Radical surgery for kidney cancer is a risk factor for chronic kidney disease
For a long time, even if a patient had a small renal tumour, oncologists would recommend surgically removing the entire kidney. It now turns out this may not be the right way to proceed with renal malignancies. Researchers claim that will the advances in imaging techniques, it is now possible to detect small-sized tumours (under 4 cm) very easily and this ensures surgeons can opt for less radical methods to remove these tumours and still get extremely positive outcomes.
A study conducted by the Memorial Slone-Kettering Cancer Center in the United States has found that patients who undergo partial nephrectomy to remove just the malignancy show lower rates of developing chronic kidney disease compared to patients who get their entire kidney removed. Nearly 80 percent of patients, who have less radical kidney surgery, tend to be free of chronic kidney disease for 3 years after the surgery compared to 35 percent patients who have their entire kidney removed. In fact, surgeons claim that opting for radical surgery for kidney cancer is one of the main risk factors for developing chronic kidney disease.
Surgeons from the Memorial Sloan-Kettering Cancer Center claim that partial nephrectomy is a good way to control renal tumours and the survival rate of such patients is comparable to those undergoing radical nephrectomy for small-sized tumours. The surgeons have found the same trend in patients that were operated in the UK.
At the same time, it also is important to know that there are risk factors to developing chronic kidney disease. These risk factors include:
In fact, in most patients with kidney tumours, one or more of these risk factors are found and this would explain why so many patients with kidney cancer are prone to developing chronic kidney disease after undergoing radical nephrectomy.
Chronic kidney disease can cause the kidneys to stop functioning and this can sometimes result in kidney failure. Other complications associated with chronic kidney disease include malnutrition, neuropathy, heart disease, lower quality of life, anaemia and hypertension. Chronic kidney disease can also result in death. It also means that you will be spending more time in the hospital to manage all other problems that result due to chronic kidney disease and this can have a profound effect on your emotional and mental wellbeing.
If you are diagnosed with kidney tumour, speak to your oncologist to find out what are the different treatment options. As far as possible, you should avoid opting for radical surgery, as it will bring along a greater risk of chronic kidney disease and all associated health issues. Instead, find out from your surgeon whether a partial nephrectomy is possible. If your surgeon refuses, it is best to seek a second opinion.
Heart Fat Predicts Risk of Death in Kidney Disease Patients
Based on an international cardiac research conducted by researchers from University of Alberta, Toronto, fat deposits around the heart can tell doctors the risk of death amongst patients suffering from chronic kidney disease.
Fat deposits around the heart can be seen with the help of simple CT scans, but these scans are not used commonly by doctors. The research was done to find out whether heart fat has an effect on patients with kidney disease and researchers found that the fat is a good indicator about the risk of death in such patients. According to the researchers, the higher the amount of fat around the heart, the greater the rate of mortality amongst the patients.
While this research was led by researchers from Canada, it also involved researcher from the United States, Italy and Venezuela and all researchers came to the same conclusion. Their findings were published in the journal Nephrology Dialysis Transplantation. The research was headed by Paul Raggi of the University of Alberta’s Department of Medicine and he is a world renowned cardiologist.
The research involved studying CT scans of 109 patients with chronic kidney disease. Researchers found that as the amount of fat around the heart increased, so did the risk of death. For every 10 cubic centimeter increase in fat around the heart, the risk of death increased 6 percent. Chronic kidney disease patients with more than average fat deposit around the heart had just 45 percent five-year survival rate.
Just because a patient is thin, it does not mean that he or she will not have fat deposits around the heart. Thin patients too can have high volume of heart fat and this as dangerous as fat and obese patients with low levels of heart fat. Researcher claim that rather than looking for calcium buildup in arteries, if doctors look for fat deposits around the heart, they will be able to predict the risk of death amongst patients with chronic kidney disease regardless of their weight and physical appearance.
What is Pulmonology?
Pulmonology is a specialty that deals with diseases afflicting the lungs and respiratory tract. Pulmonology also is known as chest medicine and respiratory medicine. Pulmonology is considered a branch of internal medicine and it also is related to intensive care medicine.
Pulmonology often involves management of patients who require life support and ventilation mechanics. Pulmonologists are well trained in conditions and diseases of the chest which include diseases, such as asthma, tuberculosis, emphysema, pneumonia and chest infections.
