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Article ; Online: Frailty in end stage renal disease: Current perspectives.

Nagaraju, Shankar Prasad / Shenoy, Srinivas Vinayak / Gupta, Ankur

2023 Volume 42, Issue 5, Page(s) 531–539

Abstract: Frailty is common in end stage renal disease (ESRD) and is a marker of poor outcomes. Its prevalence increases as chronic kidney disease (CKD) progresses. There are different measurement tools available to assess frailty in ESRD. The pathogenesis of ... ...

Abstract	Frailty is common in end stage renal disease (ESRD) and is a marker of poor outcomes. Its prevalence increases as chronic kidney disease (CKD) progresses. There are different measurement tools available to assess frailty in ESRD. The pathogenesis of frailty in ESRD is multifactorial including uraemia and dialysis related factors. In this current review, we discuss the importance of frailty, its pathogenesis, screening methods, prognostic implications and management strategies in context of ESRD.
MeSH term(s)	Humans ; Frailty/complications ; Frailty/epidemiology ; Kidney Failure, Chronic/complications ; Kidney Failure, Chronic/therapy ; Kidney Failure, Chronic/diagnosis ; Renal Dialysis ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/therapy ; Prognosis
Language	English
Publishing date	2023-02-16
Publishing country	Spain
Document type	Journal Article ; Review
ZDB-ID	2837917-2
ISSN	2013-2514 ; 2013-2514
ISSN (online)	2013-2514
ISSN	2013-2514
DOI	10.1016/j.nefroe.2021.05.008
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Article ; Online: Role of novel biomarker monocyte chemo-attractant protein-1 in early diagnosis & predicting progression of diabetic kidney disease: A comprehensive review.

Swaminathan, Shilna Muttickal / Rao, Indu Ramachandra / Bhojaraja, Mohan V / Attur, Ravindra Prabhu / Nagri, Shivashankara Kaniyoor / Rangaswamy, Dharshan / Shenoy, Srinivas Vinayak / Nagaraju, Shankar Prasad

Journal of the National Medical Association

2024 Volume 116, Issue 1, Page(s) 33–44

Abstract: Diabetic kidney disease (DKD) is the most devastating complication of diabetes mellitus. Identification of patients at the early stages of progression may reduce the disease burden. The limitation of conventional markers such as serum creatinine and ... ...

Abstract	Diabetic kidney disease (DKD) is the most devastating complication of diabetes mellitus. Identification of patients at the early stages of progression may reduce the disease burden. The limitation of conventional markers such as serum creatinine and proteinuria intensify the need for novel biomarkers. The traditional paradigm of DKD pathogenesis has expanded to the activation of the immune system and inflammatory pathways. Monocyte chemo-attractant protein-1 (MCP-1) is extensively studied, as a key inflammatory mediator that modulates the development of DKD. Recent evidence supports the diagnostic role of MCP-1 in patients with or without proteinuria in DKD, as well as a significant role in the early prediction and risk stratification of DKD. In this review, we will summarize and update present evidence for MCP-1 for diagnostic ability and predicting the progression of DKD.
MeSH term(s)	Humans ; Diabetic Nephropathies/diagnosis ; Diabetic Nephropathies/etiology ; Monocytes/metabolism ; Proteinuria/complications ; Biomarkers/metabolism ; Early Diagnosis ; Diabetes Mellitus, Type 2/complications
Chemical Substances	Biomarkers
Language	English
Publishing date	2024-01-08
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	419737-9
ISSN	1943-4693 ; 0027-9684
ISSN (online)	1943-4693
ISSN	0027-9684
DOI	10.1016/j.jnma.2023.12.001
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Zs.B 150: Show issues

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Article ; Online: Ocular and systemic vascular endothelial growth factor ligand inhibitor use and nephrotoxicity: an update.

Rangaswamy, Dharshan / Nagaraju, Shankar Prasad / Bhojaraja, Mohan Varadanayakanahalli / Swaminathan, Shilna Muttickal / Prabhu, Ravindra A / Rao, Indu Ramachandra / Shenoy, Srinivas Vinayak

International urology and nephrology

2024

Abstract: Tumor growth is intricately linked to the process of angiogenesis, with a key role played by vascular endothelial growth factor (VEGF) and its associated signaling pathways. Notably, these pathways also play a pivotal "housekeeping" role in renal ... ...

