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Adolescents miss right mix
June 2009
WASHINGTON - The healthcare system is too fragmented to give adolescents the right mix of clinical and preventive care, scientists told MedPage Today, While most adolescents are healthy, this group is especially susceptible to risky behavior, and many young people lack access to proper mental, physical, and behavioral healthcare, noted authors of a report from the Institute of Medicine and the National Research Council.
The array of specific health issues - mental illness, sexual health, and drug abuse, among others - means care for those who seek it is spread out over a variety of centers, which can be difficult for adolescents to access, noted the report.
"Adolescence is when patterns of health-promoting or health-damaging behaviors are established that will have a substantial influence on health status in adulthood, affecting rates of acute and chronic disease and life expectancy," they said.
The system shouldn’t approach caring for adolescents in the same way it cares for adults, said Dr. Robert S. Lawrence, professor of environmental health sciences and health policy at the Johns Hopkins Bloomberg School of Public Health.
ATLANTA - HealthDay News noted eating a low-salt diet is an important lifestyle change people with heart failure can make, but only 33% adhere to it, a study found. Scientists asked 116 people with heart failure to write down everything they ate for three days. Though the advised daily intake of sodium for people with heart failure is 2,000mg, those in the study ate an average of 2,671mg a day. Many weren't purposefully ignoring doctor's suggestions, said study co-author Carolyn M. Reilly, a postdoctoral fellow at Emory University. Most thought they were taking steps to cut their sodium by putting less salt on food, but she said they were aimed at the wrong target. About 70% of the sodium in the U.S. diet comes from processed foods, such as canned soups, lunch meats, and fast food, not from salt added to home-cooked meals. Sodium is added to foods to give them a longer shelf life, enhance texture, and mask bitterness. "There is so much salt hidden in foods that patients aren't aware of," Reilly stated. The study was presented at the American Heart Association's 10th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.
IOWA CITY, IA - The Disability Law & Policy e-Newsletter of the Law, Health Policy & Disability Center at the University of Iowa College of Law and the Burton Blatt Institute at Syracuse University disclosed (NCD) National Council on Disability (NCD) submitted its annual report to Congress. It recognized advances in some areas, but lingering barriers to full societal participation, including housing, healthcare, employment, and persistent institutional bias in Medicaid. NCD notes during recessions government plans historically exclude the disabled. Also, the center has developed training to help employers interview the disabled. They can use this training to learn how to present themselves effectively to potential employers in the interview process.
DURHAM, NC - HealthDay News noted that adding dasatinib to a two-drug chemotherapy regimen to treat ovarian cancer hiked the drugs’ effectiveness in lab tests, research shows. Duke Comprehensive Cancer Center scientists added dasatinib to carboplatin and paclitaxel, to treat four types of ovarian cancer cells. In some types of ovarian cancers, a pathway called SRC is involved in the abnormal cell proliferation, said Dr. Deanna Teoh, a fellow in gynecologic oncology at Duke and study lead investigator. "By examining gene expression data, we determined the combination of the leukemia drug dasatinib (Sprycel) made carboplatin and paclitaxel more effective in cell lines with higher SRC expression and SRC pathway deregulation," Dr. Teoh said. Dasatinib, marketed by Bristol-Meyers Squibb as Sprycel, is FDA-approved for treating leukemia. "These findings indicate we may be able to direct the use of a targeted therapy like dasatinib based on gene expression pathways in select ovarian cancers," she said. The study was presented at the American Association for Cancer Research annual meeting.
DALLAS - COSMOS Online noted defects in the body's circadian rhythms could underlie manic-depressive disorder. Mice with altered daily rhythms were found to display some hallmarks of the "manic" part of bipolar disorder. The mice, with a mutated version of the gene Clock, respond to lithium - used as a mood stabilizer to treat bipolar disorder. A study led by Colleen McClung, of the University of Texas’ Southwestern Medical Center, was in the Proceedings of the National Academy of Sciences. Circadian rhythms - and the genes that comprise our biological clock - have been linked to bipolar disorder and alternating mania/depression cycles. Most sufferers have disrupted sleep, appetite, and hormonal cycles, and led scientists to see a link between the disorder and abnormalities in the body's circadian rhythms. McClung's team created mice with a non-functional version of Clock, one of the most important genes regulating circadian rhythm. In tests, these mice displayed symptoms reminiscent of human mania, such as less anxiety, hyperactivity, and sleeplessness. Like human manics, they got more out of cocaine, sucrose, and stimulation of the medial forebrain bundle, a part of the brain implicated in addiction.
