RIGHT TO LIFE OF KIDNEY PATIENTS SHOULD BE RESPECTED

Government is spending crores of rupees in non-priority sectors to appease certain communities with an eye on vote bank.. for example, it is giving subsidies to Haj and other pilgrimages, it is giving subsidies for single girl child etc. It is spending crores of rupees for inoculation in areas where the diseases are never heard of.. But it is turning blind eye to the sufferings of kidney patients who are spending all their earnings to support their life and are in dire need of emergent medical care. Government does not allow any one to die; euthanasia or mercy killing is not permitted. Patients have RIGHT TO LIFE; it is a constitutional right. Government should not spend any paise on pilgrimage etc. unless it meets the emergent life saving needs of kidney patients and patients who are supporting life through expensive medications.. Patients should form an ASSOCIATION to assert the Rights of Patients..

a Wearable Artificial Kidney for dialysis patients

ScienceDaily (Aug. 21, 2009) —
Researchers are developing a Wearable Artificial Kidney for dialysis patients, reports an upcoming paper in the Clinical Journal of the American Society of Nephrology (CJASN). “Our vision of a technological breakthrough has materialized in the form of a Wearable Artificial Kidney, which provides continuous dialysis 24 hours a day, seven days a week,” comments Victor Gura, MD (David Geffen School of Medicine at UCLA).

The device—essentially a miniaturized dialysis machine, worn as a belt—weighs about 10 pounds and is powered by two nine-volt batteries. Because patients don’t need to be hooked up to a full-size dialysis machine, they are free to walk, work, or sleep while undergoing continuous, gentle dialysis that more closely approximates normal kidney function.

Such a device could lead to a “paradigm change” in the treatment of dialysis patients. Despite enduring long hours on dialysis every week—with major limitations in activities, diet, and other areas of life—dialysis patients face high rates of hospitalization and death. The U.S. dialysis population currently exceeds 400,000, with costs of over $30 billion per year. “We believe that the Wearable Artificial Kidney will not only reduce the mortality and misery of dialysis patients, but will also result in significant reduction in the cost of providing viable health care,” says Gura.

The Wearable Artificial Kidney is successful in preliminary tests, including two studies in dialysis patients. The new study provides important information on the technical details that made these promising results possible.

“However, the long-term effect of this technology on the well-being of dialysis patients must be demonstrated in much-needed clinical trials,” adds Gura. “Although successful, this is but one additional step on a long road still ahead of us to bring about a much-needed change in the lives of this population.”

Other authors were Alexandra S. Macy, Masoud Beizai, and Carlos Ezon (Xcorporeal, Inc); and Thomas A. Golper, MD (Vanderbilt University Medical Center). Dr. Gura receives a salary from Xcorporeal, Inc.

Additionally, significant contributions to the development of this new device were made by Hans Dietrich Polaschegg, PhD, Andrew Davenport, MD, Claudio Ronco MD, Andre Kaplan, MD, and Eli Friedman, MD.

http://www.renalandurologynews.com/

http://www.renalandurologynews.com/

Issues in Renal Disease: An Update

Issues in Renal Disease: An Update
Delicia Honen Yard
August 18 2009
Is CKD being defined too broadly and thus overdiagnosed?

Dr. Himmelfarb: The ASN per se doesn’t have a stand on this issue. But I would be very comfortable saying that the guidelines for classification and diagnosis of CKD promulgated by the National Kidney Foundation have had an overall benefit in developing a standardized approach to CKD. That said, controversy continues over whether the entire classification system for CKD should be based solely on the estimated glomerular filtration rate (eGFR) and whether, in essence, one size fits all for CKD. A number of efforts are under way to refine the CKD classification system, and many people feel that the classification scheme needs to be revised.

One major concern is whether the classification system, which doesn’t take into account age, tends to overdiagnose CKD in the elderly. Under the current system, about one third of people older than 70 will be classified as having CKD, yet it’s not clear that a high proportion of those individuals will progress to end-stage renal disease.

The CKD classification system is likely to be refined further in the future, but having the system, in my opinion, has been helpful in delineating the public health consequences of CKD.

Various drug combinations and dosages are continuously being tested in immunosuppressant regimens for renal transplant patients, but the best formula has yet to be determined. In what direction do you see this therapy moving?

