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   Table of Contents - Current issue
Coverpage
April-June 2021
Volume 7 | Issue 2
Page Nos. 39-57

Online since Friday, February 25, 2022

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EDITORIAL  

Adverse conditions and pregnancy and vice versa p. 39
Anita Saxena
DOI:10.4103/jrnm.jrnm_2_22  
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ORIGINAL ARTICLE Top

An integrative approach to detect protein–energy wasting among chronic kidney disease maintenance hemodialysis patients p. 43
Sunitha Premalatha, Namratha Shivani, Vaishnavi Yadav, Urmila Anandh
DOI:10.4103/jrnm.jrnm_15_21  
Background: Malnutrition is a major predictor of overall outcome in patients on hemodialysis. Regular and frequent evaluation of the nutritional status of these patients is advisable. Aims and Objectives: This study aimed to look at nutritional status of a hemodialysis cohort and to evaluate whether multiple assessment tools improve the detection of malnutrition in this cohort. Materials and Methods: A prospective study in two outpatient hemodialysis centers was conducted over 6 months. Stable patients without any irreversible organ damage and preserved cognitive function were included in the study. Data collected included demographics, comorbid conditions, and baseline laboratory investigations. The nutritional assessment tools included body mass index (BMI), 7-point Subjective Global Assessment, Global Leadership In Malnutrition (GLIM), handgrip strength, and body composition analysis. Results: A total of 121 subjects (77 males, 44 females) participated in the study. Based on BMI, only 14% were underweight. 7-point SGA detected 77 malnourished subjects, whereas according to GLIM criteria, all patients had some degree of malnutrition. Body composition analysis showed depleted total body protein mass in majority of patients. There was a correlation between total body protein mass and handgrip strength. The assessment tools showed some degree of correlation in patients who were malnourished. Conclusions: Use of a single assessment tool often underdiagnoses malnutrition in hemodialysis patients. An integrative approach using multiple evaluation tools may be beneficial in these groups of patients.
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CLASSROOM READING Top

Effect of uremic toxins on nutritional status p. 48
Anil K Bhalla
DOI:10.4103/jrnm.jrnm_17_21  
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MINI REVIEWS Top

Approach to pregnancy in patient with chronic kidney disease p. 51
Jai Prakash Ojha, Vijay Pratap Singh
DOI:10.4103/jrnm.jrnm_19_21  
A close relationship exists between kidney function and a successful pregnancy outcome. Renal disease can affect the outcome of pregnancy, pregnancy can affect the course of preexisting renal disease, and pregnancy itself can cause acute renal impairment. This article will focus on outcomes of pregnancy in patients with CKD and also pregnancy outcome in patients with ESRD on chronic maintenance dialysis.
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Renovascular hypertension p. 55
Anand Banka
DOI:10.4103/jrnm.jrnm_20_21  
Understanding the mechanisms and implications of renovascular disease remains an important challenge for clinicians caring for patients with hypertension. Renovascular hypertension is suspected when the onset of hypertension occurs before the age of 30 or after the age of 50, or when previously stable hypertension becomes more difficult to control. This article briefly reviews pathophysiology of Renovascular Hypertension, clincal pointers diagnostic tests and management of renovascular hypertension.
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