Search

Your search keyword '"Kher, V."' showing total 488 results
Start Over Author "Kher, V."
488 results on '"Kher, V."'

8. Chronic Kidney Disease of Unknown Etiology in India: What Do We Know and Where We Need to Go

Author

John, O, Gummudi, B, Jha, A, Gopalakrishnan, N, Kalra, OP, Kaur, P, Kher, V, Kumar, V, Machiraju, RS, Osborne, N, Palo, SK, Parameswaran, S, Pati, S, Prasad, N, Rathore, V, Rajapurkar, MM, Sahay, M, Tatapudi, RR, Thakur, JS, Venugopal, V, Jha, V, John, O, Gummudi, B, Jha, A, Gopalakrishnan, N, Kalra, OP, Kaur, P, Kher, V, Kumar, V, Machiraju, RS, Osborne, N, Palo, SK, Parameswaran, S, Pati, S, Prasad, N, Rathore, V, Rajapurkar, MM, Sahay, M, Tatapudi, RR, Thakur, JS, Venugopal, V, and Jha, V

Abstract

Chronic kidney disease (CKD) not associated with known risk factors has been reported from parts of India and is presumed to be similar to CKD of unknown etiology (CKDu) that has been described from Central America. The reports from India have been fragmented without clear description of the disease phenotype or its determinants. This paper summarizes the current state of knowledge around CKDu in India based on a review of literature, multi-stakeholder consultation, and a survey of Indian nephrologists. We also contacted individual research groups to solicit data. Our findings suggest that that CKDu is reported from most regions in India; however, it is interpreted differently from the phenotype described from Central America and Sri Lanka. The differences include lack of a clear demographic or occupation group, older age of affected participants, and presence of mild hypertension and low-grade proteinuria. Well-designed prospective field studies with appropriate diagnostic workup are needed to establish the disease burden and identify etiologies, along with socioeconomic and health consequences, the intersection with the environment, and the public health response. Community-based research should phenotype the entire CKD population rather than be restricted to cases with presumed CKDu based on predefined criteria. Guidelines are needed for clinical evaluation, referral, management, and harmonization of clinical documentation and health records. More data are needed to support the existence of a unique CKDu phenotype in India.

Published
2021

19. Haemodialysis vascular access: current practices amongst Indian nephrologists

Author

Bansal, D, Kher, V, Gupta, KL, Banerjee, D, and Jha, V

Abstract

INTRODUCTION: Despite the growing number of haemodialysis (HD) patients in India, little is known about vascular access practice. We investigated the use and cost of different vascular accesses by Indian nephrologists. METHODS: An online survey was emailed to 920 Indian nephrologists and 388 (42.1%) responded; 98.5% of whom were responsible for managing dialysis patients, 98% in hospitals. RESULTS: Sixty-four percent of patients initiated renal replacement therapy with HD, 7% with peritoneal dialysis, 10% kidney transplantation and 19% conservative care. Forty-eight percent of patients were self-paying, 26% had employee reimbursement and 23% had insurance. According to 59% of responders, more than three-quarters of patients started dialysis with uncuffed catheter, less than one-quarter started dialysis with fistula; and very few used grafts or tunnelled catheters. Among prevalent HD patients, over half were dialysing with fistula (79% nephrologists), rather than uncuffed catheters (15% nephrologists) or grafts (

Published
2018

23. MULTIDISCIPLINARY CONSENSUS ON THE MANAGEMENT OF UNCONTROLLED HYPERTENSION IN INDIA

Author

Es, S., primary, Fulmali, S., additional, Singh, R. Gopal, additional, Unni, G., additional, Padmanabhan, R., additional, Desai, B., additional, Hiremath, S.K., additional, Jain, V., additional, Bhawal, S., additional, Gulati, S., additional, Shete, M., additional, Nair, R., additional, Prakash, S., additional, Bhattacharya, B., additional, and Kher, V., additional

Published
2018
Full Text
View/download PDF

45. Successful Renal Transplantation Across HLA Barrier: Report from India.

Author

Aggarwal, G., Tiwari, A. K., Dorwal, P., Chauhan, R., Arora, D., Dara, R. C., and Kher, V.

Abstract

Organ donors are sometimes found "unsuitable" due to the presence of donor-specific anti-HLA antibodies in the recipient. In recent years, improved desensitization protocols have successfully helped to overcome HLA incompatibility hurdle. We present three cases where optimum desensitization was achieved in patients with the donor-specific anti-HLA antibody (DSA) leading to successful renal transplantation. All patient--donor pair underwent HLA typing, complement dependent cytotoxicity crossmatch (CDC-XM), flow cytometry XM (FC-XM), and panel reactive antibody. If any of the three tests was positive, single antigen bead assay was performed to determine the specificity of the anti-HLA antibody (s). Patients with DSA were offered organ-swap or anti-HLA antibody desensitization followed by transplantation. Desensitization protocol consisted of single dose rituximab and cascade plasmapheresis (CP) along with standard triple immunosuppression. The target DSA mean fluorescence index (MFI) was <500, along with negative CDC-XM and FC-XM for both T- and B-cells. Three patients with anti-HLA DSA, who did not find a suitable match in organ swap program, consented to anti-HLA antibody desensitization, followed by transplantation. Mean pre-desensitization antibody MFI was 1740 (1422-2280). Mean number of CP required to achieve the target MFI was 2.3 (2-3). All the three patients are on regular follow-up and have normal renal function test at a mean follow-up of 8 months. This report underlines successful application of desensitization protocol leading to successful HLA-antibody incompatible renal transplants and their continued normal renal functions. [ABSTRACT FROM AUTHOR]

Published
2017
Full Text
View/download PDF

46. Targeting renin-angiotensin system in malignant hypertension in atypical hemolytic uremic syndrome.

Author

Raghunathan, V., Sethi, S. K., Dragon-Durey, M. A., Dhaliwal, M., Raina, R., Jha, P., Bansal, S. B., and Kher, V.

Abstract

Hypertension is common in hemolytic uremic syndrome (HUS) and often difficult to control. Local renin-angiotensin activation is believed to be an important part of thrombotic microangiopathy, leading to a vicious cycle of progressive renal injury and intractable hypertension. This has been demonstrated in vitro via enhanced tissue factor expression on glomerular endothelial cells which is enhanced by angiotensin II. We report two pediatric cases of atypical HUS with severe refractory malignant hypertension, in which we targeted the renin-angiotensin system by using intravenous (IV) enalaprilat, oral aliskiren, and oral enalapril with quick and dramatic response of blood pressure. Both drugs, aliskiren and IV enalaprilat, were effective in controlling hypertension refractory to multiple antihypertensive medications. These appear to be promising alternatives in the treatment of severe atypical HUS-induced hypertension and hypertensive emergency. [ABSTRACT FROM AUTHOR]

Published
2017
Full Text
View/download PDF

Catalog

Books, media, physical & digital resources
See catalog results