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Study: Screen ED Sufferers for Cardiovascular Disease - Renal and Urology News
March 31, 2015

Screening for cardiovascular disease (CVD) in men who present with erectile dysfunction (ED) can be a cost-effective intervention for the secondary prevention of both conditions, according to a new study.

“As the link between the etiologies of ED and CVD grows stronger, both the healthcare community and patients stand to benefit from screening for and treating CVD in men with ED,” researchers wrote in an online report in the Journal of Sexual Medicine. "Such an approach could significantly decrease national healthcare costs and disease burden with significant societal implications.”

Using the known incidence and prevalence of ED and CVD, the rate of undiagnosed CVD, and the effects of CVD, Alexander W. Pastuszak, MD, PhD, of the Center for Reproductive Medicine at Baylor College of medicine in Houston, and colleagues modeled the change in prevalence of acute CVD events and ED as a function of the number of men with ED and CVD.

Dr. Pastuszak's group found that men with CVD had a 47% increased relative risk of ED. They estimated that the co-prevalence of ED and CVD was 1,991,520 men. Additionally, 44% of men with CVD risk factors are unaware of their risk, they noted. CVD screening of all men who presented with ED would identify 5.8 million men with previously unknown CVD risk factors over 20 years at a cost of $2.7 billion to screen, the researchers reported. Assuming screening and subsequent treatment results in a 20% decrease in cardiovascular events, 1.1 million cardiovascular events would be avoided, for a cost savings of $21.3 billion over 20 years.

The investigators stated that based on their model, “we call for a paradigm shift that moves research and treatment of ED away from merely deriving symptomatic improvement in the disease to a proactive and comprehensive view that appreciates and attempts to reverse the underlying and concurrent vascular pathology.”

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State to source 7 dialysis machines - Times of Zambia

By YVONNE CHATE -

GOVERNMENT has released K1, 350 000 towards the procurement of seven Kidney dialysis machines at Ndola Central Hospital.
Copperbelt Provincial medical officer Consity Mwale said the procurement of the dialysis machines would guarantee facilitation of renal services at all tertiary hospitals on the Copperbelt.
Dr Mwale said in an interview yesterday that the procurement of the kidney dialysis machines would help patients with kidney failure to filter harmful wastes, salt, and excess fluid from their blood.
“Government has released K1350 000 of which 1120 000 is for seven dialysis machines, K30,000 for the beds and K200, 000 for plant machinery that powers the dialysis  machines,” Dr Mwale said.
Dr Mwale said the seven dialysis machines were expected to be at Ndola Central Hospital (NCH) in June.
He said the machines would prevent death caused by lack of kidney dialysis at NCH.
“The dialysis machine has been on the Government’s agenda because many lives have been lost,” he said
He said early diagnosis and treatment of kidney diseases might help prevent the need for kidney transplant.
Dr Mwale said with the expected machines, it would be easy to attend to patients with Kidney failure because the province would have 11 dialysis machines of which four were already at Kitwe Central Hospital (KCH).
He said Kitwe Central Hospital would also receive six more dialysis machines from the Ministry of Health.
“It is gratifying that NCH is receiving seven kidney dialysis machines and KCH already has four functional dialysis machines and is also expecting an additional 6 machines,” he said.

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New dialysis center opening in Chehalis - Longview Daily News

Lewis County residents can now receive dialysis a little closer to home with the opening of Fresenius Medical Care North America in Chehalis.

The public is invited to an open house 2 p.m. to 6 p.m. Thursday at Fresenius, 1684 Bishop Road. Nurse Nancy Dunkleburger will give a lecture on chronic kidney disease at 2:30 p.m.

Fresenius is Lewis County’s second dialysis center, following FMC Chehalis at 505 S.E. Adams Ave. Fresenius is a national network with more than 1,800 facilities in the U.S.

Dialysis treatments are done during when patients’ kidneys fail to properly filter waste, salt and extra water. Typically, dialysis patients need treatment for up to five hours three times a week.

Fresenius staff will be available to discuss dialysis treatment options during the open house. Dietitians and social workers also will discuss healthy lifestyle options.

Light refreshments will be available.

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Exercise improves cardiovascular fitness in patients with advanced chronic ... - NephrologyNews.com

Individuals with moderate to severe chronic kidney disease (CKD) can safely exercise and expect significant improvements in cardiovascular fitness, according to a new report published in American Journal of Kidney Diseases.

