kidney Archives - First Washington News

February 13, 2023

High coffee consumption may triple kidney disease risk in some people

Three coffee beans in a line, standing vertically. — The amount of coffee and caffeine someone consumes can affect their kidney health. Antonia Gros/EyeEm/Getty Images

A new study finds that people who metabolize caffeine slowly are three times more likely to develop kidney dysfunction.
Other research has suggested that coffee promotes health, including kidney health.
The slow metabolism, says the new study, is the result of a gene variant present in half the population at large. They propose that this may account for the conflicting conclusions of previous studies.

While some research has linked the consumption of coffee to kidney damage, other research has reported no association between caffeine intake and the development of chronic kidney disease. A new study from researchers at the universities of Toronto, Canada, and Padova, Italy may offer an explanation for the differing conclusions.

It also finds that for some people, coffee can indeed be damaging to one’s kidneys.

The new study finds that the presence of a particular gene variant can result in coffee being three times more likely to cause kidney dysfunction.

The researchers say it is all about the speed at which a person metabolizes caffeine. In the study, about half of the participants had the rs762551 variant of the CYP1A2 gene, a variant that caused them to metabolize caffeine more slowly. This group was determined to be at a higher risk of kidney damage.

The authors say that this is about the same percentage of slow caffeine metabolizers in the general population.

The study assessed kidney health by tracking three accepted markers of kidney dysfunction: albuminuria, hyperfiltration, and hypertension.

The study is published in JAMA Network Open.

The observational study spanned about 16 years. It involved a population of 1,180 participants ages 18 to 45 years, with each regularly being assessed over a 7.5-year follow-up period. All participants had untreated stage 1 hypertension and had been recruited as part of the separate Hypertension and Ambulatory Recording Venetia Study.

Dr. Sara Mahdavi, was the lead author of the study as a researcher with the Department of Community and Family Medicine at the University of Toronto.

After identifying those with the problematic CYP1A2 variant, Dr. Mahdavi said:

“It was remarkable to see just how striking the effects of coffee were in the group that had this genetic variant, yet no effect whatsoever in those who did not.”

People who metabolized caffeine slower and who drank three or more cups of coffee each day were 2.7 times more likely to develop kidney dysfunction.

They were also 2.8 times more likely to develop hypertension.

Medical News Today reached out to nephrologist Dr. Francis Perry Wilson, associate professor at Yale School of Medicine, who was not involved in the study. He expressed concern about the accuracy of the authors’ conclusions:

“While the study shows an interesting association between coffee intake and the risk of kidney disease in a subgroup of the population, I have some concerns about the statistical analysis that make the conclusions difficult to interpret.”

“Particularly, the fact that the event curves go to 0 implies that every participant is assumed to experience the event over time, when in fact, that is biologically not possible. This can sometimes arise when individuals followed for longer in a study are significantly different from those followed for a shorter time,” he elaborated.

“Caffeine is the most widely studied substance in coffee and can be found in other beverages like tea, cola, and energy drinks. Coffee contains many substances that can have various effects on the body, both beneficial as well as harmful,” noted Dr. Mahdavi.

The study suggests that it is only harmful in people whose ability to quickly detoxify caffeine out of their system is impaired.

“This implicates caffeine, specifically, as the component in coffee that can damage the kidneys. It also suggests that caffeine from any source can be harmful in those individuals who have this genetic variant that impairs their ability to eliminate caffeine from their system,” she explained.

The authors hope the study’s findings will prompt a re-examination of the current guidelines approving up to 400 milligrams, or four or five cups, of brewed coffee per day.

“[D]ecaffeinated coffee is virtually devoid of caffeine, those who consume decaf would not have a higher risk of kidney dysfunction, regardless of their genetics.”
— Dr. Sara Mahdavi, lead author

There are general guidelines as to the relative amounts of caffeine one can expect to find in different caffeinated beverages such as coffee, espresso, and tea.

However, there are a surprising number of factors that determine a specific cup’s caffeine content. These include the species of bean, brewing time, the temperature of the water, pressure, the extent of roasting and grinding, the type of water, and the coffee/water balance.

According to the study’s senior investigator, the University of Toronto’s Dr. Ahmed El-Sohemy, the CYP1A2 enzyme metabolizes certain compounds such as caffeine, some medications, and several dietary substances.

“Although the enzyme detoxifies caffeine, it can actually activate some pro-carcinogens that are found on the surface of barbecued meat,” Dr. El-Sohemy noted.

