Of the tens of billions of Dollars spent each year on moderate kidney disease

by Dr.Enozia Vakil on August 2, 2013 at 11:51 General health news a new study, which will appear in the next issue of the journal of the American Society of Nephrology, says a new infection treatment kidney also accompany steep medical caosts. The study found that expenses related to the moderates of chronic renal failure (CRF) cost of health insurance to the tens of billions of dollars each year.
About 60 million people in the world have CKD. It is believed that most of the costs of CKD occur when the disease progresses to renal failure, also known as stage 5 CKD. The Centers for Disease Control and Prevention funded by the investigators of RTI International to check if people who have had early CKD also incurred considerable medical costs that could be attributed to their illness.

"It was difficult to answer this question, because the early stages of CKD will often non-diagnostic. However, using a sample of participants in the national health and Nutrition Examination Survey III, or NHANES III, we were able get measures laboratory and estimate the stages of CKD for the people in the sample, "said first author Amanda Honeycutt, PhD. The researchers then received authorization for payment of health insurance data merged with the NHANES III data to determine the impact of diseases and other factors on Medicare spending. Laboratory data used in the analysis were from 1988 to 1994, and that they were related to the costs of health insurance from 1991 to 1994.

Among the key findings:
-Medicare expenditures attributable to the 2 to 4 of the CKD stages are likely to exceed 48 billion $ per year.
-L' due to the stage 2 CKD Medicare cost $1700 per person, per year. Stage 3 CKD-related costs were $ 3,500 per person per year and for stage 4 CKD, they were $12 700 / person / year, adjusted in 2010 dollars.

"This study is important because we could identify the same beginning of CKD - before people progress to full Terminal kidney disease - contribute to high cost of health insurance," said Honeycutt. The results suggest that efforts to prevent the development of CKD can lead to significant savings. In addition, the study highlights the need to identify with CKD in its early stages to prevent the progression of the disease and avoid high medical costs attributable to the final phase of the disease.

Co-authors of the study include Joel E. Segel, BA, Xiaohui Zhuo, PhD, Thomas Hoerger, PhD, Kumiko Imai, PhD and Desmond Williams, MD PhD.

Source-Newswise

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Urine Test to Predict Kidney Transplant Rejection

by Sheela Philomena on? July 04, 2013 at 9:59 AM Organ Donation News Examination of three biomarkers in the urine of kidney transplant recipients can help diagnose transplant rejection, show results. This test for biomarkers -- molecules that indicate the effect or progress of a disease -- offers an accurate, noninvasive alternative to the standard kidney biopsy, in which doctors remove a small piece of kidney tissue to look for rejection-associated damage. The findings appear in the July 4 issue of the New England Journal of Medicine.
"The development of a noninvasive test to monitor kidney transplant rejection status is an important advance that will allow doctors to intervene early to prevent rejection and the kidney injury it causes, which should improve long-term outcomes for transplant recipients," said NIAID Director Anthony S. Fauci, M.D.

Following a kidney transplant, patients receive therapy to prevent their immune systems from rejecting the organ. Even with this immunosuppressive therapy, approximately 10 to 15 percent of kidney recipients experience rejection within one year after transplantation.

Typically, a biopsy is performed only after a transplant recipient shows signs of kidney injury. Although the procedure seldom causes serious complications, it carries some risks, such as bleeding and pain. In addition, biopsy samples sometimes do not give doctors an accurate impression of the overall state of the kidney because the samples are small and may not contain any injured tissue.

"Potentially, a noninvasive test for rejection would allow physicians to more accurately and routinely monitor kidney transplant recipients," said Daniel Rotrosen, M.D., director of NIAID's Division of Allergy, Immunology and Transplantation. "By tracking a transplant recipient's rejection status over time, doctors may be able to modulate doses of immunosuppressive drugs to extend the survival of the transplanted kidney." In the study, part of the NIH-funded Clinical Trials in Organ Transplantation (CTOT), investigators at five clinical sites collected urine samples from 485 kidney transplant recipients from three days to approximately one year after transplantation. Researchers led by Manikkam Suthanthiran, M.D., of Weill Cornell Medical College in New York and Abraham Shaked, M.D., Ph.D., of the University of Pennsylvania School of Medicine, Philadelphia, assessed the urinary cell levels of several biomarkers that previously have been associated with rejection.

Statistical analysis revealed that a group of three urinary biomarkers formed a diagnostic signature that could distinguish kidney recipients with biopsy-confirmed rejection from those whose biopsies did not show signs of rejection or who did not undergo a biopsy. The biomarkers include two messenger RNA molecules that encode immune system proteins implicated in transplant rejection and one noncoding RNA molecule that participates in protein production. The researchers used the signature to assign values to each urine sample and identify a threshold value indicative of rejection. With this test, they could detect transplant rejection with a high level of accuracy. The investigators obtained similar results when they tested a set of urine samples collected in a separate CTOT clinical trial, thereby validating the diagnostic signature.

To determine whether the urine test also could predict future rejection, the scientists analyzed trends in the diagnostic signature in urine samples taken in the weeks before an episode of rejection. The values for patients who experienced rejection increased slowly but steadily leading up to the event, with a characteristic sharp rise occurring approximately 20 days before biopsy confirmed rejection had occurred. In contrast, the values for patients who did not show any clinical signs of rejection remained relatively constant and under the threshold for rejection. These findings suggest that it might be possible to treat impending rejection before substantial kidney damage occurs.

"The test described in this study may lead to better, more personalized care for kidney transplant recipients by reducing the need for biopsies and enabling physicians to tailor immunosuppressive therapy to individual patients," said NIAID Transplantation Branch Chief Nancy Bridges, M.D., a co-author of the paper. The CTOT cooperative research consortium provided the infrastructure and collaborative environment needed to conduct the large, rigorous, multicenter study that established the efficacy of this biomarker-based test, Dr. Bridges noted.

Source-Eurekalert

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Mumbai Hospitals to Perform India's First Domino Kidney Transplant Surgeries

Domino transplantation involves a series of surgeries where in a donor provides an organ to a recipient not related to him or her while the donor's relative in turn receives the organ from another donor.

The current domino transplant surgeries will be conducted at Hinduja hospital, Bombay hospital and Hiranandani hospital while four of the five recipients are from Maharashtra.

"All the transplants will be done on the same day in different hospitals in the city. Everything ? surgeons, paramedical team, operation theatres ? is in place. The interesting thing about domino transplant is that despite blood group not matching, with the help of five way swap exchange, they are able to undergo kidney transplant. Otherwise, they have to wait for a long. All credit goes to the Apex Swap Transplant Registry (ASTRA) that addresses the issue of mismatch in blood groups or tissues in couples who need transplants", Hinduja Hospital's Dr Jatin Kothari said.

Source-Medindia

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