Papers by Swarnalatha Guditi
Transplant Infectious Disease, 2016
Kidney International Reports
Journal of Renal and Hepatic Disorders
The purpose of this study was to evaluate long-term efficacy of immunosuppressive drugs based on ... more The purpose of this study was to evaluate long-term efficacy of immunosuppressive drugs based on the type of induction therapy given to kidney transplant recipients, and determine the occurrence of graft dysfunctions or rejections. We compared the safety and efficacy of anti-thymocyte globulin (ATG) and basiliximab (BAS) in high-risk patients and analyzed the cumulative incidence of immediate, slow, and delayed graft function in kidney transplant recipients to determine their initial short-term graft function. Evaluation of the long-term efficacy after 3 years post-transplantation by assessment of patients and graft survival, incidence of infections, and risks of rejection were the primary end-points. Patients with stable graft survival were observed more with ATG (85%) than BAS (70%); in contrast, graft dysfunctions, graft nephrec-tomy, rejection episodes, and patient deaths were more prevalent with BAS than ATG, with statistically significant differences in long-term graft functio...
Kidney International Reports, Sep 1, 2022
Kidney International Reports
Saudi Journal of Kidney Diseases and Transplantation
Indian Journal of Transplantation
Introduction: Polyomavirus nephropathy (PVN) is now being frequently encountered in renal transpl... more Introduction: Polyomavirus nephropathy (PVN) is now being frequently encountered in renal transplant recipients receiving highly potent immunosuppressive drugs and has emerged as an important cause of allograft loss. In this study, we tried to study the clinical and morphological features while incorporating the latest Banff 2018 classification of PVN and correlating it with graft outcomes. Materials and Methods: This was a retrospective study including ten patients with biopsy-proven PVN. The risk factors, clinical, histomorphological, and immunohistochemical features of all the patients were studied. We scored the intrarenal polyomavirus load and Banff interstitial fibrosis as described by Banff 2018 working group. Results: There were 6 male and 4 female patients and the mean age at the time of biopsy was 42.5 ± 10.8 years. All patients were on triple immunosuppression and the mean transplant duration to the time of diagnosis was 6.98 ± 4 months. The mean serum creatinine at the time of biopsy was 2.73 ± 1.12 mg/dl. A prior history of antibody-mediated rejection was present in two patients. All ten biopsies showed tubular epithelial basophilic, intranuclear inclusions suggestive of BK virus which was confirmed by positivity for SV40 antigen on immunohistochemistry (IHC). As per the Banff 2018 classification, seven biopsies were categorized as Class 2 and three were class 3. On follow-up, three patients went into graft loss, five patients had persistent graft dysfunction, and two expired. Conclusion: PVN is an important cause of renal dysfunction and premature allograft loss. Light microscopy for viral cytopathic changes aided by IHC with SV40 is essential for the diagnosis of PVN. The Banff scheme of classification is helpful in predicting the prognosis. It is important to diagnose PVN and differentiate it from rejection for appropriate management.
SSRN Electronic Journal, 2022
Transplantation is the treatment of choice for ESRD patients in ADPKD if there are no contraindic... more Transplantation is the treatment of choice for ESRD patients in ADPKD if there are no contraindications to Surgery or Immunosuppression. Routine pre transplant evaluation for colonic diverticula or intracranial aneurysm is not required in asymptomatic subjects. Nephrectomy is not routinely indicated in ADPKD patient. It is restricted to patients with a history of recurrent cyst infection , recurrent major bleeding ,complicated lithiasis , severe Hypertension ,or massive renal enlargement ,concomitant with renal transplantation When living related donor is considered a screening test should be done to completely eliminate the possibility that the donor will develop ADPKD in future .For potential donors aged older than 30 years ultrasound abdomen is sufficient for screening , whereas in potential donor aged younger than 30 years absence of cyst will not exclude the development of ADPKD. Computed tomography and magnetic resonance imaging may be used for such patients in renal cyst dete...
