Nephrology Education
What every nephrologist needs to know about hydroxychloroquine toxicity
Isabelle Ayoub, Priyamvada Singh, Stacy Ardoin, Sergey Brodsky, and Lee Hebert
Volume 93 (2020) p. 149 - 151
Abstract
Clinical Nephrology, Vol. 93 – No. 3/2020 (149-151)
What every nephrologist needs to know about hydroxychloroquine toxicity
Isabelle Ayoub1, Priyamvada Singh2, Stacy Ardoin3, Sergey Brodsky3, and Lee Hebert1
1Division of Nephrology, 2Division of Transplant Nephrology, 3Division of Rheumatology, Department of Internal Medicine, and 4Division of Pathology, Ohio State University Wexner Medical, Columbus, OH, USA
Hydroxychloroquine (HCQ) has become the rheumatologists’s “Swiss army knife” when it comes to managing the rheumatologic manifestations of SLE and other auto-immune disorders. By contrast, nephrologists are much less comfortable in managing the multifaceted effect of HCQ. As a result, nephrologists are inclined to abdicate their responsibility for HCQ management, if this therapy was initiated by a rheumatologist. This report describes such a situation, which had devastating consequences for the patient. On this basis we suggest that this report is a story worth telling, and should encourage the nephrologist to be more involved in their patients’ HCQ management.Correspondence to:
Isabelle Ayoub, MD
Division of Nephrology, Department of Internal Medicine
Ohio State University Wexner Medical
395 W. 12 Ave., Ground Floor
Columbus, OH 43210, USA
Email: isabelle.ayoub@
osumc.edu
Original
A real-world, single-center experience of the utilization of hepatitis C-viremic kidneys for hepatitis C-negative recipients
Reem Daloul, Michaels Anthony, Kenneth Washburn, Priyamvada Singh, and Todd Pesavento
Volume 96 (2021) p. 216 - 225
Abstract
Clinical Nephrology, Vol. 96 – No. 4/2021 (216-225)
A real-world, single-center experience of the utilization of hepatitis C-viremic kidneys for hepatitis C-negative recipients
Reem Daloul, Michaels Anthony, Kenneth Washburn, Priyamvada Singh, and Todd Pesavento
The Ohio State University Medical Center, Columbus, OH, USA
The advent of direct-acting antiviral (DAA) therapies has allowed kidney transplantation from hepatitis C (HCV)-viremic donors into negative recipients. We evaluated the safety and feasibility of such practice when utilizing a patient’s health plan to cover the cost for DAAs.
Materials and methods: This was a prospective, non-randomized, pilot clinical study. 30 HCV-negative participants received kidney transplant from HCV-viremic deceased donors. HCV polymerase chain reaction (PCR) was checked on day 3 post transplant, and a request for pan-genotypic DAA therapy was sent once viremia was confirmed. Primary outcomes were the percentage of patients achieving sustained virologic response defined as undetectable HCV PCR 12 weeks after therapy completion, and the percentage of patients receiving DAAs via patient’s health plan.
Results: HCV viremia occurred in all 30 recipients. Sustained viral response was achieved in 93% of the patients. Two patients failed first-line DAAs, 1 patient due to non-compliance with the prescribed regimen while the other due to NS5A mutation. DAA therapy was successfully obtained via patient’s health plan in 28/30 patients. There was no significant liver-related complication, patient death, or graft loss.
Conclusion: Kidney transplantation from HCV-viremic donors appears to be safe. However, challenges with obtaining DAA coverage in the United States persist.Correspondence to:
Reem Daloul, MD
The Ohio State University Medical Center
395 W, 12th ave, Columbus, OH 43210, USA
Email: [email protected]
Letter to the Editor
Successful corticosteroid therapy for exenatideinduced acute interstitial nephritis
Mohankumar Doraiswamy, Raja Damayanthi Murali, Rima Kang, Aijaz Gundroo, Sergey Brodsky, Alka Tyagi, and Priyamvada Singh
Volume 96 (2021) p. 357 - 359
Abstract
Clinical Nephrology, Vol. 96 – No. 6/2021 – Letters to the editor
Successful corticosteroid therapy for exenatideinduced acute interstitial nephritis
Mohankumar Doraiswamy1, Raja Damayanthi Murali2, Rima Kang1, Aijaz Gundroo1, Sergey Brodsky1, Alka Tyagi1, and Priyamvada Singh1
1Division of Nephrology, The Ohio State University Wexner Medical Center, Columbus, and 2MetroHealth Medical Center, Cleveland, OH, USA
Correspondence to:
Priyamvada Singh
Division of Nephrology
The Ohio State University Wexner Medical Center
395 W 12th Ave, Columbus, OH, 43210, USA
Email: [email protected]
Original
Real world, retrospective experience of glucagon-like peptide-1 receptor agonists in kidney transplant recipients: A single-center case series
Priyamvada Singh, Melissa McGowan, Lauren Von Stein, Johanna Papanikolla, Annelise Nolan, Hannah Lingren, Noah Jagielski, Navdeep Singh, Shumei Meng, and Todd Pesavento
Volume 105 (2026) p. 318 - 324
Abstract
Clinical Nephrology, Vol. 105 – No. 5/2026 (318-324)
Real world, retrospective experience of glucagon-like peptide-1 receptor agonists in kidney transplant recipients: A single-center case series
Priyamvada Singh, Melissa McGowan, Lauren Von Stein, Johanna Papanikolla, Annelise Nolan, Hannah Lingren, Noah Jagielski, Navdeep Singh, Shumei Meng, and Todd Pesavento
Comprehensive Transplant Center, Ohio State University, Columbus, OH, USA
We conducted a retrospective chart review of adult kidney transplant recipients (KTxR) with type 2 diabetes treated with a glucagon-like peptide-1 receptor agonist (GLP-1RA). A total of 211, 207, 161, and 92 KTxR were followed for 6, 12, 36, and 60 months, respectively. Over 5 years, we observed statistically significant reductions in the primary endpoints of weight, HbA1c, and major adverse cardiovascular events (MACE). The mean weight reduction was as follows: 1.17 kg at 6 months (p < 0.006), 1.2 kg at 12 months (p < 0.03), 3.7 kg at 36 months (p < 0.0001), and 4.1 kg at 60 months (p = 0.001) compared to baseline. The HbA1c levels showed reductions of 0.6 mmol/mol at 6 months (p < 0.0001), 0.5 mmol/mol at 12 months (p = 0.0004), 0.3 mmol/mol at 36 months (p = 0.04), and 0.35 mmol/mol at 60 months (p = 0.35). MACE rates fell from 45.5% at GLP-1RA initiation to 18.9% during follow-up (OR 3.6 (2.3 – 5.6), p < 0.0001). Insulin requirements decreased from 50 to 27 units over 5 years. Kidney function reduces over time in KTx, likely secondary to hemodynamic or vascular-mediated risk factors, chronic immunosuppressive agents, treatment for rejections, and solitary transplanted kidney. In our study, estimated glomerular filtration rate (eGFR) not only stayed stable but also showed a trend towards improvement (eGFR improved from 50 to 53 mL/min/1.73m2). Further prospective randomized trials are needed to assess GLP-1RA efficacy and safety in KTxR.Correspondence to:
Priyamvada Singh, MBBS, FASN
Division of Nephrology and Comprehensive Transplant Center
Ohio State University
395 W 12 Avenue
Columbus, OH 43210, USA
Email: [email protected]
