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Papers by kamal kanodia

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2017

A 42-year-old female, known case of type 2 diabetic on oral hypoglycemic treatment for last two y... more A 42-year-old female, known case of type 2 diabetic on oral hypoglycemic treatment for last two years, presented in emergency with acute left flank pain of four days duration. She had a history of low-grade fever for five days. On examination, her blood pressure was 130/90 mmHg and pulse rate was 100/minute with tenderness in her left flank region. On investigation, her Haemoglobin (Hb) was 9.1 gm/dl; Total Leukocyte Count (TLC), 18.6×10 3 /μl with 87% neutrophils; platelet count, 2.36×10 5 /μl, random blood sugar 545 mg/dl; serum acetone was absent, serum creatinine, 1.86 mg/dl and serum potassium 3.6 mEq/l. She was reactive for HIV-1 by ELISA and Western blot. A routine urine examination by dipstick showed trace albumin; microscopic examination revealed 40-42 pus cells/high power field and no organism was isolated on culture. Her blood culture was negative. Ultrasonography of abdomen showed features of Left Kidney (LK) Emphysematous Pyelonephritis (EPN). Computed Tomography (CT) [Table/Fig-1] showed an enlarged and oedematous left kidney with multiple pockets of air in the pelvicalyceal system, renal parenchyma, perinephric region and ureter, suggestive of EPN Class 3A. She was treated with intravenous antibiotics, insulin and Percutaneous Nephrostomy (PCN). However, PCN did not relieve her symptoms and an emergency nephrectomy of her LK was carried out on the next day. The specimen was sent for histopathological examination.

Emerging Infectious Diseases, 2012

Plasmodium vivax is causing increasingly more cases of severe malaria worldwide. Among 25 cases i... more Plasmodium vivax is causing increasingly more cases of severe malaria worldwide. Among 25 cases in India during 2010-2011, associated conditions were renal failure, thrombocytopenia, jaundice, severe anemia, acute respiratory distress syndrome, shock, cerebral malaria, hypoglycemia, and death. Further studies are needed to determine why P. vivax malaria is becoming more severe. DISPATCHES 842 Emerging Infectious Diseases • www.cdc.gov/eid

Mitochondria and Brain Disorders

Adrenal gland is an endocrine organ comprising of an outer cortex and inner medulla. These secret... more Adrenal gland is an endocrine organ comprising of an outer cortex and inner medulla. These secrete various hormones that have a vital role in maintaining the normal homeostasis of the body. Lesions of adrenal cortex are quite common to encounter and most of these are related to the hormones secreted by three layers of adrenal cortex: the zona glomerulosa, the zona fasciculata, and the zona reticularis. Also it is very infrequent to encounter metastatic lesions in the adrenal glands too. So it is very important as a part of a clinician as well as a pathologist to know the pattern in which these hormones are secreted along with their physiological roles. Thus this chapter includes the disease that are related to excess as well as deficiencies of the hormones secreted by adrenal cortex. The chapter also includes various genetic syndromes that are associated with the disorders associated with hormones of adrenal cortex. The last part of the chapter includes a brief description of various benign as well as malignant lesions, the pathological as well as the etiological aspects and the hormonal abnormalities associated. This chapter thus mainly focuses on the pathology associated with the adrenal cortex and hormones secreted by the various layers of adrenal cortex.

