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Stories from the dialysis comunity across the globe.



Most CKD educational materials written above patient reading levels - NephrologyNews.com PDF Print

More than 90% of chronic kidney disease educational materials are written above the recommended health literacy level, putting patients at risk of poor management and health outcomes, according to a new study published in the June issue of the American Journal of Kidney Diseases.

“Our study reveals that most patient information materials are not fit for their purpose, and that materials may be too difficult for their intended audience to understand,” said Angela Webster, lead researcher and an Associate Professor Clinical Epidemiology at the University of Sydney.

The average adult patient has an 8th grade literacy level and one in five patients read at or below a 5th grade level. Among patients aged 65 or older, 40% read at or below a 5th grade level, according to the study. It is recommended that educational materials be aimed at the 5th grade level for CKD patients.

In the study, researchers looked at 80 English-language educational materials that were designed to be printed and read by CKD patients in the United States, Australia and the United Kingdom. These free educational materials were analyzed using both the Lexile Analyzer and the Flesch-Kincaid Grade Level formula.

The average readability score of all materials using either formula corresponded to a ninth-grade reading level. Only 23% of materials, using the Lexile Analyzer, and 44% of materials, using the Flesch-Kincaid measure, were pitched at the 8th grade level. Using both scales, only 5% of materials were written at the recommended 5th grade level.


Read also:

NKF survey reveals many Americans know little about their kidneys


“These findings reveal that most information materials intended for patients with CKD are pitched well above the average patient’s literacy level. As a consequence, most patients wouldn’t be able to understand important health messages in these materials,” Webster said. 

Providing patients with reading materials outside their level of understanding could make it difficult to follow medication directives, dietary restrictions, and necessary lifestyle modifications for disease management.

Poor health literacy is a particular problem for elderly, ethnic minority, and socially disadvantaged people, all of whom are more likely to have CKD. People with low health literacy are less likely to feel engaged with their health care providers, less likely to participate in their treatment decisions, and have higher death and disease rates.

“Developing patient education materials that are appropriate for all literacy levels is a challenge, but a very important challenge for improving health outcomes,” said Thomas Manley, Director of Scientific Activities for the National Kidney Foundation. “All organizations need to make a thorough assessment on the readability of their patient information materials. Conducting formal readability testing, as suggested by the study authors, along with use of patient reviewers from a variety of educational and cultural backgrounds may provide important feedback to enhance the value of materials across a larger spectrum of health literacy levels.”

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Research and Markets: Global Peritoneal Dialysis Market 2015-2019 - Business Wire (press release) PDF Print

DUBLIN--(BUSINESS WIRE)--Research and Markets (http://www.researchandmarkets.com/research/qzk8qk/global_peritoneal) has announced the addition of the "Global Peritoneal Dialysis Market 2015-2019" report to their offering.

The global peritoneal dialysis market to grow at a CAGR of 4.40% over the period 2014-2019

Peritoneal dialysis is a needle-free treatment and can be performed either by a patient or with the help of a care partner. It is used to remove waste products and extra fluid from the body during the issue with kidney functions. Peritoneal dialysis differs from hemodialysis as in this treatment the blood is not taken from the body to treat the patient. In peritoneal dialysis, a tube called PD catheter is placed in the belly of the patient, and the dialysis is carried out by sterile fluid flowing through the lining of the belly called the peritoneum. This helps the blood flow into and out of the peritoneal space and the blood is cleansed inside the body.

Emerging countries such as China, India, South Korea, and Thailand have a growing elderly population but have limited awareness about PD. However, the governments of these countries are making efforts to improve healthcare infrastructures, which benefits the market. Patients are opting for these benefits, which has led vendors to come up with new technologies. Also, the increased competition among vendors ensures the availability of the most efficient treatment at reasonable costs.

According to the report, the changing lifestyle of people and improvements in healthcare infrastructures and treatment options have resulted in a rise in life expectancy, leading to an increase in the aging population. As a person ages, the risk of problems such as inflammation or swelling of the kidneys, diabetes, urinary tract infections, urinary incontinence, and renovascular disease also increases. Therefore, the increase in the aging population has a positive influence on the growth of the market.

Further, the report states that the risks associated with dialysis such as hypertension, infections, anemia, and bone diseases are one of the major challenges in the market.

