Kidney cancer detected early with urine test

If kidney cancer is diagnosed early – before it spreads – 80 percent of patients survive. However, finding it early has been among the disease’s greatest challenges.Now, researchers at Washington University School of Medicine in St. Louis have developed a noninvasive method to screen for kidney cancer that involves measuring the presence of proteins in the urine.The findings are reported March 19 in the journal JAMA Oncology.The researchers found that the protein biomarkers were more than 95 percent accurate in identifying early-stage kidney cancers. In addition, there were no false positives caused by non-cancerous kidney disease.

Read the rest of the article at http://www.medicalnewstoday.com/releases/291246.php.

Lycopene may ward off kidney cancer in older women

A higher intake by postmenopausal women of the natural antioxidant lycopene, found in foods like tomatoes, watermelon and papaya, may lower the risk of renal cell carcinoma, a type of kidney cancer.A team led by Cathryn Bock, Ph.D., M.P.H., associate professor of Oncology at Wayne State University’s School of Medicine, made the conclusion after analyzing data from 96,196 women nationwide and in Detroit who enrolled in the Women’s Health Initiative from 1993 to 1998 and were followed through July 2013 by participating initiative sites, including Wayne State University.”We were surprised to observe a protective effect of lycopene, as several previous studies in other populations did not detect a similar relationship,” Bock said.The results are explained in “Antioxidant micronutrients and the risk of renal cell carcinoma in the Women’s Health Initiative cohort,” featured in the Feb. 15 issue of Cancer.

Read the rest of the article at http://www.medicalnewstoday.com/releases/290272.php.

Experts criticise ‘inaccurate’ view that B Vitamins have no role in Alzheimer’s disease prevention

Patients in the very early stages of dementia could miss out on a potentially effective treatment after misleading research was published last year, say medical experts.The researchers, who claimed that B vitamins were ‘sadly not going to prevent Alzheimer’s disease‘¹, have been strongly criticised.Clinicians and scientists have labelled the statement ‘inaccurate and misleading’, voicing concerns that the unjustified claim could bias research funding and health policy decisions, as well as having a negative impact on patient welfare.Dr Peter Garrard, of the Cardiovascular and Cell Sciences Research Institute at St George’s, University of London, said that the analysis of previous clinical trial data published last year cast no doubt whatever on the potential of folic acidand vitamin B-12 to prevent dementia, and that the lead author’s comments were ‘unjustified and misleading’.

Read the rest of the article at http://www.medicalnewstoday.com/releases/289766.php.

Kidney images reveal the secrets of how organ develops

Striking images reveal new insights into how the kidney develops from a group of cells into a complex organ.The pictures are helping scientists to understand the early stages of development in mammals.Researchers at the University of Edinburgh’s Roslin Institute used time-lapse imaging to capture mouse kidneys growing in the laboratory on camera.They identified a key molecule called beta-catenin that instructs cells to form specialised structures within the kidney. These structures – called nephrons -are responsible for filtering waste products from the blood to generate urine.The images reveal that a gradient in the activity of beta-catenin forms along the growing nephron. It is the concentration of the molecule that instructs cells to form each particular part of the structure.By changing the activity of beta-catenin in different places, the researchers learned that they could instruct cells to form different parts of the nephron.If nephrons do not work correctly, it can lead to a wide range of health problems — from abnormal water and salt loss, to dangerously high blood pressure. The findings will help scientists to grow nephrons in the lab that can be used to study how kidneys function.The use of time-lapsed imaging means that, rather than requiring different litters of mice to study different developmental stages, the same animals can be studied over time. This leads to a significant reduction in the number of animals needed for this type of research.

Read the rest of the article at  http://www.medicalnewstoday.com/releases/289011.php.

