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'Kids In Hospital With High Blood Pressure Double In Ten Years, US' - Medical News Today PDF Print
Featured Article
Academic Journal
Main Category: Hypertension
Also Included In: Pediatrics / Children's Health
Article Date: 20 Jun 2012 - 0:00 PDT


The number of children seen as inpatients in US hospitals nearly doubled in the ten years leading up to 2006, according to a new study published online in the journal Hypertension this week that also drew attention to the associated dramatic increase in healthcare cost.

The lead author of the national study, the first to examine high blood pressure hospitalizations in American children, was Dr Cheryl Tran, pediatric nephrology fellow in the Department of Pediatric Nephrology at the University of Michigan in Ann Arbor.

She told the media that while you might expect there to be a rise in costs as a result of a rise in the numbers, "the economic burden created by inpatient childhood high blood pressure was surprising".

For the study, Tran and colleagues analyzed records for the years 1997, 2000, 2003 and 2006 from the Healthcare Cost and Utilization Project (HCUP) Kids' Inpatient Database and found that the number of children in the US treated in hospital for hypertension as inpatients nearly doubled from 12,661 in 1997 to 24,602 in 2006.

The children most likely to be treated in hospital for high blood pressure were African-American boys, aged 10 and over. They were also more likely to be treated in a teaching hospital.

The researchers said children treated for high blood pressure tended to stay in hospital for an average of 8 days compared to the average of 4 days for other illnesses.

They also calculated that the charges for inpatient care for children with high blood pressure went up by 50% over the decade, reaching an estimated $3.1 billion.

Outpatient charges would increase this figure even further, but the researchers could not say by how much because those costs are unknown at a national level.

The biggest increases were for children with high blood pressure and end stage kidney disease:

"The coexisting condition of end-stage renal disease resulted in a significant increase in healthcare charges," write the authors.

Speculating on the reason behind these increases, Tran and colleagues suggested the biggest factor is likely to be the rise in childhood obesity.

When they examined the reasons why children were admitted to hospital, and where high blood pressure fitted in, they found:

  • The most common diagnoses were pneumonia, acute appendicitis and asthma.
  • When high blood pressure was the primary diagnosis, then the secondary diagnoses were for convulsive disorder, headache, obesity and systemic lupus erythematosus.
  • When high blood pressure was in any diagnoses, the most common primary diagnoses were lupus, complications of kidney transplant, pneumonia and acute proliferative glomerulonephritis.
Acute proliferative glomerulonephritis is a condition that causes kidney inflammation that can in turn lead to high blood pressure.

Tran said these findings suggest doctors and health professionals should be encouraging healthy lifestyle habits when they see children during well visits to reduce high blood pressure.

The American Heart Association (AHA) estimates that 1 to 3% of American children have high blood pressure, with 32% of under-20s being overweight and 17% being obese.

High blood pressure increases a child's risk of having it as an adult, which in turn increases the risk of heart problems and stroke later in life, says the AHA.

Written by Catharine Paddock PhD
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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Catharine Paddock PhD. "Kids In Hospital With High Blood Pressure Double In Ten Years, US." Medical News Today. MediLexicon, Intl., 20 Jun. 2012. Web.
20 Jun. 2012. <http://www.medicalnewstoday.com/articles/246773.php>
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Yaffe: A loved one's journey into untreatable suffering - Calgary Herald PDF Print

My 86-year-old dad, Allan Yaffe, opted to kill himself during the second week of January last year rather than live one more week in a body he called “a bag of garbage.”

Last Friday’s B.C. Supreme Court ruling against the Criminal Code’s prohibition of physician-assisted suicide took me back to the circumstances of his relatively quick death.

For at least a year before Dad faced down the nothingness he anticipated in death, he’d toyed with the notion of calling it quits.

He’d been living rather unhappily for about four years in a Vancouver nursing home — “a warehouse for the dying,” he labelled it — and, wheelchair bound, began feeling tortured by his deteriorating physical condition.

Two years earlier, my mother, living at the same home, had died of pneumonia. A year earlier, Dad had gone blind. His hearing, too, was failing.

He had been on kidney dialysis three times weekly for some six years — a ritual he positively detested.

He had lately developed chronic obstructive pulmonary disease and had to be hooked up to oxygen.

He also had problems with both his bladder and rectum.

Meanwhile, poor circulation left his legs below the knee, including his feet, perpetually infected; rotting for all practical purposes and forcing him to face the prospect of amputation.

He told me repeatedly that his life no longer was worth living, that he didn’t want to have to keep coping with all the physical trauma being thrown his way, that he was prepared to go and it would be a relief.