Saudi Journal of Kidney Diseases and Transplantation, 2020

Thrombotic microangiopathy (TMA) is devastating for renal transplantation (RT) causing graft/ pat... more Thrombotic microangiopathy (TMA) is devastating for renal transplantation (RT) causing graft/ patient loss. We present 5-year experience of TMA in RT in retrospective study of indicated renal allograft biopsies with TMA. Patient–donor demographics and associated histological findings with respect to transplants under tolerance induction protocol (Group 1) were compared with patients transplanted under triple immunosuppression (Group 2). Statistical analysis was performed using IBM SPSS Statistics version 20. Sixty-one (4.1%) of 1520 biopsies [Group 1:17 (1.9%)/882, Group 2:44 (6.9%)/638] revealed TMA. Tacrolimus trough levels were normal. There was no evidence of systemic involvement in any patient. Mean age was 36.8 years with 70.6% males, HLA-match, 2.6/6, and the most common original disease unknown (41.2%) in Group 1, and 35.9 years with 86.4% males, HLA-match, 2.1/6, and the most common original disease unknown (50%) in Group 2. Biopsies were performed at mean 5.1-year posttransplant in Group 1 and 2.3 years in Group 2. Acute TMA constituted 47% Group 1 and 43.2% Group 2 biopsies; of these, antibody-mediated rejections were observed in 58.8%, T-cell mediated rejections in 11.8%, tacrolimus toxicity in 76.5%, and other findings in 35.3% Group 1; and 61.4%, 25%, 50%, and 18.2%, respectively, in Group 2 biopsies. Higher rejection activity scores were more in Group 2. Postbiopsy 1- and 5- year patient survival was 94.1%, 86.9% in Group 1 and 92.1%, 88.3% in Group 2; 1- and 4-year graft survival was 52.9%, 15.9% in Group 1 and 20.3%, 5.4% in Group 2. TMA was poor prognosticator for RT, especially under triple immunosuppression. Antibody- mediated rejection and tacrolimus toxicity were more prone to TMA.

Urinary Tract Infection - The Result of the Strength of the Pathogen, or the Weakness of the Host, 2018

Renal replacement therapy in the form of renal transplantation (RT) is the treatment of choice in... more Renal replacement therapy in the form of renal transplantation (RT) is the treatment of choice in these patients. Various factors influence the graft survival, infections being most common. Infections account for 16% of patient deaths and 7.7% of death censored graft failure in renal transplant patients. Urinary tract infection (UTI) is the most common infectious complication accounting for 45-72% of all infections. According to few studies UTI may have a negative impact over the long term survival of renal allograft. There are multiple factors that predispose these patients to UTI. Elderly age group, female gender, increased duration of catheterization and anatomical abnormalities of the urinary tract are most common predisposing factors. E. coli is the most frequently isolated organisms from the urine of these patients. We would proceed further with two cases which presented as UTI in post-transplant period. The first patient transplanted (living donor related) for diabetes induced end stage renal disease had developed UTI 4 years posttransplant. The other patient underwent deceased donor renal transplant for adult polycystic disease related chronic kidney disease, presented 2 years post-transplant with UTI.

Turkish Journal of Biochemistry, 2019

Aim Our study was aimed to compare two different laboratory methods used to measure serum sodium ... more Aim Our study was aimed to compare two different laboratory methods used to measure serum sodium and serum potassium level i.e. between the indirect Ion Selective Electrode (ISE) based and Enzymatic based method in Beckman Coulter AU-480, USA, in serum samples. Materials and methods This was a cross sectional single center study carried out from September’16 to January’17 on 130 serum samples, to compare the result of serum sodium (S. Na+) and serum potassium (S. K+) level by indirect ISE and Enzymatic method in fully automated biochemistry analyzer (Beckman Coulter AU-480, USA). Results To validate new enzymatic method bias, CV% and correlation coefficient were measured for S. Na+ and S. K+. The study has drawn a considerable agreement for measurement of S. K+ level between two methods with mean ± SD of difference was 0.14 ± 0.22 (p = 0.2242), CV% 2.7% and r2 value of 0.94, whereas disagreement for measurement of S. Na+ level with mean ± SD of difference was 2.38 ± 2.36 (p

Indian journal of pediatrics, Aug 1, 2018

Urinary screening is a simple inexpensive tool to evaluate kidney functions. The authors carried ... more Urinary screening is a simple inexpensive tool to evaluate kidney functions. The authors carried out urinary screening of school children for early detection of kidney diseases. Children in the age group 5-15 y were screened for urinalysis. They were divided in 2 groups; group-1 included 5-10 y and group-2 included >10-15 y old children. Urine samples of 3340(78%) out of 4283 enrolled children were tested. Abnormal samples were found in 5.75%; with proteinuria in 4.59%, pyuria in 3.29% and hematuria in 4.31%. Males constituted 47.71% in group-1 and 54.64% in group-2. Low body mass index was found in 94.1% group-1 and 78.99% group-2 children. Mild proteinuria was found in 1.2% group-1 and 2.56% group-2 children. Severe proteinuria was more in group-2 (0.77% vs. 0.06%) with female preponderance. Glucosuria was found in 1 boy of group-2. Urobilinogen was more in group-2 (0.65% vs. 0.24%) with male preponderance. Nitrituria was found in 9 girls. Pyuria (2.02% vs. 1.27%) and hematuria...

