Latest news with #chronic kidney disease
Medscape
a day ago
- Health
- Medscape
Hydroxychloroquine Use May Be Beneficial in Lupus Nephritis
TOPLINE: Hydroxychloroquine exposure in patients with lupus nephritis was associated with a substantially lower risk for estimated glomerular filtration rate (eGFR) decline of ≥ 30%, particularly among those with chronic kidney disease (CKD) stage ≥ 3. METHODOLOGY: Researchers conducted a retrospective study involving 209 patients with biopsy-proven incident lupus nephritis (mean age at diagnosis, 38 years; 75% women) between 1994 and 2019 identified at a single center in Wisconsin to examine the effect of hydroxychloroquine on kidney function. Hydroxychloroquine exposure status (median dose, > 5 vs ≤ 5 mg/kg/d) was determined at each visit using electronic health records, with positive exposure ascertained by an active prescription for at least 3 months at each follow-up. The primary outcome was eGFR decline of ≥ 30% at a minimum of two follow-up visits compared with baseline eGFR, or the requirement of sustained renal replacement therapy, with a mean follow-up duration of 5.4 years. The secondary outcome included an eGFR decline of ≥ 40%, and the annual eGFR slope to assess kidney function decline over time. TAKEAWAY: Time-varying exposure to hydroxychloroquine was associated with a 59% lower risk for an eGFR decline of ≥ 30% (adjusted hazard ratio [aHR], 0.41; P = .007). Similarly, hydroxychloroquine exposure was associated with a 66% lower risk for an eGFR decline of ≥ 40% (aHR, 0.34; P = .004). In patients with CKD stage ≥ 3 at lupus nephritis diagnosis, hydroxychloroquine exposure was associated with a 77% lower risk for an eGFR decline of ≥ 30% (aHR, 0.23; P = .03). Exposure to hydroxychloroquine led to significant annual reductions in eGFR slope declines of 5.12 mL/min/1.73 m2 within 5 years of a lupus nephritis diagnosis and 3.17 mL/min/1.73 m2 within 10 years. IN PRACTICE: 'These findings emphasize the importance of starting early and continuing HCQ [hydroxychloroquine] therapy to preserve kidney health alongside overall disease control even if SLE [systemic lupus erythematosus] is limited to the kidneys [lupus nephritis],' the authors of the study wrote. SOURCE: This study was led by Shivani Garg, MD, PhD, University of Wisconsin School of Medicine & Public Health, Madison, Wisconsin. It was published online on July 20, 2025, in Arthritis Care & Research. LIMITATIONS: The single academic institution setting potentially affected population representation. Data on hydroxychloroquine blood levels were unavailable to assess adherence and absorption variability. Decline of eGFR may have been missed in patients lost to follow-up or those who died at outside institutions. DISCLOSURES: This study received support from the University of Wisconsin-Madison, Institute for Clinical and Translational Research and the Clinical and Translational Science Award program from the National Institutes of Health (NIH) National Center for Advancing Translational Sciences. One author reported receiving funding through the NIH and honoraria for presentation at a conference. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
SBS Australia
2 days ago
- Health
- SBS Australia
When Home Heals: Dialysis and the Power of Staying on Country
For many Yolŋu people, being forced to leave Galiwin'ku for dialysis has meant separation from family, country, and culture - sometimes for years, sometimes forever. Chronic kidney disease, largely caused by lifestyle changes introduced through Western foods, has taken a devastating toll. For generations, Yolŋu people followed the rhythms of the seasons, knowing when and what to eat to stay strong and healthy. Traditional foods were naturally low in sugar and highly nutritious. But the shift to store-bought foods, soft drinks, and processed foods has led to widespread chronic disease - something that was once rare in these communities. In the past, when the winds come this way, we know what to eat. It's been passed over from my grandfather. What we feel through air, it's part of the grandfather that passed over to us, so we know exactly what to eat when the season comes. Charlie Dhamarrandji, Dialysis Patient In this episode, Dr. Sarah Hanieh speaks with Charlie Yebarrarr Dhamarrandji who shares