Abstract	Tumor growth is intricately linked to the process of angiogenesis, with a key role played by vascular endothelial growth factor (VEGF) and its associated signaling pathways. Notably, these pathways also play a pivotal "housekeeping" role in renal physiology. Over the past decade, the utilization of VEGF signaling inhibitors has seen a substantial rise in the treatment of diverse solid organ tumors, diabetic retinopathy, age-related macular degeneration, and various ocular diseases. However, this increased use of such agents has led to a higher frequency of encountering renal adverse effects in clinical practice. This review comprehensively addresses the incidence, pathophysiological mechanisms, and current evidence concerning renal adverse events associated with systemic and intravitreal antiangiogenic therapies targeting VEGF-A and its receptors (VEGFR) and their associated signaling pathways. Additionally, we briefly explore strategies for mitigating potential risks linked to the use of these agents and effectively managing various renal adverse events, including but not limited to hypertension, proteinuria, renal dysfunction, and electrolyte imbalances.
Language	English
Publishing date	2024-03-18
Publishing country	Netherlands
Document type	Journal Article ; Review
ZDB-ID	204048-7
ISSN	1573-2584 ; 0301-1623 ; 0042-1162
ISSN (online)	1573-2584
ISSN	0301-1623 ; 0042-1162
DOI	10.1007/s11255-024-03990-1
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Article: Effect of Febuxostat versus Allopurinol on the Glomerular Filtration Rate and Hyperuricemia in Patients with Chronic Kidney Disease.

Nagaraju, Shankar Prasad / Shenoy, Srinivas Vinayak / Rao, Indu / Prabhu, Ravindra Attur / Rangaswamy, Dharshan / Bhojaraja, Mohan V / Guddattu, Vasudeva

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia

2024 Volume 34, Issue 4, Page(s) 279–287

Abstract: Hyperuricemia is a risk factor for the progression of chronic kidney disease (CKD). We compared febuxostat versus allopurinol in the progression of CKD and hyperuricemia in 101 patients with Stage 3-4 CKD treated with febuxostat or allopurinol for at ... ...

Abstract	Hyperuricemia is a risk factor for the progression of chronic kidney disease (CKD). We compared febuxostat versus allopurinol in the progression of CKD and hyperuricemia in 101 patients with Stage 3-4 CKD treated with febuxostat or allopurinol for at least 6 months for hyperuricemia (>7 mg/dL) between January 2012 and December 2016. Baseline characteristics, serum uric acid (SUA), serum creatinine, and estimated glomerular filtration rate (eGFR) at entry and 6 months were compared. The primary outcome was the decline in eGFR and the secondary outcomes were reductions in SUA and adverse events. Fifty-four were in the febuxostat group and 47 were in the allopurinol group. The baseline characteristics were comparable except for age. The mean dose of febuxostat and allopurinol was 43.70 ± 14.5 mg and 108.51 ± 40 mg, respectively. After 6 months, the median rate of decline in eGFR was 1.2 mL/min/1.73 m2 (IQR: 1.2, 5.5) in the febuxostat group and 3.1 mL/min/1.73 m2 (0.6, 6.2) in the allopurinol group, but this was not statistically significant (P = 0.136). The mean reduction in SUA was significantly better (P = 0.004) in the febuxostat group (3.9 ± 1.7 mg/dL) compared with the allopurinol group (2.1 ± 1.0 mg/dL). Both drugs had no serious adverse events. Febuxostat was better at reducing hyperuricemia than allopurinol, but there was no significant difference in the progression of CKD. Large randomized trials and long-term follow-up are necessary to see whether febuxostat has a favorable effect on the progression of CKD.
MeSH term(s)	Humans ; Febuxostat/adverse effects ; Allopurinol/adverse effects ; Hyperuricemia/complications ; Hyperuricemia/diagnosis ; Hyperuricemia/drug therapy ; Glomerular Filtration Rate ; Gout Suppressants/adverse effects ; Uric Acid ; Renal Insufficiency, Chronic/complications ; Renal Insufficiency, Chronic/diagnosis ; Renal Insufficiency, Chronic/drug therapy ; Treatment Outcome
Chemical Substances	Febuxostat (101V0R1N2E) ; Allopurinol (63CZ7GJN5I) ; Gout Suppressants ; Uric Acid (268B43MJ25)
Language	English
Publishing date	2024-02-12
Publishing country	Saudi Arabia
Document type	Journal Article
ZDB-ID	1379955-1
ISSN	1319-2442
ISSN	1319-2442
DOI	10.4103/1319-2442.395443
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Zs.A 4735: Show issues

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Article ; Online: Assessment of myocardial strain in hypertensive patients with periodontitis.

