Study: Gradual weight loss no better than rapid weight loss.

Forbes (10/15, Husten) reports that according to a study of 204 obese adults published in the journal Lancet Diabetes & Endocrinology, there is “no support” to the belief that weight is “likely to stay lost if it is the product of a rapid weight loss.” Rather, the study found that, “although long-term weight loss remains elusive regardless of the diet, short-term weight loss is actually more likely with rapid weight loss.”

        HealthDay (10/16, Preidt) reports the Australian study “found that whether you opt for a “crash” diet or something a bit slower, the rate at which you shed excess pounds has no bearing on whether or not those pounds will come back.” The article points out that currently guidelines suggest that “slow and steady weight loss” is believed to be “more likely than rapid weight loss to help people keep their weight under control.”

        The Telegraph (UK) (10/16, Knapton) reports half of the participants “were encouraged to lose 12.5 per cent of body weight within 12 weeks, and half who were allowed 36 weeks. The researchers found that eight out of 10 people assigned to the rapid weight loss programme achieved their goal compared with just 50 per cent of the steady dieters.”

Autoantibodies Predict Relapse in Patients with ANCA-Associated Vasculitis Involving the Kidneys

Among 166 patients with ANCA-associated vasculitis who were followed for an average of 49 months, autoantibody increases were linked with an 11-fold increased risk of relapse in patients whose kidneys were affected. Among patients without kidney involvement, such increases were associated only weakly with relapses. The findings are published in JASN. Patients with ANCA-associated vasculitis produce antibodies that damage blood vessels in the body.

First Evidence of Human Embryonic Stem Cell Therapy’s Safety, Graft Survival, and Benefit to Patients

In an early phase clinical trial of 9 patients with Stargardt’s macular dystrophy and 9 with atrophic age-related macular degeneration, all of whom received subretinal transplants of retinal pigment epithelial cells derived from human embryonic stem cells, 72% of patients had patches of increasing subretinal pigmentation consistent with transplanted retinal pigment epithelium. Best-corrected visual acuity improved in 10 eyes, improved or remained the same in 7 eyes, and decreased by more than 10 letters in 1 eye. Vision-related quality-of-life measures increased for general and peripheral vision, and for near and distance activities. The results are published in The Lancet.

Intravenous Iron May Reduce Platelet Counts in Patients with CKD

Among 203 patients with CKD who received low molecular-weight iron dextran over a median time of 2 hours and 40 minutes, average platelet counts were slightly reduced during consecutive 15-day intervals post-treatment. At the reference point of 90 days post-infusion, the drop in platelet count was statistically significant. The findings are published in the Journal of Clinical Pharmacy and Therapeutics. Additional studies are needed to examine whether the drop in platelet count translates to a reduction in thrombotic episodes.

http://www.medscape.com/features/slideshow/weight-loss-tips

Weight Loss Tips From Our Experts

Laurie Scudder, DNP, NP 

October 6, 2014

Fecal capsules could provide easier means of stopping gut infection.

The New York Times (10/12, A21, Belluck, Subscription Publication), cites research, newly published in the Journal of the American Medical Association, in which 20 people were given experimental capsules containing” strained, centrifuged and frozen” fecal material that could help clear up infections of Clostridium difficile, which causes serious diarrhea and kills 14,000 Americans annually. The study builds on previous research indicating fecal transplants could help reset the balance of bacteria in the gut. If the volunteer-to-patient results are replicated in larger trials, “the pill, developed at Massachusetts General Hospital in Boston, promises an easier, cheaper and most likely safer alternative” to the “unpleasant procedure” of fecal transplantation.

        The Washington Post (10/11, Feltman) provides details of fecal transplants, pointing out that instead of pumping fecal liquid from a donor into a patient, “it’s concentrated into a single capsule.” A single treatment “requires a gulp-worthy 30 pills — 15 on the first day and 15 on the second.” Still, the paper notes, “don’t knock it: In a trial of 20 patients, it brought normal bowel health and function to 18 — which is the same rate of success seen in more invasive methods.” Moreover, the cost of the therapy is cheaper, costing $500, “one sixth the price of either a colonoscopy or a standard course of antibiotics.”

