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25th Issue
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The Indian Pharmaceutical Association Students’ Forum
Panache -Live The Monthly Newsletter !!! February, 2013
Our Mission: The Indian Pharmaceutical Association-Students’ Forum is a national body of pharmacy students under IPA. It is a platform to promote increased student interactions and activities bringing more co-operation at a national level. IPA-SF will also link the pharmacy students in India with the rest of the world through memberships and alliances with international organizations. The IPA-SF will serve as a unifying factor for the pharmacy students’ community in India bringing them under one umbrella and thus benefit in turn the profession and thus the future health of INDIA.
Cover Story: Kidneys For Life!
2012-2013
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INSIDE THIS ISSUE
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Cover Story: Kidneys for Life!!!
Student’s speak: Chronic Kidney Disease and its various queries
HOME
WORK
Editor’s Choice: High Blood Pressure and Kidney Disease
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Special Article: A Kidney Transplant Success Story
Executive Council
Call for Articles
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Cover Story
Kidneys for Life!!!
Stop Acute Kidney Injury. Kidney day!! A day dedicated to raising awareness of the importance of healthy kidneys to our overall well being, as well as reducing the impact of kidney disease World Kidney Day is a joint initiative of the International Society of Nephrology and the International federation of kidney foundation along with a steering committee composed of nephrology and transplantation experts from all around the world. The day has several long term objectives such as high-lighting that DIABETES and HYPERTENSION are high risk factors for chronic kidney disease and these patient groups should be regularly screened. There are also objectives focusing on encouraging medical professionals to actively educate their patients and influencing local and national health authorities to invest in further kidney screening. The theme for World Kidney Day 2013, March 14: Stop Kidney Attack!! By focusing on kidney attack WKD seeks to raise awareness and stimulate discussion, education and policy development leading to improved prevention and treatment of this major kidney disease. March 14 2013 will mark the 8th World Kidney Day- a day of global action jointly organized by ISN and IFKF. Golden Rules: How to keep Kidneys Healthy? -Keep oneself fit and active -Keep regular control of blood sugar levels, blood lipids and anemia -Monitor blood pressure, reduce if necessary -Eat healthy and keep your weight in check -Do not smoke -Do not take counter pills on a regular basis. Professor Jeremy Chapman a member of World Kidney Day steering committee and edition board member for transplantation research summarizes : “World Kidney Day is a call to mobilize and deliver transplantation therapy to the one million people a year who have a right to benefit�. References: www.worldkidneyday.org www.kidney.org
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N A C U YO TUBERCULOSIS (TB) is a serious disease, but it can be PREVENTED and CURED!
If you have the SIGNS... FEVER
NO APPETITE
FEELING TIRED
Chills, night sweats
and weight loss
all the time
Get a FREE TB Test !
and FREE treatment if you need it!
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Samhitha Reddy
Deputy National TB Co-
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For further details of the campaign contact
DIAN E IN PH
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N.Harish Chaitanaya
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Student’s
Speak
Chronic Kidney Disease and its various queries
Kidneys are essential organs in the body. There is a general lack of awareness about the problems caused by kidneys and their solutions. It is very essential to be aware about the organ that is required for daily purification of our blood among many other functions. Frequently-Asked Questions about CKD When people are told they have chronic kidney disease (CKD), the first questions they often have are "How long will I live?" and "How well will I live?" This answers these and other questions about CKD, while also presenting thoughts from patients. Q: How long can I live with chronic kidney disease? A: Many people think that if their kidneys fail, they will die right away. This used to be true—50 years ago. Back then, there were not enough dialysis machines to go around and medical knowledge about kidney disease was limited. It is no longer true today. How long you can live with CKD depends on your age, other health problems, and how involved you become in your care. Most people with early CKD will never have kidney failure while others will reach kidney failure and may live for decades with dialysis or kidney transplants. There are major advances in today's healthcare. We have better drugs, know more about how to slow down kidney failure, and have updated dialysis machines. But the most important factor is still the person who has the disease. Research shows that people who become partners in their care live longer. Q: How good will be my life with CKD? A: How good your life can be with CKD depends on YOU! In the early stages, CKD may have symptoms that are so subtle you may not even notice them. In later stages, fatigue, itching, loss of appetite, and other symptoms can reduce your quality of life. How all of these symptoms can be treated. Learn what to watch for and tell your doctor, so you can get the help you need. You can also keep a good quality of life by following your treatment plan. For example, taking your medications in the