World Kidney Day

[stauffenberg]

With respect to the relationship between high blood pressure and kidney disease, this is currently a topic of debate within the medical community between those who think that high blood pressure causes kidney disease (the traditional view, which is still preserved in most patient information), and those who think that high blood pressure is just one symptom of declining renal function (which has not yet made its way into most patient information).  The debate may be resolved one way or the other, or it might be solved by some compromise, such as noting that the relation is cause and effect in one case and effect and cause in the other.  My general point, though, is that in most cases there is little the patient can do to prevent kidney failure if it is coming, although it may be delayed.  It is not like saying you can save your teeth if only you remember to brush regularly and visit the dentist twice a year, which was the impression I got from the initial posting.

[Sluff]

With respect to the relationship between high blood pressure and kidney disease, this is currently a topic of debate within the medical community between those who think that high blood pressure causes kidney disease (the traditional view, which is still preserved in most patient information), and those who think that high blood pressure is just one symptom of declining renal function (which has not yet made its way into most patient information).  The debate may be resolved one way or the other, or it might be solved by some compromise, such as noting that the relation is cause and effect in one case and effect and cause in the other.  My general point, though, is that in most cases there is little the patient can do to prevent kidney failure if it is coming, although it may be delayed.  It is not like saying you can save your teeth if only you remember to brush regularly and visit the dentist twice a year, which was the impression I got from the initial posting.

I honestly believe that both theory's are correct.


Good Luck Kitkatz.

[kitkatz]

Toastmasters liked the boa and the little speech I gave on Organ donation and to please sign their donor cards. I caught the eye of a hospital dietician who wanted to know what I knew. I told her about IHD.com.  She wanted a patient's view.

[Sluff]

Toastmasters liked the boa and the little speech I gave on Organ donation and to please sign their donor cards. I caught the eye of a hospital dietician who wanted to know what I knew. I told her about IHD.com.  She wanted a patient's view.

That's great Kit, you are a great speaker. 

[KT0930]

Yay, kit!!  (though I'm sure you got lots of this today).

[rose1999]

Well done Kit  any  of the event - like you in your boa?? 

[kitkatz]

There are pics I have to wheedle them off of the lady who had the camera.

[okarol]

Toastmasters liked the boa and the little speech I gave on Organ donation and to please sign their donor cards. I caught the eye of a hospital dietician who wanted to know what I knew. I told her about IHD.com.  She wanted a patient's view.

Great Kit! I admire you for your public speaking and speech writing talent! 

[Bill Peckham]

Stauffenberg what do you make of these two abstracts? I'll cross post from my blog http://www.billpeckham.com/from_the_sharp_end_of_the/2008/03/the-impact-of-t.html

the links get stripped when I cut and paste to follow the links to the abstracts go to the blog


The impact of truly good news

RenalWeb links to an abstract published by the Journal of the American Society of Nephrology which showed that the progression to stage 5 CKD can be markedly slowed:

    In summary, multidrug treatment titrated to urinary protein level can be safely and effectively applied to normalize proteinuria and to slow the loss of renal function significantly, especially among patients without type 2 diabetes and with otherwise rapidly progressing chronic nephropathies.

Simply stated by using medications to control one of the symptoms of kidney disease - protein in the urine - the progression of the disease is slowed. RenalWeb also links to an advance abstract from Kidney International that reports results from the GUARD study which looked specifically at type 2 diabetics. They found that one could decrease albuminuria (protein in the urine) with a combination of drugs. This research seems very hopeful. The JASN article reports at a four year follow-up "3.6 versus 30.4% reached ESRD".

Every year in the united states about 80,000 people transition to stage 5 CKD, this is slightly more than the number die or stop dialysis. These numbers are a bit tricky, I think in both cases they exclude those who do not last 3 months on dialysis. In general the rate of growth in the US dialysis census has slowed (from 6% early in this decade (the naughts?) to currently about 2 or 3%), while the mortality rate has remained stubbornly high (about 22% overall). What's happening isn't entirely clear but if you slow people's progression to stage 5 you will slow the dialysis program's growth. If the results of these studies scale up - impact stays the same as the number of people are added - then it could cause contraction in the size of the US dialysis population.

If the number of people transitioning to dialysis was cut from 80,000 to 40,000 the size of the us dialysis population would go from about 350,000 currently to about 200,000 in about 10 years.

A shrinking need for dialysis. That's not something I've heard people talk about.

[willieandwinnie]

KT, I also copied and pasted your letter and added some stuff in regards to Len and sent it to all our friends and past co-workers. I hope this will at least get one person to think about ESRD and what patients have to go through. Thanks. 

[KT0930]

My mom forwarded me a response from one of their old friends (he's known my parents since before I was born, I believe). He has Type II diabetes and was going to make sure they check his kidney function at every annual physical from now on.