Monday, 24 May 2021

Covid-19 and Kidney Damage

 In a worrying report, research shows that Covid-19 can lead to kidney damage. 

Covid-19 has been studied a great deal during the pandemic and researchers are finding evidence that it cause a whole host of problems, including acute renal failure. Research reported here gives you the technical details - for those with the deep medical knowledge, angiotensin-converting enzyme 2 (ACE2) has been implicated in the pathogenesis of chronic kidney disease (CKD) and is a membrane receptor for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus responsible for coronavirus disease (COVID-19).

As with al things Covid-19, the more research done and the longer the period over which it is investigated, the more knowledge will be available. This article summarises some of the things found so far.

Some worrying things to consider are that it looks like 81% of patients in intensive care with Covid-19 developed Acute Kideny Injury, with the virus more likely to target the kidneys than other parts of the body. And age seems to be a factor as well, with those over 60 being twice as likely to have problems as those under 60. In fact many of the factors that affect the severity of Covid-19 are similar in those who get Acute Kidney Injury.

Saturday, 22 May 2021

Get on Your Bike!

A recent news report (April 2021) claims that cycling during dialysis could dramatically improve the heart health of patients with kindey failure, and lead to significant savings for the UK's NHS.

Yes, cycling DURING dialysis. Okay, on a specially adapted bicycle during regular dialysis sessions. Not going out on the road with a dialysis machine strapped to your bac!

The research was carried out by the University of Leicester, supported by the charity Kideny Research UK and the Natioanl institute for Health Research Leicester.

The heart suffers long-term effects when you are on dialysis, and the hope was that regular exercise would reduce the problem. And after six months of using the bicycle for 30 minutes during their dialysis sessions, investigations revealed  several improvments in the patients. This sounds like a cheap way to improve a patient's health and thus reduce the need for treatment for heart problems assiciated with dialysis. It's based on the well-known fact that regular exercise will improve your health, so why not do some excerise while hooked up to your dialysis machine.? After all the time spent travelling to a centre, sitting around doing nothing but reading a book while connected to your machine, then travelling home means you have spent a very inactive day. cycling like this makes you healthier, reduces problems and saves money. What more could you want?

You can read the whole article here.

Wednesday, 18 March 2020

AI powered tool hailed as major diagnostic advance

The analysis tool, called KidneyIntelX has been developed by RenalytixAI and is expected to be launched in the middle of this year. It is described as a major break-through in this news article. It should help decide what treatment is best for a patient and whether they need medicine, dialysis or a transplant.

So how does this sort of tool work?

It's basically similar to those telephone systems where you get asked a series of questions on what help you want when calling a support helpline, with the answer you give defining what the next group of questions should be. This is how a doctor decides what is wrong with you, or how a research chemist analyses an unknown chemical by starting with a few standard tests, then choosing the next tests to use based on the results of the first texts. Eventually, the doctor or chemist reaches a conclusion, assuming they remember what the next step is after each preliminary test.

But it includes a few extra twists after that.

Initially, doctors give the software the important questions to ask and say what the answers mean, and what questions to ask next. The creators of the tool then fed into the system the medical records and answers given to questions for literally 3 million patient health records. Then the AI system kicks in and looks for common features that might not spring to mind as being related to the problem being studied. The more real cases the AI code (called a neural network) examines, the more likely the system is to spot the important trends such as do your symptoms match those of patients diagnosed as in need of dialysis by their doctor. Or the bit that humans struggle with, is there some common factor in your earlier medical history that hints about the likely outcome? Your medical history and the outcome of the treatment will be added to the system over time. as well.

This is described as the AI system learning how to diagnose and predict the best outcome. It's not got a mind of its own, it is looking for common factors between patients and what the result of certain treatments was, based on, as mentioned earlier, millions of medical records. It does also need a lot of records where the patient didn't have a kidney problem, to avoid false positives. And contrary to popular views on these systems, it does not decide what will happen to you, it advises the doctor on what to do, and the doctor makes the final decision.

It could take a doctor quite some time to read through your medical record, and to spot changes over time. But humans can miss these odd clues occasionally. This sort of software can do this very quickly and is usually very good at spotting the smaller important clues in amongst your entire medical history. So the doctor is presented with the most important data very quickly and can come to a more accurate conclusion. Freeing up more time, leading to more patients getting the treatment they need.

It's not some power-mad living machine trying to rule your life. The cyborgs from Terminator are not making the decisions. ;)

Friday, 14 February 2020

American Kidney Fund Helping People

There were a lot of people getting transplants in America in 2019. Over 24,000 in fact. And not everyone has insurance or funds to cover a transplant. But then there's the American Kidney Fund...

According to this article from Yahoo! the AKF gave grants to 1,400 people to receive kidney transplants and post-transplant care. More than 60% of the people receiving these grants were from racial and ethnic minority groups, who in general have fewer transplants than white Americans. Yet this group are more likely to need a transplant as more have kidney failure! So without these grants, many people would become financially broken and never receive a transplant.

AKF is also fully supporting the objective of finding living kidney donors.

You can find out more about the American Kidney Fund at their website.

Friday, 7 February 2020

Similar Survival Rates Found for Different Dialysis Modes

Is one form of dialysis better than another? Should you always opt for one particular type of dialysis?
This is something every patient wonders about when told they will have to have dialysis. The trouble is when you are first told you need dialysis, you probably have not considered the options until that very moment. And you wonder if you might make the wrong choice.

A recent bit of research looked at 17 other studies of the possible problem and by pooling all the results - 113,578 patients' results over a 21 year period - came to the conclusion that there is no significant difference in the mortality rate between peritoneal dialysis (PD) and in-centre hemodialysis (HD). This could affect the initial counselling of new patients in the run-up to getting dialysis. The research showed that life expectancy was virtually the same for both the therapies.

As PD is a more cost-effective option and helps preserve a normal lifestyle, they concluded that PD should be encouraged. Many people worry that "home treatment" via PD might be riskier than HD, but this appears not to be the case.