Akash Nayak - Academia.edu (original) (raw)
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Papers by Akash Nayak
Progress in Peritoneal Dialysis, 2011
Contributions to Nephrology, 2012
Peritoneal dialysis (PD) as a therapy with all its advantages has not grown as would have been ex... more Peritoneal dialysis (PD) as a therapy with all its advantages has not grown as would have been expected except in certain pockets, notably in Asia. In our opinion, from patient and their family interviews, a perception among prospective PD patients of inaccessibility to the referral PD Unit (RPU), usually for patients from rural areas in far flung places, inaccessible due to difficult terrain or long distances, play a strong role against the choice of PD as their modality choice for end-stage renal disease. We decided to address this issue by adopting novel initiatives such as easy access to the RPU through usage of internet and mobile phones from the patient homes especially in addressing the more clinically relevant infectious complications such as peritonitis and exit site infections with immediate treatment management responses from the RPU. In addition, we found that inherently the rural PD patients had several advantages over their urban counterparts and also over their hemodialysis (HD) counterparts in many socioeconomic, emotional support and nutritional parameters. We enhanced these advantages with an intensive home visit program. This two pronged approach has paid dividends in that our rural PD patients do as well, if not better than the urban PD and the HD patients, contrary to prevailing international experience.
Cardiorenal Medicine, 2013
Background: Acute kidney injury is among the most serious complications after cardiac surgery and... more Background: Acute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT) presents a high mortality rate. Consequently, we studied a Spanish cohort of patients to assess the risk factors for RRT in cardiac surgery-associated acute kidney injury (CSA-AKI).
International Journal of Technology Assessment in Health Care, 2014
A468 VALUE IN HEALTH 16 (2013) A323-A636 of the case mix of the hospital activity. As a consequen... more A468 VALUE IN HEALTH 16 (2013) A323-A636 of the case mix of the hospital activity. As a consequence, it could be a useful model to increase the awareness of the economic impact and to allow a more informed management at hospital and regional level.
Blood Purification, 2013
Ventricular assist devices (VADs) are used to improve the systemic circulation and to decrease ve... more Ventricular assist devices (VADs) are used to improve the systemic circulation and to decrease ventricular loading in patients with hemodynamic instability that is refractory to pharmacologic therapies. During an acute critical event, percutaneous devices are preferred because of their rapid deployment, since implantable devices require more extensive procedures. Implantable devices are used for patients with established end-stage heart failure as a bridge to heart transplantation, recovery or destination therapy. This report reviews mechanical principles and clinical studies regarding percutaneous VAD to address their potential renal effects. Since the focus of this study is set on devices that are dedicated to cardiac support only, extracorporeal membrane oxygenation systems are not included.
Progress in Peritoneal Dialysis, 2011
Contributions to Nephrology, 2012
Peritoneal dialysis (PD) as a therapy with all its advantages has not grown as would have been ex... more Peritoneal dialysis (PD) as a therapy with all its advantages has not grown as would have been expected except in certain pockets, notably in Asia. In our opinion, from patient and their family interviews, a perception among prospective PD patients of inaccessibility to the referral PD Unit (RPU), usually for patients from rural areas in far flung places, inaccessible due to difficult terrain or long distances, play a strong role against the choice of PD as their modality choice for end-stage renal disease. We decided to address this issue by adopting novel initiatives such as easy access to the RPU through usage of internet and mobile phones from the patient homes especially in addressing the more clinically relevant infectious complications such as peritonitis and exit site infections with immediate treatment management responses from the RPU. In addition, we found that inherently the rural PD patients had several advantages over their urban counterparts and also over their hemodialysis (HD) counterparts in many socioeconomic, emotional support and nutritional parameters. We enhanced these advantages with an intensive home visit program. This two pronged approach has paid dividends in that our rural PD patients do as well, if not better than the urban PD and the HD patients, contrary to prevailing international experience.
Cardiorenal Medicine, 2013
Background: Acute kidney injury is among the most serious complications after cardiac surgery and... more Background: Acute kidney injury is among the most serious complications after cardiac surgery and is associated with an impaired outcome. Multiple factors may concur in the development of this disease. Moreover, severe renal failure requiring renal replacement therapy (RRT) presents a high mortality rate. Consequently, we studied a Spanish cohort of patients to assess the risk factors for RRT in cardiac surgery-associated acute kidney injury (CSA-AKI).
International Journal of Technology Assessment in Health Care, 2014
A468 VALUE IN HEALTH 16 (2013) A323-A636 of the case mix of the hospital activity. As a consequen... more A468 VALUE IN HEALTH 16 (2013) A323-A636 of the case mix of the hospital activity. As a consequence, it could be a useful model to increase the awareness of the economic impact and to allow a more informed management at hospital and regional level.
Blood Purification, 2013
Ventricular assist devices (VADs) are used to improve the systemic circulation and to decrease ve... more Ventricular assist devices (VADs) are used to improve the systemic circulation and to decrease ventricular loading in patients with hemodynamic instability that is refractory to pharmacologic therapies. During an acute critical event, percutaneous devices are preferred because of their rapid deployment, since implantable devices require more extensive procedures. Implantable devices are used for patients with established end-stage heart failure as a bridge to heart transplantation, recovery or destination therapy. This report reviews mechanical principles and clinical studies regarding percutaneous VAD to address their potential renal effects. Since the focus of this study is set on devices that are dedicated to cardiac support only, extracorporeal membrane oxygenation systems are not included.