Dr. Himmelfarb: There has been enormous progress in the development of immunosuppressive medications to prevent rejection of transplanted kidneys. And this has increased the choices of immunosuppressant combinations. While the short-term rates of rejection have declined, increasing attention is being paid to preventing long-term chronic allograft nephropathy or chronic rejection and minimizing the complications from immunosuppression. I think these trends are likely to continue.

Will we ever reach the point at which immunosuppressants will not be a lifetime prescription?

Dr. Himmelfarb: Within the transplant field, there are ongoing efforts to achieve what’s called tolerance, which would result in patients not having to take lifelong immunosuppressive medications. NIH has funded the Immune Tolerance Network, which sponsors studies on tolerance. So far achieving tolerance in humans has been difficult, and, at least for the time being, getting transplant recipients to continue on their immunosuppressive drugs is critically important.

What is the best approach to increasing the number of live kidney donors?

Dr. Himmelfarb: Like virtually every other organization, we would like to see increased availability of kidney transplants, and the best way to accomplish that is through educating the public about the relative safety of kidney donation. The ASN supports the Declaration of Istanbul, which promotes the idea that a kidney should not be a commodity that is bought and sold. This is somewhat of a controversial area—whether or not payments to live kidney donors would increase the number of kidney transplants that are performed.

Do you foresee the development of novel therapies that could replace traditional dialysis and transplants?

Dr. Himmelfarb: The ASN is certainly hopeful that new therapies will make our current therapies obsolete. One possibility would be the development of artificial implantable and/or wearable kidneys. Another would be organogenesis—essentially learning how to grow new kidneys.

Would you care to comment on the state of nephrology research?

Dr. Himmelfarb: Speaking as an individual, I think that many of the leading controversies in nephrology center on the lack of high-level evidence from randomized clinical trials to support practice recommendations.
Unfortunately, nephrology lags behind somewhat in performing the kind of randomized clinical trials that give us the highest level of evidence so that we can speak confidently about the best approaches to clinical practice. I don’t know why that is, but the nephrology community is attempting to address the problem. More clinical trials are currently being performed than in the past. But if we could achieve a higher level of evidence, then we could establish better consensus on how to optimize care for people with kidney disease. The ASN is, in general, a strong advocate for all kinds of kidney-disease research, including clinical, translational, and basic science studies.

Under new legislation, Medicare payments to dialysis centers will bundle medications with other dialysis services. What effect do you expect this to have on nephrology practices?

Dr. Himmelfarb: The major concern that ASN has with the legislation is to ensure that there are no unintended consequences whereby patients might be harmed because of possible underutilization of medications that are beneficial. In other words, if you’re being paid a fixed amount for the care of a patient, there could be a tendency to underutilize certain medications that may be beneficial. It’s really not on the part of the physicians: Nephrologists do not get reimbursed more or less money based on the prescription of medications for the dialysis patient. It’s the dialysis provider whose reimbursement will be affected by the prescription of medications. That’s one reason I don’t think this legislation will have a significant effect on nephrology practices; it will have a much greater effect on the dialysis provider.

Requesting extension of travell concession

Copy of Email to Chairman, Railway Board Etc.. requestion concession to patients travelling by train for routine checkups at hospitals post transplantation

From

Smitha V.P.
——————-
——-

To,
Chairman
Railway Board

Sir,

Kidney patients suffer a lot in all respects and the medical expenses are heavy. Even after transplant of kidney they have to go for routine checkup to the hospital every month. Since they are on immunosuppressive drugs to prevent rejection of transplanted kidney, they are still patients and their medical expenses are still heavy..

Therefore I request you to extend the railway concession granted to kidney patients travelling to hospital for dialysis and transplant to those who have undergone transplant and travelling to hospital for routine checkups..

Thank you

Yours faithfully

Smitha VP
Kozhikode, Kerala

Hail OBAMA…”No one in America should go broke because they get sick,” he said to loud applause.”

Obama is introducing health insurance reforms in america.. I hope that our masters, health minister, prime minister, chief ministers, health ministers of state and political parties too feel that same ..

Read this article in Reuters

No one in America should go broke because they get sick,” he said to loud applause.

