Prasad Nair - Academia.edu (original) (raw)

Papers by Prasad Nair

Research paper thumbnail of #3945 Acute Kidney Injury (Aki) Among COVID-19 Positive Patients Increases the Risk of Mortality: A Single Center Experience

Nephrology Dialysis Transplantation

Background and Aims Renal complications of COVID-19 are not yet well studied. We aimed to evaluat... more Background and Aims Renal complications of COVID-19 are not yet well studied. We aimed to evaluate the prevalence of acute kidney injury (AKI) among positive COVID-19 hospitalize cases and explore its impact on patient outcomes. Method 586 hospitalized patients with COVID-19 were retrospectively evaluated. of them, 267 (45.5%) developed AKI- classified according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines- compared with 319 (54.5%) patients without AKI. Results Most cases were males (72.7% vs. 69.7%), and their ages ranged (60.8± 14 vs. 51.7± 16 years). Comorbid conditions significantly predominant among the AKI group were diabetes mellitus (64 vs. 42.9%), hypertension (72.6% vs. 43.5%), and ischemic heart disease (25% vs. 14.7%). Fever, cough, shortness of breath, and dehydration were the main presentations among the AKI group, and they had significant radiological findings concordant with COVID-19 (86.8% vs. 59.8%). Sepsis, volume depletion, shock, arrhythmi...

Research paper thumbnail of #3003 Impact of Full Correction of Hemoglobin Among Post-Transplant Anemic Kidney Transplant Recipients: A Prospective Randomized Controlled Trial

Nephrology Dialysis Transplantation

Background and Aims Several studies have shown that post-transplant anemia (PTA) might be associa... more Background and Aims Several studies have shown that post-transplant anemia (PTA) might be associated with increased mortality and decreased graft survival and de-novo congestive heart failure. So we aimed from this prospective randomized controlled study to assess the impact of full correction of PTA on the cardiovascular system of renal transplant recipients receiving erythropoietin stimulating agents (ESA). Method We recruited 247 kidney recipients with stable graft function in this RCT with 2 groups according to their target hemoglobin (11-12 g/dl, group 1, n=183) and (13:15 g/dl, group 2, n=64). After correction of deficiencies, the target hemoglobin was achieved using ESA. All patients were followed up clinically and Laboratory and radiologically for 12 months. Results Diabetic nephropathy was the main cause of ESKD in group 1. The studied groups were comparable regarding pre-transplant co-morbidities. Most patients received thymoglobulin as induction then cyclosporine based ma...

Research paper thumbnail of Contrast-induced Nephropathy in Kidney Transplant Recipients: A Single-center Experience

Iranian Journal of Kidney Diseases, 2023

Introduction: Data regarding contrast-induced nephropathy (CIN) in kidney transplant (KT) recipie... more Introduction: Data regarding contrast-induced nephropathy (CIN) in kidney transplant (KT) recipients are scarce despite the distinct risk factors such as the use of immunosuppressive agents, sympathetic denervation, glomerular hyperfiltration, and high prevalence of the cardiovascular disease. This study aimed to determine the prevalence of CIN in KT recipients who received low-osmolality iodine-based contrast material (CM) for radiological assessment. Methods: Between 2010 and 2020, 79 of the 3180 KT recipients followed at Hamed Al-Essa organ transplant center received low-osmolality iodine-based contrast for radiological assessment for various indications. Preventive measures including holding metformin, intravenous hydration, sodium bicarbonate and N-acetylcysteine were given before contrast administration. CIN was defined as an increase in serum creatinine of 25% from the baseline within 72 hours. Results: The enrolled patients were divided into two groups: those who developed CIN (n = 7) and those with no increase in serum creatinine level (n = 72). The mean age of the patients was 52.1 ± 12.3 years; 44 of them were males, and the cause of end-stage kidney disease was mostly diabetic nephropathy. The pre-transplant demographics were comparable between the two groups. Fortyseven cases received contrast for coronary angiography, and 32 received it for a CT scan. The graft function deteriorated in group 1, but no significant difference was found between the two groups at the end of the study. Conclusion: CIN is not uncommon in KT recipients receiving CM, especially with ischemic heart disease. Risk stratification, optimizing hemodynamics, and avoiding potential nephrotoxins are essential before performing CM-enhanced studies in KT recipients. DOI: 10.52547/ijkd.7165.

