Sreejith Parameswaran
Sreejith Parameswaran

@SreejithDr

20 Tweets 7 reads Dec 03, 2022
I spoke about 'Pulmonary Disorders in Kidney Diseases' at #ISNCON22, the annual conference of Ind Society of Nephrology yesterday - a quick recap
#PRS
Lung & Kidney involvement may be part of a systemic disease process, the Pulmonary-Renal Syndrome (#PRS) Or, the Lung conditon may be the consequence of a primary kidney disease
#ISNCON22
This was an interesting case of #PRS we managed @JipmerNephro
Lack of IF tissue in Kidney Bx meant that a conclusive diagnosis difficult, initially. #ISNCON22
Pt was treated as RPGN & a follow up Kidney Bx was done after abt 8 months, which finally revealed what was the underlying kidney disease. His #PRS was most likely from #IgAVasculitis
#ISNCON22
#IgAN is not a very common cause for #PRS with #DAH
Our systematic review revealed only a handful of cases of Diffuse Alveolar Haemorrhage (#DAH) in pts with #IgAN (not #IgAVasculitis).
#ISNCON22
pubmed.ncbi.nlm.nih.gov
Summary of cases with #DAH in #IgAN from our systematic review
#ISNCON22 #PRS
IgA mediated syndromes that presenting as #PRS
#ISNCON22 & potential mechanisms
Our experience @OfficialJipmer @JipmerNephro with #PRS in Medical ICU
#ISNCON22
-SLE more common than AAV (unlike in d West)
-There are a few Tropical conditions which 'mimic' #PRS & need to be considered in the DD
The "#PRS Mimickers".
Includes some tropical conditions relevant to the Indian situation
#ISNCON22
'Pulmonary Consequences of Renal Disease' may be mediated through myriad pathophysiological changes in Kidney Disease #PRS #ISNCON22
Pulmonary Manifestations of Kidney Disease - 01
#PRS #ISNCON22
Pulmonary Manifestations of Kidney Disease - 02
#PRS #ISNCON22
Pulmonary Manifestations of Kidney Disease - 03
#PRS #ISNCON22
Pulmonary Manifestations of Kidney Disease - 04
#PRS #ISNCON22
Why Pneumococcal & Influenza #Vaccines are important for #dialysis pts (along with COVID-19, Hep B etc).
Screening of #LatentTB with IGRA is now recommended for Dialysis pts by the National TB Elimination program in India.
#ISNCON22
"#DialysisLung" refers to the dip in PaO2 after initiation of an HD Session & the primary reason is Alveolar Hypoventilation due to CO2 diffusion into dialysis
#ISNCON22
Lung Involvement is common after #KidneyTransplantation, can be infectious or non-infectious and the spectrum is time-dependent
#ISNCON22 #PRS
The Induction agents as well as Immunosuppressive drugs used in Kidney Transplantation also can have pulmonary adverse effects (though not common).
#ISNCON22 #PRS
To Summarise:
-Pulmonary involvement is common in pts with Kidney Disease
-Consequence of Primary Kidney Disease Or Systemic Process involving both Kidney & Lungs
-Associated with significant Morbidity & Mortality
#ISNCON22 #PRS

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