Women Marching to the Kidney’s Beat

In keeping with my theme of March being Women’s History Month – minus the history – and National Kidney Month, today’s blog will be about those women around the world who have contributed to Chronic Kidney Disease knowledge. Two such women, Dr. Vanessa Grubbs and Dr. Bessie Young, were highlighted in February’s tribute to Black History Month and women in nephrology. Thank you again, ladies, for all you do for CKD patients.

When you realize the study of nephrology as we know it is only a little over 50 years old (Incredible, isn’t it?), you’ll understand why I raided The International Society of Nephrologists (ISN) October 2010 issue at http://www.theisn.org/images/ISN_News_Archive/ISN_News_35_October_2010_LR.pdf for the following information. I’ve added notes for clarification when needed.

United States: An accomplished researcher and physician, Josephine Briggs is a former ISN councilor and former councilor and Secretary of ASN (American Society of Nephrologists). She is the former director of the Division of Kidney, Urologic, and Hematologic Diseases, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), US National Institutes of Health (NIH), and was responsible for all NIH funded renal research in the 1990s. Today, she is Director of the National Center for Complementary and Alternative Medicine. She maintains a lab at NIDDK, researching the renin-angiotensin system, diabetic nephropathy, circadian regulation of blood pressure, and the effect of antioxidants in kidney disease.

Europe: Rene Habib, who passed away (in 2010), was a truly pioneering renal pathologist. She provided the first description of many renal diseases and worked with ISN founder Jean Hamburger to establish nephrology as a new discipline in Europe. Her contributions and energy were central to establishing pathology as an essential and integrated component of this new field worldwide.

India: Vidya N. Acharya was the first woman nephrologist in India and trained some 150 internists in nephrology. For three decades, her research focused on Urinary Tract Infection. She was a consultant nephrologist at Gopalakrishna Piramal Memorial Hospital and director of the Piramal Institute for training in Dialysis Technology, Renal Nutrition and Preventive Nephrology in Mumbai. She received a Lifetime Achievement Award from the Indian Society of Nephrology in 2007.

China: HaiYan Wang is the Editor of Kidney International China and has been an ISN and ASPN (American Society of Pediatric Nephrology) councilor and Executive Committee member as well as a member of the editorial boards of Chinese and international renal journals. She has published over 200 articles and books in Chinese and English. She graduated from Beijing Medical University. After three years of internship, she became a nephrology fellow at the First Hospital Beijing Medical University. Since 1983, she moved on to Chief of Nephrology and later became Professor of the Department of Medicine at the First Hospital Beijing. She has been Chairman of the Chinese Society of Nephrology and is Vice President of the Chinese Medical Association. Her unit is the largest training site for nephrology fellows in China.

United Arab Emirates: Mona Alrukhaimi is co-chair of the ISN GO (International Society of Nephrologists Global Outreach Programs) Middle East Committee, and the leader of the KDIGO (Kidney Disease: Improving Global Outcomes) Implementation Task Force for the Middle East and African regions. She is also a Member of the Governing Board of the Arab Society of Nephrology and Renal Transplantation. Since 2006, she has actively organized World Kidney Day activities in the United Arab Emirates and prepared the past four rounds of the ISN Update Course in Nephrology. Having played an active role in the Declaration of Istanbul on Organ Trafficking and Transplant Tourism, she contributes to serve on the custodian group and takes part in the Steering Committee for Women in Transplantation under The Transplantation Society.

South Africa: Saraladevi Naicker carried the weight of setting standards and provided the first training program for nephrologists in Africa over the last decade (Remember this article was published in 2010.). Specializing in internal medicine, she trained in Durban and later helped set up a Transplant Unit in the Renal Unit at Addington Hospital. In 2001, she became Chief Specialist and Professor of Renal Medicine at University of Witwatersrand in Johannesburg and in 2009 was appointed Chairman of Medicine at Wits. She is proud that there are currently (Again: in 2010) six postgraduate students from Africa studying for higher degrees in nephrology under her tutelage. Over the years, Naicker’s unit has served as the main training site for young nephrologists from across Africa and many individuals trained by her are currently practicing in Africa. Naicker received the Phillip Tobias Distinguished Teaching Award in 2006, an honor which bears testimony to her teaching prowess.

