Sunday, 8 October 2017

Daily Vitamin D Does Not Improve or Prevent Anemia

There is a believe that since patients with anemia are low in vitamin D, taking vitamin D daily will help reduce the problem. Not so says some recent research.

The articles linked to above studied data from a trial on the Effect of Vitamin D on Mortality in Heart Failure. It's conclusion was that a daily supplement does not prevent or improve aneia in patients with advanced heart failure, including those with chronic kideny disease.

This result is a little bit controversial because “Our data challenge the clinical relevance of vitamin D supplementation to increase Hb levels,” Dr Zitterman and his colleagues stated. The results disagree with a recent meta-analysis on the subject purporting vitamin D benefits, but agree with several other randomized controlled trials.

We will have to wait for more research on this topic. However it doesn't mean you should instantly stop taking vitamin D if it is perscribed by your doctor at the present moment.

Wednesday, 4 October 2017

Imaging Technique Helps to Prevent Kidney Disease

We have probably all heard of MRI - Magnetic Resonance Imaging (a spin off modification from the widely used Nuclear Magnetic Resonance Spectroscopy technique used by many research chemists, and the main tool I used in my PhD and other research in chemistry). Now, a variation on MRI can be used to detect kidney damage. The technique was developed by Osaka University researchers, in collaboration with several Japanese companies

The variation is called Diffusion tensor MRI (DTI) and ..."is ideal for detecting kidney damage, because the main functions of the kidney are all related to water movement,” explains Osaka University Professor and Surgeon Shiro Takahara. (Water in the target is what the MRI process is actually recording in the image maps shown as an MRI scan.) The article itself (linked to above) is a bit technically orientated unfortunately.

The technique is very useful as patients with diabetes are well-known to beat a high risk of developing chronic kidney disease. To identify which diabatic patients have higher risk, non-invasive technologies such as MRI are useful because they can detect abnormal perfusion in the kidneys, which could be signs of renal fibrosis, which is an early sign of kidney failure.

At the present moment, the technique is still at the development stage, but if further refined could be rolled out as a useful diagnostic technique.

Tuesday, 12 September 2017

Should we operate? Yale doctor seeks to limit surgeries for small kidney tumors.

This article, quoted below,presents a slightly contraversial view, that it is not always worth operating when a patient has a tumour on their kidney.

Not all kidney cancers are killers, and many small tumors can be left alone or watched over time because there is a low risk they will become dangerous, according to Dr. Brian Shuch at the Yale School of Medicine.

While doctors can detect more tumors because of increasingly sensitive tools, such as MRIs, surgery to remove the cancer is not called for in many cases, said Shuch, an assistant professor of urology and radiology.

“Many of these small tumors are very indolent or wimpy — low grade or low aggressiveness and low potential to spread or cause harm,” Shuch said. As many as 90 percent of tumors smaller than 4 centimeters fall into this category. Some actually turn out to be benign, he said.

Most surgeons will remove any cancerous tumor they find, out of concern for the risk of it growing, but also because they have a financial incentive to operate, as well as a fear of legal liability, Shuch said. This aggressive approach isn’t necessary and can lead to other issues later in life, such as dialysis, he said.

The full article can be found here and is worth reading. In countries where the surgeon gets paid for each operation based on the time taken and difficulty of the operation, many patients may be paying for treatment that they don't actual need. In other countries with a free health service, the views expressed in this article are the normal way to work, to spread the health service's limited resources to cases that really need them.

Wednesday, 31 May 2017

California Bill Addresses Safety Concerns At Dialysis Clinics

Saying they are concerned about safety in California’s dialysis clinics, a coalition of nurses, technicians, patients and union representatives is backing legislation that would require more staffing and oversight.

The bill, introduced by Sen. Ricardo Lara (D-Bell Gardens), would establish minimum staffing ratios, mandate a longer transition time between appointments and require annual inspections of the state’s 562 licensed dialysis clinics.

More than 63,000 Californians receive hemodialysis, which filters impurities from the blood of those with end-stage kidney disease. Demand for the procedure is growing statewide and nationwide as the population ages and more people suffer from chronic conditions that can lead to kidney failure, such as diabetes, hypertension and heart disease.

If the legislation passes, California would join several other states that have imposed minimum ratios for dialysis centers, including Utah, South Carolina and New Jersey.

You can read more about this story here and also here. Let's hope the bill succeeds in its purpose.

Monday, 29 May 2017

Hip hop artist Freeway tackles dialysis and raises awareness around kidney disease

Freeway is a hip hop rapper, a musician who loves to entertain his fans

Recently Freeway has taken on a new mission. Yes, he’s still making music, but he’s also an ambassador for the National Kidney Foundation and a constant advocate for kidney health awareness. Back in 2015, the 38-year-old rapper was diagnosed with kidney failure and is now on dialysis.

Freeway has been using his personal story to educate as many people as possible about the dangers of kidney failure, as he wasn’t aware of how crucial a healthy diet and getting regular physician check-ups could be. And beyond tweets and talks, Freeway is putting his money where his mouth is, leading marches and giving free performances to raise awareness of the issue, all while sticking to his own dialysis schedule.

You can read more about this story here and also here