Sunday, March 10, 2019

Kidney Health: Check Your Urine Color, PKD Awareness Month: Planters and Art, 3D Printed Kidney Proximal Tubules

Kidney Health

From Financial Review, by Hilary Brueck





Whether you're trying a keto plan, a new plant-based routine, intermittent fasting, or the Whole30, experts agree: dieting is hard work.

Thomas Chi, a doctor at the University of California, San Francisco, urology department, said proper hydration tends to be one of the toughest things for his dieting patients to remember when they start a new weight-loss plan.

"People who are on extreme diets, they tend to have higher levels of salt and less hydration," Chi said.

Fortunately, your body is here to help. All you have to do is take a little time to listen to the brain's subtle cues: If you're feeling thirsty, drink some water.

This is especially important if you're eating more meats and high-salt foods, Chi said, because a combination of "tons and tons of meat" and not enough water could lead to kidney stones, especially if you have a family history of the issue.

"I'm not seeing this enormous uptick of patients with kidney stones because they're all doing a keto diet now," he said.

But he still thinks it's a good idea to pay attention to when your body's asking for water.

No matter if you're on an extreme diet or no diet at all, that's generally good advice.

"A lot of times, people just seem to be a little dehydrated," the dietitian Jason Ewoldt from the Mayo Clinic previously told Business Insider.

But the popular notion that you must down eight full glasses of water a day is bogus. And nobody really needs any special sports drinks, even after a workout.

Your body knows exactly when you need more water

Just drink when you're thirsty because the body is designed to know precisely when you need more water.

There's actually a "thirst centre" in the brain that helps regulate thirst, and it's impressively tuned.

Even though it takes tens of minutes for the body to hydrate once cool water touches your lips, drinking quenches thirst within seconds.

The brain's thirst cues can be relatively mild and easily mistaken for hunger pangs, or just ignored. Pretty soon, that can prompt dehydration and lead to overeating.

A 2016 study of more than 18,000 people in the US found that those who drank more water were consistently more satisfied and ate fewer calories daily. (Drinking with a meal both helps replenish saliva and aids digestion.)

Steady water drinkers also consumed lower amounts of sugar, fat, salt and cholesterol than dehydrated people.

So if you're unsure if you're feeling peckish, try sipping on some water, waiting about 15 minutes, and checking if your stomach really is rumbling.

"If you were truly hungry, you might still feel a stomach pang, whereas if you were just thirsty, you'll feel satisfied," the Polycystic Kidney Disease Foundation said.

If you're not a big fan of water, you can dress up your drink by adding lemon juice into your glass.

That's a cheap, doctor-recommended hack to help prevent kidney-stone formation.

No need to fuss too much over the colour of your urine, either. As long as it's not a super-dark yellow or an amber colour, you're doing well.

This story first appeared in Business Insider. Read it here or followBusinessInsider Australia on Facebook.

BusinessInsider.com.au




From Science Daily

Growing evidence: Water as a potential treatment for inherited cause of kidney failure


People with polycystic kidney disease (PKD) could benefit from a moderate increase in water intake, according to new research.


A study from The Westmead Institute for Medical Research found that a moderate increase in water intake in rats with PKD led to a long-term reduction in kidney cyst growth and fibrosis.

This latest findings add to the growing body of evidence that supports water as a safe and effective treatment for PKD.

Polycystic kidney disease is the most common inherited cause of end-stage kidney disease. It is a chronic condition, in which fluid-filled cysts damage healthy tissue and kidney function.

Left untreated, it can cause complications, including high blood pressure, heart problems and, in severe cases, kidney failure.

More than 2,000 Australians with PKD currently receive dialysis or need a kidney transplant.

Lead researcher Dr Priyanka Sagar said that water may be a potential treatment for PKD, because it stops the hormone responsible for cyst growth.

"Previous studies in animals haven't shown whether this benefit continues over time, and there is presently no evidence in humans," Dr Sagar said.

"Our research in rats showed that increased water intake reduces the long-term progression of cyst growth and kidney fibrosis when administered during the early stages of kidney disease.

"Significantly, we identified that only a moderate increase in water was needed to have this sustained benefit in rats."

The research also showed that increased water intake had secondary benefits for some complications associated with PKD.