Research paper thumbnail of Idiopathic polymyositis in renal transplant recipient: a case report and review of literature

Journal of The Egyptian Society of Nephrology and Transplantation

Research paper thumbnail of P8.026: Contrast-Induced Nephropathy in Kidney Transplant Recipients: A Single-Center Experience

Research paper thumbnail of P8.021: Study the Effect of Sodium-Glucose Cotransporter-2 Inhibition Versus Dipeptidyl Peptidase-4 Inhibition in Diabetic Kidney Transplant Recipients

Research paper thumbnail of P8.027: Idiopathic Polymyositis in Renal Transplant Recipient: Case Report and Review of Literature

Research paper thumbnail of 412.4: Outcomes of Sodium–Glucose Cotransporter 2 Inhibitors And Glucagon-like Peptide-1 Receptor Agonists in Diabetic Kidney Transplant Recipients

Research paper thumbnail of MO973: Optimization of Erythropoietin Stimulating Agents for Post-Transplant Anemia in Kidney Recipients: Prospective Randomized Controlled Trial

Nephrology Dialysis Transplantation, May 1, 2022

Research paper thumbnail of POS-823 Kidney Transplant in Mentally Challenged Patients : A Single Centre Experience

Kidney International Reports, 2022

Research paper thumbnail of Seizures in a Child Post Renal Transplant: A Case of Disequilibrium Syndrome

Saudi Journal of Kidney Diseases and Transplantation, 2021

Disequilibrium syndrome is typically characterized by neurological manifestations that occur acut... more Disequilibrium syndrome is typically characterized by neurological manifestations that occur acutely posthemodialysis due to a significant drop in serum osmolality. We report a child with disequilibrium syndrome postrenal transplant and compare this presentation to previously reported cases.

Research paper thumbnail of Coronavirus 2019 pandemic and renal diseases: a review of the literature

Journal of The Egyptian Society of Nephrology and Transplantation, 2020

Objectives Most people with coronavirus 2019 (COVID-19) develop mild illness, but a minority may ... more Objectives Most people with coronavirus 2019 (COVID-19) develop mild illness, but a minority may require active medical care because of the acute respiratory distress syndrome, sepsis and septic shock, and multiorgan failure, including acute kidney injury (AKI) and cardiac injury. The effect of this infection in those with chronic kidney disease (CKD) including kidney transplant recipients has not been evaluated properly. We aimed to highlight the effect of COVID-19 on patients with CKD and the preventive measures to be taken in addition to possible therapeutic modalities till the end of May 2020. Patients and methods We have reviewed most of the literature concerning COVID-19 and focused on the renal implications. Results Patients with CKD (especially dialysis patients and kidney transplant recipients) are at high risk of death because comorbidities increase the risk of dying owing to COVID-19; moreover, COVID-19 infection exaggerates comorbidities and causes possible drug interact...

Research paper thumbnail of #3934 Safety and Efficacy of Evolocumab Among Kidney Transplant Patients at High Cardiovascular Risk

Nephrology Dialysis Transplantation

Background and Aims Proprotein convertase subtilisin/Kexin type A(PCSK-9) inhibitors have not bee... more Background and Aims Proprotein convertase subtilisin/Kexin type A(PCSK-9) inhibitors have not been evaluated among kidney transplant recipients (KTR) despite its favorable cardiovascular profile. We aimed to evaluate the safety and efficacy of evolocumab in reducing lipids and cardiovascular events among risky KTR. Method One hundred ninety-five KTR - who were followed up in Hamed Al-Essa organ transplant center with high cardiovascular risk score (>20)-were enrolled in this prospective randomized controlled study between June 2017 and June 2018. Patients who received statin and evolocumab (140 mg/ 2 weeks, group1, n = 97) while those maintained on statin alone comprised group 2(n = 98). After 24 months, they were followed up clinically and by laboratory investigations. Results The two groups had comparable demographics. Before enrollment in the study, we observed a higher prevalence of NODAT in group 2 and more smokers in group 1(p < 0.05). Basal graft function was significan...