In addition to the rs762551 variant, he said, there were a “number of factors that can either increase or decrease the activity of CYP1A2, regardless of whether a person is a fast or slow metabolizer.”

Dr. El-Sohemy said that hormonal contraceptives may decrease the activity of CYP1A2, “and effectively turn fast metabolizers into slow metabolizers.”

Cruciferous vegetables, he added, can speed up CYP1A2 activity.

The rs762551 CYP1A2 variant has also been implicated in the development of cancer. There are genetic companies that can test a person for the presence of this variant.

January 25, 2023

Omega-3 fatty acids from fish may reduce kidney disease risk

A bird's eye view of wooden baskets full of fish as a person wearing a nón lá (leaf hat) goes to stack one on top of another — Omega-3s from seafood could improve kidney health, research shows. Pham Hung/Getty Images

Chronic kidney disease affects 1 in 10 people worldwide, and if left untreated, it can lead to kidney failure.
Diet, exercise, and maintaining a healthy weight can all help to prevent or manage the condition.
A new study suggests that by including fish-rich omega-3 fatty acids in their diet, people can reduce their risk of chronic kidney disease.

Chronic kidney disease (CKD) affects more than 10{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} of the global population at around 850 million people. It is more common in older people, and risk factors include diabetes, high blood pressure, heart disease, and a family history of kidney failure.

According to the National Institutes of Health, more than 37 million adults in the United States may have chronic kidney disease.

Damage to the kidneys can happen over a long period of time, often causing no symptoms at first. Eventually, the kidneys cannot filter blood properly, leading to edema, or fluid retention, because the kidneys cannot get rid of extra fluid and salt.

People with CKD are at higher risk of cardiovascular disease and death.

Managing blood pressure and blood sugar levels is key to keeping your kidneys healthy. Being active, maintaining a healthy body weight, and eating a healthful diet are also important in both preventing and managing CKD.

Animal studies have suggested that omega-3 fatty acids may benefit kidney function.

Now, researchers from the University of New South Wales in Sydney have found that omega-3 from seafood is associated with a moderately lower risk of chronic kidney disease and a slower decline in kidney function.

The study was published in the BMJ.

The study was a part of the Fatty Acids and Outcomes Research (FORCE) consortium of studies. FORCE was set up to understand the relationships between fatty acids from our diet and metabolic processes, using data from multiple studies.

“This is an interesting study of diet potentially having a direct effect on disease progression. […] The methodology of this pooled analysis is good—more precise and avoids measurement errors related to self-report.”

— Dr. Eamon Laird, visiting research fellow, Trinity College, Dublin, who was not involved in the study.

The researchers analyzed data from 19 studies from 12 countries to assess the association between long-chain omega-3 polyunsaturated fatty acids (n-3 PUFAs) and CKD.

They estimated glomerular filtration rate (eGFR) at baseline and follow-up visits and defined incident CKD as eGFR that decreased to below 60ml/min/1.73 m2. eGFR measures how well the kidneys are removing waste from the body. The healthy range is 90-120 ml/min/1.73 m2.

The 25,570 participants were ages 49–77 years at the beginning of the study. Overall, 4,944 (19.3{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809}) developed incident CKD during the follow-up period of, on average, 11 years.

People who had higher levels of seafood-derived omega-3 in their diet had an 8{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} lower risk of incident CKD. Those with total seafood n-3 PUFA levels in the highest fifth had a 13{cfdf3f5372635aeb15fd3e2aecc7cb5d7150695e02bd72e0a44f1581164ad809} lower risk of CKD compared with those in the lowest fifth.

The researchers found this protective association with three individual omega-3s from seafood, including eicosapentaenoic acid (EPA), docosahexaenoic acid (DHA), and docosapentaenoic acid (DPA).

Dr. Shree Mulay, CEO and nephrologist at The Kidney Experts, PLLC, who was not involved in the study, welcomed the study, but urged some caution, especially in people who already have CKD.

“It’s exciting to explore if eating fattier seafood could lead to increased PUFA intake and slower CKD progression. However, it’s essential to be wary as many of these fish are packed with phosphorus — a mineral that nephrologists work hard to keep low in dialysis patients and those with advanced CKD,” she told Medical News Today.

Plant-derived omega-3s, such as alpha-linolenic acid (ALA), which is found mainly in nuts and seeds, had no effect on CKD risk.

Corresponding author, Dr. Kwok Leung Ong, senior research fellow at the School of Biomedical Sciences, University of New South Wales (UNSW), Australia, told MNT:

“For plant-derived ALA, the finding was not too surprising although still interesting to observe, since ALA generally shows weaker effect on metabolic risk factors such as lipid, glucose and inflammatory markers in clinical trials, when compared to EPA and DHA.”

