Sunday, June 8, 2014

Kidneys Can Regenerate

Kidney Research

From Haaretz Today, Israel

Israeli, U.S. researchers prove that kidneys are capable of regeneration

Experiments on mice show that, contrary to popular belief, the organ is constantly producing new cells.

American and Israeli researchers have managed to show that kidneys are capable of continuously regenerating themselves. The research, from experiments done on mice and published in the Cell Reports journal, overturns conventional wisdom saying that kidney regeneration is negligible.

The research was conducted by researchers from the Pediatric Stem Cell Research Institute at the Sheba Medical Center and from Tel Aviv University, in collaboration with scientists from the Institute for Stem Cell Biology and Regenerative Medicine at Stanford University. Their results lay the foundation for discovering new ways of repairing and growing kidneys.

Kidney failure is a common disease which is increasing in incidence, in tandem with the rise in obesity and hypertension in the Western world. Current treatment for kidney failure involves dialysis – a difficult procedure that seriously hampers patients’ quality of life – and kidney transplants, which are limited by the small number of available donated organs.

“These results are in the realm of basic science,” says the publication’s lead author, Dr. Yuval Rinkevich, who is currently doing postdoctoral training at Stanford, “but they have direct implications for kidney disease and regeneration.”

For many years, scientists believed kidneys undergo only minimal regeneration. The new research refutes this, showing that constant renewal and repair processes take place throughout their life. “This research shows that kidneys are not static organs,” explains Prof. Benjamin Dekel, head of the Sheba Pediatric Stem Cell Research Institute and the pediatric nephrology unit at Sheba Medical Center, who was part of the research team. “The kidney never rests, and keeps regenerating itself by producing differentiated cells to compensate for cells we lose through our urine. Both routinely and under stress, the kidney grows not only by increasing cell size, but by producing new cells and new parts.” [Read more]

From Herald Sun, Melbourne, Australia, by GRANT MCARTHUR

A MELBOURNE medical breakthrough that may one day keep kidney disease patients off dialysis and prevent the need for some transplants has captured the world’s attention.

Developed by the University of Melbourne, St Vincents Institute of Medical Research and Bio21, the FT011 therapy is being touted as a cure for renal failure by healing scar tissue in kidneys.

The first human trials in 60 Victorian diabetic neuropathy sufferers have recently been completed, however the drug’s ability to combat fibrosis in a range of organs has seen further trials planned for patients with heart and lung disease.

The breakthrough is so promising the company set up to develop the drug has just been sold in one of Australia’s biggest biotechnology deals.

Established with $7 million in local investment, Fibrotech Therapeutics was last month sold to Irish pharmaceutical company Shire in a deal worth an estimated $600 million.

Fibrotech chief executive Dr Darren Kelly, who began developing the drug eight years ago, said it prevented kidney scarring that caused renal failure and a life on dialysis or requiring a transplant.

“We have discovered a novel receptor that the drug blocks which causes the scar tissue to form,” Dr Kelly said.
“It’s applicable to other diseases — we have an interest in heart disease because after a heart attack you get fibrosis and scarring which causes heart disease; and we have it indicated in other diseases like liver fibrosis and lung fibrosis as well. So there is a huge potential for FT011. [Read more]

PKD Care 

From PKD Foundation of Canada 

Health Notes

This month in PKD Health Notes, Renal Dietician Kelly Welsh serves up a delicious recipe for Chicken Salad with Asparagus. With the warm weather finally here, this is the perfect dish for picnic season!

Get the recipe from her most recent blog post here.

Type of Kidney Disease May Dictate Cancer Risk

A study recently published online in the Journal of the American Society of Nephrology found that PKD patients may be less likely to develop cancer than those with other types of kidney disease, but they still have a higher cancer risk than people in the general population.

