Gout and CKD - A New Era of Hope! 
By Peter Laird, MD
It is important to properly diagnose and manage gout to prevent long term complications which are even more prevalent in the chronic kidney disease patient and even more so in patients treated by renal transplant due to drug interactions and declining renal function throughout the life of the donated organ. Treatment options for renal transplant patients are tempered by the many drug-drug interactions with the most widely used anti-gout medications and the usual anti-rejection regimens. Recent studies give hope to chronic kidney disease patients that we can utilize a new medication called Febuxostat to prevent and treat high uric acid levels and symptomatic gout attacks...read full article
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Gout and CKD - A New Era of Hope
It was not until 1962 that scientists discovered that gout is caused by the excess accumulation of monosodium urate (MSU) crystals in the tissues surrounding joints. Uric acid (also known as urate) forms in the body as the natural process of protein break down. Normal levels are less than 7.0 mg/dL. Many people who have chronic kidney disease experience their first attack as their kidney function progressively declines due to reduced urinary excretion of uric acid.
The National Kidney Registry
The National Kidney Registry was started and is personally managed by a complete transplant industry outsider - a dad who just wanted to find a compatible donor for his daughter. Below is the founder's story.
When my youngest daughter was 10 years old, her kidneys failed. When we learned that she would never recover her kidney function, I raced home to check my old military records for my blood type to see if I would be able to donate my kidney. I was overcome with relief when I discovered that we were both "A" blood type and I would be able to donate.
Transplant Website Review
Today's feature site is US Transplant, at www.ustransplant.org. I've been a huge fan of this particular site for many, many years, as it gives volumes of center specific information as well as nationwide stats. I reference it frequently for data that I need to gather for lectures, 1:1 talks with patients regarding their particular situation as well as to just stay current on transplant statistical information. There are areas to check national stats, local hospital & OPO stats and research resources.
How to Multi-List for a New Kidney
Be aware that it is against federal law to buy or sell an organ in the United States punishable by severe fines and jail time. So unless you decide to go outside of the United States and take the risks in some third world country of buying an organ, you had best learn the "ins and outs" that UNOS allows by Multiple Listing
Proteinuria
The presence of protein in the urine, an early sign of kidney disease. One of the major medical complications of diabetes is diabetic nephropathy, a type of kidney disease that develops slowly over the course of years. Diabetic nephropathy can lead to end-stage renal disease (kidney failure), necessitating dialysis or kidney transplantation. In fact, diabetic nephropathy is the leading cause of kidney failure in the United States.
Nephropathy
A complication of diabetes that damages the kidneys' ability to filter waste from the blood. Diabetic nephropathy is the single most common cause of kidney failure in the Western world. Nearly one-third of all people with Type 1 diabetes will eventually develop kidney failure due to diabetic nephropathy. A small percentage of people with Type 2 diabetes will also eventually develop diabetic nephropathy.
Metformin
A popular oral drug for treating Type 2 diabetes. Metformin (brand name Glucophage) is a member of a class of drugs called biguanides that helps lower blood sugar levels by improving the way the body handles insulin-namely, by preventing the liver from making excess glucose and by making muscle and fat cells more sensitive to available insulin.
Lori's Lines "Turning Scary Emotions into Hope for a Wonderful Life"
Our emotions typically are triggered because of a fear of the unknown and how living with CKD will affect our lives and those that we love. People often become extremely emotional during times of emotional stress, and we can be happy one minute and tearful the next. If this sounds like you, the first thing to realize is that you are not alone! Research has shown the most people go through many emotional stages when they are first diagnosed with an illness. In my case, I have had CKD since I was a small child, and my lifelong journey has been heralded by many changes in both the status of my disease as well as how I deal with it emotionally.
Vitamin D and CKD
It's seems that everyone is talking about vitamin D and for a good reason. Long winter months indoors and use of heavy sunscreen are some of the reasons that keep our bodies from absorbing the UV rays necessary to make healthy amounts of vitamin D leading to vitamin D deficiency. But for people with chronic kidney disease, it's not just an issue of vitamin D deficiency but a deficiency in active vitamin D as well.
Immunosuppressant Drug Therapy & Generics
Generic medications are being offered or substituted for brand name medications. There are many generics on the market currently for blood pressure and lipids as well as organ transplant rejection meds.
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"So let me encourage you to get involved with your community. You can be a blessing to those around you. And tell your story! You may inspire someone at risk for kidney disease to have things checked out." -Regina Alvis Texas
Excerpt from RSN's 2009 Essay Contest
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