Multiple Sclerosis Successfully Reversed In Mice: New Immune-suppressing Treatment Forces The Disease Into Remission

Multiple Sclerosis Successfully Reversed In Mice: New Immune-suppressing Treatment Forces The Disease Into Remission

ScienceDaily (Aug. 12, 2009) — A new experimental treatment for multiple sclerosis (MS) completely reverses the devastating autoimmune disorder in mice, and might work exactly the same way in humans, say researchers at the Jewish General Hospital Lady Davis Institute for Medical Research and McGill University in Montreal.

MS is an autoimmune disease in which the body’s own immune response attacks the central nervous system, almost as if the body had become allergic to itself, leading to progressive physical and cognitive disability.

The new treatment, appropriately named GIFT15, puts MS into remission by suppressing the immune response. This means it might also be effective against other autoimmune disorders like Crohn’s disease, lupus and arthritis, the researchers said, and could theoretically also control immune responses in organ transplant patients. Moreover, unlike earlier immune-supppressing therapies which rely on chemical pharamaceuticals, this approach is a personalized form of cellular therapy which utilizes the body’s own cells to suppress immunity in a much more targeted way.

GIFT15 was discovered by a team led by Dr. Jacques Galipeau of the JGH Lady Davis Institute and McGill’s Faculty of Medicine. The results were published August 9 in the prestigious journal Nature Medicine.

GIFT15 is composed of two proteins, GSM-CSF and interleukin-15, fused together artificially in the lab. Under normal circumstances, the individual proteins usually act to stimulate the immune system, but in their fused form, the equation reverses itself.

“You know those mythical animals that have the head of an eagle and the body of a lion? They’re called chimeras. In a lyrical sense, that’s what we’ve created,” said Galipeau, a world-renowned expert in cell regeneration affiliated with the Segal Cancer Centre at the Jewish General and McGill’s Centre for Translational Research. “GIFT15 is a new protein hormone composed of two distinct proteins, and when they’re stuck together they lead to a completely unexpected biological effect.”

This effect, explained Galipeau, converts B-cells — a common form of white blood cell normally involved in immune response — into powerful immune-suppressive cells. Unlike their better-known cousins, T-cells, naturally-occurring immune-suppressing B-cells are almost unknown in nature and the notion of using them to control immunity is very new.

“GIFT15 can take your normal, run-of-the-mill B-cells and convert them — in a Superman or Jekyll -Hyde sort of way — into these super-powerful B-regulatory cells,” Galipeau explained. “We can do that in a petri dish. We took normal B-cells from mice, and sprinkled GIFT15 on them, which led to this Jekyll and Hyde effect.

“And when we gave them back intravenously to mice ill with multiple sclerosis, the disease went away.”

MS must be caught in its earliest stages, Galipeau cautioned, and clinical studies are needed to test the treatment’s efficacy and safety in humans. No significant side-effects showed up in the mice, he said, and the treatment was fully effective with a single dose.

“It’s easy to collect B-cells from a patient,” he added. “It’s just like donating blood. We purify them in the lab, treat them with GIFT15 in a petri dish, and give them back to the patient. That’s what we did in mice, and that’s what we believe we could do in people. It would be very easy to take the next step, it’s just a question of finding the financial resources and partnerships to make this a reality.”

Kidney patient’s own stem cells used to cure cancer

Patient’s own stem cells used to cure cancer
Malathy Iyer, TNN 27 July 2009, 01:30am IST
MUMBAI: For 15 years, Rakesh Singh (name changed) went about his high-pressure job as a senior engineer in a central government firm with a transplanted kidney.

Daily, he would pop immuno-suppressant pills to prevent his body from rejecting the donated organ. Then, about 18 months ago, he was struck by an “explosive” form of cancer called multiple myeloma — big boils erupted across and within his body, impairing his ability to sign and speak.

Singh’s disease put doctors in the city’s Jaslok Hospital in a bind about what line of treatment to follow: reducing the immuno-suppressants to let his body fight the cancer cells could have led to a possible rejection of the kidney.

It was then decided to give him a second transplant — of the bone marrow this time — with his own stem cells. Today, Singh is cancer-free and a medical marvel of sorts.

It has been a month since the 49-year-old underwent a PET (positron emission tomography) scan that categorically showed that he had no more cancer cells in his body. He has been breathing easy since then, but the doctors who treated him over 18 months have got a tad busier: they have a big announcement to make to the world.

