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.