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NIDDK-funded Study Finding: Blood Pressure May Affect Mortality Rates in U.S. Veterans with CKD

Photo of an elderly veteran.

Researchers have found that U.S. veterans with non-dialysis-dependent chronic kidney disease (CKD) and a certain combination of systolic and diastolic blood pressure may have a higher mortality risk. The study, funded by the National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and the U.S. Department of Veterans Affairs, was published August 20 in Annals of Internal Medicine.

The authors reviewed medical records of more than 650,000 patients with CKD—seen in Veterans Affairs healthcare facilities over a 7-year period—to determine the relationship between systolic and diastolic blood pressure and mortality. Patients were mostly white males with a mean age of 73 years. The recently released hypertension guideline from the panel appointed to the Eighth Joint National Committee (JNC 8) recommends a blood pressure treatment target of less than 140/90 mm Hg for patients with CKD.

Researchers examined many blood pressure combinations and found that the lowest mortality rates occurred in patients with a blood pressure of 130 to 159/70 to 89 mm Hg. The authors note that lowering systolic blood pressure that leads a diastolic blood pressure of less than 70 mm Hg may be potentially harmful in a similar patient population.

NIH-funded Study Finding: Protein-based Urine Test Predicts Kidney Transplant Outcomes

Levels of a protein found in the urine of kidney transplant recipients can distinguish those at low risk of developing kidney injury from those at high risk, a study suggests. The results also suggest that low levels of this protein, called CXCL9, can rule out rejection as a cause of kidney injury. The study was funded by the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health (NIH), and appeared online August 22 in the American Journal of Transplantation.

In this multicenter Clinical Trials in Organ Transplantation leaving site icon study, doctors periodically collected urine samples from 280 adult and child kidney transplant recipients for 2 years after transplantation. Transplant recipients with low urinary CXCL9 protein 6 months after transplantation were unlikely to experience rejection or loss of kidney function over the next 18 months. Urinary CXCL9 levels began to increase up to 30 days prior to clinical signs of kidney injury, which could allow doctors to intervene early to potentially avoid rejection-associated kidney damage.

“The results of this study support the further development of noninvasive tests for the detection and management of transplant rejection,” said NIAID Director Anthony S. Fauci, M.D.

Tips for Finding Reliable Health Information Online

Finding accurate, reliable, and current health information online can be difficult and overwhelming. The Internet has a wealth of health information—some information is true and accurate, and some is not.

Here are a few things to keep in mind when visiting a website:

  • Websites should have a way to contact the organization or webmaster. If the site provides no contact information or it is not clear who runs the site, use caution.
  • Beware of claims that offer one cure for a variety of illnesses, like a breakthrough or secret ingredient.
  • Look for latest findings from research, not an individual’s opinion.
  • And, always remember to write down questions to bring to doctor visits.

Several Government resources offer additional tips when searching for online health information:

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MedlinePlus Guide to Healthy Web Surfing
This page includes suggestions for evaluating the quality of health information on websites.

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Evaluating Internet Health Information: A Tutorial from the National Library of Medicine
This 16-minute tutorial from the National Library of Medicine (NLM) teaches consumers to evaluate the health information found on the Web.

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NIDDK Healthy Moments Series
Healthy Moments is an annual series of weekly radio episodes featuring National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) Director Griffin P. Rodgers, M.D., M.A.C.P. Each week, Dr. Rodgers provides tips on how to prevent and manage a variety of diseases and conditions.

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FAQ: Reference & Consumer Health Questions
This page from the NLM provides health information and NLM resources based on frequently asked consumer health questions.

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Finding and Evaluating Online Resources on Complementary Health Approaches
This guide from the National Center for Complementary and Alternative Medicine provides help for finding reliable websites, and outlines things to consider in evaluating health information from websites and social media sources.

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Evaluating Online Sources of Health Information
The National Cancer Institute provides a list of questions for consumers to ask when looking for cancer information online. A video from the Federal Trade Commission is included.

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Online Health Information: Can You Trust It?
The National Institute on Aging provides information for older adults on finding reliable sources of health information online.