Israel: Batya Kristal is Professor of Medicine at the Technion Medical School, Haifa. She is the first woman to direct an academic nephrology department in Israel. At the Western Galilee Hospital, Nahariya, she leads a translational research project focusing on different aspects of oxidative stress and inflammation. She also heads a large clinical nephrology and dialysis program, which uniquely integrates staff and patients from the diverse ethnic population of the Galilee. Founder of the Israeli NKF, initiator and organizer of the traditional annual international conferences at Nahariya, she is truly an important role model for women in the country.

Australia: After holding resident positions in medicine and surgery and as registrar in medicine at the Baragwanath Hospital in Johannesburg, Priscilla Kincaid-Smith was director and physician of Nephrology at Royal Melbourne Hospital and Professor of Medicine at University of Melbourne. She demonstrated overwhelming evidence of the link between headache powders and kidney damage and contributed to research on the links between high blood pressure and renal malfunction. The only female ISN President so far, she was named Commander of the Order of the British Empire “for services to medicine”, was awarded the David Hume Award from the National Kidney Foundation (USA) and became a Companion of the Order of Australia.

There’s very little room for me to add my own words this week so I’ll use them to add myself as a lay woman in nephrology (What hubris!) to let you know that the edited digital version of SlowItDownCKD 2016 will be out on Amazon later this week. You guessed it: in honor of National Kidney Month.

 

Until next week,

Keep living your life!

It’s the Funniest Thing…

You want to know about Chronic Kidney Disease brain fog?  Let me tell you about Chronic Kidney Disease brain fog.  I wrote a book about the Book Coverexperiences of the newly diagnosed CKD patient based upon my own experience – What Is It and How Did I Get It? Early Stage Chronic Kidney Disease.  Nice job on that one, Gail.

Four years later, I published The Book of Blogs: Moderate Stage Chronic Kidney Disease, Parts 1 & 2… with neither a topic listed for each blog nor an index. Well, how the heck are you supposed to find the information you’re looking for??? And it’s taken me this long to figure that out. Take it from me, CKD brain fog exists.

So, what is this CKD brain fog of which I speak? According to integrative medicine expert Dr. Isaac Eliaz, when experiencing brain fog:

“…people feel as if there is a thick fog dampening their mind. While the medical and mental health establishments don’t generally recognize brain fog as a condition, it’s a surprisingly common affliction that affects people of all ages. Symptoms include pervasive absentmindedness, muddled thought processes, poor memory recall, difficulty processing information, disorientation, fatigue, and others.”

You can read more at http://www.rodalenews.com/brain-fog.

It was www.naturopathconnect.com (a link that sometimes works, sometimes doesn’t) that offered me my first insight into how our kidneys and brain fog are connected.

bottled water“Make sure your liver and kidneys are not overloaded or congested. When your liver and kidneys are not functioning well, they are less able to clear your system of the multitude of toxins that float around in your bloodstream. When your body is overloaded with toxins, your brain suffers as well….Dehydration may be a key factor in less-than-optimal kidney function, so water is essential to keep the kidneys in tip-top shape.”

Got it – toxins.  Uh, what toxins?  And how do they affect the brain, I wondered.  Back to researching.

Dr. Martin Morrell of healthtap.com offered an explanation. However, this is not an endorsement of him or the site.  I am not a fan of asking online doctors unfamiliar with your particular medical history for advice.

“… if your blood urea increases, which is supposed to be cleared by your kidneys, this ‘poison’ will affect the ability of the brain to work properly.”

Oh, blood urea. Well that explains it. But how can I explain blood urea?  I’ll allow the experts to do that.

http://www.patient.co.uk/health/routine-kidney-function-blood-test has the simplest explanation.

“Urea is a waste product formed from the breakdown of proteins. Urea is usually passed out in the urine. A high blood level of urea (‘uraemia’) indicates that the kidneys may not be working properly, or that you are dehydrated (have a low body water content).”

In the U.S., we call this test B.U.N. or Blood Urea Nitrogen Blood Test.  So as I understand it, if your protein intake is high, more urea is produced.  But since your kidneys are already compromised by CKD, the toxins remaining in your body are not eliminated as well and are still in the blood that flows through your brain.  Okay, that’s logical.protein

The more urea remaining in your system, the more sluggish your brain.  It does sound like a perfectly formed ‘if-then’ equation from probability theory. The only difference here is that this is not a theory, but, rather, what we may encounter as CKD patients.