 

Expert panel recommends new approaches to management of autosomal dominant polycystic kidney disease

January 29th marks the publication of a report by the European ADPKD Forum (EAF), an international, multidisciplinary panel of experts from the fields of nephrology, hepatology and genetics, as well as patient group representatives, dedicated to improving the health and quality of life of people with autosomal dominant polycystic kidney disease (ADPKD) – a chronic, progressive, inherited disease in which fluid-filled cysts grow in the kidneys and liver.¹

The report, entitled ‘Translating Science into Policy to Improve ADPKD Care in Europe’, details the important role of healthcare professionals to improve the development and delivery of ADPKD care, and provides a comprehensive overview of the current management of ADPKD throughout Europe. For more information read here http://www.medicalnewstoday.com/releases/288665.php.

 

Insights into the role of genetic variants in kidney disease

New research provides insights into the ties between certain genetic variants and kidney disease in African Americans. The genetic association is one of the strongest ever reported for a common disease, and these latest findings may help improve diagnosis and treatment. The study appears in an upcoming issue of the Journal of the American Society of Nephrology (JASN).

African Americans have a 4-fold increased risk for chronic kidney disease compared with European Americans. Recent work from several research groups has shown that much of this risk is due to genetic variations in a gene called apolipoprotein L1 (APOL1), which creates a protein that is a component of HDL, or good cholesterol. These variants arose tens of thousands of years ago in sub-Saharan Africa, and so are present in individuals who have recent sub-Saharan African ancestry. Approximately 5 million African Americans carry APOL1 risk variants, placing them at increased risk for kidney disease.

Jeffrey Kopp, MD (National Institutes of Health) and his colleagues investigated the role of APOL1 variants in a particular form of kidney disease called focal segmental glomerulosclerosis (FSGS). The team studied information on 94 patients with FSGS and found that patients who had APOL1 variants tended to have more advanced disease when they were diagnosed, which fits with prior observations that this genetic form of FSGS progresses rapidly. Previous research has shown that patients with two APOL1 variants respond to glucocorticoids with reductions in urinary protein excretion, but they nonetheless may experience progressive loss of kidney function. The present study showed a similar pattern with cyclosporine and mycophenolate mofetil. “New therapies targeting APOL1 injury pathways are needed, as standard therapies do not work for many people with this gene variant,” said Dr. Kopp.

The investigators also found that 72% of self-identified African Americans in the study had APOL1 risk variants, similar to earlier findings. “We also found the APOL1 risk genotype in 2 individuals of Hispanic descent, which is well known, and in 2 individuals who self-identified as White, or European American, which has not been reported before. This last finding suggests that APOL1 risk variants can be present in individuals who self-identify in various ways,” said Dr. Kopp.

In an accompanying editorial, Christopher Larsen, MD (Nephropath) and Barry Freedman, MD, PhD (Wake Forest School of Medicine) write that “the report by Kopp et al. enhances our understanding of a common etiology of the FSGS lesion seen on kidney biopsy in African Americans.” They note, however, that the findings from the trial, although informative, are not encouraging due to the poor outcomes that patients with APOL1 variants often ultimately experience.

Adapted by MNT from original media release

Picture courtesy of healthmeup.com

http://www.medicalnewstoday.com/releases/287813.php

Kidney disease undiagnosed in majority of type 2 diabetics

Only 12 percent of type 2 diabetics with chronic kidney disease (CKD) are properly diagnosed as having CKD, according to a new study published in PLOS Medicine.

Diabetes is the leading cause of kidney failure in the United States, and more than 35 percent of diabetics over age 20 are estimated to have CKD.

“This research underscores the urgency of testing at-risk populations for kidney disease,” said Joseph Vassalotti, MD, Chief Medical Officer of the National Kidney Foundation. “We are missing important opportunities to prevent kidney failure, dialysis and cardiovascular events in those most at risk.”

The multi-site cross-sectional study, Awareness, Detection and Drug Therapy in Type 2 Diabetes Mellitus and Chronic Kidney Disease (ADD-CKD), conducted by the National Kidney Foundation (NKF), assessed a total of 9,339 patients with type 2 diabetes in 466 primary care practices across the nation. Of the 5,036 patients with CKD (as defined by urine protein excretion and eGFR), only 12.1% of patients were diagnosed by their primary care practitioner.