Narendran, Nirosha / Shenoy, Santhosh / Kodangala, Subramanyam / Raghavendra Vamsi, Anegundi / Kamath, Vinayak

Dental and medical problems

2023 Volume 60, Issue 1, Page(s) 61–69

Abstract: Background: Left ventricular (LV) relaxation is affected by hypertension. The inflammatory mediators produced in response to systemic inflammation, such as in periodontal disease, may also alter ventricular mechanics and the existing ventricular ... ...

Abstract	Background: Left ventricular (LV) relaxation is affected by hypertension. The inflammatory mediators produced in response to systemic inflammation, such as in periodontal disease, may also alter ventricular mechanics and the existing ventricular dysfunction. Thus, the systemic inflammatory burden which occurs in response to chronic periodontitis may alter myocardial activity. Objectives: The current study aimed to assess the myocardial strain among controlled hypertensive patients with periodontitis by using two-dimensional (2D) echocardiography. Material and methods: The study involved 150 controlled hypertensive patients, equally divided into group A (without periodontitis) and group B (with periodontitis). The cardiac strain was measured with 2D echocardiography and represented as global longitudinal strain (GLS), while the periodontal inflamed surface area (PISA) score quantified the systemic inflammatory burden experienced by these individuals due to chronic periodontitis. Results: In the multiple linear regression model, the adjusted R2 for group B indicated that 88% of the variation in GLS was due to the independent variable (PISA). Thus, with every one-unit rise in PISA, there was a mild alteration in GLS of 7.54 × 10-5. A scatter plot depicted a positive correlation between PISA and GLS. Conclusions: Within the limitations of the study, it can be concluded that an increase in the PISA score may cause mild alterations in the GLS score, which could indicate the possible influence of periodontitis on myocardial activity.
MeSH term(s)	Humans ; Ventricular Function, Left ; Chronic Periodontitis/complications ; Chronic Periodontitis/diagnostic imaging ; Hypertension/complications ; Hypertension/diagnostic imaging ; Echocardiography/methods
Language	English
Publishing date	2023-04-01
Publishing country	Poland
Document type	Journal Article
ZDB-ID	2592057-1
ISSN	2300-9020 ; 2300-9020
ISSN (online)	2300-9020
ISSN	2300-9020
DOI	10.17219/dmp/152707
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Article ; Online: Renin angiotensin aldosterone system in pulmonary fibrosis: Pathogenesis to therapeutic possibilities.

Gupta, Dipankar / Kumar, Ashok / Mandloi, Avinash / Shenoy, Vinayak

Pharmacological research

2021 Volume 174, Page(s) 105924

Abstract: Pulmonary fibrosis is a devastating lung disease with multifactorial etiology characterized by alveolar injury, fibroblast proliferation and excessive deposition of extracellular matrix proteins, which progressively results in respiratory failure and ... ...

Abstract	Pulmonary fibrosis is a devastating lung disease with multifactorial etiology characterized by alveolar injury, fibroblast proliferation and excessive deposition of extracellular matrix proteins, which progressively results in respiratory failure and death. Accumulating evidence from experimental and clinical studies supports a central role of the renin angiotensin aldosterone system (RAAS) in the pathogenesis and progression of idiopathic pulmonary fibrosis. Angiotensin II (Ang II), a key vasoactive peptide of the RAAS mediates pro-inflammatory and pro-fibrotic effects on the lungs, adversely affecting organ function. Recent years have witnessed seminal discoveries in the field of RAAS. Identification of new enzymes, peptides and receptors has led to the development of several novel concepts. Of particular interest is the establishment of a protective axis of the RAAS comprising of Angiotensin converting enzyme 2 (ACE2), Angiotensin-(1-7) [Ang-(1-7)], and the Mas receptor (the ACE2/Ang-(1-7)/Mas axis), and the discovery of a functional role for the Angiotensin type 2 (AT
MeSH term(s)	Angiotensin I/metabolism ; Angiotensin-Converting Enzyme 2/metabolism ; Animals ; Antifibrotic Agents/therapeutic use ; Humans ; Lung/drug effects ; Lung/metabolism ; Lung/pathology ; Lung/physiopathology ; Molecular Targeted Therapy ; Peptide Fragments/metabolism ; Proto-Oncogene Mas/metabolism ; Pulmonary Fibrosis/drug therapy ; Pulmonary Fibrosis/metabolism ; Pulmonary Fibrosis/pathology ; Pulmonary Fibrosis/physiopathology ; Renin-Angiotensin System/drug effects ; Signal Transduction
Chemical Substances	Antifibrotic Agents ; Peptide Fragments ; Proto-Oncogene Mas ; Angiotensin I (9041-90-1) ; Angiotensin-Converting Enzyme 2 (EC 3.4.17.23) ; angiotensin I (1-7) (IJ3FUK8MOF)
Language	English
Publishing date	2021-10-02
Publishing country	Netherlands
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Review
ZDB-ID	1003347-6
ISSN	1096-1186 ; 0031-6989 ; 1043-6618
ISSN (online)	1096-1186
ISSN	0031-6989 ; 1043-6618
DOI	10.1016/j.phrs.2021.105924
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Zs.A 721: Show issues

