Urology

1. AUGUST 2023
TRANSPLANT MEET

2. MR.JAYAPAL 46/M –
MRS.MALARVIZHI 46/F

3. MR.JAYAPAL 46/M- B POSITIVE
• Married, 2 children, Farmer
• 2013- Epistaxis – SHT- not followed up
• Nov 2019- Uremic symptoms –
Diagnosed CKD5D initiated on MHD
• NKD- NK
• Dec 2022- Refractory Anemia- BMBX-
cellular marrow, adequate iron stores.
Suspect EPO resistance , started on
Desidustat. Anemia improved
• CKD 5D /MHD 2/7 –DV-3.5YR
• DA- L BCF
• No of DC-3
• VM- NEGATIVE
• NO Femoral canulation
• H/O PRBC transfusions -2
• VCU/IVD- NORMAL
• ALL FITNESS OBTAINED
• ECHO-EF-60%,no RWMA, grade II LVDD
• u/o-100 ml/d
• NO FAMILY HISTORY
• DME/DMS- OBTAINED
• Prelim Cross match - Negative

4. VCU

5. ILIAC VESSEL DOPPLER

6. PEDIGREE CHART

7. MRS.MALARVIZHI 45/F- O POSITIVE
• P2L2
• WIFE
• NVD, PS done
• Regular Menstrual cycle
• NO COMORB
• OGTT- NORMAL
• 24 HR URINE CR CLEARANCE-160
ml/min
• 24 hr urine protein- 37 mg/d
• S Cr-0.6
• TFT- NORMAL
• COVID VACCINE COMPLETED
• VM- NEGATIVE
• Cardiac function – EF 60%, no RWMA
• ALL FITNESS OBTAINED.
• OG- cervicitis – S/P Fractional
curettage, HPE – Chronic cervicitis-
treated
• DTPA – scaled GFR – 101.82, LK-47.41,
RK-48.28
• CTRA- B/L single artery and veins.

8. DTPA

9. CT RENAL ANGIO

10. MR.RAJENDRAN 50/M –
MRS.RENUGA 41/F

11. MR.RAJENDRAN 50/M-A POSITIVE
• Married, 2 children, Cooli
• SHTN – 8 yrs
• DM – 5 yrs
• CAD- S/P PTCA in 2018
• 2020 Jan- pulmonary edema – Creat 4.5,
CKD-5ND – managed conservatively
• 2022 Dec- Volume overload – initiated on
MHD @ RGGGH
• CKD 5D /MHD 3/7 –DV-8 months
• DA- L BCF
• No of DC-2
• VM- NEGATIVE
• NO Femoral canulation
• No PRBC transfusions
• VCU/IVD- NORMAL
• ALL FITNESS OBTAINED
• ECHO- Global hypokinesia of LV, EF -
36%/ Mod LVSD, Mod TR
• u/o-100 ml/d
• NO FAMILY HISTORY
• DME/DMS- OBTAINED
• Prelim Cross match - Negative

12. VCU

13. ILIAC VESSEL DOPPLER

14. PEDIGREE CHART

15. MRS.RENUGA 41/F- O POSITIVE
• P2L2A1
• WIFE
• POST HYSTERECTOMY STATUS
• NO COMORB
• OGTT- NORMAL
• 24 HR URINE CR CLEARANCE-154
ml/min
• 24 hr urine protein- 130 mg/d
• S Cr-0.7
• TFT- NORMAL
• COVID VACCINE COMPLETED
• VM- NEGATIVE
• Cardiac function – EF 60%, no RWMA
• ALL FITNESS OBTAINED
• DTPA – scaled GFR – 85.74, LK-
42.23ml, RK-43.51ml
• CTRA- B/L single artery and veins.
Right Prehilar Branching

16. DTPA

17. CT RENAL ANGIOGRAM

18. MR. NAVEEN 23/M – MR. MAYILRAJ
45/M

19. MR. NAVEEN 23/M- AB POSITIVE
• Un married, Dip in Engg
• Oct 2022- Uremic symptoms –
Diagnosed CKD5D initiated on HD @
Thirunelveli
• NKD- NK
• Referred to RGGGH.. Initiated on MHD
• ANA – speckled 2+, C3 – 71, C4 – 32,
• ANA -3 negative, anti dsDNA - Negative
• CKD 5D /MHD 2/7 –3/7 --- 8 mths
• DA- L RCF
• No of DC-2
• VM- NEGATIVE
• Left Femoral canulation +
• H/O PRBC transfusions -nil
• VCU/IVD- NORMAL
• ALL FITNESS OBTAINED
• ECHO-EF-60%,no RWMA, mild TR
• u/o-100 ml/d
• NO FAMILY HISTORY
• DME/DMS- OBTAINED
• Prelim Cross match - Negative

20. VCU

21. ILIAC VESSEL DOPPLER

22. PEDIGREE

23. MRS.MAYILRAJ 45/M- A POSITIVE
• Reformed smoker and alcoholic
• Father
• NO COMORB
• OGTT- NORMAL
• 24 HR URINE CR CLEARANCE-93.8
ml/min
• 24 hr urine protein- 121 mg/d
• S Cr-0.9
• TFT- NORMAL
• COVID VACCINE COMPLETED
• VM- NEGATIVE
• Cardiac function – EF 70%, no RWMA
• ALL FITNESS OBTAINED.
• DTPA – scaled GFR – 104.78, LK-47.61
ml, RK-47.07 ml
• CTRA- B/L single artery and veins.
• Interrupted mixed density plauque
noted in B/L common iliac causing
20% lumen narrowing
• Vascular opinion obtained

24. DTPA

25. CT RENAL ANGIO

26. VASCULAR OPINOIN

27. THANK YOU