IOWA CITY, IA - The Disability Law & Policy e-newsletter of the Law, Health Policy & Disability Center at the University of Iowa College of Law and the Burton Blatt Institute at Syracuse University noted that the U.S. Equal Employment Opportunity Commission (EEOC) ruled the Transportation Security Administration (TSA) violated the Rehabilitation Act when it discriminated against an employee by moving him from teaching to a screening job. The transfer required the employee - with a degenerative disability and a cane to walk and stand - to work up to eight hours standing. EEOC found TSA’s job change was clearly arbitrary, since the employee successfully completed all his duties and had an "exceeds" rating in his annual review. The employee received back pay, $150,000 for compensatory damages, and attorney fees.
DURHAM, NC - Several studies suggest statins help prevent prostate cancer and cut erectile dysfunction risk, HealthDay News noted. "At this point, there seems to be mounting evidence there may be a role for statins in prostate cancer treatment or prevention," said Dr. Lionel L. Banez, of the Division of Urologic Surgery and Duke Prostate Center at Duke University Medical Center and lead author of one study. "There will be more men taking statins for cardiovascular reasons, and this is a great opportunity for us to see how many of these men develop prostate cancer and whether these cancers are aggressive." All reports were given at the American Urological Association's annual meeting in Chicago. One study found men taking statins before surgical removal of their prostate had a lower risk of having cancer return. "The use of statins at surgery was (tied to) a 30% (lower) risk of prostate cancer recurrence," said lead scientist Dr. Robert J. Hamilton, a urology resident at the University of Toronto Medical Center. He thinks the anti-inflammatory properties of statins may explain the finding, but it might be the ability of these drugs to lower cholesterol that has an effect on cancer cells. Another study focused on inflammation inside prostate tumors. "We looked at the (tie) between statin use and prostate tumor inflammation," Dr. Banez said. "We found men using statins prior to surgery had a significantly lower risk for inflammation within their prostate tumor."
SALT LAKE CITY - HealthDay News noted children of older mothers and from breech births are almost twice as likely to have an Autism Spectrum Disorder (ASD), scientists report. Findings support the idea that much of Autism has a genetic base, scientists say. "A child with breech is twice as likely as a child who didn’t breech to develop Autism," said lead scientist, Dr. Deborah Bilder, assistant professor/psychiatry, University of Utah School of Medicine. A breech birth occurs when the infant exits with the legs and buttocks first instead of the head. These children are usually delivered by Caesarian section. For mothers 35 and older, the risk their child will develop ASD is 1.6 times greater than for children of younger women. For women having their first child, the risk is 1.8 times higher than if they delivered before, Dr. Bilder said. The absolute risk for Autism in any child is still relatively small, she stressed. "I don't think there’s good reason right now to instill worry in moms over 34 already concerned with other genetic issues," she said." I think this is a finding to pursue, because this suggests a potential genetic cause for Autism." There’s no doubt ASD runs in families, Dr. Bilder said. "I see a lot of families with autistic children, particularly in Utah, where families are larger. We’re also looking at environmental issues - prenatally."
ROCHESTER, MN - Medicalnewstoday.com noted Mayo Clinic scientists found patients taking statins before a stroke had better results and recovery than those who weren't on the drug - even when cholesterol levels were ideal. In the Journal of Stroke and Cerebrovascular Diseases, lead researcher Dr. Latha Stead wrote: "We were trying to determine if the daily use of statins had more of an impact on stroke patients than simply lowering `bad’ (low-density lipid) cholesterol. We knew statin use improved outcomes in general, so we focused on the patients who had optimal LDL levels and found it still had quite significant value." Statins are enzymes used widely to improve cardiovascular health and, recently, for certain vascular conditions in the brain. One use has been to lower the level of LDL which can add to arterial blockages. The Mayo team found statin used in this study cut the severity of strokes and improved significantly overall outcomes. Scientists think specific benefits may include plaque stabilization and improved cell function in vascular walls, plus anti-inflammatory and antioxidant factors.