Research paper thumbnail of #4112 Impact of Add-On Extracorporeal Membrane Oxygenation on the Outcome of Critically Ill COVID-19 Positive Patients

Nephrology Dialysis Transplantation

Background and Aims Growing reports arguing the value of extracorporeal membrane oxygenation (ECM... more Background and Aims Growing reports arguing the value of extracorporeal membrane oxygenation (ECMO) support on COVID-19 survival. The earliest studies reported prohibitively high mortality in small cohorts. International medical organizations still recommended, early in the pandemic, that ECMO should be considered if conventional treatment was not successful. To evaluate the impact of add-on ECMO on the outcome of critically ill COVID-19 patients. Method An observational study recruited critically ill COVID-19 patients necessitating ECMO support during their stay in governmental hospitals of Kuwait from March 2020 to December 2021. Socio-demographic characters (age, sex, smoking history, comorbidities), clinico-laboratory parameters (days of mechanical ventilation before ECMO, routine investigations, LDH, ferritin, D-dimer, arterial blood gases &reporting any positive cultures; sputum, blood &/or others), chest radiological findings, and different lines of management (steroids, anti...

Research paper thumbnail of #3895 Comparable Reno-Cardiac Protective Effects of SGLT2 Inhibition Versus DPP-4 Inhibition in Diabetic Kidney Transplant Recipients: Kuwait Experience

Nephrology Dialysis Transplantation

Background and Aims Diabetes is the most common cause of chronic kidney disease (CKD) globally. T... more Background and Aims Diabetes is the most common cause of chronic kidney disease (CKD) globally. The renal and cardio-vascular benefits of the new anti-diabetic agents are not assessed comprehensively. We aimed to evaluate the short term renal and cardio-protective effects of Sodium-Glucose Cotransporter-2 Inhibition (SGLT2i) Vs. Dipeptidyl peptidase-4 Inhibition (DPP4i) among diabetic kidney transplant recipients. Method In this observational trial, 222 diabetic kidney transplants recipients (NODAT or type 2 diabetes) were enrolled and were categorized into two groups. Group 1 (n = 99) received SGLT2i while group 2(n = 123) received DPP4i as an add on antidiabetic medications. All patients in the two groups were followed up for 12 months. Results Most patients in the two groups (1&2) were men (59.6 vs. 61.7%, p = 0.73) in their middle age (58.5±11.9 vs. 54.4±12.9, p = 0.016) years respectively. The two groups were matched regarding their demographics especially the type of donor, ty...

Research paper thumbnail of P8.023: Acute Kidney Injury Among COVID-19 Positive Patients Is Associated With Higher Mortality: Single Center Experience

Research paper thumbnail of P16.08: COVID-19 Positive Kidney Transplant Recipients Behave Differently Compared to Non-transplant Patients ICU: Single Center Experience

Research paper thumbnail of MO972: Impact of Inhibition of Pcsk-9 Among Renal Transplant Recipients with High Cardiovascular Risk

Nephrology Dialysis Transplantation, May 1, 2022

Research paper thumbnail of Outcomes of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in kidney transplant recipients with diabetes

The European Society for Organ Transplantation, 2021

Research paper thumbnail of MO1001THE Outcome of Plasma Cell-Rich Acute Rejection in Kidney Transplantation, is It Really Poor?

Nephrology Dialysis Transplantation, 2021

Background and Aims The outcome of Plasma cell-rich acute rejection (PCAR) in kidney transplant i... more Background and Aims The outcome of Plasma cell-rich acute rejection (PCAR) in kidney transplant is reported to be poor. However, PCAR which can be associated with any type of rejection, may not be considered as independent morphological prognostic feature. Different treatment modalities were prescribed with variable responses. We report here four cases of PCAR and describe their presentations, type of rejection, associated conditions and treatment outcome. Method Out of 1920 kidney transplant recipients under follow up in our centre from 1996 till 2019, four patients were reported to have PCAR according to 2007 Banff classification. They were re-evaluated based on 2015 Banff classification. The treatment protocol was tailored according to the type of rejection and associated conditions. Results The four patients, aged 28, 44, 46 and 54 years, had live unrelated renal transplant done somewhere abroad with no data about donor HLA typing. Two of them were females. One had high PRA and ...

