PubMed Health⌕ Search

Biomedical subjects

K S Chugh

Publications and source records attributed to K S Chugh.

At least 91 records · Page 5Linked to original sources
PubMed1990

Acute renal failure due to leukaemic infiltration of kidneys.

Three patients with acute lymphatic leukaemia who presented with non-oliguric acute renal failure resulting from leukaemic infiltration of the kidneys are reported. Chemotherapy resulted in clinical remission of leukaemia with regression of renal size and prompt improvement in renal function in two cases. The third patient died on the second day of therapy and a post-mortem renal biopsy revealed dense leukaemic infiltration of the kidneys. Early institution of specific chemotherapy for leukaemia, maintenance of fluid and electrolyte balance, and dialytic support whenever indicated may prove helpful in prevention of serious complications associated with renal failure and in halting further ischaemic injury to the kidney.

Acute Kidney Injury↗
PubMed1989

Snake-bite-induced acute renal failure in India.

Acute renal failure complicates the course in 5% to 30% of victims of severe viper poisoning. No consensus exists on the single mechanism causing acute renal failure after viper bite. It is known, however, that viper venom induces several clinical abnormalities that favor the development of acute renal failure. These alterations include a varying degree of bleeding, hypotension, circulatory collapse, intravascular hemolysis, and disseminated intravascular coagulation with or without microangiopathy. A direct cytotoxic action of snake venom on the kidney is suspected, but convincing evidence is still lacking. Severe hypocomplementemia is consistently present, but I doubt its role in the causation of renal lesions. Hypersensitivity to venomous or antivenomous protein occasionally causes acute renal failure. In sea snake poisoning, myonecrosis and myoglobinuria appear to play the predominant pathogenetic role. The renal lesions of clinical significance in envenomed patients are acute tubular and patchy or diffuse cortical necrosis. Glomerulonephritis, interstitial nephritis, and papillary necrosis have been reported in rare patients. I trust that this overview of the clinical and basic-science aspects of snake-bite-induced acute renal failure will prompt investigators to further define the pathogenetic mechanisms involved. Lessons learned may aid patients with acute renal failure of diverse causes, both here in India and around the world.

Acute Kidney Injury↗
PubMed1989

Acute renal failure in infants in the tropics.

This study records our experience with 40 infants who developed acute renal failure in a tropical environment over a period of 2 years. All the patients required intermittent peritoneal dialysis. Septicaemia (88%) and acute gastroenteritis (55%) constituted the leading causes of acute renal failure. Haemolytic uraemic syndrome was present in six (18%) patients. An elevated serum creatinine (85%), metabolic encephalopathy (75%), uncompensated metabolic acidosis (75%) and hyperkalaemia (48%) were the major indications for dialysis, while fluid overload was present in only 18% of the infants. Intermittent peritoneal dialysis was used in all the patients and was found to be effective. Procedural complications were minor and infrequently encountered. The clinical course and laboratory data consistent with haemolytic uraemic syndrome was observed in six patients, and acute tubular necrosis was the predominant renal lesion in the remainder. Mortality was 75%. The aetiology of acute renal failure in infants in the tropics differs significantly from that in the West, and even within a given country marked regional variations exist.

Acute Kidney Injury↗
PubMed1989

Factitious haematuria. A report of two cases.

Two patients who presented with recurrent gross haematuria are described. Both underwent extensive invasive investigations including renal biopsies before it was discovered that they had factitious haematuria produced by contaminating urine with blood from self inflicted skin wounds.

Adolescent↗
PubMed1989

Changing trends in acute renal failure in third-world countries--Chandigarh study.

The pattern of acute renal failure in third-world countries is changing albeit at a slower pace compared to that in developed countries. Of the 1862 patients with acute renal failure requiring dialysis between 1965 and 1986 in a north Indian centre, 60, 15 and 25 per cent were related to medical, obstetrical and surgical conditions respectively. Among the medical patients, diarrhoeal diseases which caused 23 per cent of the total number of cases of acute renal failure in the period 1965 to 1974 caused only 10 per cent in 1981 to 1986. In the same period, acute renal failure due to sepsis and drugs increased while that due to copper sulphate poisoning and intravascular haemolysis showed a downward trend. Obstetrical acute renal failure declined from 22 per cent in 1965 to 1974 to 9 per cent during the period 1981 to 1986. This decline was chiefly due to a fall in cases of septic abortion, puerperal sepsis and postpartum haemorrhage. Surgical acute renal failure increased from 11 per cent during the period 1965 to 1974 to 31 per cent in the 1980s, predominantly due to an increase in patients with obstructive uropathy. Despite these favourable trends, the pattern of acute renal failure in the third world continues to be different from that in the developed countries.

