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Half of American adults may have chronic kidney disease in their future ... - Managed Care magazine PDF Print

Chronic kidney disease (CKD) threatens to become a major health burden in coming years—and that may come as news to many of the Americans who will be affected, according to a study in the American Journal of Kidney Diseases. As the authors put it, awareness of CKD “remains low in the United States, and few estimates of its future burden exist.” In fact, according to federal government health surveys, less than 10% of Americans with the early stages of CKD are aware of their condition.

Researchers at RTI International, a not-for-profit research group, used their own previously developed CKD Health Policy Model to make their predictions. By their reckoning, more than half (54%) of Americans ages 30 and older who don’t currently have CKD will develop the condition some time in their lives.

Lifetime incidence risk for common causes of morbidity when no disease is present at age 30, U.S. population

*Index age 45.
CKD=chronic kidney disease.
Sources: SEER Cancer Statistics Review, JAMA.

They also forecast a ramping up of CKD prevalence from the current level of 13.2% to 14.4% in 2020 (28 million Americans). By 2030, their model projects the prevalence will reach 16.7% (38 million Americans).

Estimated prevalence, CKD, U.S. population, 2015–2030

Source: Hoerger TJ et al., American Journal of Kidney Diseases, March 2015.

Lead author Thomas Hoerger, PhD, tells Managed Care that the group’s results argue for “interventions to control the conditions that increase the risk of CKD (primarily, tight glycemic control for persons with diabetes and better blood pressure control for persons with hypertension), and [also] partly for the development of new interventions to slow progression among persons in the early stages of CKD.”

The main risk factors for CKD include diabetes, hypertension, and age. Early detection and treatment of CKD can forestall or delay heart disease and kidney failure. Likewise, early treatment of diabetes and hypertension can prevent CKD from developing.

However, as Hoerger and his colleagues point out, the clinical significance of early stage CKD among the elderly with borderline numbers is somewhat debatable, partly because of competing health problems.

Even if these CKD forecasts come true, there’s good news about one of its most dire consequences, end-stage renal disease (ESRD).

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Dialysis beneficiaries want scheme to reach more people - The Hindu PDF Print

Sixty-year-old Lalita from Madikeri was virtually in tears while narrating her experience of peritoneal dialysis, which she has been undergoing for the past one year since being trained at the Government Wenlock Hospital.

“I am really indebted to Health Minister U.T. Khader for including me in this (pilot) scheme. (Following peritoneal dialysis) I am now spending good time with my family members,” said Ms. Lalitha.

“I want this scheme to reach far more beneficiaries,” she said.

Ms. Lalita was one of 20 beneficiaries of peritoneal dialysis undertaken on a pilot basis by the State government at the Government Wenlock Hospital last year.

The beneficiaries here are those with chronic renal failure. The beneficiary or his or her family members, have been trained for a week to perform peritoneal dialysis in their house. The State government bears the expense of Rs. 24,000 per month included by each beneficiary.

The beneficiaries on Wednesday had come to share their experience of doing peritoneal dialysis for over a year.

“I had lost hope in life following problems I faced with haemodialysis. Peritoneal dialysis has given me a new lease of life,” said Praveen Kumar, a resident of Puttur. Mr. Kumar said haemodialysis sessions had made him weak.

“Peritoneal dialysis has brought turnaround in my life,” said Mr. Kumar, who now runs a grocery shop.

Following peritoneal dialysis, Henry Pinto from Belthangady said that he has been driving an autorickshaw, which he stopped following haemodialysis.

“Each session of peritoneal dialysis lasts for about thirty minutes and it has to be done thrice a day. I space out these sessions and earn,” he said.

Mr. Pinto said the news of the government stopping supply of Dialysis liquid, which was used in Peritoneal Dialysis, did cause him concern.

Baby Shetty from Mandarthi in Udupi asked the Minister to ensure that there will not be any discontinuity in providing Dialysis liquid and medicines to beneficiaries. She also sought services of doctors at the Wenlock Hospital once a month.

Hearing the beneficiaries, Mr. Khader said the State government was considering extending peritoneal dialysis to more people with chronic renal failure.

There will not be any shortfall in availability of Dialysis liquid and medicines required for the beneficiaries, he said.

20 beneficiaries with chronic renal failure have been taken

on a pilot project by the government

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Nephrology Dialysis Transplantation Reports Phase 2 Data of Investigational ... - Nasdaq PDF Print

Nephrology Dialysis Transplantation Reports Phase 2 Data of Investigational ...
Nasdaq
SAN FRANCISCO, Aug. 12, 2015 (GLOBE NEWSWIRE) -- FibroGen, Inc. (Nasdaq:FGEN), a research-based biopharmaceutical company, today announced that Nephrology Dialysis Transplantation has published encouraging Phase 2a safety and efficacy ...

and more »

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Nephrology Dialysis Transplantation Reports Phase 2 Data of Investigational ... - GlobeNewswire (press release) PDF Print

SAN FRANCISCO, Aug. 12, 2015 (GLOBE NEWSWIRE) -- FibroGen, Inc. (Nasdaq:FGEN), a research-based biopharmaceutical company, today announced that Nephrology Dialysis Transplantation has published encouraging Phase 2a safety and efficacy data for roxadustat, an orally active potent hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) for the treatment of anemia associated with chronic kidney disease (CKD). In a multicenter, randomized, placebo-controlled trial that was conducted in non-dialysis subjects with anemia associated with stage 3 or 4 CKD, roxadustat produced dose-dependent increases in hemoglobin (Hb) within 14 to 25 days.

