Browsing by Author "Manas Ranjan Behera"

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Outcomes of symptomatic coronavirus disease 19 in maintenance hemodialysis patient in India
(John Wiley and Sons Inc, 2021) Narayan Prasad; Manas Ranjan Behera; Mansi Bhatt; Sanjay Kumar Agarwal; N. Gopalakrishnan; Edwin Fernando; Arpita Roy Chaudhary; Manisha Sahay; Shivendra Singh; Apoorva Jain; Shruti Tapiawala; Aniket Kamble; Umesh Khanna; Rubina Bohra; Anurag Gupta; Urmila Anandh; Vivekanand Jha
Background: Maintenance hemodialysis (MHD) patients face disadvantages with higher risk of acquiring SARS-CoV-2 infection, atypical manifestations, and associated multiple comorbidities. We describe patients' outcomes with symptomatic COVID-19 on MHD in a large cohort of patients from India. Methods: Data were collected prospectively from hemodialysis units in 11 public and private hospitals between March 15, 2020, and July 31, 2020. The survival determinants were analyzed using stepwise backward elimination cox-regression analysis. Results: Of the 263 total patients (mean age 51.76 ± 13.63 years and males 173) on MHD with symptomatic COVID-19, 35 (13.3%) died. Those who died were older (p = 0.01), had higher frequency of diabetic kidney disease (p = 0.001), comorbidities (p = 0.04), and severe COVID-19 (p = 0.001). Mortality was higher among patients on twice-weekly MHD than thrice-weekly (p = 0.001) and dialysis through central venous catheter (CVC) as compared to arteriovenous fistula (p = 0.001). On multivariate analysis, CVC use (HR 2.53, 95% CI 1.26–5.07, p = 0.009), disease severity (HR = 3.54, 95% CI 1.52–8.26, p = 0.003), and noninvasive ventilatory support (HR 0.59, 95% CI 0.25–0.99, p = 0.049) had significant effect on mortality. Conclusion: The adjusted mortality risk of COVID-19 in MHD patients is high in patients associated with severe COVID-19 and patients having CVC as vascular access. © 2021 Wiley Periodicals LLC.
Protocol and Methods: Role of Levothyroxine on the Progression of Chronic Kidney Disease in Subclinical Hypothyroid Populations (LP‑CKD) – A Multicenter Randomized Controlled Trial
(Wolters Kluwer Medknow Publications, 2023) Narayan Prasad; Shivendra Singh; Vivek Kumar; Manisha Sahay; Arpita Ray Chaudhury; Manas Ranjan Behera; Ravi Shankar Kushwaha; Deependra Yadav; Sonam Gautam; Akhilesh Jaiswal
Introduction: Subclinical hypothyroidism (SCH) is highly prevalent and associated with chronic kidney disease (CKD). However, it is still unanswered whether the restoration of euthyroid status in these patients will be beneficial in retarding a decline in glomerular filtration rate in early CKD patients. We aim to evaluate the efficacy of levothyroxine therapy versus placebo in slowing estimated glomerular filtration rate (eGFR) decline among CKD patients (stage 2–4) with SCH. Methods: This study will be a multicentric, double‑blind, randomized, parallel‑group, placebo‑controlled study. A total of 500 CKD patients, 250 patients in the treatment group and 250 patients in the placebo group, will be randomized. The randomization between the treatment arm and placebo arm will be performed as per the computer‑generated random number table in a 1:1 ratio. The sample size was calculated based on the assumed reduction in eGFR after 1‑year follow‑up in the treatment and placebo groups of 10% and 25%, respectively, at a minimum two‑sided 99% confidence interval and 90% power of the study and considering 20% loss on follow‑up. Each patient will be followed every 3 months for at least 1 year after randomization. Individuals completing 1‑year follow‑up visits will be considered for analysis. The baseline and follow‑up data will be compared between the treatment and placebo groups. The study will evaluate the efficacy and safety of levothyroxine therapy versus placebo in slowing eGFR decline among CKD patients (stage 2‑4) with SCH. The primary endpoint will be the end of follow‑up of the patients, reduction of eGFR by ≥50% from a baseline of that patient, or development of ESKD or death of the patients. The secondary endpoint will be any cardiovascular event or arrhythmia after the institution of the drug. © 2023 Wolters Kluwer Medknow Publications. All rights reserved.