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Statin use during surgery improves survival in renal cell carcinoma - Healio PDF Print

Statin use at the time of surgery was independently associated with improved disease-specific survival and OS rates in patients with renal cell carcinoma, according to the results of a retrospective cohort study.

“Despite plausible mechanistic links for a protective role of statins in the development of cancer, epidemiologic studies evaluating the association between statin use and cancer risk have been controversial,” Peter E. Clark, MD,of the department of urologic surgery at Vanderbilt University Medical Center, and colleagues wrote. “Although earlier studies had suggested an increased risk of cancer associated with statin use, other studies have reported a neutral effect and the remaining have described protective effects for some cancers up to a 50% RR reduction for cancer incidence.”

Peter E. Clark, MD

Peter E. Clark

Clark and colleagues conducted a retrospective analysis of 916 consecutive patients with renal cell carcinoma. The median age of the population was 60.8 years and the cohort was 65% male. All patients underwent radical or partial nephrectomy at Vanderbilt University Medical Center between 2000 and 2010.

Twenty-nine percent of patients (n = 270) reported statin use at the time of surgery.

Median follow-up was 42.5 months.

Across the entire cohort, 3-year OS was 79% (95% CI, 76-81.6). The 3-year OS rate was 83.1% (95% CI, 77.6-87.3) among statin users and 77.3% (95% CI, 73.7-80.6) among nonusers. Statin users demonstrated a 3-year disease-specific survival rate of 90.9% (95% CI, 86.3-94) vs. a 83.5% (95% CI, 80.1-86.3) 3-year disease-specific survival rate for nonstatin users (P= .015).

Statin use was not statistically associated with OS in the univariable analysis (HR = 0.91; 95% CI, 0.68-1.21). However, results of the multivariable analysis — adjusted for factors such as age, higher stage and grade, metastatic disease and preoperative anemia — indicated statin use was significantly and independently associated with improved OS (HR = 0.62; 95% CI, 0.43-0.9) and disease-specific survival (HR = 0.48; 95% CI, 0.28-0.83).

Researchers conducted exploratory multivariable survival analyses for 582 patients with locoregional disease. After a median follow-up of 42.8 months, 104 overall deaths and 45 disease-specific deaths had occurred. Statin use remained a statistically significant factor for OS (HR = 0.31; 95% CI, 0.13-0.73) and disease-specific survival (HR = 0.63; 95% CI, 0.4-0.97).

Researchers acknowledged the lack of data on length and dosage of statin use in individual participants is a limitation to these findings.

“Our data suggest that statin use at the time of surgery is independently associated with improved OS and disease-specific survival,” Clark said in a press release. “This study is among the first research confirming a survival advantage for patients who are taking these drugs.” – by Cameron Kelsall

Disclosure: HemOnc Todaycould not verify the researchers’ relevant financial disclosures at the time of reporting.

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Dialysis providers limit impact of Texas flooding on patient care - NephrologyNews.com PDF Print

Only two dialysis clinics in the Houston and Austin, Texas area had to be closed this past week in response to tremendous flooding that killed at least 13 people. Eleven are still missing.

DaVita Kidney Care closed down one of its Houston clinics and one near Austin because of the flooding, but transferred those patients to other units.

“As the result of the Texas floods, DaVita had two full closures of centers —one in Houston and one in Taylor, Texas (northeast of Austin),” said Tom Bradsell, manager of the DaVita Village Emergency Response Team. “We also had several other centers where we had either delayed openings or the elimination of some shifts as the result of the adverse weather conditions."

“This event came quickly and we immediately responded by contacting patients in flooded areas to make sure they were okay. For those patients in areas where center operations were impacted, we worked quickly to find centers where they could receive their treatments and shifted clinical teammates to those centers to accommodate the increase in patients. In some centers we also added a shift to accommodate the increase in patients,” Bradsell said.

DaVita, along with Fresenius Medical Care North America and U.S. Renal Care, treat the most outpatient dialysis patients in Texas who are in the Medicare-funded ESRD Program. Spokespersons for those providers said that while dialysis services were disrupted, the clinics continued to operate.

The flooding in Dallas and Houston has caused over $45 million in property damage, officials estimate.

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The effects of cinacalcet on blood pressure, mortality and cardiovascular ... - Nature.com PDF Print

Nature.com

The effects of cinacalcet on blood pressure, mortality and cardiovascular ...
Nature.com
Patients with end-stage renal disease often have derangements in calcium and phosphorus homeostasis and resultant secondary hyperparathyroidism (sHPT), which may contribute to the high prevalence of arterial stiffness and hypertension. We conducted a ...

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WATCH: Twelve-year-old in run for dialysis unit - The Southern Reporter PDF Print

Kieron Butler, 12, had the idea to run between Melrose and Gala rugby clubs – and back again – in aid of the dialysis unit at Borders General Hospital in memory of his great aunt who died recently.

Kieron, backed up by his brother Martin Lammie and Martin’s friend Alan Everett, completed the eight-mile run on Saturday morning in just 62 minutes.

WATCH: Twelve-year-old in run for dialysis unit - The Southern Reporter

12-year-old Kieron Butler with Martin Lammie and Alan Everett following their run for the dialysis unit at the BGH

With this, along with an earlier treadmill run and bake sale at the BGH, they have raised £1,460.

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MANCHESTER RENAL PATIENTS GET BOOST - Jamaica Gleaner (subscription) PDF Print

MANDEVILLE, Manchester:

WITH RENAL patients who require dialysis having to pay up to $45,000 per week for treatment, Jamaica Standard Products has committed to making annual donations to the Renal Department of the Mandeville Regional Hospital (MRH) to offset costs and supplies.

John Minott, managing director of Jamaica Standard Products, made a donation of $650,000 last Thursday at a handover ceremony. He said the facility has received over $1.5 million over the last three years from proceeds from the company's High Mountain Coffee 10K road race.

"The High Mountain Coffee 10K road race is mandated to assist needy projects in our community and, over the past three years, we have been partnering with the Mandeville Regional Hospital to contribute to their renal department ... . We recognise so many people who are affected with kidney disease year after year and it is in this regard that Jamaica Standard Products offers financial assistance to purchase much-needed supplies for the department."

Everton McIntosh, senior medical officer, MRH, while explaining the magnitude of end-stage renal failure, said persons should take preventative measures as treatment is costly and sometimes inaccessible.

unaffordable treatment

"This is the only dialysis unit in the public sector outside of Kingston and the south coast. There's none in Clarendon and none in St Elizabeth and the capacity to handle patients with end-stage kidney disease is very limited ... . It is also very expensive. You're looking at $15,000 per treatment, and ideally, you need three treatments per week, but the reality is, most persons can only afford two or one ... . Persons have mortgaged their houses, sold their cars because, without effective dialysis, the end result is death."

McIntosh also noted that several persons are currently on a long waiting list and will only have the chance to go on the machine if someone migrates or dies.

But while so many have passed on, renal patient Delroy Campbell is pleased to have witnessed the expansion of the dialysis unit.

"I remember, before the expansion, the space was so tight, but now the nurses can move freely because we in a bigger space. I have been going through this for 10 years now, and it's something that has been in my family ... my brother needed a kidney and when I went to do tests to see if I could help, the doctor said 50 per cent a mine nuh good. My daughter isn't a patient as yet, but she has renal failure as well ... . If it wasn't for these donations and the nurses and doctors at the hospital, I don't know what would happen ... . Many have passed on, but we who are here have to do what we have to do," he said.

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