Quick Kidney Quips

Remote or Rural Residence Not Associated with Increased Time to Kidney Transplantation

CHICAGO—Contrary to what may be a common perception, researchers found no evidence that the likelihood of kidney transplantation is lower among remote- or rural-dwelling patients treated for kidney failure in the United States, according to a study in the April 22/29 issue of JAMA.

Kidney transplantation is a life-saving medical procedure for which the demand far exceeds the supply of transplantable organs. A recent study suggested that rural location of residence within the United States was associated with lower rates of solid organ transplantation compared with those living in urban areas, a finding 
that is consistent with other work showing that rural dwellers have reduced access to health services, which raises the possibility that current organ allocation schemes may discriminate against people living farther away from transplant centers, according to background information in the article.

Marcello Tonelii, M.D., S.M., of the University of Alberta, Edmonton, and colleagues examined the association between distance from the closest transplant center and time to placement on the kidney transplantation waiting list or time to kidney transplantation. “Because the mandatory pre-transplantation medical evaluation is more likely to be available in major medical centers, we hypothesized that people residing further from the nearest transplant center would be less likely to undergo transplantation,” the authors write. The study included 699,751 adult patients with kidney failure who had initiated renal replacement in the United States between 1995 and 2007 and were on a prospective mandatory registry list.

During median (midpoint) follow-up of 2.0 years, 122785 (17.5 percent) patients received a kidney transplant. Median distance to the closest transplant center was 15 miles. Participants were classified into distance categories by miles from a transplant center with 0-15 miles serving as the referent category.

“In contrast to our a priori hypothesis, we found that the likelihood of receiving a kidney transplant from a deceased or living donor among patients living farther away was similar to or greater than those residing within 15 miles of kidney transplant centers. Similarly, and again in contrast to our hypothesis, the adjusted likelihood of kidney transplantation was slightly lower among rural dwellers.”

The authors add that the findings were independent of demographic factors, co-existing illnesses and measured socioeconomic characteristics.“Although unexpected, our findings are encouraging because
determining eligibility for kidney transplantation is a logistically challenging process that requires sequential diagnostic tests and encounters with health care clinicians. The finding that time to transplantation is similar or even shorter among remote- and rural-dwelling patients with kidney failure suggests that disparities in
access for remote- and rural- dwellers with other diseases could be reduced or eliminated,” the researchers write.

“These data suggest that efforts to improve equitable access to transplantation should not focus on populations defined solely by residence location.”

(JAMA. 2009;301[16]:1681-1690)

Blood vessels grown from kidney patient’s own cells

Researchers in California have developed a way to grow blood vessels for seriously ill people with kidney disease from their own cells which should increase the ease and safety of dialysis.

People in dialysis require a shunt to divert their blood to a dialysis machine. The tubes can be made from their own blood vessels but doctors often run out of healthy vessels and have to use plastic tubes which pose a risk of infection and inflammation. In a study published in the medical journal, The Lancet, researchers from Cytograft Tissue Engineering describe how they grew sheets of tissue which they then rolled into supplementary blood vessels.

The procedure involved taking skin from patients, growing new tissue in a lab, rolling it into blood vessels and then transplanting the grafts into the patient’s upper arms and connecting them to dialysis machines.
Out of the initial eight trials, five had functioning grafts for hemodialysis for between six and 20 months. Compared with regular dialysis patients, they needed less care, including surgeries, to maintain the vessels.

The study is promising but costly said one researcher. The vessels cost between $15,000 and $20,000 US.

Used courtesy of The Kidney Foundation of Canada Southern Alberta

Branch Upcoming Events with The Kidney Foundation – Mark Your Calendar!

Here are the upcoming events for The Kidney Foundation of Canada, SK Branch. Please call toll free
1-888-664-8588 ext. 23 or email klytle@kidney.sk.ca for further information:

 September 20 – Regina Give the Gift of Life Fun Run and Walk – We are looking for individuals to sit on the planning committee for this fun event. Gain great experience, great fun and great friends! Call Iris at 306.347.0711 for further information or email ilord@kidney.sk.ca

4th Annual Invitational Golf Event

We would like to cordially invite you to The 4th Annual Invitational Golf Event on Tuesday, June 16th at the Royal Regina Golf Club in Regina Saskatchewan at 11:30 AM.

As a golfer, after raising the minimum pledge amount of $1,964.00, you will be treated to the following:

• An Apple iPod Touch
• Return luxury transportation from your doorstep to the course
• A delicious luncheon before tee-off
• 18 holes of regular play (with cart) at the Royal Regina Golf Club
• Refreshments on the course
• Prizes, Prizes, and more Prizes!
• A five star reception and dinner
• One in sixteen chance of winning a trip for two to the 100th playing of Canada’s National Open Championship – the RBC Canadian Open.

If you would like to be one of our sixteen guests please contact Joan at jkortje@kidney.sk.ca or call 306.347.0711 or click here to register on-line.

Saskatchewan Branch - 1-2217 Hanselman Court, Saskatoon, SK S7L 6A8 - Tel.: (306) 664-8588 / 1-888-664-8588
Charitable Registration Number: 107567398RR0001