Health Leader, Kidney's Need Love, Too

STORY BY

Karen Krakower

When Grammy Award-winning soul singer Barry White died of kidney failure July 4, his death focused attention on the dangers of kidney disease.

About 10 million Americans have chronic kidney disease, and another 20 million are at increased risk because they have diabetes, high blood pressure or other risk factors. According to the National Vital Statistics Report, kidney disease causes more than 39,000 deaths annually in the United States.

Research by University of Texas Medical School at Houston physician Austin Stack, emphasizes the importance of early diagnosis and treatment. Over one third of patients with end-stage renal disease in the U.S. see a nephrologist, or kidney specialist, for the first time within four months of starting dialysis. This greatly increases risk of death, according to Stack’s study, which was published in the February issue of the American Journal of Kidney Disease.

Early Referral Key to Survival

Within the first year of dialysis, patients whose first visit to a nephrologist was less than four months before they started dialysis had a 68 percent higher risk of death than those whose first visit was earlier.

Patients with early treatment – who saw a nephrologist at least twice in the year before starting dialysis – had a 20 percent lower risk of death than those without early treatment.

“Early referral to a nephrologist provides an enormous opportunity for managing the complications of chronic kidney disease and ensures optimal preparation for patients who require dialysis or kidney transplant,” said Stack, an assistant professor of medicine and a clinical epidemiologist in the Division of Nephrology and Hypertension at the Medical School.

“The study shows for the first time in a nationally representative sample a clear association between early and frequent nephrology contact and improved patient survival,” he said. Stack based his findings on an analysis of 2,264 patients from a national study of the U.S. Renal Data System.

“Two” Reasons to See a Specialist

Seeing a specialist early in the course of kidney disease allows for more effective treatment of hypertension, anemia and other related medical conditions, such as diabetes, coronary artery disease and congestive heart failure. In some cases, he said, declining kidney function can be halted, delayed or even reversed, avoiding the need for dialysis or transplant.

A new National Kidney Disease Education Program, under the auspices of the National Institutes of Health, is encouraging people in high-risk categories – those with hypertension, diabetes or a relative with kidney problems – to ask their physicians to be tested. Early efforts are targeted at black Americans, who are four times more likely than others to suffer kidney failure.

UPDATED: 10-02-2003

Health Tip:

Fireworks
Don’t lose your independence
on Independence Day!

They’re beautiful, hypnotic, inspiring and dangerous. Each year, thousands of injuries occur from fireworks. The Centers for Disease Control and Prevention (CDC) cite

In 2006, 11 dead and an estimated 9,200 treated in emergency departments for fireworks-related injuries in the United States.
An estimated 5 percent of fireworks-related injuries treated in emergency departments required hospitalization.

Most injuries involved:

Hands (2,300 injuries), eyes (1,500 injuries), and the head, face, and ear (1,400 injuries).
Burns were the most common injury type to all body parts except the eyes and head areas, where contusions, lacerations and foreign bodies in the eye occurred more frequently.

Most common fireworks involved:

Firecrackers, associated with the greatest number of estimated injuries at 1,300. There were 1,000 injuries associated with sparklers and 800 associated with bottle rockets.
Sparklers, accounting for one-third of the injuries to children younger than 5.

Between 2000-05, more than one-third of the fireworks-related deaths involved professional devices that were illegally sold to consumers.

According to the American Academy of Ophthalmology, if you are going to light firecrackers:

Use a specially designed stick, or "punk," rather than a match to light fireworks.
Have a bucket of water ready.
Always follow manufacturers' directions and dispose of used fireworks properly.
Never give a firecracker or sparkler to a child.
Never use a bottle rocket.
Do not light firecrackers bigger than your pinkie, do not light them indoors, and avoid relighting duds.
Never put fireworks in your pocket, throw them while lit, or make homemade firecrackers.
In case of eye injury, do not touch the eye. Tape a clean paper cup over the eye to prevent contamination or further injury. Immediately seek medical attention from an ophthalmologist (eye MD).

What is banned nationwide: Any firecracker with more than 50 milligrams of explosive powder and any aerial firework with more than 130 milligrams of flash powder is banned under federal law, as are mail order kits and components designed to build these fireworks.