        The Los Angeles Times (10/11, Kaplan) notes that several studies have showed that the transplants “really work.” The paper reports that In a breakthrough report unveiled last year in the New England Journal of Medicine, “researchers reported that CDI patients who got a fecal transplant (in addition to a bowel cleansing and the antibiotic vancomycin) fared far better than those who didn’t.” According to the piece, of the 16 patients in the fecal transplant group, “13 saw their infections clear up after one treatment and two of the remaining three got better after a second treatment – an overall cure rate of 94%.”

        The news was also covered by Bloomberg News(10/11, Cortez), NPR (10/11), TIME (10/13) and BBC News(10/11, Mundasad).

Standard and Intensive Glucose Control Strategies Lead to Similar Survival Rates Among Diabetics

In a 6-year follow-up analysis of the ADVANCE trial, there were no significant differences in all-cause mortality or major macrovascular events (a composite of nonfatal myocardial infarction, nonfatal stroke, or death from any cardiovascular cause) between intensive-glucose-control and standard-glucose-control groups. However, the intensive-glucose-control group (with a target HbA1c of <6.5%) experienced a 46% decreased risk of ESRD compared to the standard-glucose-control group. The studyof 11,140 type 2 diabetics with ≥1 additional cardiovascular risk factor was published in the New England Journal of Medicine.

Arteriovenous Fistulas May Cause Adverse Cardiac Effects

Arteriovenous Fistulas May Cause Adverse Cardiac Effects

In 24 patients with stage 5 CKD undergoing arteriovenous fistula creation, left and right ventricular end-systolic volume increased by 21% and 18%, respectively, after 6 months, and left and right atrial area increased 11% and 9%, respectively. There was also a 12.7% increase in left ventricular mass. Endothelial-dependent vasodilatation had decreased from 9% before fistula creation to 3% at 6 months after fistula creation. Fistula formation did not significantly alter aortic distensibility. Left ventricular ejection fraction remained unchanged, while average cardiac output increased by 25%. The findings are published in the International Journal of Nephrology and Renovascular Disease

Omega-3 Fatty Acids Provide Small Improvement in Kidney Function after Myocardial Infarction

Long-term supplementation with 400 mg/d eicosapentaenoic acid–docosahexaenoic acid (EA–DA) provided a small beneficial effect on kidney function in the Alpha Omega Trial of 2344 patients with a history of myocardial infarction. After 40 months, the decline in creatinine–cystatin C-based GFR was 2.1 less mL/min/1.73 m² in patients receiving EA–DA compared to the placebo. Patients receiving EA–DA had a 17% decreased risk of incident CKD, and a 15% decreased risk of rapid kidney function decline (≥3 mL/min per year) compared to patients receiving a placebo. The findings are published in CJASN.

'Medical Food' Bests Ibuprofen in Chronic Low Back Pain

http://www.medscape.com/viewarticle/832922

Pauline Anderson

October 07, 2014

 

Theramine, a "medical food" containing an amino acid blend (AAB), significantly improves chronic low back pain and reduces inflammation compared with low-dose ibuprofen, a nonsteroidal anti-inflammatory drug (NSAID), or a combination of these 2 treatments, results of a new study show.

This is the second study looking at theramine in low back pain. The first (Am J Ther. 2012;19:108-114) compared this medical food with another NSAID, naproxen.

"Now we have done 2 multicenter, double-blind trials showing the effectiveness of theramine, not only on pain but also inflammation, and we are not seeing significant side effects," commented study author David S. Silver, MD, president and chief operating officer, Targeted Medical Pharma Inc, Los Angeles, California.

Observers have expressed both encouragement and reservation about this study, which was published onlineSeptember 18 in the American Journal of Therapeutics.

Dietary Amino Acids

Back pain affects up to 90% of people during their lifetime. Chronic low back pain is the number one cause of time lost from work, said Dr Silver.

NSAIDs are frequently prescribed to treat chronic back pain, and among these, ibuprofen is the most commonly prescribed.

It's believed that patients with chronic pain have decreased levels of neurotransmitters responsible for pain inhibition and control of inflammation, the authors note. There's evidence in plasma of a deficiency of amino acid precursors that are important to chronic pain modulation, said Dr Silver, a rheumatologist who has treated patients with fibromyalgia in his Los Angeles, California, practice.

