March 13, 2014 – The DCRI’s Uptal Patel, MD, explains how recent innovations may improve kidney transplant outcomes
World Kidney Day is a far-reaching initiative designed to raise awareness of the importance of the kidney to overall health and to reduce the frequency and impact of kidney disease and its associated health problems worldwide. In honor of this year’s campaign, which will focus on chronic kidney disease and aging, the DCRI’s Uptal Patel, MD, (pictured right) has written an editorial addressing an important issue at the younger end of the age spectrum – how to improve outcomes for kidney transplantation in children and adolescents. The editorial is scheduled to appear in the April issue of the journal Pediatrics and is currently available online.
In the editorial, Patel explained that while the success rate for kidney transplantation in this population has gone up over the past 25 years, there is still a need to improve long-term outcomes. Since these children face a high risk of cardiovascular mortality in early adulthood, one way to improve long-term outcomes is by requiring more system-wide approaches to cardiovascular risk management. Preventing chronic allograft nephropathy, which is one of the most common causes of graft failure after the first year, will also help achieve better long-term outcomes.
According to Patel, adolescents and young adults have particularly high rates of graft loss. This trend could potentially be related to high rates of medication non-adherence. Recent health care legislation allowing young adults to remain under their parents’ insurance for longer could help alleviate some of the financial reasons for poor adherence. Patel also pointed out that newly developed procedures which reduce hypertension can help lower long-term cardiovascular risk and improve allograph function. Regeneration of tissues and organs could also contribute to minimizing immunologic risk and improving medication adherence.
“Since kidney transplants are the treatment of choice for children and adolescents with kidney failure, highlighting the improvements in patient and allograft survival is very important,” explained Patel. “However, further improvements in long-term outcomes will be necessary to decrease the very high rates of death that children and adolescents with kidney disease face as adults.”
Patel also acts as chair of the Chronic Kidney Disease Advisory Group and is a member of the Public Policy Board for the American Society of Nephrology (ASN). In honor of World Kidney Day, the ASN has produced several educational pieces to highlight key issues in kidney disease today, including the following:
- Deidra Crews, MD, FASN, an assistant professor of medicine at Johns Hopkins University, discusses the essential role that primary care providers play in protecting the kidney health of older individuals, and how the contributions of nephrologists and primary care providers mesh to provide optimum care to older people with kidney disease. Link to YouTube video
- The ASN provides responses to four key questions on dealing with chronic kidney disease and aging. Link to PDF