Research paper thumbnail of #3945 Acute Kidney Injury (Aki) Among COVID-19 Positive Patients Increases the Risk of Mortality: A Single Center Experience

Nephrology Dialysis Transplantation

Background and Aims Renal complications of COVID-19 are not yet well studied. We aimed to evaluat... more Background and Aims Renal complications of COVID-19 are not yet well studied. We aimed to evaluate the prevalence of acute kidney injury (AKI) among positive COVID-19 hospitalize cases and explore its impact on patient outcomes. Method 586 hospitalized patients with COVID-19 were retrospectively evaluated. of them, 267 (45.5%) developed AKI- classified according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines- compared with 319 (54.5%) patients without AKI. Results Most cases were males (72.7% vs. 69.7%), and their ages ranged (60.8± 14 vs. 51.7± 16 years). Comorbid conditions significantly predominant among the AKI group were diabetes mellitus (64 vs. 42.9%), hypertension (72.6% vs. 43.5%), and ischemic heart disease (25% vs. 14.7%). Fever, cough, shortness of breath, and dehydration were the main presentations among the AKI group, and they had significant radiological findings concordant with COVID-19 (86.8% vs. 59.8%). Sepsis, volume depletion, shock, arrhythmi...

Research paper thumbnail of #3003 Impact of Full Correction of Hemoglobin Among Post-Transplant Anemic Kidney Transplant Recipients: A Prospective Randomized Controlled Trial

Nephrology Dialysis Transplantation

Background and Aims Several studies have shown that post-transplant anemia (PTA) might be associa... more Background and Aims Several studies have shown that post-transplant anemia (PTA) might be associated with increased mortality and decreased graft survival and de-novo congestive heart failure. So we aimed from this prospective randomized controlled study to assess the impact of full correction of PTA on the cardiovascular system of renal transplant recipients receiving erythropoietin stimulating agents (ESA). Method We recruited 247 kidney recipients with stable graft function in this RCT with 2 groups according to their target hemoglobin (11-12 g/dl, group 1, n=183) and (13:15 g/dl, group 2, n=64). After correction of deficiencies, the target hemoglobin was achieved using ESA. All patients were followed up clinically and Laboratory and radiologically for 12 months. Results Diabetic nephropathy was the main cause of ESKD in group 1. The studied groups were comparable regarding pre-transplant co-morbidities. Most patients received thymoglobulin as induction then cyclosporine based ma...

Research paper thumbnail of Contrast-induced Nephropathy in Kidney Transplant Recipients: A Single-center Experience

Iranian Journal of Kidney Diseases, 2023

Introduction: Data regarding contrast-induced nephropathy (CIN) in kidney transplant (KT) recipie... more Introduction: Data regarding contrast-induced nephropathy (CIN) in kidney transplant (KT) recipients are scarce despite the distinct risk factors such as the use of immunosuppressive agents, sympathetic denervation, glomerular hyperfiltration, and high prevalence of the cardiovascular disease. This study aimed to determine the prevalence of CIN in KT recipients who received low-osmolality iodine-based contrast material (CM) for radiological assessment. Methods: Between 2010 and 2020, 79 of the 3180 KT recipients followed at Hamed Al-Essa organ transplant center received low-osmolality iodine-based contrast for radiological assessment for various indications. Preventive measures including holding metformin, intravenous hydration, sodium bicarbonate and N-acetylcysteine were given before contrast administration. CIN was defined as an increase in serum creatinine of 25% from the baseline within 72 hours. Results: The enrolled patients were divided into two groups: those who developed CIN (n = 7) and those with no increase in serum creatinine level (n = 72). The mean age of the patients was 52.1 ± 12.3 years; 44 of them were males, and the cause of end-stage kidney disease was mostly diabetic nephropathy. The pre-transplant demographics were comparable between the two groups. Fortyseven cases received contrast for coronary angiography, and 32 received it for a CT scan. The graft function deteriorated in group 1, but no significant difference was found between the two groups at the end of the study. Conclusion: CIN is not uncommon in KT recipients receiving CM, especially with ischemic heart disease. Risk stratification, optimizing hemodynamics, and avoiding potential nephrotoxins are essential before performing CM-enhanced studies in KT recipients. DOI: 10.52547/ijkd.7165.

