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New national scheme for assessing patients for the deceased donor transplant waiting list

About 500 people start treatment for end stage kidney disease each year in New Zealand. Over 2,000 patients are on dialysis.  The best treatment for kidney failure is a kidney transplant. There are 600 to 700 patients with kidney failure on the waiting list for a deceased donor transplant but only 110 to 120 transplants, about half from live donors, are carried out each year.

The Transplant Subcommittee of the National Renal Advisory Board has developing a tool for the prediction of survival after deceased donor transplantation to aid potential recipient education and patient selection for the waiting list. This tool will be used from 1 April 2013 by the three New Zealand transplant units as part of the assessment for patients with kidney failure who wish to be placed on the waiting list for a deceased donor kidney. This is not a change in the eligibility criteria for transplantation,rather a process to enable more uniform and transparent application of established criteria across the country.

You can read more about this new tool in the Patient Information section of the website.
 

 

Weta Workshop Screening 12 March 2013

Emma from Weta Workshop has her blood pressure checked as part of Kidney Health Week and Salt Awareness Week with Carmel Gregan-Ford from Kidney Health NZ, Heather Kizito from the Stroke Foundation and Lucy Smith from St Johns.

 

 

 Get your kidneys checked on World Kidney Day

Thursday 14 March 2013

Is there a history of kidney disease in your family?
If so you may be at risk yourself

•    People with a family history of kidney disease are three to nine times more likely to     develop kidney failure than a person without such a family history
•    This is especially true if you are Maori and Pacific
•    Kidney failure has profound effects on the lives of patients and their families
•    Kidney disease is silent with 80-90% of people unaware they have it
•    Nearly 4,000 New Zealanders are on treatment for kidney failure
•    Around  500 new patients start dialysis each year
•    Treatment is expensive costing the health system around $150 million annually
•    The good news is that there are things we can do to protect our kidneys if the diagnosis is made early
•    Checking for kidney disease is simple

Well known actor and director, Michael Hurst, has a family member with kidney disease and already knows that he is at increased risk. Michael says, “because of my family history of kidney disease I make sure I get a regular kidney check with my GP”.

 

Hercules aka Michael Hurst getting his blood pressure taken by his GP, Dr Barney Montgomery, as part of his kidney check.

During Kidney Health Week (11-15 March 13), KHNZ, kidney units and patient support groups will be encouraging family members of people with kidney disease to get their doctor to check out their kidneys. KHNZ will be giving family members this card to take with them when they visit their GP.

On World Kidney Day, 14 March 13, KHNZ will team up with staff from the Northland DHB kidney unit to offer kidney checks to family members of kidney patients at Forum North, Whangarei.

For more information about getting checked contact:
•    Your GP
•    Kidney Health New Zealand www.kidneys.co.nz

ENDS

More information

Professor Kelvin Lynn, Medical Director of Kidney Health New Zealand
Telephone 03 353 1242
Mobile 0274 376 542
kelvin@kidneys.co.nz                    www.kidneys.co.nz

 

Stop Kidney Attack

Dr John Pickering
Christchurch Kidney Research Group,
Department of Medicine,
University of Otago Christchurch

The theme for this year’s World Kidney Day (14 March 2013) is “Kidney’s for Life: Stop Kidney Attack.”  Whereas Chronic Kidney Disease is the name for the progressive and slow forming kidney disease many are familiar with, Kidney Attack, or Acute Kidney Injury as it is more formally know, is the name for rapid onset kidney failure.  Few are familiar with this disease despite there being about 30,000 cases a year in New Zealand contributing to about 1,300 deaths!

