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Current information
Researched, selected, and condensed by Consumer MedHelp |
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Current information
Researched, selected, and condensed by Consumer MedHelp |
Diabetes Heart Disease Kidney Disease
Kidney Disease
Breakthrough! Transplant Now Possible with "No-Match" Kidneys Johns Hopkins University surgeons have successfully transplanted kidneys from non-matching donors by using a blood filtration process called "plasmaphereis" prior to surgery. The high success record of this experimental technique means that a kidney patient can now, potentially, receive a transplant from any donor. The Johns Hopkins team believe that the new technique may eventually double the number of transplants. Speaking of this major breakthrough, team leader, Robert Montgomery, MD, said: "I can tell any patient... that they can be transplanted with a high likelihood of success."
Caution: A High Protein Diet May Harm your Kidney High-protein diets have become a popular weight loss strategy, but the American Kidney Fund is now warning against them. Renal physicians recommend consuming no more than two grams of protein per kilogram (2.2096 lbs.) of body weight to avoid putting stress on the kidneys through dehydration.
Meantime, the Bluesprings company, a Chicago-area spring water firm, is joining the American Kidney Fund in public education about kidney disease. The "Naturally Zero" brand water displays the AKF logo and AKF information on each bottle, and a portion of the proceeds from sales are going to support the AKF. Drinking lots of water is a component of maintaining a healthy kidney.
Researchers Exploring Correlation between Blood Pressure Readings
and Death in Dialysis PatientsDuke University researchers don't know why dialysis patients who have a large difference between systolic and diastolic blood pressure readings die more often than patients who show less of a gap between upper and lower blood pressure numbers, but they do know that for every 10 point difference, the dialysis patient mortality rate increases by 12%. They are continuing to investigate the reasons for the adverse effects of increased pulse pressure.
Giving Older Kidney Patients Age-Matched Kidneys Does not Improve Transplantation Odds A recent USRDS (United States Renal Data System) survey discloses that kidneys received from donors age 18-29 are more likely to survive the graft than kidneys received from donors age 55 or older. Therefore, the common practice of matching kidneys from older donors to older recipients doesn't improve the chances of a successful transplant. The age of the donor is more significant than the age of the recipient, although older recipients are less likely to experience a successful transplant than younger recipients.
Physicians Must Guard Against Over-Dosing with Iron Dextran Renal physicians regularly prescribe iron dextran supplements to hemodialysis patients to guard against the known risks of anemia. However, a 2002 study in the Journal of the American Society of Nephrology shows the administering more than 1000 mg of iron dextran to those patients during a six month period elevates the risk of hospitalization and death.
ESRD Patient Numbers and Costs Keep Climbing Researchers at the Center for Biomedical Engineering report that as of July, 2001 over 1.1 million patients were on dialysis treatment throughout the world. They expect the number will climb to over two million by 2010. In the U. S., the total annual cost per patient is about $66,000. The world-wide cost of treating ESRD will surpass $1 trillion for the first decade of the 21st century.
USRDS researchers are also forecasting a substantial increase in the number of End-Stage Renal Disease patients. Currently, about 400,000 Americans are impacted. By 2010, they anticipate that the U. S. cost for on-going ESRD programs will cost $28.3 billion.
Is Morning Dialysis More Beneficial for Older Patients? A study reported in the Journal of the American Medical Association (Dec. 5, 2001) finds that patients aged 60 or older fare better with morning dialysis. The eleven-year study shows that morning dialysis increases life span by over a year. Why? Morning dialysis patients more often sleep during treatment, but the authors of the study don't know if sleep patterns affect their findings.
Higher Dialysis "Doses" and Special Filters Make No Difference A five-year study of Hemodialysis patients, funded by NIDDK, finds that the minimum conventional dialysis "dose" works as well as higher dialysis doses. The study also finds that treatment with high-flux dialyzers does not improve patient outcomes.
Renal Patients -- Be Careful about Cipro Use Cipro, the antibiotic of choice for combating anthrax, is particularly hard on the kidneys. People with early-stage renal disease stand a greater risk of moving on to End-Stage renal disease unless they use Cipro in the proper dosage. Be cautious and follow your physicians advice.
Reimbursement Problems Clog Expanded Use of Nocturnal Home Dialysis Nocturnal Home Dialysis is a procedure which has seen vast improvement in recent years. Patients' quality of life is improved, and they have better control of blood pressure, use fewer medications, have better control of phosphorus, and have, as a group, fewer hospitalizations.
What's the problem? According to Robert S. Lockridge, Jr., MD, director of the NHHD program in Lynchburg, VA, the present reimbursement formulas for this treatment mean that dialysis providers in Canada and the U. S. cannot afford to offer it, even though "this new modality is safe and better for selected patients with ESRD."
Effective Medications: Losartan and Irbesartan Michigan researchers have found that the drug losartan delays the onset of ESRD and "reduced the initiation of dialysis or transplantation by 28%. Other researchers report that the drug irbesartan slows loss of kidney function and reduced the risk of kidney failure by nearly 25%.
Kidney Donors Face No Long-Term Side Effects Reuters Health reports that most kidney donors retain normal kidney functioning. Only 7% of donors develop "medically significant protein-uria." David A. Goldfard, MD, says "we've got a very strong database that attests to the long-term safety of renal donation with respect to kidney function," although he expresses a desire for further tracking of the effects of kidney donation beyond twenty years. This study brings reassurance to patients who may hesitate to ask a relative to donate a kidney for fear that the donor would suffer damage.
Dialysis Patients Run Higher Than Usual Risk of Fungal Infections An analysis of 328,000 dialysis patients, conducted by NIH and Walter Reed Army Medical Center clinicians, shows that dialysis patients are at increased risk of developing fungal infections, some of which effect patient survival. Candidiasis is the main culprit, but occurrences of cryptococcosis and coccidiodomycosis are higher than previously thought.
Life Options Distributes Materials on Redesigned Web Site You can now download numerous materials from the The Life Options web site: www.lifeoptions.org . The Life Options program, sponsored by Amgen Renal Advances, provides many resources to help patients live well with kidney disease. For further information, call the Rehabilitation Resource Center at (800) 468-7777 or e-mail lifeoptions@MEIresearch.org.
Visit Medicare's New
"Dialysis Facilities Compare" web siteGet the scoop on your present or prospective dialysis facility. Medicare's "Dialysis Facility Compare" site is located at www.Medicare.gov/Dialysis/Home.asp. You can compare your local facilities with other throughout the U.S. for many characteristics, including quality outcome measures.
Call 1-800-MEDICARE (1-800-633-4227) and ask for publication no. HCFA-10128, an easy-to-read booklet that explains Medicare coverage of Kidney Dialysis and Kidney Transplant Services. The free booklet is also available in a Spanish version. The guide highlights resources listed on the Medicare Internet site (www.medicare.gov), including information about certified dialysis sites. It also offers phone numbers and addresses for State Health Insurance Assistance Programs, ESRD networks, and some other kidney-specific organizations.
