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October 31, 2006, 4:01 AM CT

Topiramates Increases Risk Of Kidney Stones

Topiramates Increases Risk Of Kidney Stones Drs. Khashayar Sakhaee (left), chief of mineral metabolism, and Dion Graybeal.
Credit: UT Southwestern Medical Cente
Topiramate (Topamax), a drug usually prescribed to treat seizures and migraine headaches, can increase the propensity of calcium phosphate kidney stones, scientists at UT Southwestern Medical Center have found.

A study - the largest cross-sectional examination of how the long-term use of topiramate affects kidney-stone formation - appears in the recent issue of the American Journal of Kidney Diseases.

Several case reports have described an association between topiramate and the development of kidney stones, but this complication had not been well recognized and physicians have not informed patients about the risk, the UT Southwestern scientists said. More important, the mechanism of stone formation was largely unknown previously.

"The wide-spread and escalating use of topiramate emphasizes the importance of considering the long-term impact of this drug on kidney-stone formation," said Dr. Khashayar Sakhaee, senior author of the study and chief of mineral metabolism at UT Southwestern.

More than 29 million Americans suffer from migraines, with women being affected three times more often than men, as per the National Headache Foundation.

"Topiramate is probably one of the most usually prescribed and most effective neurological medications right now," said Dr. Dion Graybeal, assistant professor of neurology and an author of the study.........

Posted by: Daniel      Permalink         Source


October 15, 2006, 6:43 PM CT

Kidney Damage After Heart Surgery

Kidney Damage After Heart Surgery
The occurence rate of kidney damage linked to coronary artery bypass surgery has increased significantly over the past 16 years in the United States, but the rate of death from such damage has decreased significantly during the period, as per a new analysis.

In their analysis of more than 5 million discharges from hospitals across the United States, the scientists at Duke University Medical Center observed that the occurence rate of acute renal failure linked to coronary artery bypass surgery increased almost five-fold during the study period. The scientists estimate that approximately 20,000 cases of the disorder occur nationwide each year.

The rate of death from acute renal failure caused by bypass surgery dropped almost three-fold during the study period, the scientists said. Still, patients with the disorder tend to have higher death rates, and also to require longer hospital stays, than patients who do not experience kidney damage after surgery.

The findings suggest that current strategies used to prevent acute renal failure following bypass surgery may not be as effective as previously thought, the scientists said.

"Postoperative acute renal failure remains a serious complication of bypass surgery that does not seem to have been influenced by any strategies designed to prevent it," said Patricia McGugan-Clark, R.N., an intensive care nurse and member of the study team. "More research needs to be conducted to identify those patients who are most susceptible to acute renal failure and which strategies are most effective".........

Posted by: Mark      Permalink         Source


September 20, 2006, 9:40 PM CT

White Blood Cells And Transplanted Kidneys

White Blood Cells And  Transplanted Kidneys
In an example of biological irony, the same white blood cell chemistry known to damage kidneys used for transplants may also help prevent such damage, as per a federally funded study in genetically engineered mice at Johns Hopkins.

Scientists have long known that when blood flow is cut off and then returned to transplanted kidneys or other organs, immune system cells called T lymphocytes produce toxic natural chemicals that contribute to ischemic reperfusion injury (IRI). Nature cannot distinguish between deliberate surgical wounds needed to remove and re-implant a donor kidney and other kinds of organ damage in which certain toxic chemicals are needed to clean up or remove bad tissue.

But in the new study reported in the recent issue of The Journal of Immunology, the Hopkins team reports that that T cells can also play a role in reducing cellular damage in IRI kidneys, as per Hamid Rabb, M.D., medical director of kidney and pancreas transplantation at The Johns Hopkins University School of Medicine.

IRI occurs in 30 percent to 40 percent of kidneys removed from dead donors, resulting in lower kidney survival rates, shortened kidney life and a cost increase of approximately $20,000 per patient from the initial hospital stay and therapy alone, as per Rabb. Researchers therefore are interested in identifying means of preventing or rapidly treating IRI, but one barrier to greater understanding has been the inability to detect the lymphocytes in the kidney during the first critical six hours after blood flow is returned.........

