Hepatitis in living-donor renal allograft recipients.
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Biomedical subjects
Publications and source records attributed to C K Jacob.
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Forty-six patients from 23 Indian families with hereditary chronic nephritis (HCN) with or without Alport's syndrome are presented. The occurrence of this disease in diverse Indian races, communities and castes is now documented. Clinical and laboratory findings in these patients are similar to those reported from temperate regions.
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A retrospective study of children admitted to a south Indian hospital during an 11 year period showed that 70% of the renal diseases encountered in children in this region are of types which have a good prognosis. Post-streptococcal glomerulonephritis was the most common. The relative prevalence of steroid-sensitive nephrotic syndrome and different histological types of idiopathic nephrotic syndrome was similar to that in developed Western countries. Haemolytic-uraemic syndrome complicating bacillary dysentery was the most common cause of acute renal failure.
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Fifty-five consecutive patients with end-stage renal disease entering haemodialysis programmes over a two-month period and 48 consecutive recipients of renal allografts during a period of 6 months were investigated for hepatitis B virus (HBV) and hepatitis D virus (delta) infection. HBV markers were present in 25 of the former and 40 of the latter. Of the 65 patients with HBV infection, 12 were not available for delta antibody screening. HBV infection was present for a mean of 2.5 months and 45.3% of those infected had clinical hepatitis; none had fulminant hepatitis. All the patients tested were negative for antidelta antibody. An additional patient on dialysis with delta superinfection and hepatic encephalopathy is also reported.
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BACKGROUND: The serum lipid profile of renal transplant recipients from the Indian subcontinent is not available. Cyclosporin A causes dyslipidaemia, a major risk factor for coronary artery disease which is a significant cause of mortality in these patients. We compared the effect of two dosage schedules of cyclosporin A on the lipid profile of transplant recipients. METHODS: Two hundred and eight renal allograft recipients were randomized to receive either a high or a low dose of cyclosporin A for 12 months. Their cholesterol and triglyceride levels were measured at monthly intervals for the first six months and at the ninth and twelfth months. The area under the curve was measured and multiple linear regression analysis was done. ANOVA for repeated measures was carried out. RESULT: Patients receiving a higher dose of cyclosporin A had higher cholesterol and triglyceride levels compared to those receiving the lower dose schedule. The multivariate analysis showed that a low dose of cyclosporin A was significantly associated with reduced cholesterol (p < 0.07) and triglyceride levels (p < 0.04) after controlling the effect of other covariates. ANOVA for repeated measures showed that cholesterol levels were significantly lower in the low-dose cyclosporin A group (p < 0.05). CONCLUSION: Low dose cyclosporin A reduces the risk of dyslipidaemia in Indian renal transplant recipients.
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