The book clearly explains which kidney treatment services are covered by Medicare and which ones the patient is responsible for. The revised guide is a very helpful tool for all kidney patients.
AKA funded Patient Assistance Program Benefits Thousands The American Kidney Fund's "Renagel Patient Assistance Program" is helping thousands of low-income hemodialysis patients. Patients who cannot afford Renagel tablets, a phosphate binder, will receive supplies through AKF when referred by nephrologists and social workers. Genzyme Corporation contributes the product.
For more information, call the AKF Patient Services Dept. at 800-638-8299, ext. 6675.
Call for "Dining Out With Confidence" The NKF has updated their brochure, "Dining Out with Confidence: A Guide for Patients with Kidney Disease." Designed to guide people toward appropriate meal choices in restaurants, including ethnic and fast food restaurants.
Call 800-622-9010 to ask for the brochure.
Have questions about dialysis treatment, kidney disease, insurance coverage, income support? You can join the thousands of patients who call the American Kidney Fund (800-638-8299) or visit helpline@akfinc.org to receive support and accurate information. The number of calls and internet visitors is rising each month, according to the AKF.
Over 50,000 men women and children are waiting for a kidney in U. S. Although the number of transplants are increasing by around 6% a year, the waiting list continues to grow. In 2001 Tommy Thompson, US Dept. of Health and Human Services launched "Gift of Life" donation initiative. The agency is promoting awareness of donation opportunities to U. S. employers and citizen groups. Increasing the number of donors is crucial to solving the problem. You can download a Model donation card at www.organdonor.gov.
Since 1998, the number of New Jersey residents who have agreed to become organ donors has doubled. Now 25% of New Jerseyites have signed a document indicating their willingness to donate organs. But, says Joseph Rother, president of the Sharing Network, it's still not enough to meet the need. Over 1,900 New Jersey residents are still waiting for a transplant.
Intravenous iron replacement improves blood counts and increases the mean corpuscular volume according to a Univ. of Colorado study published in The Journal of Investigative Medicine. Hemodialysis patients treated with iron injected intravenously had shorter hospital stays and mortality declined among them. The iron treatment also appears to lead to "considerable improvement in nutrition and well being" as well as to reduce anemia. Taking iron orally does not show the same benefit.
Moderate use of analgesics such as aspirin, acetaminopen, ibuprofen and naproxen has no adverse effect on kidney functions, according to the National Kidney Foundation. Although using painkillers in high doses over an extended time period is not advisable, fears that painkillers were linked with kidney disease have been disproved by the results of a 14 year study by researchers at Brigham and Women's Hospital, Boston. For more details, see the Journal of the American Medical Association [2001;286:315-321.]
Bone marrow stem cells from patient's own bodies may be used to treat kidneys in the future, according to scientists at the British Imperial Cancer Research Fund. Unfortunately, the research is at an early stage and it is probably several years away from widespread use as a technique to prevent kidney failure.
Mayo Clinic researchers have begun studying the use of CT technology (fast computed tomography scanning) to observe kidney function, locate problems, and, potentially, diagnose kidney disease before symptoms appear. Juan C. Romero, MD, a Mayo clinic physiologist hopes that the "Fast CT procedures will eliminate 50% of conventional renal related lab tests and provide quick results. Most importantly, the technique will allow physicians to evaluate individual kidney function without invasive procedures. Studies must continue before the Fast CT scanning becomes a standard medical tool for evaluating kidney function, however.
Beneficiary Improvements and Protection Act (BIPA) expedites Reimbursement for Transplant Medication BIPA (the Beneficiary Improvements and Protection Act) indefinitely extends drug coverage for certain Medicare patients. If you're having trouble getting reimbursement, contact HCFA. The extended immunosuppressive coverage applies to recipients whose organ transplant was initially covered by Medicare or will receive a transplant in the future and are 65 years of age or older and disabled.
Transplant Patients who Have NOT Had Long-Term Dialysis Do Better Kidney transplant recipients who receive a kidney from a living donor and who have NOT been on long-term dialysis have a 50% lower risk of organ rejection. The Univ. of Pennsylvania researchers who studied a population of about 8,500 patients conclude that "Preemptive transplantation of kidneys from living donors without the previous initiation of dialysis is associated with longer allograft survival than transplantation performed after the initiation of dialysis." The study was published in The New England Journal of Medicine [2001; 344 (10).
Identification of Cell Subtype will help predict Organ Transplant Acceptance A subtype of dendritic cells help prevent organ rejection, according to Univ. of Pittsburgh researchers. Dendritic cells are a rare type of white blood cells. This finding will help clinicians to provide a "road map" which will help identify transplant patients who can do without immunosuppression medications as well as to predict which patients are likely to accept a transplant.
Post-Transplant Tumors in children May Now be Thwarted More Easily A drug called rituximab has proved effective in suppressing the development of tumors which have developed in children following transplants of heart, lung, liver, kidney, or small bowel transplants. A specific molecule on the B cells (the cells that develop into tumors) is affected by Rituximab.
"Hope Through Sharing" Program Launched "Hope Through sharing" is a new program launched by Boston's New England Medical Center. This program allows family members of people waiting for a kidney transplant to donate a kidney to a stranger while their loved one moves up on the waiting list.
New Urine Test May Help Early Detecting Renal Transplant Rejection A new test measures the presence of two proteins -- perforin and granzyme B -- in the urine. It appears that high levels of these proteins are a sign that the kidney is in distress. It's most desirable to diagnose kidney-rejection before the fact, rather than after the fact.
Synthetic Blood Vessels Will Help Dialysis Patients An engineering team at North Carolina State University has developed synthetic blood vessels (arteries, veins, and bypass grafts) which are helpful both for hemodialysis patients and those at risk of a stroke. The team predicts that their work "will lead to new therapies that will reduce the incidence of cardiovascular disease" and "significantly reduce" restenosis in hemodialysis patients.
The synthetic blood vessels "provide smooth blood flow throughout the body, lessening the trauma that occurs when vessels become clogged or stressed by repeated treatments.
Gene Research Sheds Light on Kidney Cancer and Polycystic Kidney Disease The discovery that a tumor suppressor gene that inhibits cancer of the kidney is linked to a gene which controls PKD leads to hope that new therapies will emerge, according to findings published in Molecular Cell (April 26, 2001).
Withdrawing Steroid Treatment after Pancreas-Kidney Transplants Proves Beneficial Stopping steroid treatment after simultaneous pancreas-kidney (SPK) transplants reduces the risk of organ rejection according to a new Northwestern Univ. study. Patients who were treated with Thymoglobin rather than steroids had better organ survival rates and fewer side effects. Many costly, long-term medical problems are associated with corticosteroid treatment, which has been widely used to prevent organ rejection. Among the side-effects of steroid treatment are increased infections, hypertension, increased cholesterol levels, weight gain, cataracts, osteoporosis and damage to the immune system.
Risk of Kidney Failure Reduced by ACE Inhibitor Some people develop chronic kidney disease because of hypertension. Hypertensive patients can lessen the chances of kidney failure by taking an angiotensin-converting enzyme inhibitor (ACEI) according to a June issue of the Journal of the American Medical Association.
