Browsing by Author "Sanjiv Jasuja"

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Burden and predictors of hypertension in India: Results of SEEK (Screening and Early Evaluation of Kidney Disease) study
(BioMed Central Ltd., 2014) Youssef Mk Farag; Bharati V Mittal; Sai Ram Keithi-Reddy; Vidya N Acharya; Alan F Almeida; Anil C; Ballal Hs; Gaccione P; Issacs R; Sanjiv Jasuja; Kirpalani Al; V. Kher; Modi Gk; Georgy Nainan; Jai Prakash; Mohan M Rajapurkar; Rana Ds; Rajanna Sreedhara; Sinha Dk; Bharat V Shah; Sham Sunder; Raj Kumar Sharma; Sridevi Seetharam; Tatapudi Ravi Raju; Ajay K Singh
Background: Hypertension (HTN) is one of the major causes of cardiovascular morbidity and mortality. The objective of the study was to investigate the burden and predictors of HTN in India. Methods. 6120 subjects participated in the Screening and Early Evaluation of Kidney disease (SEEK), a community-based screening program in 53 camps in 13 representative geographic locations in India. Of these, 5929 had recorded blood pressure (BP) measurements. Potential predictors of HTN were collected using a structured questionnaire for SEEK study. Results: HTN was observed in 43.5% of our cohort. After adjusting for center variation (p < 0.0001), predictors of a higher prevalence of HTN were older age ≥40 years (p < 0.0001), BMI of ≥ 23 Kg/M2 (p < 0.0004), larger waist circumference (p < 0.0001), working in sedentary occupation (p < 0.0001), having diabetes mellitus (p < 0.0001), having proteinuria (p < 0.0016), and increased serum creatinine (p < 0.0001). High school/some college education (p = 0.0016), versus less than 9th grade education, was related with lower prevalence of HTN. Of note, proteinuria and CKD were observed in 19% and 23.5% of HTN subjects. About half (54%) of the hypertensive subjects were aware of their hypertension status. Conclusions: HTN was common in this cohort from India. Older age, BMI ≥ 23 Kg/M2, waist circumference, sedentary occupation, education less, diabetes mellitus, presence of proteinuria, and raised serum creatinine were significant predictors of hypertension. Our data suggest that HTN is a major public health problem in India with low awareness, and requires aggressive community-based screening and education to improve health. © 2014 Farag et al.; licensee BioMed Central Ltd.
Epidemiology and risk factors of chronic kidney disease in India - Results from the SEEK (Screening and Early Evaluation of Kidney Disease) study
(2013) Ajay K. Singh; Youssef M.K. Farag; Bharati V. Mittal; Kuyilan Karai Subramanian; Sai Ram Keithi Reddy; Vidya N. Acharya; Alan F. Almeida; Anil Channakeshavamurthy; H Sudarshan Ballal; P. Gaccione; Rajan Issacs; Sanjiv Jasuja; Ashok L. Kirpalani; Vijay Kher; Gopesh K. Modi; Georgy Nainan; Jai Prakash; Devinder Singh Rana; Rajanna Sreedhara; Dilip Kumar Sinha; Shah Bharat V.; Sham Sunder; Raj K. Sharma; Sridevi Seetharam; Tatapudi Ravi Raju; Mohan M. Rajapurkar
Background: There is a rising incidence of chronic kidney disease that is likely to pose major problems for both healthcare and the economy in future years. In India, it has been recently estimated that the age-adjusted incidence rate of ESRD to be 229 per million population (pmp), and >100,000 new patients enter renal replacement programs annually. Methods. We cross-sectionally screened 6120 Indian subjects from 13 academic and private medical centers all over India. We obtained personal and medical history data through a specifically designed questionnaire. Blood and urine samples were collected. Results: The total cohort included in this analysis is 5588 subjects. The mean ± SD age of all participants was 45.22 ± 15.2 years (range 18-98 years) and 55.1% of them were males and 44.9% were females. The overall prevalence of CKD in the SEEK-India cohort was 17.2% with a mean eGFR of 84.27 ± 76.46 versus 116.94 ± 44.65 mL/min/1.73 m2 in non-CKD group while 79.5% in the CKD group had proteinuria. Prevalence of CKD stages 1, 2, 3, 4 and 5 was 7%, 4.3%, 4.3%, 0.8% and 0.8%, respectively. Conclusion: The prevalence of CKD was observed to be 17.2% with ∼6% have CKD stage 3 or worse. CKD risk factors were similar to those reported in earlier studies.It should be stressed to all primary care physicians taking care of hypertensive and diabetic patients to screen for early kidney damage. Early intervention may retard the progression of kidney disease. Planning for the preventive health policies and allocation of more resources for the treatment of CKD/ESRD patients are imperative in India. © 2013 Singh et al.; licensee BioMed Central Ltd.
INASL-ISN Joint Position Statements on Management of Patients with Simultaneous Liver and Kidney Disease
(Elsevier B.V., 2021) Anil Arora; Ashish Kumar; Narayan Prasad; Ajay Duseja; Subrat K. Acharya; Sanjay K. Agarwal; Rakesh Aggarwal; Anil C. Anand; Anil K. Bhalla; Narendra S. Choudhary; Yogesh K. Chawla; Radha K. Dhiman; Vinod K. Dixit; Natarajan Gopalakrishnan; Ashwani Gupta; Umapati N. Hegde; Sanjiv Jasuja; Vivek Jha; Vijay Kher; Ajay Kumar; Kaushal Madan; Rakhi Maiwall; Rajendra P. Mathur; Suman L. Nayak; Gaurav Pandey; Rajendra Pandey; Pankaj Puri; Ramesh R. Rai; Sree B. Raju; Devinder S. Rana; Padaki N. Rao; Manish Rathi; Vivek A. Saraswat; Sanjiv Saxena; Shalimar; Praveen Sharma; Shivaram P. Singh; Ashwani K. Singal; Arvinder S. Soin; Sunil Taneja; Santosh Varughese
Renal dysfunction is very common among patients with chronic liver disease, and concomitant liver disease can occur among patients with chronic kidney disease. The spectrum of clinical presentation and underlying etiology is wide when concomitant kidney and liver disease occur in the same patient. Management of these patients with dual onslaught is challenging and requires a team approach of hepatologists and nephrologists. No recent guidelines exist on algorithmic approach toward diagnosis and management of these challenging patients. The Indian National Association for Study of Liver (INASL) in association with Indian Society of Nephrology (ISN) endeavored to develop joint guidelines on diagnosis and management of patients who have simultaneous liver and kidney disease. For generating these guidelines, an INASL-ISN Taskforce was constituted, which had members from both the societies. The taskforce first identified contentious issues on various aspects of simultaneous liver and kidney diseases, which were allotted to individual members of the taskforce who reviewed them in detail. A round-table meeting of the Taskforce was held on 20–21 October 2018 at New Delhi to discuss, debate, and finalize the consensus statements. The evidence and recommendations in these guidelines have been graded according to the Grading of Recommendations Assessment Development and Evaluation (GRADE) system with minor modifications. The strength of recommendations (strong and weak) thus reflects the quality (grade) of underlying evidence (I, II, III). We present here the INASL-ISN Joint Position Statements on Management of Patients with Simultaneous Liver and Kidney Disease. © 2020 Indian National Association for Study of the Liver