Nephrology
Article Abstract:
About 90,000 patients in the US require dialysis for kidney disease. A major focus of the field of nephrology is understanding the factors that lead to the progressive failure of the diseased kidney. One extremely important risk factor for kidney failure is high blood pressure (hypertension); the control of hypertension can slow or, in some cases even prevent, the progression of kidney disease. Some researchers suspect that the regulation of dietary protein might help to slow the progression of kidney disease, but definitive evidence supporting the benefit of a protein-restricted diet has not yet been presented. There should be no widespread adoption of dietary measures until such scientific support becomes available. In cases of kidney insufficiency, the body's major nitrogen waste product, urea, may accumulate to high levels in the blood. This condition, called uremia, may ultimately cause problems with a variety of other organs of the body. However, the mechanisms by which the damage to the other organs takes place are still poorly understood. Nephrologists are examining the changes that occur in the body's balance of salt and water, the synthesis and breakdown of proteins, and the interrelationship of the many glands of the body, in an effort to understand the consequences of uremia. Parathyroid hormone, secreted by the parathyroid glands, is increased in the blood of patients with kidney failure. It is thought that this hormone, which normally controls the return of calcium from the bone into the blood, may play an important role as a uremic toxin'. While normal levels of this hormone are critical for health, abnormally high levels can result in disturbances of the brain and muscle, as well as abnormalities of the heart and the immune system. (Consumer Summary produced by Reliance Medical Information, Inc.)
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1991
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Nephrology
Article Abstract:
Research on restricting dietary protein, hemolytic uremic syndrome caused by Escherichia coli (E. coli), uremic toxicity and differences in dialysis technique is discussed. Research on restricting protein intake in patients with kidney insufficiency is inconclusive, though results of a large-scale study sponsored by the National Institute of Diabetes and Digestive and Kidney Diseases are expected to be released. Diarrhea and kidney failure were associated with a strain of the bacteria E. coli found in undercooked hamburgers in Washington in 1993. Some of the affected children required dialysis and two died. Uremic toxicity is caused by an excess of wastes in the blood and is associated with kidney failure. The condition appears to be associated with excess calcium in the cells. Treatment with calcium channel blockers is being investigated. Patients treated with dialysis in the US have a lower five-year survival rate than patients in Japan and Europe. Several factors may be responsible for this difference. Patients are treated longer in Europe than in the US and dialysis machines are 20% larger in Europe.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1993
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Nephrology
Article Abstract:
Captopril may reduce significantly serum creatinine levels in insulin-dependent diabetics. The Diabetes Control and Complication Trial demonstrated that intensive insulin therapy may slow development of diabetic neuropathy, retinopathy and nephropathy. The National Institute of Diabetes and Digestive and Kidney Diseases formulated recommendations to curtail the progression of chronic renal disease including changes in dietary protein intake, lowering of blood pressure and treatment with ACE inhibitors, and intensive insulin therapy for insulin-dependent diabetics. Genetic causes of kidney diseases are being explored.
Publication Name: JAMA, The Journal of the American Medical Association
Subject: Health
ISSN: 0098-7484
Year: 1995
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