In a study comparing equations that assess glomerular filtration rate and the risk of mortality and ESRD, a team of researchers have found that a newer equation, CKD-EPI, may prove more beneficial than the current standard, MDRD.  Data from 1.1 million adults from 40 countries showed that CKD-EPI more accurately predicted risk of death and kidney failure in people with chronic kidney disease. CKD-EPI and MDRD use the same variables of age, sex, race and serum creatinine, but apply different coefficients. With the CKD-EPI equation, fewer people were classified as having CKD. 92% of labs currently use MDRD, despite the fact that the equation misdiagnoses elderly people, women, and people with less muscle mass who do not have kidney disease. MDRD may also pass over patients with real kidney disease who happen to have low serum creatinine levels and a higher GFR. Though the authors of the study believe CKD-EPI is more reliable and could prove helpful in preventing and treating CKD, they say better filtration markers besides serum creatinine are still needed.

Sources:

Comparison of Risk Prediction Using the CKD-EPI Equation and the MDRD Study Equation for Estimated Glomerular Filtration Rate, Journal of the American Medical Association, May 9, 2012

LA BioMed’s Dr. Kalantar-Zadeh: Risk Prediction Equation for Death/End Stage Renal Disease, Eureka Alert, May 8, 2012

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A team of researchers from University of Alberta and University of Florida have shown that angiotensin-converting enzyme-2 or ACE2 can protect against diabetic complications, specifically heart damage, in diabetic mice. Their previous research demonstrated that ACE2 protects the kidneys as well. ACE2 protects by breaking down Angiotensin II, a hormone which contributes to high blood pressure and cardiovascular disease. In the latest study, diabetic mice without ACE2 experienced heart and vascular dysfunction.

The research team plans to study Type 1 and Type 2 diabetics to assess their blood levels of ACE2 and determine whether its protective benefits hold true for humans. Lead researcher, Dr. Gavin Oudit, is currently testing a genetically engineered version of ACE2, which he developed in the hopes of preventing diabetic complications of the kidneys, eyes and heart.

Sources:

An Ace in the Hole for Treating Diabetes, University of Alberta, May 16, 2012

Loss of Angiotensin-Converting Enzyme-2 Exacerbates Diabetic Cardiovascular Complications and Leads to Systolic and Vascular Dysfunction, Circulation Research, April 3, 2012

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A team of international researchers led by the Institute of Cancer Research in the UK have found two regions of the human genome linked to increased risk for the most common form of childhood kidney cancer, Wilms tumor. Scientists have suspected a genetic role in the rare disease because it can occur in siblings and twins. The ICR team analyzed DNA variants from Wilms tumor patients as well as healthy people in the UK and America. They noted that the two regions they identified have been linked to other diseases and cancers. Learning more about how these regions are involved in Wilms tumor should lead to better understanding of the disease and improved treatments in the future.

Source:

Scientists Find DNA Variants Linked to Childhood Cancer, The Institute of Cancer Research, April 29, 2012

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Scientists from Kidney Research UK have discovered a way to increase the success of kidney transplants from deceased donors by reviving the kidneys prior to transplantation using normothermic perfusion. Blood flow is reintroduced to the kidney via a special machine, effectively reversing the damage caused by storing the kidney on ice. The scientists believe kidneys treated with normothermic perfusion will perform sooner after transplantation, work better and last longer, with less likelihood of rejection.

This new treatment could increase the number of organs available from deceased donors. “Marginal” organs from donors with diabetes or hypertension or from donors who have suffered cardiac arrest are typically discarded, but this could change if the scientists are able to successfully revive such kidneys and assess their future performance prior to transplantation.

Source:

Revolutionary New Kidney Transplant Procedure, Medical News Today, March 8, 2012

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In an ongoing study, Northwestern Medicine and University of Louisville researchers have shown that it may be possible to eliminate the need for rejection drugs in kidney transplantation. The scientists paired living kidney donors with unrelated recipients with compatible blood type and a negative crossmatch. The kidney patients underwent radiation and chemotherapy treatments to prepare their bodies to receive specially processed bone marrow stem cells from their donors. Ideally, the stem cells grow in the patient’s marrow, creating a second bone marrow system. Patients received these stem cells one day after kidney transplantation and were eventually weaned off anti-rejection drugs after one year. Early results of the study are promising. The researchers hope that patients who are currently experiencing success will be able to stay off immunosuppressant drugs long-term. They plan to conduct a second study using patients with existing kidney transplants from living donors.

Source:

New Transplant Method May Allow Kidney Recipients to Live Life Free of Anti-Rejection Medication, Science Daily, March 11, 2012

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A team of researchers from University of Miami Miller School of Medicine and Xiamen University in China have shown that a combination of mesenchymal stem cell therapy and immune suppressing calcineurin inhibitors (CNIs) produces better short-term transplant outcomes than standard anti-rejection drugs and CNIs. Patients who received a transplant from a living relative were treated with their own mesenchymal stem cells or MSCs, which act as natural immune cell suppressors. Six months after transplant, they experienced fewer acute rejections and better kidney function and had lower risk of infections. They also recovered faster from acute rejection. After one year, survival and rejection rates were comparable with patients who had received the standard induction therapy. Though the benefits of the stem cell therapy appear to have been short-lived, the researchers view the results as a step forward. Dr. Robert Provenzano, Chair of the Department of Nephrology, Hypertension, and Transplantation at St. John Providence Health System said, “I see this as the continued evolution of transplant medicine. It’s very exciting to be able to use your own natural cells instead of more toxic medications.”

Source:

Stem Cell Therapy Could Boost Kidney Transplant Success: Study, Health Day, March 20, 2012

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Mount Sinai School of Medicine researchers studying the genetic material of mice with HIV and renal fibrosis have discovered that a regulator protein known as HIPK2 plays a part in scarring of the kidney. Using algorithms and special software developed at Mount Sinai, the scientists were able to pinpoint HIPK2. Their studies showed that upregulation of HIPK2 led to disease, while eliminating HIPK2 alleviated fibrosis and improved kidney function in the mice. They plan to continue to explore HIPK2 as a novel therapeutic target for kidney disease.

Source:

Promising New Drug Target for Kidney Disease, Science Daily, March 12, 2012

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