Kidney International Reports, 2021
Lupus, 2021
Background The optimal duration of maintenance therapy is controversial in proliferative lupus ne... more Background The optimal duration of maintenance therapy is controversial in proliferative lupus nephritis (LN). Discordance between clinical parameters of renal remission and histological findings has made repeat biopsy a compulsory tool to confirm the histological remission (HR), but the timing is debatable. Aim of this study was to find the correlation of sustained complete clinical remission (CR) in sever lupus nephritis with histological findings on repeat kidney biopsy and appropriate duration of treatment in maintenance phase after achieving complete clinical remission. Methods Repeated kidney biopsy (biopsy 2) was performed on patients of biopsy proven (biopsy 1) proliferative LN who had been in CR for at least 2-years. The clinical and histologic findings of these groups (biopsy 1 and biopsy 2) were compared. Total 29 patients were included for the final analysis. Group 2 was further divided as per the duration of sustained CR (>48 months & <48 months). Regression analy...
Journal of Metabolic Syndrome, 2018
Type 2 Diabetic nephropathy (DN), chronic multifactorial disorder is a devastating complication o... more Type 2 Diabetic nephropathy (DN), chronic multifactorial disorder is a devastating complication of DM and a main cause of end stage renal failure. A variety of factors like metabolic, hemodynamic, genetic and multiple pathogenic events contribute to the renal damage in type 2 DN. The present study was designed to assess blood glucose, serum lipid profiles, immune-inflammatory and oxidative stress markers in type 2 DN patients in different stages of the disease and healthy controls. Our study showed that FBS, PPG, HbA1c, TC, TG, LDL-C, ADA, CRP, MDA, NO and DNA damage were significantly high in type 2 DN patients (p<0.01) compared to controls. In stage wise comparison also FBS, PPG, HbA1c, LDL-C, CRP, MDA, NO and DNA damage showed significant difference (p<0.05). Further, a significant positive correlation was found between PLBS, LDL-C and CRP and oxidative stress markers (MDA, NO, DNA damage) suggesting that monitoring these biochemical parameters at regular intervals may reduce the stage wise progression of type 2 DN and might help in early detection, precise prognosis/therapeutic modalities.
Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis, 2008
Indian Journal of Transplantation, 2018
Introduction: Late acute rejection (LAR) is different from early acute rejection with respect to ... more Introduction: Late acute rejection (LAR) is different from early acute rejection with respect to risk factors, management, and prognosis. The long-term graft survival has been shown to be adverse after LAR. Materials and Methods: This was a prospective study including 15 biopsies reported as LAR in 12 patients. The clinical details, transplant duration, risk factors, biopsy findings, antirejection treatment, and outcome are studied. Results: The risk factors for developing LAR in our study included delayed graft function, associated infections, and noncompliance. Majority were combined cellular and antibody mediated. Antibody-mediated rejection (ABMR) component was identified in 13 biopsies. Plasma cell-rich form was seen in four biopsies. Most of the patients had persistent graft dysfunction with five of them going into graft loss. Conclusion: It is important to identify LAR, especially late ABMRs. They are different from chronic rejections. The graft outcome was found to be poor.
Indian Journal of Cardiovascular Disease in Women WINCARS, 2018
Journal of laboratory physicians
Kidney involvement is a major cause of mortality in systemic amyloidosis. Glomerulus is the most ... more Kidney involvement is a major cause of mortality in systemic amyloidosis. Glomerulus is the most common site of deposition in renal amyloidosis, and nephrotic syndrome is the most common presentation. Distinction between AA and AL is done using immunofluorescence (IF) and immunohistochemistry (IHC). Renal biopsy helps in diagnosis and also predicting the clinical course by applying scoring and grading to the biopsy findings. The study includes all cases of biopsy-proven renal amyloidosis from January 2008 to May 2017. Light microscopic analysis; Congo red with polarization; IF; IHC for Amyloid A, kappa, and lambda; and bone marrow evaluation were done. Classification of glomerular amyloid deposition and scoring and grading are done as per the guidelines of Sen S . There are 40 cases of biopsy-proven renal amyloidosis with 12 primary and 23 secondary cases. Mean age at presentation was 42.5 years. Edema was the most common presenting feature. Secondary amyloidosis cases were predomin...
Indian Journal of Nephrology, 2017
Immunosuppression predisposes to a variety of infections, some of which occur at unusual sites. O... more Immunosuppression predisposes to a variety of infections, some of which occur at unusual sites. Of all the forms of mucormycosis, involvement of the intestines is rare. High degree of suspicion along with the use of invasive procedures can facilitate the diagnosis of these infections. We report a rare case of gastrointestinal Mucor in a patient with nephrotic syndrome.
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Papers by Swarnalatha Guditi