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Kidney Donation is Safe

Kidney location after transplantation.
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People who decide to donate a kidney to their near and dear ones need not fear any long term implications as donation has no negative impact on donor’s general health, say experts. Donors can lead a perfectly normal life and, on the contrary, are benefitted psychologically, having the satisfaction of saving a life, they add. Similar observations have been made by a study done in puerto rico which has been reported in the transplantion proceedings . People with one normal kidney can lead a perfectly nomal life and in fact one in 1,000 people are born with single kidney, Dr. S.   C. Tiwari, professor at the department of nephrology at aiims, said. Hence, mortality for donors is same as for normal people with there being hardly any chance of death because of complications arising out of donation, he said. Tiwari said the institute, where on an average two kidney transplants are performed in a week, did not have a policy of keeping a track of kidney donors.

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However, recipients, who usually come for health follow up regularly, are enquired about the health of donors, generaly related to them. The only difference a donation makes for donors is that their remaining kidney is under more pressure as it has to work for the whole body. thus, donors are asked to live a regulated life and control their diet, blood pressure and physical activity so that work load on kidney does not exceed, Tiwari said. till three months after donation, donors’ single kidney remains hypertrophy, which reflects that it is coping with entire body’s load, and then it adjusts, Tiwari said.

During these three months, the donors are supposed to take special care. One significant outcome of kidney donaiton is that donors have a sense of “eternal satisfaction” for contributing to the life of a relative, he added. The opinion on kidney donation is strengthened by the study, carried out under the puerto rico renal transplant programme, an academic programme based in an affiliated community hospital, in puerto rico.

The study, based on a documentation of the long-term health of live kindney donors, said that in general the health after many years of donation reflects more or less the health of the general population, stressing that kidney donation is a relatively safe procedure with little morbidity and no mortality in the majority of cases. Risk of mortality is estimated to be 0.03 per cent while acute complication rates vary and are relatively low at eight per cent in places with vast experience in living donation, it said. the puerto rico study involved follow up of the health of 20 donors who had donated their kidney 20 years ago or more.

The donors were interviewed and subjected to a complete history and physical examination, including blood pressure and urine analysis, the report said. of the 20 donors, 12 were females and eight males. the donors were in the mean age of 61 years. Significantly all the donors expressed happiness over donation, the report said. in terms of health parameters, the donors had normal urine analyses, excluding one, a 73-year-old woman who had donated kidney to her daughter, who had persence of protein in urine (proteinuria), the report said adding the woman had developed de novo diabetes. Five of the 20 donors developed de novo hypertension at least 10 years after the donation.However, all of them had a strong family history of hypertension, it said. however, donors had elevated levels of creatinin, a product of muscle breakdown, in their serum and lower creatinin clearance by kidneys.

The report said that though it indicated reduced kidney function, the increase in serum creatinin was not significant. Tiwari said that at aiims he had not seen any donor having a creatinin level, which has caused any problem. Dr. D. S. Rana, a nephrologist at the ganga ram hospital, said that creatinin level sometimes increases in marginal donors – donor who are aged (above 65), or have mild hypertension, or have slightly abnormal kidney function. All these are contraindicaitons for kidney donation, but such people are sometimes accepted as donors when no other suitable donor is available, rana said, adding even such donors do not carry any major risk. If raised levels of creatinin are observed, patients are asked to avoid high protein diet, rana said. during the donation surgery also, donors are not at an additional risk. The risks are same as in any other surgery.

Sources: The Times Of India

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Health Moves ‘Halve Early Deaths’

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Women could halve their risk of premature death by adopting a healthier lifestyle, research suggests…..
Smoking accounted for nearly a third of the deaths

By avoiding cigarettes, exercising regularly, eating healthily and keeping weight in check, 55% of early deaths from chronic diseases could be avoided.

Following all four lifestyle tips could cut 44% of cancer deaths and 72% of cardiovascular deaths, the study of nearly 80,000 nurses suggests.

The work is published on the British Medical Journal website.

In the 24-year study, 28% of the 8,882 deaths could be attributed to smoking and 55% to the combination of smoking, being overweight, not doing enough exercise and a poor diet.

Drinking too much alcohol also contributed, but women with “light-to-moderate” alcohol consumption of up to one drink a day were less likely to die from cardiovascular diseases than teetotallers.

Report author Dr Rob van Dam, from the Brigham and Women’s Hospital and Harvard Medical School, said the study’s positive findings on moderate consumption of alcohol should not encourage people to “go overboard”.

“It seems to be that drinking a little alcohol can lower the risk of heart disease, but you have to look at the overall picture too. We also saw in our study that people who drink a lot of alcohol have a higher risk of dying from cancer.”

