ECAB Clinical Update: Nephrology Kidney Disease and Nutrition “This page intentionally left blank" ECAB Clinical Update: Nephrology Kidney Disease and Nutrition Z. Patel Shruti Tapiawala H. Sudarshan Ballal Vishwanath S. Arvind Ganpule Jitendra Jagtap Sanjeev Gulati Avinash Ignatius Jai Prakash Ramen Baishya K.
Nayak Preeti Singhai Vijay Kher Mayoor V. Shah Shyam Bansal Editor Bharat V. Shah ECAB Clinical Update: Nephrology A division of Reed Elsevier India Private Limited Copyright © 2011 Elsevier Mosby, Saunders, Churchill Livingstone, Butterworth Heinemann and Hanley & Belfus are the Health Science imprints of Elsevier. All rights reserved.
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However, readers are strongly advised to confirm that the information, especially with regard to drug dose/usage, complies with current legislation and standard of practice. Opinions expressed in this book are those of the authors and do not necessarily reflect those of Elsevier India Pvt., the editors, or sponsors. Elsevier India Pvt. assumes no liability for any material published herein.
The publisher does not endorse the quality or value of the advertised/sponsored products described therein. Please consult full prescribing information before issuing prescriptions for any products mentioned in this publication. ISBN 978-81-312-2763-3 Published by: Elsevier, a division of Reed Elsevier India Private Limited Registered Office: 622, Indraprakash Building, 21 Barakhamba Road, New Delhi - 110001 Corporate Office: 14th Floor, Tower 10B, DLF Cyber City, Phase-II, Gurgaon 122002, Haryana Printed at EIH Ltd, Unit: Printing Press, IMT, Manesar. ECAB Clinical Update: Nephrology ELSEVIER CLINICAL ADVISORY BOARD MEMBERS Kidney Disease and Nutrition CONTRIBUTORS Mrs.
Shruti Tapiawala Dr. Sudarshan Ballal Dr. Arvind Ganpule Dr. Jitendra Jagtap Dr.
Sanjeev Gulati Dr. Avinash Ignatius Dr. Jai Prakash Dr. Ramen Baishya Dr.
Preeti Singhai Dr. Vijay Kher Dr. Shyam Bansal EDITOR Dr. Shah ELSEVIER INDIA Clinical Education and Reference Division DIRECTOR SALES MANAGER - CLINICAL Vidhu Goel SPECIALTIES Ravindra Kamble CONTENT MANAGER CONTENT DESIGNERS AND Dr.
Arundhati Kar EDITORS Ms. Bobby Choudhury Dr. Jayeeta Bhattacharjee EDITORIAL OFFICE Elsevier, a division of Reed Elsevier India Private Limited 14th Floor, Building No. 10B, DLF Cyber City, Phase-II, Gurgaon, Haryana – 122002, India.
Telephone: + 91-124-4774444 Fax: + 91-124-4774100 E-mail: ecab@elsevier.com About the Authors Dr. Shah is the Managing Trustee of Narmada Kidney Foundation and Consultant Nephrologist, at Lilavati Hospital and Research Center and Balabhai Nanavati Hospital in Mumbai. In the past, he has been the Head, Department of Medicine and Head of Nephrology section at P. Hinduja National Hospital, Mahim, Mumbai.
Shah has published more than 60 research papers and authored three books. He is a teacher for DNB program in nephrology and member of scientific committee of Indian Society of Nephrology. Vishwanath is currently working as a Consultant Nephrologist in Manipal Hospital, Bangalore. He has secured several distinctions including gold medal in MBBS from Mysore University and also Dr.
Trivedi Gold Medal in Nephrology for being the all India topper in DNB, Nephrology in 2004. He did his training from Manipal Institute of Nephrology and Urology, Manipal Hospital, Bangalore. He is trained in both adult and pediatric nephrology. He has several publications in national journals and also several presentations in both national and international conferences to his credit.
He also authored many chapters in text books including two chapters in Principles and Practice of Pediatric Nephrology, edited by Dr. His areas of interest include peritoneal and hemodialysis, renal transplants, pediatric nephrology and interventional nephrology. Sudarshan Ballal is currently the Chairman, Medical Advisory Board, Manipal Health System and Director of Manipal Institute of Nephrology & Urology, Manipal Hospital, Bangalore. Ballal ranked first in MBBS in all subjects and was also recognized as the best outgoing student of the medical college; he also ranked first in Mysore University.