History of Pulmonology
The field of pulmonology came into existence after researchers discovered the function of pulmonary circulation. During a historical study it was thought that the blood reaching the right side of the heart was able to pass through small pores in the septum into the left side. This theory was revealed by Galen. However the theory of blood circulation to the right side of the heart was proved to be false after the theory of pulmonary circulation postulated and proven.
Diagnostic Techniques for Pulmonary Diseases
Diagnostic techniques of pulmonary disease generally focus on:
Hereditary diseases that affect the lungs
- Exposure to toxic substances
- Exposure to infectious agents
- Diathesis that can predispose to many other conditions.
Physical diagnostics are also essential part of diagnosing pulmonary-related diseases and condition. This includes:
Inspection of hands for signs like clubbing and cyanosis
- Checking the respiratory rate
- Inspecting and examining the chest
- Palpation of the trachea, chest wall movement and cervical lymph nodes.
Surgical procedures that are performed on the lungs are generally performed by thoracic surgeons. Pulmonologists very often perform procedures to get samples from the inner parts of the lungs and chest. They make use of radiographic techniques to view lungs and usually assist surgeons in diagnosing the condition accurately.
Therapeutics and Treatment
Medication is one of the most essential treatments for curing pulmonary-related diseases. Typically, medications, such as steroids and bronchodilators, are used. At times, depending on the diagnosis, pulmonologists may also prescribe antibiotics, antagonists and leukotriene.
Patients diagnosed with inflammatory lung conditions like chronic pulmonary disease and asthma, oral medications and oxygen therapy are prescribed. When these fail, the patient may be put on mechanical ventilation.
Pulmonary rehabilitation is another important treatment procedure. Under this procedure a multidimensional spectrum of services is used to treat a pulmonary disease. This is usually done by a trained team of surgeons, doctors and allied healthcare professionals. The main goal of this rehabilitation is to help the patient achieve and maintain his independence.
Pulmonary rehabilitation seeks to educate patients and their families. It aims to improve quality of life through oxygen therapy, emotional support and exercise.
Vitamin D in Neurological Disorders
Although Vitamin D is not an essential nutrient, the skin manufactures this vitamin when it is exposed to ultra violet rays from the sun. These rays react with a form of cholesterol known as 7-dehydro cholesterol. Vitamin D deficiencies are not uncommon. Possible reasons for vitamin D deficiency include absorption problems, lack of exposure to sunlight in colder climates or from modern lifestyle practices, which keep many people indoors for most of the day, regardless of the climate in which they live.
Vitamin D is involved in bone formation and also has important effects on the nervous system.
During brain development in a growing fetus, Vitamin D acts like a hormone by controlling nerve transmission, nerve cell protection and immune functions. Deficiency of Vitamin D during these crucial early periods of growth can result in delayed or faulty neurologic development and activity. Vitamin D has also been associated with neuropsychiatric disorders; supplementation can prevent or reverse many neurologic conditions associated with low Vitamin D.
Dementia and Parkinson’s disease are neurologic disorders that primarily affect older adults; certain neuromuscular disorders are also more common in this segment of the population. Deficient levels of Vitamin D play a role in the development of these conditions. Additionally, a study published in the Current Drug Targets discusses the role that Vitamin D plays in prevention and treatment of stroke. The researchers identify low levels of Vitamin D and arterial hypertension as risk factors for stroke and encourage use of the vitamin as a safe and inexpensive option in the management of this condition.
Vitamin D deficiency plays a role in chronic pain disorders. Musculoskeletal pain and neuro muscular dysfunction that does not respond to medication may be due to or associated with Vitamin D deficiency.
Low vitamin D levels are also often found in patients with neuromuscular weakness and those with osteoporosis or a history of fractures. Women in peri- and postmenopause who are Vitamin D deficient are at particular risk for developing neuromuscular weakness due to low estrogen levels and the lack of bone and muscle preserving effects of estrogen.
The effect of Vitamin D on the immune system was examined with regard to multiple sclerosis (an autoimmune disease that attacks and degrades the insulation around nerve cells) in a study that was published in the Journal of Immunology. Vitamin D inhibits the production of T cells, a component of the immune system that provides a protective effect and minimizes risk and severity of over-activation of T cells, which occurs in autoimmune conditions.