Research paper thumbnail of Idiopathic polymyositis in renal transplant recipient: a case report and review of literature

Journal of The Egyptian Society of Nephrology and Transplantation

Research paper thumbnail of P8.026: Contrast-Induced Nephropathy in Kidney Transplant Recipients: A Single-Center Experience

Research paper thumbnail of P8.021: Study the Effect of Sodium-Glucose Cotransporter-2 Inhibition Versus Dipeptidyl Peptidase-4 Inhibition in Diabetic Kidney Transplant Recipients

Research paper thumbnail of P8.027: Idiopathic Polymyositis in Renal Transplant Recipient: Case Report and Review of Literature

Research paper thumbnail of 412.4: Outcomes of Sodium–Glucose Cotransporter 2 Inhibitors And Glucagon-like Peptide-1 Receptor Agonists in Diabetic Kidney Transplant Recipients

Research paper thumbnail of MO973: Optimization of Erythropoietin Stimulating Agents for Post-Transplant Anemia in Kidney Recipients: Prospective Randomized Controlled Trial

Nephrology Dialysis Transplantation, May 1, 2022

Research paper thumbnail of POS-823 Kidney Transplant in Mentally Challenged Patients : A Single Centre Experience

Kidney International Reports, 2022

Research paper thumbnail of Seizures in a Child Post Renal Transplant: A Case of Disequilibrium Syndrome

Saudi Journal of Kidney Diseases and Transplantation, 2021

Disequilibrium syndrome is typically characterized by neurological manifestations that occur acut... more Disequilibrium syndrome is typically characterized by neurological manifestations that occur acutely posthemodialysis due to a significant drop in serum osmolality. We report a child with disequilibrium syndrome postrenal transplant and compare this presentation to previously reported cases.

Research paper thumbnail of Coronavirus 2019 pandemic and renal diseases: a review of the literature

Journal of The Egyptian Society of Nephrology and Transplantation, 2020

Objectives Most people with coronavirus 2019 (COVID-19) develop mild illness, but a minority may ... more Objectives Most people with coronavirus 2019 (COVID-19) develop mild illness, but a minority may require active medical care because of the acute respiratory distress syndrome, sepsis and septic shock, and multiorgan failure, including acute kidney injury (AKI) and cardiac injury. The effect of this infection in those with chronic kidney disease (CKD) including kidney transplant recipients has not been evaluated properly. We aimed to highlight the effect of COVID-19 on patients with CKD and the preventive measures to be taken in addition to possible therapeutic modalities till the end of May 2020. Patients and methods We have reviewed most of the literature concerning COVID-19 and focused on the renal implications. Results Patients with CKD (especially dialysis patients and kidney transplant recipients) are at high risk of death because comorbidities increase the risk of dying owing to COVID-19; moreover, COVID-19 infection exaggerates comorbidities and causes possible drug interact...

Research paper thumbnail of #3934 Safety and Efficacy of Evolocumab Among Kidney Transplant Patients at High Cardiovascular Risk

Nephrology Dialysis Transplantation

Background and Aims Proprotein convertase subtilisin/Kexin type A(PCSK-9) inhibitors have not bee... more Background and Aims Proprotein convertase subtilisin/Kexin type A(PCSK-9) inhibitors have not been evaluated among kidney transplant recipients (KTR) despite its favorable cardiovascular profile. We aimed to evaluate the safety and efficacy of evolocumab in reducing lipids and cardiovascular events among risky KTR. Method One hundred ninety-five KTR - who were followed up in Hamed Al-Essa organ transplant center with high cardiovascular risk score (>20)-were enrolled in this prospective randomized controlled study between June 2017 and June 2018. Patients who received statin and evolocumab (140 mg/ 2 weeks, group1, n = 97) while those maintained on statin alone comprised group 2(n = 98). After 24 months, they were followed up clinically and by laboratory investigations. Results The two groups had comparable demographics. Before enrollment in the study, we observed a higher prevalence of NODAT in group 2 and more smokers in group 1(p < 0.05). Basal graft function was significan...