“The important implication from our study is that adequate consumption of seafood and oily fish (where most such blood omega-3 fatty acids come from) may help to prevent or delay the development of chronic kidney disease.”

— Dr. Kwok Leung Ong

And Dr. Laird agreed: “The seafood-derived omega-3 is in a ‘ready to use’ form by the body already, and it makes scientific sense it would be associated with a health outcome such as CKD.”

Although the findings from the study are promising, the results do not indicate a causal relationship.

“It should be noted that our findings do not prove a causal relationship between seafood n-3 PUFA and CKD risk as the findings were observational, but they are supportive and consistent with current clinical guidelines that recommend adequate intake of seafood as part of healthy dietary patterns, especially when seafood replaces the intake of less healthy foods,” Dr. Ong said.

Dr. Laird, meanwhile, called the findings “controversial,” and said many other compounds could have had a similar effect.

“[T]he authors did not take into account other dietary factors (including other vitamins (e.g., vitamin D) and minerals found in fish) which also have anti-inflammatory benefits which the EPA and DHA levels are just tracking against,” he noted.

“Direct mechanisms could have included anti-inflammatory, direct effects on the immune system and dampening ‘inflamaging’. In addition, higher DHA and EPA may have reno-protective properties in kidney diseases, with attenuation of fibrosis.”

— Dr. Eamon Laird

“An earlier analysis of trials in 2017 found that there was no reduction in markers of inflammation (CRP, IL-6, TNF-alpha) in patients with CVD supplemented with omega-3. However, the effects could be localized to the kidney and not show up in body system-wide inflammatory measures,” Dr. Laird added.

The Dietary Guidelines for Americans recommend that adults eat 8-10 ounces (225-280g), or 2-3 portions, of seafood each week. Children should eat 2-3 ounces weekly to limit methylmercury exposure. The American Heart Association advises a similar intake. On average, Americans eat less than half of that.

Most seafood contains some n-3 PUFAs, but the highest levels are found in cold-water oily fish such as:

salmon
anchovies
herring
mackerel (Atlantic and Pacific)
tuna (bluefin and albacore)
sardines

People can also get their seafood-derived omega-3s from fish oil supplements. For people on a vegetarian diet, chia seeds, flax seeds, and walnuts are high in ALA, some of which the body converts to EPA and DHA.

DHA and EPA are both thought to reduce inflammation, which has been linked to a range of chronic conditions, such as type 2 diabetes, heart disease, and other autoimmune disorders.

So, although this study does not prove conclusively that including seafood in your diet will reduce your risk of CKD, for most people, increasing the intake of seafood, particularly oily fish, is likely to benefit overall health.

June 5, 2022

How stage 4 kidney cancer diagnosis didn’t stop this young woman from getting a great new job

Katie Coleman stood experience-to-deal with with a choice no job seeker should ever have to make. She could notify her prospective employer she had stage 4 kidney cancer, the most everyday living-threatening stage of all.

Or she could stay mum.

She realized she risked shedding any shot at the occupation by remaining genuine about her prognosis — or risked dropping her self-respect by maintaining tranquil about it.

This may possibly seem like the plot of an episode of “Grey’s Anatomy.” It is not. It is the selection that confronted the 31-calendar year-aged resident of Austin, Texas, who has been battling the deadly disorder for nearly a few a long time.

“The number of ppl advising me to not disclose my [diagnosis] is astounding,” she tweeted in mid-April. The worry was that companies might fret about the charges and absenteeism that can outcome from these a situation — even even though federal law prohibits employers from getting wellness concerns into account when employing.

But, though interviewing for the superior-tension application engineering task she desperately desired, Coleman shared her diagnosis with the CEO of MDisrupt, an Austin-primarily based firm that connects clinicians and experts with electronic well being companies.

Ruby Gadelrab, CEO and founder of MDisrupt, was unfazed. Times just after interviewing Coleman for a work, she tweeted: “Today I met a applicant who applied for one particular of our work opportunities, and she may well just be the most inspiring person I have at any time satisfied.”