This medication has been used for diabetic kidney disease since 1994, but now researchers are also recommending its use for hypertensives with kidney disease.
Many More Americans Are Hypertensive than Previously Suspected; Hypertension A Risk Factor for Kidney Disease Johns Hopkins University researchers say that many hypertensive patients are undiagnosed or receiving inadequate treatments. They conclude that both patients and physicians need to become better educated about the problems associated with chronic kidney disease. Only 11% of the patients in the study had blood pressure levels below the recommended level for kidney patients.
Erectile Dysfunction Widespread in Hemodialysis Patients Some degree of Erectile Dysfunction (ED) is present in 82% of hemodialysis patients, say Univ. of Pennsylvania researchers. ACEIs treatment actually reduces the incidence of ED, however.
More Patients Waiting for Transplants than Ever Before Over 75,000 people are waiting for a life-saving organ transplant in the US, and about 15 people on the waiting list die every day. Only about a third of the patients will receive the organ they need. As recently as 1990, the shortfall in available organs for transplant was only about 5,000; in 2001 the gap between people waiting for transplants and available organs is about 50,000.
As the risks of organ transplant have fallen, and a greater range of patients have become candidates for a successful transplant, need has exceeded supply. In fact, in 1990 only about 20,000 patients were assigned to a transplant waiting list; in 2000, almost 74,000 patients were put on the waiting list.
Increasing organ donation is crucial to solving the problem. The United Network for Organ Sharing says that making the decision to become a donor and communicating that wish to family members is easy. Visit www.shareyourlife.org or call 888/355-SHARE to obtain organ donation cards and family notification forms.
Even Low-Level Lead Toxins Contribute to Kidney Disease Heavy lead exposure has been known to have toxic effects on the kidney for some time. Now a report published in the Archives of Internal Medicine (January, 2001) discloses that "long-term, low-level environmental lead exposure" may very well contribute to chronic kidney disease.
Nephrotoxity Risk from Aristolochic Acid People who ingested products containing aristolochic acid risk kidney disease. The most chilling statistic comes from a study of patients in Belgium, all of whom took a diet pill containing the acid. Of the 100 patients in that group, 70 were diagnosed with acute kidney disease and required a transplant or dialysis. Two cases appeared in Great Britain, involving patients ingesting a preparation to combat eczema.
The acid is present in some botanical products.
AV Fistula Works Better for Men than WomenThe best venous access route for you probably depends upon whether you're a man or a woman. Two common methods of venal grafts for dialysis patients are the PTFE graft and the AV fistula. According to Johns Hopkins researchers, women seem to experience fewer complications than men do with PTFE grafts, whereas men have fewer problems with the AV fistula. (AV fistulas placed in men functioned for an average of 929 days before needing repair, whereas those placed in women required repair after only 329 days. The reasons for the gender difference aren't yet clear. Researchers speculate that the the AV fistula doesn't mature as quickly in women as in men.
New Transplant Procedure Makes Thousands Eligible About 7,000 patients among the 45,000 hoping for a kidney transplant have been thought likely to reject the organ because of elevated antibody levels. Now a procedure called "positive crossmatch transplant" greatly lowers the risk of rejection. (Patients with elevated antibodies undergo a treatment called plasmapheresis and have their spleens removed before receiving the transplanted organ.
Daily Dialysis Works Best Daily home hemodialysis is more effective than three-times-weekly dialysis, according to researchers speaking at the American Society of Nephrology fall 2000 meeting. A two year study shows that the daily regime significantly improved patients' physiological, biochemical and hemotological measurements. An average 45% reduction in blood pressure medication among patients in the daily dialysis group is only one of the significant improvements. Patients also recover from dialysis treatment and resume normal activities sooner than do patients on the three-times-weekly treatment schedule.
Medicare Claim Guidelines for Home Dialysis Released For information on the guidelines for payment of Home Dialysis claims under Medicare visit www.hcfa.gov/pubforms on the web or contact Renee Hildt at 410-786-1446 or Doris Barham at 410-786-6146 about procedures.
Smokers More likely to Have Kidney Problems A study of nearly 8,000 people reported on in the Oct. 17, 2000 issue of Annals of Internal Medicine discloses that smokers, even relatively light smokers, are more apt to develop kidney problems than non-smokers. Albumin in the urine, a sign of poor kidney function, occurs twice as often in people who smoke a pack a day or less than it is to appear in non-smokers. Heavy smokers (those who puff more than a pack each day) are more than twice as likely as light smokers to have the problem.
However, the study did not follow participants to determine who among them developed specific kidney problems or kidney failure.
ACE Inhibitors Help Protect Diabetics against Kidney DiseasePatients with either Type I or Type II diabetes who were prescribed an ACE (angiotensin-converting enzyme) inhibitor were three times less likely to develop renal problems compared to those who were not prescribed that medication according to an Iowa study published recently in the Annals of Pharmacotherapy.
Progress in ARPKD Research Atosomal recessive polycystic kidney disease (ARPKD) is an inherited form of kidney disease which affects 12 to 15 million children throughout the world. A University of Minnesota research team headed by Dr. George Witman has discovered a gene (Tg737) which causes a mutation in cilia in the tubes of the kidneys of mice. Although other gene mutations might also lead to the cilia defect, this is the first identification of a gene definitely associated with ARPKD. Potentially, then, one might screen prenatally fetuses at risk of developing ARPKD. In years to come, the disease might even be a candidate for gene replacement therapy.
Warning: Don't take St. John's Wort after Kidney Transplant Two kidney transplant recipients had acute rejection experiences related to taking the herb St. John's wort, which interferes with the anti-rejection drug, cyclosporine.
Physicians recommend that all patients consult their doctors before self-medicating with herbal remedies.
Pope Supports Transplants Organ donation is "an act of love," says Pope John Paul II. He told the International Congress of Transplant Specialists that brotherly love can be expressed in the decision to become an organ donor. He called sale of organs "morally unacceptable," however.
Network Helps Living Donors Living kidney donors are eligible for special health insurance programs and medical assistance at participating transplant centers, says Thomas McCune, MD, president of SEOPF (The South-Eastern Organ Procurement Foundation.) The Living Donor Network established by SEOPF is available to all transplant centers, enabling professionals to access medical and demographic characteristics of all donors. Dr. McCune says he hopes the LDN will "ease" the decision of people who are considering donating kidneys. For additional information, visit http://www.seopf.org.
Renal Disease Cases Rising The USRDS (United States Renal Data System) anticipates that three times as many people will suffer from end-stage renal disease by 2010. Currently 323,000 people are diagnosed in the US. The expected 77% increase will affect Medicare budgets, since caring for these patients will cost over $28 billion by the end of the decade.
The number of patients being treated with hemodialysis has doubled since 1990, and transplants are not keeping up with the need.
Dialysis Patients Using Anabolic Steroids Aren't as Tired,
Develop More Lean Body MassNew research shows that using nandrolone decanoate, an anabolic steroid, helps to build lean body mass in dialysis patients. Patients receiving the steroid also "reported less fatigue and scored better on physical performance tests." The Univ. of California study was recently published in the Journal of the American Medical Association.
