Demystifying Medicine One Month at a Time

Tag: chronic kidney disease

The Gift that Kept Giving

Old guy, generous young guy and his even more generous sister. (Photo: AP)

In case you missed it, there was a heartwarming story in the news about two kidney transplant recipients.

One, a young man with an autoimmune disease that destroyed his kidneys, was lucky enough to receive the gift of a kidney from his sister.

When the new kidney started to fail from the same disease process, he was offered the chance to have it removed so that another, older patient (who did not suffer from the same disease process ) could try to benefit from it.

Charitably, both he and his sister (the original donor) accepted this plan.

It worked!

The older gentleman (who happens to be a retired surgeon) is now in good condition, off of dialysis, and feeling better than he has in years.

According to news reports, this is the first documented U.S. case of ‘kidney recycling.’

For you medical buffs, the disease in question is focal segmental glomerulosclerosis (“FSGS“). And it’s not unusual that it would harm the donated kidney-the disease process occurs independent of the origin of the kidney (i.e. even if the donated kidney had come from an unrelated donor, his FSGS would have started going to town on that one as well). According to the literature, this happens ~40% of the time.

Yet when removed from the FSGS environment, the kidney recovered function and now works well in a new recipient.

Weird science!

Black & White

black & white

Imagine if I told you that because of the color of your skin, you wouldn’t be allowed access to certain health care services.

Pretty outrageous, right?

After all, discrimination based on skin color or ethnicity is beyond the pale in 21st century America.

What if the color of your skin made you four times more likely to suffer a life-threatening illness?

You might think it unfair, but you’d recall that certain disease states affect different groups of people at varying rates.

When we control for access to care, these differences in health outcomes are known to researchers and advocates as health care disparities.

One of the places I encounter disparate health outcomes most starkly is in the dialysis unit.

Dialysis is blood filtration for people whose kidneys have stopped working. It’s been around since the early1960s, but became mainstream therapy in 1973 when Congress expanded Medicare to include all persons with End Stage Renal Disease (ESRD).

With that generous entitlement, no one with chronic kidney failure dies from it in the United States.

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