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

Banff'13 update included C4d-antibody-mediated rejection (ABMR) as a separate entity responsi... more Banff'13 update included C4d-antibody-mediated rejection (ABMR) as a separate entity responsible for graft dysfunction with limited clinical/prognostic implications. We present a retrospective study to determine the incidence and outcome of C4d-negative ABMR. A total of 987 renal allograft (RA) biopsies obtained from 987 RA recipients were studied from January 2013 to January 2016. All samples were subjected to light microscopy using standard stains and C4d immunohistochemistry on paraffin sections and reported according to modified Banff's criteria. Adequate biopsies with immunological injuries were categorized as Group 1: pure ABMR, Group 2: combined ABMR with concurrent T-cell-mediated rejection (TCR), and Group 3: pure TCR. Groups 1 and 2 were further subgrouped as C4d positive (Group 1a and 2a) or C4d negative (Group 1b and 2b). Graft function was measured by serum creatinine (SCr) level (mg/dL). Of the 987 biopsies, 43.3% (404) biopsies revealed immunological injury. O...

Journal of clinical and diagnostic research : JCDR, 2017

Recurrent or de novo glomerulonephritis are one of the well-known causes for renal allograft dysf... more Recurrent or de novo glomerulonephritis are one of the well-known causes for renal allograft dysfunction in early and late period after renal transplantation. Focal Segmental Glomerulosclerosis (FSGS) is a devastating lesion of the renal allograft. De novo FSGS is uncommon compared to recurrent FSGS. To find out the incidence of de novo FSGS. A retrospective evaluation of renal allograft biopsies was performed from 2007 to 2015, by light microscopy and immunohistochemistry including patient-donor demographics. Graft function status in terms of serum creatinine (SCr) and proteinuria were evaluated. Out of 2,599 renal allograft biopsies performed, 1.6% biopsies were reported as de novo FSGS. Majority were live related females donors with mean age of 43.8 years. Mean time of biopsy was 1.1 years post-transplant with proteinuria of 2.95 grams/24 hours and SCr of 2.24 mg/dL. Histopathological variants were collapsing 47.6%, Not Otherwise Specified/ classical 35.7%, cellular 9.5% and peri...

Journal of Interdisciplinary Histopathology, 2017

Primary adrenal lymphoma is a rare entity and may be suspected in patients having bilateral adren... more Primary adrenal lymphoma is a rare entity and may be suspected in patients having bilateral adrenal masses, with/without lymphadenopathy, and with/without adrenal insufficiency. We report a rare case of a 45-year-old man who presented with pain in the abdomen, with no signs of adrenal insufficiency and bilateral adrenal masses on imaging. Light microscopy findings with immunohistochemistry and flow cytometry confirmed the diagnosis of diffuse large B-cell lymphoma. The patient was offered cyclophosphamide, adriamycin, vincristine, and prednisolone chemotherapy regimen and doing well till the last follow-up.

Journal of clinical and diagnostic research : JCDR, 2016

Collapsing Glomerulopathy (CG) is recognized as distinct pattern of proliferative parenchymal inj... more Collapsing Glomerulopathy (CG) is recognized as distinct pattern of proliferative parenchymal injury with poor response to empirical therapy. A single center retrospective study was carried out to find out clinicopathological features of idiopathic CG. A total of 3335 native renal biopsies were analyzed retrospectively which were performed from 2008 to 2014 with emphasis on clinicopathological correlation and histopathological presentation. Idiopathic CG constituted 0.75% incidence (25 out of 3335 biopsies) of all biopsies, adults constituting major study part with 88%. The duration of the symptoms at the time of biopsy was 34.12±26.09 days and 35±22.91 days respectively in adults and children. Hypertension was noted in 9(40.9%) and oliguria in 8(36.4%) in adults. Urinalysis revealed microscopic haematuria 12(54.5%) in adults. Nephrotic range proteinuria was reported in 10 (45.5%) adult patients. Glomerular collapse with hyperplasia/ hypertrophy of podocytes was seen in 4.54±3.11 gl...

