KidneySZ.com

The new website http://www.kidneysz.com/ has just been launched.

This is the official Nephrology Clinic website platform for Dr Soehardy Zainudin, who is a Consultant Nephrologist and Physician currently practising in Tropicana Medical Centre, Kota Damansara.

A new drug for Diabetic Nephropathy

Researchers at the University of California, San Diego School of Medicine, the National Institutes of Health (NIH) and the Mayo Clinic have published promising results of a clinical study using an experimental anti-fibrotic and anti-inflammatory drug called pirfenidone to treat patients with diabetic nephropathy. Their study will be published in the April 21 issue of the Journal of the American Society of Nephrology (JASN).

Influence of the timing of cardiac catheterization and amount of contrast media on acute renal failure after cardiac surgery

Journal of Research in Medical Sciences, 04/26/2011

MirmohammadSadeghi M et al. –

The patients who progressed to ARF were more likely to have received a higher dose of contrast agent compared to the mean dose. However, the time interval between cardiac surgery and last catheterization was not significantly different between the patients with and without acute renal failure (ARF). Minimizing the amount of contrast agent has a potential role in reducing the incidence of postoperative ARF in patients undergoing cardiac surgery, but delaying cardiac surgery after exposure to these agents might not have this protective effect.

Death rates among those with high blood pressure decreasing, but still high

Death rates have decreased among people with high blood pressure but remain far higher than in those without it, according to research in Circulation: Journal of the American Heart Association.

Researchers examined changes in death rates among adults ages 25 to 74, using results from two national health surveys: The National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-up Study followed participants recruited between 1971 and 1975 and the NHANES III Linked Mortality Study followed participants recruited between 1988 and 1994.

The study found:

• The overall death rate (number of deaths for every 1000 person-years and adjusted for age) was 18.8 among NHANES I participants with high blood pressure — 42% higher than in those without it (13.3).
• From NHANES I until NHANES III, mortality rates had fallen to 14.3 in hypertensive patients — 57% higher than in those without high blood pressure (9.1). 
• Although men were more likely to die than women in both time periods, the decline in deaths among hypertensive men (7.7, a 33% relative reduction) was more than four times larger than among hypertensive women (1.9, a 12% relative reduction).

"On average, hypertensive women had larger declines in their blood pressure than hypertensive men, but didn't do as well in other measures related to heart disease risk," the researchers said. "Compared with hypertensive men, women gained more weight, were more likely to be diagnosed with diabetes and were less likely to quit smoking."
Between the two surveys, hypertensive patients had a:

• 45% smaller reduction in total cholesterol levels
• 30% larger increase in body mass index 
• 3.6 times larger increase in the diagnoses of diabetes 
• 25%larger decrease in the percentage of smokers

End-Stage Renal Failure requiring dialysis

One of the challenges facing a Nephrologist is when breaking news about End-Stage Renal Failure to a patient and telling him or her about the need for life-long haemodialysis 3 times every week.

The reactions I often got out of the patients vary from one of despair to denial to anger. Sometimes it is best to let the patient go through the emotions before they settle down with some degree of acceptance of their disease and the unavoidable treatment.

What is High-Efficiency and what is High-Flux ?

Unusually Low or High Endogenous Creatinine