Few are familiar because Kidney Attacks are almost always following some other event; including cardiac surgery, severe infections, trauma, overdose, use of contrast agents in scans etc etc etc. Every Heart Attack is a Kidney Attack because when the heart stops pumping blood, even for a few minutes, no blood reaches the kidneys.  Normally the kidneys receive 25% of the blood from each beat of the heart.  No blood means a no oxygen to the kidney tissues resulting in damaged kidney cells.  Damaged kidney cells mean that filtration does not occur as it should.  This can be temporary or permanent or fatal.  About 4-5% of all hospital patients have a kidney attack.  Within the intensive care unit one third or more of patients have an attack, often a serious one.  The worst require supportive dialysis – at this stage there is only a 50% chance of survival. When an attack occurs the odds for dying in hospital rise four fold.  Recent research has shown that Kidney Attacks also increase the chance of a person getting Chronic Kidney Disease or End Stage Renal Disease at a later date.  Furthermore, those with Chronic Kidney Disease are more at risk of Kidney Attack should they be in hospital for any reason.

For decades Kidney Attack has been one of those diseases only diagnosed in retrospect.  The problem is that the method of detection has been slow.  The physician is often only aware of the Kidney Attack a day or two after it has occurred.  This is like water running down a drain.  If there is a partial blockage a long way down we only know some time later when the water has backed up all the way to the sink (and overflowed it on to the floor inevitably!).  Many of us have had a car that breaks down, inevitably in the middle of the nowhere, costing us lots of time and money.  Wouldn’t it be better to know before it breaks down at a time when we can do something about it?  Detecting Kidney Attack early has been a priority for the international nephrology research community and the Christchurch Kidney Research Group (CKRG) over the past few years.  We are looking for metal filings in the oil drops of the garage floor to identify if the engine has been damaged.  In reality this means looking for signals of damage in the blood plasma and, in particularly, in the urine.  That is why my children call me a “pee scientist.”

It was the new techniques of proteomics and genomics that have helped identify the first new biomarkers of kidney injury.  For the scientists this was like the first X-rays of broken bones – whereas previously a physician was able to tell if the arm was not functioning well, they could now see the actual injury – very exciting.  Now we have a tool to measure injury – the injury biomarker.  Much of our research is about identifying what those new biomarkers mean and how they can be used clinically.

From 2005-2008 Professor Zoltan Endre of CKRG oversaw in Christchurch and Dunedin Intensive Care Units the world’s first trial of the drug Erythropoietin (EPO – the same stuff the cyclists cheated with!) for the prevention of Kidney Attack.  Critically it was the first trial to ever use one of the new biomarkers to detect injury to the kidney early, rather than wait a day or two for the more traditional methods.  While a new treatment was not discovered, it was a breakthrough in methodology.  Much has been learnt about a multitude of biomarkers measured during that trial and subsequent studies. 

Our latest finding, with the help of some mathematical modelling and the good staff of Christchurch Hospital’s Emergency Department and Intensive Care Unit, is that following a heart attack the traditional method of telling that a patient does not have a Kidney Attack is flawed.  Indeed, the marker measured in the blood that was thought to represent Kidney Attack only if it increases was found to represent Kidney Attack even if it remained unchanged.  With this knowledge physicians may avoid further stress to the kidney and give it support to recover, and researchers may trial new interventions designed to Stop Kidney Attack.

- Ends -

 

Hon Tony Ryall

Minister of Health

12 March 2013           Media Statement       

Campaign to protect Kiwis against flu starts 

 
Health Minister Tony Ryall rolled up his sleeves at Karori Medical Centre in Wellington today to receive his annual influenza vaccination and launch the 2013 influenza immunisation campaign.

“We want more New Zealanders to be protected against this serious disease – this year the goal is to vaccinate 1.2 million people,” says Mr Ryall.

“Around 400 New Zealanders die, directly or indirectly, each year from influenza.  Last year the disease put more than a thousand people in hospital and nearly 50,000 people visited their GP with influenza-like-illness.

“The predominance of the A(H3N2) influenza virus in the Northern Hemisphere this season is a concern if it spreads more widely here than it did in 2012 because I understand infections with this virus can be particularly severe for the elderly and those with an ongoing medical condition.”

Mr Mark McIlroy was also at the launch today to encourage more people to be immunised. His wife, Catherine (49) had been a previously fit and healthy woman when she was struck down by the A(H3N2) flu virus in July 2012.  She died of the disease within five days of showing symptoms.