Warning: Don't substitute Commercial
Baking Soda Powder for prescribed tablets.Citing the case of an Iowa man suffering from facial twitches and tingling in the limbs, the American Journal of Medicine warns that kidney patients should never use store-bought baking soda in place of sodium bicarbonate tablets. Overdosing on sodium bicarbonate can cause problems with heart rhythm, seizures and muscle spasm. Prescribed sodium bicarbonate tablets contain filler, so figuring out how much powder would equal a tablet is not possible.
View Donor Quilt on WebThe National Donor Family Quilt -- which honors the selflessness of organ donors -- is sponsored by the National Donor Family Council. Four times a year, the Council hosts quilt pinning ceremonies so that people can honor donors and share feelings.
You can look at many of the "Patches of Love" and read stories about donors at http://www.kidney.org/recips/donor.
The quilt recently traveled to Rome for display at the International Congress of the Transplantation Society.
Warning: Dialysis Patients Should Avoid Eating Star Fruit Dialysis patients need to be alerted to a possible danger from eating star fruit.
An article in Nephrol Dial Transplant (1998) suggested that star fruit contains "an excitator neurotoxin" and has been linked with death in some dialysis patients and in those with renal insufficiency. The elliptical-shaped tropical fruit is connected with a variety of toxic episodes, Diana Wolking, MS, RD, CNSD reported in the Sept. 2000 issue of Nephrology News and Issues.
Visit Upgraded Transplant Patient Data Source Web Site The United Network for Organ Sharing (UNOS) has upgraded its Transplant Patient Datasource (TM), an internet resource at http://www.patients.unos.org. The updated site now presents separate post-transplant data for adult and pediatric patients. UNOS also offers a comment form for visitor's suggestions. Both the UNOS site and its companion site, Transplant Living (TM), www.patients.unos.org, have been recognized for excellence at the Partnerships 2000 Technology Games and 2000 Virginia Public Relations Competitions.
UNOS Cooperating with Mexico's National Transplant Council An agreement between UNOS and Mexico's CONATRA aims at helping Mexico develop its transplant and organ donation programs. In 1999 22,000 plants were performed in the US while only 630 transplants were performed in Mexico.
Exchange of clinical and scientific information will be of special help to Mexican-American communities in the US. However, the organizations do not expect there to be any actual organ exchange program between the two countries. Hispanics in California and Texas receive about 30% of the kidney transplants in those regions and also account for about 25% of organ donors.
D.C. Area Medical Consortium Expands Kidney Donations The newly-formed Washington Regional Voluntary Living Donor Registry is expanding opportunities for one person to donate a kidney to another with paired exchanges, Living donor/cadaver exchanges and non-designated donations. The new options will bypass obstacles created by the necessity of matching blood tissue types between recipients and donors.
If someone wants to donate a kidney to a friend or relative, but the blood types do not match, the program tries to find another donor and recipient in the same circumstance and to arrange a "paired exchange." A person awaiting a kidney transplant might also receive a kidney donated from a cadaver. In that case, a relative or friend of the person who has died will gain priority on the waiting list.The number of non-designated kidney donations is rising, too. The consortium director, Lori Brigham, says that she is now receiving at least two phone calls a week from people who are interested in donating a kidney to a stranger.
"Virtual Visits" Being Used in California A pilot telemedicine program has been inaugurated by the California Pacific Medical Center's Kidney and Pancreas Transplant Team. Connecting Fresno-area patients fro their local clinic to a San Francisco-based transplant team, Twenty-five patients have made "virtual visits with their physicians, social workers or nurse coordinators to check-up on conditions and to discuss side effects of medication, lab work, symptoms, and emotional issues.
Three ISDN lines connect the San Francisco and Fresno units, which use televisions in both locations to transmit images and sound. "Telemedicine enables us to always be within reach of transplant patients -- even when they're 200 miles away," according to Steven Katznelson, MD, a nephrologist connected with the program.
Norfolk, VA Hospital Enrolls in Living Donor Network The South-Eastern Organ Procurement Foundation has formed a Living Donor Network. A new database regarding living kidney donors allows professionals to collect demographic and medical characteristics of the donors. Most important, donors at transplant centers participating in the program receive substantial life, disability and medical insurance protection relating to complications that might arise from donating a kidney. Sentara Norfolk General Hospital is the first hospital in the nation to participate, but the Procurement Foundation is offering the program to all kidney transplant centers in the country.
Take Time to Talk: NKF and Cemetery and
Funeral Associations Launch Cooperative ProgramThe "Take Time to Talk" program encourages families to discuss organ and tissue donation options. Funeral association counselors regularly offer guidance to families on a variety of issues, including veteran and Social Security benefits, living wills, and memorial arrangements. Now organ and tissue donation options are being added to these discussions. The "Take Time to Talk" manuals answers to common questions about donation, as well as key facts and sample organ donor cards.
Kidney Transplants Less Successful for Older Patients Long term acceptance of transplanted kidneys is lower in older adults, Univ. of Michigan researchers reported in May. Although younger patients have a higher rate of immediate, acute rejections (23.6% for the 18-49 year old age group compared to 17% for those over 65), the older patient group is more apt to lose the grafted kidney over a period of time. Only 40% retained a functioning graft after eight years. Researchers speculate that change in lipoproteins, growth factors and cytokines may increase graft loss in the over 65 population.
Kidney Patients Benefit from Joining the Patient/Family Council The Patient and Family Council is an organization open to all kidney patients, family members and friends. Working with the National Kidney Foundation to improve care of kidney patients, the Council encourages patient and family involvement in all Foundation activities.
Council. members receive free subscriptions to publications such as NKF Focus and Transplant Chronicles, access to a toll-free information hotline, and many other benefits. To enroll, visit http://www.kidney.org/patients/bro/cfm.
Number of Canadian Dialysis Patients Increases Renal dialysis treatment in Canada has been rising at an average annual rate of 6%, according to the Canadian Institute for Health information (CIHI). The over 75 age group is the fastest growing segment of the renal patient population; the average age of a new patient is 60.
Nearly 30% of newly diagnosed kidney patients already have diabetes. Renal patients die, most commonly, from cardiovascular disease, the agency reports. For more information on Canadian health trends, visit http://www.cihi.ca/wedo/hscort.htm.
Neglecting Oral Health Can Promote Onset of Kidney Disease U. S. Surgeon General David Satcher's report on Oral Health in America concurs with several other studies that oral infections are often connected with problems with major organs, such as the kidney. Regular brushing, flossing, and dental exams can help maintain overall health, as well as oral health.
Most Americans Say They Would Consider Donating an Organ A National Kidney Foundation survey finds that 90% of of American adults would consider donating a kidney or part of another organ to a family member. Fifty percent of those surveyed say they would consider donating to help a friend; And twenty-five percent say they would consider donating to a stranger.
The need for donations of organs by living donors has risen because of the overall shortage of organs and the increase in the number of transplants attributed to better medical techniques.