BOSTON - MedPage Today noted the U.S. emergency care system rated a C-minus, a state-by-state study by the American College of Emergency Physicians (ACEP) found. It considered legislative and regulatory environment, infrastructure, and available workforce. It didn’t measure quality of care in individual hospitals or individual ER providers. Although the C-minus was no better than in 2006, the two reports are "significantly different and not directly comparable," said ACEP. This report "provides a more extensive evaluation of the nation's (ER) system and confirms its tenuous condition." The report task force was chaired by Dr. Stephen Epstein, of Beth Israel Deaconess Medicare Center. ER overcrowding, an overall poor infrastructure, and a spotty medical liability environment yielded the low overall grade, said ACEP. "The findings are sobering," authors said. "The (ER) system in the U.S remains in serious condition, with numerous states facing critical problems." Massachusetts scored highest with a B, then the District of Columbia, Rhode Island, Maryland, and Nebraska. The lowest was Arkansas: D-minus.
ANN ARBOR, MI - University of Michigan scientists reveal gene therapy can be used to stop periodontal disease, the leading cause of adult tooth loss. The findings in Gene Therapy show using gene transfer to treat life-threatening woes isn’t new, but this group is the first known to use the gene delivery approach to show potential treating chronic ills such as periodontal disease, said William Giannobile, professor at the U-M School of Dentistry and study principal investigator. "Gene therapy hasn’t been used in non-life-threatening disease. (Periodontal disease) is more disabling than life- threatening," said Giannobile, who directs the Michigan Center for Oral Health Research and is appointed to the U-M College of Engineering. "This is so important because the next wave of improving medical therapeutics goes beyond saving life, and moves to improving the quality of life." The study was in collaboration with Seattle-based Targeted Genetics. In July, TA released human trial results showing the same gene therapy approach had positive affects in human patients with rheumatoid arthritis, another chronic, non-life-threatening, disabling condition.
CHICAGO - Adding a patient photo to a file may boost the radiologist's empathy and produce a more thorough report, scientists told MedPage Today. Radiologists were more likely to relate better to the patient whose scans they were interpreting and write longer, more detailed reports when they saw a patient photo, Dr. Yehonatan N. Turner, of Shaare Zedek Medical Center in Jerusalem, said at the Radiological Society of North America meeting. "Radiologists often review CT images at a later time, or from remote locations, and lack physician/patient contact," Dr. Turner said. "We thought maybe the addition of a photo would enable a more personal approach." Radiology is often criticized for a lack of empathy with individual patients, but putting a face on the scan could change that. Scientists analyzed results for 315 patients referred for CT scan. Dr. Turner said the study was divided into an objective and a subjective part. Reports were significantly longer when the patient's photograph was added.
BOSTON - Scientists report a blind man in Switzerland made his way through a maze, with no conscious sensation of seeing the world around him, HealthDay News reports. This phenomenon indicates the brain has ways of processing vision beyond those understood, scientists said. Visual skills include mechanisms "for orienting and doing in the world rather than for understanding," study lead author Beatrice de Gelder, a researcher at Tilburg University in the Netherlands and Harvard Medical School, stated. Scientists were aware of so-called "blindsight," in which the sightless show ability to sense things around them. In the case of the man in this study, he can sense facial expressions, and his brain shows signs of reacting to the emotions shown on the faces of others. Study authors said the man has a skill unseen in the blind - ability to navigate a maze, in this case boxes and chairs placed in his way. The man, age and name undisclosed, suffered two strokes that damaged the visual centers of his brain. He can't see, and brain scans show no signs of activity in the visual centers, study authors said. They reported in Current Biology the man was able to navigate the maze and didn't require an assistant who stood by.
NEW YORK - Traditionally, doctors lacked a clear way to predict which patients might be headed for chronic kidney disease (CKD). Now, scientists at New York-Presbyterian Hospital/Weill Cornell Medical Center and the University of North Carolina/Chapel Hill have an eight-point risk checklist. In the Archives of Internal Medicine, the model stratifies middle-aged and older patients at high risk for newly-diagnosed CKD, which is a gradual, even fatal loss of kidney function. The National Kidney Foundation says 26 million U.S. adults have CKD and millions more are at greater risk. "These patients are often battling conditions - diabetes or heart disease, so anything we can do to predict and then lower risk for kidney disease will be invaluable," says study senior author Dr. Phyllis A. August, professor of medical research at Weill Cornel and an internist and nephrologist at New York-Presbyterian. She and colleagues took data from the Atherosclerosis Risk in Communities trial and the Cardiovascular Health Study, with 14,155 men and women 45 or older. "We discovered eight factors - older age, anemia, female sex, hypertension, diabetes, peripheral vascular disease, and any history of congestive heart failure or cardiovascular disease - accurately predicted which older patients would proceed to CKD and which wouldn’t," said study co-author Dr. Heejung Bang, assistant professor in the Division of Biostatistics and Epidemiology in the Dept. of Public Health at Weill Cornell.
