kumar, Bansal, Shyam B., Khare, Anshika, Dhaliwal, Maninder, Raghunathan, Veena, Wadhwani, Nikita, Nandwani, Ashish, Yadav, Dinesh Kumar, Mahapatra, Amit Kumar, and Raina, Rupesh
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HEPARIN , *HEMODIALYSIS , *CHILD patients , *HEMODYNAMICS , *ACQUISITION of data - Abstract
Background: In critically sick adults, sustained low efficiency dialysis [SLED] appears to be better tolerated hemodynamically and outcomes seem to be comparable to CRRT. However, there is paucity of data in critically sick children. In children, two recent studies from Taiwan (n = 11) and India (n = 68) showed benefits of SLED in critically sick children. Aims and objectives: The objective of the study was to look at the feasibility and tolerability of sustained low efficiency daily dialysis-filtration [SLEDD-f] in critically sick pediatric patients. Material and methods: Design: Retrospective study Inclusion criteria: All pediatric patients who had undergone heparin free SLEDD-f from January 2012 to October 2017. Measurements: Data collected included demographic details, vital signs, PRISM III at admission, ventilator parameters (where applicable), number of inotropes, blood gas and electrolytes before, during, and on conclusion of SLED therapy. Technical information was gathered regarding SLEDD-f prescription and complications. Results: Between 2012–2017, a total of 242 sessions of SLEDD-f were performed on 70 patients, out of which 40 children survived. The median age of patients in years was 12 (range 0.8–17 years), and the median weight was 39 kg (range 8.5–66 kg). The mean PRISM score at admission was 8.77±7.22. SLEDD-f sessions were well tolerated, with marked improvement in fluid status and acidosis. Premature terminations had to be done in 23 (9.5%) of the sessions. There were 21 sessions (8.6%) terminated due to hypotension and 2 sessions (0.8%) terminated due to circuit clotting. Post- SLEDD-f hypocalcemia occurred in 15 sessions (6.2%), post- SLEDD-f hypophosphatemia occurred in 1 session (0.4%), and post- SLEDD-f hypokalemia occurred in 17 sessions (7.0%). Conclusions: This study is the largest compiled data on pediatric SLEDD-f use in critically ill patients. Our study confirms the feasibility of heparin free SLEDD-f in a larger pediatric population, and even in children weighing <20 kg on inotropic support. [ABSTRACT FROM AUTHOR]
- Published
- 2018
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27. 'Virtual pediatric renal grand rounds': an innovative E-learning
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Sethi, Sidharth Kumar and Singla, Shilpa
- Subjects
Pediatrics ,Continuing medical education ,Health ,Twitter (Online service) - Abstract
Sirs, With the availability of the newer web tools in Web 3.0, such as Blogs, Wikis, Twitter and Podcasts, physicians are able to interact and disseminate vital information to fellow [...]
- Published
- 2011
28. Treatment of AKI in developing and developed countries: An international survey of pediatric dialysis modalities.
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Raina, Rupesh, Chauvin, Abigail M., Bunchman, Timothy, Askenazi, David, Deep, Akash, Ensley, Michael J., Krishnappa, Vinod, and Sethi, Sidharth Kumar
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TREATMENT of acute kidney failure ,HEMODIALYSIS ,PEDIATRICS ,HEALTH surveys ,CAUSES of death ,DISEASE incidence ,DEVELOPED countries - Abstract
Hypothesis: Acute kidney injury (AKI) is a common cause of morbidity and mortality worldwide, with a pediatric incidence ranging from 19.3% to 24.1%. Treatment of pediatric AKI is a source of debate in varying geographical regions. Currently CRRT is the treatment for pediatric AKI, but limitations due to cost and accessibility force use of adult equipment and other therapeutic options such as peritoneal dialysis (PD) and hemodialysis (HD). It was hypothesized that more cost-effective measures would likely be used in developing countries due to lesser resource availability. Methods: A 26-question internet-based survey was distributed to 650 pediatric Nephrologists. There was a response rate of 34.3% (223 responses). The survey was distributed via pedneph and pcrrt email servers, inquiring about demographics, technology, resources, pediatric-specific supplies, and preference in renal replacement therapy (RRT) in pediatric AKI. The main method of analysis was to compare responses about treatments between nephrologists in developed countries and nephrologists in developing countries using difference-of-proportions tests. Results: PD was available in all centers surveyed, while HD was available in 85.1% and 54.1% (p = 0.00), CRRT was available in 60% and 33.3% (p = 0.001), and SLED was available in 20% and 25% (p = 0.45) centers of developed and developing world respectively. In developing countries, 68.5% (p = 0.000) of physicians preferred PD to costlier therapies, while in developed countries it was found that physicians favored HD (72%, p = 0.00) or CRRT (24%, p = 0.041) in infants. Conclusions: Lack of availability of resources, trained physicians and funds often preclude standards of care in developing countries, and there is much development needed in terms of meeting higher global standards for treating pediatric AKI patients. PD remains the main modality of choice for treatment of AKI in infants in developing world. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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29. Pediatric renal transplant practices in India.