UNOS offers New On-Line Organ-Matching Service The United Network for Organ Sharing (UNOS) and the Scientific Registry of Transplant Recipients (SRTR) are working together to match donated organs for U. S. recipients through a new on-line system called Unet. Before Unet was in operation, several separate computer systems were employed to match organs with recipients. The new system improves "the UNOS member's ability to access and use the national transplant system." Hospitals can easily place their patients on a waiting list. The OPO (organ procurement organization) which receives an organ then contacts the hospital and offers the organ for the matched patient.
UNOS employs an encrypted system to protect the privacy of patients.
Independent Dialysis Facilities Increase
Non-Profit Facilities DeclineThe Health Care Financing Administration reports that 1999 saw an increase of 342 independent dialysis facilities, over a hundred more additional facilities than in 1998. The total number of Medicare approved dialysis care providers reached 3,825 by the end of '99. OF these, 2,824 are for-profit based facilities. Hospitals are continuing to sell-off dialysis facilities to for-profit chains. Only 25.4% of ESRD in the US were non-profit facilities by the end of 1999.
NKF Publishes New Nutrition Guidelines The National Kidney Foundation has published new nutrition guidelines for adults and pediatric patients with chronic renal failure. "Nutrition is critical in determining the success of outcomes in patients receiving dialysis treatment," said Joel Kopple, MD, chairman of the Nutrition Work Group and President of the NKF.
Among the key points:
- Pediatric patients should be monitored for daily vitamin, zinc, and copper intake, as well as being treated with recombinant human growth hormone.
- Adult patients need to receive adequate L-carnitin.
- Adult patients need 1.2 grams of protein per kilogram of body weight per day. (Children's requirements are keyed to chronological age as well as body weight.)
Maintaining appropriate energy intake is crucial, too. The new guidelines take account of age differentiations among adults.
THE NUTRITIONAL STATUS OF ALL PATIENTS SHOULD BE ROUTINELY ASSESSED.
Calcium-Laced Supplements Pose Problems for ESRD Patients A new study in the May 18th, 2000 issue of The New England Journal of Medicine shows that many young adult dialysis patients.show serious coronary artery calcification.as a result of using calcium-laced supplements to control phosphorus.
Medical researchers have long been aware of coronary artery disease in older patients, but are shocked at the signs of this disease in younger patients on long-term dialysis.
The only calcium-free phosphate binder on today's market is Renagel, produced by Geltx Pharmaceuticals. Unfortunately Renagel capsules cost about $.51, while standard calcium tablets cost pennies apiece. William Goodman, MD, the UCLA researcher who is the lead author of the study, says that he puts his patients on a mixed regimen of Renagel and calcium in an effort to moderate calcium intake while containing costs.
Patients on dialysis have a 10-20 times higher rate of cardiovascular disease than the general population, and cardiovascular disease accounts for nearly 50% of all deaths in dialysis patients.
Free Kidney Patient Education Materials Available The Life Options Rehabilitation Program offers FREE EDUCATION MATERIALS for Dialysis patients. For more information, call 800-468-7777, e-mail lifeoptions@medmed.com, or visit the Life Options web site: http://www.lifeoptions.org.
Hypertension Medication Delays Kidney Failure
for ADPKD PatientsAccording to a study published this spring in the American Journal of Kidney Diseases, the progression of autosomal dominant polycystic kidney disease (ADPKD) may be stemmed by using medication to control high blood pressure. The treatment, University of Colorado School of Medicine researchers say, may delay kidney failure for about 15 years.
"Bioartificial Kidney" Research Progressing Pending FDA approval, Univ. of Michigan researchers are ready to begin testing a "Bioartificial" kidney on humans. Part machine, part living tissue, the artificial kidney has already been tested on dogs. It provides nearly 50% of the functional capacity of a normal kidney.
The great advantage of the Bioartificial kidney is that it uses living kidney cells and can produce important hormones, provide immune functions, and process metabolites. In other respects, it works like a standard hemodialysis machine since it resides outside the body, filters blood, and removes excess water and waste products.
New Pennsylvania Law Benefits Dialysis Patients A new Pennsylvania law allows manufacturers of dialysis supplies to distribute prepackaged supplies directly to self-administering dialysis patients, as long as they are under a doctor's care.
Renal Transplants Help Patients Live Longer A recent study confirms that transplant patients live an average of 10 years longer than similar dialysis patients. The New England Journal of Medicine reports that the increase in life expectancy for transplant patients was greatest for adults between 20-39 and least for adults 60-74.
Transplants offer a better quality of life as well. Complications after surgery are the greatest threat faced by transplant patients, but within a few months of receiving the new organ, such excess risk disappear.
Over 43,000 people in the U.S are waiting for transplants, according to the United Network for Organ Sharing, although only about 12,000 transplants were performed in 1999.
Thrombosis Incidence Reduced by Fish Oil Supplements Fish oil supplements significantly reduce thrombosis in the vascular access grafts of patients on hemodialysis, according to St. Louis University researchers. Half the patients studied received fish oil supplements following new PTFE grafts; the other half received corn oil supplements. Only 13% of the patients receiving fish oil developed thrombosis within a year, compared to 71% of the patients receiving corn oil supplements.
The fatty acids in fish oil are beneficial to vascular smooth muscle cells, according to the 1999 study.
More than 50% of all patients with PTFE grafts develop thrombosis within two years. Thrombosis is the most common cause of hospitalization of dialysis patients.
Cadaveric Renal Transplantation Rate Affected
by Demographics and GeographyA 1999 study of 46,000 patients by the US Renal Data System, the University of Michigan, and the University Renal Research and Education Association found that patients in the upper Midwest received a first-time kidney transplant at a rate double that of patients in New York.
Comparison of the time from onset of disease to being placed on a waiting list varied widely, as did the period before transplant. "Generally, the regions with the highest waiting list rates had the lowest transplantation rates.
Overall, the rate for receiving a first cadaveric transplant among all dialysis patients was significantly different from the national average in 10 out of the 11 regions, ranging from 30% lower to 30% higher than the national average."
FDA approves Epogen for treating Anemia
in Children with Chronic Renal FailureAmgen's "Epogen" (Epoetin alfa) alleviated the anemia of end-stage renal disease and reduced blood transfusion dependency in four clinical trials involving 128 pediatric dialysis patients. No patients were withdrawn because of adverse drug reactions, although some experienced hypertension, abdominal pain, and headache.
Only 7.4% of children under age 19 develop ESRD because of diabetes and hypertension, diseases associated with nearly 66% of adult cases. Glomerulo- nephritis ( thought by some to be caused by an allergic response to infection) is the most frequent cause of pediatric ESRD, followed by Cystic/hereditary/congenital disease. Pediatric death rates are lower, too.
In the US, 6 out of 100,000 children are ESRD patients. Risk increases with age. Most ESRD patients in the US are Caucasian (71%), followed by African Americans (22%). Children are far more likely than adults to receive a transplant within a year after diagnosis. The majority of Caucasian children receive an organ donated by a living relative, while the majority of African American children receive kidneys from cadaveric donors.