The influenza vaccine for 2013 Southern Hemisphere season includes two new
strains based upon recommendations from the World Health Organization. The vaccine this year includes:
•    A/California/7/2009(H1N1) pdm09-like virus
•    A/Victoria/361/2011(H3N2)-like virus (new strain for 2013
•    B/Wisconsin/1/2010-like virus (new strain for 2013).

Last year over one million New Zealanders had a flu vaccination – around 23 percent of the population.  However we want more people to be protected and I encourage you to get your flu vaccination, especially if you are in one of the at risk groups,” says Mr Ryall.

The flu vaccination is free to those at greatest risk of serious influenza complications, including New Zealanders over the age of 65, pregnant women, and people with on-going conditions such as asthma or heart problems.

People who are not eligible for the programme can purchase the vaccine from their general practitioner or selected pharmacies.

For further information go to www.fightflu.co.nz or www.health.govt.nz or call 0800 IMMUNE 0800 466 863.

Photograph of Health Minister Tony Ryall receiving his annual influenza vaccination from Robyn Taylor a nurse at Karori Medical Centre.
 

Announcing the endorsement of the New Zealand Nephrology Nursing Knowledge and Skills Framework by the National Nursing Consortium: practice standards endorsement

October 2012

Maureen Morris, chair of the Consortium, congratulates the Nursing Advisory Group, Renal Society of Australasia (NZ Branch) on receiving a five year endorsement for their knowledge and skills framework until September 2017.  The framework may be accessed on the Health Improvement and Innovation Resource Centre website www.hiirc.org.nz/page/35787/new-zealand-nephrology-nursing-knowledge

The committee has congratulated the Nursing Advisory Group for its commitment to improving standards for renal patients in New Zealand, and acknowledged and applauded the clear framework for specialty practice development.  In particular, the committee commended the concise and clear way in which the framework is presented.

New Zealand Scientist wins International Award 21.08.2012

 

Dr Suetonia Palmer, a senior lecturer at University of Otago, Christchurch, has been recognised with an A$25,000 (NZ$32,480) Fellowship award for her dedication to improving the treatment of people with chronic kidney disease.

Tonight Dr Palmer will be presented with a L'Oreal Woman in Science fellowship award at an ceremony in Melbourne.  Her win is good news for New Zealand's 2,500 dialysis patients and good news for women in science.

• Suetonia is one of three Australasian women who have each gained a For Women in Science 2012 Fellowship awarded by L'Oreal Australia and New Zealand.

• Is is the sixth year of the fellowsips and the first year they have been open to New Zealand scientists.  There were more than 200 nominations for the award.

• Dr Palmer will us the Fellowship to look at the best options for dialysis.  "My wish is that over the next decade we can give back control of their lives to dialysis patients - so they can be in charge of their own treatment, get back to work and make them feel better."

• This is imprtant for New Zealand where there are about 2,500 people on some form of dialysis and that number is increasing by 6.9 per cent a year.

Click here for a news publication on Dr Palmer's Fellowship

 

PRESS STATEMENT - FOR IMMEDIATE RELEASE   

7 June 2012

Funding will help Kidney Donation and Improve Lives

Kidney Health New Zealand today congratulated Health Minister Tony Ryall
and Michael Woodhouse MP on their announcement of significant funding to
support and encourage kidney donation.

"I know from personal experience how receiving a donated kidney can
completely change a person's life," said Dave Henderson, the Chair of
Kidney Health New Zealand.

"We have been working with the Health Ministry and with Mr Woodhouse to
identify the best ways to increase transplantation, and Government has
responded with targeted funds for those areas," said Mr Henderson.

"As the Minister identified, over 600 New Zealanders are currently
waiting and hoping to receive a new kidney. I was one of those, and at
the time I was too ill to work more than part-time or to carry on many
of the family and recreation activities that most New Zealanders take
for granted.

"After my original kidneys failed and had to be removed I had to do
dialysis for 3 years before I was fortunate to receive a donated kidney,
and with it I received a whole new lease on life. I'm able to live a
full life again"  said Mr Henderson.

"Research on the costs and benefits of kidney dialysis compared to
transplantation is very clear in what it shows. Quite apart from the
potential improvement in quality of life of the patient and their
family, there are significant financial savings for the country in
transplantation.