It's not possible to treat pain by boosting amino acids through the diet, Dr Silver said. "You can't just take amino acids and hope that you're going to produce neurotransmitters" to control pain, he said. Dietary amino acids may not be adequately absorbed, may be deaminated by the liver before crossing the blood-brain barrier, and may not be taken up by the appropriate neurons, he noted.

Current pain therapies don't adequately address these issues, said Dr Silver. NSAIDs, for example, are only moderately effective in relieving pain and are associated with significant gastrointestinal adverse effects. Other pain treatments, including muscle relaxants and opioid analgesics, have limited efficacy, may produce sedation and constipation, can be used inappropriately, or can lead to addiction issues.

"We think theramine fits very nicely into that void," said Dr Silver.

As a "medical food," theramine does not require US Food and Drug Administration preapproval; however, everything in the product must be GRAS (generally recognized as safe), said Dr Silver. "The claims [of a medical food] must be specifically for the nutritional management of a disease when a distinct nutritional requirement that cannot be met through regular diet is recognized," he said.

The claims of medical foods must be supported by clinical studies, unlike dietary supplements or nutraceuticals, which can't make disease claims and don't require clinical studies, he added.

Through its cellular technology, theramine is designed to specifically target precursors to neurotransmitters involved in pain and inflammation (acetylcholine, histamine, serotonin, D-serine, and nitric oxide).

Multicenter Study

The new eight-site, three-arm study was funded by Targeted Medical Pharma. It included 122 patients aged 18 to 75 years who had back pain lasting longer than 6 weeks, with pain present on 10 of 14 days, and evidence of at least moderate pain.

The individual study sites were entirely responsible for recruiting study participants, said Dr Silver.  Patients were not paid to participate in the study and were reimbursed only for reasonable expenses, such as travel costs.

The patients were randomly assigned to one of three groups: two AAB tablets twice a day with one ibuprofen placebo; ibuprofen (400 mg once daily) with two AAB placebos twice a day; or two AAB tablets twice daily with ibuprofen (400 mg once a day).

The researchers used the lowest recommended dose of ibuprofen because, explained Dr Silver, "we didn't feel that utilizing placebo for patients with chronic pain was ethical, and we didn't want to expose patients to a higher risk of NSAID-induced complications by using high-dose therapy."

After 28 days, participants were evaluated by using the Roland-Morris Disability Index and the Oswestry Disability Scale (primary endpoints), as well as a visual analogue scale (VAS).

Significant Improvement

The study showed that in both the AAB and combined therapy groups, pain assessments were considerably and statistically significantly improved compared with the ibuprofen-alone group. In the AAB-alone group, the Roland-Morris Disability Index score fell by 50.3% and the Oswestry Disability Scale score fell by 41.91% (P < .05 for both vs ibuprofen).

In the combination group, the Roland-Morris Index fell by 63.1% and the Oswestry Disability Scale score fell by 62.15% (P < .05 for both vs ibuprofen). Similar results were observed with use of the VAS.

The study also showed improvements in measurements of inflammation in patients taking AAB. From blood samples, researchers found that in the AAB-alone group, the C-reactive protein (CRP) level fell by 47.05% and the interleukin-6 (IL-6) level fell by 23.55% (P < .001 for both vs ibuprofen). In the combined group, CRP fell by 35.99% and IL-6 fell by 43.1% (P < .001 for both).

Interestingly, in the ibuprofen alone group, levels of CRP rose by 60.1% and IL-6 rose by 12.65%.

Dr Silver noted that the previous head-to-head study of theramine and naproxen also showed a reduction in inflammatory markers in persons taking the medical food. "So not only is it a pain-relieving agent, but it does seem to reduce inflammation."

Since CRP indicates inflammation, which may be involved in heart disease, theramine could also have cardioprotective qualities, said Dr Silver, although he stressed that this has not been studied.

It's not clear why inflammatory markers increased in patients taking ibuprofen in this study, said Dr Silver. Again, this was the second time that his research group has shown this effect. It could be because NSAIDs are antiprostaglandin drugs and not necessarily anti-inflammatory drugs, he said.

