Title: To study the calcium and phosphorus metabolism in patients of sickle cell nephropathy from tribal area of central India

Biography:

Punit Gupta has completed MBBS, MD (Medicine), DM (Nephrology) and PhD. He is the Honorary Nephrologists to the Governor of Chhattisgarh State since 2009. He is Chairman and Members of many important academic and management committees of various Government Medical Institutions in the country and the Pt. Deen Dayal Upadhyay Health Sciences University, Raipur. He has guided over 100 Postgraduate & Technologist student for their thesis & Project in Nephrology & Research and also severed as an examiner for the university examinations. A man of researches and publication, he has presented more than 160 research papers and abstracts on kidney diseases in tribal populations at renowned national and international conferences. His oral paper was awarded first prize in ISNCON 2007, New Delhi. He was awarded internationally prestigious APCN Developmental awards in Malaysia 2008 and a follow scholarship by International Society of Peritoneal Dialysis in Turkey 2008. His paper was recognized as a best Paper in API 2014, Bhilai. He was awarded Certificate of Excellence awards by the Times of India groups 2016. His work was appreciated with certificate of appreciation by Indian Dietician association 2016. He was felicitated by Agrasen Agrawal Samaj for his excellent work in Tribal Population 2016. He was honoured with excellence award by ‘Z’ TV Chhattisgarh for this distinguishes work in kidney disease in rural population of Chhattisgarh in 2017. He has developed a concept of Teledialysis, first of its kind in Asia. He has developed Portable dialysis Machine (MAKE-D) for 60 billion kidney patients in world who require dialysis many times in a week. He has developed an abdominal Pressure Measurement Scale, which is very useful of Continuous Ambulatory Peritoneal Dialysis Patients (type of dialysis). He has developed and economic, efficient and effective walkie talkie system for consultation and directions to the hospital staff and doctors. He has been awarded Dr. B. C. Roy National Award for his research to give Aid or Assistance to Research Project for the year 2016.

Abstract

To study calcium and phosphorus metabolism in patients of sickle cell nephropathy, presenting to a Tertiary care hospital in a series of patients with sickle-cell anaemia, serum phosphate and magnesium concentrations were elevated. Serum calcium concentrations were normal. Urinary excretion of calcium was decreased. The maximum tubular reabsorption of phosphate per litre of glomerular filtrate (TmP/GFR) was significantly increased in these patients.The increase in phosphate reabsorption explains the elevated serum phosphate observed in these patients.

Material and Method: 45 patients with Sickle cell nephropathy admitted in Nephrology Unit, Department of Medicine, Pt.J.N.M. Medical College, Raipur were studied. All patients were subjected to Renal Function Tests, serum electrolytes including Calcium and phosphorus and all other relevant routine investigations.        

Result: A total of 45 patients were studied of which 13 were males and 32 females.Fig.1. The mean age of the patients was 26.48 ± 11.6 years. Male to female ratio was1: 2.462. Mean serum Calcium level was 9.404±0.562 while mean serum Phosphorus was 4.348±1.8109. Mean Calcium Phosphorus product was 40.76±18.09 and it was ≥55 in 11% cases out of which 80% were females and 20% were males. Among patients with Calcium Phosphorus product ≥ 55, 20% patient had aortic valve calcification compared to 2.5% in those with Calcium Phosphorus product < 55. In patients with Proteinuria ≥ 1 mean Calcium Phosphorus product was 39.669± 20.19 compared to 41.67 ± 15.13 in patients with Proteinuria < 1gm/day. Also Proteinuria ≥ 1 was present in 40% while Proteinuria < 1gm/24hrs was 60% among patients with Calcium phosphorus product more than 55.Fig.2

Conclusion: Females had more commonly Calcium phosphorus product more than 55 as compared to males. 11% patients had Calcium phosphorus product more than 55. Aortic valve calcification is the most common cardiac abnormality seen. Itching and other skin manifestations were much more common in patients with Calcium phosphorus product more than 55.