right doses at the right times may help slow your kidney disease. Your quality of life with CKD depends on your attitude, and how you accept the changes and take control of your health and your life. Q: Can I still have a good life if I need dialysis? A: Yes, you can live long and live well with dialysis. Many people—even those with loved ones on dialysis—don't know that there are many types of dialysis. You can choose a treatment that lets you keep doing all or most of the things you value. People who are very sick before they start dialysis are often surprised to find that they feel much better a few weeks or months later. The unknown you imagine is often much scarier than the reality. Learn all you can, and talk to people who are doing well—like people who do their treatments at home, or while they sleep. You'll see that you can have a good life on dialysis. Q: I'm tired all the time. Is there a treatment for fatigue? A: Even healthy people complain of being tired. But people with CKD can be so exhausted that they fall asleep during the day—even after 8 to 10 hours of sleep at night. One reason for fatigue can be anemia, a shortage of oxygen-carrying red blood cells. People with CKD often have anemia because damaged kidneys make less of a hormone called erythropoietin (or EPO). EPO tells the bone marrow to make new red blood cells. Without a fresh supply of red blood cells, the body has less oxygen. This makes you more tired and cold, and less able to focus and fight disease. If your fatigue is due to anemia, your doctor may prescribe iron and injections of a man-made form of EPO.
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Student’s
speak
Q: How can I keep my kidneys working as long as possible? A: There are a number of treatments, including medications and lifestyle changes, that may help keep your kidneys working longer. People can even get transplants before having dialysis, especially if they have a willing living donor. Ask your doctor what would help you. Q: Should I keep working? A: Yes! Most people find that disability pays much less than working—but their bills don't go away just because they're ill. If you have CKD and a job, try to keep it if you can, or find a new one. Work can make you feel like you're still you, and that you are still helping to support your family. Work may also be a vital part of your social life. If your job comes with a health plan, it can also help you get good care and pay for prescription drugs.
Reference: lifeoptions.org
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Editor’s Choice
High blood pressure and kidney disease
Kidney disease can lead to high blood pressure in many people. The opposite is also true: having high blood pressure increases the risk of developing kidney disease. High blood pressure can damage the kidneys. This reduces the kidneys' ability to remove fluids and waste products from the blood, and can lead to kidney failure. When the kidneys fail, their function needs to be replaced, either through dialysis treatments or a kidney transplant. What is high blood pressure? Blood pressure measures the force of blood against the walls of the blood vessels. Extra fluid in the body increases the amount of fluid in blood vessels and makes blood pressure higher. Narrow, stiff, or clogged blood vessels also raise blood pressure. Hypertension can result from too much fluid in normal blood vessels or from normal fluid in narrow, stiff, or clogged blood vessels. What are the signs and symptoms of high blood pressure? Most people with high blood pressure have no symptoms. The only way to know whether a person's blood pressure is high is to have a health professional measure it with a blood pressure cuff. The result is expressed as two numbers. A person's blood pressure is considered normal if it stays at or below 120/80, which is commonly stated as "120 over 80." People with a systolic blood pressure of 120 to 139 or a diastolic blood pressure of 80 to 89 are considered prehypertensive and should adopt lifestyle changes to lower their blood pressure and prevent heart and blood vessel diseases. A person whose systolic blood pressure is consistently 140 or higher or whose diastolic pressure is 90 or higher is considered to have high blood pressure and should talk with a doctor about the best ways to lower it. How does high blood pressure hurt the kidneys? High blood pressure makes the heart work harder and, over time, can damage blood vessels throughout the body. If the blood vessels in the kidneys are damaged, they may stop removing wastes and extra fluid from the body. The extra fluid in the blood vessels may then raise blood pressure even more. It's a dangerous cycle. What is renal failure? Renal failure (also kidney failure or renal insufficiency) is a medical condition in which the kidneys fail to adequately filter waste products from the blood.[1] The two main forms are acute kidney injury, which is often reversible with adequate treatment, and chronic kidney disease, which is often not reversible. In both cases, there is usually an underlying cause. Renal failure is mainly determined by a decrease in glomerular filtration rate, the rate at which blood is filtered in the glomeruli of the kidney. This is detected by a decrease in or absence or determination of waste products (creatinine or urea) in the blood. Depending on the cause, hematuria (blood loss in the urine) and proteinuria (protein loss in the urine) may be noted. In renal failure, there may be problems with increased fluid in the body (leading to swelling), increased acid levels, raised levels of potassium, decreased levels of calcium, increased levels of phosphate, and in later stages anemia. Bone health may also be affected. Long-term kidney problems are associated with an increased risk of cardiovascular disease.