He added that rheumatologists don't rely on NSAIDs "as our big anti-inflammatory agents," but rather on other medicines, such as methotrexate, an antifolate drug used to treat some autoimmune diseases, such as rheumatoid arthritis.

None of the patients taking theramine in this new study experienced any significant adverse effects, said Dr Silver. No gastrointestinal adverse effects were observed or reported.

The overall results suggest that theramine can be used as a primary therapy or an adjunct to ibuprofen, said the authors.

Although a dose of two AAB capsules twice daily was used in the study, Dr Silver has used up to eight a day to treat some patients. However, he doesn't think there would be any benefit beyond that. "At some point, you're going to get a threshold effect," he said.

Other Populations

Dr Silver is investigating the effectiveness of theramine in other patients with pain. He and his colleagues are studying this product in chronic migraine and are finalizing a plan to study it in military personnel with back pain. Another study will investigate theramine in patients who have had a hemorrhoidectomy, in whom narcotics are contraindicated because of constipation issues.

Theramine is available in pharmacies but since it's classified as a medical food, it must be used under medical supervision, said Dr Silver.

When approached for a comment, Lynn Webster, immediate past president, American Academy of Pain Medicine (AAPM) and vice president, scientific affairs, PRA Health Science, said he was heartened by the study.

"We ought to be encouraged about research in areas that can provide us with any type of medication that is safer," he told Medscape Medical News. "It appears that this whole new class offers hope that we will be able to have fairly effective therapies for some conditions, particularly for pain, that are safer than what we have now."

Also asked to comment, Christopher Standaert, MD, professor, Rehabilitation Medicine, University of Washington, Seattle, said he couldn't provide "a formal comment" because he felt he didn't know enough about the relevant pharmacology and serum chemistry to determine the validity of the study from that perspective.

However, he did raise some issues "to think about." These included the following:

1. The study was of a commercial product. It was apparently performed by the company that makes that product and conducted at commercial sites funded by the same manufacturer. 

2. The paper doesn't include the raw data on outcomes — only percentages of improvement — and doesn't discuss issues such as the success of blinding and patient adherence.

3. There is little information on the study patients and how they were recruited.

4. Although the authors discuss the negative aspects of NSAIDs, they don't say much about potential downsides of the drug under study.

The study was funded by Targeted Medical Pharma, maker of theramine. Dr Silver is president of the company. Dr Standaert has disclosed no relevant financial relationships.

Am J Ther. Published online September 18, 2014.  Abstract

 

Hospitals across us preparing for potential Ebola cases.

The New York Times (10/8, Belluck, Subscription Publication) reports, “Since a Liberian man tested positive for Ebola in Dallas a week ago and officials announced on Monday that a nurse in Spain had been infected by the virus there, calls have been pouring into the” CDC from physicians “and nurses wanting help in protecting themselves and their employees from the disease.” Currently, the CDC “is not recommending hazardous-material suits.” Abbigail Tumpey, an agency spokeswoman, said, “We’re saying that we don’t think the extra is necessary.” But, Tumpey said, “if facilities want to use it, they need to train their staff in appropriate use.”

        Cecilia Vega reported on ABC World News (10/7, story 4, 2:46, Muir) that hospitals around the nation are “on high alert,” adding that doctors say that “what happened in Dallas was a real wake-up call.”

        NBC News (10/8) reports that “the Dallas case has made U.S. hospitals hyper-alert to the threat of Ebola virus, Centers for Disease Control and Prevention director Dr. Thomas Frieden says.”

        John Blackstone reported on the CBS Evening News(10/7) that “across the country, of more than 1,600 nurses who responded to an online survey by National Nurses United, 77 percent say their hospital has not communicated to them any policy regarding potential admission of patients infected by Ebola.”

        The AP (10/8, Caruso) reports that New York City “911 operators have been told to ask people who describe Ebola-like symptoms and ask for ambulances if they’ve traveled to West Africa recently.” Meanwhile, one “Ohio hospital has hung up signs imploring patients to let nurses know immediately if they have traveled recently to West Africa.”