Posted by: Mark      Permalink         Source


September 18, 2006, 9:51 PM CT

Link Between Kidney Cancer And Sunlight Exposure

Link Between Kidney Cancer And Sunlight Exposure
Closer to the equator you live, lower is your chances for kidney cancer. Using newly available data researchers have shown a clear association between deficiency in exposure to sunlight, specifically ultraviolet B (UVB), and kidney cancer.

UVB exposure triggers photosynthesis of vitamin D3 in the body. This form of vitamin D also is available through diet and supplements. Previous studies from this core research team have shown an association between higher levels of vitamin D3 and a lower risk of cancers of the breast, colon and ovary.

"Kidney cancer is a mysterious cancer for which no widely accepted cause or means of prevention exists, so we wanted to build on research by one of the co-authors, William Grant, and see if it might be related to deficiency of vitamin D," said study co-author Cedric Garland, Dr. P.H., professor of Family and Preventive Medicine in the UCSD School of Medicine, and member of the Moores UCSD Cancer Center.

There will be approximately 208,500 cases and 101,900 deaths from kidney cancer worldwide in 2006, including 39,000 new cases and 12,700 deaths in the United States, according to the International Agency for Research on Cancer and the American Cancer Society.

The study, published in the International Journal of Cancer's online edition dated September 15, is the research team's newest finding relating exposure to the sun as a source of vitamin D, and estimated vitamin D deficiency to higher rates of several major types of cancer.........

Posted by: Mark      Permalink         Source


September 2, 2006, 10:05 PM CT

Reducing contrast material in elderly

Reducing contrast material in elderly
The dose of contrast material can be effectively reduced by at least 10% for elderly patients undergoing a multi-detector CT examination of the pancreas and biliary region a new study finds. When the dose is reduced, the cost of the examination and the risk of complications is reduced. This study was conducted by the Department of Technical Radiology at Nagoya University School of Health Science in Nagoya, Japan.

"When interpreting CT images acquired using the established protocol in our clinical practice, it was noted that in some examinations of elderly patients, contrast enhancement of the pancreatic parenchyma was too intense," said Shigeki Itoh, MD, lead author of the study. "Therefore, we speculated that it might be possible to reduce the dose and rate of contrast material injection without adversely affecting the degree of contrast enhancement in elderly patients," said Dr. Itoh.

The study included 112 patients, ranging from 23-80 years old who had known or suspected pancreatobiliary disease who were split into three groups (60 years old or younger with a contrast injection of 0.08 milliliters/kg/sec, 60 years old or older with a contrast injection of 0.08 milliliters/kg/sec, and 60 years old or older with a contrast injection of 0.07 milliliters/kg/sec).........

Posted by: Sue      Permalink         Source


August 31, 2006, 4:38 AM CT

Drink Orange Juice To Keep Kidney Stones Away

Drink Orange Juice  To Keep Kidney Stones Away
A daily glass of orange juice can help prevent the recurrence of kidney stones better than other citrus fruit juices such as lemonade, scientists at UT Southwestern Medical Center have discovered.

The findings indicate that eventhough a number of people assume that all citrus fruit juices help prevent the formation of kidney stones, not all have the same effect. The study is available online and is scheduled would be reported in the Oct. 26 issue of the Clinical Journal of the American Society of Nephrology.

Medically managing recurrent kidney stones requires dietary and changes in lifestyle as well as therapy such as the addition of potassium citrate, which has been shown to lower the rate of new stone formation in patients with kidney stones.

But some patients can't tolerate potassium citrate because of gastrointestinal side effects, said Dr. Clarita Odvina, assistant professor of internal medicine at the Charles and Jane Pak Center for Mineral Metabolism and Clinical Research and the study's lead author. In those cases, dietary sources of citrate such as orange juice may be considered as an alternative to pharmacological drugs.

"Orange juice could potentially play an important role in the management of kidney stone disease and may be considered an option for patients who are intolerant of potassium citrate," Dr. Odvina said.........

Posted by: Mark      Permalink         Source


August 1, 2006, 9:25 PM CT

How Kidneys Retain Proteins

How Kidneys Retain Proteins Image courtesy of acem.org.uk
New research may finally settle a decades-old debate about how the kidney keeps valuable blood proteins from harmfully slipping into the urine, a serious health symptom that often precedes kidney failure.