Papers are being written, archives are being rechecked and old-timers being consulted before the doctors submit their claim to Nephrology Dialysis Transplant, a European journal.

“Singh is the first kidney transplant patient in the world to undergo a stem cell transplant to beat multiple myeloma (a cancer of the plasma cell) after ablative chemotherapy,” say nephrologist Dr Madan Bahadur, hematologist Dr Sameer Shah and oncologist Dr Ganpati Bhat.

KEM Hospital’s head of nephrology department, Dr V Hase, says, “The Jaslok patient’s case is of great academic interest. Firstly, it is rare for a kidney transplant patient to develop multiple myeloma. Secondly, no transplant patient in India has undergone a stem cell transplant as a rescue mission against cancer.’’

Dr Hase adds that renal failure is a known complication of multiple myeloma. ‘‘So, in the western world, multiple myeloma patients would undergo stem cell transplant first and a renal transplant later,’’ he says. ‘‘But in the Mumbai case, the opposite has happened.’’

As for the man who underwent the Rs 19-lakh rescue, ‘‘life in the last 18 months has been a struggle for survival’’. He smiles as he recalls the difficulty he had in signing papers.

Health, commerce ministries seek infra status for healthcare

Health, commerce ministries seek infra status for healthcare
5 Jul 2009, 0050 hrs IST, Writankar Mukherjee & Gulveen Aulakh, ET Bureau
KOLKATA/CHANDIGARH: Union commerce and health ministries have made a strong pitch to the finance ministry to accord infrastructure status to the
healthcare sector in the budget. The move is in line with UPA’s focus on bringing social sector reforms and likely to further boost private sector investment in semi-urban and rural markets.

Two top-level industry officials, who are closely tracking the development with the union government, said it is the first time that both commerce and health ministries have given such a proposal even though the healthcare industry was lobbying for the status for the last couple of years. Little wonder, that expectations are high that the infra status for healthcare will be announced in this year’s budget.

Infrastructure status usually comes with a tax holiday of ten years and will enable private hospitals to raise cheaper long-term capital. Hospitals now enjoy a five-year tax holiday in Tier II and III areas provided they commence operations between April 1, 2008 and March 31, 2013.

This proposal was announced in last year’s budget. “The commerce, health ministry as well as the Planning Commission have recognised that awarding infrastructure status will improve the nation’s healthcare index. The UPA government is committed to such social sector reforms,” a senior industry official said.

Wockhardt Hospitals CEO Vishal Bali said infrastructure status to healthcare sector will help private hospitals to access funds easily for expansion.

“Plus, the tax holiday which comes with infrastructure status will be an added incentive for investment. The biggest example is the country’s IT sector blossoming after it was awarded infrastructure status,” he said.

Healthcare service providers feel infrastructure status will also bring down cost of treatment. “If Rs 55-60 lakh per bed is being invested right now, the cost can come down to Rs 35 lakh per bed, which will ultimately make hospitals and better treatment available to a large number of people,” said Max Healthcare CEO and MD Pervez Ahmed.

Industry estimates suggest India at present requires around $80-billion investment in the healthcare sector. While the bed: population ratio in developed nations is 7:1000, in India it is around 1:1000.

A WHO survey indicated that India ranks at 171 out of the 175 nations in terms of percentage of GDP spent in the public sector on healthcare. In the same survey, India ranks 17 in terms of private sector spending on health.

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Union commerce and health ministries have made a strong pitch to the finance ministry to accord infrastructure status to the healthcare sector in the budget.

Gujarat has maximum Kidney transplant in the World

Gujarat has maximum Kidney transplant in the World

2009-07-03 20:27:37

Gujarat Global News Network, Ahmedabad

Government run Kidney Hospital has one kidney transplant a day which makes it number one hospital in the world. Making this claim, Gujarat Health Minister Jay Narayan Vyas said that Gujarat had 118 cadaver transplants which was also a world record.

Replying to a question in the State Assembly, Vyas said that in the last two years there were 980 cases of kidney transplant in the state of which 767 were in Ahmedabad alone. He said that efforts were being made to declare the Kidney hospital in Ahmedabad a centre for excellence.

There are seven hospitals in Gujarat with the facility of kidney transplant. Of these five are in Ahmedabad, one in Nadiad and one in Vadodara.

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