Indian doctors remove giant 7.4 kilo kidney from man

NEW DELHI — Indian surgeons have cut a kidney weighing the same as a bowling ball out of a man with a life-threatening genetic condition, a surgeon said Monday.

The 7.4 kilogram kidney is one of the biggest ever removed in an operation.

"It was a huge lump that was occupying half of his abdomen. We knew it was a big kidney but never thought it would be this heavy," said Sachin Kathuria, a member of the surgical team, told AFP.

The 56-year-old patient, suffering from autosomal dominant polycystic kidney disease, underwent the two-hour operation at the Sir Ganga Ram Hospital in Delhi last month.

A normal kidney weighs about 120 to 150 grams and is 12 centimeters long.

Kathuria said the kidney cut out from the man was nearly 45 centimeters long.

The Guinness Book of Records says the largest kidney removed from a human was 4.25 kg in an operation in Dubai in 2017. 

Doctors at the New Delhi hospital said however they had found medical accounts of a kidney weighing 9 kilos being cut from a patient.

The disease the unnamed man was suffering from causes cysts full of fluids to start growing in kidneys. Doctors called for the operation when they detected internal bleeding and spreading infections. 

Kathuria said the man was now in good condition and on dialysis awaiting a kidney transplant.

source: news.abs-cbn.com

Vitamin C supplements tied to men's kidney stones

NEW YORK - Men who take vitamin C supplements are at higher-than-average risk of developing kidney stones, a new study from Sweden suggests.

The findings don't prove the vitamin itself triggers stones to form. But researchers said that because there are no clear benefits tied to taking high-dose vitamin C, people who have had stones in the past might want to think before taking extra supplements.

"I don't think I would hold this up and say, ‘You shouldn't take vitamin C, and here's the evidence,'" said Dr. Brian Matlaga, a urologist who studies kidney stones at Johns Hopkins Medicine in Baltimore.

But, "When you talk to patients, a lot of times you'll find patients are taking non-prescribed medications, like vitamin supplements… and there may not be great evidence that there's an actual health benefit associated with these," he told Reuters Health.

The new finding "suggests that stone formers who take regular vitamin C may actually place themselves at increased risk," said Matlaga, who wasn't involved in the study.

Researchers led by Laura Thomas of the Karolinska Institutet in Stockholm used data from a large study of middle-aged and elderly Swedish men who answered a series of questions on their diet and lifestyle, then were tracked for an average of 11 years.

The current analysis included 907 of those men who said they took regular vitamin C tablets and more than 22,000 who didn't use any nutritional supplements.

Of the vitamin C users, 3.4% developed kidney stones for the first time during the study, compared to 1.8% of non-supplement users. Men who took vitamin C supplements at least once a day had the highest risk of kidney stones, researchers reported Monday in JAMA Internal Medicine.

"It has long been suspected that high doses of vitamin C may increase the risk of kidney stones as some of the vitamin C absorbed by the body is excreted in urine as oxalate - one of the key components of kidney stones," Thomas told Reuters Health by email.

Stones are made up of tiny crystals, which can be formed by calcium combining with oxalate. They usually pass on their own, but can cause severe pain in the process. Larger stones occasionally require surgery.

Men are more likely to form stones than women.

‘An important part of a healthy diet'

The findings don't mean people shouldn't get plenty of vitamin C through fruits and vegetables, researchers said. The antioxidant is important for bone and muscle health - and severe deficiency can cause scurvy.

"Vitamin C is an important part of a healthy diet," Thomas said. "Any effect of vitamin C on kidney stone risk is likely to depend both on the dose and on the combination of nutrients with which it is ingested."

Swedish supplements, like those the study participants would have taken, typically contain about 1,000 milligrams (mg) of vitamin C per tablet, she noted. Most vitamin C supplements sold in the US contain either 500 or 1,000 mg.

The US Institute of Medicine recommends 90 mg per day for men - the amount in a small glass of orange juice or a cup of broccoli - and 75 mg for most women.

Matlaga said more research is needed to determine for certain whether reasonable doses of vitamin C may increase the risk of kidney stones. For now, he said people who haven't had kidney stones before shouldn't worry about any related risks tied to the vitamin.

source: abs-cbnnews.com

Kidney transplants among Filipinos with diabetes rising

MANILA, Philippines – Kidney transplants among Filipinos afflicted with diabetes have been steadily rising the past 20 years, a leading Filipino urologist said.

Dr. Benjamin l. Mendoza, a US-trained urologist, noted that “most kidney transplants we are doing are those afflicted with diabetes.”

