Biopeer

Kidney research makes progress

In a possible breakthrough, American scientists have found a gene to be the cause of a severe, early-onset form of kidney disease and renal failure in children. The scientists, from the University of Michigan Medical School, examined blood samples from 26 families all over the globe where children had been diagnosed with steroid–resistant nephrotic syndrome. They found mutations in the phospholipase C epsilon (PLCE1) gene in 12 children with the disease while there were no mutations in the control subjects of the study. With two children from Israel and Turkey having been cured of severe nephrotic syndrome, the researchers believe that if treatment can be administered early, the defects caused by PLCE1 can be surmounted.

Meanwhile, diabetics afraid that drugs that lower their blood pressure can give them kidney disease can breathe a sigh of relief. Researchers from the Mario Negri Institute for Pharmacological Research, Italy, have determined that ACE inhibitors lessen the chances of patients developing diabetes-related kidney disease. The findings were based on a study conducted on 1,204 volunteers suffering from type 2 diabetes and high blood pressure. The researchers observed that taking an ACE inhibitor either alone or with a calcium channel blocker decreased the levels of microalbuminuria, the first indicator of kidney disease.

On the other hand, American researchers from the UT Southwestern Medical Center, Dallas, have determined that regular intake of topiramate can increase one’s chances of developing calcium phosphate kidney stones. At the end of the study, the largest cross sectional analysis of topiramate’s long–term effects, the researchers found that taking topiramate for even a year makes the kidney unable to excrete acid and causes acid to build up in the blood. The researchers hope that the results will aid others to find ways to prevent kidney stone formation by topiramate.

Diagnostic research underway for neurodegenerative and kidney diseases

Significant studies conducted by American researchers have increased the potential of diagnostic testing.

Researchers at the University of Washington and Harborview Medical Center have found a way to diagnose neurodegenerative diseases like Alzheimer’s and Parkinson’s in their early stages. In a large multi-site study, the researchers used the proteomics system iTRAQ to identify and link more than 1,500 potential biomarkers in cerebrospinal fluid from patients with one of three neurodegenerative diseases: Alzheimer's, Parkinson's, or Dementia with Lewy bodies (DLB). However, the study will have to be conducted on a much larger scale before it could play its part in a diagnostic tool.

Researchers are also on their way to developing a skin test that could detect Alzheimer’s disease. Scientists from the Blanchette Rockefeller Neurosciences Institute in Maryland have discovered chemical changes that distinguish patients with early Alzheimer's from those with other neurodegenerative disorders. They found that the inflammatory chemical bradykinin produced chemical changes in the brain and skin cells of Alzheimer’s patients, which were different from those of patients suffering from diseases like Parkinson’s. These changes were best visible in the two enzymes ERK1 and ERK2. The researchers hope that the findings will lead to a non-invasive test for Alzheimer’s disease.

Meanwhile, researchers from San Francisco VA Medical Center have found that measuring the levels of cystatin C is a more accurate way to diagnose kidney disease than the standard kidney function test, which considers creatinine. They measured levels of cystatin C and creatinine in blood samples from 4,663 people, age 65 and older, and matched those results with health outcomes up to nine years later. It was found that those with high cystatin C levels were three times more likely to develop chronic kidney disease and 40 per cent more likely to suffer heart failure.

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Kidney disease research makes progress

Researchers from three different countries have significantly contributed to a better understanding of kidney diseases.

An Australian study has found a link between diabetes and kidney disease. The study involving 3,900 participants with Type 2 diabetes found that 50 per cent of them had faulty kidney function. Prof Merlin Thomas, head of the biochemistry of diabetic complications laboratory at the Baker Heart Research Institute and the lead author of the study, said that the study is significant as the high incidence of kidney disease in people with Type 2 diabetes shows a possible link between the two. Having both the conditions increases the risk of heart attack and stroke. Early screening is one way of preventing complications. The findings of the study were published in the Medical Journal of Australia.

Meanwhile, an American study has found that healthy kidneys are able to keep blood proteins out of the urine due to a kidney structure called the glomerular basement membrane (GBM). The study was conducted on genetically-modified mice that did not have a gene for laminin beta 2, a protein that's part of the GBM. The mice were then given the imaging agent ferritin. The researchers used an electron microscope to take pictures of the ferritin and found that it was easier for it to slide through the GBM in the genetically modified mice than in normal mice. The researchers hope that the findings will lead to a better understanding of nephrotic syndrome and more effective treatments.

Korean scientists too are working towards better treatments. Researchers have found a new protein COMP-Ang1 that effectively prevented kidney disorders from progressing when it was injected into mice. Korean firm Genexel had originally developed the substance as a blood vessel formation promoter.

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Recent studies on kidney stone

A study by Mayo Clinic researchers has found that lithotripsy, a common treatment for kidney stones significantly increases the risk of diabetes and hypertension later in life. The study reviewed charts of 630 patients administered with shock wave lithotripsy and obtained a response sheet to a questionnaire from these patients. A comparative study was conducted between shock wave lithotripsy patients at Mayo Clinic and other patients of the same age, gender who had been to an urologist for kidney stones around the same time but received a different treatment. The observation of the study revealed that shock wave lithotripsy increased the risk probability of having diabetes to 3.75 times and of hypertension to 1.47 times more in comparison to other treatments for kidney stones.

Another study relating to kidney stone, carried out by researchers at UT Southwestern Medical Center has found that people with type 2 diabetes have highly acidic urine, which increases the risk of developing uric-acid kidney stones. This is the first study that compared urinary biochemical characteristics of type 2 diabetics with nondiabetics. The researchers will now find out what causes type 2 diabetics to have highly acidic urine, and what other urinary factors protect some diabetics who do not form uric-acid stones.

Meanwhile, Yale School of Medicine researchers have identified a gene that functions to protect the body against kidney stones. The gene or transporter, known as SLC26A6 secretes oxalate into the intestine and prevents absorption of too much of the oxalate from the diet thereby inhibiting the formation of calcium oxalates or kidney stones.

Risk of urinary incontinence associated with hormone therapy

Data from the most recent Women's Health Initiative study contradicts another widely held assumption about hormone therapy for older women. Many physicians have prescribed hormone therapy as a means of treating urinary incontinence.

New results reveal the risk of urinary stress incontinence increased for women taking estrogen - even for those who weren't incontinent at the beginning of the study. Stress incontinence occurs if people urinate when they cough, sneeze, or make a sudden movement, etc.

Reasons for the incontinence are not clear, but evidence suggests estrogen may promote the degradation of collagen... which is part of the supporting structure of the urethra and bladder, says the lead author of the study, Dr. Susan Hendrix, Professor of Obstetrics and Gynecology at Wayne State University School of Medicine.