New and Updated Publications

Recent Issues

December 2013

NIH Expands Study to Better Understand Kidney Disease Progression

Photo of three generations of African American males

Researchers from the Chronic Renal Insufficiency Cohort (CRIC) study are embarking on another 5 years of work to identify risk factors for progression of early-stage chronic kidney disease (CKD), better understand the importance of reduced kidney function in older persons, and learn what role CKD may play in other illnesses that require hospitalization. CRIC is supported by the National Institutes of Health (NIH).

A major goal of the next 5 years is to recruit 1,500 people to the existing group of nearly 4,000 study participants. This additional time will allow researchers to collect more data needed to explore and build upon findings compiled during the past 10 years, and examine in much greater detail the broad range of illnesses experienced by people with CKD.

“Together with expanding the existing study population to include additional older patients and earlier stages of CKD, this fresh approach amounts to a regeneration of the CRIC study that will map out a whole new way to evaluate the impact of CKD,” said Dr. Robert Star, director of the Division of Kidney, Urologic, and Hematologic Diseases at NIH’s National Institute of Diabetes and Digestive and Kidney Diseases.

NIH-funded Study Finding: Urine Test for Biomarkers, a Noninvasive Alternative to Kidney Biopsy, Can Diagnose and Predict Kidney Transplant Rejection

Analysis of three biomarkers in the urine of kidney transplant recipients can diagnose—and even predict—transplant rejection, according to results from a clinical trial sponsored by the National Institute of Allergy and Infectious Diseases, part of the NIH. This test for biomarkers—molecules that indicate the effect or progress of a disease—offers an accurate, noninvasive alternative to the standard kidney biopsy, in which doctors remove a small piece of kidney tissue to look for rejection-associated damage.

In the study, part of the NIH-funded Clinical Trials in Organ Transplantation, investigators at five clinical sites collected urine samples from 485 kidney transplant recipients from 3 days to approximately 1 year after transplantation. The findings appear in the July 4 issue of the New England Journal of Medicine.

New Tools Help Dietetic Educators Teach CKD Nutrition Therapy

The National Kidney Disease Education Program has developed a suite of materials to support dietetic educators in teaching students and interns about nutritional interventions for CKD patients. The materials are designed to provide students and interns with the basic information they will need once they become practicing registered dietitians to counsel patients who have CKD.

New and Updated Publications

September 2013

NKDEP Increases Outreach to Hispanics with New Website, Media Campaign

National Kidney Disease Education Program logo

Word is spreading about the National Kidney Disease Education Program’s (NKDEP’s) new Spanish website, thanks to a successful outreach campaign targeting Hispanic television, radio, and online media. As a result, website traffic and web visitor engagement from Hispanics in these areas have increased substantially.

“The great interest from the media reflects the need for more health information in Spanish,” said NKDEP Director Andrew S. Narva, M.D., F.A.C.P. “We were very surprised to see how little is available for the public in Spanish about kidney disease.”

Hispanic adults are at higher risk for kidney disease than non-Hispanic white adults largely because they are twice as likely to be diagnosed with diabetes, a leading risk factor for kidney disease.

2012 Nobel Prize in Chemistry Awarded to Two NIH Grantees

The 2012 Nobel Prize in chemistry was awarded jointly to National Institutes of Health (NIH) grantees Robert J. Lefkowitz, M.D., of the Howard Hughes Medical Institute and Duke University Medical Center, and Brian K. Kobilka, M.D., of the Stanford University School of Medicine, for groundbreaking discoveries on G-protein-coupled receptors. Dr. Lefkowitz has received support from the National Heart, Lung, and Blood Institute (NHLBI) since 1974. Dr. Kobilka has received support from the NHLBI, the National Institute of Neurological Disorders and Stroke, the National Institute of General Medical Sciences, and the National Institute on Drug Abuse since 1990.

“About half of all medications, including beta blockers, antihistamines, and various kinds of psychiatric medications, act through these receptors,” said NIH Director Francis S. Collins, M.D., Ph.D. “NIH is proud to have supported this work, which began as basic science and ultimately led to dramatic medical advances.”