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Editor’s Choice Classification: 1.Acute kidney injury Acute kidney injury (AKI), previously called acute renal failure (ARF), is a rapidly progressive loss of renal function, generally characterized by oliguria (decreased urine production, quantified as less than 400 mL per day in adults,less than 0.5 mL/kg/h in children or less than 1 mL/kg/h in infants); and fluid and electrolyte imbalance. AKI can result from a variety of causes, generally classified as prerenal, intrinsic, and postrenal. The underlying cause must be identified and treated to arrest the progress, and dialysis may be necessary to bridge the time gap required for treating these fundamental causes. Acute kidney failure usually occurs when the blood supply to the kidneys is suddenly interrupted or when the kidneys become overloaded with toxins. Causes of acute failure include accidents, injuries, or complications from surgeries in which the kidneys are deprived of normal blood flow for extended periods of time. Heart-bypass surgery is an example of one such procedure. 2. Chronic kidney disease Chronic kidney disease (CKD) can also develop slowly and, initially, show few symptoms.CKD can be the long term consequence of irreversible acute disease or part of a disease progression. Chronic Kidney Disease (CKD) has numerous causes. The most common causes of CKD are diabetes mellitus and long-term, uncontrolled hypertension. Polycystic kidney disease is another well-known cause of CKD. The majority of people afflicted with polycystic kidney disease have a family history of the disease. Other genetic illnesses affect kidney function, as well.Overuse of common drugs such as aspirin, ibuprofen, and acetaminophen (paracetamol) can also cause chronic kidney damage.Some infectious diseases, such as hantavirus, can attack the kidneys, causing kidney failure. How is kidney failure diagnosed? Diagnosis of kidney failure is confirmed by blood tests measuring the buildup of waste products in the blood. BUN, creatinine, and GFR are routine blood tests used to measure the buildup of waste products in the blood. BUN and creatinine become elevated, and the glomerular filtration rate (GFR) decreases. This is the rate with which blood is filtered through the kidneys and can be calculated based upon the creatinine level, age, race, and gender. Urine tests may be done to measure the amount of protein, detect the presence of abnormal cells, or measure the concentration of electrolytes. Protein in the urine is not normal and can be a clue that damage to the kidneys has occurred. When the urine is examined under a microscope, abnormal aggregations of red and white blood cells called casts can be seen in the urine with kidney disease. Comparing the concentrations of electrolytes in the blood and urine can help decide whether the kidneys are able to appropriately monitor and filter blood. Other tests are used to diagnose the type of kidney failure. Abdominal ultrasound can assess the size of the kidneys and may identify whether any obstruction exists. Biopsy of the kidney uses a thin needle that is placed through the skin into the kidney itself to get bits of tissue to examine under the microscope. What is the treatment for kidney failure? Once kidney failure is present, the goal is to prevent further deterioration of renal function. If ignored, the kidneys will progress to complete failure, but if underlying illnesses are addressed and treated aggressively, kidney function can be preserved, though not always improved.