"Keeping people on dialysis is very expensive, and the cost is growing
as the number of people needing it grows. While there is an upfront cost
for the transplant operation, the longer term costs for a successful
transplant are much less" said Mr Henderson.

"In thanking the Minister and Mr Woodhouse for their commitment, Kidney
Health New Zealand also acknowledges and thanks all those New Zealanders
who have in the past already donated a kidney. By that decision those
donors and their families have made a huge and positive difference for
other individuals and families. We have the greatest respect for that"

Contacts:
Dave Henderson                    Prof. Kelvin Lynn
Chair                                    Medical Director
Kidney Health New Zealand     Kidney Health New Zealand
Tel:  027 4848 165                 Tel: 027 4376 542

Click here to view Government accouncement on extra funding to encourage more organ donation
 

William (Bill) Leslie Francis Utley, Urologist

Born August 6,1922.  Died April 14, 2012

Bill Utley made major contributions to the care of people with kidney disease. He graduated from the University of NZ in Dunedin in 1945 and trained as a urologist in the UK before returning to Christchurch Hospital in 1952.

Bill's father had spinal vertebral injuries in WWI, and subsequent osteomyelitis, a spinal abscess resulting in tetraplegia.  He died soon after Bill was two years old.  In the early 1950's, Bill travelled to the Stoke Mandeville Hospital in England where Sir Ludwig Guttman was pioneering modern care for spinal injuries patients.  At this time people with spinal injuries often died of kidney failure.

Bill was the prime mover in establishing a spinal unit in Christchurch Hospital in 1968.  Later, in 1979, he succeeded in establishing a purpose-built Spinal Unit at Burwood Hospital, Christchurch.

He was a strong advocate of rehabilitation and making the patient as independent as possible believing that this offered the best chance for good quality of life.  These principles are similar to those espoused by advocates for home dialysis.  Bill made contributions, together with Professors George Rolleston and Fred Shannon, to the understanding of reflux nephrology (kidney scarring), an important cause of kidney failure.

He undertook the first kidney transplant in Christchurch in 1972 and, in 1981, together with other urologists in Christchurch, he assisted in the establishment of a kidney transplant program in Riyadh, Saudi Arabia where Christchurch nephrologist, Peter Little, had established the Kingdom's first unit for managing end-stage kidney disease.

Bill is survived by his wife Pat, and two daughters.  Kidney Health New Zealand wishes to extend our sincere sympathies to Pat and the family and acknowledge Bill's many contributions to kidney disease and spinal injury patients in Christchurch and the rest of New Zealand.

Professor Ted Arnold is thanked for help in preparing this obituary

 

Kidney Health New Zealand supports New Zealand kidney health professionals to attend the Home Therapies Conference 2012 in Sydney, Australia, 14-16 March 2012

The following health professionals attended the Home Therapies Conference 2012 in Sydney Australia, with support from Kidney Health New Zealand

Jude Kearns, Community Dialysis Nurse, Capital and Coast District Health Board

Natasha Darby, Renal Nurse, Hastings Hospital

Julia Bates, Renal Dietitian, Middlemore Hospital

Julie Pesirla, Peritoneal Dialysis Nurse, North Shore Hospital

Blair Donkin, Registered Nurse, Dunedin Dialysis Unit

 

Kidney donor Sandra Paton receiving her certificate from Auckland City Major, Len Brown at a function recognising living donors.  8 March 2012

MP Jo Goodhew having her blood pressure checked by Carmel Gregan-Ford at Parliament as part of our Kidney Health Week.  6 March 2012

 

Click Here to view Otago Daily Times story - "Father, son recover after Kidney Surgery" 3/12/11

 

Obituary

Dr Peter J Little MB ChB, FRACP, FRCP     15/11/1930 to 19/5/2011

Peter Little, the founder of the Christchurch renal unit and a pioneer of home dialysis in New Zealand, died recently.