He said it could be easy for people to adopt the basic lifestyle recommendations.

Simple advice

“In busy, modern life it’s more difficult to adapt to these factors, but people don’t have to spend hours lifting heavy weights.

“It’s simple dietary changes like eating more whole-grains and less red meat, walking to work and to the grocery shop, these really add up. And of course the thing to state is not to smoke.”

According to Dr van Dam, the recommendations in his study could apply to men as well as women.

The 77,782 women aged 34 to 59 who took part in the study completed detailed follow-up questionnaires every two years about their diet, frequency of physical activity, alcohol intake, weight, how much they smoked, and disease history.

Over the follow-up period the authors documented 8,882 deaths including 1,790 from heart disease and 4,527 from cancer.

A spokeswoman from the British Nutrition Foundation said: “This study reaffirms the importance of prevention.

“It is worth making lifestyle changes now, so that our later years are spent free from diseases such as cancer and heart disease.”

“It is worth making lifestyle changes now, so that our later years are spent free from diseases”.…as per British Nutrition Foundation spokeswoman

Risk reduction

Meanwhile, a study by the British Heart Foundation has found women at high risk of diabetes can reduce their body’s insulin resistance – the most important biological risk factor for diabetes – by exercising.

After seven weeks of an exercise programme of three 30 minute exercise sessions in the first week, working up to five 60 minute sessions in weeks six and seven, insulin resistance had reduced by 22% in women whose family history put them at a high risk of type 2 diabetes.

Professor Peter Weissberg, medical director at the BHF, said: “I hope the findings will encourage people to get active for their health.”

Sources: BBC NEWS:Sept. 16. ’08

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Work Stress ‘Changes Your Body’

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A stressful job has a direct biological impact on the body, raising the risk of heart disease, research has indicated.The study reported in the European Heart Journal focused on more than 10,000 British civil servants.

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……………………………..Stress seems to produce biochemical changes

Those under 50 who said their work was stressful were nearly 70% more likely to develop heart disease than the stress-free.

The stressed had less time to exercise and eat well – but they also showed signs of important biochemical changes.

The studies of Whitehall employees – from mandarins to messengers – started in the 1960s, but this particular cohort has been followed since 1985.

As well as documenting how workers felt about their job, researchers monitored heart rate variability, blood pressure, and the amount of the stress hormone cortisol in the blood.

They also took notes about diet, exercise, smoking and drinking.

Then they found out how many people had developed coronary heart disease (CHD) or suffered a heart attack and how many had died of it.

Lead researcher Dr Tarani Chandola, of University College London, said: “During 12 years of follow up, we found that chronic work stress was associated with CHD and this association was stronger both among men and women aged under 50.

“Among people of retirement age – and therefore less likely to be exposed to work stress – the effect on CHD was less strong.”

Biological factors

On the one hand, those who reported stressful jobs appeared less likely to eat sufficient amounts of fruit and vegetables, and were less likely to exercise – although problem drinking did not emerge as a significant problem in this study.

Lifestyle, the researchers concluded, was nonetheless a key factor in the development of the disease.

But the team also say they are now confident they understand the biological mechanisms that link stress and disease, a connection widely held to exist but which has been difficult to prove.

These mechanisms held true regardless of lifestyle.

Stress appeared to upset the part of the nervous system which controls the heart, telling it how to work and controlling the variability of the heart rate.

Those who reported stress were also recorded as having poor “vagal tone” – the impulses which regulate heartbeat.

A major part of the neuroendocrine system – which releases hormones – also seemed to be disturbed by stress, evidenced by the fact that anxious workers had higher levels of the stress hormone cortisol in the morning.

Worker status

While the younger worker seemed to be more at risk, the findings were the same regardless of the status of the worker.

Previous studies had suggested those of lower employment grades may be more at risk.

“We did not find strong evidence that the effect of work stress on heart disease is worse for those in lower grades – the effect of stress was pretty much the same across different grades,” said Dr Chandola.

“However, later on in the study, some parts of the civil service underwent considerable change in their working environments, including privatisation.

“We are currently exploring whether the effects of these changed work stress levels, partly brought about by privatisation, are particularly deleterious for those in the low grades of the civil service.”

The British Heart Foundation said the research added to our understanding of how stress at work may alter the body’s chemistry.

“The study also reinforces what has been identified by previous research, that stress at work is often associated with unhealthy behaviours such as smoking, lack of exercise and a poor diet – all which can impact on heart health,” said June Davison.

“There are many ways that we can help ourselves by learning how to cope with stressful situations.

“Keeping fit and active also helps to relieve stress and therefore reduce the risk of heart disease.”

Sources: BBC NEWS.23 Jan’08

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