Hormone That Predicts Premature Death in Kidney Patients Found

Researchers at the University of Colorado School of Medicine have found the blood levels of a particular hormone that can help predict which kidney disease patients will develop heart problems, need dialysis, and die prematurely. Testing for this hormone could identify which patients need early treatment, thereby lowering their health risks and lengthening their lives.

"This discovery allows us to predict at-risk patients before they require dialysis," said lead investigator Michel Chonchol, MD, an associate professor of medicine specializing in nephrology. "That's critical because approximately 23 percent of patients on dialysis die in the first year."

Quiz on Kidney
The kidneys are two bean-shaped organs, each about the size of a fist, and are located just below the rib cage, one on each side of your spine.

Healthy kidneys filter about half a cup of blood every minute, removing wastes and extra water to make urine. The urine flows from the kidneys to the bladder through two thin tubes of muscle called ureters, one on each side of your bladder. The bladder stores urine. The kidneys, ureters, and bladder are partof the urinary tract.

kidneys remove wastes and extra fluid from your body. Kidneys also remove acid that is produced by the cells of your body and maintain a healthy balance of water, salts, and minerals-such as sodium, calcium, phosphorus and potassium-in your blood ().

Acute Renal (Kidney) Failure- Causes, Symptoms, Diagnosis, Treatment and Complications
Acute renal failure is the sudden cessation of the functioning of kidneys, that can be due to reduced renal blood flow, damage to renal tissues.

Without this balance, nerves, muscles, and other tissues in the body may not work normally.

Kidneys also make hormones that help

Control your blood pressure
Make red blood cells
Keep your bones strong and healthy

The findings were published Friday in the Journal of the American Society of Nephrology.

Renal Tubular Acidosis (RTA)-Causes-Types-Diagnosis-Treatment-Complications
Renal tubular acidosis/RTA results in acid content of the blood being higher than normal and that of the urine lower than normal. Renal tubular acidosis causes include Addison’s disease, drugs, mineralcorticoid deficiency.

Chonchol and fellow CU School of Medicine researcher Jessica Kendrick, MD, studied the blood plasma of patients with advanced kidney disease and found that levels of fibroblast growth factor-23, a hormone known as FGF-23, increased as the patient's kidney function decreased.

The hormone regulates phosphorous levels in the body. As the kidneys fail, they are unable to excrete phosphorous which raises FGF-23 levels. The higher the hormone levels, the greater chance the patient will die.

History of Urinary Stone Disease
Stones in the urinary system can form in the kidneys and can sometimes travel down towards the bladder to give rise to acute colics.

"At this point we don't know how the hormone changes the body," Chonchol said.

By the time a patient is down to just 30 or 40 percent kidney function, the levels of FGF-23 can predict who will die, have a cardiac event or end up on dialysis. Almost 50 percent of the deaths result from cardiovascular issues like heart attack.

Until now, doctors relied on measuring phosphorous to assess phosphate balance in patients with kidney disease.

"Prior to a patient going on dialysis the phosphorous levels shoot up," Chonchol said.

But he found that long before phosphorous levels jump, FGF-23 levels have already increased. Identifying this earlier will allow doctors to intervene with drugs that can lower phosphorous which would then lower the hormone level.

"This has provided us a critical marker to look for," Chonchol said, "A marker that could save lives."

Kidney disease currently afflicts 20 million Americans and is a growing problem as the nation gets increasingly obese and diabetes continues to rise.

"The best ways to prevent kidney disease is through blood pressure control, diet, exercise and maintaining a healthy body weight," Chonchol said.

Source-Eurekalert