        The Wall Street Journal (10/8, West, Subscription Publication) reports that this week, New York City Mayor Bill de Blasio said, “We know that if we have even the possibility that someone may have Ebola that they’re going to be handled in a very careful and aggressive manner. So I feel very, very confident. All New Yorkers should feel confident.”

        The Los Angeles Times (10/8, Therolf) reports that yesterday, “Los Angeles County public health officials said...they have no doubt that they are ready to handle any potential cases” of Ebola.

        The Sarasota (FL) Herald-Tribune (10/8) reports, “From setting up hospital task forces to training urgent care clinics and emergency room workers,” Southwest Florida “hospitals say they are taking steps in advance to treat Ebola patients if necessary.”

        US to begin screening airline passengers from West Africa this week. Kate Snow reported on NBC Nightly News (10/7, story 3, 2:13, Williams) that while passengers leaving West Africa “are already being screened,” the US government will now “begin screening incoming passengers at airports in this country some time this week.” Snow noted that experts say that while it is “likely another Ebola case will travel into the US,” isolated cases “do not equal an outbreak.” CDC Director Dr. Thomas Frieden was shown saying, “The enemy is a virus. It’s a difficult virus to stop, but we know how to control it.”

        The New York Times (10/8, Mouawad, Subscription Publication) reports that while health officials “promised extra measures to screen airline passengers arriving into the United States,” they “remained opposed to more draconian travel restrictions that they say would cause more problems than they would solve.” CDC Director Dr. Thomas Frieden “said new measures would be announced in coming days but cautioned against measures that could backfire or prove ineffective in the long run.” Frieden said, “If we do something that impedes our ability to stop the outbreak in West Africa, it could spread further there, we could have more countries like Liberia, and the challenge would be much greater and go on for a longer time.”

        The Washington Post (10/7, Halsey) reports the White House said Tuesday new screening measures for airline passengers will be released in “the coming days.” The article cites Sen. Charles Schumer saying the new steps are being developed by the CDC. The article notes that the President’s promise of “stepped-up screening” will “fall on the shoulders of the Customs and Border Protection officers who greet passengers arriving from abroad.” The CBP is quoted saying, “When a traveler or alien is identified with a possible communicable disease, CBP personnel will take the appropriate safety measures by donning personal protective equipment...If they identify an individual believed to be infected, CBP will contact CDC along with local public health authorities to help with further medical evaluation.”

        Another Washington Post (10/7, Berman) article says the new measures “could theoretically prevent some people who are infected with the Ebola virus from entering the country” but will not be able to stop every person with Ebola arriving in the US “because of the simple realities of the disease ravaging West Africa, whose symptoms take time to manifest, as well as the nature of air travel in the 21st century.” Frieden is quoted saying, “The plain truth is, we can’t make the risk zero until the outbreak is controlled in West Africa...What we can do is minimize that risk.”

CDC study: Patients receive high amount of antibiotics while in hospital.

Bloomberg News (10/8, Cortez) reports a study from the Centers for Disease Control and Prevention has shown that “half of people hospitalized in the U.S. get antibiotics to fight off infections each day, with some receiving four or more medications.” The study is aimed at documenting how often antibiotics are given in hospitals as the CDC works to “reduce the 2 million infections and 23,000 deaths each year in the U.S. tied to drug-resistant bacteria.”

        HealthDay (10/8, Haelle) reports the antibiotics given to US hospital patients “are commonly the ones more likely to promote the growth of antibiotic-resistant bacteria.”

US life expectancy reaches record high.

USA Today (10/8, Copeland) reports that life expectancy in the United States rose in 2012 to a record high of 78.8 years, up from 78.7 years in 2011, “according to a new report on mortality in the USA from the Centers for Disease Control and Prevention’s National Center for Health Statistics. “ Life expectancy for females was 81.2 years, and 76.4 years for males. The difference of 4.8 years is the same as 2011. The report also found that the age-adjusted death rate fell 1.1 percent in 2012 to a record low of 732.8 per 100,000 people. The report attributes “much of the recent improvement in both death rates and life expectancy to reductions in deaths from such major illnesses as heart disease, cancer and stroke.”

