So what should determine your priority for dialysis treatment? Your current state of health or your current state of residence? According to a recent news alert from Stanford University, it's your place of residence, more often than not.
The type and intensity of treatment older Americans receive for kidney failure depends on the region where they receive care rather than on evidence-based practice guidelines and patient preferences, according to a study to be published in the July 14 Journal of the American Medical Association.
There are pronounced regional differences in treatment practices for older adults with kidney failure, including decisions about starting or stopping dialysis, that don't seem to be explained by differences in patient characteristics, said Manjula Kurella Tamura, MD, senior author of the study and assistant professor of nephrology at the Stanford University School of Medicine.
The report says that many important decisions are more likely to be influenced by where you live rather than the patient's actual needs.
In the UK they call this sort of thing "postcode lottery", and it affects all sorts of health care problems. People have been known to move house, just to get treatment.
The researchers found another, rather unexpected, result. Some areas spend much more on health care and have a higher density of nephrologists — physicians specializing in kidney disease. But despite this, patients with kidney failure in these areas were less likely to have seen a nephrologist before starting dialysis! And more amazingly, patients in the higher spending areas didn't actually fair any better than those in the other areas.
You might want to read the news alert as it does seem a strange set of results.
In my opinion, it's almost as if the specialists move to the areas that spend most, but don't necessarily give value for money treatment.
Thursday, 15 July 2010
Tuesday, 15 June 2010
Facebook user searches for a kidney
Melissa Foster had to wait for nine years before she received a kidney transplant, using a kidney from her brother Matt Freiberg in 1997. But now that kidney is failing and so she did what any normal person would do - she’s turned to Facebook to find one!
She has a page on Facebook, just like 300 million others do (including me ;) ) asking anyone with blood type O to go have a test and help her. It's called, unsurprizingly, Find a Kidney for Melissa Foster. She's tried lots of different ways to attract attention to her dilemma, including a bike ride that got some newspaper publicity and a blog - http://www.kidney4mel.com/
The Facebook page was created in mid May, and is proving popular, with many people linking to it as a friend. If someone links to the site as a friend using their Facebook page, then soon literally millions of people will know about her problem and perhaps a donor will come forward. At the present moment there are 808 people saying they like the page. If each one has 100 friends who each view it and one in ten then mentions it on their page, and each of these have 100 friends, well when you multiply the numbers together, you get a staggering number of people involved.
Melissa began having problems with her kidneys when she was 16 after a urinary tract infection backed up to her kidneys, causing them to fail. She started dialysis treatments at 16 and received her transplant when she was 25.
Now obviously this way of attracting attention might not work for everyone, and of course if hundreds of patients tried this, soon the web would be flooded with "find me a donor" pages, and perhaps others would just switch off to responding. It happens with major disasters, people become so saturated with seeing an appeal for help their brain filters it out. But it might just work - her blog includes a video by another renal failure patient who found a kidney donor via Twitter and Facebook.
So I tried entering "kidney donor found twitter" into Google, and then replaced twitter with facebook. Try it yourself - you'll be amazed with the results. Go on, read some wonderful stories about realy generous people coming forward.
She has a page on Facebook, just like 300 million others do (including me ;) ) asking anyone with blood type O to go have a test and help her. It's called, unsurprizingly, Find a Kidney for Melissa Foster. She's tried lots of different ways to attract attention to her dilemma, including a bike ride that got some newspaper publicity and a blog - http://www.kidney4mel.com/
The Facebook page was created in mid May, and is proving popular, with many people linking to it as a friend. If someone links to the site as a friend using their Facebook page, then soon literally millions of people will know about her problem and perhaps a donor will come forward. At the present moment there are 808 people saying they like the page. If each one has 100 friends who each view it and one in ten then mentions it on their page, and each of these have 100 friends, well when you multiply the numbers together, you get a staggering number of people involved.
Melissa began having problems with her kidneys when she was 16 after a urinary tract infection backed up to her kidneys, causing them to fail. She started dialysis treatments at 16 and received her transplant when she was 25.
Now obviously this way of attracting attention might not work for everyone, and of course if hundreds of patients tried this, soon the web would be flooded with "find me a donor" pages, and perhaps others would just switch off to responding. It happens with major disasters, people become so saturated with seeing an appeal for help their brain filters it out. But it might just work - her blog includes a video by another renal failure patient who found a kidney donor via Twitter and Facebook.
So I tried entering "kidney donor found twitter" into Google, and then replaced twitter with facebook. Try it yourself - you'll be amazed with the results. Go on, read some wonderful stories about realy generous people coming forward.
Wednesday, 2 June 2010
Juggling exams and dialysis
For all teenagers, trying to study properly for exams and being totally prepared for them can be hard work, given how many distractions teenagers have. Especially if you just happen to be on dialysis. Sixteen year old Welsh teenager Sahibaa Ali is in the middle of sitting her GCSE exams but she has a special timetable to fit around the dialysis she has three times a week (she's been on dialysis for two years). It's lucky the exam board can adjust things to help her. Many students with medical problems are unaware that they can get some help for exams. But getting your own special timetable to fit around dialysis treatments is not a common occurrence. Link to news item.