As a patient’s CKD worsened, the proportion of patients correctly identified as having CKD increased (1.1% of Stage 1, 4.9% for Stage 2, 18.0% for Stage 3, 52.9% for Stage 4, and 58.8% for Stage 5). Clinicians were more successful in recognizing CKD in more advanced stages (e.g., 3 and 4), but still missed nearly half of patients with stage 4 CKD, while 209 (47%) of the 445 clinicians enrolled in the study did not identify any of their patients as having CKD. No differences were noted in clinicians’ likelihood of identifying chronic kidney disease based on practice setting, number of years in practice or number of patients seen per week.

“This shows we need clearer and simpler messages for both primary care clinicians and patients regarding the importance of screening for chronic kidney disease in people with diabetes,” said Chester Fox, MD, Professor of Family Medicine, University at Buffalo and ADD-CKD Steering Committee member. “We want to use these data to draw attention to the simple fact that recognizing kidney disease and performing simple steps may keep people off dialysis.”

As a result of the findings, the National Kidney Foundation has announced two initiatives to tackle kidney disease in at-risk individuals. NKF will include ACR urine testing in its popular KEEP Healthy community screening program. An ACR (albumin/creatinine ratio) urine test uses a simple dipstick to identify protein in the urine – often the first sign of kidney damage. NKF has also launched its Primary Care Initiative to help doctors adopt appropriate preventive measures into routine clinical practice. These include using specific diabetes drugs in those with reduced kidney function, avoidingnon-steroidal anti-inflammatory drugs (NSAIDs) which can damage the kidneys in those at risk and using kidney-protective medications such as ACE inhibitors and Angiotensin Receptor Blockers (ARBs).

“We can increase the awareness, prevention and management of chronic kidney disease in people living with diabetes by identifying CKD in its earliest stages,” Dr. Vassalotti said. “Only by working closely with primary care clinicians to understand their workflow, can we enhance care for people with CKD.”

The ADD-CKD study is sponsored by Boehringer Ingelheim Pharmaceuticals Inc.

Picture courtesy to himachalayurveda.com

http://www.medicalnewstoday.com/releases/287389.php

 

 

Genes expressed during urinary tract infections suggest next-generation treatment

Urinary tract infections can occur with no apparent cause, and as effectiveness of antibiotics fades, treating them is also becoming less predictable.

University of Michigan Medical School researchers have identified bacterial genes that help the infections spread, providing a potential new target for treating UTIs, a global public health concern mostly affecting women. UTIs lead to lost work time, emergency room visits and health care spending of $3.5 billion in the United States.

The research findings, published in Proceedings of the National Academy of Sciences, reveal the specific genes expressed by Escherichia coli, the bacteria that most often causes UTIs in otherwise healthy people.

“The bacterium is becoming resistant to currently available antibiotics, making it imperative to develop new treatment and prevention strategies,” says senior study author Harry T. Mobley, Ph.D., the Frederick G. Novy professor and chair of the Department of Microbiology and Immunology at the University of Michigan Health System. “The next logical step is to identify and develop therapies that selectively block these UTI-specific genes.”

In the study of 42 women, 7.7 percent had infections that were resistant to ciprofloxacin and 15.3 percent did not respond to trimethoprim/ sulfamethoxazole, two antibiotics commonly used for treatment.

The U-M team used genomic screening tools to take a deeper look at the mechanisms for infection. Rather than the expected virulence factor, the newly discovered E. coli-specific genes helped protect the bacterial species from the toxic effect of metal ions the body uses to fight infection.

Attacking this function, and other mechanisms that promote survival of the bacteria in the urinary tract, may be a strategy for new microbial agents, authors say.

