Indian Journal of Kidney Diseases

Oral Fosfomycin for UTI – Guidelines to clinicians Useful fallback—not your frontline UTI antibiotic. By Dr Suresh Kumar, ID consultant, Chennai Summary: ▪️Lower eficacy vs nitrofurantoin → clinical cure 70.7% vs 82.5% in uncomplicated cystitis ▪️Use mainly when first-line agents unsuitable (allergy,resistance, interactions) Active primarily against E. coli and Enterococcus faecalis;poor for other gram-negatives ▪️Avoid in pyelonephritis/febrile UTI → higher relapse (15% vs 4.3%) Role limited to selected niches: ⚡uncomplicated cystitis, ⚡pregnancy, ⚡mild catheter-associated infection, ⚡prostatitis,⚡prophylaxis

🧂Cut the salt, save kidneys & heart❤️ 👤Small♻️: no extra salt, avoid processed foods, read labels, go fresh 🌍Big impact: action across schools,industry & policy A true low-sodium movement=better BP & India’s public health #Hypertension #Nephrology 🔗doi.org/10.4103/ijkd.i…

@anupamayj @AnandhUrmila @drmanishasahay @WomenNeph_india @MayuriTrivedi80 @AleyaAnitha @snamratarao @arvindcanchi @myadla

IJKD Jan- March 2026 issue is now online. Highlights ⭐️ Review article on Pregnancy and long- term kidney care ⭐️ Review on PMNDP program -National dialysis program in India ….. and more Access at journals.lww.com/ijkd/pages/def…

“Less is More” – We Need to Think of the Patients First : Indian Journal of Kidney Diseases journals.lww.com/ijkd/fulltext/…

The Obese Kidney – A Hidden Face of CKD @JasmineNephro @medflutter_ A new entity — Fatty Kidney Disease (FKD) — has emerged to describe fat accumulation within and around the kidneys in obese and diabetic individuals, much like fatty liver disease. This visceral and perirenal fat infiltration compresses renal structures, activates hormonal cascades, and induces inflammation and fibrosis, leading to progressive kidney injury. 🧬 Pathophysiology in Simple Words Fat accumulation in the renal hilum and interstitium compresses blood vessels and nerves. This mechanical pressure activates the renin–angiotensin–aldosterone system (RAAS) and sympathetic nervous system, causing sodium retention, hypertension, and renal fibrosis. Simultaneously, lipotoxicity occurs when free fatty acids infiltrate renal cells, generating oxidative stress, mitochondrial dysfunction, and cytokine release. Insulin resistance worsens this lipid overload and inflammation. Fat droplets within podocytes and mesangial cells lead to glomerulomegaly, basement membrane thickening, albumin leakage, and glomerulosclerosis. In parallel, elevated leptin levels stimulate sodium reabsorption and endothelial proliferation through TGF-β and nitric oxide pathways, culminating in renal fibrosis. All these processes ultimately merge into chronic kidney disease (CKD) — often misclassified as diabetic or hypertensive nephropathy. 🧩 How to Recognize It Fatty kidneys appear enlarged but structurally intact on imaging — unlike cystic or infiltrative kidneys. They are typically seen in patients with obesity, metabolic syndrome, type 2 diabetes, or hypertension. 👉 When an obese or diabetic patient has a declining eGFR with preserved kidney size, always consider Fatty Kidney Disease. ⚕️ Management Approach The management parallels that of metabolic syndrome and nonalcoholic fatty liver disease (NAFLD). The cornerstone remains lifestyle therapy — including a hypocaloric diet, aerobic and resistance exercise, and sustained weight reduction. In morbid obesity, bariatric or endoscopic metabolic surgery can reverse renal fat deposition and improve renal function. Pharmacologic therapy targets the cardio–renal–metabolic axis: RAAS blockers (ACE inhibitors, ARBs, aldosterone antagonists) mitigate hemodynamic and fibrotic stress. SGLT2 inhibitors (e.g., empagliflozin) offer renal and metabolic protection. GLP-1 receptor agonists (liraglutide, semaglutide) reduce weight, lipotoxicity, and inflammation. Finerenone, a nonsteroidal mineralocorticoid receptor antagonist, adds antifibrotic and anti-inflammatory benefit, complementing existing CKD therapies. 💡 CME INDIA Take-Home Messages 🔹 Fatty Kidney Disease is to the kidney what NAFLD is to the liver — a reversible metabolic injury. 🔹 Suspect it when kidneys are large but renal function declines in obese or diabetic patients. 🔹 Shift the focus from creatinine correction to metabolic correction — treat obesity, insulin resistance, and hypertension together. 🔹 Early intervention through lifestyle and modern cardio-renal-metabolic drugs can halt or reverse CKD progression. 📚