When I broke my back while at university, the Uni generously allowed me more time for each exam, to help with the pain from sitting in one position for several hours, so it is always worth enquiring is help is available.
When I broke my back while at university, the Uni generously allowed me more time for each exam, to help with the pain from sitting in one position for several hours, so it is always worth enquiring is help is available.
Wednesday, 12 May 2010
Keeping it in the Family
There are several well-known causes of kidney failure. Diabetics, for example, are likely to suffer from renal failure. High blood pressure is another problem likely to lead to kidney damage. But recent research came to a surprising conclusion - who you are married to (or live with, I suppose) can result in an increased chance of you having kidney problems.
Yes, I was somewhat surprised when I saw this reported as well!
Research published in the American Journal of Kidney Diseases reports that the spouses (partners) of patients on dialysis are likely to suffer from chronic kidney disease themselves, and are advised to be tested.
The research looked at 196 first- and second-degree relatives and 95 spouses of 178 hemodialysis (HD) patients, and found that a significantly higher prevalence of CKD was found in relatives (the genetic link mentioned in the previous post), but an even higher prevalence was found in spouses / partners, who were more likely to suffer from CKD than the general population. Overall four out of ten spouses suffered from CKD, compared to less than one in ten of the general population.
The Taiwanese research scientists suggest that health habits, often similar for husbands and wives, were probably an important factor. Are both smokers? Are both inactive? Are both obese? Couples often adopt each other's lifestyle to some extent and if their lifestyle includes a factor that may lead to kidney problems, then they can both be at risk.
So, if you or your partner have CKD, then it's time for both of you to make a visit to the doctor.
Yes, I was somewhat surprised when I saw this reported as well!
Research published in the American Journal of Kidney Diseases reports that the spouses (partners) of patients on dialysis are likely to suffer from chronic kidney disease themselves, and are advised to be tested.
The research looked at 196 first- and second-degree relatives and 95 spouses of 178 hemodialysis (HD) patients, and found that a significantly higher prevalence of CKD was found in relatives (the genetic link mentioned in the previous post), but an even higher prevalence was found in spouses / partners, who were more likely to suffer from CKD than the general population. Overall four out of ten spouses suffered from CKD, compared to less than one in ten of the general population.
The Taiwanese research scientists suggest that health habits, often similar for husbands and wives, were probably an important factor. Are both smokers? Are both inactive? Are both obese? Couples often adopt each other's lifestyle to some extent and if their lifestyle includes a factor that may lead to kidney problems, then they can both be at risk.
So, if you or your partner have CKD, then it's time for both of you to make a visit to the doctor.
Wednesday, 14 April 2010
Genes Linked to Kidney Disease Identified
It's been described as break-though research. And it could lead to new treatments in the future.
An international team, including scientists from Edinburgh University (the place I got my Ph.D from), have found 13 new genes that influence renal function, and another seven that affect the production and secretion of creatinine.
Creatinine has been found to be a fairly reliable indicator of kidney function. If the kidney function is impaired, the creatinine level in the blood rises due to poor removal from the body by the kidneys. An abnormal high level is a warning of the possible impending failure of the kidneys.
Although chronic kidney disease is linked to age, and other conditions such as diabetes and high blood pressure, it has been known that there is a genetic component as well.
Two research articles were published on different aspects of the work. The first study involved 67,093 individuals of European ancestry, and collaborative work by 95 scientists all over the world. The second study involved another a further 23,000 individuals.
Dr Jim Wilson, a geneticist at the University of Edinburgh who worked on the study, said, "This work could revolutionize the treatment of kidney disease in the future – but this will take some time."
Obviously we shouldn't expect to hear of new treatments in the immediate future, but fundamental research such as this can't fail to lead to a better understanding of how the kidneys function and how they begin to fail.
See the BBC News Service for a longer report.
Or read the first article abstract at Nature and a second article's abstract, also at Nature
An international team, including scientists from Edinburgh University (the place I got my Ph.D from), have found 13 new genes that influence renal function, and another seven that affect the production and secretion of creatinine.
Creatinine has been found to be a fairly reliable indicator of kidney function. If the kidney function is impaired, the creatinine level in the blood rises due to poor removal from the body by the kidneys. An abnormal high level is a warning of the possible impending failure of the kidneys.
Although chronic kidney disease is linked to age, and other conditions such as diabetes and high blood pressure, it has been known that there is a genetic component as well.
Two research articles were published on different aspects of the work. The first study involved 67,093 individuals of European ancestry, and collaborative work by 95 scientists all over the world. The second study involved another a further 23,000 individuals.
Dr Jim Wilson, a geneticist at the University of Edinburgh who worked on the study, said, "This work could revolutionize the treatment of kidney disease in the future – but this will take some time."
Obviously we shouldn't expect to hear of new treatments in the immediate future, but fundamental research such as this can't fail to lead to a better understanding of how the kidneys function and how they begin to fail.
See the BBC News Service for a longer report.
Or read the first article abstract at Nature and a second article's abstract, also at Nature
Subscribe to:
Posts (Atom)