Environmental factors might be responsible for the astonishing prevalence of chronic kidney disease in the region of Uddanam (Andhra Pradesh state, India), which accounts for 24% of the population and 45% of the causes of death. We should all be involved and help study this phenomenal situation because similar circumstances may be present now in other parts of the world, and more could arise in the future. First, the quality of water should be improved.
I'm 58 and at stage 4. I have no intention of going on Dialysis. I do not want to die in the hospital and dialysis is only good for waiting for a kidney. Until I get someone to give e an accurate percentage of my chances of survival receiving a kidney from a non-family member who is my blood type and tissue type. I will not go on dialysis. So far I cannot get the truth out of a doctor, so I am forced to get info on the net which is dubious and I am not educated unfortunately. My understanding, so far, is that my chances of living with a strangers kidney is very low and I may die on the table. Until I get the info I need I am leaning toward conservative care, but I have no idea where to get such care.
An extensive review on renal path, particularly explaining the subtle changes such as mesangial hypercellularity, and endocapillary proliferation and lupus podocytopathy - an excellent review by Prof Ritambhara
Good afternoon sir, waiting for your lectures since 1-2 years now. Please continue teaching us with your informative lectures. Thank you Regards: Dr. Paike Nilrohit MD DM Nephro. Consultant nephrologist and transplant physician, Solapur, Maharashtra
Great presentation, and the chapters listed above - EXCELLENT. Your knowledge is brilliant. I had my living donor in 1981, going on 40+ now. At that time, I was told our HLA match was 75-80% match and transplant was acceptable. Being in 1981, we felt that in London, Hammersmith Hospital (Imperial College) had one of the best renal units in the UK. \the kidney had seen start in theatre, but thereafter it stopped for 2 weeks and needed dialysis support. Had ONE rejection episode in 2 months time, managed with high dose IV methylprednisolone and since then my renal function has been excellent. I am ONLY taking prednisolone 10mg daily because in 1981 we only had azathioprine + prednisone regime; however, I was unable to make any red blood cells (complete bone marrow toxicity). The only other option was cyclophosphamide, as even cyclosporin was not available in 1981, but was not making any white cells and was in isolation for 6-8 weeks. As my renal function was great, they had to try prednisolone only. This has worked really well. I wanted to ask what do you think may have happened? A blood test between me and my brother showed no activity, indicating no antibodies against the transplant. How can this be with a 75% match? Prior to the transplant, they gave me 2 units of my brothers blood, to try and get 'used to' the kidney. Do you think thiis was a factor and do you do this currently? I would be very grateful for some insight. Many thanks Vivek Jha.
I wish I had come across this sort of video in nephrology training years , spent so much time trying to understand on my own.Excellent lecture 👏🏻👏🏻 Thank you Jha sir and Nada madam .
Good stuff. My final exam for my Clinical Nutrition Master degree was Paediatric Dietetics, and I drew cases with AKI and CKD, and watching this helped alot.
Thanks to Dr. Gbenga on RU-vid for his herbal medicine which cured me of Hepatitis A after series of medication which produces no result, since April 2, 2021 I have been cured completely.
I m Dr.D.Prabhakar, consultant nephrologist and transplant physician at Sraddha Hospital Visakhapatnam, Andhra Pradesh It is a great learning platform and thank you all for the in depth discussion about evidence based medicine in treatment of COVID patients. Special regards to Prof. Vivekanand Jha sir for organizing such a session. i have admitted and treated at least 80 patients, including 5 post kidney transplant patients in COVID first wave and followed evidence based medicine regarding dexamethasone dose and timing of initiation ( recovery trial) and also dose and timing of Remidisvir which showed exemplary results. Only 2 of all admitted patients (none from transplanted patients) died (one patient had alzheimer's dementia and other had COPD). However in wave 2, the scenario is different. Initially i followed what i did in wave one, however the results are not good when compared to wave one. The clinical presentation like late onset cytokine storm in some patients and in some patients rapid worsening of lung infilrates which i rarely saw in wave one troubled me a lot this time. As i didn't have access to other drugs mentioned in management of COVID (toclizumab), i escalated steroid dose in some patients and saw positive results. This time i treated ten post kidney transplant patients (40 non kidney transplant patients) with 12 mg dexamethasone and with holding anti metabolite. 8 out of 10 responded and discharged and in rest 2 there was a need to escalate steroids and i lost one patient. So, do u suggest to apply EBM which was observed in wave one also in second wave, especially in centers where access to other mentioned drugs is limited? thank you.
Great lecture sir! I have a doubt. In a patient who comes with heart failure and hyponatremia, how do we determine if the low na is because of frusemide or due to the cardiac failure itself. How much will the urine na help here? Even if the primary pathology was the heart failure, the urine na would be more than 20 because of the frusemide, which will confound our picture!