He was further trained at St. Louis University Medical Center, USA and Board certified in Internal Medicine, Nephrology & Critical Care, USA. Ballal is the winner of the prestigious “Rajyostava Award 2005” conferred by the Government of Karnataka for contributions in ECAB Clinical Update: Nephrology n About the Authors the field of Medicine and Nephrology. Ballal has the rare honor of being appointed as Honorary Clinical Professor of Medicine at St.
Louis University Medical Center, St. Arvind Ganpule is currently a Consultant, Urologist and Chief Division of Laparoscopic Surgery at the Muljibhai Patel Urological Hospital (MPUH), Nadiad, India. He completed his Surgical Residency at Dr. Medical College, Solapur, India in 2001; completed his Fellowship in Endo-urology from the same institute and joined MPUH in 2002.
Since then he has been doing advanced laparoscopy and heading the division of laparoscopy at MPUH. His special interests include application of single port approach in urologic surgery. Incidentally, MPUH is the center who has done the largest number of single port donor nephrectomy. Apart from laparoscopy he is also interested in percutaneous renal surgery.
Ganpule has 46 publications in peer reviewed journals, more than 40 published abstracts and has authored/co-authored 6 chapters. He has presented numerous papers in national and international meetings including papers at prestigious meetings such as AUA and WCE. He was a part of the largest epidemiological study in India on Natural History of BPH, which was subsequently published in BJUI. He has devised a novel cost effective retrieval bag for use in laparoscopy (published in urology).
He is a recipient of the prestigious MIUC scholarship of the west zone chapter of Urological Society of India and the Vijayawada prize of the Urological Society of India for the year 2009–10. Sanjeev Gulati is currently the Associate Director at Fortis Institute of Renal Sciences and Transplantation, New Delhi. He was previously working as Additional Professor in Nephrology at Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow. He has also had the privilege of working as an Associate Professor in Nephrology at the prestigious McMaster University, Hamilton, Canada.
He is qualified in adult and pediatric nephrology and has authored more than 130 scientific papers published in indexed journals including NEJM, Kidney International, and American Journal of Kidney Diseases. He has also authored 15 chapters in various textbooks (including About the Authors n ECAB Clinical Update: Nephrology the prestigious Oxford Textbook of Nephrology and Comprehensive Pediatric Nephrology). He has received several awards for his outstanding research from the Indian Council of Medical Research, Indian Academy of Pediatrics, Indian Society of Nephrology, Australian College of Pediatrics, Royal College of Pediatrics and Child Health– UK, Royal College of Physicians and Surgeons of Canada, and the Japanese Society of Nephrology. He is a reviewer for several prestigious journals like Pediatrics, American Journal of Kidney Diseases, Pediatric Nephrology, and Indian Pediatrics.
He has been in the Executive Committee of the Indian Society of Nephrology, Indian Society of Pediatric Nephrology, Peritoneal Dialysis Society of India, and Indian Society of Organ Transplantation. His areas of special interest include renal transplantation and kidney diseases in children. Jai Prakash is the Professor and Head of the Department, Institute of Medical Sciences, Banaras Hindu University, Varanasi. He has been the founder faculty and the Head, Department of Nephrology, IGIMS, Patna in the past and has been instrumental in establishing the renal transplantation services in Department of Nephrology, BHU, Varanasi in addition to CAPD and augmentation of existing hemodialysis services.
He has been an invited speaker and Chairperson at various scientific sessions at national and international level. Jai Prakash’s biography has been published in the 15th edition of Who’s Who in the World and among 2000 Outstanding Intellectuals of the 20th Century by IBC Cambridge (UK). Jai Prakash has more than 145 publications including chapters in 5 books and has published 63 papers in national and 22 in international journals. Shruti Tapiawala is presently practicing as a Consultant Nephrologist at Kokilaben Dhirubhai Ambani Hospital in the city of Mumbai.