Research paper thumbnail of #4112 Impact of Add-On Extracorporeal Membrane Oxygenation on the Outcome of Critically Ill COVID-19 Positive Patients

Nephrology Dialysis Transplantation

Background and Aims Growing reports arguing the value of extracorporeal membrane oxygenation (ECM... more Background and Aims Growing reports arguing the value of extracorporeal membrane oxygenation (ECMO) support on COVID-19 survival. The earliest studies reported prohibitively high mortality in small cohorts. International medical organizations still recommended, early in the pandemic, that ECMO should be considered if conventional treatment was not successful. To evaluate the impact of add-on ECMO on the outcome of critically ill COVID-19 patients. Method An observational study recruited critically ill COVID-19 patients necessitating ECMO support during their stay in governmental hospitals of Kuwait from March 2020 to December 2021. Socio-demographic characters (age, sex, smoking history, comorbidities), clinico-laboratory parameters (days of mechanical ventilation before ECMO, routine investigations, LDH, ferritin, D-dimer, arterial blood gases &reporting any positive cultures; sputum, blood &/or others), chest radiological findings, and different lines of management (steroids, anti...

Research paper thumbnail of #3895 Comparable Reno-Cardiac Protective Effects of SGLT2 Inhibition Versus DPP-4 Inhibition in Diabetic Kidney Transplant Recipients: Kuwait Experience

Nephrology Dialysis Transplantation

Background and Aims Diabetes is the most common cause of chronic kidney disease (CKD) globally. T... more Background and Aims Diabetes is the most common cause of chronic kidney disease (CKD) globally. The renal and cardio-vascular benefits of the new anti-diabetic agents are not assessed comprehensively. We aimed to evaluate the short term renal and cardio-protective effects of Sodium-Glucose Cotransporter-2 Inhibition (SGLT2i) Vs. Dipeptidyl peptidase-4 Inhibition (DPP4i) among diabetic kidney transplant recipients. Method In this observational trial, 222 diabetic kidney transplants recipients (NODAT or type 2 diabetes) were enrolled and were categorized into two groups. Group 1 (n = 99) received SGLT2i while group 2(n = 123) received DPP4i as an add on antidiabetic medications. All patients in the two groups were followed up for 12 months. Results Most patients in the two groups (1&2) were men (59.6 vs. 61.7%, p = 0.73) in their middle age (58.5±11.9 vs. 54.4±12.9, p = 0.016) years respectively. The two groups were matched regarding their demographics especially the type of donor, ty...

Research paper thumbnail of P8.023: Acute Kidney Injury Among COVID-19 Positive Patients Is Associated With Higher Mortality: Single Center Experience

Research paper thumbnail of P16.08: COVID-19 Positive Kidney Transplant Recipients Behave Differently Compared to Non-transplant Patients ICU: Single Center Experience

Research paper thumbnail of MO972: Impact of Inhibition of Pcsk-9 Among Renal Transplant Recipients with High Cardiovascular Risk

Nephrology Dialysis Transplantation, May 1, 2022

Research paper thumbnail of Outcomes of sodium-glucose cotransporter 2 inhibitors and glucagon-like peptide-1 receptor agonists in kidney transplant recipients with diabetes

The European Society for Organ Transplantation, 2021

Research paper thumbnail of MO1001THE Outcome of Plasma Cell-Rich Acute Rejection in Kidney Transplantation, is It Really Poor?

Nephrology Dialysis Transplantation, 2021

Background and Aims The outcome of Plasma cell-rich acute rejection (PCAR) in kidney transplant i... more Background and Aims The outcome of Plasma cell-rich acute rejection (PCAR) in kidney transplant is reported to be poor. However, PCAR which can be associated with any type of rejection, may not be considered as independent morphological prognostic feature. Different treatment modalities were prescribed with variable responses. We report here four cases of PCAR and describe their presentations, type of rejection, associated conditions and treatment outcome. Method Out of 1920 kidney transplant recipients under follow up in our centre from 1996 till 2019, four patients were reported to have PCAR according to 2007 Banff classification. They were re-evaluated based on 2015 Banff classification. The treatment protocol was tailored according to the type of rejection and associated conditions. Results The four patients, aged 28, 44, 46 and 54 years, had live unrelated renal transplant done somewhere abroad with no data about donor HLA typing. Two of them were females. One had high PRA and ...