Peter Little was born and educated in Hawke’s Bay and trained in medicine at the University of Otago. He met Professor Hugh de Wardener while working as a locum at Fulham Hospital, London and decided to become a nephrologist at a time when the subspecialty was just emerging following the establishment of the feasibility of long term dialysis.

In 1966 Dr Little was appointed as Canterbury’s first nephrologist to set up a renal unit at Christchurch Hospital. He was Head of the Nephrology Department from 1976 to 1979. The principles of treatment for people with kidney disease that he established still influence the treatment of people with kidney failure today.

The first kidney patient started dialysis in Christchurch in 1969 and the first kidney transplant was done in 1972. His colleagues elected him as the President of the Australasian Society of Nephrology from 1976 to 1978.

Peter Little will be remembered as quite a character. Having a great intellect and being a clear analytical thinker, he did not always get on with the establishment but he was held in high esteem by patients and doctors in training and was always one to support the underdog. His flamboyant dress and trademark bowtie were as well known at Addington Raceway as at Christchurch Hospital.

Dr Little left Christchurch in 1980 to establish and head a renal unit in Saudi Arabia and subsequently worked in Baghdad where he developed a large, successful living donor kidney transplant programme. He returned to New Zealand to live in retirement but continued to travel, particularly to Ireland and Thailand.

The board and staff of Kidney Health New Zealand extend their sincere condolences to Dr Little’s widow, Dolores, and his family.

 

Protect your kidneys and save your heart

By Dr Suetonia Palmer - March 2011

We now know that kidney disease and heart disease go hand in hand. Both are common and frequently occur together. About 10 to 15% of the adult population in New Zealand have kidney disease detected by screening (nearly 500,000 people) and this number is on the rise. About 26,000 New Zealanders need hospital care each year for a heart attack and between one-third and one-half of these patients will have kidney disease.  This year, World Kidney Day on March 10, 2011 highlighted this association between kidney and heart health with the theme “Protect Your Kidneys and Save Your Heart.”

Having kidney disease directly affects the way heart disease develops and progresses. People with even mild kidney disease have a substantially higher chance of developing heart problems in the first place (either blocked arteries or heart failure) while the combination of heart and kidney disease means that heart problems may progress more rapidly. Treatment for heart problems can be more challenging when kidney disease is present – some medications such as blood pressure treatments may be avoided [sometimes unnecessarily] or used at lower doses.

You might have thought that because the clearly strong links between kidney and heart health are well established, we would have a lot of information about how this occurs. Why does it happen? Unfortunately, while both heart and kidney health share important risk factors, such as high blood pressure and diabetes, the actual detailed mechanisms relating the two are yet to be fully worked out.  Worldwide, advocates and policy makers are increasingly focussing on the important link between cardiovascular disease and kidney disease – and research in this area is highly active.

It is not all bad news…there are many practical and simple steps that can be made by all of us and our families/whānau to reduce our risks of heart disease by first protecting our kidney health. It is still important to make sure we keep our blood pressure normal, reduce our risks of diabetes through healthy eating and exercise, avoiding or quitting smoking, and minimising our salt intake. Screening kidney health is simple (checking with your doctor to measure your blood pressure and a urine protein test) and knowing early whether you have kidney disease is the first step to getting the right treatment and saving your heart.

 

 

 

Media Release - February 2011

Protect Your Kidneys, Save Your Heart.

World Kidney Day on 10 March aims to raise awareness of the importance of the kidney in maintaining a healthy heart.  Kidney Health New Zealand will lead a number of special events throughout New Zealand aimed at promoting awareness of kidney disorders and encouraging a healthy lifestyle.

The sixth World Kidney Day will call attention to the large, and often unappreciated, role played by chronic kidney disease (CKD) in increasing the risk of premature cardiovascular disease. Cardiovascular disease (heart, stroke and blood vessel disease) is the leading cause of death in New Zealand, accounting for 40% of deaths annually. Every 90 minutes a New Zealander dies from coronary heart disease (16 deaths a day). Many of these deaths are premature and preventable.

Maori and Pacific people have an increased risk of both CKD and cardiovascular disease. Death rates for Maori and Pacific people with these conditions are significantly higher than for the rest of the population.

