Latest news with #ARBs
Time of India
03-06-2025
- Health
- Time of India
Evolution of kidney care: Past lessons, present innovation towards a hopeful future
Evolution of kidney care Past lessons, present innovation towards a hopeful future Kidney disease has long stood as a silent threat—one that quietly erodes health until its effects are irreversible. Among its many forms, chronic kidney failure remains particularly severe. It's important to reflect on how far we've come, the challenges that remain, and the promise the future holds. The past: From hopelessness to hope A century ago, the diagnosis of chronic kidney failure was tantamount to a death sentence. There were no effective treatments, no dialysis, and little understanding of disease progression. Early attempts at dialysis in the 1920s were primitive—massive and complex machines with limited impact and frequent complications. Most patients slipped away quietly, undiagnosed and untreated. The 1950s brought a glimmer of hope. The first kidney transplants—fraught with the dangers of immune rejection—eventually gave way to success, beginning with a landmark 1954 transplant between identical twins. Over time, medical science developed ways to tame the immune system with anti-rejection medications, transforming kidney transplantation from an experimental procedure into a viable, lifesaving therapy. India reached its own milestone in 1971, with the first successful transplant performed at Christian Medical College, Vellore, ushering in a new era of domestic nephrology care. The present: Precision, progress, and accessibility Today, the field of nephrology is a testament to scientific progress. Chronic kidney disease (CKD) no longer hides in the shadows; awareness is growing, diagnostics are improving, and treatments are more accessible than ever. In India alone, an estimated 10–12% of the population lives with some form of kidney disease. The root cause of this- Diabetes—a condition affecting over 77 million Indians, with nearly half already showing signs of kidney damage. Advancements in diagnostic tools—from routine ultrasounds to precise kidney biopsies—allow for earlier detection and intervention. Pharmaceutical breakthroughs, including SGLT2 inhibitors, ACE inhibitors, ARBs, and newer agents like finerenone, are helping clinicians slow the progression of disease and safeguard kidney function. When kidney failure becomes advanced, life does not have to stop. Innovations in dialysis—whether hospital-based or increasingly at home—offer patients a chance at stability and quality of life. Transplantation, once considered a last resort, now stands as a symbol of medical triumph. With decades of research yielding better immunosuppressive drugs and surgical precision, transplant survival rates have improved significantly. From laparoscopic procedures to more refined HLA-matching protocols, the outcomes today are better than ever. Even procedures once thought impossible—transplants across incompatible blood types, combined liver-kidney operations, and pancreas-kidney transplants for diabetic patients—are becoming increasingly common. The future: Toward artificial organs and regenerative breakthroughs Looking forward, the horizon of kidney care is expanding with promise. Scientists are pushing boundaries with novel therapeutics aimed at halting kidney decline earlier and more effectively than ever before. Recently, Zydus Lifesciences also conducted a campaign #LifeKaFilter that revolves around the importance of kidney health. The campaign highlighted various issues including how dialysis and transplants are lifesavers, but prevention is always better. Also, highlighted the government schemes that can ease the burden of kidney treatment costs. Researchers are exploring portable and wearable dialysis devices, which may soon enable patients to achieve even greater independence, offering freedom from the rigid schedules and physical toll of traditional dialysis. Perhaps the most revolutionary prospect lies in xenotransplantation—transplanting genetically engineered animal kidneys, typically from pigs, into humans. Though still in the realm of clinical trials, these experiments hint at a future where organ shortages may no longer be the bottleneck they are today. We are entering a golden era in nephrology, where technology, science, and access are converging to make what was once a life-threatening disease highly manageable, even curable. Author: Dr. Siddharth Mavani, Director, Nephrology and Kidney Transplant, Marengo CIMS Hospital, Ahmedabad The above is non-editorial content and TIL does not guarantee, vouch or endorse any of it. Please take all steps necessary to ascertain that any information and content provided is correct, updated, and verified. Stay informed with the latest business news, updates on bank holidays and public holidays . AI Masterclass for Students. Upskill Young Ones Today!– Join Now
Time of India
26-05-2025
- Health
- Time of India
How can people with diabetes effectively prevent kidney disease?