Acute Kidney Injury↗
PubMed1989

Upper gastro-intestinal mucosal changes in patients with chronic renal failure.

A prospective study was undertaken to determine the radiological, endoscopic and histological changes of upper gastro-intestinal mucosa in patients with end-stage renal failure and the effect of haemodialysis. Of the 30 patients studied, 28 (93%) had presented with upper gastrointestinal symptoms. Abnormal findings on upper gastrointestinal endoscopy were observed in 66.7% patients. These comprised oesophagitis (23.3%) gastritis (30%), duodenitis (33.3%) and peptic ulcer (6.7%). Histological study of the mucosal tissue biopsy in 24 patients showed oesophagitis, gastritis and duodenitis in 12.5%, 45.8% and 37.5% respectively. Ten patients were re-evaluated after institution of haemodialysis therapy for a minimum of one month. Though there was a significant improvement in gastrointestinal symptoms (p less than 0.05), there was no effect on endoscopic changes. The study documents a high incidence of mucosal inflammatory changes rather than that of ulcer disease in chronic renal failure.

Adolescent↗
PubMed1989

Nephropathy in type 2 diabetes mellitus in Third World countries--Chandigarh study.

We studied the profile of nephropathy in 250 patients, 177 males and 73 females, with type 2 diabetes mellitus. The mean age was 55.9 +/- 8.8 years. Therapy for control of diabetes included diet alone in 1.6%, oral hypoglycaemic agents in 90.6% and insulin in 7.8%. Glycaemic control was satisfactory in 4.8%, fair in 41.2% and poor in 54.0%. Blood sugar values were normal without any therapy in 33 out of the 206 patients (16%) after the onset of renal insufficiency. The mean interval between the onset of diabetes and the appearance of proteinuria was 9.5 +/- 7.05 years. Proteinuria appeared within one year in 23 patients (9.2%), 1-5 years in 32 (12.8%), 6-10 years in 86 (34.4%) and more than 10 years in the remaining 109 patients (43.6%). Proteinuria was of nephrotic range in 17.6% of patients. Renal insufficiency was present in 206 (82.4%) patients and occurred 10.5 +/- 7.5 years after the detection of diabetes. Hypertension was present in 61.2% and was first detected 7.5 +/- 7.4 years after onset of diabetes. Endstage renal disease occurred 11.8 +/- 6.8 years after the onset of diabetes mellitus. Thus, clinical evidence of diabetic nephropathy is present in most patients with type 2 diabetes mellitus within a decade after the detection of diabetes. Subsequent progression to end-stage renal failure is rapid in the face of poorly controlled hypertension and hyperglycemia in the economically poor countries.

Adult↗
PubMed1988

Cyclophosphamide in renal transplantation.

Success in renal transplantation is now largely dependent on safe and effective immunosuppression. Nonspecific immunosuppression by chemical agents continues to be the mainstay of clinical immunosuppression. Azathioprine and prednisolone have remained the two main drugs used in combination in standard immunosuppressive therapy in renal transplantation for many years. Although cyclophosphamide (CP) was tried in the early years of transplantation, enthusiasm for its use was dampened by the advent of newer agents. We have analyzed our experience with 29 recipients of living-related donor (LRD) renal allotransplantation on cyclophosphamide therapy. Cyclophosphamide is a safe and effective alternative to azathioprine in clinical renal allotransplantation. Due to its easy availability and the fact that it is a cheaper alternative to azathioprine and cyclosporine, it is more significant for developing countries.

Adult↗
PubMed1988

Acute renal failure following multiple hornet stings.

Five patients who developed acute renal failure due to acute tubular necrosis following multiple hornet (Vespa orientalis) stings are described. All of them had intravascular hemolysis. Evidence for rhabdomyolysis was present in 2 patients. Two patients had elevated transaminase and alkaline phosphatase levels and in 1 of these, liver biopsy showed centrilobular necrosis. Two patients had thrombocytopenia in the absence of disseminated intravascular coagulation. Two patients died of infections while the remaining 3 recovered completely. Acute renal failure following multiple hornet stings appears to result mainly from intravascular hemolysis or rhabdomyolysis although a direct nephrotoxic effect of venom cannot be excluded.

Acute Kidney Injury↗