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Sethi, Sidharth Kumar, Sinha, Rajiv, Rohatgi, Smriti, Kher, Vijay, Iyengar, Arpana, and Bagga, Arvind
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- *
KIDNEY transplantation , *MEDICAL care , *IMMUNOSUPPRESSIVE agents , *PEDIATRICS , *NEPHROLOGISTS - Abstract
Limited access to tertiary-level health care, limited trained pediatric nephrologists and transplant physicians, lack of facilities for dialysis, lack of an effective deceased donor program, non-affordability, and non-adherence to immunosuppressant drugs poses a major challenge to universal availability of pediatric transplantation in developing countries. We present the results of a survey which, to the best of our knowledge, is the first such published attempt at understanding the current state of pediatric renal transplantation in India. A designed questionnaire formulated by a group of pediatric nephrologists with the aim of understanding the current practice of pediatric renal transplantation was circulated to all adult and pediatric nephrologists of the country. Of 26 adult nephrologists who responded, 16 (61.5%) were involved in pediatric transplantation, and 10 of 15 (66.6%) pediatric nephrologists were involved in pediatric transplantation. Most of the centers doing transplants were private/trust institution with only three government institutions undertaking it. Induction therapy was varied among pediatric and adult nephrologists. There were only a few centers (n=5) in the country routinely doing >5 transplants per year. Preemptive transplants and protocol biopsies were a rarity. The results demonstrate lower incidence of undertaking pediatric transplants in children below 6 years, paucity of active cadaveric programs and lack of availability of trained pediatric nephrologists and staff. In contrast to these dissimilarities, the immunosuppressant use seems to be quite similar to Western registry data with majority favoring induction agent and triple immunosuppressant (steroid, mycophenolate mofetil and tacrolimus) for maintenance. The survey also identifies major concerns in availability of this service to all regions of India as well as to all economic segments. [ABSTRACT FROM AUTHOR]
- Published
- 2017
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30. Pediatric Lung Transplantation: Indications and Outcomes
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Werner, Raphael, Benden, Christian, Shapiro, Ron, editor, Sarwal, Minnie M., editor, Raina, Rupesh, editor, and Sethi, Sidharth Kumar, editor
- Published
- 2023
- Full Text
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31. Immunosuppression after Liver Transplantation in Pediatric Population
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Umman, Veysel, Zeytunlu, Murat, Emre, Sukru, Shapiro, Ron, editor, Sarwal, Minnie M., editor, Raina, Rupesh, editor, and Sethi, Sidharth Kumar, editor
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- 2023
- Full Text
- View/download PDF
32. A child with mental retardation and asymmetrical hypertrophy of limbs.
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Sethi, Sidharth Kumar, Yadav, Dinesh, Garg, Parvesh, Chawla, Jyoti, and Goyal, Deepak
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INTELLECTUAL disabilities , *HYPERTROPHY , *EXTREMITIES (Anatomy) , *JUVENILE diseases , *PEDIATRICS , *DIFFERENTIAL diagnosis , *PEOPLE with intellectual disabilities , *HYPERPIGMENTATION , *PROTEUS syndrome , *DIAGNOSIS - Abstract
A 5-year-old male child presented with progressively increasing asymmetrical overgrowth of limbs, hyperpigmentation on the right half of the body, and mental retardation since 9 months of age. [ABSTRACT FROM AUTHOR]
- Published
- 2011
- Full Text
- View/download PDF
33. POWERPOINT PRESENTATION SHARING FOR PEDIATRICIANS!
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Sethi, Sidharth Kumar
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WEB portals ,PEDIATRICS ,COMPUTER network resources - Abstract
The article recommends several PowerPoint sharing portals to pediatricians including Slideshare at http://www.slideshare.net/, MyPlick at http://www.myplick.com/, and Zentation at http://zentation.com/.
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- 2010
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34. Defining Acute Kidney Injury in Children
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Sutherland, Scott M., Sethi, Sidharth Kumar, editor, Raina, Rupesh, editor, McCulloch, Mignon, editor, and Bunchman, Timothy E., editor
- Published
- 2021
- Full Text
- View/download PDF
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