Browsing by Author "Agrawaal, Krishna Kumar"
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Publication Acute Kidney Injury among Patients Visiting the Nephrology Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Agrawaal, Krishna Kumar; Raghubanshi, Prabesh; Bohaju, Anjana; Acharya, JiyaAbstract Introduction: Acute kidney injury is an abrupt decline in renal function often associated with a decrease in urine output. It is the leading cause of in-hospital mortality worldwide with prolonged hospital stays, the requirement of mechanical ventilation and short-term dialysis. The aim of the study was to find out the prevalence of acute kidney injury among patients visiting the Nephrology unit in a tertiary care centre. Methods: This descriptive cross-sectional study was done among patients presented to the Nephrology Unit of the Department of Internal Medicine in a tertiary centre from 9 February 2022 to 21 October 2022. Ethical approval was taken from Institutional Review Committee (Reference number: UCMS/IRC/047/22). Data was collected from hospital records and the outcome was recorded in terms of in-hospital mortality and the requirement for renal replacement therapy. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 1848 patients, 113 (6.12%) (5.03-7.21, 95% Confidence Interval) had acute kidney injury. About 38 (32.75%) required inotropes whereas 10 (8.85%) required mechanical ventilation. In-hospital all-cause mortality was seen in 14 (12.39%) of the study population and 20 (17.70%) of the study population required renal replacement therapy. The most common cause of acute kidney injury was infection pneumonia followed by acute gastrointestinal infections were the most common infective aetiology. Conclusions: The prevalence of acute kidney injury was found to be lower than the studies done in similar settings. It is common in patients admitted with infection. It is responsible for in-hospital mortality.Publication Complications of Arterio-Venous Fistula in Patients Undergoing Haemodialysis(Nepal Health Research Council, 2022) Agrawaal, Krishna KumarAbstract Background: Vascular access is required for hemodialysis and arterio-venous fistula is the preferred access. Various guidelines have recommended monitoring and surveillance of arterio-venous fistula as the standard of care. This study looked into usefulness of clinical examination to detect complications of arterio-venous fistula. Methods: The study was conducted in the from February 2022 till September 2022 under Nephrology unit, Departement of Internal Medicine at Universal College of Medical Sciences. Ethical clearance was taken. Patients undergoing hemodialysis were enrolled in the study. After informed and written consent, clinical examination of arterio-venous fistula was done by look, listen and feel method. Data was collected as per the approved performa. Statistical analysis was done using Statistical Package for the Social Sciences software version 17. Results: Total enrolled study population was 73. Mean age of the study population was 47.45 years ± 14.60 years with a Male: Female ratio of 1.3:1. Complications were seen in a total of 33 patients with an overall rate of 45.2%. The mean duration of AVF creation was 32.68 ± 24.56 months. Most common complication of arterio-venous fistula was overall stenosis 18 (24.7%). Conclusions: There is a higher rate of complications of arterio-venous fistula. Monitoring and surveillance of arterio-venous fistula should be performed as a standard of care in every hemodialysis centre. Keywords: Arterio-venous fistula; complication; hemodialysisPublication Harnessing Social Media to Enhance Nephrology Academia(Nepal Medical Association, 2023) Meena, Priti; Mohanasundaram, Subashri; Kurian, Jithu; Prasad, Ganesh Srinivasa; Bhargava, Vinant; Panda, Sandip; Agrawaal, Krishna KumarAbstract The process of learning has been confined to the realms of educational institutions. Over the last ten years, the semantics of social media networks have evolved with the use of mobile gadgets. Consequently, nephrologists have realised the potential benefits of using these platforms for their educational and career development. Social media can change the horizon of nephrology education. The concept of bedside examination, teaching and sharing experiences have changed with the advent of Facebook, YouTube, Instagram and X (former Twitter). Other networking portals, such as WhatsApp, Telegram, X (former Twitter), and Pinterest, have also amassed the attention of selected users. Despite split opinions on the utility of social media, it is undeniable that it has influenced interaction between students and mentors. Resources ranging from online networks, blogs, visual aids, podcasts, online journal clubs, videos, live conference coverages, and tutorials have made it possible for nephrologists to stay informed and educated with recent updates. In this review, we discuss how social media can enrich nephrology academia, facilitate the sharing of research and access to fellowships and mentorship programs, provide career prospects to trainees, and broadcast scientific conferences while bringing nephrology societies together.Publication Maintenance Hemodialysis among Patients Visiting Nephrology Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Agrawaal, Krishna KumarAbstract Introduction: Maintenance hemodialysis is the treatment of renal failure and chronic kidney disease. Though the government of Nepal is providing free hemodialysis there is no chronic kidney disease registry or data to look into the clinical profile of patients. The aim of this study is to find out the prevalence of maintenance hemodialysis among patients visiting the nephrology unit in a tertiary care centre. Methods: This was a descriptive cross-sectional study carried out from October 2021 to October 2022. Ethical approval was taken from the Institutional Review Committee (Reference number: UCMS/IRC/132/22). All patients receiving maintenance hemodialysis were enrolled in the study. Convenience sampling was done. Point estimate and 95% Confidence Interval were calculated. Results: Among 2190 patients visiting the nephrology unit, maintenance hemodialysis was prevalent in 100 (4.57%) (3.70-5.44, 95% Confidence Interval). Conclusions: The prevalence of maintenance hemodialysis was found to be similar to the other studies done in similar settings.Publication Mean Urea Reduction Ratio among Patients Undergoing Hemodialysis at a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2023) Agrawaal, Krishna Kumar; Kandel, Sanjog; Devkota, SudhanAbstract Introduction: Chronic kidney disease is a major cause of mortality with a prevalence of 6%. Over the past half-century, hemodialysis has been the most preferred modality of treatment for sustaining the life of patients with end-stage kidney disease. Despite hemodialysis being freely available, achieving adequacy in hemodialysis is a challenging task. Inadequate dialysis is responsible for the high mortality. This study aimed to find out the mean value of the urea reduction ratio among patients undergoing hemodialysis at a tertiary care centre. Methods: This was a descriptive cross-sectional study conducted from 15 January 2023 to 15 April 2023. Ethical approval was taken from Institutional Review Committee (Reference number: UCMS/IRC/044/23). Patients aged >18 years, undergoing maintenance hemodialysis and giving informed and written consent were included in the study. Urea reduction rate and single-pool Kt/V were estimated. Convenience sampling method was used. Results: Among 100 patients, the mean urea reduction ratio among the study population was 25.24±15.59%. Males represented 62 (62%) of the study population. The mean age was 47.9±14.74 years. Hypertension and Diabetes mellitus was found to be the leading cause of end-stage kidney disease with 61 (61%) and 27 (27%) respectively. The mean value of spKT/V was 0.73±0.162. Conclusions: The mean urea reduction ratio was found to be lower than the other studies done in similar settings.