The thing was, Dad always knew he had the power to order up his own death simply by curtailing his dialysis.

In that sense, the Criminal Code discriminates against those who must rely on a helping hand to reach the Pearly Gates.

Three and a half days into my father’s dialysis boycott — a briefer than anticipated period during which time morphine medication failed to fully diminish either his discomfort or acute awareness — Dad crossed to the other side in his brown leather La-Z-Boy.

Of course, I had no idea how to go about accompanying him on his final journey. I listened in those last days as he confided a few things about his life that I’d never known. I took him a takeout hotdog — his final food request, which he wound up not being able to get down.

In the year and a half since then, I’ve thought often, it was a mercy for him to pass on.

And it would be a similar mercy for other mentally aware folks who, like my Dad, face a life of abject suffering and want a similar release but require a doctor’s help.

Politicians dread dealing with such sensitive social issues that polarize the electorate. They know there will be little upside, in terms of popular appeal, for them in supporting the necessary Criminal Code change. But it’s the humane thing for Parliament to do.

The fact physician-assisted suicide has become available in Oregon and the Netherlands should provide a guide for the government in crafting the necessary safeguards to ensure any system of euthanasia is not abused, that mentally depressed individuals are not given free rein to just opt for suicide.

The Harper government has not yet determined whether it will appeal last Friday’s court ruling. Rather than waste time on such an appeal, Conservatives should get on with the task of easing the way for those, like my father, seeking to escape their untreatable suffering.

Barbara Yaffe is a columnist with the Vancouver Sun.

© Copyright (c) The Calgary Herald

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Wife is a million-to-one match for husband's kidney transplant - Sunderland Echo PDF Print


Published on Wednesday 20 June 2012 09:29

A BRAVE wife has turned out to be the perfect match for her husband in his desperate search for a kidney donor.

Michele and Gavin Johnson were celebrating today after doctors gave them the go-ahead for the life-changing transplant, saving the 50-year-old from an anxious wait for a suitable organ.

Experts estimate the odds of receiving a good match from a spouse are as high as “one in a million”.

“She is absolutely amazing,” said Gavin. “If she hadn’t put herself forward then I could have been waiting years for a donor, with my condition getting worse and worse.

“I don’t know what I would have done without her help.”

As well as dramatically improving his health, the operation will also save the HGV driver from a lifetime of dialysis.

“I had a transplant about 23 years ago, which is progressively failing,” he said. “I have long-term chronic kidney failure and with the prospect of years on dialysis things were not looking good.

“My wife unselfishly didn’t hesitate to offer her kidney to help my quality of life.

“Over the last couple of years, my health has got worse and worse and I’m now at the stage where I need a transplant.”

Turn to Page 5

But Gavin and Michele, 46, from Washington, faced an agonising wait as medics carried out a series of tests.

“There were about five or six tests over eight months,” he said. “The doctors examine blood, tissue, pretty much everything to make sure that you are a match.

“At every stage, there is a chance that you could be knocked back.

“At first it wasn’t too bad, but as you get further and further along you start to get more and more anxious.

“There is always the fear that it will be snatched away from you at the last minute.

“But we’ve now had confirmation that the operation can go ahead. We’re a perfect match.”

The couple, who have been married for nine years, are now expected to undergo surgery at the Freeman Hospital, in Newcastle, in the coming months.

“It will make such a huge difference,” said dad-of-three Gavin. “At the minute, I’m not able to work and I have to undergo regular dialysis, which can be a challenge in itself.

“Essentially, you have dialysis fluid drained in and out of your stomach. You try to get on with your life, but it is a bit like having a Sunday dinner every few hours.

“You struggle to find the energy to do anything and then it starts all over again.

“The transplant will give both of us much more freedom.

“We can get on with our lives.”

Kidney Research UK estimates the chances of receiving a good match from a non-related living donor in the same household, such as a spouse, can be as high as “one in a million”.

Professor Neil Turner, chairman of the group, said: “For the 7,000 people in the UK who need a kidney transplant, their best chance of finding a match will be from an immediate family member, such as a parent, child or sibling.

“The chances of receiving a good match from a spouse or partner are much, much lower, although it is not unheard of.

“Making transplants better is an important part of our work and more research is needed to help the three million people in this country at risk from kidney disease, by finding a cure.

“Unfortunately, however, we’re currently only able to fund a fifth of all projects aimed at combating the illness.”