“After adjusting for a number of factors, the researchers concluded that patients with polycystic kidney disease were 16 percent less likely to develop cancer than those with other kidney diseases. Compared to people in the general population, cancer risk was 48 percent higher in polycystic kidney disease patients and 86 percent among those with other kidney diseases.”

From Business Wire, London, UK


Today marks the formation of the European ADPKD Forum (EAF), a new multidisciplinary group of leading medical and patient group experts dedicated to improving the health and quality of life of people with ADPKD – a progressive and chronic genetic kidney disease.

The EAF initiative, co-chaired by Tess Harris, President of PKD International, and Dr Richard Sandford, Consultant Clinical Geneticist at Addenbrooke’s Hospital, Cambridge aims to:
Increase awareness of the impact of ADPKD on patients and health services
Recommend strategies at the health policy level to improve ADPKD care, based on the latest scientific evidence and expert insight
Encourage and facilitate collaboration between the individuals and groups involved in the management of people with ADPKD.

ADPKD is a progressive and chronic systemic disease, for which there are no approved therapies, formal care pathways or clinical guidelines.1, 2 The condition, which accounts for 10% of all patients in end stage renal failure, is characterised by the development and expansion of fluid-filled cysts in the kidney, leading to a substantial increase in total kidney volume.1, 3, 4 Patients commonly suffer from acute and chronic pain, and cysts can affect other organs, notably the liver.1, 3, 4 Ultimately, ADPKD leads to kidney failure in the majority of affected people; approximately 50% of ADPKD patients will reach ESRD by age 59 and 75% will reach ESRD by age 70.5

As one of the most common inherited diseases, and the fourth leading cause of kidney failure, the condition represents a significant clinical and economic challenge to healthcare professionals and services throughout Europe. [Read more]

Kidney Concerns

From Chicago Tribune Health Section, Medical Edge Mayo Clinic

For many, lifestyle changes and medication can slow progression of chronic kidney disease

DEAR MAYO CLINIC: My wife was diagnosed with "moderate" chronic kidney disease about three months ago. What does this mean? Are there things she can do to stop the progression of the disease?

ANSWER: Your kidneys are two bean-shaped organs, each the size of a fist. They're located in the back of your abdomen, one on each side of your spine. Your kidneys' main job is filtering waste and excess fluid from blood to make urine. They also do other tasks, including adjusting the balance of minerals and acids in the blood and regulating blood pressure.

Kidney disease occurs when the kidneys have been damaged and no longer work the way they should. Early on, kidney disease may not cause symptoms. As it worsens, symptoms may appear. But they're often vague and can include fatigue, poor appetite, nausea and swollen ankles, legs or hands.

Chronic kidney disease, or CKD, is usually diagnosed with a blood test that measures creatinine. Creatinine is produced by muscles and removed from the body by the kidneys. As kidney function decreases, the level of creatinine in the blood increases. This level is used to calculate the estimated glomerular filtration rate, or eGFR, which is a better indicator of kidney function than creatinine alone. Abnormal amounts of protein or other markers of kidney damage in the urine may indicate CKD, as well.

Chronic kidney disease is often broken down into five stages. In stage three, or "moderate" CKD, eGFR is between 30-59 ml/min/1.73m2. Stage three CKD is usually progressive. That means it can get worse as time goes on. It is unlikely that it can be completely cured, but in many cases, lifestyle changes and medications help slow its progress. Slowing the progress depends, in part, on the cause. Although many diseases and conditions can damage the kidneys, the two main causes of CKD are diabetes and high blood pressure.

In most cases, controlling blood pressure is the most important step a person with CKD can take. Keeping blood pressure at a healthy level may involve taking medication, eating less sodium, staying at a healthy weight and increasing physical activity.

If your wife has diabetes, following her doctor's directions for controlling blood sugar can help slow kidney disease. Over time, both high blood pressure and high blood sugar can damage small blood vessels and cause scarring in the kidneys, making it difficult for them to work properly.

