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About Dr. Shamik Shah, MBBS, MD, DNB (Nephrology), ISN Fellow
Expertise
I can answer all questions related to kidney diseases, hypertension, plasmapheresis and kidney transplantation. I am a Board certified Nephrologist in India. I was a post-Doctoral Scholar at the Division of Nephrology & Hypertension,Department of Medicine, University of California, San Diego. My area of interest is Critical care Nephrology and Acute Kidney Injury. Please mention the units in which your lab results were reported and the normal reference range for your laboratory.

Professional Profile
http://www.linkedin.com/in/shamikshah

Experience
8 years

Publications
- Shah SH, Mehta RL. “Anticoagulation in CRRT: Is Citrate better?”; Vineet Nayyar Ed. Critical Care Update 2009, Jaypee Brothers (In press)
- Shah SH, Mehta RL. “Non-dialytic management of acute kidney disease”; Evidence based Nephrology, BMJ, (In press)
- Shah SH, Mehta RL. “Epidemiology of Community-acquired AKI”; Ronco C, Bellomo R, Kellum J Eds. Critical Care Nephrology, Saunders. ISBN 1-4160-4252-0
- Abdeen O, Shah SH, Mehta RL; “Dialysis therapies in the surgical intensive care unit”; William Wilson, Christopher Grande, David Hoyt Eds. Trauma: Resuscitation, Anesthesia, and Critical Care, Informa Healthcare, NY 2007. ISBN 0-8247-2920-X
- Shah SH, Mehta RL. Acute kidney injury in critical care: time for a paradigm shift? Curr Opin Nephrol Hypertens. 2006 Nov;15(6):561-5.
- Shah, SH, Soroko S, Lischer E, Mehta RL. Delivered vs. Prescribed dose of Dialysis in Hospitalized Patients: Results of an Audit. J Am Soc Nephrol 17(Abstracts Issue): 2006, 107A.
- Shah SH et al “Biochemical Nutritional Parameters in Non-vegetarian and Vegetarian CAPD patients” Perit Dial Int 2001; 21 Suppl 2: S1-182
- Shah SH et al “Basiliximab in renal transplantation – Does it prevent acute rejections?” Indian J Nephrol 2000: 10: 100-144.

Education/Credentials
MBBS, MD (Internal Medicine), Diplomate of National board (Nephrology), ISN Fellow

Awards and Honors
Fellowship of the International Society of Nephrology 2005.
Young Investigator Award by the International Society of Peritoneal Dialysis 2001

You are here: Experts > Health/Fitness > Nephrology > Nephrology > kidney transplantee - problems

Nephrology - kidney transplantee - problems

Expert: Dr. Shamik Shah, MBBS, MD, DNB (Nephrology), ISN Fellow - 9/21/2008

Question
Dear Dr. Shah,
I have two different questions. Hope you will understand my situation and provide your advice at your earliest.
1)
I am a kidney transplantee of four and half years on immunosuppressant viz cyclosporine, azathirprine and preduisolone; was absolutely OK in terms of kidney function and total and differential count of WBC.
But within 17 days, my WBC count has gone low to 2600 and lymphocytes has gone upto 50%. My urine C/S has revealed UTI with E. coli. Please advice, what should I do?

2)
What does low WBC count (2600) and high lymphocytes (50%) in renal transplantee of four and half years with normal BP and urine output, feverless conditions mean? Do bacterial, viral infections cause these conditions?
Looking forward to your earliest and helpful suggestions,
Regards,
Nirmal

Answer
Hi Nirmal,

Thanks for asking my opinion on "Allexperts".

Urine culture readings are meaningless without a colony count. If the E.Coli colony count is more than 1,00,000, you have significant UTI and should start treatment according to the antibiotic sensitivity pattern.

There can be many causes of a low TLC with a lymphocytic predominance. A detailed history, physical exam, other lab tests and imaging studies are required to diagnose your condition. Please get in touch with your Transplant Nephrologist ASAP.

By the way, the word "transplantee" isn't in the dictionary. A more appropriate term would be "transplant recipient".

Good luck,

Dr. Shah

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