Improving Dialysis
People who suffer from kidney failure need dialysis to help cleanse their blood. But it doesn't remove all of the dangerous impurities. A new way to boost the effectiveness of dialysis and save the lives of many people who depend on it.
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George Jones has gambled with his life. He ignored his doctor's advice to take measures to keep his high blood pressure in check.
It took kidney failure for George to listen to doctors. Now, three days a week, for three and a half hours, he's hooked to a dialysis machine.
George Jones
Dialysis patient
"I guess if it wasn't for dialysis, I wouldn't be here."
While dialysis keeps him alive, it has only about a tenth of the blood cleansing power of normal kidneys.
William Finn, M.D.
University of North Carolina Medical School
Chapel Hill, NC
"And one of the big limitations of people on dialysis is that the dialysis machine doesn't take out the phosphorus as well as one might think."
Excess phosphorus can cause deadly bone and cardiovascular problems. A new drug Fosrenol allows phosphorus to pass through the body without being absorbed.
William Finn, M.D.
"Many of the patients don't object to taking it. It doesn't have some of the complications of other agents."
Study results show Fosrenol reduced death rates among patients by about half. George is one patient who has benefited.
George Jones
"It has been very, very important to me to have medicines with me that help me and I think this new medicine might do the job."
The study included more than 1,200 patients on hemodialysis. More than 350,000 people in the United States receive treatment for kidney failure and about 60% of those will undergo hemodialysis.
BACKGROUND: According to the National Institutes of Health, more than 350,000 people in the United States receive treatment for kidney failure, or end-stage renal disease each year. About 60 percent of patients undergo hemodialysis, a process that removes wastes and excess fluid from the bloodstream by passing it through a membrane in an artificial kidney machine. Although regular hemodialysis treatment helps maintain life, studies show it provides only about a tenth of the cleaning function of normal kidneys.
DIALYSIS COMPLICATIONS: One of the problems with hemodialysis is that it does not do an adequate job of removing phosphorus from the blood. Elevated phosphorus levels in the blood can trigger hyperparathyroidism, a condition that may lead to serious bone and cardiovascular problems. Research indicates a buildup of calcium in coronary blood vessels can lead to an increased risk for cardiac death. Research has also shown that elevated phosphorus levels in the blood is an independent risk factor for mortality among kidney patients on hemodialysis.
Many patients on dialysis take medications that bind dietary phosphorus, thereby allowing its excretion in the stool rather than its absorption by the body. Traditional binding agents include calcium carbonate (a main ingredient in popular stomach relievers) and calcium acetate. However, some patients using these calcium-based binders develop high calcium levels, which can contribute to cardiovascular disease.
A BETTER WAY: Now, scientists are looking at non-calcium-based binders as a way to get phosphorus out of the body without increasing calcium to dangerous levels. One drug currently being tested is lanthanum carbonate (Fosrenol), developed by Shire Pharmaceuticals Group, PLC, in the United Kingdom. It is not yet approved for use in the United States.
A recent study, which was part of the FDA approval process at the University of North Carolina at Chapel Hill, showed a 50-percent reduction in the number of deaths among kidney hemodialysis patients who were given Fosrenol to prevent excess phosphorus from accumulating in the bloodstream. Researchers found it to be well-tolerated by patients. Patients also found it easier to take because it is chewable and does not require a lot of fluid to swallow. Excess fluid build up is a problem for dialysis patients. UNC-CH researchers believe Fosrenol will become the preferred phosphate binder for dialysis patients. FDA approval of Fosrenol may occur as soon as March 2003.
National Kidney Foundation
30 East 33rd St.
New York, NY 10016
(800) 622-9016
http://www.kidney.org
Copyright © 2003 Ivanhoe Broadcast News, Inc.
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