From EurekaAlert
World first MRI study sheds light on heart damage during kidney dialysis
Experts in magnetic resonance imaging (MRI) and kidney disease have carried out the first ever scans to study the heart function of kidney patients while they are having dialysis treatment.
People with kidney failure need regular dialysis to remove fluid and waste products from their blood, but this process can cause falls in blood pressure and reduced blood flow to the heart. Over time this can cause long-term damage to the heart.
Research at The University of Nottingham was undertaken to investigate stress on the heart during kidney dialysis and to compare two different types of dialysis in this regard: standard haemodialysis (HD) and hemodiafiltration (HDF), a process that removes more fluid during treatment but with additional replacement fluid being given to the patient.
Experts from the University's Sir Peter Mansfield Imaging Centre (SPMIC) and the Centre for Kidney Research and Innovation (CKRI) carried out MRI scans on 12 kidney dialysis patients who were each allocated to receive both standard haemodialysis (HD) and HDF in a random order.
The study found significant cardiovascular effects with both standard haemodialysis and HDF, but no differences between the two. Results demonstrate that cardiac MRI can be a vital tool for evaluating future improvements to dialysis treatment.
Professor of Physics, Sue Francis, said: "This is the first time that MRI has been used to look at heart function while the kidney patient is actually undergoing dialysis. There were several hurdles to overcome to achieve this. We had to set up a dialysis machine in our MRI research centre, change the metal needles that go into the patient to non-magnetic silicone ones, extend and insulate the lines that connect the patient to the dialysis machine and position the equipment using our knowledge of the magnetic fields in the MRI unit."
Professor of Medicine (Nephrology), Maarten Taal, said: "Using this unique set-up we were able to monitor multiple cardiovascular measurements while dialysis was taking place in the patients. We measured how many litres of blood were pumped per minute by the left ventricle of the heart, how well the heart muscle was able to contract, blood flow in the coronary artery which supplies the heart muscle and myocardial perfusion to check the efficiency of blood flow to the capillaries or tiny blood vessels in the heart muscle."
"Interestingly, we found all measures of systolic contractile function fell during both standard haemodialysis and haemodiafiltration with partial recovery after dialysis. All patients showed some degree of left ventricular dysfunction and blood flow to the small capillaries in the heart muscle decreased significantly during both types of treatment. Our observations confirm the need for interventions to reduce the negative impact of dialysis on the heart."
Having successfully tested this method, the research team is now aiming to test the effects of other dialysis treatments using MRI.
Intradialytic Cardiac Magnetic Resonance Imaging to Assess Cardiovascular Responses in a Short-Term Trial of Hemodiafiltration and Hemodialysis is published in the Journal of the American Society of Nephrology (JASN).
From WBUR.com, by Karen Given
5 Months After Donating Kidney, Steve Russolillo Ran His Best Marathon
"It wasn’t on a third date, but you know, it was — I would say within the first year of dating this came up," Steve says. "Shelly’s mom would ultimately need a transplant at some point. The timing was unknown, It could be in a year, it could be in five years, it could be 10 years, who knows? But it was — this was just something that was on the horizon."
Steve says he just tried to do the things that good companions do: He listened, he comforted, he hoped for the best. Life went on. The disease progressed. Shelly’s mom, Batya, got sicker. Steve and Shelly’s relationship progressed, which led to happier developments.
"I proposed to Shelly in March, end of March, 2015. Really, the first thought that came to mind was, 'It has to be running related, somehow,'" Steve says. "It was a Sunday morning in Central Park, and I tried to make it as normal of a run as possible, like, 'Hey, Shell, let’s go running this morning.' 'OK, fine.'"
"How’d you hide a ring in running clothes?" I ask.
"So, I had it in the box and I put the box in this running jacket that I was wearing," Steve says with a laugh. "And I thought that I caught her glancing at it. And in my head I kind of freaked out: 'Oh, my God, she knows something’s up.'"
Shelly didn’t know. After running for about a mile, Steve stopped, got on one knee and proposed. Shelly’s sister was there to take pictures.
The Search For A Donor
But Batya Banjo was still getting sicker. Doctors told her it was time for a kidney transplant. The family had already started the search for a living donor.