The story of a forgotten drug Reserpine traced in this IJKD article @ijkdwin journals.lww.com/ijkd/fulltext/…

Changing paradigm of “Nephrology” services and education in India - a review by master teacher Dr Kasi Visweswaran in the current issue of IJKD @ijkdwin journals.lww.com/ijkd/fulltext/…

New issue alert🔥 With articles on CKM syndrome, a review on changing paradigm of Nephrology education and services and a new feature on historical milestones in Nephrology. Read on journals.lww.com/ijkd/pages/cur…

New life New Beginnings A book by transplant recipients and donors and doctors Blessed to gift the book to my dear friend and renowned nephrologist and Chairman Manipal Hospitals Dr Ballal and his team @KirpalViney @Vasuragh @somusp9 @sundar__raghav @Dr_Kristin_G @karthik2k2 @Jasonphilip8 @anjaliuthup1909 @arvindcanchi @dineshgrao @NottoIndia @VijayKher8 @DrSDiggikar @drshyambansal @SayaliBThakare @krithikasivasw @krithicism @chetanabelagere @GauthamMachaiah

Great job @MoHFW_INDIA for introducing Sugarboards in all government offices. All private offices should also follow this. It feels incredible to see our small idea, spreading into a national movement.

New issue alert 🔥 journals.lww.com/ijkd/pages/cur… Issue highlights ✍️Dietary pattern and NCD ✍️CKD in the elderly ✍️ Hypertension in the young @AnandhUrmila @Ubkhanna @sundar_s1955 @arvindcanchi @valerie_luyckx @anupamayj

@dr_sourabha @anupamayj Thank you 🙏 It’s a fruition of the good work of so many great minds at Win -India

Congratulations @anupamayj ma’am for the feat!

Happy to share that IJKD @ijkdwin is now indexed in DOAJ ( Directory of Open access journals ) @DOAJplus Heartfelt gratitude to our authors, reviewers & editorial board @AnandhUrmila @ISNkidneycare @ISNeducation @arvindcanchi

🔴Stages of Cardiogenic Shock 🫀⤵️ 🔹⚡️⚡️⚡️ #CardioMed #MedEd #MedX #medtwitterWhat #MedTwitter #CardioEd #medx #medEd #CardioTwitter #cardiotwitter #MedX #MedEd #cardiology #cardiotwiteros #FOAMed #medicine #cardiox #medical #cardiovascular #medtwitter #medtwitter #paramedic

Virtual cross match - review Lucidly written by @DTapiawala journals.lww.com/ijkd/fulltext/…

🫘Does Copeptin really predict ADPKD progression Read our latest publication in @ijkdwin journals.lww.com/ijkd/fulltext/… 👏@dr_vaish26

📝Our latest publication-Pseudo AKI in cancer 😬How to differentiate pseudo from true AKI journals.lww.com/ijkd/fulltext/… @ijkdwin 🎊Congrats to my co author and @ISNkidneycare mentee @Anaghashreyas

Lower rates of successful pregnancy outcomes in pts with LN (35.9% vs. 63.5%), higher spontaneous abortion rates (64.1% vs. 32.9%). Increased occurrence of gestational hypertension (23% vs. 9.6%) & preeclampsia (7.6% vs. 0%) was observed in the LN group journals.lww.com/ijkd/fulltext/…

We are familiar with this name. We have all used the catheters designed by this genius, but we know very little about the person. I write about Dr Mahurkar in the just-released bulletin of @NephKarnataka @krithicism @arvindcanchi @sundar_s1955 @snamratarao @Nair_Sanj