Papers by Ruchi Gupta Mahajan
Pediatric Transplantation, Apr 3, 2021
Medullary sponge kidney (MSK) disease predisposes patients to recurrent nephrolithiasis, which af... more Medullary sponge kidney (MSK) disease predisposes patients to recurrent nephrolithiasis, which affects one in every 5000 people in the United States.
Pediatric Nephrology, Jun 25, 2020
Hypertension, Sep 1, 2019
Background: The prevalence of clinical HTN in children and adolescents is 3.5%. Measuring BP with... more Background: The prevalence of clinical HTN in children and adolescents is 3.5%. Measuring BP with an inappropriate cuff is the most common cause of misdiagnosing hypertension. Incorrect measurement can result in unnecessary investigations, treatment, and follow-up for the mistaken diagnosis of hypertension, or no treatment for hypertension in individuals mistakenly thought to have normal BP. Methods: A Prospective case control study of healthy children 4-12 years of age visiting Flushing Hospital Medical Center ACC, between Jan-Nov 2018. Data collected included age, gender, ethnicity, body mass index (BMI), arm circumference, and BP values obtained with different size cuffs. Subjects were divided into 4 BMI groups, differentiated as underweight (B1, BMI < 18.5), normal weight (B2,18.5-24.9), overweight (B3,25-29.9), or obese( B4, > 30). Result: The study was conducted with 137 patients with average age of 7.67 ± 2.48 (Median age 7.0). The study sample included 64 (43%) females and 73 (57%) males with 91% were Hispanic. Two patients were obese and given the limited sample size were excluded.The systolic BP was found to be 5 mmHg less with the larger cuff and 5 mmHg more with the smaller cuff. A one-way ANOVA was done to compare the effect of age on changes in systolic BP when a larger cuff was used. These was no statistical significance between changes in systolic BP for the different age groups (F(8,125)=1.318, p =0.2407). A one-way ANOVA was done to compare the effect of BMI on changes in systolic BP when a larger cuff was used. There was no statistical significance between changes in systolic BP for the BMI groups (F(2,131)=2.349, p =0.09). The same was done for the smaller cuff and systolic BP. No statistically significant change was found because of age (F(8,113)=0.7423, p=0.65 ) or BMI (F(2,119)=2.916, p =0.05). No statistical/clinical difference was found when measuring diastolic BP. Conclusions: Systolic BP in children aged 4-12 years was 5 mmHg higher when measured with a smaller cuff and 5 mmHg lower when measured with a larger cuff. Diastolic BP was not clinically significant for different cuff sizes. Age and BMI did not affect the differences in BP measurement.
Journal of Heart and Lung Transplantation, Apr 1, 2022
Pediatric Transplantation, Nov 21, 2021
BackgroundFocal segmental glomerulosclerosis (FSGS) predisposes patients for risk of recurrent di... more BackgroundFocal segmental glomerulosclerosis (FSGS) predisposes patients for risk of recurrent disease in allografts.MethodsWe report a case of a recipient of an unrelated living donor renal transplant and discuss considerations for utilization of ofatumumab and eplerenone in treatment for recurrent FSGS.ResultsThe recipient was initially managed with scheduled plasmapheresis, intravenous immunoglobulin (IVIG), and rituximab post‐transplant during index hospitalization. With notable recurrence of FSGS noted on kidney transplant biopsy, she was initially treated with additional plasmapheresis sessions leading to downtrend in proteinuria. The patient was then transitioned to LDL‐A pheresis, which resulted again in uptrend in proteinuria. This prompted return to scheduled plasmapheresis sessions weekly, leading again to a downtrend in proteinuria. Albumin levels remained within normal range throughout her course. Following initiation of eplerenone and ofatumumab, the patient demonstrated normalization of urine protein:creatinine ratio and remission of FSGS recurrence without need for additional apheresis.ConclusionsWith notable risk of recurrence of FSGS in kidney transplants leading to allograft failure, the use of ofatumumab and eplerenone in conjunction should be considered for management to induce remission.
Journal of Pediatric Hematology/Oncology, 2022
Atypical hemolytic uremic syndrome (aHUS) is associated with significant mortality and morbidity,... more Atypical hemolytic uremic syndrome (aHUS) is associated with significant mortality and morbidity, including acute renal injury, anemia and thrombocytopenia. Rare cases of aHUS in a child with acute leukemia before diagnosis or during chemotherapy have been reported. We report a pediatric case of B-cell acute lymphoblastic leukemia complicated by pancreatitis with concomitant aHUS following induction chemotherapy.
Journal of Nephrology, 2020
While there are increasing reports of acute kidney injury among hospitalized adults with COVID-19... more While there are increasing reports of acute kidney injury among hospitalized adults with COVID-19, there is still limited information on renal complications associated with COVID-19 in children. The cause of kidney involvement in COVID-19 is likely multifactorial, and appears to involve a complex process, including complement dysregulation and thrombotic microangiopathy. We present a pediatric case of COVID-19 and renal failure due to thombotic microangiopathy, successfully treated with eculizumab.
Hypertension, 2019
Background: The prevalence of clinical HTN in children and adolescents is 3.5%. Measuring BP with... more Background: The prevalence of clinical HTN in children and adolescents is 3.5%. Measuring BP with an inappropriate cuff is the most common cause of misdiagnosing hypertension. Incorrect measurement can result in unnecessary investigations, treatment, and follow-up for the mistaken diagnosis of hypertension, or no treatment for hypertension in individuals mistakenly thought to have normal BP. Methods: A Prospective case control study of healthy children 4-12 years of age visiting Flushing Hospital Medical Center ACC, between Jan-Nov 2018. Data collected included age, gender, ethnicity, body mass index (BMI), arm circumference, and BP values obtained with different size cuffs. Subjects were divided into 4 BMI groups, differentiated as underweight (B1, BMI < 18.5), normal weight (B2,18.5-24.9), overweight (B3,25-29.9), or obese( B4, > 30). Result: The study was conducted with 137 patients with average age of 7.67 ± 2.48 (Median age 7.0). The study sample included 64 (43%) females...
Kidney360, 2021
Key Points AKI was a common finding among pediatric patients hospitalized with COVID-19–associate... more Key Points AKI was a common finding among pediatric patients hospitalized with COVID-19–associated MIS-C.Older age, increased inflammation, and left ventricular systolic dysfunction may be risk factors for AKI in children with MIS-C.Although children with MIS-C may develop AKI, our study suggests that most experience mild disease, swift resolution, and promising outcome. Background Multisystem inflammatory syndrome in children (MIS-C) is a recently identified entity in association with COVID-19. AKI has been widely reported in patients with primary COVID-19 infection. However, there is a paucity of literature regarding renal injury in MIS-C. We aim to characterize AKI in MIS-C in this cohort identified at a major children's hospital in New York City during the COVID-19 pandemic. Methods We conducted a retrospective cohort study of children 0–20 years old admitted to Morgan Stanley Children's Hospital (MSCH) between April 18th and September 23rd, 2020. Patients were included ...
Uploads
Papers by Ruchi Gupta Mahajan