Professor Lynn, Medical Director of Kidney Health New Zealand, notes, “Increased attention to kidney health can improve long-term health outcomes by reducing both kidney and cardiovascular disease.” A simple urine protein check or a blood test can detect CKD.  Proteinuria (increased amounts of protein in the urine) is an important marker of both CKD and an increased risk of cardiovascular disease. People with proteinuria develop cardiovascular disease more quickly.

Dr Lynn says, “There is now evidence to suggest that early detection and treatment of CKD can reduce proteinuria, slow the progression of CKD and reduce cardiovascular risk as well. “

There is now compelling evidence that including selective screening for CKD in health programmes designed primarily to reduce cardiovascular disease will significantly improve the outcomes of not only CKD, but also diabetes and cardiovascular disease that will dominate future health care strategies.

To highlight how easy it is to screen for CKD, Kidney Health New Zealand, with the help of kidney nurses and doctors from Wellington Hospital, will be offering blood pressure and urine protein checks for Members of Parliament and their staff at Parliament Buildings on World Kidney Day 10 March 2011.

Other activities include community screening for CKD in Napier on 7 March and Whangarei on 8 March. Throughout the week, biscuit maker Griffin’s predominantly Pacific staff at their two Auckland manufacturing facilities at Papakura and Wiri will be given information about CKD. Kidney units and patients support groups have also organised activities to raise awareness of CKD.

To learn more about World Kidney Day and Kidney Health New Zealand’s activities visit www.kidneys.co.nz
The National Heart Foundation of New Zealand has additional information regarding heart disease  www.heartfoundation.org.nz

Chronic kidney disease is common, harmful and treatable.

Professor Kelvin Lynn, Medical Director of Kidney Health New Zealand
Telephone: Christchurch Hospital on (03) 364-1828, 0274-376-542
kelvin.lynn@cdhb.govt.nz   www.kidneys.co.nz
 

Ends

- February 2011-

Stem cell research unlocks potential for exploring kidney regeneration

 
Associate Professor Alan Davidson, who moved recently to The University of Auckland, led research at Harvard Medical School that identified adult kidney stem cells in zebrafish (a commonly used biological model). These cells can be transplanted from one fish to another fish, whereby they grow into functional nephrons in the transplanted recipient. This is the first time that adult kidney stem cells have been isolated. The work was recently published in the prestigious journal Nature.
 

 

Associate Professor Alan Davidson

 

The discovery raises the possibility of new ways of treating kidney failure. New Zealand has extremely high rates of kidney disease, particularly amongst Maori and Pacific people.
 
Details of the research can be found at http://news.harvard.edu/gazette/story/2011/01/adult-kidney-stem-cells-found-in-fish/

  Dr Davidson was awarded a Rutherford Distinguished Fellowship by the Royal Society of New Zealand so that he could return to New Zealand. He also won a prestigious 2010 Marsden grant of more than $900,000 over three years to continue his research into kidney regeneration using stem cells.
 
He will be focusing on nephrons (the delicate structures that purify our blood) which humans cannot re-grow once they are damaged by diseases like diabetes and hypertension. He plans to scrutinize adult zebrafish as they are able to grow new nephrons.

- Ends -

 

- Jan 2011 -

Kidney Health New Zealand shares the concerns of Diabetes New Zealand regarding District Health Boards' response to the Diabetes Epidenic.

Comments from the Minister of Health, Tony Ryall, regarding the performance of the “Get Checked” programme and concerns raised by Diabetes New Zealand overlook the huge savings and benefits from the service, for DHBs and for New Zealanders.

 The Minister’s comments regarding DHB funding of the detection and treatment of diabetes spell bad news for renal services and the funding of expensive kidney failure treatment.

 Early detection and treatment of chronic kidney disease (CKD) in people with diabetes is very important as it slows or halts the progression of kidney disease. Good blood pressure and blood sugar control for people with diabetes are the best ways to reduce the risk of kidney damage. Lifestyle changes such as losing weight, exercising, stopping smoking, eating less salt and drinking less alcohol are also important.