"Interestingly, we found that increased water intake also reduced hypertension," Dr Sagar said.

"PKD is linked to an increased risk of cardiovascular disease, so this is an important protective effect."

Currently, treatment options for PKD in humans are limited. Dr Sagar said that further studies are needed in humans to prove that water is an effective treatment for kidney cysts.

"We're finding more evidence to support water as a viable treatment for PKD," she said.

"However, further studies are needed to determine its effectiveness.

"Water is cheap and accessible, so the idea that it could be used as a treatment for PKD in the future is very exciting," she concluded.


Story Source:

Materials provided by Westmead Institute for Medical Research. Note: Content may be edited for style and length.





From MD Linx

Long-term trajectory of kidney function in autosomal-dominant polycystic kidney disease

In a 14-year observational cohort study (The Consortium for Radiologic Imaging Studies of Polycystic Kidney Disease study), researchers assessed the trajectories of glomerular filtration rate (GFR) decline in 241 adults with autosomal dominant polycystic kidney disease (ADPKD). Taking into account baseline age and magnetic resonance imaging measurements of total kidney volume (TKV) according to the method of Irazabal, 5 subclasses of participants were defined, as an estimate of the rate of kidney growth. Using mixed polynomial models, they reconstructed and fitted GFR trajectories spanning over four decades of life. For validation, they used data from the HALT-PKD study. Findings revealed a nonlinear GFR decline in ADPKD. A single measurement of kidney volume could predict GFR decline trajectory throughout adulthood. The possible utility of these models was suggested for clinical prognostication, clinical trial design, and patient selection for clinical interventions. Growth in kidney volume was causally related to GFR decline. The use of TKV as a surrogate endpoint in clinical trials was supported.


Read the full article on Kidney International





PKD Research

From ECN Magazine, by Harvard University




Immunofluorescence staining of a 3D bioprinted vascularized proximal tubule with a proximal tubule epithelial marker stained in green in the proximal tubule channel and a vascular endothelial marker stained in red in the adjacent vascular channel. The magnified cross-section illustrates that the two different cell types form luminal perfusable structures in their respective channels. Credit: Wyss Institute at Harvard University


Every day our kidneys tackle the daunting task of continuously cleaning our blood to prevent waste, salt and excess fluid from building up inside our bodies. To achieve this, the kidneys' approximately one million filtration units (glomeruli) first remove both waste products and precious nutrients from the blood stream, then specialized structures known as the proximal tubules reabsorb the "good" molecules returning them to our bloodstream. While the reabsorptive functions of the proximal tubule can be compromised by drugs, chemicals, or genetic and blood-borne diseases, our understanding of how these effects occur is still limited.

To enable the study of renal reabsorption outside the human body, Wyss Institute Core Faculty member Jennifer Lewis, Sc.D., and her team working within the Wyss Institute's 3D Organ Engineering Initiative that she co-leads, and in collaboration with the Roche Innovation Center Basel in Switzerland, created a 3D vascularized proximal tubule model in which independently perfusable tubules and blood vessels are printed adjacent to one another within an engineered extracellular matrix. This work builds upon a continuously perfused 3D proximal tubule model reported earlier by the team that still was lacking a functional blood vessel compartment. Using their next-generation device, the team has measured the transport of glucose from the proximal tubule to the blood vessels, along with the effects of hyperglycemia, a condition associated with diabetes in patients. Their study is published in the Proceedings of the National Academy of Sciences (PNAS).

Lewis is also the Hansjörg Wyss Professor of Biologically Inspired Engineering at Harvard John A. Paulson School of Engineering and Applied Science (SEAS), the Jianmin Yu Professor of Arts and Sciences and a member of the Harvard Stem Cell Institute.

"We construct these living renal devices in a few days and they can remain stable and functional for months," said first-author Neil Lin, Ph.D., who is a Roche Fellow and Postdoctoral Fellow on Lewis' team. "Importantly, these 3D vascularized proximal tubules exhibit the desired epithelial and endothelial cell morphologies and luminal architectures, as well as the expression and correct localization of key structural and transport proteins, and factors that allow the tubular and vascular compartments to communicate with each other."