"We put a flyer out. I mean, literally, we made this flyer, and Shelly posted it and posted it on Twitter," Steve says. "We actually had 11 people raise their hand and went and got tested."
Eleven people stepped up. Eleven people were medically disqualified.
"Each one, one after the other, you get your hopes up and you get really excited, and then, you get the bad news," Steve says. "I’m watching very interesting people step up. I’m watching complete strangers from the internet. I’m watching close friends. I watched my own aunt go and get tested. I’m sitting here thinking to myself, 'If all these people can raise their hands, why can’t I?'"
Why not, Steve? I can think of one reason. Shelly might need a kidney someday. The disease runs in her family. But Steve and Shelly decided to focus on the current need rather than worry about a potential need later. So, Steve went in for testing. At first, no one knew but Shelly. They didn’t want to get the family’s hopes up.
Besides, Steve had some tough questions for the doctors.
"At the time I had ran five marathons, 15 to 20 half marathons — I mean this was really important to me," he says. "It was the first thing I asked them, I said, 'Will I be able to run?' and if they had said no — oh, God. I just asked myself a difficult question. I don’t know how I would’ve responded to that. But, thank God, they said yes. So I don’t have to answer that question now. But I wanted to know what the sacrifices were ahead of time, and this would’ve been a really, really huge one for me."
For Ralph Beach, even Thanksgiving doesn't bring a holiday from the treatment keeping him alive.
He spends 10 hours a day on dialysis while he waits for a possible kidney transplant. A normal, healthy kidney is about the size of a fist; Beach's doctors said his are the size of footballs. He has polycystic kidney disease, a hereditary condition.
"It causes cysts to grow in your kidneys, and over time, as the cysts grow bigger and bigger, your kidneys shut down and no longer function," he said.
The wait list for a kidney donation is at least five years, time Beach isn't sure he'll have. He's gotten more than 90 responses from possible donors since putting up yard signs asking for help, but he hasn't found a match yet.
PKD Report
From MedGadget
Global Markets Direct’s latest Pharmaceutical and Healthcare disease pipeline guide Polycystic Kidney Disease Pipeline Review, H2 2016, provides an overview of the Polycystic Kidney Disease (Genetic Disorders) pipeline landscape.
Polycystic kidney disease (PKD) is a disorder in which clusters of cysts develop primarily within kidneys. Polycystic kidney disease symptoms may include high blood pressure, back or side pain, headache, blood in urine, frequent urination and kidney failure. The predisposing factors include age and family history. Treatment includes antihypertensive drugs and diuretics.
Report Highlights
Global Markets Direct’s Pharmaceutical and Healthcare latest pipeline guide Polycystic Kidney Disease Pipeline Review, H2 2016, provides comprehensive information on the therapeutics under development for Polycystic Kidney Disease (Genetic Disorders), complete with analysis by stage of development, drug target, mechanism of action (MoA), route of administration (RoA) and molecule type. The guide covers the descriptive pharmacological action of the therapeutics, its complete research and development history and latest news and press releases.
The Polycystic Kidney Disease (Genetic Disorders) pipeline guide also reviews of key players involved in therapeutic development for Polycystic Kidney Disease and features dormant and discontinued projects. The guide covers therapeutics under Development by Companies /Universities /Institutes, the molecules developed by Companies in Pre-Registration, Phase III, Phase II, Phase I, Preclinical and Discovery stages are 1, 1, 2, 1, 11 and 2 respectively for Similarly, the Universities portfolio in Preclinical and Discovery stages comprises 2 and 2 molecules, respectively for Polycystic Kidney Disease.
Polycystic Kidney Disease (Genetic Disorders) pipeline guide helps in identifying and tracking emerging players in the market and their portfolios, enhances decision making capabilities and helps to create effective counter strategies to gain competitive advantage. The guide is built using data and information sourced from Global Markets Directs proprietary databases, company/university websites, clinical trial registries, conferences, SEC filings, investor presentations and featured press releases from company/university sites and industry-specific third party sources. Additionally, various dynamic tracking processes ensure that the most recent developments are captured on a real time basis.
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