The report considers the following segments of the market:

  • Peritoneal dialysis products
  • Peritoneal dialysis services

The global peritoneal dialysis market is categorized based on the type of application:

  • Continuous ambulatory peritoneal dialysis (CAPD)
  • Automated peritoneal dialysis (APD)

Key vendors

  • B. Braun Melsungen
  • Baxter International
  • DaVita Healthcare Partners
  • Fresenius Medical Care

Other prominent vendors

  • Covidien
  • Dialysis Clinic
  • Diversified Specialty Institute Holdings
  • Huaren Pharmaceutical
  • Medical Components
  • NephroPlus
  • Nipro
  • Northwest Kidney Centers
  • NxStage Medical
  • Renal Services
  • Sandor
  • Satellite Healthcare
  • Sichuan Kelun Pharmaceutical
  • U.S. Renal Care

For more information visit http://www.researchandmarkets.com/research/qzk8qk/global_peritoneal

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Combination of Agents in NEFROSIL™ found to be Highly Effective in Renal ... - PR Newswire (press release) PDF Print
SCOTTSDALE, Ariz., June 2, 2015 /PRNewswire/ -- Prismic Pharmaceuticals Inc., a specialty pharmaceutical company developing FDA-approved prescription drugs and FDA-regulated medical foods, today announced the results of a study in an animal model of renal disease of the combination of ingredients in one of its lead products, NEFROSIL™, which is in development for Chronic Kidney Disease (CKD). NEFROSIL™ is a proprietary formulation of ultra-micronized palmitoylethanolamide combined with silymarin, a polyphenolic compound.   The study was recently published in The European Journal of Pharmacology, and was conducted by Daniela Impellizzeri, Giuseppe Bruschetta, Akbar Ahmad, Rosalia Crupi, Rosalba Siracusa, Rosanna Di Paola, Irene Paterniti, Marco Prosdocimi, Emanuela Esposito, and Salvatore Cuzzocrea. The aim of the study, as noted by the authors, was to verify whether or not a combination treatment of palmitoylethanolamide and silymarin (Prismic's NEFROSIL™) "could exert more potent effects as compared to the single substances administered alone, allowing for administration of lower doses of the single agents in the treatment of renal disease. Thus, by reducing inflammation and by inhibiting oxidative stress, PEA + Silymarin treatment may reduce risk factors associated with the progression of renal diseases." Based on the results achieved, the authors concluded that the results clearly demonstrated that palmitoylethanolamide combined with silymarin "attenuated the degree of renal inflammation," and also concluded that the combination "demonstrated both efficacy and safety in an animal model of kidney disease." Commenting on behalf of the study sponsor, Prismic Pharmaceuticals, Dr. T. Forcht Dagi, MD, MPH, MBA, DMedSc, FAANS, FACS, FCCM, stated that, "It is important to note that Prismic's palmitoylethanolamide (PEA) has been extensively studied and its capability to reduce inflammatory processes and ischemia/reperfusion (I/R) damage in several validated animal models is well established. In this most recent study, the silymarin was shown to reduce kidney dysfunction, histological damage, neutrophil infiltration and oxidative stress in a dose dependent manner, and when combined with Prismic's proprietary formulation of palmitoylethanolamide, the therapy showed a pronounced synergistic or "potentiating" effect, significantly attenuating the degree of renal inflammation." Prismic's CEO, Peter Moriarty, commented that, "This is another positive step in the development of NEFROSIL™.  Prismic looks forward to making NEFROSIL™ available to CKD patients as an FDA-regulated medical food in late 2016 following the successful completion of a human clinical study. The study will be conducted in patients with CKD and diabetes mellitus and will measure improvements in the albumin-creatinine ratios and reduction in proteinuria, and other markers associated with progression of CKD." About Prismic Pharmaceuticals, Inc.
Prismic Pharmaceuticals, Inc. is a privately held specialty pharmaceutical company developing highly differentiated proprietary products in two distinct FDA categories, Prescription Drugs and Prescription Medical Foods, based on its two lead pharmaceutically active ingredients, ultra-micronized palmitoylethanolamide, and ultra-pure, high EPA, Omega-3. The company is developing products to address three key therapeutic areas with very large patient populations, and where there are clear and significant unmet clinical needs, namely, chronic kidney disease, depression, and severe chronic pain.Contact 480.422.1810 or visit
www.PrismicPharma.com.

INFORMATION CONTACT
Peter J. Moriarty
Tel: 480.422.1810

 

SOURCE Prismic Pharmaceuticals, Inc.

