Kidney Transplants May Help Obese Patients with Kidney Problems

Often, medical treatment has to balance the overall benefit and life expectancy of the patient. When resources are limited or expensive, someone with several problems may be considered less likely to benefit from expensive treatment for one problem when another problem makes the treatment just a stop gap before the other life threatening problem drags their health down even more.

However a recent article suggests that in the case of a kidney transplant, obese patients are just as likely to make good progress as normal or thin patients. The risk of death over the next year decreases by about 66% in obese patients who receive a transplant, compared to obese patients staying on dialysis. This is very much the same as for non-obese patients.

This report on some recent research seems to contradict earlier research which suggested that obese patients on dialysis did better than thin patients and worse after a transplant.

You can read the article here; the research was conducted at the University of British Columbia and St. Paul's Hospital in Vancouver, Canada.

Don't just sit there...

Dialysis, by its very nature, requires patients to do a lot of sitting around (or lying around) during the actual treatment. Dialysis however, tends to break down protein within the muscle fibre, and so patients become weak and less mobile.

Doctors from the University of Virginia, echoing what has been said many times over the years, recommend patients should take some exercise to stay healthy. They are recommending a program called Sit Fit - exercises that can be done while sitting, for patients during the dialysis itself. It uses a type of exercise bike, and the pedalling required benefits patients.

A search using Google reveals reports on this sort of exercise going back many years. So while not exactly new news, and there are alternatives to the Sit Fit program, it might be news to some of you. So in conclusion, don't just sit there, get those pedals working. You'll feel so much better afterwards.

Here's a link to a pdf from the famous Guys and St Thomas hospital in the UK, on dialysis and pedalling towards a better life. And an image of the exercise bike in action.

New Vascular Access Port Design

The trouble with hemodialysis is that you need an access port to extract the patient's blood and feed it into the dialysis machine, then return it. There are several common access ports that are routinely used, described in more detail here. The access port however can get infected, become sore and irritating, and lead to blood clots being formed. They can fail of the course of a patient's treatment and need replacing. Now a new type of access is available.

The new system, created by a set of former students and staff at the world famous Johns Hopkins Hospital, is claimed to be less troublesome and be longer lasting than other techniques. The new system, called the Hemova Port, has progressed to the animal trial stage after two years of development work. The special feature that is hoped to reduce problems is that it is only interacting with the flow of blood during dialysis sessions. It is claimed that this will lead to improved patient safety and treatment outcomes. The device sits just under the skin. It has a built-in cleaning loop, and is said to be usable much sooner than normal fistulas or grafts. It should benefit patients on long term treatment who have suffered from damaged access points.

The group have received several grants and awards to fund their research. Their website can be found here

Elvis is Alive!

Elvis the Kitten, of course, who did you think I was referring to?

Elvis may only be one year old but he has had an eventful life already. He started by trying to eat some lilies on a Valentine's Day bouquet that his owner Bob Armstrong bought for his wife, Paula. Lilies are not something kittens should try eating, and they poison the poor little things, and soon Elvis was mopping around, lethargic and not eating. A visit to the vet and mention of the lilies set alarm bells ringing, and things just got worse for the poor little guy. his kidneys were failing, as shown by a blood test. He was recommended to be put on dialysis. Yes, cat dialysis does take place. A visit to The School of Veterinary Medicine at Pennsylvania, soon gave him some relief, but his live was only being extended for the short term. He needed a transplant. Yes, pets do get transplants too.

The School of Veterinary Medicine at Penn. has done about 150 animal kidney transplants. Rescued cats get a new home with the owner of the cat they are a donor for, so a donor was sought to save Elvis. When a suitable donor was found, a health check ws made and then, on April 1st, (not this is not an elaborate hoax), on April 1st 1st, both cats were prepared for surgery, but at the last minute it had to be postponed (Elvis had had so many transfusions, it caused problems), and another donor was sought. And the surgery took place. Want to guess the donor cat's original name, found after a bit of research by the team involved? Elvis of course!

However, things didn't go as smoothly as planned, and poor Elvis (the sick one) was rushed off again for emergency treatment,as blood was not getting to his new kidney. His heart stopped for five minutes on the operating table, but the surgeons managed to save him.

Here he is! (No blue suede collar though.) Isn't he sweeeet?

So Elvis has returned from the dead! He still needs a daily dose of drugs to keep him okay. But hey, lots of rock legends...

Rock and Roll!
Read the story here if you don't believe me

What will these skilled vets get up to next, MRI scans for pets perhaps?

Kidney Disease In Older Age Linked To Overweight Starting In Early Adulthood

More research linking weight to possibility of kidney problems in later life.

This research suggests that being overweight early in your life could significantly increase the risks of developing kidney disease by the time people reach old age, according to a study appearing in an upcoming issue of the Journal of the American Society of Nephrology (JASN). Once again excess weight is showing up as a risk factor for chronic kidney disease.

It doesn't help that globally there is a trend for many people to become overweight, if not obese. In some countries it is more of a problem than others.

The research looked at a group of people born in one particular week in March 1946 in England, who were part of a long term data collection study. This gave information about the body weight of 4,584 individuals at six points in their life.

Among the major findings where the following points:

• Participants who were overweight beginning early in adulthood (ages 26 or 36 years) were twice as likely to have CKD at age 60 to 64 years compared with those who first became overweight at age 60 to 64 years or never became overweight.
• The link between overweight and CKD was only in part explained by taking diabetes and hypertension into account.
• Larger waist-to-hip ratios ("apple-shaped" bodies) at ages 43 and 53 years were also linked with CKD at age 60 to 64 years.

According to one quote, up to 36% of chronic kidney disease cases at age 60 - 64 could be avoided if the patients hadn't become overweight until later in life. The exact timing of when the weight gains start to affect things is currently unclear however.