his personal journey with chronic kidney failure and receiving dialysis treatment, and Kat Baxter, a dialysis nurse from Purple House, living on country in Galiwin'ku. Together, they discuss what it means to receive dialysis on country, the reality of chronic disease in remote communities, and how Yolŋu knowledge and traditions continue to play a vital role in health and healing. Two Worlds, One Health is created by Dr Sarah Hanieh Host : Dr Sarah Hanieh Production assistance : Lindy Marlow Artwork: Ruth Gulamanda Dhurrkay and Rickisha Banba Gurruwiwi Music : Djutjuti Nha Djamarrkuli, Shepherdson College, Galiwin'ku, Department of Education, Northern Territory. Mixed: Max Gosford Photos credit: Lindy Marlow Thanks to Joel Supple for her guidance. This podcast was recorded on the lands of the Yolŋu people in Galiwin'ku. I pay my respect to their Elders, past and present, and acknowledge their ongoing connection to the land, water, and culture Links:
Medscape
17-07-2025
- Health
- Medscape
Oral Semaglutide Offers Kidney Benefits in T2D
TOPLINE: The administration of up to 14 mg oral semaglutide for about a year led to a reduction in the urinary albumin-to-creatinine ratio (UACR) by over 40%, without changing the rate of kidney function decline in patients with type 2 diabetes (T2D). METHODOLOGY: Researchers in Spain conducted a retrospective cohort study to evaluate the real-world effectiveness of oral semaglutide on kidney outcomes in patients with T2D. They included 819 patients (median age, 63 years; 45.8% women) with T2D who initiated oral semaglutide (up to a dose of 14 mg/d) between 2021 and 2022, had undergone kidney function tests within 3 months before starting oral semaglutide, and had at least one follow-up measurement at 3 months. In this cohort, the baseline median estimated glomerular filtration rate (eGFR) was 88.1 mL/min/1.73 m 2 , and the median UACR was 12 mg/g; 33.5% of patients had an UACR ≥ 30 mg/g, 47.2% had chronic kidney disease (CKD), and 57% were on background SGLT2 inhibitor treatment. , and the median UACR was 12 mg/g; 33.5% of patients had an UACR ≥ 30 mg/g, 47.2% had chronic kidney disease (CKD), and 57% were on background SGLT2 inhibitor treatment. Co-primary endpoints were changes from baseline in the UACR and eGFR slope at 6 and 12 months. TAKEAWAY: At 12 months, oral semaglutide use led to a reduction in the UACR by 40.0% in the overall cohort and by 50.7% and 49.9% in those with an UACR of 30-299 mg/g and ≥ 300 mg/g, respectively (P < .001 for all). Across all albuminuria levels and CKD stages, the median eGFR remained stable, with median values of 88.1 and 87 mL/min/1.73 m 2 at 6 and 12 months, respectively. at 6 and 12 months, respectively. Low risk for liver fibrosis (measured using the fibrosis-4 index) was associated with over fivefold higher odds of achieving a more than 30% reduction in the UACR (adjusted odds ratio, 5.50; P = .006). Fewer than 5% of patients had a major adverse kidney event by follow-up, and those who stopped semaglutide or had higher low-density lipoprotein cholesterol levels faced a higher risk. IN PRACTICE: "Our data strongly suggest the renal benefits of oral semaglutide in a broad population of PWT2D [people with T2D]. Given the global supply chain issues for subcutaneous GLP-1 RAs [receptor agonists], the results of this study may be helpful in supporting clinical decision making," the authors wrote. SOURCE: This study was led by Oscar Moreno-Pérez, General University Hospital Dr Balmis of Alicante, Alicante, and Rebeca Reyes-Garcia, University Hospital of Torrecárdenas, Almería, both in Spain. It was published online on July 11, 2025, in Clinical Kidney Journal. LIMITATIONS: This study was limited by its retrospective observational design without a control group and by potential variability in UACR measurements. The lack of adherence data and a short follow-up period may have led to an underestimation of kidney events. Additionally, selection bias could not be ruled out despite adjustment for confounders. DISCLOSURES: This study received a grant from Novo Nordisk to subsidise publication costs. Some authors reported receiving honoraria and/or consulting fees from several pharmaceutical companies, including the funding agency. This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.