Avoiding medications that can harm the kidneys and getting treatment for other medical conditions that lead to CKD also can help. Some of those conditions include inherited disorders such as polycystic kidney disease, immune system disorders, infections, kidney stones and damage from medications. Even medications available without a prescription (including ibuprofen, naproxen and omeprazole) can hurt the kidneys. She should check with her doctor before taking new medications. [Read more]

From MedicalXpress

Findings show benefit of changing measure of kidney disease progression

Developing therapies for kidney disease can be made faster by adopting a new, more sensitive definition of kidney disease progression, according to a study published byJAMA. The study is being released early online to coincide with its presentation at the European Renal Association-European Dialysis and Transplant Association Congress.

Chronic kidney disease (CKD) is a worldwide public health problem, with increasing prevalence, poor outcomes, and high treatment cost. Yet, despite the avail¬ability of simple laboratory tests to identify people with earlier stages of CKD, there are fewer clinical trials for kidney disease than for other common diseases. One contributing reason may be that the established CKD progression end point (i.e., a doubling of serum creatinine concentration from baseline, corresponding to a 57 percent reduction in estimated glomerular filtration rate [GFR]), is a late event, requiring long follow-up periods and large sample size, which limits the feasibility of kidney-related clinical trials. Improved methods for estimating GFR may allow using smaller decreases in estimated GFR as alternative end points to assess CKD progression, according to background information in the article.

Josef Coresh, M.D., Ph.D., of the Johns Hopkins Bloomberg School of Public Health, Baltimore, and colleagues with the Chronic Kidney Disease Prognosis Consortium, examined the association of decline in estimated GFR with subsequent progression to end-stage renal disease (ESRD; initiation of dialysis or transplantation). The study included 1.7 million participants with 12,344 ESRD events and 223,944 deaths after repeated measurements of kidney function over a 1 to 3 year baseline period. Data collection took place between 1975 and 2011.

The researchers found that declines in estimated GFR smaller than a doubling of serum creatinine concentration were strongly and consistently associated with subsequent risk of ESRD. A doubling of serum creatinine, corresponding to a 57 percent decline in estimated GFR, was associated with a greater than 30-fold higher risk of ESRD. However, over a 1- to 3-year period, a doubling of serum creatinine concentration was present in less than 1 percent of participants. In contrast, a 30 percent decline in estimated GFR was nearly 10 times more common and was associated with an approximately 5-fold increased risk of ESRD. [Read more]

From ABC 6 News, Augusta Georga, By Randy Key

Obese, Older, Caucasian Women On Dialysis Most At Risk For Rare Deadly Condition

Obese, Caucasian females over age 50 with diabetes and on dialysis because their kidneys have failed are among those at highest risk for the rare and deadly condition calciphylaxis, according to an analysis of the United States Renal Data System.

Calciphylaxis occurs when calcium and phosphorus bind to form a biological cement that blocks and inflames small blood vessels, putting patients at risk for major infection and skin ulcers as well as patches of dying skin, said Dr. Lu Huber, nephrologist at the Medical College of Georgia at Georgia Regents University.

“It’s all about balance, and our kidneys help regulate that balance,” said Huber, who scoured the national database of 2.1 million patients with failed kidneys to better define incidence and risk factors with the goal of better identifying and managing those at highest risk.

Her findings were cited as one of eight best abstracts submitted to the 51st European Renal Association - European Dialysis and Transplant Association Congress May 31st-June 3rd in Amsterdam.

Huber found the condition occurred in 459, or 0.02 percent, of the patients, who were mostly white, older women on traditional hemodialysis, where an external machine filters the total blood volume typically three times a week rather than the continuous efforts of healthy kidneys.

The median time from the first dialysis treatment to a diagnosis of calciphylaxis was less than four years, median survival time was 176 days, and 50 percent of deaths were within 87 days. Being over age 65, Caucasian, and diabetic are significant risk factors for death from calciphylaxis. [Read more]

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