FREE Video on Loan at Blockbusters throughout USA
"CHOICESOptions for Living with Kidney Failure"
The video "Choices
This educational video, produced by Baxter Healthcare-- Renal Division, with help from the AAKP, is available at Blockbuster Video Stores without charge. You may also find it on loan at some public libraries.
Good News for Dialysis PatientsUSRDS 1999 Report Shows "Steady Improvement in Survival" Changes in dialysis care are improving first year survival rates for all ESRD patients, according to a new USRDS report. Researchers believe the increase in average doses of hemodialysis and peritoneal dialysis and other care changes account for the improvement, although they cannot explain the wide variations linked to geographic location.
The improved survival rate for ESRD patients is most dramatic in the first few years of dialysis. Since 1986 second year death rates have decreased by 33%. However, the improvement drops off to about 10% during the third to fifth year of treatment. The expected lifetime of dialysis patients is still between 16% and 38% less than that of others of the same age, sex, and race.
Transplantation is still the optimal treatment for ESRD patients, especially in the wake of recent improvements in immuno suppressive therapy.
A fuller account of these trends is found in Nephrology News and Issues, September, 1999.
Medicare Now Covers Pancreas Transplants
for ESRD PatientsAs of July 1, 1999, Medicare patients who have had a kidney transplant, as well as those who need a combined kidney/pancreas transplant, will receive coverage for a pancreas transplant. The new Health Care Financing Administration decision will benefit many thousands who suffer from both kidney disease and diabetes. (A 1997 report shows that over 100,00 ESRD patients also had diabetes.)
Previously, kidney transplant patients had to pay as much as $30,000 out-of-pocket for a pancreas transplant.
If you received a kidney transplant before you became a Medicare beneficiary, do you qualify for a Medicare-covered pancreas transplant? The language of the new regulation needs clarifying, experts say. Check carefully before arranging for pancreas surgery to make sure you're covered.
End Stage Renal Disease Growth Rate Declining in US Fewer people were diagnosed with End Stage Renal Disease between 1992 and 1997 than in the previous five year period, according to the 1999 USRDS Annual Data report. The annual growth rate has declined from 9% to 6%.
Although the report does not suggest reasons for the improvement, it identifies diabetes as the most common cause of ESRD. This newest report continues to show that ESRD is more common among men than women and more common among Blacks and Native Americans than among Whites and Asians.
You may view the complete 1999 report on the web at http://www.med.umich.edu/usrds/index.htm.
Early Screening Helps Reduce Risk of Kidney Disease Over 1 in 4 adults Face Complications Testing urine for protein content ought to be part of routine medical check-ups, especially for people with diabetes or high blood pressure, according to the National Kidney Foundation. Those with a family history of heart attacks, strokes, or kidney failure ought to be especially alert to the possibility of impaired kidney function. If you're prone to urinary tract infections, it's important to be tested regularly, since they can also lead to kidney disease.
Literally millions of Americans suffer from kidney disease, and more than a quarter of a million of them are on dialysis. Thousands are awaiting scarce kidney transplants. Fifty to sixty million people suffer from high blood pressure and 15 million from diabetes, both of which create kidney problems.
The lesson? Find out if you have undetected kidney disease, or conditions which can lead to kidney disease. Then do all you can to help your kidney. Medication, losing weight, and modifying your diet can help. Even if you're not in a high-risk group, you should have this test done once a year, says Dr. Garbed Eknoyan, past president of the NKF.
A standard test for the presence of albumin in the urine will detect "leaky" kidneys. If the kidney is not functioning properly, it allows substances to seep into the urine which should be recycled and retained by the body.
Like many other nephrologists, Andrew Levey MD of the New England Medical Center believes that a low protein diet benefits patients with reduced kidney function because it lessens the burden on the kidney. In fact, most Americans eat twice as much protein as they need.
New Restless Legs Syndrome Treatment Proves Effective Restless legs syndrome (RLS) affects many dialysis patients, as well as several million other Americans. Now researchers have discovered that medications used to treat Parkinson's disease, especially pramipexole, help alleviate the symptoms of restlessness at bedtime and during the night.
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Heart Disease Update Exercise Good for Transplant Patients Transplant patients who engage in aerobic exercise develop more endurance than patients who do not, according to a 1999 New England Journal of Medicine study. That's no surprise. Lung transplant recipients benefit from stationary bike training, for instance. Patients with transplants are encouraged to participate in sports, too. Competing in the World Transplant Games, an Olympics-type event open to people with a functioning organ transplant, could be both fun and beneficial.
Heart Transplants Decrease,
Kidney and Liver Transplants Rise in 1999Because of a decline in organ donations, fewer heart transplants occurred in 1999 than in 1998, according to UNOS (The United Network for Organ Sharing.) The decline is related to fewer "willed" organs (cadaveric organs).
Kidney and liver transplants rose, however, largely because of contributions from living donors.
Heart Patients' APOE-4 Status
Should be Assessed Before SurgeryDuke University researchers have linked the E-4 variant of the apolipoprotein (APO) gene to the incidence of kidney damage suffered during surgery. The same E-4 component apparently signals a predisposition for Alzheimer's Disease.
Currently, about 1% of heart surgery patients incur lasting damage to the kidneys, requiring dialysis. The presence of the E-4 component, rather than the the E-2 and E-4 type, is implicated with renal damage, possibly because of altered blood flow or dislodging of plaque from the walls of blood vessels during surgery.
The APO gene assists liver cells in clearing cholesterol from the blood. People with the E-4 variant of this gene build up "bad" LDL cholesterol because the gene isn't functioning properly.
Heart patients with APOE-4 should be screened carefully before making surgical decisions because they are more likely than APOE-2 and APOE-3 patients to develop kidney problems that will greatly affect quality of life.
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Diabetes News Severe Problems Afflict Young Type 2 Diabetics The first long-term study of children diagnosed with type 2 diabetes reveals that many victims of the disease suffer multiple medical complications as young adults. Diagnosis of type 2 (or "adult onset) diabetes in children is on the rise, especially in ethnic groups such as Hispanics, Native Americans, and Blacks. The reasons for the increased occurrence of the disease in children aren't entirely clear, but some believe childhood obesity is the key. "Obesity is pulling the trigger," says pediatrician Silva Arlanian of the University of Pittsburgh school of Medicine. "Rates of obesity in children are escalating like a rocket. Two of five children are overweight, and some races are even more prone to be overweight."
Eating Processed Meat Promotes Diabetes If your diet is high in processed meat, including bacon and hot dogs, your risk of developing type 2 diabetes is increased by 50%, especially if you're male, according to Harvard School of Public Health researchers.
Men who eat processed meats five or more times a week are at the highest risk level. This study adjusted for the effects of smoking, obesity, eating of fats, and physical activity and concluded the eating processed meat is a significant, independent risk-factor for diabetes. Frank Hu, the senior author of the study, said: "We are not proposing to ban hot dogs. It's just a matter of moderation.... People should reduce the frequently of eating processed meats."