“Cardiovascular disease is the major cause of morbidity and mortality for patients with CKD,” said Nicole Isbel, MD, an associate professor in the department of nephrology at Princess Alexandra Hospital, University of Queensland, Australia. “This study was unique in that we didn’t disqualify any participants with preexisting conditions, such as high blood pressure, diabetes or previous heart disease. We demonstrated that exercise is safe, and can significantly improve fitness in those with poorly controlled cardiovascular risk factors.”

The study was based on 72 patients between 18-75 years old, with one or more uncontrolled cardiovascular risk factor and CKD as defined by an estimated glomerular filtration rate (eGFR) between 25-60mL/min/1.73 m2. Participants were predominantly male (63%) with moderately to severely decreased kidney function, 42% were diabetic, the mean BMI was 33 kg/m2, and 28% had a prior history of cardiovascular disease.


Related articles

Lifestyle modifications improve CKD patient outcomes

Researchers find significant link to daily physical activity, vascular health

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Exercise benefits patients with chronic kidney disease


 

 

After a cardiac stress test and, if required, a review by a cardiologist, participants were prescribed exercises based on the American College of Sports Medicine guidelines recommending 150 minutes of moderate activity per week. Patients were encouraged to aim for at least 30 minutes of aerobic and/or strength training activities a day. The majority of patients chose walking, swimming and cycling.

At the end of 12 months, patients in the exercise group significantly increased their exercise capacity by 25% whereas those in a control group had a 2% decrease. Those in the exercise group were also able to walk further in a 6-minute walk test. There was also a small but significant weight loss observed in the intervention group.

“It’s very noticeable how physically inactive patients with CKD can become and that they are often fearful of exercise,” said Isbel. “This study shows exercise not only improves kidney patients’ health, but makes them feel better. Exercise training should be part of the treatment plan. Doctors and nurses should have confidence to prescribe and promote exercise training, because it can be done safely and exercise programs can be designed for all, even if patients have had serious health issues.”

Those with CKD who are interested in incorporating an exercise plan into their treatment should get their doctor or nephrologist to refer them to a qualified trainer, according to the National Kidney Foundation. They also recommend working with a multi-disciplinary team who can take into account a patient’s medical history and exercise preferences.

It has been clearly established that adoption of healthy lifestyle habits, including exercise can prevent or slow the progression of kidney disease,” said Thomas Manley, director of scientific activities for the National Kidney Foundation. “It’s very positive to see that a healthcare provider prescribed and monitored exercise model can also improve cardiovascular health in patients with advanced CKD.”

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Higher Phosphorus Levels Linked to Mortality - Renal and Urology News
March 31, 2015

The findings generally support KDOQI guidelines for dialysis patients, which recommend maintaining serum phosphorus levels between 3.5 and 5.5 mg/dL.

Higher Phosphorus Levels Linked to Mortality - Renal and Urology News
Patients with higher baseline levels of phosphorus, ranging from 3.5 to more than 7.5 mg/dL, had a greater risk of mortality.

Hemodialysis (HD) patients with a high serum phosphorus levelthat subsequently rises have a greater risk of early death compared with those with a stable level between 3.5 and 5.5 mg/dL, according to new research presented at the National Kidney Foundation 2015 Spring Clinical Meetings in Dallas.

For the study, investigators led by Kamyar Kalantar-Zadeh, MD, MPH, PhD, of the University of California, Irvine Medical Center and medical director for nephrology at Renal & Urology News, examined the change in serum phosphorus levels in nearly 96,500 patients receiving maintenance HD from 2007 to 2011. A rise or decline of serum phosphorus by more than 0.5 mg/dL after baseline was noted. More than half of patients (60%) had diabetes, 43% were female, and 32% were African American. The average age was 63.

After adjusting for potential confounders, patients with higher baseline levels of phosphorus, ranging from 3.5 to more than 7.5 mg/dL, had a greater risk of mortality. This was especially true for those who had a rise in their phosphorus levels 91 days later.

Greater mortality was also seen among patients with low baseline phosphorus (below 3.5 mg/dL), whose levels declined by the next quarter.

Whether decreasing phosphorus levels to the Kidney Disease Outcomes Quality Initiative (KDOQI) recommended target (3.5 to less than 5.5 mg/dL) might improve mortality should be investigated, according to the researchers.

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