RELATED LINKS
http://www.PrismicPharma.com

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Researchers work to build replacement kidneys in the lab - NephrologyNews.com PDF Print

Researchers at Wake Forest Baptist Medical Center are working to build replacement kidneys in the lab, and have reported new findings in two recent studies. The team's goal is to make use of the more than 2,600 kidneys that are donated each year, but must be discarded due to abnormalities and other factors. The scientists aim to “recycle” these organs to engineer tailor-made replacement kidneys for patients.

“We believe the two studies we are reporting provide critical information to the booming field of organ bioengineering as it applies to the kidney,” said Giuseppe Orlando, M.D., Ph.D., a transplant surgeon and regenerative medicine researcher. Orlando is part of a team at the Wake Forest Institute for Regenerative Medicine aiming to recycle human kidneys. Another group at the institute is doing the same thing with pig kidneys.

The process begins by washing the discarded organs in a mild detergent to remove all cells. The idea is to replace these cells with a patient’s own kidney stem cells, making a tailor-made organ that would not be rejected and wouldn’t require the use of powerful anti-rejection medication. But are the organs a suitable platform for engineering after going through the process to remove cells?

To help answer that question, the researchers evaluated whether the washing process affects a small sac of capillaries in kidneys called the glomerulus. These vessels, which are vital to the kidney’s role of filtering contaminants out of the body, operate at a pressure that is at least three times higher than other capillaries in the body. The scientists injected resin into the structures to measure vessel size and used pulse-wave technology to measure pressure within the vessels. The researchers also screened the kidney structures to see if they retained growth factors that play an important role in function.

In the journal Transplantation, the research team reports that the size, structure and function of the micro-vessels in the glomerulus are preserved after the cell-removal process. In addition, vital proteins known as growth factors that regulate cell growth and function are retained within the kidney structures. 

“These growth factors play a vital role in the formation of new vessels and kidney cells,” said Orlando. “The fact that they are preserved means they can potentially facilitate the repopulation of cells into the structure and reduce the potential of clot formation.”

In a separate study, published in the journal CellR4, the team reported on the interactions that occur when stem cells are placed on kidney structures that have been through the cell removal process. 

“Understanding the interaction between the kidney structure and cells, as well as the choice of cell type to use, is an important challenge to address before a viable and functioning kidney structure can be manufactured and transplanted into patients,” said Orlando.

The team seeded stem cells derived from amniotic fluid onto sections of kidney structures. In this first study to describe the long-term results of this process, the scientists observed that the stem cells proliferated when placed on the structures and were functionally active as demonstrated by the fact that they secreted chemicals and growth factors involved in such critical pathways as inflammation and the formation of new blood vessels.

“These results indicate that discarded human kidneys are a suitable platform for engineering replacement kidneys and that when cells are added, the structures behave as an effective and viable biosystem,” said Orlando.

The researchers’ next steps are to identify the appropriate cells to regenerate the vascular compartment of the kidney as well as the compartment of the kidney responsible for blood filtration.

The research reported in Transplantation was funded by the Liberitutti Foundation.

Co-researchers on the Transplantation paper were Andrea Peloso, M.D., Ph.D., Christopher Booth, B.S., Jao Paulo Zambon, M.D., Ph.D., Shay Soker, Ph.D., and Robert J. Stratta, M.D., Wake Forest Baptist Medical Center; John Robertson, VMD, Ph.D., Timothy O’Brien, BSME, and Charles Aardema, B.S., VA Tech; and Stgik Petrosyan, B.S., Stefano Da Sacco, Ph.D., Robert De Filippo, M.D., and Laura Perin, Ph.D., University of Southern California. 

 

Co-researchers on the CellR4paper were Andrea Peloso, M.D., Ph.D., Zang Wang, Ph.D., Ravi Katari, B.S., Alan C. Farney, M.D., Ph.D., Jeffrey Rogers, M.D., Robert J. Stratta, M.D., and Shay Soker, Ph.D., Wake Forest Baptist; and Stefano Da Sacco, Ph.D., S. Sedakyan, Ph.D., Roger E. De Filippo, M.D., Laura Perin, Ph.D., and Astgik Petrosyan, B.S., University of Southern California.

 

 

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Growth and development Determinants of kidney size - Nature.com PDF Print

Growth and development Determinants of kidney size
Nature.com
Kidney size increases with increasing body mass and in response to the loss of a single kidney but the mechanisms behind these changes are unclear. Recent data reveal context-dependent roles for PTEN-dependent class I PI3K/mTORC2/Akt signalling and ...

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