ATLANTA - HealthDay News noted eating a low-salt diet is an important lifestyle change people with heart failure can make, but only 33% adhere to it, a study found. Scientists asked 116 people with heart failure to write down everything they ate for three days. Though the advised daily intake of sodium for people with heart failure is 2,000mg, those in the study ate an average of 2,671mg a day. Many weren't purposefully ignoring doctor's suggestions, said study co-author Carolyn M. Reilly, a postdoctoral fellow at Emory University. Most thought they were taking steps to cut their sodium by putting less salt on food, but she said they were aimed at the wrong target. About 70% of the sodium in the U.S. diet comes from processed foods, such as canned soups, lunch meats, and fast food, not from salt added to home-cooked meals. Sodium is added to foods to give them a longer shelf life, enhance texture, and mask bitterness. "There is so much salt hidden in foods that patients aren't aware of," Reilly stated. The study was presented at the American Heart Association's 10th Scientific Forum on Quality of Care and Outcomes Research in Cardiovascular Disease and Stroke.
IOWA CITY, IA - The Disability Law & Policy e-Newsletter of the Law, Health Policy & Disability Center at the University of Iowa College of Law and the Burton Blatt Institute at Syracuse University disclosed (NCD) National Council on Disability (NCD) submitted its annual report to Congress. It recognized advances in some areas, but lingering barriers to full societal participation, including housing, healthcare, employment, and persistent institutional bias in Medicaid. NCD notes during recessions government plans historically exclude the disabled. Also, the center has developed training to help employers interview the disabled. They can use this training to learn how to present themselves effectively to potential employers in the interview process.
DURHAM, NC - HealthDay News noted that adding dasatinib to a two-drug chemotherapy regimen to treat ovarian cancer hiked the drugs’ effectiveness in lab tests, research shows. Duke Comprehensive Cancer Center scientists added dasatinib to carboplatin and paclitaxel, to treat four types of ovarian cancer cells. In some types of ovarian cancers, a pathway called SRC is involved in the abnormal cell proliferation, said Dr. Deanna Teoh, a fellow in gynecologic oncology at Duke and study lead investigator. "By examining gene expression data, we determined the combination of the leukemia drug dasatinib (Sprycel) made carboplatin and paclitaxel more effective in cell lines with higher SRC expression and SRC pathway deregulation," Dr. Teoh said. Dasatinib, marketed by Bristol-Meyers Squibb as Sprycel, is FDA-approved for treating leukemia. "These findings indicate we may be able to direct the use of a targeted therapy like dasatinib based on gene expression pathways in select ovarian cancers," she said. The study was presented at the American Association for Cancer Research annual meeting.
DALLAS - COSMOS Online noted defects in the body's circadian rhythms could underlie manic-depressive disorder. Mice with altered daily rhythms were found to display some hallmarks of the "manic" part of bipolar disorder. The mice, with a mutated version of the gene Clock, respond to lithium - used as a mood stabilizer to treat bipolar disorder. A study led by Colleen McClung, of the University of Texas’ Southwestern Medical Center, was in the Proceedings of the National Academy of Sciences. Circadian rhythms - and the genes that comprise our biological clock - have been linked to bipolar disorder and alternating mania/depression cycles. Most sufferers have disrupted sleep, appetite, and hormonal cycles, and led scientists to see a link between the disorder and abnormalities in the body's circadian rhythms. McClung's team created mice with a non-functional version of Clock, one of the most important genes regulating circadian rhythm. In tests, these mice displayed symptoms reminiscent of human mania, such as less anxiety, hyperactivity, and sleeplessness. Like human manics, they got more out of cocaine, sucrose, and stimulation of the medial forebrain bundle, a part of the brain implicated in addiction.