Clinical Kidney Journal, 2016

Background: Globally there is an increase in incidence of chronic kidney diseases (CKDs). Diabete... more Background: Globally there is an increase in incidence of chronic kidney diseases (CKDs). Diabetes mellitus (DM), hypertension and stone diseases are the major risk factors for CKD. We organized kidney disease screening camps in a semi-urban population of Gujarat, India on the occasion of World Kidney Day (WKD). Methods: Voluntary participants from six towns were screened. Estimated glomerular filtration rate (eGFR) was calculated by the Modification of Diet in Renal Disease formula and CKD was defined as an eGFR <60 mL/min/1.73 m 2 or albuminuria ≥1+. Urogenital ultrasonography was performed with emphasis on stone burden. Participants with known diabetes, stone diseases, hypertension, kidney/liver/cardiac disease, hepatitis, HIV, transplant recipients, pregnant women and those <18 years were excluded from the study. Results: Of the 2350 participants (1438 men), CKD was found in 20.93% and eGFR <60 mL/min/1.73 m 2 was noted in 8.29% of participants. The prevalence of CKD peaked after the seventh decade of life in both genders. There was no significant difference in the prevalence of CKD between coastal and non-coastal regions, however, obesity, hypertension and diabetes were more common in the coastal belt, whereas stone burden was greater in the non-coastal region. Conclusions: The prevalence of CKD in a semi-urban apparently healthy Indian population was higher than the reported prevalence in developed countries. Significant differences between regions point to the need to evaluate and correctregionspecific risk factors.

Nephro-Urology Monthly, 2015

Background: Renal biopsy is a well-established diagnostic modality for the assessment of kidney d... more Background: Renal biopsy is a well-established diagnostic modality for the assessment of kidney diseases in children. It can provide diagnostic precision and prognostic value and guide in therapeutic options for many renal diseases. Objectives: This report describes the indication, histopathological patterns, and epidemiology of renal diseases in children in India. Patients and Methods: This is a single-center study on renal biopsies performed between January 2008 and December 2013 in 346 children (age ≤ 14 years). Results: Eleven (3.17%) biopsies were inadequate, and 335 biopsies were considered for analysis. The mean age was 7.91 ± 3.04 years with a predominance of males (68.1%). Nephrotic syndrome (46.2%) was the most common indication, followed by urinary abnormality (41.19%), acute nephritic syndrome (10.74%), and chronic renal failure (1.79 %). Primary glomerulonephritis (GN) was predominant (81.79%), and secondary GN constituted 16.12% of the biopsies. Primary GN included mesangial proliferative GN (MePGN), IgM nephropathy, focal segmental glomerulosclerosis, minimal change disease, IgA nephropathy, membranoproliferative GN, membranous nephropathy, crescentic GN, and post-infectious GN. Secondary GN revealed lupus nephritis, hemolytic uremic syndrome, amyloidosis, and hypertensive nephropathy. Tubulointerstitial nephritis was observed in 2.08%. The most common histological pattern of primary GN was MePGN (20%) and in secondary GN it was lupus nephritis (7.76%). Conclusions: The present study provides data on the epidemiology of renal diseases in children in India and will be helpful for developing a national registry and devising therapeutic guidelines.

International Journal of Nephrology and Renovascular Disease, 2009

Renal involvement, which can rarely occur in echinococcosis, more commonly manifests as hydatid c... more Renal involvement, which can rarely occur in echinococcosis, more commonly manifests as hydatid cyst of the kidney. Scattered case reports of nephrotic syndrome secondary to hydatid cyst in the liver or lung have been reported for over two decades. The glomerular picture varied from minimal change lesion to mesangiocapillary glomerulonephritis. We report a case of predominantly tubulointerstitial nephritis with mesangioproliferative glomerulonephritis in a patient with hepatic hydatid cyst which responded to cyst resection alone.

