Feature Channels: Kidney Disease

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High-tech medicine and human kindness combine in UAB’s ongoing kidney chain, a series of transplant surgeries that have given 101 people a new lease on life.

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• In an interview study of kidney specialists, 4 different approaches to discussing the option of dialysis versus conservative management for older patients with kidney failure were evident. • Nephrologists should reflect on their approach and understand the strengths and weaknesses of each.

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The ASN Foundation for Kidney Research provides more than $3 million in funding for clinical and basic research for members at all stages of their careers.

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Phospholipases are enzymes that cleave the tail group off of phospholipids, which make up cell membranes. These tails, or free fatty acids, can go on to act as signaling molecules. Lysosomal phospholipase A2, or LPA2, is a phospholipase from the macrophages that protect the lung.

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People with chronic kidney disease are at unusually high risk of also developing cardiovascular disease; in fact, a patient with non-dialysis kidney disease is more likely to die of heart failure than to develop end-stage kidney failure. However traditional atherosclerosis risk factors contribute less strongly to cardiovascular disease in chronic kidney disease patients than in subjects with intact kidney function.

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Researchers have long sought drugs that could help to prevent diabetic kidney disease (DKD), which afflicts about 40% of people with type 2 diabetes. Among the current contenders are a class of diabetes management drugs known as DPP-4 inhibitors. Scientists at Joslin Diabetes Center now have shown that in mouse models of diabetic kidney disease, the DPP-4 inhibitor linagliptin produces two signs of prevention against kidney damage.

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• Among individuals with autosomal dominant polycystic kidney disease, those who were treated with tolvaptan for up to 11 years had a slower rate of kidney function decline compared with historical controls. • Annualized kidney function decline rates of tolvaptan-treated patients did not change during follow-up.

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In a study published in the journal Science, researchers suggest that ZHX2 is a potential new therapeutic target for clear cell renal cell carcinoma, which is the most common type of kidney cancer.

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With the opening of a pre-transplant kidney evaluation clinic in Jackson, Tennessee, the Vanderbilt Transplant Center is joining a range of other clinical programs participating in telemedicine at Vanderbilt University Medical Center (VUMC).

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SLU surgeon Sameer A. Siddiqui, M.D., and his research team examined patient records to study the best approach for renal trauma injuries.

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• Compared with warfarin use, direct oral anticoagulant use was linked with a 23% higher risk of bleeding in patients with chronic kidney disease. • There was no difference between direct oral anticoagulant and warfarin users in benefits from prevention of ischemic stroke.

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Study findings from a team of scientists led by George C. Tsokos, MD, Chief of the Division of Rheumatology at BIDMC, overturn conventional wisdom about kidney disease.

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A comprehensive study by the Keck School of Medicine of USC has found that robotic partial nephrectomy offers significantly better patient outcomes as compared with open or laparoscopic techniques.

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New evidence shows the power of a method aimed at changing the longstanding problem of encouraging patients with chronic diseases to take their medicine faithfully: insurance plans that charge patients less for the medicines that could help them most. Some plans even make some of the medicines free to the patients with certain conditions.

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The Loyola Center for Cancer Care & Research at Palos Health South Campus in Orland Park is the first center in Illinois – and only the fifth in the country – to offer a groundbreaking MRI-guided radiation therapy that targets tumors with millimeter precision.

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• A synthetic adeno-associated virus was highly efficient at delivering genetic material to different kidney cell types in mice and humans. • The viral vector was also successfully used in gene therapy strategies to treat mice with kidney scarring.

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Research led by Washington University School of Medicine in St. Louis has shown, in mice, that genetic material can be delivered to damaged cells in the kidneys, a key step toward developing gene therapy to treat chronic kidney disease. The potentially fatal condition affects 30 million Americans, most of whom don’t realize they have chronic kidney disease.

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New research links outdoor air pollution — even at levels deemed safe — to an increased risk of diabetes globally, according to a study from Washington University School of Medicine in St. Louis and the Veterans Affairs (VA) St. Louis Health Care System. The findings raise the possibility that reducing pollution may lead to a drop in diabetes cases in heavily polluted countries such as India and less polluted ones such as the United States.

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A new study finds a newer blood thinner may be a safer choice for reducing stroke risk in those who have both end-stage kidney disease and atrial fibrillation.

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• Patients with advanced kidney disease described feelings of isolation, abandonment, alienation, mistrust, and even self-blame that would likely be surprising to the clinicians taking care of them.

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Kidney diseases have so far been underestimated in many respects: most people are not aware of their impaired kidney function. In general, kidney diseases are “silent diseases”, most often there are no apparent early symptoms. Many people with kidney diseases are not aware that they have been living with higher risks of cardiovascular diseases, infections, hospitalizations, and of course kidney failure which requires dialysis or transplantation.

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Administration of nitric oxide gas during and for 24 hours following heart surgery decreased the risk of patients developing acute and chronic kidney problems, a randomized, controlled trial conducted in China found.

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• In states that expanded Medicaid under the Affordable Care Act to cover more low-income individuals, there was an increase in the number of Medicaid beneficiaries who were preemptively waitlisted to receive a kidney transplant. • Medicaid expansion was associated with greater gains racial and ethnic minorities in being listed pre-emptively on the transplant waitlist compared with whites.

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• The blood pressure–lowering medication ramipril reduced protein excretion—or proteinuria—in children with chronic kidney disease. • Greater reductions in proteinuria during the first months of treatment were linked with a lower risk of kidney disease progression.