Twitter: @SunderlandEcho


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Higher Rate Of Untreated Kidney Failure Among Elderly - Ivanhoe PDF Print

(Ivanhoe Newswire) – An estimated 26 million American adults suffer with chronic kidney disease (CKD), and according to a new study, many cases are left untreated, especially among the elderly. In the study that included nearly two million adults in Canada, the rate of progression to untreated kidney failure was considerably higher among older adults (85 years and older), compared to younger individuals. Past research had indicated that older adults were least likely to have untreated kidney failure.

"Studies of the association among age, kidney function, and clinical outcomes have reported that elderly patients are less likely to develop end-stage renal disease (ESRD) compared with younger patients and are more likely to die than to progress to kidney failure even at the lowest levels of estimated glomerular filtration rate [eGFR; flow rate of filtered fluid through a kidney]," according to background information in the article. Previous studies have defined kidney failure by receipt of long-term dialysis, which reflects both disease progression and a treatment decision. "Because it is plausible that the likelihood of initiating long-term dialysis among individuals with kidney failure varies by age, earlier studies may provide an incomplete picture of the burden of advanced kidney disease in older adults, based on the incidence of long-term dialysis alone."

Brenda R. Hemmelgarn, M.D., Ph.D., of the University of Calgary, Alberta, Canada, and colleagues conducted a study to determine whether age is associated with the likelihood of treated kidney failure (renal replacement therapy: receipt of long-term dialysis or kidney transplantation), untreated kidney failure, and all-cause mortality.

During a follow-up after 4 and a half years, 97,451 (5.4 percent) of study participants died, 3,295 (0.18 percent) developed treated kidney failure, and 3,116 (0.17 percent) developed untreated kidney failure. Researchers also discovered that adjusted rates of death increased with increasing age. Also, rates of treated kidney failure were consistently higher among the youngest age group.

The opposite results were evident for untreated kidney failure. The risk of untreated kidney failure increased with lower vs. higher eGFR categories, and this association was stronger with increasing age. "For the lowest eGFR stratum (15-29 mL/min/1.73 m2), adjusted rates of untreated kidney failure were more than 5-fold higher among the oldest age stratum (85 years or older) compared with the youngest age stratum (18-44 years)."

The researchers write that their results suggest that the incidence of advanced kidney disease in the elderly may be substantially underestimated by rates of treated kidney failure alone.

"These findings have important implications for clinical practice and decision making; coupled with the finding that many older adults with advanced chronic kidney disease [CKD] are not adequately prepared for dialysis, these results suggest a need to prioritize the assessment and recognition of CKD progression among older adults. Our findings also imply that clinicians should offer dialysis to older adults who are likely to benefit from it—and should offer a positive alternative to dialysis in the form of conservative management (including end-of-life care when appropriate) for patients who are unlikely to benefit from (or prefer not to receive) long-term dialysis. Given the large number of older adults with severe CKD, these results also highlight the need for more proactive identification of older adults with CKD, assessment of their symptom burden, and development of appropriate management strategies. Finally, our study demonstrates the need to better understand the clinical significance of untreated kidney failure, the factors that influence dialysis initiation decisions in older adults, and the importance of a shared decision making process for older adults with advanced CKD."

SOURCE: JAMA and Archives Journals June 2012


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Raising money for renal unit - Wanganui Chronicle PDF Print

Joan Manning is in the Hunterville Women's Institute, one of seven member groups aligned to the Wanganui Federation.

Each institute was given $10 worth of tea bags and coffee to grow to raise funds for Kidney Kids to refurbish Auckland's renal unit.

Mrs Manning said the Hunterville Institute had already held two fundraisers with 12 members in Marton and eight at Hunterville, and raised $200 between the two. Each member paid $5 for an afternoon tea and they also held raffles, with one of the prizes being a voucher from Paper Plus. She said this was an opportunity to inspire each other, and there'll be a lunch to follow. Mrs Manning said she's not sure what they'll have yet, but mentioned the national dish of South Africa, bobotie - a mixture of curried meat and fruit with a creamy golden topping. "We are sending our Marton delegate Jean Martin to conference so the extra money will replenish what we used."

The institute will hold a blind auction in August on its club day at the Friendship Hall in Marton.

Club days are held on the first Monday of every month and guest speakers are invited to address the members.

This month's speaker was fireman Terry O'Keefe on how to "keep themselves safe".

Mrs Manning came to New Zealand from South Africa 30 years ago where she was a member of a women's institute. A teacher, Mrs Manning taught in Pukerua Bay before moving to Hunterville.

She now also teaches the elective applique at Hunterville School when she is not organising institute events.

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