 

Simple urine and blood tests and a blood pressure check can detect early signs of kidney problems. A blood sugar check for diabetes can be done on a finger prick blood sample. People with diabetes can have a free annual check through the “Get Checked” programme.

 

At the end of 2009, there were 2260 people with kidney failure on dialysis in New Zealand and for nearly half diabetes was the cause of their kidney disease. This number is predicted to rise by four to six percent annually, at least until 2020, mainly because of the diabetes epidemic.

 

About 40% of people with diabetes will develop CKD which also increases their risk of cardiovascular disease and other complications of diabetes. Maori and Pacific people with diabetes have an increased risk of getting chronic kidney disease. One in three people on dialysis are Maori and one in five a Pacific person.

 

The treatment of kidney failure is expensive and costs at least $100 million a year in New Zealand. Kidney Health New Zealand estimates that there are about 200,000 people in New Zealand with significant CKD.

 

Any cutback in the “Get Checked” programme will only lead to greater numbers of New Zealanders developing kidney disease, and the costs to the country will continue to grow.

 

 

Click here for December 2010 Media Release from Otago University

 

Summer Studentship funding from Kidney Health New Zealand assists Christchurch medical student, Isaac Campbell’s research career.

In late 2008, Kidney Health New Zealand funded a Summer Studentship at the University of Otago, Christchurch for 10 weeks over the university vacation for a Isaac Campbell. Dr John Pickering from the Christchurch Kidney Research Group supervised Isaac’s project Timing of injury and biomarker-based diagnosis of Acute Kidney Injury (AKI). Isaac won the prize for the best scientific report.
Now Isaac’s work as part of the research programme of the Christchurch Kidney Research Group has contributed to an important paper on acute kidney injury published recently in the prestigious journal, Kidney International.

Kidney Health New Zealand congratulates Isaac and the research team on this achievement.

The abstract from the publication is shown below.

Original Article

Kidney International (2010) 77, 1020–1030; doi:10.1038/ki.2010.25; published online 17 February 2010

Early intervention with erythropoietin does not affect the outcome of acute kidney injury (the EARLYARF trial)

Zoltán H Endre1, Robert J Walker2, John W Pickering1, Geoffrey M Shaw1,3, Christopher M Frampton1, Seton J Henderson1,3, Robyn Hutchison2, Jan E Mehrtens1,3, Jillian M Robinson1, John B W Schollum2,6, Justin Westhuyzen1, Leo A Celi2, Robert J McGinley4, Isaac J Campbell1 and Peter M George5
1.    1Christchurch Kidney Research Group, Department of Medicine, University of Otago,    

Christchurch, New Zealand
2.    2Department of Medicine and Surgery, University of Otago, Dunedin, New Zealand
3.    3Intensive Care, Christchurch Hospital, Christchurch, New Zealand
4.    4Deakin University Medical School, Geelong, Australia
5.    5Canterbury Health Laboratories, Christchurch, New Zealand
6.    6Dunedin Hospital, Department of Nephrology, Dunedin, New Zealand

Correspondence: Zoltán H. Endre, Christchurch Kidney Research Group, Department of Medicine, University of Otago–Christchurch, PO Box 4345, Christchurch, New Zealand. E-mail: Rowena.fisher@otago.ac.nz
Received 13 October 2009; Revised 29 November 2009; Accepted 28 December 2009; Published online 17 February 2010.

ABSTRACT

We performed a double-blind placebo-controlled trial to study whether early treatment with erythropoietin could prevent the development of acute kidney injury in patients in two general intensive care units. As a guide for choosing the patients for treatment we measured urinary levels of two biomarkers, the proximal tubular brush border enzymes γ-glutamyl transpeptidase and alkaline phosphatase. Randomization to either placebo or two doses of erythropoietin was triggered by an increase in the biomarker concentration product to levels above 46.3, with a primary outcome of relative average plasma creatinine increase from baseline over 4 to 7 days. Of 529 patients, 162 were randomized within an average of 3.5 h of a positive sample. There was no difference in the incidence of erythropoietin-specific adverse events or in the primary outcome between the placebo and treatment groups. The triggering biomarker concentration product selected patients with more severe illness and at greater risk of acute kidney injury, dialysis, or death; however, the marker elevations were transient. Early intervention with high-dose erythropoietin was safe but did not alter the outcome. Although these two urine biomarkers facilitated our early intervention, their transient increase compromised effective triaging. Further, our study showed that a composite of these two biomarkers was insufficient for risk stratification in a patient population with a heterogeneous onset of injury.
  