What to do?  What to do?  Obviously, keeping our protein intake low will help.  My renal diet limits me to five ounces of protein a day. I rarely ingest more protein than that. Well, bully for me!

So how else can I alleviate my sometimes brain fog…especially since I’m working on three books at the same time as well as wanting to make some sort of index for the books mentioned above?

I was all over the web on this one and found that besides what I was already doing for my CKD, I could also avoid heavy metal (and I always thought that was a kind of music) exposure, use a blue light, get myself some natural sun light, check my medication side effects and lots more.

Dr. Isaac Eliaz who wrote the RodaleNews article in 2013 suggests several more natural remedies:

  1. Improve your diet and digestion.
  2. Detoxify.
  3. Support cell power.water to cells
  4. Control stress.
  5. Exercise.

I can agree with most of the items on Dr. Eliaz’s list no matter what’s causing the brain fog, but with CKD I’d talk over detoxing and/or taking supplements to support cell power with my nephrologist before actually following that advice.  Some nephrologists are dead (Yikes! Wrong word choice) set against detoxifying while others have a more eclectic approach to gentle detoxifying.

Supplements are a whole other story. There are so many different approaches here that I usually research whichever supplement I’m considering, then bring that research to my nephrologist to talk it over with him. Result: some supplements I agreed weren’t looking so good for me after our talk; others, he agreed were well worth a try.

Bahar Gholipour of Live Science at http://www.livescience.com/45502-foggy-brain-causes.html writes about other possible causes of brain fog. She includes multi-tasking, pregnancy, chemotherapy, menopause, and chronic fatigue syndrome among the causes. If any one of these causes exists in your life, maybe it’s not CKD brain fog you’re experiencing… or maybe it is… or maybe it’s a combination.  No one seems to be certain just what can cause brain fog, although I’m pretty comfortable with the explanations I’ve offered above.

It’s real.  Brain fog could be affecting you, especially if you have CKD.  And from what I’ve read, once you’ve gotten your CKD slowed down as much as possible, the other ‘fixes’ are easy.Kidney Arizona

Here’s a quick reminder about The National Kidney Fund of Arizona’s Path to Wellness screening on Saturday, September 19, 2015 at the Indo American Cultural Center. This consists of free blood and urine testing, which is evaluated onsite to assess for the risk of diabetes, heart and kidney diseases, and chronic disease management education, plus overall health assessment and one-on-one consultation with a physician for the screenees. A follow-up 6-week series of Healthy Living workshops that teach chronic disease self-management skills is then offered.

Just like last week, one last thing: P2P’s Chronic Illness Buy & Sell page is on Facebook IMG_1398at https://www.facebook.com/groups/P2PBuy.Sell/.  It will be the place to go for anything chronic illness related. My first book is advertised there and both The Book of Blogs: Moderate Stage Chronic Kidney Disease books will be soon, too.

Until next week,

Keep living your life!

It’s – Almost – Not Science Fiction Anymore!

If you look on the blogroll to the right, below the calendar, you’ll see the American Society of Nephrology included.  Personally, I’m thankful this organization was one of the first to acknowledge my blog. As a Chronic Kidney Disease patient, I’m thankful they exist to keep us updated on the latest findings about our disease (among other things). This is the largest organization to deal with kidney disease.  That would explain why I periodically look at their site to see if there’s anything to share with early stage patients.  On Wednesday, their tweet referred to an article that could make kidney patients who are dreading eventual dialysis cry – for joy, that is.  I freely admit I am one of those.

Could patients’ own kidney cells cure kidney disease?

Reprogrammed kidney cells could make transplants and dialysis things of the past

  • Patients’ own kidney cells can be reprogrammed and used as therapy against kidney disease
  • Cells can easily be collected from the urine
  • 88,000 patients are waiting for a kidney transplant in the United States, and they wait for an average of 3 to 5 years

Washington, DC (July 27, 2011) — Approximately 60 million people across the globe have chronic kidney disease, and many will need dialysis or a transplant. Breakthrough research published in the Journal of the American Society Nephrology  (JASN) indicates that patients’ own kidney cells can be gathered and reprogrammed.  Reprogramming patients’ kidney cells could mean that in the future, fewer patients with kidney disease would require complicated, expensive procedures that affect their quality of life.