Free Malaysia Today
15-07-2025
- Health
- Free Malaysia Today
Why CKD continues to fly under the radar
CKD is a progressive condition in which the kidneys gradually lose their ability to filter waste and excess fluids from the blood. (Envato Elements pic) PETALING JAYA : The prevalence of chronic kidney disease (CKD) in Malaysia surged from 9.07% in 2011 to 15.48% in 2018, signalling a worrying trend. Today, more than 50,000 Malaysians receive dialysis, according to the health ministry, which projects this number could exceed 100,000 by 2040 if early intervention continues to be elusive. Yet, many remain unaware they might be at risk: the slow, symptomless nature of CKD and lack of public awareness often lead to late diagnosis, after significant and irreversible kidney damage has set in. CKD is a progressive condition in which the kidneys gradually lose their ability to filter waste and excess fluids from the blood. By the time patients experience symptoms like fatigue, bodily swelling, or changes in urination, significant and often irreversible damage has already occurred. 'CKD is a dangerous disease precisely because it hides in plain sight,' explained consultant nephrologist and physician Dr Chong Yip Boon. 'Left undetected, it can result in life-threatening complications such as cardiovascular disease, symptomatic anaemia, metabolic bone diseases, fluid overload and ultimately, irreversible renal failure and death. 'Its insidious onset and silent progressive nature make early detection both challenging and critical. Lack of public awareness and regular health screenings further increase the difficulty in its early diagnosis.' Dr Chong Yip Boon. One of the key reasons CKD is frequently diagnosed at advanced stages is the widespread lack of public awareness and regular checkups. Most individuals do not experience any discomfort or clear symptoms in the early stages of the disease. Even when signs appear, they are often misattributed to other, less serious conditions. The common mindset that 'feeling fine means being healthy' leads to delayed action, especially among high-risk individuals. 'The issue isn't that kidney tests aren't available. In fact, they are included in most health screening packages,' Chong noted. 'The problem is that people simply don't come in for checkups until it's too late.' Screening is especially important for high-risk groups: those with diabetes, hypertension, heart disease, morbid obesity, kidney stones, gout, or a family history of kidney disease. Others include the elderly, frequent users of painkillers or over-the-counter medications, and those who self-medicate regularly. The health ministry projects that, without early intervention, the number of Malaysians who require dialysis could hit 100,000 by 2040. (Bernama pic) In some cases, early signs may be more visible than people realise. For example, abnormal bubbly or foamy urine can be an early indicator of protein loss – a possible sign of kidney damage. A simple urine test with a GP or specialist can determine whether symptoms are benign or related to CKD. Chong places emphasis on practical lifestyle steps to reduce the risk of kidney disease: drink at least 2 litres of water per day (if there are no underlying heart conditions); maintain a healthy and balanced diet; avoid overuse of painkillers, unprescribed supplements, and self-medication; exercise regularly and aim for sustainable weight reduction; avoid or limit smoking and alcohol consumption; schedule routine full-body screenings and checkups to have a more well-informed overview of one's health; manage existing underlying medical conditions such as diabetes, hypertension, high cholesterol, and heart disease. 'Malaysians must begin to see kidney health as an essential part of general wellbeing, not something to think about only when symptoms appear,' Chong stressed. 'Routine screening, especially among at-risk individuals, can lead to early detection, delay disease progression, improve quality of life, and significantly reduce long-term healthcare costs.'