In the 1980s Filipinos afflicted with kidney disease was due to infection, inflammation and hypertension, but during the last two decades the culprit is diabetes.

”About 1,000 kidney transplants are being performed in the country per year during the past two decades and counting,” Dr. Mendoza told the Philippines News Agency in an interview.

”Fifty percent is attributed to diabetes and the other half is due to various illnesses,” Dr. Mendoza added.

To avoid diabetes, the best antidote is diet, regular exercise, including brisk walking for at least half an hour, and a regular medical check-up, particularly blood sugar or even urinalysis, Dr. Mendoza said.

”Drinking plenty of water is also good but intake of water must be done during the day. Drinking plenty of water at night is not advisable because one’s sleep is interrupted when one has to go to the rest room to urinate.”

”Early detection of diabetes is also a big advantage for a patient to enable him to control his blood sugar level,” he said.

Kidney transplant is very expensive, ranging from P1 million if you have a donor and P3 million or more if you have none, Dr. Mendoza said.

Dr. Mendoza holds clinic at the National Kidney Institute, St. Luke’s Medical Center, East Avenue Medical Center and other big hospitals in Metro Manila.

He said it is very expensive to have a kidney transplant.

”The cost is at least one million pesos that is if you have a donor and is more if you have none, running into P3 million,” Dr. Mendoza said.

However, he advised kidney patients to coordinate with kidney foundations found in some big hospitals like the National Kidney Institute.

”The foundation will help facilitate the finding of a donor,” he said.

Dr. Mendoza also said the donor will be taken cared of by the foundation, including livelihood and insurance.

The US-trained doctor warned “to avoid dealing with middlemen in kidney transplant because they are more expensive as their only motive is money.”

”You will be shortchanged,” Dr. Mendoza said.

A prospective donor will be screened thoroughly before he is considered donor, he said.

”We have to make sure that the would-be donor is not suffering from major illness,” he said.

Once a donor is found to be compatible with the patient’s kidney, the donor will undergo a surgery called open or laparoscopy wherein the incision is limited to a small portion of the stomach, Dr. Mendoza said.

It will take one to two weeks to screen a donor.

Dr. Mendoza also said that foreigners are coming to the country to undergo kidney transplant because the cost is much less.

“Filipino doctors are at par with the world’s best and our facilities are also comparable to the best in the world,” he said.

source: interaksyon.com

Bayer challenges Indian ruling on cheaper cancer drugs

NEW DELHI -- German pharmaceutical giant Bayer AG has challenged a ground-breaking Indian ruling that allowed a local firm to produce a vastly cheaper copy of its patented drug for kidney and liver cancer.

India's patents chief ruled in March the price Bayer charged for the drug, Nexavar, was "exorbitant" and ordered the firm to give a so-called "compulsory licence" to make the medicine to Indian company Natco Pharma.

"We will rigorously continue to defend our intellectual property rights which are a prerequisite for bringing innovative medicines to patients," Bayer spokesman Aloke Pradhan told AFP in an emailed statement on Saturday.

The patent controller's order "damages the international patent system and endangers pharmaceutical research," Pradhan said.

It was not immediately known when the appeal, filed with the country's Intellectual Property Appellate Board on Friday, would be heard.

Drug firms insist they need patent protection for medicines to recoup costs of long years of research and development.

Under the World Trade Organization's TRIPS Agreement, which governs trade and intellectual property rules, compulsory licences are a legally recognized means to overcome barriers in accessing affordable medicines.

The Indian ruling in March marked the first time a so-called "compulsory licence" for production of a patented drug had been granted in the country of 1.2 billion, known as a global generics drug powerhouse.

India has long been a key provider of cheap generic medicines to the developing world as it did not issue drug patents until 2005, when it was obliged to adhere to WTO intellectual property regulations.

But after a new patent law was introduced in 2005, newer medicines are increasingly being patented in India, keeping prices high.

Under the ruling, Natco will pay Bayer a six percent royalty on sales of the drug and sell the medicine for 8,800 rupees ($165) a month -- compared to the 280,000 rupees ($5,320) the company charges, which is more than 30 times as much.

Patent controller P.H. Kurian granted the right to Natco to produce the drug after concluding Bayer's pricing made it "out of reach" of most Indian patients.

Experts have said the Indian ruling could pave the way for a rush of other "compulsory licence" applications in India and in other poor nations, allowing access to patented life-saving drugs at a fraction of the cost.

source: interaksyon.com