(Press-News.org) DURHAM, N.C. -- Researchers at Duke Medicine have determined that kidney function plays a critical role in the fate of patients being treated for sepsis, a potentially life-threatening complication of an infection.
In a study published May 20, 2015, in the journal Kidney International, Duke researchers and their colleagues identified physiological changes at the molecular level that might be affected by acute kidney injury. The findings could help physicians improve hemodialysis practices, increasing patient survival rates after kidney failure.
Acute kidney injury is a serious and common health complication, occurring in up to 20 percent of all hospitalized patients and more than 45 percent of patients in a critical-care setting, according to the National Institutes of Health.
"There are a lot of things that we assume to be true about the impact of acute kidney injury on patients," said lead author Ephraim Tsalik, M.D., Ph.D., assistant professor at Duke University School of Medicine. "This study is the first to comprehensively characterize what is happening at the patient level, potentially as a cause and a consequence of acute kidney injury that we see in the setting of critical illness."
Sepsis, which is defined as systemic inflammation resulting from an infection, often results in an abrupt decrease in the kidney's ability to effectively filter the blood.
The Community Acquired Pneumonia and Sepsis Outcome Diagnostic (CAPSOD) study, led by Stephen Kingsmore, M.B, D.Sc., of Children's Mercy Hospitals and Clinic, was initially created as a repository for patients visiting the emergency department with suspected sepsis. The researchers used clinical and molecular information generated in the CAPSOD study to correlate patient-level data with changes in molecular markers in the blood.
They found that kidney function was a major determinant of how a patient responded to treatment for sepsis.
"We have over 2,000 patients enrolled in the CAPSOD repository," Tsalik said. "We are trying to use new tools to ask why is it that some patients show up and get sicker, despite getting all the right treatment, and why some patients show up, get the right treatment, and quickly get better."
Using an "'omics-based" approach, the researchers looked at variations in metabolite level, protein production, and gene expression in the blood in 150 patients with critical illness. The study design also allowed the researchers to investigate what impact hemodialysis, a medical treatment for kidney failure that filters toxins from the blood, was having on a variety of molecular markers.
"Rather than setting out to prove existing hypotheses, this study was designed to identify new questions or associations we were not previously aware of," Tsalik said. "There were a number of things that we expected to see and did, such as the accumulation of molecules normally cleared by the kidney among patients with kidney dysfunction."
Those known molecules are usually filtered out when a patient is receiving hemodialysis; however, the researchers also identified other chemicals and metabolites that were not previously shown to be abnormal in patients on hemodialysis.
"It may be that these newly implicated metabolites are not clinically relevant, but by identifying them, we've opened up opportunities for researchers to see if they cause toxicity to the patient," Tsalik said. "We want to understand how to improve the care of patients with acute kidney injury and those requiring hemodialysis."
INFORMATION:
In addition to Tsalik, study authors at Duke include Vance Fowler Jr., and Christopher Woods; along with Laurel Willig, Neil Miller, and Stephen Kingsmore of Children's Mercy Hospitals and Clinic; Brandon Rice and Jennifer van Velkinburgh of the National Center for Genome Resources; Darrell Dinwiddie of the University of New Mexico; Robert Mohney, Jonathan McDunn, and Eric Mayer of Metabolon Inc; Seth Glickman of University of North Carolina-Chapel Hill; Charles Cairns currently of the University of Arizona; Anja Jaehne and Emanuel Rivers of the Henry Ford Hospital; Ronny Otero of the University of Michigan; Robert Glew of the University of New Mexico; Mohan Sopori and Raymond Langley of the Lovelace Respiratory Research Institute; and Kevin Harrod, currently at the University of Alabama Birmingham.
This work was supported in part by grants from the National Institutes of Health (U01AI066569, P20RR016480, HHSN266200400064C), Pfizer Inc., and Roche Diagnostics Inc., and was also funded in part through the Clinical Science Research and Development Service of the VA Office of Research and Development.
DENVER, CO -- Most people associate osteoporosis with women. But the truth is, one in four men over the age of 50 will break a bone as a result of this condition. That's more men than will have prostate cancer, according to the National Osteoporosis Foundation.
Now a leading researcher at National Jewish Health is calling for men to be included in the screening guidelines for osteoporosis. Elizabeth Regan, MD, PhD, a researcher at National Jewish Health, studied more than 3,000 smokers and former smokers ages 45 to 80 and tested their bone density. What she found was ...