        Bloomberg News (10/8, Pettypiece) reports that eight of the 10 main causes of death fell in 2012, according to the report, “including a 1.8 percent reduction in heart disease-related deaths and a 1.5 percent drop in cancer deaths.” Elizabeth Arias, a demographer at the CDC and an author of the paper, stated, “We continue to follow the pattern that we have been seeing for a few decades, where life expectancy is gradually increasing and death rates from the leading causes of death are decreasing.”

        The AP (10/8, Stobbe) adds that the suicide rate increased more than 2 percent “to 12.6 per suicide deaths per 100,000 American,” the highest level since 1987.

Sandwiches Account for One-Fifth of Total Sodium Intake

On any given day, 49% of US adults eat at least 1 sandwich, and sandwiches account for one-fifth of total daily sodium intake, according to research from the Department of Agriculture. Compared to individuals who did not report consuming a sandwich on the intake day, sandwich reporters had significantly higher energy and sodium intakes. The findings come from 1 day of dietary intake data from 5762 adults in What We Eat in America, the dietary interview component of the National Health and Nutrition Examination Survey 2009–2010. The results are published in the Journal of the Academy of Nutrition and Dietetics.

Wearable Artificial Kidney: First Clinical Trial

http://video.renalandurologynews.com/video/Wearable-Artificial-Kidney-firs

Prototype of what may be the future. Still needs to be a bit smaller but still amazing technology that's only going to get better 

Severe Sleep Apnea Linked to Resistant Hypertension

Medscape reported that according to the results of a 284-patient study published in the September issue of the Journal of Clinical Sleep Medicine, “severe obstructive sleep apnea [OSA] may interfere with blood pressure (BP)–lowering treatment in patients at high cardiovascular disease risk or with established cardiovascular disease.” Researchers found that “patients with severe obstructive sleep apnea had a 4-fold higher odds of resistant elevated BP despite receiving an aggressive antihypertensive mediation regimen, even after consideration of well-recognized hypertension risk factors, including age, sex, race, body mass index, smoking, diabetes mellitus, and cardiovascular disease (adjusted odds ratio, 4.1; 95% confidence interval [CI], 1.7 – 10.2).” An accompanying editorial concluded, “Since spironolactone has the potential to improve BP control and [apnea hypopnea index] in patients with resistant [hypertension], spironolactone should be considered, along with CPAP therapy, in these patients.”

Exercise May Improve Dialysis Patients’ Physical and Mental Health

Aerobic activity, but not strength/flexibility activity, was linked positively with health-related quality of life, and inversely with depressive symptoms and premature death among 5763 dialysis patients who were followed for a median of 1.6 years. Very active patients were 40% less likely to die during follow-up than inactive or rarely active patients. In dialysis patients with heart failure, aerobic activity was not linked with prolonged survival, but was associated positively with health-related quality of life and inversely with depressive symptoms. Patients had higher aerobic activity levels if they were treated in dialysis clinics offering exercise programs, according to the CJASN study.

Strict Blood Glucose Control after Heart Surgery May Not Be Necessary

A recent study found survival after heart bypass surgery was not affected by the level of blood glucose control during hospitalized recovery, as long as the level was maintained at <180 mg/dL. Also, health-related quality of life improved in all patients from baseline to 6 months, whether or not they had strict blood glucose control. For the Annals of Thoracic Surgery study, 189 patients were randomized to strict (90–120 mg/dL) or liberal (121–180 mg/dL) glucose control protocols and were followed for an average of 3.3 years. Considering less strict blood glucose control after surgery may help reduce the risk of hypoglycemia.

Blood Markers Predict Heart Failure Risk in CKD Patients

Among 3483 patients with CKD in the Chronic Renal Insufficiency Cohort Study, participants with the highest blood levels of high-sensitivity troponin T at the start of the study had a nearly fivefold higher risk of developing heart failure over a median of nearly 6 years than those with the lowest levels. Those with the highest levels of N-terminal pro-B-type natriuretic peptide had a nearly 10-fold higher risk of developing heart failure compared to those with the lowest levels. The findings are published in JASN. Previous research has shown that these blood markers strongly predict heart failure in the general population.

Position paper highlights obesity-cancer link.

Position paper highlights obesity-cancer link.