Kidney disease affects more than one third of people with diabetes and is the most common cause of renal failure on a global scale. People with diabetes can get kidney disease as result of poor control of glucose levels or other secondary causes like infections, autoimmune diseases, harmful medications etc. Preventing diabetic kidney disease needs a proactive approach with optimal management of lifestyle, medications to control the risk factors, and regular screening. Lifestyle changes are key in control of the metabolic risk factors for the kidney disease. Portion control of carbohydrates with increasing the vegetables, and lean proteins is important for good glycemic control. Eliminate simple carbs and processed sugars. Salt restriction is necessary for control of hypertension. A physical activity schedule involving aerobic and resistance training with at least 150 minutes of moderate activity is necessary. Weight loss of even 5% can improve the insulin sensitivity and reduce the blood pressure. Adequate hydration is important for renal health. People with diabetes are at a higher risk for urinary infections. It is important to screen and treat the urinary infections promptly as ascending infections often cause renal dysfunction. Especially people with additional risk factors like urinary stones, phimosis, and urethral strictures etc. need to be extra cautious. Medications such as NSAIDs, antifungals, and antibiotics which can potentially lead to renal injury should be used cautiously under medical supervision. When choosing the medications in patients with diabetes, the risk for kidney disease needs to be considered. We have medications like SGLT2 inhibitors, and GLP1 receptor agonists which can reduce the progression of kidney damage independent of the glucose control they provide. For patients with early signs of renal damage like proteinuria, these medications can delay and potentially prevent the onset of kidney disease. In addition, we need to control the cholesterol levels to optimal targets for reduction of cardiovascular events in addition to renal protection. Medications used for control of blood pressure like ACE inhibitors and ARBs also reduce the proteinuria and help in prevention of progression of the kidney disease. We have a new class of medications called non-steroidal MR blockers e.g. Finerenone which also reduce the proteinuria and prevent kidney disease progression. With the help of lifestyle measures and appropriate medications, we should target optimal glucose levels with Hba1c <7% for most adults and to keep the blood pressure < 130/80 mm Hg. Regular screening for kidney disease helps in early detection. Annual screening for proteinuria (using urine albumin to creatinine ratio) and estimated glomerular filtration rate (calculated based on serum creatinine level) is imperative for people with type 2 diabetes. Timing of the intervention plays an important role in prevention of kidney damage. Educating the patients about complication screening during clinic visits for diabetes helps a lot. At a community level educating the public with collaboration of dieticians, primary care physicians, endocrinologists, and nephrologists is imperative in spreading the awareness. Promoting widespread access to screening tests boosts efforts in early diagnosis and prevention. We need to think of primordial prevention. Identifying the people with metabolic risk factors, and preventing diabetes, and hypertension through lifestyle measures will have a greater impact than interventions at a later stage. To summarize, prevention diabetic kidney disease revolves around improvement of lifestyle, optimization of the metabolic risk factors through medications, and regular screening to diagnosed the kidney disease in a very early stage. With early diagnosis and optimal management, we can preserve the renal health and improve the quality of life for people with diabetes. Dr. Varun Suryadevara, Endocrinologist, MBBS MD Internal Medicine DM Endocrinology, Apollo Hospitals, Bangalore One step to a healthier you—join Times Health+ Yoga and feel the change
Hindustan Times
21-05-2025
- Health
- Hindustan Times
Understanding and managing hypertension: A focus on women