Lowering Blood Pressure in Diabetic Patients
Lessens Chance of Stroke / Renal DiseaseNew guidelines from the National Kidney Foundation counsel physicians to work aggressively to lower blood pressure in patients suffering from both hypertension and diabetes. Targeting blood pressure goals at 130/80 mmHG, the NKF says, will require physicians to "shift to more flexible pharmacological treatment strategies," using multi-drug therapies.
Diabetics Suffer from Anemia An Amgen, Inc. study finds that most patients with diabetes do not realize they risk developing anemia, which is, in fact, an early signal that diabetic nephropathy is developing.
Warning signs of anemia include fatigue, dizziness, rapid heartbeat, and shortness of breath. Recommendation: If you're diabetic, test regularly for anemia.
Thirty-three Percent Increase in US Diabetes Cases During the past decade the number of Americans with diabetes rose by 33% according to a study by the Centers for Disease Control and Prevention. Type 2 diabetes "is closely tied to obesity," states William Keane, President of the National Kidney Foundation, and "many experts believe the higher incidence is due in large part to America's weight problem." About 55% of all Americans are considered to be overweight.
Diabetes is not only a troublesome disease in itself but it is a leading cause of chronic renal disease and kidney failure. Early diagnosis and treatment of diabetes reduce the likelihood of developing renal disease. Annual tests of blood sugar, blood pressure, and kidney function are important.
The medical community agrees that eating a balanced diet and engaging in regular exercise is an important component of maintaining good health.
Cinnamon Helps Delay Diabetes Adding between a quarter teaspoon and full teaspoon of cinnamon to your daily diet may help delay or actually prevent type II diabetes, according to the U. S. Agricultural Research Service. Nutritionist Richard Anderson suggests adding cinnamon daily to orange juice, coffee, oatmeal, or other food.
Why? Cinnamon enhances the ability of fat cells to recognize and respond to insulin, thereby increasing glucose metabolism. It contains a substance called methyl hydroxy chalcone polymer (MHCP) which helps fat cells respond to insulin.
As always, check with your physician before making changes in your diet.
Diabetics May Need C-peptide Hormone Using C-peptide, along with insulin, reduces diabetic complications, such as kidney disease, according to the Diabetes Symposium in Michigan. Early research suggests that administering C-peptide to some Type 2 diabetics reduced complications of the disease. Swedish researchers have also discovered that daily injection of C-peptide limit problems in Type I diabetics, as well.
Cell Transplant May Offer Diabetes Cure On June 6, 2000 researchers at the University of Alberta, Canada, announced the development of a cell transplant technique that could eliminate the need for insulin injections for diabetes. Eight patients who were injected with pancreas cells began to produce the missing insulin. If a larger study, slated to begin this summer, confirms the early findings, insulin-dependent diabetes could be defeated. According to Dr. James Shapiro, who led the study, the transplant techniques will be a tremendous advance, particularly for patients with Type 1 Diabetes.
Diabetics who receive the transplant must take three different drugs to prevent the body from rejecting transplanted cells, and those drugs do increase the risk of cancer and infection. But that risk may be well worth taking for serious diabetics. Dr. Shapiro said that one of the patients who received the cell transplant used to fall into a diabetic coma several times a week and doesn't even need insulin shots after receiving the transplant.
A junior high school teacher who was one of the eight volunteer transplant recipients says: "I can now do things I never dreamed I would do, like teaching an entire morning or afternoon without stopping to eat a snack or testing my blood glucose, (or) going for walks when I want.
The researchers' success is due to their creating better techniques for extracting cells from donated pancreases and by determining which drugs would prevent rejection of those cells.
Obtaining sufficient numbers of pancreatic cells is still an obstacle to wide-spread treatment. The next step forward, according to Dr. Jonathan Lakey, co-author of the study, will be to find a way to grow the cells in the laboratory.
Dr. Shapiro said that he hopes, in time, transplanting pancreatic cells can be accomplished with fewer anti-rejection drugs.
Read more about this study at the New England Journal of Medicine web site: http://www.nejm.org,
New Blood Pressure Guidelines for Diabetics The National Kidney Foundation is now recommending a new standard of 130 over 80 for diabetic patients because of the number of cardiovascular complications and instances of kidney failure in patients who have diabetes and high blood pressure.
The American Diabetes Association, however, is standing by the current standard of 130 over 85 because of the increased treatment with ACE inhibiting drugs that would be needed to drive blood pressure down to the lower standard.
The blood pressure standard for the general population is still less than 140 over 90.
Researchers Identify Reason for Link
between Diabetes and Kidney FailureUniversity of Pennsylvania researchers have discovered that diabetic kidney failure "is triggered by the transforming growth factor-beta (TGF-beta) protein," which stimulates the development of scar tissue within the kidneys and ultimately prevents the kidney from properly filtering toxins.
When researchers gave diabetic mice an antibody that neutralizes the growth factor, scar tissue did not develop. Fuad Ziyadeh, MD, who headed the study said: 'To our knowledge, this is the first ... study to establish that kidney disease in diabetics is caused by this growth-factor protein." He added that it might be possible to develop drugs "that would inhibit the metabolic actions of the TGF-beta protein in the kidney."
This finding addresses both juvenile and adult-onset diabetes. Although treatments for hypertension and hyperglycemia in diabetes patients have improved recently, renal failure rates haven't declined. Diabetes remains the primary cause of kidney failure throughout the industrialized world.
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Cancer Promising Cancer Drug Treatment Trials use Combretastin A cancer breakthrough? Time will tell. British researchers are excited by trial results from using a new drug called combretastin to treat many common types of human cancer in mice and in trials involving 60 patients in the U. S. When combined with radiation therapy, combretastin proved 85 percent effective against types of cancer which produce solid tumors. These include bowel, breast, liver and lung cancer. Worldwide tests of the treatment on cancer patients will begin next year. However, it may be five years before the drug becomes freely available for treatment of humans.
Combretastin, which is made from the bark of an African bush willow, destroys the developing blood vessels generated by tumors without affecting normal blood vessels. However, it needs to be used in conjunction with radiation, because combretastin leaves a rim of cancerous cells at the edge of tumors. Radiation therapy completes the attack on the tumor by ensuring all the leftover cells are killed off. Antibodies with radioactive 'warheads' home in on the disease cells and destroy them. Dr. Pedley of the British Cancer Research Campaign said that combretastatin may be unable to kill the rim of outer tumor cells because those rely on the body's normal blood vessels for nourishment. According to Dr. Lesley Walker, the excellent results of using combretastin confirm that "treatments that directly target cancers and spare normal tissue will be the therapies of the future. As well as improving the effectiveness of treatment, this combination should greatly reduce side-effects for the patient."
New Renal Cancer Drug on Fast-Track for Certification CC1-779, a motor inhibitor, has shown sufficient promise as a treatment for varying tumor types, including renal cancer, that it's on the FDA's fast-track certification schedule. More information is available at the Wyeth-Ayerst Laboratories' Web site: www.wyeth.com.
