New Kidney Test Cuts Dialysis Need

New Kidney Test Cuts Dialysis Need

A new non-invasive test for kidney disease is providing a simple, safe, cheap and reliable method of detection.

The test - developed by clinicians at Hammersmith Hospital and Imperial College London (ICL) - can detect disease before symptoms become apparent and offers a quicker way of finding out if patients are responding to treatment. It could mean that some patients might not need costly dialysis.

About 100,000 people in the United Kingdom have kidney disease and the number is increasing, costing the National Health Service more than two billion pounds annually. More than 7,000 people die from kidney failure every year.

"Patients with a progressive kidney disease due to vasculitis often develop kidney failure, the only treatment for which is dialysis or kidney transplant," explained Dr Fred Tam, consultant nephrologist at Charing Cross and Hammersmith Hospitals and senior lecturer at ICL.

"By looking at a chemical produced when the kidney becomes inflamed, we can test patients' urine for the level of disease, often before clinical symptoms appear."

The test could eventually replace the need to take biopsies from the kidney - a complicated and uncomfortable surgical procedure.

Current treatments for kidney vasculitis involve using drugs that knock out the body's immune system. These drugs can cause side-effects, including vulnerability to infection and risk of reduced fertility.

This new test can accurately measure response to treatment, allowing clinicians to tailor treatments to individual patients. "The test can tell us if a treatment is working, and shows us, before it is too late, if we need to change the medication, without the need to perform a biopsy," added Dr Tam.

The test works by identifying the amount of a cytokine molecule (a protein released by a cell that affects the behaviour of other cells) called monocyte chemoattractant protein-1 (MCP-1) present in the urine.

MCP-1 is produced by the body as a response to inflammation, and attracts white blood cells to the area to combat pathogens. But over-reaction of the white blood cells may also cause vasculitis and organ damage.

Each test costs under 20 pounds. Kidney dialysis costs about 29,000 pounds a year for one patient. The development was reported in the journal Nephrology Dialysis Transplantation.

Imaging Technique Aids Early Detection of Eye Disease
Pictures of the retina taken by a new technique could help to diagnose and monitor the progress of most prevalent diseases of the eye - glaucoma, diabetic retinopathy and age-related macula degeneration. The technique was revealed at the recent Institute Of Physics conference Photon 04 in Glasgow, United Kingdom.

By 2020 there will be 200 million visually impaired people worldwide but 80 per cent of these cases are preventable or treatable, it was claimed. For this to happen, screening and early detection are crucial. Dr Sonny Ramachandran, from Heriot Watt University in Edinburgh, outlined a new technique that uses spectral imaging, a non-invasive and safe method of taking pictures of the retina, to study the blood vessels of the eye and reveal the presence or progression of any disease.

The Heriot Watt researchers modified a standard ophthalmoscope, adding a liquid crystal tuneable filter that allowed them to take images of the retina at a series of specific wavelengths. The images are captured by a sophisticated digital camera - a cooled, low-noise CCD camera. Image processing corrects for the movements of the eye while the pictures are being taken, and a large set of images are combined in a "data cube" to improve the quality of the resolution

Spectral imaging is especially useful because it allows scientists to take images taken at specific wavelengths. Crucially, wavelengths between 580nm and 600nm reveal the oxygenation state of the blood vessels in the eye, telling doctors what areas are healthy and what might be diseased. Dr Andrew Harvey, one of the supervisors of the project, said: "So far, we have used this technique to take images of the retina in healthy subjects, patients with diabetic retinopathy and patients with glaucoma and in all cases it seems that our images are extremely successful in helping doctors detect and chart the condition. We are now at the stage of trialling this much more rigorously in a clinical setting but are very hopeful that this will be a promising new tool that will help doctors screen and monitor the major diseases of the eye.

"Some of the existing screening techniques, such as the fluorescein angiogram for diabetic patients, can be painful and in some cases dangerous with patients dying during treatment," he pointed out. "This new technique is safe, quick and simple and totally non-invasive so going for regular check-ups every four months won't be so daunting for patients."