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Article ; Online: Hypertensive emergency and seizures during haemodialysis.

Murali, Shraddha / Shenoy, Srinivas Vinayak / Prabhu, Ravindra Attur / Nagaraju, Shankar Prasad

BMJ case reports

2021 Volume 14, Issue 9

Abstract: Intracranial abscesses are uncommon, serious and life-threatening infections. A brain abscess is caused by inflammation and collection of infected material, coming from local or remote infectious sources. Patients with chronic kidney disease on dialysis ... ...

Abstract	Intracranial abscesses are uncommon, serious and life-threatening infections. A brain abscess is caused by inflammation and collection of infected material, coming from local or remote infectious sources. Patients with chronic kidney disease on dialysis are prone to invasive bacterial infections like methicillin-resistant
MeSH term(s)	Anti-Bacterial Agents/therapeutic use ; Brain Abscess/drug therapy ; Brain Abscess/etiology ; Humans ; Male ; Methicillin-Resistant Staphylococcus aureus ; Middle Aged ; Renal Dialysis ; Seizures/drug therapy ; Seizures/etiology ; Staphylococcal Infections/complications ; Staphylococcal Infections/diagnosis ; Staphylococcal Infections/drug therapy
Chemical Substances	Anti-Bacterial Agents
Language	English
Publishing date	2021-09-21
Publishing country	England
Document type	Case Reports ; Journal Article
ISSN	1757-790X
ISSN (online)	1757-790X
DOI	10.1136/bcr-2021-242471
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Article: Comparison of Oxidant Stress Levels among Healthy, Chronic Periodontitis, and Ischemic Heart Disease Subjects with Presence or Absence of Chronic Periodontitis.

Pampani, Priyanka / Shenoy, Santhosh / Punj, Anahita / Kamath, Vinayak B

Contemporary clinical dentistry

2021 Volume 12, Issue 2, Page(s) 157–163

Abstract: Objective: To investigate the total oxidant levels in healthy, chronic periodontitis (CP), and ischemic heart disease (IHD) and to check for any correlation among them.: Materials and methods: A sample of 80 were split into four groups of healthy ... ...

Abstract	Objective: To investigate the total oxidant levels in healthy, chronic periodontitis (CP), and ischemic heart disease (IHD) and to check for any correlation among them. Materials and methods: A sample of 80 were split into four groups of healthy subjects (Group I), CP subjects (Group II), IHD subjects (Group III), and IHD subjects having periodontitis (Group IV). The serum and saliva samples collected were analyzed for levels of hydrogen peroxide (H Results: There were significant ( Conclusion: The oxidant levels (H
Language	English
Publishing date	2021-06-14
Publishing country	India
Document type	Journal Article
ZDB-ID	2582352-8
ISSN	0976-2361 ; 0976-237X
ISSN (online)	0976-2361
ISSN	0976-237X
DOI	10.4103/ccd.ccd_192_20
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Article: Comprehensive Conservative Care in End-Stage Kidney Disease.

Palat, Gayatri / Shenoy, Srinivas Vinayak / Shetty, Lakshmitha / Vishnubhotla, Sivakumar

Indian journal of palliative care

2021 Volume 27, Issue Suppl 1, Page(s) S11–S13

Abstract: In patients with end-stage kidney disease (ESKD), when there maybe situations where dialysis does not offer benefits in terms of survival or health-related quality of life, dialysis should not be viewed as the default therapy. Such patients can be ... ...

