Guest guest Posted October 28, 2004 Report Share Posted October 28, 2004 " HSI - Jenny Thompson " <HSIResearch Kidney Punch Thu, 28 Oct 2004 08:55:03 -0400 Kidney Punch Health Sciences Institute e-Alert October 28, 2004 ************************************************************** Dear Reader, Kidney disease carries two secrets. One secret is the disease itself. Many people go for years with undetected kidney disease, and then, once symptoms appear, it's often too late to reverse the damage. Health officials believe that as many as 10 to 20 million people may have some level of chronic kidney disease (CKD). The other secret is revealed in two studies that were published last month in the New England Journal of Medicine (NEJM). In these studies, researchers found a disturbing correlation between CKD and cardiovascular disease (CVD) that makes early detection of kidney disease more important than ever. --------------------------- Built-in filter --------------------------- Both of the studies begin by recognizing that kidney failure and advanced kidney disease are associated with CVD. But the association of CVD with less severe kidney dysfunction has not been clearly defined. In the first study, researchers examined three years of data collected from the Kaiser Permanente Renal Registry in San Francisco. The medical records of more than one million patients were included. The average age of the patients was 52. The Kaiser team specifically looked for an association between health risks (including CVD) and impaired kidney function, measured with GFR. A blood test reveals GFR (glomerular filtration rate), which indicates the rate at which kidneys are able to filter waste from the bloodstream. When GFR drops below 60, that's considered a red flag for potential problems. The results: As GFR dropped, the risks of CVD, stroke, hospitalization and death all increased. That wasn't necessarily a surprise. But the Kaiser study found that a GFR between 45 and 59 increased the risk of death by 17 percent, and sharply increased the risk of CVD by more than 40 percent. In the second study, researchers in the cardiovascular division of Boston's Brigham and Women's Hospital examined the association between chronic kidney disease and CVD-related deaths in more than 14,500 people who had suffered heart attacks. The Boston team reports that when GFR was at least 75, death risk was a little over 14 percent, while a GFR below 45 boosted death risk to more than 45 percent. Noting that factors common to kidney disease (such as protein in the urine, high homocysteine levels, inflammation and anemia) may boost death and CVD risk, the researchers concluded that even mild kidney disease should be considered a major risk factor for cardiovascular complications after a heart attack. --------------------------- Putting kidneys to the test --------------------------- People with diabetes and/or high blood pressure are at highest risk to develop kidney problems, closely followed by those with a family history of kidney disease. But when warning signs are noted before kidney function is reduced, treatment may prevent further damage. If you fall into any of the categories above, or if you're elderly (unfortunately, the kidneys don't age well for some of us), you should be regularly screened for kidney disease. Many people fall into more than one high-risk category, and their risks multiply. But in the case of kidney disease, even one risk factor is enough to warrant regular testing. There are two early detection tests, and the National Kidney Foundation recommends that those at high risk complete BOTH at least once a year. The first is a blood test to assess your GFR. The second is a simple urine test that detects albumin excretion rate (AER). Albumin is a protein synthesized in the liver that works to transport various substances in the blood stream. When too much albumin is excreted in the urine, it's a clear sign that the kidneys may be in trouble. Fortunately, there are steps you can take to slow the progression of kidney disease and to prevent it from developing in the first place if you are at high risk. In the e-Alert " Take 2 " (7/28/03), I told you about a study that showed how regular intake of vitamins C and E may help lower AER. A low-protein diet is also recommended to protect the kidneys. And although kidney stones are not necessarily indicative of kidney disease, research shows a low-protein, low- salt diet offers better protection against kidney stones than the traditionally recommended low-calcium diet. Needless to say, managing blood pressure and blood sugar levels is also crucial. If you fall into even one of the high risk groups, make sure to have both the albumin urine test and the GFR blood test performed at least once a year. And talk to your doctor about other steps you can take to prevent kidney disease from developing. ************************************************************** What does your heart yearn for? It yearns for fish. In the e-Alert " Fascinatin' Rhythm " (10/25/04) that I sent you on Monday, I looked at a study that showed how fish oil supplements provided significant benefits for patients with arrhythmias (abnormal heart rhythms). Now a different type of study has come to a similar conclusion. Researchers at Harvard Medical School examined 12 years of hospital discharge records, electrocardiograms and dietary data for more than 4,800 people over the age of 65. About 980 subjects were diagnosed with atrial fibrillation (AF) the most common type of arrhythmia, especially in the elderly. Results showed that regular consumption of tuna or broiled or baked fish was clearly associated with a lower incidence of AF. For subjects who ate fish five or more times each week, risk of AF was reduced by 35 percent, compared to subjects who ate fish less than once a month. In the published study – which appeared in the journal Circulation – the authors wrote: " Consumption of tuna and other broiled or baked fish correlated with plasma phospholipid long-chain n-3 fatty acids, whereas consumption of fried fish or fish sandwiches (fish burgers) did not. " Translation: Fast food fish won't do the trick if you want to increase omega-3s. Which brings us back to the basics: Omega-3s are good for your heart, whether you get them from a good quality fish, or a fish oil supplement. And when it comes to supporting heart health with good nutrition, you'll be hard pressed to find better advice than that of HSI Panelist Allan Spreen, M.D. This is just a reminder to e-Alert readers in the Scottsdale/Phoenix, Arizona, area that Dr. Spreen will be signing copies of his book " Nutritionally Incorrect " in your area tomorrow (10/29), at 4:00 PM. Dr. Spreen will be at the opening of Granola's in Scottsdale (7119 Shea, Suite 101C – on the corner of Scottsdale and Shea). The subtitle of his book says it all: " Why the American Diet is Dangerous and How to Defend Yourself. " And not only is it full of indispensable information, but it's also written in Dr. Spreen's very lively and readable style. So drop by and meet Dr. Spreen, and say hello from his friends at HSI. To Your Good Health, Jenny Thompson Health Sciences Institute ************************************************************** Sources: " Chronic Kidney Disease and the Risks of Death, Cardiovascular Events, and Hospitalization " The New England Journal of Medicine, Vol. 351, No. 13, 9/23/04, content.nejm.org " Relation Between Renal Dysfunction and Cardiovascular Outcomes After Myocardial Infarction " The New England Journal of Medicine, Vol. 351, No. 13, 9/23/04, content.nejm.org " Studies Strengthen Kidney and Heart Disease Link " Science Daily, 9/29/04, sciencedaily.com " Fish Intake and Risk of Incident Atrial Fibrillation " Circulation, Vol. 110, No. 4, 7/27/04, ncbi.nlm.nih.gov " Fish Oils Can Regulate Heart Beat " NutraIngredients.com, 9/10/04, nutraingredients.com Copyright ©1997-2004 by www.hsibaltimore.com, L.L.C. The e-Alert may not be posted on commercial sites without written permission. Quote Link to comment Share on other sites More sharing options...
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