In genetically modified mice, researchers at Washington University School of Medicine in St. Louis captured images of a defective version of a kidney structure leaking a substance from the blood into the urine. The images suggest that the structure, known as the glomerular basement membrane (GBM), normally plays a key role in keeping blood proteins out of the urine.

The finding, published in the recent issue of the Journal of Clinical Investigation, will help doctors understand nephrotic syndrome, a condition with symptoms that include blood proteins in the urine. The syndrome can be triggered by a variety of genetic and environmental factors and leads to kidney failure over a varying time period.

"All the therapys we now use for nephrotic syndrome are either non-specific, meaning that we can't say for sure that they directly address the problem, or they are toxic," notes lead author George Jarad, M.D., a postdoctoral research scholar. "The first step to developing a specific therapy is to understand exactly what's happening. We have to know the details of the process before we can devise a remedy."........

Posted by: Mark      Permalink         Source


July 31, 2006, 6:48 AM CT

Diagnosis And Referrals For Kidney Disease

Diagnosis And Referrals For Kidney Disease
Results of a national study of 304 U.S. physicians, in which "mock" patients' symptoms were presented for diagnosis, suggest that a sizeable percentage of primary care doctors probably fail to properly diagnose and refer patients with chronic kidney disease (CKD).

Their findings, published in the recent issue of the American Journal of Kidney Diseases, show that of 126 kidney specialists surveyed, 97 percent properly diagnosed CKD and 99 percent would have recommended specialized kidney care for the "patient." But only 59 percent of the 89 family physicians and 78 percent of 89 general internal medicine physicians fully recognized the signs and symptoms of CKD. And referrals to a nephrologist were made by only 76 percent of the family physicians and only 81 percent of general internists.

"We, as physicians, can certainly do better," says L. Ebony Boulware, M.D., Assistant Professor of Medicine at The Johns Hopkins University School of Medicine, and lead author of the study.

"Millions of people have kidney disease, but a substantial number may not have their disease recognized," Boulware added. "Simply put, our study shows that primary care physicians are not recognizing kidney disease in high-risk patients as often as they should".

In the study, the Hopkins group asked the surveyed physicians to evaluate the medical files of a simulated patient being treated by a primary-care doctor and suffering from progressive CKD. CKD is a growing epidemic, affecting an estimated 10 million Americans. The medical "record" contained clues to the condition indicating that, based on guidelines issued in 2000 by the National Kidney Foundation, the patient should be referred to a nephrologist for evaluation of CKD.........

Posted by: Mark      Permalink         Source


June 19, 2006, 9:23 PM CT

Suggest your News Item To Medicineworld

Suggest your News Item To Medicineworld
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Posted by: Janet      Permalink


June 4, 2006, 8:51 AM CT

New Drug Combo For Kidney Cancers

New Drug Combo For Kidney Cancers
By using a new combination of two anticancer drugs, scientists at Duke University Medical Center have dramatically improved response rates of patients with metastatic kidney cancer, which is now generally considered incurable.

The results suggest that combining the two drugs may slow the disease's progression in significant numbers of patients, eventhough the drug combination is not a cure, said the researchers.

In the study, 40 percent of patients who received the newly approved drug sorafenib together with the established drug interferon-alpha experienced "major shrinkage" of their kidney tumors and tumors that had metastasized, or spread elsewhere. A "major" response is generally is defined as 30 percent or greater shrinkage of all tumors in the body.

In comparison, only 5 percent of patients who receive sorafenib alone show a major response, recent studies have shown. Similarly, just 10 percent to 15 percent of patients who receive only interferon alpha, considered the standard therapy for kidney cancer, show a major response.

"By combining the drugs, we are seeing more major responses in greater numbers of patients, but we don't yet know how long the responses will last," said Jared Gollob, M.D., associate professor of medicine and immunology at Duke. "There are great new drugs on the market with relatively low toxicity, but the question physicians now face is how to make them work better for patients."........

Posted by: Mark      Permalink         Source



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Did you know?
The National Institute of Dental and Craniofacial Research (NIDCR), part of the National Institutes of Health, announced today the launch of a seven-year clinical study that could accelerate research on better pain-controlling therapys for a jaw condition called temporomandibular joint and muscle disorders (TMJDs).

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