In the first study, Sharon Ricardo, PhD (Monash University, in Clayton, Australia) and her colleagues took cells from an individual’s kidney and coaxed them to become progenitor cells, allowing the immature cells to form any type in the kidney. Specifically, they inserted several key reprogramming genes into the renal cells that made them capable of forming other cells.

In a second study, Miguel Esteban, MD, PhD (Chinese Academy of Sciences, in Guangzhou, China) and his colleagues found that kidney cells collected from a patient’s urine can also be reprogrammed in this way. Using cells from urine allows a technology easy to implement in a clinic setting. Even better, the urine cells could be frozen and later thawed before they were manipulated.

If researchers can expand the reprogrammed cells—called induced pluripotent stem cells (iPSCs)—and return them to the patient, these IPSCs may restore the health and vitality of the kidneys. In addition to providing a potentially curative therapy for patients, the breakthroughs might also help investigators to study the causes of kidney disease and to screen new drugs that could be used to treat them.

In an accompanying editorial, Ian Rogers, PhD (Mount Sinai Hospital, in Toronto, Ontario, Canada) noted that “together, these two articles
demonstrate the feasibility of using kidney cells as a source of iPSCs, and efficient production of adult iPSCs from urine means that cells can
be collected at any time.”

Just as exciting, the ease of collection and high frequency of reprogramming described in these articles may help improve future therapies in many other areas of medicine.

###

Dr. Ricardo’s co-authors include Bi Song, Jonathan Niclis, Maliha Alikhan, Samy Sakkal, Aude Sylvain, Andrew Laslett, Claude Bernard (Monash University, in Clayton, Australia); and Peter Kerr, (Monash Medical Centre, Australia, in Clayton, Australia).

Dr. Esteban’s co-authors include Ting Zhou, Christina Benda, Yinghua Huang, Xingyan Li, Yanhua Li, Xiangpeng Guo, Guokun Cao, Shen Chen,
Duanqing Pei (Chinese Academy of Sciences, in Guangzhou, China); Sarah Duzinger (University of Natural Resources and Life Sciences); Lili Hao, Jiayan Wu (Chinese Academy of Sciences, Beijing, China); Yau-Chi Chan, Kwong-Man Ng, Jenny Cy Ho, Hung-Fat Tse (University of Hong Kong, Pokfulam, in Hong Kong, HKSAR, China); Matthias Wieser (University of Natural Resources and Life Sciences and Austrian Center for Industrial Biotechnology (ACIB), in Vienna, Austria); Heinz Redl (Austrian Cluster for Tissue Regeneration, Vienna, Austria); and Johannes Grillari, Regina Grillari-Voglauer ( University of Natural Resources and Life Sciences and Evercyte GmbH, in Vienna, Austria).

The articles, entitled “Generation of Induced Pluripotent Stem Cells from Human Kidney Mesangial Cells” and “Generation of Induced
Pluripotent Stem Cells from Urine,” as well as the editorial “Induced Pluripotent Stem Cells from Human Kidney,” are online at http://jasn.asnjournals.org/ doi 10.1681/ASN.2010101022, doi 10.1681/ASN.2011010106 and 10.1681/ASN.2011050501

The content of this article does not reflect the views or opinions of The American Society of Nephrology (ASN). Responsibility for the information and views expressed therein lies entirely with the author(s). ASN does not offer medical advice. All content in ASN publications is for informational purposes only, and is not intended to cover all possible uses, directions, precautions, drug interactions, or adverse effects. This content should not be used during a medical emergency or for the diagnosis or treatment of any medical condition. Please consult your doctor or other qualified health care provider if you have any questions about a medical condition, or before taking any drug, changing your diet or commencing or discontinuing any course of treatment. Do not ignore or delay obtaining professional medical advice because of information accessed through ASN. Call 911 or your doctor for all medical emergencies.

Founded in 1966, and with more than 12,000 members, the American Society of Nephrology (ASN) leads the fight against kidney disease by
educating health professionals, sharing new knowledge, advancing research, and advocating the highest quality care for patients.