CNN (10/1, Wilson) reports that the American Society of Clinical Oncology (ASCO) has published a new position paper (10/1) in the Journal of Clinical Oncology highlighting the link between obesity and cancer. According to the paper, which was written by Dr. Clifford Hudis and colleagues, “Obesity is a major, under-recognized contributor to the nation’s cancer toll and is quickly overtaking tobacco as the leading preventable cause of cancer.” In addition to drawing attention to the link between the conditions, ASCO calls for additional research.

        ABC News Radio (10/2) reports that, according to ASCO, “About 84,000 cancer diagnoses are believed to be attributed to obesity each year, along with 15 percent of cancer deaths.”

        The Dallas Morning News (10/2, Landers) reports that a 2013 survey of 1,011 adults conducted by the AP “found that only 7 percent of Americans realized there was a link between obesity and cancer.”

Transplant Plus Native Nephrectomy May Benefit Patients with Polycystic Kidney Disease

Among 143 ADPKD patients (67 who underwent transplantation alone and 76 who also underwent concurrent unilateral native nephrectomy), nephrectomy patients had a greater decrease in the average number of antihypertensive medications at 12, 24, and 36 months follow-up than transplantation-only patients. Nephrectomy patients also experienced greater decreases in defined daily dose of antihypertensives at 12, 24, and 36 months. The study’s findings were presented at the 32ⁿᵈ World Congress of Endourology and highlighted by Renal & Urology News.

Low Magnesium Levels Linked with Increased Risk of CKD and ESRD

In a recent study, adults with the lowest baseline serum magnesium levels had a 58% increased risk of developing CKD and a 2.4-fold increased risk of developing ESRD over a median follow-up of 21 years. These associations remained significant after excluding users of diuretics and across subgroups stratified by hypertension, diabetes, and self-reported race. The Kidney International results pertain to 13,226 adults in the Atherosclerosis Risk in Communities study with baseline eGFR ≥60 mL/min/1.73 m² in the late 1980s who were followed through 2010.

Wearable Artificial Kidney Greenlit For Safety Testing

the RUN take:

Researchers expect to start safety and performance testing of a Wearable Artificial Kidney (WAK)this autumn. The WAK is a miniaturized dialysis machine that can be worn on the body.The device connects to the patient via a catheter and is worn on a tool belt-like carrier.

 

Like a conventional dialysis machine, it filters the blood of patients whose kidneys have stopped working. Unlike current portable or stationary dialysis machines, the WAK can run continuously on batteries and is not plugged into an electrical outlet or attached to a water pipe. The current model weighs about 10 pounds, but future modifications could make it lighter and more streamlined.

 

Currently, dialysis patients have little ability to move around during treatment. Dialysis sessions are time-consuming and frequent, occurring around three times a week and lasting for 3-4 hours each. Researchers developed this device to give end-stage renal failure patients freedom during their dialysis treatments. The WAK was one of three proposals out of 32 applications chosen by the Food and Drug Administration (FDA) to participate in its Innovation Pathway program. The program was designed to encourage the timely development of safe, breakthrough medical products. To test the WAK under the FDA’s criteria, up to 16 patients will be selected with the goal of 10 completing the full trial.

 

The testing will be conducted in an inpatient hospital setting at UW Medical Center in Seattle. Clinical measurements will be made during and after treatment with the WAK, and the patients will then be observed for at least 28 days. The safety and performance of the WAK must be evaluated before any additional studies are held.

Researchers expect to start testing the Wearable Artificial Kidney this autumn. 

Medical researchers have received approval to begin safety and performance testing of the Wearable Artificial Kidney. The federal Food and Drug Administration and the University of Washington Institutional Review Board accepted the protocol for the clinical trial. Expected to start this autumn in Seattle, it will be the first human study in the United States to be conducted on the device.

The Wearable Artificial Kidney, also known as the WAK, is a miniaturized dialysis machine that can be worn on the body. The carrier resembles a tool belt; the device connects to a patient via a catheter. Like conventional dialysis machines, it is designed to filter the blood of people whose kidneys have stopped working.

FROM HSNEWSBEAT.UW.EDUREAD FULL ARTICLE