Fighting kidney disease with diet, drugs and genetic testing

Eating vegetables and fruits and drinking pomegranate juice  have positive effects on kidney disease, according to two presentations at the  American Society of Nephrology's scientific meeting  in Denver Colorado.

One study placed patients with moderately reduced kidney function on a diet high in fruits and vegetables. The researchers hypothesized that the Western diet produces an acidic environment in the body that can worsen as kidney function decreases. After 30 days on the diet, the patients had reduced urine excretion of three markers that signal kidney injury: albumin, transforming growth factor, and N-acetyl-á-D- glucosaminidase. While the study by Texas A&M College of Medicine and Scott and White Healthcare was small– only 40 patients - the researchers indicated their findings merit larger and longer term studies to determine whether the dietary intervention, which is a simple and inexpensive treatment, produces the same results.

Many people have seen commercials claiming the health and antioxidant benefits of drinking pomegranate juice, which include claims that it can lower cholesterol and blood pressure in patients with diabetes and hypertension.

An Israeli study found that dialysis patients who drank pomegranate juice before dialysis treatments showed reduced inflammation and minimized oxidative stress damage from free radicals, as well as lower hospitalization rates from infections.

The small study included 101 patients who received either pomegranate juice or a placebo three times per week for a year. The researchers say their findings show that pomegranate juice has powerful antioxident properties with benefits for dialysis patients.

African Americans with kidney disease related to high blood pressure and who carry gene variant common in African Americans are 1.5 times more likely to be at risk for progressive kidney disease, researchers from Johns Hopkins University said at the scientific meeting last week.

End stage renal disease occurs when the kidneys fail or almost completely fail to properly remove waste from the body. ESRD is 13.1 times more common in African Americans compared with white subjects, according to the American Society of Nephrology.

The variant MYH9 gene was very common, present in 55 percent of the AASK (African American Study of Kidney Disease and Hypertension) study participants. Its association with progressive kidney disease was independent of age, sex, or treatment for high blood pressure. The same variants are present in many African Americans without kidney disease, however.

Knowing how specific genetic variations can effect outcomes and the progression of kidney disease "and may lead to areas of research to slow or prevent progressive kidney disease," according to Brad Astor, lead researcher from Johns Hopkins Bloomberg School of Public Health in Baltimore, Maryland.

Chronic kidney disease patients who took the cholesterol-lowering drug Vytorin had one-sixth fewer strokes, heart attacks or operations to open blocked arteries than patients who took a placebo. The results of the five-year SHARP (Study of Heart and Renal Protection) trial were presented on Saturday.

The main benefit to patients was the reduction in procedures to open blocked arteries and preventing certain types of strokes, according to lead researcher Dr. Colin Baigent of Oxford University, who presented the findings. In the group of patients treated with Vytorin, 284 had operations to unblock arteries, compared with 352 patients in the placebo group, which was statistically significant. Baigent explained that while the 9,000 patient study was large, it did not include enough patients to show differences in heart attacks and coronary deaths.

A press release from Merck, maker of Vytorin, noted, "This is the first prospective clinical study in patients with chronic kidney disease to demonstrate the benefit of lowering LDL (bad) cholesterol on major vascular events."
Vytorin is a combination of cholesterol fighters ezetimibe (Zetia) and simvastatin (Zocor), that is used for treating high levels of cholesterol in the blood.