Wednesday, July 4, 2012

Singing the Blues

American Idol season 11 winner Phillip Phillips recently underwent a six and a half hour surgery to remove several kidney stones.  Reportedly Phillips underwent 8 procedures between January and May 23rd the finale date of Idol.  Among the 8 procedures one reportedly included a ureteral stent which helped provide time for him to complete Idol but was complicated by stent encrustation.  Phillips tolerance for pain and desire to win  allowed him to delay things until this most recent “reconstructive kidney surgery”.
Nephrolithiasis is a common disease that is estimated to produce over $2 billion in medical costs in the United States yearly.  Renal colic affects over 1 million people each year and accounts for approximately 1% of all hospital admissions.  The lifetime prevalence of nephrolithiasis is approximately 12% for men and 7% for women in the United States, while those who have a family member with a history of stones doubles these rates.
For our local fans, Phillips appears to have made a full recovery and will be in Nassau Coliseum this summer.

Don't fear, there is hope!
Nutrition to Prevent Kidney Stones!

Tuesday, May 29, 2012

On Second Thought.... Intensive Glucose Control Won't Necessarily Prevent Renal Impairment

Meta-Analysis: Intensive Glucose Control Won't Necessarily Prevent Renal Impairment

Patients with type 2 diabetes won't necessarily escape renal complications with intensive glucose control, according to a meta-analysis of seven trials, published in the Archives of Internal Medicine.

Researchers examined renal outcomes — both surrogate (albuminuria) and clinical (creatinine doubling, end-stage renal disease, and death from renal disease) — in some 28,000 patients randomized to intensive or standard glycemic control. They found that although albuminuria was less likely with intensive control, the rate of clinical renal outcomes was roughly the same in the two groups.

One commentator argues that the studies included in the analysis were of too brief duration to provide definitive results. Other commentators point out that intensive control with multidrug regimens carries its own potential harms, including possibly higher cardiovascular risks, and that there are 50 CV deaths for every kidney-related death in patients with type 2 diabetes.

Tuesday, April 10, 2012

DaVita Launches New Educational Website

DENVER—DaVita Inc. today announced the launch of its Kidney Smart website,, for anyone with questions about chronic kidney disease (CKD).

The website offers educational information for individuals affected by CKD at no cost and is recommended for potential patients, caregivers, or anyone looking to learn more about the disease and its risk factors.

Diabetes is the number one cause of kidney failure, followed by high blood pressure. Individuals with cardiovascular disease, obesity, high cholesterol, and those over age 60 or with family history of the disease are also at risk. Other high-risk groups for kidney disease include African Americans, Hispanics, Native Americans, Pacific Islanders and Asian Americans.

“Our goal is to de-mystify kidney disease,” explained Ben Harber, senior director of clinical operations for DaVita VillageHealth. “That’s why DaVita designed a website that answers the questions most patients ask when they are diagnosed with kidney disease.”

Monday, April 9, 2012

Chinese Teen Sells Kidney For iPad And iPhone

An iPhone and iPad were worth more to a Chinese teenager than his kidney, according to a report Friday from China's Xinhua news agency. Now five people in southern China face charges of illegal organ trading.
The 17-year-old, surnamed Wang, received about $3,500 for his kidney, which was removed and delivered to a recipient last April. Wang's mother grew suspicious when her son returned home with the costly new gadgets, and his confession soon followed. Xinhua says the teen is now suffering from "renal insufficiency" — a decreased level of kidney function — and that his condition is deteriorating.
The five charged include the surgeon, as well as the broker, who was reportedly penniless and hounded by gambling debts. Another of those charged was tasked with hunting for donors through online chat rooms, Xinhua says, and another with leasing the operating room. Together, they shared the rest of the $35,000 received for the organ after giving Wang his share.
The case is stirring alarm in China as citizens worry about increasing consumerism, particularly among the young, The Associated Press says.
Also alarming is the enormous gap between people needing transplants in China and donors, which Xinhua says has led to a huge black market for organs.

Thursday, April 5, 2012

ASN Weighs In on Overutilization and the Choosing Wisely Campaign

An initiative of the ABIM Foundation, Choosing Wisely is focused on encouraging physicians, patients and other health care stakeholders to think and talk about medical tests and procedures that may be unnecessary, and in some instances can cause harm.

To spark these conversations, nine specialty societies created lists of "Five Things Physicians and Patients Should Question" — evidence-based recommendations that should be discussed to help make wise decisions about the most appropriate care based on a patients’ individual situation.

American Society of Nephrology's Contribution

Top 5 List

1. Don't perform routine cancer screening for dialysis patients with limited life expectancies without signs or symptoms unless they are transplant candidates. This includes mammography, colonoscopy, PSA testing, and pap smears. It is neither cost-effective nor does it improve survival.

2. Don't administer erythropoiesis-stimulating agents to chronic kidney disease patients with hemoglobin levels greater than or equal to 10 g/dl without symptoms of anemia. ESAs have no survival or cardiovascular disease benefit and may be harmful. They should be used to maintain hemoglobin at lowest levels that minimize need for transfusion.

3. Avoid nonsteroidal anti-inflammatory drugs in people with hypertension or heart failure or chronic kidney disease of all causes, including diabetes. This can elevate blood pressure, make antihypertensive drugs less effective, cause fluid retention and worsen kidney function. Acetaminophen, tramadol, or short-term narcotic analgesics may be safer.

4. Don't place peripherally inserted central catheters in stage III-V chronic kidney disease patients without consulting nephrology. Excessive venous puncture damages veins. PICC lines and subclavian vein puncture can cause venous thrombosis and central vein stenosis.

5. Don't initiate chronic dialysis without ensuring a shared decision-making process between patients, families, and physicians. Limited observational data suggest survival may not differ for older adults with multiple co-morbidities who initiate chronic dialysis versus those who manage their disease conservatively.

Thursday, February 16, 2012

Warren Buffett’s Berkshire Hathaway Adds DaVita to Portfolio

It was recently revealed that Warren Buffet's Berkshire Hathaway has taken a new stake in a company I have a feeling a couple of you have heard of called DaVita. For those who do not know, DaVita Inc, a dialysis services company in the United States, specializing in administrative services to outpatient dialysis centers, as well as providing acute inpatient dialysis and related laboratory services in hospitals. 

A total of 2,684,500 shares of DaVita were purchased in the fourth quarter of 2011, and was worth approximately $203 million ($203,512,000) as of 12/31/2011.