VR.Krishnakumar

MD, DNB,DM, DrNB Nephrology,Glomcon-KPCP 2024,Fellowship in Glomerular Disease -Glomcon 2025 ,Fellow Renal Transplant & immunology, IJN Visual Abstract Creator,

[VR.Krishnakumar @KKNephBytes]

Renal Allograft Journey #Failinggraft #Failedgraft #Transplant #KKNephBytes @DrAkshayaJ @DrMedhavi_G @drshyambansal @hafeeq_benil @hardik4u24 @isn_india @myadla @priti899 @arvindcanchi @CMEINDIA1

[VR.Krishnakumar @KKNephBytes]

Blood transfusion amd Alloimmunization #Transplant #Immunology #KKNephBytes @arvindcanchi @CMEINDIA1 @DrAkshayaJ @DrMedhavi_G @drshyambansal @hafeeq_benil @hardik4u24 @isn_india @myadla @priti899 @suhalikapath @ShreshtaT @JJayameena @AnjanaGopal9 @DrAnjanaAsokan @hafeeq_benil

[VR.Krishnakumar @KKNephBytes]

Post transplant TMA. Key points #transplant #KKNephBytes
@CMEINDIA1 @DrAkshayaJ @DrMedhavi_G @drshyambansal @hafeeq_benil @hardik4u24 @myadla @priti899 @ShreshtaT @suhalikapath, @arvindcanchi

[VR.Krishnakumar @KKNephBytes]

Post transplant diarrhoea #transplant #diarrhea
@arvindcanchi @CMEINDIA1 @DrAkshayaJ @DrMedhavi_G @drshyambansal @hafeeq_benil @hardik4u24 @IamGopambuj @isn_india @myadla @priti899 @suhalikapath @

[VR.Krishnakumar @KKNephBytes]

TCMR with Hemorrhage Key Points
#Transplant #Biopsy #KKNephBytes
@arvindcanchi @CMEINDIA1 @DrAkshayaJ @DrMedhavi_G @drshyambansal @hafeeq_benil @hardik4u24 @isn_india @myadla @ShreshtaT @

[VR.Krishnakumar @KKNephBytes]

@priti899 @NephroSeeker @DrAkshayaJ @DrMedhavi_G @CharuMalik_ISN @valerie_luyckx @myadla @bhushan_sree @thisis_drgsp @IamGopambuj @arvindcanchi Congtz

[Arvind Canchi (Conjeevaram)🇮🇳 @arvindcanchi]

Paired Kidney Donation Guidelines okayed by the Karnataka Government. This is great news.

[VR.Krishnakumar @KKNephBytes]

ABCDE frame work New Era In Kidney Health
#KKNephBytes #CKD
@DrAkshayaJ @drshyambansal @hafeeq_benil @hardik4u24 @isn_india @NDTsocial @priti899 @ShreshtaT @suhalikapath @JJayameena @nephromythri @arvindcanchi @CMEINDIA1 @ISNkidneycare

[VR.Krishnakumar @KKNephBytes]

HLA-B15: A Hidden Story Beneath the Surface
#KKNephBytes #Immunology
@DrAkshayaJ @drshyambansal @hardik4u24 @isn_india @priti899 @sciqst @ShreshtaT @suhalikapath @arvindcanchi @hafeeq_benil @JJayameena

[Sayed S Rahman @SayedSRahman1]

Membranous Nephropathy

🔬Anti-PLA2R = used for Diagnosis , Prognosis, Monitoring

📊 Risk stratify: Based on
Proteinuria + eGFR + AntiPLA2R

🟢 Low risk→ Supportive
🟡 Mod→ Observe ± RTX
🔴 High→ Rituximab / Cyclophosphamide+Steroid

👍for Antigens: VA @KKNephBytes 💯
#KDIGO

[Akshaya Jayachandran 🇮🇳 @DrAkshayaJ]

Honoured to be a part of this amazing team !!✨🎉🗺️
Looking forward to #ISNWCN & Japan 🇯🇵 !!
@ISNWCN @Alexgr23 @Glomkeeper @manishmedicine1 @Arunkr_Dr @acssjr @brammahin @NephroSeeker @dra_miliflores @Dilushiwijay @GabyNeph @HarukaM_5 @KajareeG @DrMedhavi_G @deniise_am @myadla