High blood pressure, or hypertension, is often called the 'silent killer' because it rarely shows symptoms but can lead to severe health complications like heart attacks, strokes, and kidney failure. Understanding blood pressure readings and when to act can save lives — especially among women, who face unique risk factors across their life stages. Hypertension affects more women because of hormonal changes, reproductive health, and lifestyle factors. Some of those include contraceptive pills, PCOS, menstrual and thyroid disorders, menopause and ageing, genetics, etc. Normal Blood Pressure: Systolic < 120 mm Hg and Diastolic < 80 mm Hg Elevated Blood Pressure: Systolic 120–129 mm Hg and Diastolic < 80 mm Hg Stage 1 Hypertension: Systolic 130–139 mm Hg or Diastolic 80–89 mm Hg Stage 2 Hypertension: Systolic ≥ 140 mm Hg or Diastolic ≥ 90 mm Hg Guidelines recommend initiating antihypertensive medications at lower thresholds in individuals with added risk factors, such as diabetes or chronic kidney disease. The general target blood pressure is below 140/90 mm Hg, but for those with diabetes or kidney disease, stricter control — below 130/85 mm Hg — is advisable. Doctors typically begin treatment with any of the following: Thiazide diuretics, Calcium channel blockers, ACE inhibitors, Angiotensin receptor blockers (ARBs). However, medication is only one piece of the puzzle. Lifestyle modifications play a powerful and often underestimated role. Lifestyle changes: The natural remedy You can lower your blood pressure naturally by engaging in at least 30 minutes of walking, steering clear of isometric exercises or weightlifting (which can spike blood pressure), limiting salt intake to less than 5 grams per day, etc. You may use pink or rock salt in moderation, but always ensure iodised salt is part of your diet, especially among pregnant women and young children, to avoid thyroid issues. Say no to processed foods, fried items, and excess fat. Aim for 6–8 hours of quality sleep each night. Reduce screen time. Practice yoga or meditation regularly to manage stress and anxiety, which can elevate blood pressure. Avoid high-calorie, processed, and salty foods. Engage in sports or physical activity daily. Use hormonal medications, painkillers, and steroids cautiously. Educate young girls on healthy eating and the risks of obesity and PCOS. Manage menopause positively with nutrition, mental well-being, and regular check-ups.
Medscape
15-05-2025
- Health
- Medscape
Psoriasis Tied to Kidney Disease in T2D, Despite Treatment
Patients with type 2 diabetes (T2D) who have psoriasis showed an increased risk for renal disease, including diabetic neuropathy, chronic kidney disease (CKD), end-stage renal disease (ESRD), and dialysis despite renoprotective therapy, while CKD risk had increased at 10 years after starting treatment among those receiving biologics. METHODOLOGY: Researchers conducted a retrospective cohort analysis using TriNetX data from 2014-2024, which included patients with T2D who started treatment with angiotensin-converting enzyme inhibitors (ACEis), angiotensin II receptor blockers (ARBs), or sodium-glucose cotransporter-2 inhibitors (SGLT2is). After propensity score matching, 27,044 patients were included in two cohorts — with and without psoriasis, diagnosed before starting renoprotective therapy. A total of 7771 patients with psoriasis received biologics, including interleukin (IL)-23, IL-17, IL-12/23, or tumor necrosis factor (TNF) alpha inhibitors. Study outcomes were diabetic nephropathy, CKD, ESRD, and need for dialysis at 3, 5, and 10 years. TAKEAWAY: At 3 years, patients with psoriasis demonstrated a significantly higher risk for diabetic nephropathy (absolute risk increase [ARI], 1.31; P < .0001), CKD (ARI, 1.80; P < .0001), ESRD (ARI, 0.38; P < .0001), and dialysis (ARI, 0.28; P < .0001). < .0001), CKD (ARI, 1.80; < .0001), ESRD (ARI, 0.38; < .0001), and dialysis (ARI, 0.28; < .0001). The increased risk persisted at 5 years (ARI, 2.02, 3.28, 0.58, 0.42, respectively; all P < .0001), and at 10 years (ARI, 3.30, 6.33, 0.94, 0.63, respectively; all P < .0001). < .0001), and at 10 years (ARI, 3.30, 6.33, 0.94, 0.63, respectively; all < .0001). Patients with psoriasis who received biologics showed a higher risk for CKD at 10 years despite renoprotective therapy ( P < .0001) than those without psoriasis. IN PRACTICE: 'Psoriasis may trigger a T-helper-17-driven inflammatory response, leading to the production of cytokines such as IL-17, IL-12/23, and TNF,' which induce renal inflammation, and this process is 'not targeted by ACEis, ARBs, or SGLT2is,' which may explain the persistently elevated CKD risk in patients with both T2DM and psoriasis, according to the study authors. They added that the findings support earlier evidence that 'biologics do not ameliorate the deterioration of renal function' in those with existing renal issues and a prospective study is needed to confirm these associations. SOURCE: The study was led by Tarun Sontam, Texas A&M School of Medicine, Dallas, Texas, and was published online on May 7 in the Journal of the American Academy of Dermatology . LIMITATIONS: The study did not account for psoriasis severity or duration and adherence to renoprotective therapy. The authors noted that uncontrolled factors might influence the findings. DISCLOSURES: The authors reported having no conflicts of interest. The study had no funding source.
