STORY BYWhen Grammy Award-winning soul singer Barry White died of kidney failure July 4, his death focused attention on the dangers of kidney disease.
About 10 million Americans have chronic kidney disease, and another 20 million
are at increased risk because they have diabetes, high blood pressure or other
risk factors. According to the National Vital Statistics Report, kidney disease
causes more than 39,000 deaths annually in the United States.
Research by University of Texas Medical School at Houston physician
Austin Stack, emphasizes the importance of early diagnosis and treatment.
Over one third of patients with end-stage renal disease in the U.S.
see a nephrologist, or kidney specialist, for the first time within
four months of starting dialysis. This greatly increases risk of
death, according to Stack’s study, which was published in the
February issue of the American Journal of Kidney Disease.
Within the first year of dialysis, patients whose first visit to a nephrologist
was less than four months before they started dialysis had a 68 percent higher
risk of death than those whose first visit was earlier.
Patients with early treatment – who saw a nephrologist at least twice in
the year before starting dialysis – had a 20 percent lower risk of death
than those without early treatment.
“Early referral to a nephrologist provides an enormous opportunity for
managing the complications of chronic kidney disease and ensures optimal preparation
for patients who require dialysis or kidney transplant,” said Stack, an
assistant professor of medicine and a clinical epidemiologist in the Division
of Nephrology and Hypertension at the Medical School.
“The study shows for the first time in a nationally representative sample
a clear association between early and frequent nephrology contact and improved
patient survival,” he said. Stack based his findings on an analysis of
2,264 patients from a national study of the U.S. Renal Data System.
Seeing a specialist early in the course of kidney disease allows for more effective
treatment of hypertension, anemia and other related medical conditions, such
as diabetes, coronary artery disease and congestive heart failure. In some cases,
he said, declining kidney function can be halted, delayed or even reversed, avoiding
the need for dialysis or transplant.
A new National Kidney Disease Education Program, under the auspices of the National
Institutes of Health, is encouraging people in high-risk categories – those
with hypertension, diabetes or a relative with kidney problems – to ask
their physicians to be tested. Early efforts are targeted at black Americans,
who are four times more likely than others to suffer kidney failure.
UPDATED: 10-02-2003
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Summer Carbon Monoxide Dangers
Generators used to cool off homes in hot summer months can cause death through carbon monoxide (CO) poisoning.
CO is an odorless, colorless gas that can kill or seriously and permanently injure people who inadvertently breathe in the noxious fumes emitted from generators in an enclosed space.
During hurricane season, emergency rooms see a rise in cases of CO poisoning from people bringing generators into their homes to provide power, often for cooling fans as well as cooking.
“During Hurricane Rita, we had a family of five die here in Houston for CO poisoning,” reminds UT Medical School Hyperbaric Medicine expert, Dr.Caroline Fife. “The Center for Disease Control and Prevention tracked deaths from CO poisoning due to combustion engines after Katrina and Rita and there was a dramatic increase.”
“Teak surfing”—holding on to the back of a power boat’s swim platform and being towed—is another danger. The boat’s exhaust pipe is in the face of the swimmer.
People riding in the back of pick-up trucks are at risk, too. Numerous cases have been cited of children poisoned by riding beneath tarpaulins or enclosed “cabs” in the back of the truck. In these cases, the trucks had a leak in the exhaust system or a rear-exiting tail pipe, not a side exit.
Fife also has seen this in boats with malfunctioning exhaust systems. She urges doctors and bystanders to pay special attention when groups of people begin to feel ill at the same time, particularly severe headache and nausea. Children often become symptomatic before adults.
“People associate CO poisoning with cold weather and northern states, but in the South, we see it a lot in summer with people just trying to stay cool,” Fife says.