Is ovulation related to higher racial bias? Though recent research, from Michigan State University, suggested that there was a link, new research from the University of Chicago Booth School of Business was unable to replicate those findings.
In four studies, documented in their paper "In Search of an Association Between Conception Risk and Prejudice," Carlee Beth Hawkins, a doctoral student, and her co-authors were unable to find any evidence that there is an increase in racial bias related to conception risk.
Hawkins, along with Cailey Fitzgerald of the University ...
Some major trucking companies are turning to natural gas to fuel their fleets -- and to earn "green" credit among customers. But celebrating lower emissions could be premature, according to an analysis in the ACS journal Environmental Science & Technology. Researchers have found that converting heavy-duty trucks to run on natural gas could lead to negative climate impacts if steps are not taken to improve engine efficiency and reduce methane emissions from the fuel's supply chain.
Burning natural gas emits less carbon dioxide (CO2) into the atmosphere than other fossil ...
May 20, 2015 -- Available research does not support the contention that athletes are uniquely at risk of chronic traumatic encephalopathy (CTE) or other neurodegenerative disorders, according to a review in the June issue of Neurosurgery, official journal of the Congress of Neurological Surgeons. The journal is published by Wolters Kluwer.
Widely reported and publicized cases of CTE in retired athletes overlap with other neurodegenerative disorders, while the observed symptoms could result from a wide range of other factors, suggests the review by Dr. Gavin A. Davis of ...
Americans' energy use continued to grow slowly in 2014, fueled by increases in the use of natural gas, wind and solar, according to the most recent energy flow charts released by Lawrence Livermore National Laboratory.
Each year, the Laboratory releases charts that illustrate the nation's consumption and use of energy. Overall, Americans used 0.9 quadrillion (quads) British thermal units (BTUs) more in 2014 than the previous year, an increase of about 1 percent.
The Laboratory also released a companion chart illustrating the nation's energy-related carbon dioxide emissions. ...
New evidence has linked Arctic warming with severe weather in countries including the UK and US.
Professor Edward Hanna and PhD student Richard Hall, from the University of Sheffield's Department of Geography, are part of a select group of international climate scientists investigating links between Arctic climate change and extreme weather in the northern mid-latitudes.
They have found that while it is too soon to know for certain whether the Arctic played a role in persistent cold events during the extreme wet UK winter of 2013/14 and recent USA East Coast winters, ...
New Haven, Conn. -- Yale researchers found a close association between acute hospitalizations and the development and progression of disability among older adults at the end of life. Their findings may have profound implications for medical decision-making for older people and those who care for them.
The research was published May 20 in The BMJ (British Medical Journal).
In an earlier study, Thomas M. Gill, M.D., professor of medicine, and his co-authors at Yale School of Medicine had shown that the course of disability for older adults at the end of life was varied ...
TAMPA, Fla. - Melanoma is predicted to result in approximately 10,000 deaths in 2015. The majority of these deaths are due to advanced stage disease that has spread or metastasized to other sites. The prognosis for patients with metastatic melanoma remains poor, with 5-year survival rates of 63 percent in patients who have metastatic disease in regional lymph nodes, and only 17 percent in patients who have metastatic disease in distant sites. Moffitt Cancer Center researchers participated in an international phase 3 study that demonstrated that a drug called ipilimumab ...
A team led by environmental engineers from Drexel University are the first independent researchers to take a closer look at the air quality effects of natural gas extraction in the Marcellus Shale region of Pennsylvania. The group used a mobile air quality monitoring vehicle to survey regional air quality and pollutant emissions at 13 sites including wells, drilling rigs, compressor stations and processing areas. Their work establishes baseline measurements for this relatively new area of extraction.
While there have been a number of studies focusing on water quality ...
The number of new Ebola cases is tapering off, but the search for new treatments continues. Now, one research team has found potential drug candidates that successfully treated up to 90 percent of mice exposed to the Ebola virus. They report their findings in the journal ACS Infectious Diseases.
Bogdan A. Solaja, Rekha G. Panchal and colleagues note that the U.S. Food and Drug Administration has yet to approve any therapeutic drugs or vaccines against the Ebola virus that, since December 2013, has infected more than 25,000 people and taken the lives of more than 10,000. ...
