COVID-19 disease in peritoneal dialysis patients: a single centre experience from India

BACKGROUND

This study presents our data on mortality in end stage renal disease (ESRD) patients on peritoneal dialysis (PD) who developed COVID-19.

MATERIALS AND METHODS

Sri Padmavathi Medical College Hospital, Sri Venkateswara Institute of Medical Sciences University, was designated the State COVID Hospital in March 2020. In a retrospective observational study, we collected the data of ESRD patients on PD and identified the risk factors for mortality.

RESULTS

Prior to the pandemic, 136 patients with ESRD were on peritoneal dialysis at our Institute. Among them, 27 (19.8%) eventually developed COVID-19, and 14 of them (51.8%) died. Serum albumin levels were lower and D-dimer levels were significantly higher in deceased patients than in survivors.

DISCUSSION

The mortality rate in ESRD patients on PD with COVID-19 at our institution was higher than in other published studies.

Water drinking practices in adpkd patients: A questionnaire based study

Introduction:

Patients with autosomal dominant polycystic kidney disease (ADPKD) who have normal renal function (creatinine clearance, >90 ml per minute per 1.73 m² of body-surface area) might potentially benefit from frequent water intake that would be sufficient to reduce plasma AVP levels and decrease the average urine osmolality, bringing it closer to that of plasma.

Materials and Methods:

In this cross-sectional study, the patients of ADPKD, chronic kidney disease stages 1–5 were included. We formed a questionnaire on the dietary recommendation to the patients. The questions enquired whether the patients received the recommendation from the faculty and the postgraduates of the nephrology department that (a) they should consume at least 3000 mL of water per day, (b) that they should not consume coffee and tea,(c) adherence of patients to the advice of the nephrologists.

Results:

Of 294 patients, 142 (48.2%) did not receive any dietary recommendation. The rest 152 (51.7%) were given the appropriate dietary recommendation. Majority of the patients mentioned that they lacked the access to the water when they intend to consume. Despite the advice from the nephrologists, 95 (32.3%) failed to observe the abstinence from coffee and tea. The reason expressed for not quitting coffee and tea was the force of the habit.

Conclusion:

Treating doctorsfailed to inform 48% of patients the proper diet. Only 20.3% of patients consumed >3.0 litre of water per day. The demand of the agricultural work at a place away from home deprived majority of the participants of the study from the potable water.

Nephrology Postgraduate Training in Peritoneal Dialysis: An Online Survey

Introduction:

One of the reasons for the peritoneal dialysis (PD) underutilization is related to the training of nephrology postgraduates in PD. This notion is not yet investigated in our country.

Methods:

We gathered the emails of the heads of the departments of nephrology of all medical colleges and the institutes, which impart DM nephrology post-graduation. We sent the questionnaire framed on the postgraduate training of PD. We received the questionnaire responses anonymously. The broad headings in the questionnaire are information on training resources, training activities, perceived adequacy of the training, and the factors, which limit the utilization of PD.

Results:

There are 42 medical colleges and institutes (excluding Sri Venkateswara Institute of Medical Sciences) that impart DM nephrology post-graduation in our country. Of these, 30 heads of the departments had responded. More than half of the heads of the department felt that the PD training postgraduates were inadequate. When asked to describe the reason for the perceived inadequacy of PD training, the primary reason noted included was insufficient numbers of PD patients (66.67%).

Discussion:

The conclusion may be drawn from our study that the postgraduate training in PD in our country is gratifying. Our hypothesis that a lacuna in postgraduate training in PD may be one of the reasons for the underutilization of PD seems ungrounded.

Toxic Epidermal Necrolysis and Acute Kidney Injury due to Glyphosate Ingestion

The literature, particularly from India, is scarce on the renal effects of glyphosate poisoning. Glyphosate causes toxicity not only after its ingestion but also after dermal exposure by inhalation route and on eye exposure. We present a patient report of glyphosate consumption which resulted in toxic epidermal necrolysis – the first report after glyphosate consumption and acute kidney injury.