[VR.Krishnakumar @KKNephBytes]

Dormant but Dangerous: DQ Will Return
#KKNephbytes
#transplant
#immunology
@DrAkshayaJ @drshyambansal @hardik4u24 @isn_india @ShreshtaT @priti899 @suhalikapath @arvindcanchi

[Dr Priti MD,FASN🇮🇳 (प्रिति) @priti899]

"😎Glad to see our data, hitting the press! 🚀
✔️ Driven by these findings, we’ve just kicked off an RCT 🎲 in the department comparing VKA💊 versus DOACs in NS. 💥Likely to move the needle on anticoagulation strategies in NS . https://t.co/W5TGhaQoKq

@SaynaNorouzi @AKronbichler @myadla @SwarnalathaGud2

[VR.Krishnakumar @KKNephBytes]

*When Positivity Misleads: Recognizing False Signals in SAB Testing*
***********************
⚡SAB positivity can represent artefact rather than true immunologic risk

⚡High MFI alone is unreliable without pattern and clinical context

⚡A broad, tapering (“long-tail”) pattern suggests non-specific reactivity

⚡Lack of sensitization history should prompt cautious interpretation

⚡FlowPRA and FCXM discordance helps identify non-clinical antibodies

⚡Absence of a shared epitope supports non-specific binding

⚡Misinterpretation can lead to false DSA assignment and inflated cPRA

⚡Result in unnecessary exclusion of compatible donors

⚡Always interpret SAB results in integration with clinical and laboratory correlation

⚡Pattern recognition is more reliable than numerical thresholds

#KKNephBytes #Immunology
@arvindcanchi @DrAkshayaJ @drshyambansal @hardik4u24 @isn_india @priti899 @suhalikapath @AnjanaGopal9 @raja_1980 @dr_sourabha @iamnephrologist

[VR.Krishnakumar @KKNephBytes]

Hi!
We are currently analyzing HLA-DQ antibodies, and our observations suggest a predominant role of the beta chain in driving immunogenicity. However, the alpha chain significantly modulates this response, and in some cases, we are seeing isolated alpha-chain–targeted epitopes contributing to DSA formation.
These findings highlight the complexity of DQ heterodimer immunogenicity—both chains cannot be interpreted in isolation. Further population-based and eplet-level analyses are needed to better understand these patterns and their clinical relevance.

[VR.Krishnakumar @KKNephBytes]

*HLA-DQ Antibodies: The Silent Cracker That Starts the Blast*
***************************
⚡HLA-DQ antibodies are the most common de novo DSA

⚡HLA-DQ DSA have the worst graft outcomes (ABMR, TG, graft loss)

⚡DQ mismatch carries the highest risk of sensitization (↑cPRA)

⚡ HLA-DQ has dual polymorphism (α + β chains)

⚡Can form multiple heterodimers (cis + trans pairing)

⚡ More heterodimers → more epitopes → higher immunogenicity
⚡ HLA-DQ shows low expression but high pathogenicity

⚡ Expression is delayed but sustained → chronic rejection

⚡ DQ antibodies activate Akt / S6 / IL-6 pathways

⚡ Current matching underestimates DQ risk

⚡ Eplet/pairing-based analysis > antigen matching

#KKNephBytes #Immunology
@arvindcanchi @DrAkshayaJ @drshyambansal @hardik4u24 @isn_india @priti899 @suhalikapath @JJayameena

[VR.Krishnakumar @KKNephBytes]

“World Kidney Day Awareness: CKD Do’s and Don’ts "
#WorldKidneyday @DrAkshayaJ @worldkidneyday @arvindcanchi @drshyambansal @taruna_pahuja @KKNephBytes @YashenduSarda @isn_india

[VR.Krishnakumar @KKNephBytes]

Good Diet Save your Kidney #WorldKidneyday @DrAkshayaJ @worldkidneyday @arvindcanchi @drshyambansal @taruna_pahuja @KKNephBytes @YashenduSarda @isn_india