The U-M has a remarkable record in research of molecular mechanisms leading to bacterial infections. The Mobley research team is among scientists identifying a potential approach for a vaccine to prevent urinary tract infections.

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/286876.php

 

Kidney function likely affected by perceived racial discrimination

Perceived racial discrimination may contribute to disparities related to kidney disease, according to a study presented at ASN Kidney Week 2014 at the Pennsylvania Convention Center in Philadelphia, PA.

Psychosocial factors such as perceived racial discrimination have been associated with chronic diseases, but little is known about the relationship between perceived racial discrimination and kidney function decline. Researchers led by Angedith Poggi-Burke, MPH and Deidra Crews, MD, FASN (National Institute on Aging and Johns Hopkins University School of Medicine, respectively) studied 1,574 adults with preserved kidney function in the Healthy Aging in Neighborhoods of Diversity across the Life Span (HANDLS) study (Baltimore City, Maryland). The team found that 20% of individuals perceived themselves to have been discriminated against ‘a lot’ because of their race. Such individuals were more likely to be African American and have a higher educational background, but they were more likely to be living in poverty than those who reported little-to-no perceived discrimination. Additionally, those who perceived ‘a lot’ of discrimination had higher systolic blood pressure but a lower prevalence of diabetes than those perceiving little-to-no discrimination.

Overall, perceived racial discrimination was linked with greater kidney function decline over 5 years of follow-up that was independent of socio-demographic, lifestyle, and health factors. When analyzed by race and sex, the link between perceived racial discrimination and kidney function decline remained only among African American women. Systolic blood pressure was responsible for 15% of this association.

“Perceived racial discrimination may contribute to disparities in kidney disease and might exert its effect on risk of kidney function decline through stress-related pathways,” said Dr. Crews. “This study can serve as a basis for future studies focusing on psychosocial stressors and their potential contributions to the initiation and progression of kidney disease.”

Adapted by MNT from original media release

http://www.medicalnewstoday.com/releases/285537.php

Picture courtesy of www.medindia.net

 

 

Identifying transplant rejection

Acute rejection after kidney transplantation occurs in about 15%-20% of patients despite immunosuppressive therapy. Rejection is usually heralded by an increase in the patient’s serum creatinine (a marker of kidney function), and a kidney biopsy is then performed to confirm whether rejection is taking place.

However, elevated creatinine is not sufficiently sensitive to identify all early rejection or specific enough to prevent some unnecessary kidney biopsies, so a noninvasive means of identifying acute rejection is needed.

In the Assessment of Acute Rejection in Renal Transplantation study published this week in PLOS Medicine, Silke Roedder, Tara Sigdel, senior author Minnie Sarwal (Department of Surgery, University of California San Francisco, San Francisco, California, United States of America), joint first author Nathan Salomonis (University of Cincinnati), and colleagues developed a 17-gene set to analyze patients’ peripheral blood samples to determine which patients were at risk of acute rejection of their kidney transplants.

The authors used 558 peripheral blood samples from 438 adult and pediatric renal transplant patients from eight renal transplant centers in the United States, Mexico, and Spain and enrolled between 2005 and 2012 to develop a quantitative real-time polymerase chain reaction (PCR) test. They developed the test in 143 samples from adults with and without acute rejection as determined by kidney biopsy, and then finalized and validated the test in three cohorts of patients.

The ability of the test to identify acute rejection in the final validation cohort was measured using the statistical approach of area under the curve. With 0.5 being equal to pure chance and 1.0 being perfect identification, the area under the curve for the test was 0.93 (95% CI 0.86-0.99). The authors conclude that the “kSORT assay is a simple, robust, and clinically applicable blood test.” They are using kSORT in a prospective observational trial as well as a second prospective, randomized, double-blinded clinical interventional trial, which will establish how “kSORT can be used serially post-transplant to complement current clinical practice guidelines for stratifying patient immune risk, medication load, and requirement for biopsy.”

 

http://www.medicalnewstoday.com/releases/285283.php