Now, kidney damage can be detected early

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Marker Identifies Disease 10 Yrs Before Onset

Durgesh Nandan Jha | TNN

New Delhi: A new technique for early detection of Chronic Kidney Disease (CKD) could save many lives in future. With the help of a multi-marker panel of proteins and hormones, individuals at a greater risk of developing the disease can be identified up to 10 years before its clinical onset. By the time CKD is usually diagnosed, it is stage III and IV and half of the kidney is already damaged.
Doctors say it will be possible to start treatment and make lifestyle changes at an early stage with the help of this finding. According to a doctor, the new biomarkers can be tested in a single blood sample. The biomarkers are homocysteine, a marker for atherosclerosis; aldosterone, a hormone that affects salt handling by the kidneys; and BNP, which is involved in maintenance of blood pressure and volume.
The biomarkers have been identified with the help of a research carried out on more than 2,300 persons with normal kidney functions. The subjects were tested for over a period of 10 years to find the biomarkers that can identify high-risk individuals. The study has been published in the latest edition of the Journal of the American Society of Nephrology.
According to Dr S C Tewari, director of nephrology and renal transplant at the Fortis Institute for Renal Sciences, the new biomarkers can be tested in a single blood sample. ‘‘It is a revolutionary finding and can help in saving the life of many patients,’’ said Tewari. He said serum creatinine, the primary biomarker for CKD is insensitive to early perturbations in renal function, particularly in patients without overt clinical CKD.
CKD affects 16% of the Indian population. It is associated with metabolic abnormalities and bone disease and is also an important risk factor for peripheral vascular disease, cardiovascular disease, stroke, all of which cause mortality. Hypertension and diabetes are key risk factors but do not fully help in identifying individuals at risk of developing CKD.
Said Dr Sandeep Mahajan, nephrologist, AIIMS, ‘‘All the existing diagnostic tests including eGRF and CKD-EPI are creatinine-based. The identification of the disease through this process is delayed and the new finding — if validated on Indian population — can bring a revolutionary change in treatment of CKD. We can use certain drugs and lifestyle modification such as weight control and dietary changes to prevent the disease.’’
He added the present results require further replication and testing in clinical trial settings as well as in costeffectiveness settings before being brought into the clinical arena.
Chronic Kidney disease (CKD)
CKD is associated with metabolic abnormalities and bone disease and is also an important risk factor for peripheral vascular disease, cardiovascular disease, stroke — all of which can be fatal 16 % suffers of Indian from population CKD
Available medical test
Glomerular Filtration Rate (GFR) is based on serum creatinine measurement. Half the kidney is damaged in most cases by the time the disease is diagnosed, say doctors
Predict CKD 10 years before its clinical onset
New CKD biomarkers validated through research
Protein which is the marker for atherosclerosis (thickening of arteries)
Hormone that affects salt handling by kidneys
B-type natriuretic peptide | Indicates heart damage in patients Benefits of early diagnosis
Certain medicines and lifestyle modification like weight control and dietary changes at an early stage can prevent the disease or delay the prognosis These new biomarkers were developed after prolonged research on 2,300 patients of American origin. Doctors say replication on Indians and cost-effectiveness needs to assessed

Kidney transplants cross blood group barrier

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Mumbai: It was love that prompted Nashik resident Meera Dhikale to donate one of her kidneys to her husband Fakira, but in the process the couple may well have changed the course of organ transplant medicine in India.     The transplant, conducted on September 2, had two noteworthy features: it was performed between persons with incompatible blood groups, and it was done without the mandatory removal of the recipient’s spleen. ‘‘Earlier, when we did such incompatible surgeries, it involved two major operations in the same session: the transplant itself and the splenectomy,’’ said Dr Bhupendra Gandhi, nephrologist with Jaslok Hospital, the only centre in the country to have performed 25 such transplants in the last seven years. ‘‘In Fakira’s case, for the first time in this country we used a drug called Rituximab to reduce the antibodies in his blood in place of the splenectomy. Thus we reduced the chances of Meera’s donated kidney being rejected by Fakira’s body.’’     This could be a way to increase the organ donor pool. India adds almost 1 lakh patients of chronic kidney disease every year, but there is a dearth of donors.
Pacemaker in brain helps cure OCD
In a first for Asia, Obsessive Compulsive Disorder (OCD) — a medical condition that results in repetitive behaviour such as handwashing, counting, checking or cleaning — has been treated with a pacemaker fitted in the brain. A team from Vimhans successfully implanted a pacemaker in the brain of an OCD patient, which “significantly reduced her peculiarities in just two weeks time”. P 13 ‘Incompatible’ transplants way forward? Mumbai: A successful kidney transplant in Mumbai on September 2 involved the donor and recipient having incompatible blood groups.     Such incompatible blood group donation — called ABO incompatible transplants — could just be the way forward even though some doctors point out that it has higher rejection rates than the matched transplant procedure and is more expensive. Mumbai’s Jaslok Hospital and CMC Hospital in Vellore are the only centres in the country to do these transplants.     Incompatible transplants are not new; Jaslok itself performed the first such transplant seven years ago. In 2006, Vikas R’s wife donated a kidney to him and he is doing well. ‘‘We had no one else among our blood relations who could donate a kidney to me. So we decided to go ahead with this new procedure,’’ said Vikas (name changed), who is also Dr Gandhi’s patient. Dr Sandeep Guleria AIIMS nephrologist, said, ‘‘ABO Incompatible transplants are a good way of increasing the donor pool, and procedure is not medically difficult.’’ Malathy Iyer | TNN

Genes can tell which kidney transplant recipients don’t need lifelong drugs

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Washington, May 27 (ANI): A pattern of genes could soon identify kidney transplant recipients that do not need immunosuppressive drugs for the rest of their lives, a new study has claimed.

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