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More than 500 men who suffered with problems urinating due to an enlarged prostate have undergone holmium laser enucleation of the prostate (HoLEP), a minimally invasive procedure, at Scott & White Medical Center – Temple. This innovative urological procedure provides much-needed relief for men with a prostate enlargement, also known as benign prostatic hyperplasia (BPH), a condition that can prevent the bladder from emptying properly and could lead to kidney damage or failure.

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Diagnosing type 2 diabetes in clinical practice may require only a single blood sample, according to a study led by researchers at Johns Hopkins Bloomberg School of Public Health.

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DRG International, a leading international medical diagnostic company, will showcase the NEW DRG® Hepcidin 25 (bioactive) HS (High Sensitive) ELISA Kit (EIA-5782R) at the 2018 AACC Conference in Chicago, Illinois from July 29 – August 2. As the first of its kind to market, this kit accurately detects bioactive Hepcidin levels as an additional marker to aid in identifying a variety of disorders.

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Research published in JAMA Internal Medicine found that tamsulosin does not significantly effect patient-reported passage or capture of kidney stones.

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• Researchers have identified genetic variants linked to an increased risk of developing nephrotic syndrome, a pediatric kidney disease. • The variants are found in genomic regions involved in regulation of the immune response.

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Scientists have developed an algorithm that predicts potentially dangerous low blood pressure, or hypotension, that can occur during surgery. The algorithm identifies hypotension 15 minutes before it occurs in 84 percent of cases, the researchers report in a new study published in the Online First edition of Anesthesiology.

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• Among individuals with chronic kidney disease, hard illicit drug use was associated with higher risks of kidney disease progression and early death. • Tobacco smoking was associated with a higher risk of early death. • Alcohol drinking was associated with a lower risk of early death.

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The number of insurance denials for life-saving hepatitis C drugs among patients with both private and public insurers remains high across the United States. Private insurers had the highest denial rates, with 52.4 percent of patients denied coverage, while Medicaid denied 34.5 percent of patients and Medicare denied 14.7 percent.

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Results of a large-scale study suggest that the oral diabetes drug metformin is safe for most diabetics who also have chronic kidney disease (CKD). The study of more than 150,000 adults by Johns Hopkins Medicine investigators found that metformin’s association with the development of a life-threatening condition called lactic acidosis was seen only among patients with severely decreased kidney function.

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An experimental drug that blocks abnormal neural communication after spinal cord injury could one day be the key to improving quality of life by improving bladder function, new research suggests.

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The latest research and features in cell biology in the Cell Biology News Source

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Artificial Intelligence (AI) will be deployed against Mount Sinai’s massive patient data warehouse biorepository and to innovate more accurate disease detection and management for introduction in 2019

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• Among living kidney donors, the post-donation concern that was considered most important was kidney health, followed by the surgical, lifestyle, functional, and psychosocial impacts of donation. • The hypothetical long-term risks associated with kidney removal—including mortality and cardiovascular disease—were of relatively lower importance.

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The nationally recognized Kidney Cancer Program at UT Southwestern Medical Center’s Harold C. Simmons Comprehensive Cancer Center led a team of investigators who identified a new way to help doctors determine the prognosis for patients with stage 3 kidney cancer, which has important implications for decisions about surgery and inclusion in clinical trials.

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• A secondary analysis of a clinical trial has shown that when all patients with type 2 diabetes received comparable diabetes-related care, black race was not associated with accelerated kidney function decline, and fewer black participants developed chronic kidney disease.

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A study led by scientists at Cincinnati Children’s reveals one mechanism involved in regulating when nephron formation ends. If translated to clinical practice years from now, the result could be reduced need for kidney transplants and fewer deaths from kidney disease.

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An analysis of lymph node dissection in non-metastatic renal cell carcinoma indicates the procedure is often performed for stage 1 disease and shows no overall survival benefit. Investigators from Rutgers Cancer Institute of New Jersey presented the work at the Annual Meeting of the American Urological Association.

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• Among hospitalized adults, those who experienced acute kidney injury were 44% more likely to be hospitalized for heart failure in the year after discharge.

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Children who underwent cardiac surgery were less likely to develop acute kidney injury if they had been treated with acetaminophen in the first 48 hours after their procedures, according to a Vanderbilt study just published in JAMA Pediatrics.

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The annual meeting of the Society for Academic Emergency Medicine (SAEM). The SAEM 2018 meeting will bring together more than 3,000 physicians, researchers, residents and medical students from around the world.

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Click here to go directly to the Cancer News Source

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Pediatric researchers have found that children and adults treated with some oral antibiotics have a significantly higher risk of developing kidney stones. This is the first time that these medicines have been linked to this condition. The strongest risks appeared at younger ages and among patients most recently exposed to antibiotics.

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• Use of oral antibiotics was linked with an increased risk of developing kidney stones. • Risk decreased over time but was still elevated several years after antibiotic use. • Risk was highest for young patients.

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Since 1968, UAB Medicine has performed more than 14,000 life-saving organ transplants.

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At 4 months old, Raegen was diagnosed with congenital nephrotic syndrome.Early on in Raegen Allard’s life, her mother, Francisca Allard, noticed something wasn’t quite right with her beautiful daughter. Raegen would seem upset after she ate and her stomach was enlarged. She also had a bruise around her belly button, which worried Allard further.