IOWA CITY, IA - The Disability Law & Policy e-newsletter of the Law, Health Policy & Disability Center at the University of Iowa College of Law and the Burton Blatt Institute at Syracuse University noted that the U.S. Equal Employment Opportunity Commission (EEOC) ruled the Transportation Security Administration (TSA) violated the Rehabilitation Act when it discriminated against an employee by moving him from teaching to a screening job. The transfer required the employee - with a degenerative disability and a cane to walk and stand - to work up to eight hours standing. EEOC found TSA’s job change was clearly arbitrary, since the employee successfully completed all his duties and had an "exceeds" rating in his annual review. The employee received back pay, $150,000 for compensatory damages, and attorney fees.
DURHAM, NC - Several studies suggest statins help prevent prostate cancer and cut erectile dysfunction risk, HealthDay News noted. "At this point, there seems to be mounting evidence there may be a role for statins in prostate cancer treatment or prevention," said Dr. Lionel L. Banez, of the Division of Urologic Surgery and Duke Prostate Center at Duke University Medical Center and lead author of one study. "There will be more men taking statins for cardiovascular reasons, and this is a great opportunity for us to see how many of these men develop prostate cancer and whether these cancers are aggressive." All reports were given at the American Urological Association's annual meeting in Chicago. One study found men taking statins before surgical removal of their prostate had a lower risk of having cancer return. "The use of statins at surgery was (tied to) a 30% (lower) risk of prostate cancer recurrence," said lead scientist Dr. Robert J. Hamilton, a urology resident at the University of Toronto Medical Center. He thinks the anti-inflammatory properties of statins may explain the finding, but it might be the ability of these drugs to lower cholesterol that has an effect on cancer cells. Another study focused on inflammation inside prostate tumors. "We looked at the (tie) between statin use and prostate tumor inflammation," Dr. Banez said. "We found men using statins prior to surgery had a significantly lower risk for inflammation within their prostate tumor."
SALT LAKE CITY - HealthDay News noted children of older mothers and from breech births are almost twice as likely to have an Autism Spectrum Disorder (ASD), scientists report. Findings support the idea that much of Autism has a genetic base, scientists say. "A child with breech is twice as likely as a child who didn’t breech to develop Autism," said lead scientist, Dr. Deborah Bilder, assistant professor/psychiatry, University of Utah School of Medicine. A breech birth occurs when the infant exits with the legs and buttocks first instead of the head. These children are usually delivered by Caesarian section. For mothers 35 and older, the risk their child will develop ASD is 1.6 times greater than for children of younger women. For women having their first child, the risk is 1.8 times higher than if they delivered before, Dr. Bilder said. The absolute risk for Autism in any child is still relatively small, she stressed. "I don't think there’s good reason right now to instill worry in moms over 34 already concerned with other genetic issues," she said." I think this is a finding to pursue, because this suggests a potential genetic cause for Autism." There’s no doubt ASD runs in families, Dr. Bilder said. "I see a lot of families with autistic children, particularly in Utah, where families are larger. We’re also looking at environmental issues - prenatally."
ROCHESTER, MN - Medicalnewstoday.com noted Mayo Clinic scientists found patients taking statins before a stroke had better results and recovery than those who weren't on the drug - even when cholesterol levels were ideal. In the Journal of Stroke and Cerebrovascular Diseases, lead researcher Dr. Latha Stead wrote: "We were trying to determine if the daily use of statins had more of an impact on stroke patients than simply lowering `bad’ (low-density lipid) cholesterol. We knew statin use improved outcomes in general, so we focused on the patients who had optimal LDL levels and found it still had quite significant value." Statins are enzymes used widely to improve cardiovascular health and, recently, for certain vascular conditions in the brain. One use has been to lower the level of LDL which can add to arterial blockages. The Mayo team found statin used in this study cut the severity of strokes and improved significantly overall outcomes. Scientists think specific benefits may include plaque stabilization and improved cell function in vascular walls, plus anti-inflammatory and antioxidant factors.
BOSTON - MedPage Today noted the U.S. emergency care system rated a C-minus, a state-by-state study by the American College of Emergency Physicians (ACEP) found. It considered legislative and regulatory environment, infrastructure, and available workforce. It didn’t measure quality of care in individual hospitals or individual ER providers. Although the C-minus was no better than in 2006, the two reports are "significantly different and not directly comparable," said ACEP. This report "provides a more extensive evaluation of the nation's (ER) system and confirms its tenuous condition." The report task force was chaired by Dr. Stephen Epstein, of Beth Israel Deaconess Medicare Center. ER overcrowding, an overall poor infrastructure, and a spotty medical liability environment yielded the low overall grade, said ACEP. "The findings are sobering," authors said. "The (ER) system in the U.S remains in serious condition, with numerous states facing critical problems." Massachusetts scored highest with a B, then the District of Columbia, Rhode Island, Maryland, and Nebraska. The lowest was Arkansas: D-minus.