As a first step towards testing drugs and modeling diseases, the team induced "hyperglycemia", a high-glucose condition typical of diabetes and a known risk factor for vascular disease, in their model by circulating a four-fold higher than normal glucose concentration through the proximal tubule compartment. "We found that high levels of glucose transported to endothelial cells in the vascular compartment caused cell damage," said Kimberly Homan, Ph.D., a co-author on the study and Research Associate in Lewis' group at the Wyss Institute and SEAS. "By circulating a drug through the tubule that specifically inhibits a major glucose transporter in proximal tubule epithelial cells, we prevented those harmful changes from happening to the endothelial cells in the adjacent vessels."

The team's immediate focus is to further scale up these models for use in pharmaceutical applications. "Our system could enable the screening of focused drug libraries for renal toxicity and thus help reduce animal experiments," said Annie Moisan, Ph.D., a co-author and industry collaborator on the study, and Principal Scientist at Roche Innovation Center Basel. "I am thrilled by the continued efforts from us and others to increase the physiological relevance of such models, for example by incorporating patient-specific and diseased cells, since personalized efficacy and safety are the ultimate goals of predicting clinical responses to drugs."

"Our new 3D kidney model is an exciting advance as it more fully recapitulates the proximal tubule segments found in native kidney tissue," said Lewis. "Beyond its immediate applications for drug screening and disease modelling, we are also exploring whether these living devices can be used to augment kidney dialysis." Currently, life-saving dialysis machines filter blood, but they are unable to retrieve precious nutrients and other species from the filtrate that the body needs for many of its functions, which can cause specific deficiencies and complications down the line. Lewis and her colleagues believe that 3D bioprinted vascularized tubules may lead to improved renal replacement therapies.

"This study presents a significant step forward in human kidney engineering that enables human disease and drug-related studies to be carried out over extended periods of time in vitro. It also represents a major step forward for the Wyss Institute's 3D Organ Engineering Initiative, which aims to generate functional organ replacements with enhanced functionalities for patients in need," said Wyss Institute Founding Director Donald Ingber, M.D., Ph.D., who is also the Judah Folkman Professor of Vascular Biology at HMS and the Vascular Biology Program at Boston Children's Hospital, as well as Professor of Bioengineering at SEAS.






PKD Awareness

From Sylvan Lake News, Alberta, Canada, by KAYLYN WHIBBS
Sylvan Lake’s Winter Village planter contest helps spread awareness


March is Polycystic Kidney Disease Awareness month



The winner of Best Overall Non-Profit in the planter contest with the 2018 Waterfront Winter Village has a very personal touch behind its tree.

Sylvan Lakes’ Rosalie Thon, and her friends, Evan Masse, Trish Jenks and her son Clayton William, designed the planter for kidney disease and transplant awareness.

Thon has Polycystic Kidney Disease and spent four years doing dialysis while waiting to get a new kidney.

She did a battery of tests and had four calls before her kidney came Sept. 21, 2017.

“In that part of my journey I met Evan [Masse], he was my roommate [in the hospital] and he as well had a kidney transplant, and so we just became really good friends and when the planter came up I just thought I wanted to give something back,” said Thon in an interview, adding she has learned a lot throughout her journey.

Masse lives north of Edmonton, but made the trip down to help decorate the tree.

“I know for a fact a lot of people don’t know a lot about kidney disease and/or transplant, so I thought what a better opportunity than to take advantage of this tree,” explained Thon.

The blue and green colouring of the tree was inspired by the colours of The Kidney Foundation of Canada and was decorated with kidney shaped stress balls and cards with ribbon pins for awareness.

“Rosalie and I decided to give people awareness of donating organs, it is a lifesaver for people even though it is sad that some people have to sacrifice their life to save other people,” said Masse in a letter, adding he is thankful for all the people who donate.

Decorating the tree was a two-day project and represented transplant awareness right down to its roots after they removed the original little tree to transplant in an artificial one.

The Kidney Foundation of Canada, Northern Alberta and The Territories branch in Edmonton donated the stress kidneys and cards to use as decorations.

This was the group’s first time entering a planter in the competition and is very proud to have been voted number one in their category.

Thon says when she sets out to do something she always wants to be a high achiever, so she told the group she wanted to win.