Be sure to take into account the “potentially,””could mean,” and “if” included in the article.  This is not a fait accompli, but we’re certainly closer to avoiding dialysis than we’ve ever been before. [not so silent happy dance in front of the computer] And make sure you read ASN’s disclaimer at the end of the article.  You’ll also see their own information about their society at the end of the article.

If you’re interested in seeng my source, use this URL:  http://www.eurekalert.org/pub_releases/2011-07/ason-cpo072711.php

I am thrilled whenever I find new information that gives me hope.  This is a thrilling day.

Until Tuesday,

Keep living your life!

Published in: on July 29, 2011 at 10:57 am  Leave a Comment  

Resources, Anyone?

In the final edit of my book, I realized just how many resources there are out there for us.  I’ll try to give you a taste of each in the next few blogs.

For example, today I did a plain old ordinary Yahoo search for “CKD” and came up with the following address:

http://www.spacedaily.com/reports/Winding_back_the_clock_with

_kidney_stem_cells_999.html

I followed  it and ended up at the following article from SpaceDaily.com of all places.  They call themselves “your portal to space” and usually report on the newest developements in the space industry, but here we have our disease.  Be sure to read the last paragraph at least twice.

Winding back the clock with kidney stem cells


In
the short-term, the Monash researcher plans to continue work on the
kidney stem cells to study how environmental factors influence how
kidney cells behave, tests drugs for their ability to reduce kidney cyst
formation and cell proliferation, and better understand how genetic
kidney disorders develop in the first place.

by Staff Writers

Monash, Melbourne (SPX) May 20, 2011

Stem cell research courts both controversy and support in the community- depending on your viewpoint. Now, for the first time, scientists at Monash University’s
Immunology and Stem Cell Laboratories (MISCL) have shown that they can
make human stem cells from healthy adult kidneys without working on human embryos, circumventing ethical concerns around this research.

This achievement will allow group leader Associate Professor Sharon Ricardo and her team to model genetic kidney diseases in the laboratory and tease out the mechanisms that control these difficult-to-treat disorders.

“We’re taking human kidney cells and winding back the clock to make their early precursors,” Associate Professor Ricardo said.

For the challenging project, which was published in the Journal of the American Society of Nephrology, the Monash researchers started with healthy  adult kidney cells, which they reprogrammed back to an embryonic-like state, then compared these kidney stem cells with off-the-shelf embryonic stem cells, and showed that both could form different embryonic tissue types, with their genetic features preserved.

“These kidney cells had their slate wiped clean. Now that gives us the opportunity to change that kidney precursor into all kidney cell types,” Associate Professor Ricardo said.

In collaboration with Professor Peter Kerr from Monash Medical  Centre, the research team has now generated four stem cell lines from  patients with polycystic kidney disease and Alport syndrome, two leading  genetic kidney disorders.

“As these stem cells can divide indefinitely in a culture dish, we can make a limitless source of patient-specific stem cells, make kidney cysts and screen drugs on those cells,” Associate Professor Ricardo said.

“Our ultimate goal is to make off-the-shelf mature kidney cells that patients can use for drug testing and disease modelling.”

Associate Professor Ricardo, who is approaching pharmaceutical companies to screen drugs on the kidney stem cells, believes that this personalised medicine approach will produce safer medicines in the future.

But in the short-term, the Monash researcher plans to continue work on the kidney stem cells to study how environmental factors influence how kidney cells behave, tests drugs for their ability to reduce kidney cyst  formation and cell proliferation, and better understand how genetic
kidney disorders develop in the first place.

Associate Professor Ricardo, who was funded by the Australian Stem Cell Centre and Alport Foundation, Australia, collaborated with six Monash researchers including lead author Bi Song
and Professor Claude Bernard; Professor Peter Kerr, Monash Medical Centre; and Dr Andrew Laslett from CSIRO Molecular and Health Technologies, also in Clayton.

As someone who still isn’t sure how she developed CKD, I’m really intereted in the genetic aspect of this research.  And environmental factors in developing the disease?  What a marvelous idea – figure out what we’re doing to our environment that ends up making us ill and stop doing it.  As I see it, medical thinking has changed dramatically in the last few years.  It’s not just treat the symptoms anymore, but find the cause and prevent the disease.  Gives me hope.

Until Tuesday,

Keep living your life.

Published in: on May 20, 2011 at 12:36 pm  Leave a Comment