ANN ARBOR, MI - University of Michigan scientists reveal gene therapy can be used to stop periodontal disease, the leading cause of adult tooth loss. The findings in Gene Therapy show using gene transfer to treat life-threatening woes isn’t new, but this group is the first known to use the gene delivery approach to show potential treating chronic ills such as periodontal disease, said William Giannobile, professor at the U-M School of Dentistry and study principal investigator. "Gene therapy hasn’t been used in non-life-threatening disease. (Periodontal disease) is more disabling than life- threatening," said Giannobile, who directs the Michigan Center for Oral Health Research and is appointed to the U-M College of Engineering. "This is so important because the next wave of improving medical therapeutics goes beyond saving life, and moves to improving the quality of life." The study was in collaboration with Seattle-based Targeted Genetics. In July, TA released human trial results showing the same gene therapy approach had positive affects in human patients with rheumatoid arthritis, another chronic, non-life-threatening, disabling condition.
CHICAGO - Adding a patient photo to a file may boost the radiologist's empathy and produce a more thorough report, scientists told MedPage Today. Radiologists were more likely to relate better to the patient whose scans they were interpreting and write longer, more detailed reports when they saw a patient photo, Dr. Yehonatan N. Turner, of Shaare Zedek Medical Center in Jerusalem, said at the Radiological Society of North America meeting. "Radiologists often review CT images at a later time, or from remote locations, and lack physician/patient contact," Dr. Turner said. "We thought maybe the addition of a photo would enable a more personal approach." Radiology is often criticized for a lack of empathy with individual patients, but putting a face on the scan could change that. Scientists analyzed results for 315 patients referred for CT scan. Dr. Turner said the study was divided into an objective and a subjective part. Reports were significantly longer when the patient's photograph was added.
BOSTON - Scientists report a blind man in Switzerland made his way through a maze, with no conscious sensation of seeing the world around him, HealthDay News reports. This phenomenon indicates the brain has ways of processing vision beyond those understood, scientists said. Visual skills include mechanisms "for orienting and doing in the world rather than for understanding," study lead author Beatrice de Gelder, a researcher at Tilburg University in the Netherlands and Harvard Medical School, stated. Scientists were aware of so-called "blindsight," in which the sightless show ability to sense things around them. In the case of the man in this study, he can sense facial expressions, and his brain shows signs of reacting to the emotions shown on the faces of others. Study authors said the man has a skill unseen in the blind - ability to navigate a maze, in this case boxes and chairs placed in his way. The man, age and name undisclosed, suffered two strokes that damaged the visual centers of his brain. He can't see, and brain scans show no signs of activity in the visual centers, study authors said. They reported in Current Biology the man was able to navigate the maze and didn't require an assistant who stood by.
NEW YORK - Traditionally, doctors lacked a clear way to predict which patients might be headed for chronic kidney disease (CKD). Now, scientists at New York-Presbyterian Hospital/Weill Cornell Medical Center and the University of North Carolina/Chapel Hill have an eight-point risk checklist. In the Archives of Internal Medicine, the model stratifies middle-aged and older patients at high risk for newly-diagnosed CKD, which is a gradual, even fatal loss of kidney function. The National Kidney Foundation says 26 million U.S. adults have CKD and millions more are at greater risk. "These patients are often battling conditions - diabetes or heart disease, so anything we can do to predict and then lower risk for kidney disease will be invaluable," says study senior author Dr. Phyllis A. August, professor of medical research at Weill Cornel and an internist and nephrologist at New York-Presbyterian. She and colleagues took data from the Atherosclerosis Risk in Communities trial and the Cardiovascular Health Study, with 14,155 men and women 45 or older. "We discovered eight factors - older age, anemia, female sex, hypertension, diabetes, peripheral vascular disease, and any history of congestive heart failure or cardiovascular disease - accurately predicted which older patients would proceed to CKD and which wouldn’t," said study co-author Dr. Heejung Bang, assistant professor in the Division of Biostatistics and Epidemiology in the Dept. of Public Health at Weill Cornell.