Congratulations Rachael

New Zealand's first Renal Nurse Practitioner

Rachael Walker has just been registered as New Zealand's first Renal Nurse Practitioner with prescribing rights.  Rachael is employed by the Hawkes Bay District Health Board and has been working in the renal department there for the last six years, prior to this Rachael's background was in medical wards in New Zealand and in the United Kingdom.  For the last three years Rachael has been employed by the HBDHB as the Clinical Nurse Specialist - Pre-dialysis.  Rachael completed her Masters at the end of 2009.  She has undertaken research into the pre-dialysis nursing role in New Zealand.  Rachael is also a mother of two, aged four and one.  Rachael plans to work in collaboration with the renal team to improve outcomes for patients with Chronic Kidney Disease, raising its awareness and having a strong preventative approach for patients, especially those at high risk of progressing to end stage renal failure.

 

Rachael Walker is pictured here with Drew Henderson Nephrologist for Hawkes Bay, following her achievement.

 

New web-based patient information resources developed by Kidney Health New Zealand

 

Chronic kidney disease (CKD) is common, harmful and preventable. Diabetes is the most common cause of CKD in New Zealand. Maori and Pacific people have high rates of diabetes and diabetic CKD. Over 80% of people with CKD are unaware they have the condition.

 

Early detection allows treatment to prevent or delay CKD causing kidney failure. Living with kidney failure has a significant impact on the lives of patients. Treatment of kidney failure is expensive – over $100 million annually.

 

Easily accessible, accurate and relevant information is important for supporting patients with CKD and the health professionals that care for them.

 

Kidney Health New Zealand, funded by the Ministry of Health, has developed seven web-based patient information resources. The form and content of these resources were finalized after review by a consultation group of stakeholders (see attached).

 

People seeking information on kidney disease and its treatment will be able access this on-line on the Kidney Health New Zealand (www.kidneys.co.nz), Ministry of Health (www.moh.govt.nz/nrab) and Auckland District Kidney Society (www.kidneysociety.co.nz) websites. The information can be read on-line or printed off for further distribution.

 

Kidney Health New Zealand expects that this resource will complement the information provided to patients with CKD by their health professionals.

 

 

Professor Kelvin Lynn, Medical Director of Kidney Health New Zealand

Telephone: Christchurch Hospital on (03) 364-1828, 0274-376-542

kelvin.lynn@cdhb.govt.nz   www.kidneys.co.nz

 

Consultation group

 

Name	Group	Role
Carmel Gregan-Ford	KHNZ	Education Manager
Kelvin Lynn	KHNZ	Medical Director
David Henderson	KHNZ	Chair
Nick Polaschek	MoH	Project manager
Johan Rosman	National Renal Advisory Board	Chair
Drew Henderson	Hawke’s Bay DHB	Nephrologist
Rachel Barrett	Auckland District Kidney Society	Educator
Tania Psathas	Wellington Region Kidney Society	Patient/consumer
Tania Barkely	Wellington Region Kidney Society	Patient/consumer
Wally Papa	Waikato/Maori	Patient/consumer
Nick Gavey	Midland region	Patient/consumer
Tafale Maddren	Northland DHB	Educator
Helen Hoffman	Capital & Coast DHB	Educator
Kate Grundy	Canterbury DHB	Palliative care physician
Sarah Armstrong	Canterbury DHB	Transplant co-ordinator
Lorelei Mason	Media	TV reporter
Zeus Hakaraia	Tahi Design	Web designer
Madeleine Price	Canterbury DHB	Dietitian
Edith Ieremia	Canterbury DHB	Pacific health educator
Cindy Priest	Hawke’s Bay DHB	Social worker

 

 

 

 

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