Monday, 10 September 2018

Research aims to prevent kidney failure caused by type 2 diabetes

A grant of $1.75 million spread over four years has been made to study how to prevent kidney damage and, ultimately, failure, caused by type 2 diabetes.

The chief researcher in this project is Dr Krisztian Stadler, who has published 56 research articles which are often quoted in other scientists' work.

"Kidney disease is a major complication of obesity and type 2 diabetes," Dr. Krisztian Stadler said. "Our projects focus on discovering the mechanisms that lead to the death of proximal tubular epithelial cells."

Tubular epithelial cells play a crucial role in kidney function, and the cells require high amounts of a specific type of energy source to work correctly - lipids and fatty acids, Dr. Stadler said. Unfortunately, people with type 2 diabetes have lipid metabolism derailments. Their kidney tubular cells can't properly burn fat or make enough of the molecule adenosine 5'-triphosphate (ATP) to meet the cells' energy needs. Without enough ATP, tubular epithelial cells wither and die.

"Our hope is that by understanding these mechanisms, future interventions can be designed not only to treat but to prevent tubular cell injury and kidney failure," Dr. Stadler said.

You can read the press release here

Friday, 7 September 2018

Peritoneal Dialysis Still Not Used Enough

The two main types of dialysis are Hemodialysis, the original version, where a patient visits a clinic regularly and spends a long time hooked up to a machine and Peritoneal Dialysis which occurs overnight in the patients home, via a catheter inserted into the patient's abdomen. Peritoneal Dialysis is much more convenient for the patient, as it happens while they are asleep and doesn't require regular appointments at a clinic three times a week. So life becomes a bit less restricted for the patient. It's also cheaper.

But a report here points out that only a small percentage of patients use Peritoneal Dialysis! About 9 - 10% of patients in the US. In other countries that emphasize this option, the numbers are a lot higher - as many as 80% of kidney failure patients in Hong Kong are on Peritoneal Dialysis! In the UK the figures vary from region to region, as reported here and can be as high as 30% in adults and 56% in children.

So why so few in the US? It's been suggested that patients are not being advised to take this route and that clinicians claim there is not enough staff available who can train the patient to carry out the procedure at home. Of course, if care is geared towards expensive to set up dialysis clinics, would you expect these centres to recommend a cheaper alternative? Why are more patients not doing a bit of research before committing to Hemodialysis, which requires a lot of reorganising of their life and work? If you have just been diagnosed as needing dialysis or know someone who has, make an effort to check out the various methods available and make your own decision.

Even Medicare is trying to promote home dialysis, as reported here.

Saturday, 11 August 2018

Study shows Vitamin D Lowers Infection Risk

Infections are common and can be fatal in patients undergoing long-term dialysis. Recent studies have shown conflicting evidence associating infection with vitamin D status or use of vitamin D and have not been systematically reviewed in this population.

So a group of medical scientists took a detailed look at existing studies and carefully analysed the results.

If a patient has high or normal serum levels of vitamin d and uses vitamin D supplements, there is a lower risk osf infection for patients on long-term dialysis.
A review by  two groups, one at Karolinska Institutet in Stockholm, Sweden and the other at Guangdong Provincial Hospital of Chinese Medicine, of 17 studies came to this conclusion. Also, those with vitamin D deficiency who took supplements reduced their chances of infection by 41%.

You can have a read of the summary here

Tuesday, 31 July 2018

Kidney Donor Found via Facebook

We all know that some people act as anonymous altruistic kidney donors, and how amazing they are. This news item refers to how one young lady found a donor.

Louise Sach was told she was in kidney failure aged 8 and wouldn't make it through adulthood without a transplant.

Louise Sach, 28, had reached a stalemate in her search for a donor after being told her kidney function was starting to seriously deteriorate last year.

In a last bid to find a match, Louise set up a Facebook page to see if she could attract a donor.

She hoped an old friend or colleague might come forward.

The last thing she expected was a complete stranger to give her the kidney she so badly needed.

Incredibly, that's exactly what happened.

Kayleigh Wakeling, 33, from Hertfordshire stepped forward and now the two are best friends.

You can read the full news item on the Mirror's website.

Saturday, 28 July 2018

Kidneys and the Brain

Kidney disease doesn't just affect a patient's body, it's hard on their brain too—but no one really knows to what extent. Scientists at Queens University, Canada, are conducting studies into the kidney-brain connection.

Patients on dialysis are being assessed by the KINARM, a state-of-the-art robotic system developed at Queen’s University, to measure the brain effects of kidney disease. The KINARM precisely measures what’s happening in an individual’s brain or nervous system by testing their ability to perform ordinary movements and tasks.

Leading the research is Dr. Boyd, a critical care doctor and neurologist at Kingston Health Sciences Centre who looks at the links between oxygen levels and brain injury in intensive care patients. He says the project was sparked by a casual conversation with Dr. Rachel Holden, a kidney disease specialist at KHSC whose patients are often in intensive care. “We were talking about sensors for tissue oxygenation in the brain, she suggested that we should use them on her patients,” says Dr. Boyd.

Early indications have been startling, he says. “We’ve been told by the KINARM team that our cohort of patients are some of the most cognitively impaired they’ve ever seen.”  

While there is some evidence showing that kidney disease, especially in its later stages, can affect some brain functions such as attention and memory, the conventional pen-and-paper tests used to track these effects produce variable and subjective results – and they can’t diagnose the motor effects of brain injury, says Dr. Boyd.

The researchers will compare patients’ test scores and oxygenation data to study which procedure – hemodialysis or home dialysis -- has the better effect on patients’ cognitive function.

You can read the full report on the University's website.