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

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.

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.  

Vitamin K antagonist use and renal function in pre-dialysis patients

A research article, available at Dove Press, discusses whether vitamin K or oral anticoagulants is the best option for patients with only mildly reduced kidney function. Here we quote directly from the article. (Data was collected from 984 patients.)

A post hoc analysis of a recent trial on direct oral anticoagulants versus vitamin K antagonists showed that amongst patients with mildly decreased kidney function, use of vitamin K antagonists was associated with a greater decline in renal function than use of direct oral anticoagulants. Whether these vitamin K antagonist effects are the same in pre-dialysis patients is unknown. Therefore, the aim of this study was to investigate the association between vitamin K antagonist use and the rate of renal function decline and time until start of dialysis in incident pre-dialysis patients.

Conclusion: In incident pre-dialysis patients, the use of vitamin K antagonists was not associated with an accelerated kidney function decline or an earlier start of dialysis compared to non-use. The lack of knowledge on the indication for vitamin K antagonist use could lead to confounding by indication.

New Microsensor Enables Kidney Dialysis to be Customized to the Patient's Needs

It's nice to have the personal touch when having dialysis. Having your doctor or nurse set things up to better match your needs. But new research goes a step further than that.

Researchers from TU Eindhoven have developed a microsensor that makes it possible to directly monitor and adjust the composition of kidney dialysis fluid. This is a crucial step towards patient-specific dialysis, which will remove a significant proportion of the serious side effects of the use of standard dialysis fluid. And on 29 March 2018, Manoj Kumar Sharma will be awarded a PhD for his research on this sensor.

The number of patients worldwide on dialysis is quite astonishing - 2 million people are being treated just now.

Salts and impurities in the blood are removed via the dialysate fluid, passing through a membrane into the fluid. The rate of flow is dependant on the concentration difference between the blood and the dialysate. And the concentration in the blood varies from patient to patient. It doesn't help that the dialysate is supplied at a standard concentration, not tailored to each patient (and the patient's needs would be different at each session. There are side effects if the mismatch in concentrations is too high or too low.

It would be better to continuously adjust the concentrations of salts in the dialysate so that they are optimal for the patient. This, however, requires that the concentrations of salts in the dialysate can be monitored live, but there has not been a reliable technique to do this so far.

But now things are changing for the better.

PH D student Manoj Kumar Sharma has devised an ingenious solution for this. He developed a micro-system with a centrally positioned microchannel through which dialysate flows. He covered the walls of the microchannel with sensor molecules, which are only fluorescent in the presence of a salt, such as sodium. The more sodium there is in the dialysate, the stronger the fluorescence. To reinforce this effect, he introduced micropillars into the microchannel, resulting in even more surface covered with sensor molecules.

A laser light shines on the microchannel and activates the fluorescence of the sensor molecules. Sharma captures this fluorescence using glass fibres that he connected to the channel in the micro-system. The light passes through the fibres to a spectrometer for analysis. The laser light, which is of a different wavelength, is first filtered out. Then, based on the measured intensity of the fluorescence, the sodium concentrations can be read out.

If the sensors and monitoring system can be mass produced and used on a large scale, built into dialysis machines, one day each patient will receive during their dialysis session a customised dialysate to match their needs, the concentration changing to suit the current state of their blood.


Visit the University website to read the full article on this exciting development.