Abstract	In patients with end-stage kidney disease (ESKD), when there maybe situations where dialysis does not offer benefits in terms of survival or health-related quality of life, dialysis should not be viewed as the default therapy. Such patients can be offered comprehensive conservative care as an alternative to dialysis. Conservative (nondialytic) management of ESKD includes careful attention to fluid balance, treatment of anemia, correction of acidosis and hyperkalemia, blood pressure, and calcium/phosphorus metabolism management and dietary modification. Individualized symptom management and supportive care are crucial to maximize the quality of life. We propose that model of comprehensive conservative care in ESKD should manage both diseases as well as provide supportive care. Facilitating implementation of comprehensive conservative care requires coordination between nephrology and palliative care at patient, professional, administrative, and social levels to maximize benefit with the motto to improve the overall quality of life.
Language	English
Publishing date	2021-05-30
Publishing country	India
Document type	Journal Article ; Review
ISSN	0973-1075
ISSN	0973-1075
DOI	10.4103/ijpc.ijpc_63_21
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Article ; Online: Hydroxychloroquine in nephrology: current status and future directions.

Rao, Indu Ramachandra / Kolakemar, Ashwija / Shenoy, Srinivas Vinayak / Prabhu, Ravindra Attur / Nagaraju, Shankar Prasad / Rangaswamy, Dharshan / Bhojaraja, Mohan Varadanayakanahalli

Journal of nephrology

2023 Volume 36, Issue 8, Page(s) 2191–2208

Abstract: Hydroxychloroquine is one of the oldest disease-modifying anti-rheumatic drugs in clinical use. The drug interferes with lysosomal activity and antigen presentation, inhibits autophagy, and decreases transcription of pro-inflammatory cytokines. Owing to ... ...

Abstract	Hydroxychloroquine is one of the oldest disease-modifying anti-rheumatic drugs in clinical use. The drug interferes with lysosomal activity and antigen presentation, inhibits autophagy, and decreases transcription of pro-inflammatory cytokines. Owing to its immunomodulatory, anti-inflammatory, anti-thrombotic effect, hydroxychloroquine has been an integral part of therapy for systemic lupus erythematosus and lupus nephritis for several decades. The therapeutic versatility of hydroxychloroquine has led to repurposing it for other clinical conditions, with recent studies showing reduction in proteinuria in IgA nephropathy. Research is also underway to investigate the efficacy of hydroxychloroquine in primary membranous nephropathy, Alport's syndrome, systemic vasculitis, anti-GBM disease, acute kidney injury and for cardiovascular risk reduction in chronic kidney disease. Hydroxychloroquine is well-tolerated, inexpensive, and widely available and therefore, should its indications expand in the future, it would certainly be welcomed. However, clinicians should be aware of the risk of irreversible and progressive retinal toxicity and rarely, cardiomyopathy. Monitoring hydroxychloroquine levels in blood appears to be a promising tool to evaluate compliance, individualize the dose and reduce the risk of retinal toxicity, although this is not yet standard clinical practice. In this review, we discuss the existing knowledge regarding the mechanism of action of hydroxychloroquine, its utility in lupus nephritis and other kidney diseases, the main adverse effects and the evidence gaps that need to be addressed in future research. Created with Biorender.com. HCQ, hydroxychloroquine; GBM, glomerular basement membrane; mDC, myeloid dendritic cell; MHC, major histocompatibility complex; TLR, toll-like receptor.
MeSH term(s)	Humans ; Hydroxychloroquine/adverse effects ; Lupus Nephritis/drug therapy ; Nephrology ; Antirheumatic Agents/adverse effects ; Lupus Erythematosus, Systemic
Chemical Substances	Hydroxychloroquine (4QWG6N8QKH) ; Antirheumatic Agents
Language	English
Publishing date	2023-08-02
Publishing country	Italy
Document type	Journal Article ; Review ; Research Support, Non-U.S. Gov't
ZDB-ID	1093991-x
ISSN	1724-6059 ; 1120-3625 ; 1121-8428
ISSN (online)	1724-6059
ISSN	1120-3625 ; 1121-8428
DOI	10.1007/s40620-023-01733-6
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