Baby Boy is Kidney Donor

This is probably the greatest and saddest story we will ever read about kidney donation. If you don't read this in total awe of the people who agreed to the transplant, you have no soul.

When she was a mere 12 weeks pregnant with twins, Jess Evans was told that one of her sons was suffering from a rare and fatal condition, which prevents the brain developing properly. Their son-to-be, Teddy, had anencephaly, a rare and lethal abnormality. He was likely to be still born, or die very soon after being born.

The doctors offered Jess and her partner Mike Houlston the option of an abortion, but they wished to see and love their child, no matter how short a life he would have. Then after a while they considered organ donation, although initially they were told this would not be possible. When born their son, whom they named Teddy, lived for just 100 minutes. Doctors then carried out a transplant of his tiny kidneys, a mere 4cm in length, into an adult man. The tiny organs were fully functional even in the womb, and will grow to full size while saving the recipients life.

Paul Murphy, of NHS Blood and Transplant, described Teddy’s donation as “exceptional”.
“Every donation is inspirational. It is a selfless act of heroism,” he said. “But Teddy’s story is exceptional. He was the youngest organ donor in the UK.”

I have no idea of the dreadful pain this couple went through, but everyone must admire their generosity and heroism. It would break most people. Fortunately the other twin had no problems and lives on, which must be some comfort for them. They deserve the utmost respect.

You can read more on the BBC News site and on The Guardian newspaper's site.

The Need For an Affordable Dialysis Machine

Lancet published an interesting article very recently - see it here. The Australian authors systematically looked through MedLine for renal studies and data. They found that at least 2.3 million people are dying EVERY YEAR due to lack of access to dialysis or a kidney transplant. It's possible that the figure could be a frightening 7.1 million with a huge number of these unfortunates being in Asia.

They found that there were approximately 2.6 million people receiving dialysis or on transplants, but there could be as many as 9.7 million who missed out, as treatment in developing countries is at a lower rate. They noted the largest treatment gaps in low-income countries, particularly Asia (1·907 million people needing but not receiving RRT; conservative model) and Africa (432 000 people; conservative model). Worldwide use of RRT is projected to more than double to 5·439 million (3·899–7·640 million) people by 2030, with the most growth in Asia (0·968 million to a projected 2·162 million [1·571–3·014 million]). One major and rather obvious reason for so many missing out is the annual bill for dialysis. So the George Institute and three research organisations are offering a $100,000 prize to the successful designer of the first low cost dialysis machine. Among the requirements are meet safety standards, run off solar power, purify water on the spot and cost $1000 to make. Current price??? up to $20,000! Are these machines overpriced, given that the technology has been around for half a century?

There was a second article on the same topic in the same issue of Lancet - read that one here. The findings of that article were very similar. Dialysis and kidney transplantation transformed medical care for patients with kidney failure, but these renal replacement therapies (RRTs) are unavailable to most patients who need them worldwide. Chronic kidney disease is now the 18th leading cause of death worldwide. Accurate estimation of the number of people with kidney failure receiving RRT and forecasting of future trends is essential for planning services and programmes to address kidney failure worldwide.

So let's hope that the prize for researchers is won sooner rather than later.

Kidney Disease Awareness Grows

It must be good news for many to hear this, especially given that we had World Kidney Day last week!

Organisations like the National Kidney Foundation do their best to raise awareness, and the continual stream of advice, along with advances in treating diabetes (one of THE major causes of kidney disease) and high blood pressure treatments seem to be getting through. Does it do any good? Well the American government reported in the latest figures availabble that there were fewer new cases of people going on to dialysis in 2011 compared to 2010. And over the previous two years the number of new cases held steady. LINK

This sort of news doesn't hit the headlines of newspapers, but for kidney disease sufferers, it is very welcome. Two factors were highlighted as being responsible - greater awareness and better treatment of the leading causes. Now if only they can get more transplants.

Cooking methods may reduce phosphorus content in some foods

Dialysis patients have to control their phosphorus intake and phosphorus levels. The kidneys normally excrete excess phosphorus into the urine; however, kidney disease can prevent the body from getting rid of any buildup of phosphorus and that can cause problems for the bones and heart. And unfortunately hemodialysis removes only a small amount of phosphorus from the blood, hence the need for phosphorus binders while on dialysis. Recent research published in the Journal of Renal Nutrition suggests that boiling in water or stewing in oil can reduce the phosphorus content of some foods.

The results vary for different foods stuffs, this is not a universal panacea but it does help a lot with some foods. However the calcium levels increased when boiling in water when using hard water

Most of the thermal processing methods did not significantly reduce protein content. Boiling increased calcium content in all foodstuffs because of calcium absorption from the hard water. In contrast, stewing in oil containing a small amount of water decreased the calcium content of vegetables by 8% to 35% and of chicken meat by 12% to 40% on a dry weight basis. Some types of thermal processing significantly reduced the phosphorus content of the various foodstuffs, with levels decreasing by 27% to 43% for fresh and frozen vegetables, 10% to 49% for meat, 7% for pasta, and 22.8% for rice on a dry weight basis. On the basis of these results, we modified the thermal processing methods used to prepare a standard hospital menu for dialysis patients. Foodstuffs prepared according to the optimized menu were similar in protein content, higher in calcium, and significantly lower in phosphorus than foodstuffs prepared according to the standard menu.

If you examine the references section in the link to the journal article (above) you will find links to several other studies on how different cooking methods for your food can be of benefit to dialysis patients.

Study gives HIV-positive kidney transplants the thumbs up

Life is bad enough if you are HIV-positive, but what if you have kidney failure as well? What are your chances after a transplant? And can an HIV-positive donor help?

HIV-positive people with kidney failure who get a donated kidney from another person with HIV/AIDS fare as well as patients who get one from an uninfected donor, according to a South African study published on Thursday in the New England Journal of Medicine. This is an important piece of research because it opens up a new group of desperately needed kidney donors for HIV/AIDS patients, who are especially vulnerable to renal failure, said the study’s lead author, Elmi Muller, who pioneered such "positive to positive" renal transplants in 2008. Especially since between a quarter and a fifth of HIV-positive patients who do not receive timely treatment get chronic kidney disease now have some hope.

The HIV-positive patients had comparable survival rates to patients who had received kidneys from donors who were HIV-negative. The survival rate among the patients was 84% after one year, 84% after three years, and 74% after five years. And remember, a kidney transplant can save more than one life, as the recipient frees up a dialysis machine for someone else.

For more details see here