She has performed studies in the field of renal nutrition. Her fields of interest have been the subjective global assessment in kidney disease patients, malnutrition inflammation score in dialysis patients, assessment of nutrition by urea generation and urea removed in stable maintenance hemodialysis patients and many more. These studies were presented and awarded at National conferences and have been published in medical literature. ECAB Clinical Update: Nephrology n About the Authors Dr.
Nayak is presently the Chief Nephrologist at Global Hospitals at Hyderabad. He is a pioneer in the field of peritoneal dialysis internationally and also well known in the areas of chronic kidney disease management, cadaver kidney transplantation & liver dialysis. He was responsible for the country’s first simultaneous heart and kidney transplantation (SHK). He is a member of various task forces & committees and has developed Best Practice Guidelines in Nephrology for our country.
He has been past President of the Peritoneal Dialysis Society of India (PDSI), is a Councilor of the International Society of Peritoneal Dialysis (ISPD), and Chief Coordinator of the Asian PD Core Group. He has successfully held the prestigious and hugely successful 2nd Asian Chapter Meeting of the ISPD, Hyderabad in January 2005. He has contributed extensively in International Journals such as Kidney International (KI), American Journal of Kidney Diseases (AJKD), Journal of American Society of Nephrology (JASN), Nephrology Dialysis and Transplantation (NDT), Peritoneal Dialysis International (PDI), Nephrology, American Journal of Gastroenterology, Contributions to Nephrology to name a few. He was also the guest editor for special issue on “Renal Transplantation in South Asia” in the “Journal of Nephrology & Renal Transplantation (JNRT)”.
Vijay Kher is presently the Chairman, Medanta - Medicity Kidney and Urology Institute, Gurgaon. Before joining Medanta he was the Director of Nephrology & Renal Transplant Medicine at Fortis Healthcare Ltd., after 10 distinguished years as Senior Consultant & Academic Co-coordinator with Indraprastha Apollo Hospitals in New Delhi, bringing with him more than 25 years’ experience. He has worked internationally with Henry Ford Hospital, Detroit, USA and University of Cincinnati Medical Center, Ohio, USA and domestically with the Sher- i-Kashmir Institute of Medical Sciences, Srinagar, J&K; Sanjay Gandhi Post-Graduate Institute of Medical Sciences, Lucknow; and PGIMER, Chandigarh. Kher, a Doctorate in Medicine (DM) in Nephrology, is recognized as an expert in the fields of nephrology and renal transplant medicine.
His areas of expertise and special focus include prevention and attenuation About the Authors n ECAB Clinical Update: Nephrology of progression of chronic kidney disease, kidney transplantation improving outcomes and hepatitis and kidney disease. He is one of the first physicians to practice the concept of pre-emptive kidney transplantation in India. He has successfully completed more than 1500 transplants, for patients from all around the world. Regionally, he is considered to be one of the pre-eminent transplant physicians in Asia.
Kher has published 70 international and 60 national publications and authored more than 20 textbook chapters. He is a Fellow of National Academy of Medical Sciences and Indian Society of Nephrology and Royal College of Physicians, Edinburgh. He is a member of an expert panel to select faculty at various prestigious national medical institutes and a Diplomate National Board Examiner for more than 15 years. “This page intentionally left blank" Contents ECAB Clinical Update Information.
i Nutritional Requirements in Health�������������������������������������������1 Mrs. Patel and Dr. Shruti Tapiawala Dietary Modifications in Diabetic Nephropathy����������������������10 Dr. Nutritional Management of Hypertension and Hypertensive Nephropathy������������������������������������������������������16 Dr.
Sudarshan Ballal and Dr. Dietary Modifications in Renal Stone Disease�������������������������26 Dr. Arvind Ganpule, Dr. Jitendra Jagtap and Dr.
Ramen Baishya Nutritional Management in Nephrotic Syndrome�������������������36 Dr. Avinash Ignatius and Dr. Sanjeev Gulati Nutritional Therapy in Acute Kidney Injury������������������������������47 Dr. Jai Prakash Nutritional Management in Chronic Kidney Disease���������������63 Dr.
Preeti Singhai, Dr. Shah and Dr. Shah Nutritional Management of a Hemodialysis Patient����������������80 Dr. Shruti Tapiawala Nutritional Management of a Peritoneal Dialysis Patient��������92 Dr.
Nayak and Dr.