NIDDK Epidemiologist Paul Eggers Retires

Photo of Dr. Paul Eggers

Paul Eggers, Ph.D., director of kidney and urology epidemiology in the National Institute of Diabetes and Digestive and Kidney Diseases’ (NIDDK’s) Division of Kidney, Urologic, and Hematologic Diseases, retired in January after 36 years of federal service, including 12 years at the NIDDK. Dr. Eggers is most known for his dedication to developing and managing the U.S. Renal Data System, which provides data on the incidence, prevalence, morbidity, mortality, and costs of end-stage renal disease.

NIDDK Director Griffin P. Rodgers, M.D., M.A.C.P., noted that Dr. Eggers’ efforts have truly been a labor of love. “We are fortunate that he will continue to lend his knowledge and expertise to the research community after he formally retires.”

July 2013

Study Finding: Acute Kidney Injury Can Lead to Permanent Kidney Damage

Illustration of kidneys in a translucent body

Research supported by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) suggests that survivors of acute kidney injury leaving site icon (AKI)—a sudden loss of kidney function—have a lifelong increased risk for developing permanent kidney damage, resulting in decreased kidney function. In observance of World Kidney Day on March 14, the National Institutes of Health (NIH) sought to increase awareness of the long-term effects of AKI.

Over the past decade in the United States, the rate of AKI requiring dialysis has increased by 10 percent each year, and associated deaths have more than doubled. While rates of AKI are highest among hospitalized patients and people with existing kidney problems, AKI can also occur in people with normally functioning kidneys—usually as a result of illness, injury, or certain medicines.

"We now know acute kidney injury is not the isolated or temporary condition we once believed it to be. However, in many cases, it is preventable and treatable," said NIDDK Director Griffin P. Rodgers, M.D., M.A.C.P. "We must continue to support research to help us better understand the connection between acute kidney injury and chronic kidney disease, to prevent acute kidney injury in those at risk, and to identify and treat the condition when it does occur."

First Recipients of Research Grants to Support Genomic Studies in Africa Announced

The NIH and Wellcome Trust, a global charity based in London, have announced grants aimed at fostering cutting-edge research in the African scientific community. The Common Fund, a program supporting multidisciplinary programs across the NIH, is providing partial support for this global initiative. Scientists will conduct genomic research on kidney disease, diabetes, heart disease, obesity, and other conditions through inaugural grants of the Human Heredity and Health in Africa Consortium (H3Africa). "H3Africa aims to transform the way science is conducted in Africa by creating a sustainable research infrastructure and catalyzing the use of advanced genomic technologies to improve our understanding of a variety of diseases," said NIH Director Francis S. Collins, M.D., Ph.D.

NIDDK to Study Approaches for Improved Survival for People on Hemodialysis

Photograph of a person with IV tubing in his left arm

More than 400,000 people are currently treated by hemodialysis under Medicare’s End-Stage Renal Disease (ESRD) Program. To improve patient well-being and survival and to reduce complications, the NIDDK is funding Novel Interventions to Reduce Morbidity and Mortality of Hemodialysis Patients, a new program to encourage collaboration on pilot and feasibility studies. The studies will inform the design of subsequent full-scale randomized controlled trials of novel therapies.

Researchers are tasked to identify interventions that can improve patient outcomes. Interventions being considered for study include anti-inflammatory drugs, changes in dialysis techniques, changes in treatment protocols, and psychosocial interventions to treat depression or improve social support.

“This program of weighing the effectiveness of novel therapies holds the promise of moving the field forward in bold leaps,” said Paul Kimmel, M.D., of the NIDDK’s Division of Kidney, Urologic, and Hematologic Diseases. “The best potential ESRD therapies may be those that we currently shy away from as rather risky approaches. Also, partnering with the pharmaceutical industry could pave the way for Food and Drug Administration approval of new drug therapies.”

New and Updated Publications


Page last updated January 29, 2014


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