Professional medical historical past is personal

Coleman’s particular story is both hair-increasing and hope-inducing. It took 18 months to get an accurate analysis in the to start with location, just after 8 medical practitioners insisted she was as well youthful for most cancers and the genuine dilemma should be anxiety. Last but not least, on New Year’s Eve 2020, an ultrasound performed in an crisis room assisted decide she experienced metastatic renal oncocytoma, a rare kind of kidney most cancers, which turned malignant only following it unfold to her liver. Then she underwent considerable operation to remove a 12-centimeter tumor from her suitable kidney and several tumors from her liver. In a second technique, medical professionals burned very small tumors off her liver that have been too compact to see during the initially surgical treatment. Coleman asked medical professionals at the Nationwide Cancer Institute to accomplish the surgical treatment and process mainly because they were the only types who she consulted who have been willing to operate. She also knew they ended up fascinated in studying exceptional kidney cancers like hers.

None of this — not the operation, the prognosis, her honesty — stopped Coleman from snaring her aspiration, nor MDisrupt from hiring her as a total-time software developer.

Coleman’s working experience has grow to be one thing of social media lore as she shares updates about her most cancers struggle and her new task in posts on Twitter, YouTube, Instagram, and TikTok. She’s leaving a deep footprint across social media that she thinks could aid fellow most cancers individuals for years to occur.

At the same time, her tale has turn into a large-profile reminder to companies and career candidates that a future employee’s health care heritage is their have enterprise — except if they decide to share it.

The Individuals with Disabilities Act prohibits inquiring prospective employees everything about their clinical history — or applying wellness challenges as a basis for not selecting them, reported Joyce Walker-Jones, senior lawyer and adviser at the U.S. Equivalent Employment Chance Fee.

I seem at my prognosis as my biggest energy.

Katie Coleman

Walker-Jones does not propose sharing professional medical data with opportunity businesses. “If an applicant knows they have a severe health-related situation, they do not have a obligation to disclose it — even if they will require sensible accommodations if they get the position,” she claimed.

In that regard, Coleman threw caution to the wind.

She used for the job at MDisrupt simply because a recruiter who’d spotted her cancer-be-damned social media posts approached her. Gadelrab stated she wasn’t conscious of Coleman’s most cancers battle and never ever requested about her wellness. But Coleman opted to guide with her prognosis and shared her story.

“I seem at my diagnosis as my greatest strength,” Coleman stated. The type of tumor she has is practically usually benign, but in her case, it was not.

Coleman contacted Pushed to Remedy — an group for unusual kidney cancers — for aid. And Driven to Treatment connected her to the National Cancer Institute.

Since slide, she has been off remedy and said she is on “active surveillance,” checking with scans every three months to continue to keep a shut eye on a several suspicious places as well smaller to handle.

She also is on a particular mission to demolish her most cancers — in element by holding digital tabs on all the twists and turns in her health-related journey with an application she designed. Coleman started operating on her app strategy immediately after her surgery but before her liver procedure in 2021.

The application makes it possible for her to retain monitor of her medical professionals — and all the things else she demands for her treatment — in a single place. She shared her development for other people to use cost-free of cost. Gadelrab “really favored that I was making a positive out of a detrimental,” Coleman claimed.

Gadelrab mentioned she seeks 3 significant attributes — none well being-linked — in new staff: enthusiasm, reason, and likely. She reported she observed all three in Coleman.

“Katie was so passionate. She has a way of communicating her empathy to suppliers and patients that’s unique from many others,” reported Gadelrab. “That is exactly the sort of contemplating that we need to have to have as a firm: empathy for our consumers. Katie came in with that.”

Even now, Coleman was hesitant about having the work after she obtained the supply. She was ready for nonetheless an additional vital most cancers scan. She was nervous about leaving a enterprise that experienced been excellent to her. And she was nervous about modifying insurers. Then, a little something sudden persuaded her to take the offer you.

While at residence packing her bags to go to the clinic for the scan — which the people at MDisrupt understood was coming — she listened to a knock at her door. When she answered, she saw a large bouquet of orange roses — the coloration that signifies kidney cancer consciousness. It was from MDisrupt. The take note claimed: “Good luck on the scans.”

She took the occupation.

Coleman’s 1st day was in late April. She performs from household most of the time but visits the office environment at the time or 2 times weekly for group gatherings. She doesn’t advise that all individuals with really serious ailments be so open with possible companies.

“My guidance is to very first do the research on the company that you want to work for and know that they will be supportive,” she stated.

Coleman, who has 40,000 TikTok followers and practically 5,000 Twitter followers, proceeds to doc her cancer struggle on social media — and in a new weblog. She pokes fun at herself in her posts since, she explained, her self-deprecation frequently elicits a lot more donations to the kidney cancer research she encourages. Maybe her modern tweet says it ideal:

“My pet peeves can be summarized by: 1. Cancer. 2. Mansplaining. 3. Missing sauce packets w/takeout.”