Browsing by Author "Shah, Dibya Singh"
Now showing 1 - 2 of 2
Results Per Page
Sort Options
Publication BK Virus Nephropathy and Transplant Outcomes: A Single Center Study(Institute of Medicine, Tribhuvan University, 2024) Ojha, Prashanta; Shah, Dibya Singh; Phuyal, Mandira; Mishra, Anand; Sigdel, Mahesh RajAbstract: Background: A significant proportion of renal allografts are complicated by BK Polyoma Virus infection which, if not managed in time, leads to BK Polyoma virus Nephropathy (BKVN). Early recognition and reduction of immunosuppressants is the mainstay of management of BKVN. We aimed to study the clinical characteristics of patients with BKVN, its timeline, management strategies and its outcome at one year of diagnosis. Methods: An observational study was done in Tribhuvan University Teaching Hospital, Nepal, in September 2024. The medical records of living-donor renal transplant recipients between August 2008 to April 2024 with biopsy proven BK virus Nephropathy were reviewed. Time since transplant, recipient age, recipient sex, donor age, donor sex, relationship with Donor, Blood group compatibility, induction agent and immunosuppressive used at the time of BKVN diagnosis, mode of diagnosis and clinical presentation, co-morbid diabetes, other infections during the time of diagnosis, changes in maintenance immunosuppression, other treatments received, renal function 1 year after diagnosis and need for dialysis were studied. Results: Out of 847 living-donor kidney transplants, 15 (1.77%) had BK virus nephropathy. Thirteen (86.7%) were males; mean age was 42 ± 11.53 years and 5(were diabetic. Average HLA mismatch was 3/6. BKVN was diagnosed after a mean period of 16.07±13.24 months after transplant. Thymoglobulin was used as induction agent in 11(73.3%) cases. All the patients were on Tacrolimus, Mycophenolate mofetil and Prednisolone. Average creatinine was 147.93±40.882µMol/L. Patients were managed with reduction in immunosuppressives and fluoroquinolones. Average creatinine after 1 year of diagnosis was increased by 10% to 164.43 ± 101.03µMol/L while one patient required maintenance hemodialysis 3 years later. Conclusion: BKVN was seen in less than 2% of renal allograft recipients; at 16.07±13.24 months after transplant. There was significant renal dysfunction at diagnosis which did not improve at one year, while 1 patient required maintenance hemodialysis.Publication Urinary Tract Infection among Post-renal Transplant Patients in the Department of Nephrology of a Tertiary Care Centre: A Descriptive Cross-sectional Study(Nepal Medical Association, 2022) Khatri, Bikash; Maharjan, Suresh; Lamsal, Jagdish; Khatri, Bijay; Shah, Dibya SinghAbstract Introduction: Urinary tract infection is the most common infection among renal transplant recipients and increases the risk of hospitalization or even death. The study aimed to find the prevalence of urinary tract infection among post-renal transplant patients in the Department of Nephrology of a tertiary care centre. Methods: This is a descriptive cross-sectional study which was conducted among 217 post-renal transplant patients at the Department of Nephrology of a tertiary care centre from 1st November, 2017 to 31st October, 2018. The study was approved by the Institutional Review Committee (Reference number: 245(6-11-E)2074-75). Convenience sampling was used. The data were entered in Microsoft Excel 2011 and analyzed using the Statistical Package for the Social Sciences version 20.0. Point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data and mean with standard deviation for continuous data. Results: Among 217 patients, urinary tract infection was seen in 27 (12.44%) (8.05-16.83 at 95% Confidence Interval). One (3.70%) patient had the infection within three months of transplant, and 17 (62.96%) had infection after more than a year of transplant. Conclusions: The prevalence of urinary tract infection among kidney transplant recipients in our study was lower than previous studies done in similar settings.