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5 results

  • Dietary fish oil reduces glomerular injury and elevated renal hydroxyeicosatetraenoic acid levels in the JCR:LA-cp rat, a model of the metabolic syndrome

  • Harold M. Aukema, Jing Lu, Faye Borthwick, Spencer D. Proctor
  • Journal:
    British Journal of Nutrition / Volume 110 / Issue 1 / 14 July 2013
    Published online by Cambridge University Press:
    15 November 2012, pp. 11-19
    Print publication:
    14 July 2013
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  • We have previously shown nutritional intervention with fish oil (n-3 PUFA) to reduce numerous complications associated with the metabolic syndrome (MetS) in the JCR:LA-corpulent (cp) rat. In the present study, we sought to explore the potential role of fish oil to prevent glomerulosclerosis in JCR:LA-cp rats via renal eicosanoid metabolism and lipidomic analysis. Male lean and MetS JCR:LA-cp rats were fed a lipid-balanced diet supplemented with fish oil (5 or 10 % of total fat). After 16 weeks of feeding, albuminuria was significantly reduced in MetS rats supplemented with 5 or 10 % fish oil ( − 53 and − 70 %, respectively, compared with the untreated MetS rats). The 5 % fish oil diet resulted in markedly lower glomerulosclerosis ( − 43 %) in MetS rats and to a lesser extent in those supplemented with 10 % fish oil. Interestingly, untreated MetS rats had higher levels of 11- and 12-hydroxyeicosatetraenoic acids (HETE) v. lean rats. Dietary fish oil reduced these levels, as well as other (5-, 9- and 15-) HETE. Whilst genotype did not alter prostanoid levels, fish oil reduced endogenous renal levels of 6-keto PGF1α (PGI2 metabolite), thromboxane B2 (TxB2), PGF2α and PGD2 by approximately 60 % in rats fed 10 % fish oil, and TxB2 ( − 50 %) and PGF2α ( − 41 %) in rats fed 5 % fish oil. In conclusion, dietary fish oil prevented glomerular damage in MetS rats and mitigated the elevation in renal HETE levels. These results suggest a potential role for dietary fish oil to improve dysfunctional renal eicosanoid metabolism associated with kidney damage during conditions of the MetS.

  • Hospitalization Rates Among Dialysis Patients During Hurricane Katrina

  • David Howard, Rebecca Zhang, Yijian Huang, Nancy Kutner
  • Journal:
    Prehospital and Disaster Medicine / Volume 27 / Issue 4 / August 2012
    Published online by Cambridge University Press:
    19 July 2012, pp. 325-329
    Print publication:
    August 2012
  • Introduction

    Dialysis centers struggled to maintain continuity of care for dialysis patients during and immediately following Hurricane Katrina's landfall on the US Gulf Coast in August 2005. However, the impact on patient health and service use is unclear.

    Problem

    The impact of Hurricane Katrina on hospitalization rates among dialysis patients was estimated.

    Methods

    Data from the United States Renal Data System were used to identify patients receiving dialysis from January 1, 2001 through August 29, 2005 at clinics that experienced service disruptions during Hurricane Katrina. A repeated events duration model was used with a time-varying Hurricane Katrina indicator to estimate trends in hospitalization rates. Trends were estimated separately by cause: surgical hospitalizations, medical, non-renal-related hospitalizations, and renal-related hospitalizations.

    Results

    The rate ratio for all-cause hospitalization associated with the time-varying Hurricane Katrina indicator was 1.16 (95% CI, 1.05-1.29; P = .004). The ratios for cause-specific hospitalization were: surgery, 0.84 (95% CI, 0.68-1.04; P = .11); renal-related admissions, 2.53 (95% CI, 2.09-3.06); P < .001), and medical non-renal related, 1.04 (95% CI, 0.89-1.20; P = .63). The estimated number of excess renal-related hospital admissions attributable to Katrina was 140, representing approximately three percent of dialysis patients at the affected clinics.

    Conclusions

    Hospitalization rates among dialysis patients increased in the month following the Hurricane Katrina landfall, suggesting that providers and patients were not adequately prepared for large-scale disasters.

    Howard D, Zhang R, Huang Y, Kutner N. Hospitalization rates among dialysis patients during Hurricane Katrina. Prehosp Disaster Med. 2012;27(4):1-5.

  • Chapter 26 - Demoralization in the medical setting

  • Edited by James J. Amos, University of Iowa, Robert G. Robinson, University of Iowa
  • Book:
    Psychosomatic Medicine
    Published online:
    04 August 2010
    Print publication:
    27 May 2010, pp 235-241

  • Summary

    It is well recognized that depression represents a significant co-morbidity for patients already confronted with chronic medical conditions. Individuals with kidney disease are not an exception to this observation. Many potential psychological, social, and biological contributions to the high rate of depression in patients with end-stage renal disease (ESRD) have been identified. Patients with ESRD on dialysis often suffer the loss of work status and time, health, and independence. Approximately one in four patients with ESRD chooses to voluntarily discontinue dialysis treatment. Many different classes of antidepressants have been used in this complex patient population. The medications most often utilized include the selective serotonin reuptake inhibitors (SSRIs) and the serotonin-norepinephrine reuptake inhibitors (SNRIs). The administration of tricyclic antidepressants (TCAs) in patients with renal disease is rife with potential complications. Electroconvulsive therapy has been used in patients with ESRD, and it appears well tolerated and effective in this patient population.

  • 21 - Renal disease

  • from Part III - Working with specific units
  • Edited by Geoffrey Lloyd, Priory Hospital, London, Elspeth Guthrie, University of Manchester
  • Book:
    Handbook of Liaison Psychiatry
    Published online:
    10 December 2009
    Print publication:
    24 May 2007, pp 506-526

  • Summary

    Renal services tend to be specialist settings serving patients from a wide geographical area. Some patients in renal services have primary renal diseases such as inherited polycystic kidney disease, others have a multisystem disease. Patients receiving renal replacement therapy often form the bulk of referrals from renal medicine to a liaison psychiatry service. In common with other patients suffering chronic medical conditions, patients with renal disease have to face the loss of their pre-existing health and they may also suffer other losses such as loss of their job, curtailment of leisure activities, relationship breakdown and loss of self-esteem. The multiple losses experienced by patients with end-stage renal disease increase their vulnerability to grief-like adjustment reactions and depression. Thus, as with other medical conditions, diagnosis of depression in patients with renal disease should rely more heavily on the psychological features such as anhedonia, guilt, loss of self-esteem, hopelessness and suicidal ideation.

  • The nurse's role in feeding patients with renal disease

  • Elaine P. Murray
  • Journal:
    Proceedings of the Nutrition Society / Volume 59 / Issue 3 / August 2000
    Published online by Cambridge University Press:
    28 February 2007, p. 487
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