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Editor’s Choice
1.Diet Diet is an important consideration for those with impaired kidney function. Consultation with a dietician may be helpful to understand what foods may or may not be appropriate. Since the kidneys cannot easily remove excess water, salt, or potassium, these may need to be consumed in limited quantities. Foods high in potassium include bananas, apricots, and salt substitutes. 2.Medications Medications may be used to help control some of the issues associated with kidney failure. · Phosphorus-lowering medications (calcium carbonate [Caltrate], calcitriol [Rocaltrol], sevelamer [Renagel]) · Red blood cell production stimulation (erythropoietin, darbepoetin [Aranesp]) · Red blood cell production (iron supplements) · Blood pressure medications like Beta 2 agonists, Beta 1 blockers, ACE inhibitors, angiotensin II receptor blockers. · Vitamins Once the kidneys fail completely, the treatment options are limited to dialysis or kidney replacement by transplantation. 1.Dialysis Dialysis cleanses the body of waste products in the body by use of filter systems. There are two types of dialysis; 1) hemodialysis, and 2) peritoneal dialysis. · Hemodialysis: Hemodialysis uses a machine filter called a dialyzer or artificial kidney to remove excess water and salt, to balance the other electrolytes in the body, and to remove waste products of metabolism. · Peritoneal dialysis: Peritoneal dialysis uses the lining of the abdominal cavity as the dialysis filter to rid the body of waste and to balance electrolyte levels. A catheter is placed in the abdominal cavity through the abdominal wall by a surgeon and is expected to remain there for the long-term. 2.Kidney transplantation If kidney failure occurs and is non-reversible, kidney transplantation is an alternative option to dialysis.
References: www.wikipedia.com www.webmd.com www.ncbi.com
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Special Article
A Kidney Transplant Success Story
‘I'd give up all my organs to save my children’ For Dr T P Lahane, dean of the state-run J J Hospital, World Kidney Day is a reminder of the precious donation his mother made 18 years ago. While Lahane has become a household name because of his expertise in eye-care, not many people know that he is a recipient of his mother's kidney. Around 20 years ago, when he was in his mid-thirties, he was diagnosed with a kidney problem. After undergoing dialysis for five years, the doctors treating him decided it was time that he underwent a transplant. Lahane, who hails from Makhegaon-a small village in Latur districtreceived a kidney from his mother on February 22, 1995. The first symptom manifested in 1991, when Lahane was making his daily rounds checking in on his patients in a hospital in Beed. He found he could not walk. "I started feeling giddy. My blood pressure was 240/140. Further tests revealed that my creatine levels were extremely high," said Lahane.When the time came to discuss the transplant with his family, Dr Lahane recalls that all eight members of his family had agreed to donate their kidneys. "The doctors tested my parents, four sisters and two brothers. My mother's kidney was the best match," he said. His mother Anjanabai Lahane, now 77 years old, said the only thought in her mind at the time was to save her son. "I was afraid, not for myself, but for him. I just wanted him to be all right. I would have given all my organs to save my children," she said. "Apart from old-age, I suffer from no health problems.� Most people are under the impression that a transplanted kidney does not last a lifetime but Lahane believes otherwise. As long as the donor and the recipient take proper care, they can both lead a normal life, he said. "After a transplant, the immunity of the recipient is low as he or she is usually put on a lifelong dose of immuno-suppressants. But apart from minor viral infections, I haven't suffered from any infections after the transplant," said Lahane, adding that he has no diet restrictions, but is very particular about his medicines.
References: Timesofindia.indiatimes.com www.thenews.com wiki.org
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Executive council
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CALL FOR ARTICLES 1. The selection of articles will solely be the discretion of the Publication Committee of IPA-SF. 2. Every article should have a word limit between 150 to 200 words. 3. Articles should be typed in any normal font (Times New Roman) and should have a font size 12 and sent to panachelive@gmail.com in Microsoft Word Format. 4. Articles should be the Author's original work. If the article has been directly picked up from some source then it may amount to plagiarism and such Author's will be barred from any future participation. 5.The names of any references used should be clearly mentioned. 6.The names of any Co-author/s should also be mentioned. 7.The name of the institution/company of the Author/Co-author/s should be mentioned. 8.The efforts of the Authors and Co-authors whose articles have been selected will be duly acknowledged.
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