“I wanted to win not out of arrogance, but just to get the story out even more,” said Thon, adding she also likes being creative.

Thon and Masse used the lighting ceremony and the planter along the lakeshore throughout the winter as a talking point to help raise awareness, knowledge and share their story.

She said it was exciting to be able to make connections with people and spread the word about kidney disease and transplant.

Since polycystic is hereditary her son, Clayton William, also has polycystic kidneys.

Thon explained hers started with a 2.5 cm cyst, which took 20 years to almost completely shut down her kidney function, so it is hard to tell when William will need to go through the dialysis and transplant procedure.





From The Daily Bruin, UCLA

Art exhibit sheds light on lives of those affected by genetic disorders

The exhibit was created to provide more insight into the lives of patients affected by genetic disorders. (Lauren Man/Daily Bruin)



An art exhibit in Powell Library showcases the hidden impact genetic disorders often have on the lives of UCLA students.

The exhibit, which opened Feb. 19 and will remain open through March in the Powell Library rotunda, showcases various forms of art submitted by five students who have genetic disorders such as lymphoma and cystic fibrosis.

Rushna Raza, a fourth-year molecular, cell, and developmental biology student, said she created the exhibit because of her interest in genetics and because she wanted to provide more insight into the lives of patients affected by these disorders.

“I believe the genetic and the social perspectives are both important because patients’ lives go beyond what meets the eye,” she said. “Those stories never get told unless you ask.”

The exhibit features five pieces of visual and interactive artwork created by students that aim to educate others on the invisible suffering caused by genetic disorders, Raza said. Some students chose to focus on illnesses that affect them directly, while others explored genetic diseases that have affected their loved ones. The projects also reflected the roles these heritable diseases have played throughout their families’ histories.

Chelsea Krob, a fourth-year art student who has autosomal dominant polycystic kidney disease, created a multimedia gallery to raise awareness of her illness.

Her project, “Through Your Journey,” tells the story of her struggle with PKD through photos and a digital recording of a conversation between Krob and her father, who died from the same illness in May.

“My project aims to look at the intergenerational effects of this disease and also my unique relationship with my dad, since we both have (PKD),” she said.

Krob’s portion of the exhibit also features a wall on which observers can add their handprints with ink. She said she was inspired by a previous project concept in which she planned to represent every day of her father’s life through thumbprints.

Raza said the handprint wall represents how everyone is unique due to small differences in their genomes. Similarly, even though human handprints have the same basic shape, small variations make them unique. Raza said this aspect of the exhibit allows students to participate in and leave their own mark on the artwork.

Krob said she hopes observers can gain a better understanding of the lives of people with PKD through her project.

“I used multiple approaches to give the viewer, wherever they’re at with life or death, an entry point into the work,” she said.

Hollie St. Claire, who graduated from UCLA in fall 2018, portrayed the impact of cystic fibrosis in her life through her carving, “Breaking Through.” Three of St. Claire’s siblings have the disease and she recently learned she is a carrier. She said she hopes to show that people with cystic fibrosis are strong and that there is hope for a cure.

To demonstrate the strength of those with cystic fibrosis, St. Claire created a painted carving that depicts an individual pushing against an arch containing strands of DNA. She said she aims to challenge the notion that individuals with cystic fibrosis are weak or fragile.

“The individual in my carving is breaking through the barriers of genetic restrictions,” she said.

Ketana Chadalavada, a fourth-year psychology student who designed the exhibit’s online graphics, said her painting “Survivor” represents her struggle with lymphoma, which she was diagnosed with last year.

She said her portrayal of a bald figure demonstrates her reclaiming ownership of her body. The lime green ribbon over the figure’s heart is an official symbol of lymphoma awareness and ties the painting to the broader lymphoma community.

“I really wanted to show the mental side to my story, including how I coped with (lymphoma) and what I learned from it,” Chadalavada said.

In addition to raising awareness for genetic disorders, Raza added she created the exhibit because she was interested in combining science and art. She said even though she does not consider herself to be an artist, she is proud to have put together a project that allows students to tell their personal stories through art.

“I wanted this project to be a chance for students to share that intimate part of their history through an artistic platform,” she said.

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