AKA funded Patient Assistance Program Benefits Thousands The American Kidney Fund's "Renagel Patient Assistance Program" is helping thousands of low-income hemodialysis patients. Patients who cannot afford Renagel tablets, a phosphate binder, will receive supplies through AKF when referred by nephrologists and social workers. Genzyme Corporation contributes the product.
For more information, call the AKF Patient Services Dept. at 800-638-8299, ext. 6675.
Call for "Dining Out With Confidence" The NKF has updated their brochure, "Dining Out with Confidence: A Guide for Patients with Kidney Disease." Designed to guide people toward appropriate meal choices in restaurants, including ethnic and fast food restaurants.
Call 800-622-9010 to ask for the brochure.
Bone Cancer Treatment Risks Kidney Failure Side Effect Bone marrow transplantation (BMT) has been increasing as a bone cancer treatment in recent years, but now an editorial in the British medical journal, Lancet, states that as many as 15% of bone marrow transplant patients experience acute renal failure and as many as 20% of long-term survivors of the transplant treatment develop chronic renal failure. This side effect poses a "major problem" researchers need to address.
Can Kidney Cancer Be Stopped by
Sibling Blood Cell Transfusion?Kidney cancer can be reversed by transfusing blood cells from a healthy sibling according to a study published in the Sept. 14 issues of the New England Journal of Medicine. Dr. Nicholas Vogelzang, an advisor for the Kidney Cancer Association called the discovery "the biggest advance in kidney cancer in 22 years," but the national Institutes of Health cautioned that the treatment has its dangers and requires further study because patients have been followed for only two years and doctors conventionally require a five year remission period to assume that a patient is likely to remain cancer-free.
The author of the study, Dr. Richard Childs, says that the treatment remains experimental right now, since it takes months to work and two out of 19 patients died from the treatment itself. Dr. Robert Figlin of UCLA suggest that only about 20% of kidney cancer cases would be slow-growing enough to make the blood cell transfusion an option, in any case, but Voelzang argues that the treatment might be applicable to many as 53% of patients.
However, only one out of four siblings is likely to be a suitable donor. The donated blood cells must closely match the patient's own, and the donor must be healthy.
General Medical News Are You Eligible for a Drug Discount? Together Rx is a new prescription drug benefit program for Medicare patients who do not have any prescription drug coverage from another source and who meet the limited income requirement of $28,000 per year (individual) or $38,000 per year (couple).
Sponsored by seven major pharmaceutical companies, the Together Rx card offers 20% to 40% off the regular cost of over 150 prescription medicines. Larger discounts may be available to people with lower incomes.
Call 800-865-7211 (toll-free) to apply for the card.
"Huffing" Can be Fatal At least 6% of all US children experiment with inhalants like glues and paints by the 4th grade and nearly 20% say they've "huffed" by the time they reach eighth grade. Scientists find the practice alarming.
Stephen Dewey of the Brookhaven National Laboratory says he has seen 6th grade children on dialysis because of organ damage incurred by "huffing." The common chemical inhaltant, toluene, found in glue, paint, and other household products, damages the central nervous system and seriously effects the kidney, liver, and heart. It can lead to permanent organ damage and even to death.
High Blood Pressure Affects Your Kidney The national Kidney and Urologic Diseases information clearinghouse is offering a new factsheet, explaining the relationship between hypertension and renal disease, and explaining how hypertension can be controlled by diet, exercise, and medications. The publication is free. Call NKUDIC (800-891-5390). Or visit www.niddk.nih.gov. At that site, click on "Health Information" and then on "Kidney" to see a list of titles of free publications.
A recent study of elderly patients in San Francisco has confirmed prior medical findings that systolic hypertension is linked to all forms of kidney dysfunction, particularly in older patients.
Artificial Bladders and Kidneys? A Boston doctor is awaiting FDA approval to implant an artificial bladder in a patient. Anthony Atala, MD, expects that permission for the transplant will come this summer. Engineering of artificial organs offers limitless possibilities, according to Atala. "Eventually, I think that by following the same strategies, just about every organ in the human body will be repairable at the very least."
Other Massachusetts researchers are working with material from cloned cow embryos to construct miniature kidneys. That research is promising, but far from complete.
Researchers agree that tissue engineering is in the early stages of development, but they hope that it will eventually reduce the need for standard transplants and give hope to countless patients on waiting lists.
Good news! Medicare Now Reimburses
Nutritional Therapy and Pain TreatmentBeginning January 1, 2002, Medicare expanded coverage to reimburse patients for nutrition therapy and management of pain. Cindy Moore, director of Nutrition Therapy at the Cleveland Clinic Foundation says that covering medical nutrition therapy has the potential of improving patients' quality of life and is likely to save taxpayers money by reducing the numbers of people who develop heart disease, renal disease, and other chronic illnesses.
Pain management coverage is important to many categories of patients, especially cancer and AIDS victims. There's a new reimbursement code. It's easiest for physicians who identify themselves as pain management specials to obtain payment.
Preventing Diabetes Prevent Diabetes Problems: Keep Your Kidneys Healthy is a new, easy-to-read booklet published by the NKUDIC. Call 1-800-891-5390 for a free copy. You can also request this booklet, and others in the Prevent Diabetes Problems series, by visiting the NIDDK web site (www.niddk.nih.gov) Just click on "Health Information" and then on "Kidney Diseases" to choose a title from the list.
Reduce Your Blood Pressure Immediately For decades experts have extolled the benefits of exercise in reducing blood pressure, but most people assume that lower blood pressure readings come only as a future reward for a long-term, sustained exercise program. Now, a January '01 article in the American Journal of Hypertension shows that 45 minutes on a treadmill reduced the blood pressure of sedentary men for as long as 12-16 hours after the exercise session.
Transplants Without Drugs? Intolerance of a transplanted organ is a major problem for all transplant patients, one conventionally addressed by a host of immunosuppressive drugs, all of which create side effects.
However, the Transplantation Institute at the University of Pittsburgh has weaned a group of liver transplant patients off anti-rejection drugs. That achievement has led to the Immune Tolerance Network awarding the Pittsburgh research team a $728,000 grant to look for clues to predict which patients will prove transplant tolerant. The team hopes to develop predictive tests to determine which patients are likely candidates for being weaned from the drugs.
Herbal Ingredient May Lead to Nephropathy Don't use herbal medicines which contain aristolachic acid, the U. S. Food and Drug Administration warns. A significant percentage of the people in England and Belgium who had used products containing the acid developed Nephropathy, a form of kidney disease. The products containing the acid were taken for treatment of eczema, in England, and in a diet pill in Belgium.
California Establishes Nurse-Patient Ratios California will become the first state to establish nurse-to-patient staffing ratio requirements in all hospital departments. The legislation is designed to ensure that cost-cutting by hospitals and managed care organizations do not harm patient care.
Presently, California has the next-to-lowest nurse-patient ration in the U.S. (Washington is the lowest.) The new law will take effect in 2002. The financial impact of the new law won't be known until the California Dept. of Health Services completes the task of defining the appropriate nurse-patient ratio for various hospital departments, but Dorel Harms of the Californian Healthcare Association says that the new law will definitely increase the number of nurses required.
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