Time of India
01-05-2025
- Health
- Time of India
National High Potassium Awareness Day: Be aware of high potassium: A silent danger to your heart
In today's busy lifestyles, people often fail to notice when they are unwell unless symptoms become very serious. Mild tiredness or muscle weakness rarely prompts a doctor's visit. However, for a person with chronic kidney disease (CKD) or heart failure (HF), these may be early signs of high potassium ( hyperkalaemia – excessive potassium in the blood). This condition often progresses without any obvious signs and can become life-threatening if not treated in time. The global prevalence of hyperkalaemia is estimated at around 6% to 7%. However, in patients with CKD or HF, the risk can rise sharply to 40–50%. Hence, it is important to raise awareness so that at-risk patients can take proactive steps to prevent or manage this condition. What is hyperkalaemia? Potassium is an essential mineral that plays a key role in keeping your muscles strong, your nerves healthy, and your heartbeat regular. When blood potassium levels rise above 5 mEq/L, a condition is called hyperkalemia that can silently threaten your health, especially your heart. In the early stages (mild hyperkalaemia), there are often no symptoms. Many people might not even realise they have it. However, if potassium levels continue to rise, it can cause muscle weakness, tingling sensations, fatigue, or irregular heartbeats. In severe cases (extreme hyperkalaemia), it can cause dangerous heart rhythm disturbances and sudden cardiac arrest. Who is at risk? High potassium levels are common in people with chronic kidney disease, as healthy kidneys usually remove extra potassium. It is also seen in those with heart failure, diabetes, or those taking certain medications such as blood pressure medicines (ACE inhibitors, ARBs, potassium-sparing diuretics). Why early detection matters Hyperkalemia can easily be detected by a simple blood test. Early diagnosis allows doctors to manage the condition before it becomes serious. Ignoring high potassium can result in life-threatening complications. Which foods are rich in potassium Potassium is found in many healthy foods, including bananas, oranges, potatoes, spinach, and dry fruits. While these foods are good for most people, those at risk of high potassium may need to limit their intake as per the advice of their doctor or dietitian. How is high potassium treated? Treatment depends on how high the potassium level is and the underlying cause. It may include: • Dietary changes: Reducing high-potassium foods after medical advice. • Adjusting medications: Modifying or changing medicines that raise potassium. • Diuretics: Water tablets are prescribed to encourage urination and remove excess potassium, which helps to keep potassium levels under permissible levels in high-risk patients. • Potassium binders: Special medicines doctors prescribe that help safely eliminate potassium through stools. Newer potassium binders have shown immense promise in stabilising potassium levels safely and effectively. • Tablet sodium bicarbonate: This tablet helps lower high potassium levels by making the blood less acidic, which pushes potassium back into the body's cells and reduces its level in the blood. It is especially useful when high potassium is linked to conditions like kidney problems with acidosis. • Emergency treatment: In severe cases, urgent hospital treatment may be needed to reduce potassium levels quickly. Health Tips to Prevent High Potassium • Know your risk: If you have kidney problems, heart failure, or diabetes, check your potassium regularly. • Know the SAFE range: A potassium level between 3.5 and 5.0 mEq/L is normal. • Manage your diet carefully: Avoid drastic dietary changes without professional advice. Some healthy foods can be risky in kidney disease. • Use medications wisely: Always inform your doctor about all your medicines, as some common drugs can raise potassium. • Stay hydrated: Dehydration can worsen potassium imbalance. • Monitor regularly: Regular blood tests can detect early problems. • Don't ignore symptoms: Muscle weakness, palpitations, or unexplained tiredness should never be ignored. (ByDr. Sanjay N. Pandya, Consulting Nephrologist, Rajkot, Gujarat) Masterclass for Students. Upskill Young Ones Today!– Join Now