"To our knowledge, this publication is the first peer-reviewed article to feature a HIF-PHI, a new class of drug, in a multi-dose study of patients with anemia. Data from the study offer insight into the potential ability of roxadustat to treat CKD-associated anemia," said Anatole Besarab, MD, executive director, clinical research at FibroGen and lead author.

Anemia is a common complication of kidney disease. While the risk of hospitalization, heart disease and death is higher for patients with kidney disease than for those without kidney disease, the risk of these events is even higher for patients with both anemia and kidney disease. Anemia can be treated in people with kidney disease, but often the disease is not treated in patients who have not yet begun dialysis. One of the approved therapies for anemia, erythropoietin analogues, has been the standard approach for managing the anemia of kidney disease and reducing the need for red blood cell (RBC) transfusion. However, the safety of using erythropoietin analogues to treat the anemia of kidney disease has been questioned. In controlled trials, greater risks for death, serious adverse cardiovascular reactions such as hospitalization for heart failure, and stroke occurred when erythropoietin analogues were administered targeting Hb levels >13 g/dL.

Untreated or delayed treatment of CKD-associated anemia can be linked to a higher likelihood of hospitalization, red blood cell transfusion, and mortality rates. This study evaluated 116 subjects who were living with CKD and concomitant anemia but were not undergoing dialysis. Of these 116 subjects, 96 were evaluable for efficacy. Baseline characteristics for roxadustat and placebo groups were comparable. Roxadustat 0.7, 1.0, 1.5, or 2.0 mg/kg, increased Hb levels in a dose-related manner. Hb responder rates were dose dependent and ranged from 30 percent with roxadustat 0.7 mg/kg to 100 percent with roxadustat 2 mg/kg. The median time to response ranged from 42 days (1 mg/kg) to 14 days (2 mg/kg). Roxadustat transiently and moderately increased endogenous erythropoietin and reduced hepcidin levels. Adverse events were similar in the roxadustat and placebo groups. Most common adverse events associated with roxadustat were diarrhea (9.1%), headache (6.8%), back pain (4.5%), fatigue (4.5%) and hyperkalemia (4.5%). Detailed results and safety data from the trial were published in Nephrology Dialysis Transplantation and can be viewed here http://www.ncbi.nlm.nih.gov/pubmed/26238121.

"FibroGen is committed to improving outcomes for people living with anemia of CKD and related conditions through the roxadustat program and the portfolio of HIF-PHI research we are building," said Tom Neff, chief executive officer of FibroGen. "We look forward to the future publication of our other completed Phase 2 studies of roxadustat, including those of dialysis and incident dialysis patients."

Through FibroGen's strategic collaborations with AstraZeneca AB and Astellas Pharma Inc., roxadustat is currently in global Phase 3 development.

About Roxadustat

Roxadustat (FG-4592) is an orally administered small molecule inhibitor of hypoxia-inducible factor (HIF) prolyl hydroxylase activity, in development for the treatment of anemia in patients with chronic kidney disease (CKD). HIF is a protein transcription factor that induces the natural physiological response to conditions of low oxygen, "turning on" erythropoiesis (the process by which red blood cells are produced) and other protective pathways.

About FibroGen

FibroGen is a research-based biopharmaceutical company focused on the discovery, development and commercialization of novel therapeutics to treat serious unmet medical needs. The company utilizes its extensive experience in fibrosis and hypoxia-inducible factor (HIF) biology to generate development programs in multiple therapeutic areas. Its most advanced product candidate, roxadustat, or FG-4592, is an oral small molecule inhibitor of HIF prolyl hydroxylases, or HIF-PHs, in Phase 3 clinical development for the treatment of anemia in CKD. A second product candidate, FG-3019, is a monoclonal antibody in Phase 2 clinical development for the treatment of idiopathic pulmonary fibrosis (IPF), pancreatic cancer and liver fibrosis. For more information please visit: www.fibrogen.com.

Greg Mann
FibroGen, Inc.
415-978-1433

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Dialysis: Only 28% in Georgia Referred for Transplant - Medscape PDF Print
Medscape
Only 28.0% of patients with end-stage renal disease (ESRD) are referred for transplant evaluation within a year of starting dialysis in Georgia, the US state with the lowest transplantation rate, new research shows. The study, published in the August ...
Georgia dialysis facility referral rate for kidney transplants is low and variable Emory News Center
Variation in Dialysis Facility Referral for Kidney Transplantation Among

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