Cardiac Monitoring At Home
According to recent figures, one person suffers a heart attack every two minutes in the United Kingdom. To combat this, a company called Broomwell Health Watch has launched the UK's first cardiac home-monitoring service that could potentially save the 160,000 lives that are claimed by such attacks every year.

Many people fail to spot the symptoms of a heart attack and this delay can lead to irreversible damage of the delicate myocardial tissue in survivors. Studies have shown that the average time from onset of symptoms to a call for help is between two and six hours.

The Health Watch Tele Medical service spots vital symptoms within minutes so the patient can receive rapid diagnosis from a specialist cardiac nurse if they are worried about the onset of an attack. It monitors heart patterns from the comfort of a patient's home, helping to diagnose life-threatening changes to heart activity within minutes, dramatically reducing the possibility of heart damage.

This groundbreaking service, which provides peace of mind to anyone whose family has a history of heart disease, or who suffers from heart problems or hypertension (high blood pressure), works through state-of-the-art monitoring devices that forward information about blood pressure, breathing rate, pulse, heart rate and ECG to a team of specialist cardiac nurses.

The Health Watch monitoring centre is staffed 24/7 so that subscribers can talk directly to cardiac experts at any time. Being in touch with a monitoring centre provides them with peace of mind, calmness and a sense of security. The centre can call an ambulance if there is an emergency and forward medical information to the hospital (where the hospitals have the facility to receive such information) before the patient arrives, saving yet more critical time.

Users pay a one-off fee for a monitoring device and a subscription fee. The service has been launched with two types of devices: the "Mini-Clinic" and 12-lead ECG. The Mini-Clinic is an ingenious "reassurance" device about the size of a wristwatch. It contains a panic alarm and transmits data on breathing rate, heart rate, temperature and heart rhythm (1 lead ECG) to the Health Watch centre. Subscribers dial into the centre's cardiac experts and within just two to three minutes they have a diagnosis. This one ECG device is particularly good for people suffering from heart palpitations and arrhythmia and for general and routine cardiac monitoring.

The 12 Lead ECG is a compact handheld device designed to provide a much more comprehensive reading of the heart. It can even be used in clinics and hospitals because the device is much quicker and easier to use than those generally available. It takes only 45 seconds to record information and around 45 seconds to send it via any landline phone so that a specialist cardiac nurse or doctor can provide rapid diagnosis.

Dr David Lipkin, consultant cardiologist at the Royal Free Hospital in London, said: "This is very clever technology that will hopefully make a big difference to patient healthcare and save lives. I'm very excited by the whole concept. It allows us to detect problems earlier to avoid irreversible damage to the heart and detect changes in heart rhythms that only happen at interim periods - not always while a patient is in casualty."

Shaking The Salt Habit
Consumers can drastically improve their diet to include less salt, sugar and fat by retraining their palates, say nutritionists.

According to research from Cardiff University in Wales and food manufacturing giant Heinz, it takes between eight and 12 weeks to retrain a palate. Professor Tim Jacob, of Cardiff University's School of Biosciences, said: "Over the last few years we have simply become accustomed to too much taste but as food companies such as Heinz work to reduce levels of salt in their products the initial taste difference that some people are sensitive to will also reduce."

Brussels sprouts and cabbage might even become the nation's favourites, he added. Food habits have changed significantly in the last 30 years. Suet pudding, bread and dripping and fried breakfasts are getting the thumbs down as the British opt for saltier tastes, claims the research.

The UK's reliance on high salt foods has increased by around seven per cent over the last 15 years with 40 per cent of the population using salt at the table and more than 70 per cent adding salt before even tasting their food. "To help with the acceptance of food with a reduced salt content, manufacturers need to focus on other flavours," said Professor Jacob.

Scott Garrett, Brand Director at Heinz, commented: "Heinz has recently reduced salt, sugar and fat across its range of soups and replaced it with more core ingredients than ever before. On average the soup range now has 25 per cent less salt while there are 13 per cent more tomatoes in the cream of tomato soup and 30 per cent more vegetables in cream of vegetable soup."

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