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2009

Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia, 2012

C1q nephropathy with hemolytic uremic syndrome (HUS) is an uncommon combination associated with r... more C1q nephropathy with hemolytic uremic syndrome (HUS) is an uncommon combination associated with rapidly progressive renal failure. We report a case of C1q nephropathy with HUS in an 18-year-old man associated with rapidly progressive renal failure. The patient did not respond to treatment with steroids and was started on maintenance hemodialysis. C1q nephropathy with HUS is rare and can lead to rapidly progressive renal failure.

Indian journal of pathology & microbiology, 2007

Immunofluorescence (IF) studies are important diagnostic tool in understanding pathogenesis invol... more Immunofluorescence (IF) studies are important diagnostic tool in understanding pathogenesis involved in graft injury. Acute humoral rejection (AHR) associated with circulating donor-specific cytotoxic antibodies, is a poor prognosticator for graft survival. It can be diagnosed by staining for C4d antibody using indirect IF technique. C4d staining required to diagnose AHR was made mandatory for reporting renal allograft biopsies in 7th Banff conference. We present 2 years experience of IF studies using C4d polyclonal antibody on 546 renal allograft biopsies belonging to two groups of patients; 464 from group A (tolerance induction protocol) and 82 from group B (controls). We observed C4d focal positivity in 4 (0.9%) biopsies from group A and 4 (4.9%) from group B. We conclude that it is advisable to collect simultaneous core biopsy samples for IF studies and light microscopy to give better definition of allograft injury and thereby support in clinical management.

Hong Kong Journal of Nephrology, 2005

Background: The most interesting recent development in transplantation immunobiology is the clini... more Background: The most interesting recent development in transplantation immunobiology is the clinical implementation of tolerance induction. We report our experience of megadose hematopoietic stem cell transplantation with non-myeloablative minimum conditioning in renal allograft recipients. Methods: This was a retrospective, single-center study of 159 renal allograft biopsies from two groups of patients: one group underwent a tolerance induction protocol (TIP) before renal transplantation; the other underwent renal transplantation directly. Biopsies were classified into two subgroups to differentiate between acute and late rejection: 127 biopsies, comprising 64 from patients who underwent a TIP and 63 from controls, performed within 180 days after transplantation; and 32 biopsies, comprising 26 from patients who underwent a TIP and six from controls, performed 180 days after transplantation. All patients received cyclosporine 7 mg/kg/day, tapered to 3 mg/kg/day 3 months after transplantation, and subsequently continued at the latter dosage. Results: There was markedly less immunologic injury (i.e. generally fewer and milder rejection episodes) evident in biopsies from patients who underwent TIP than in biopsies from controls. Cyclosporine toxicity was considerably greater in patients from the TIP versus control group (82.9% vs 40.6%). Conclusion: TIP protects renal allografts from immunologic injury and has an unexplained cyclosporinesparing effect.

The Indian Journal of Pediatrics, 2012

Objective To find out the incidence and natural history of IgMN in India. Methods Renal biopsies ... more Objective To find out the incidence and natural history of IgMN in India. Methods Renal biopsies of children ≤12 y age of last 6 y were retrospectively evaluated. Their clinical and biochemical presentation were correlated. Patients with systemic diseases/disorders were excluded from the study. Results Immunoglobulin M nephropathy (IgMN) constituted 11.9% (n028) of 236 renal biopsies. Mean age was 10 y, predominant in boys (n024), most of the patients presented with proteinuria and edema. The most common associated histopathological finding was mesangial proliferative glomerulonephritis (MePGN) in 60.7% (n017) followed by minimal change disease (MCD) in 28.6% (n08) and focal segmental glomerulosclerosis (FSGS) in 10.7% (n03). In 85.7%, IgM appeared as the sole immunoglobulin deposit mainly in mesangial regions, followed by accompanied C3 in 3.6% (n01) and C1q+C3 in 10.7% (n03) biopsies. Conclusions IgMN was observed in 11.9% biopsies with commonest morphology of MePGN followed by MCD and FSGS; proteinuria was bad prognosticator in addition to FSGS and co-deposition of other immunoglobulins had no significance.