Diabetes, Cardiovascular Disease, Chronic Kidney Disease

A January 2024 study by Professor Edward Gregg, Head of the School of Population Health, RCSI University of Medicine and Health Sciences, Dublin, Ireland, and colleagues said, “As the first intervention study to associate remission with reduction of diabetes-related complications, this is encouraging news for those who can achieve remission from type 2 diabetes. While our study is also a reminder that maintenance of weight loss and remission is difficult, our findings suggests any success with remission is associated with later health benefits.”

JOURNAL

Diabetologia

ARTICLE TITLE

Impact of remission from type 2 diabetes on long‑term health outcomes: findings from the Look AHEAD study

ARTICLE PUBLICATION DATE

18-Jan-2024

COI STATEMENT

See full paper for disclosures

Kidney Stones and the Microbiome

A December 2023 report by St. Joseph’s Health Care London (St. Joseph’s).said,

• “Kidney stone disease has been rising in recent years, affecting roughly 10 per cent of people,”

• “While previous research has shown a connection between the gut microbiome and kidney stones in those who have taken antibiotics, we also wanted to explore the connection to other microbiomes in the hopes we can advance understanding and potential treatments.”

• “Our testing – called shotgun metagenomic sequencing – allowed us to discover which bacteria were present in the gut and the genetic capabilities of those bacteria, or how it functions. We also did a simpler sequencing of the oral and urinary samples,”

• “It’s a more complex story. The microbes form a kind of network that’s stable and beneficial in healthy people, but in those with kidney stones, that network is broken down. They’re not producing the same vitamins and useful metabolites, not just in the gut but also in the urinary tract and oral cavity,”

• “We found not only that those who got kidney stones had an unhealthy microbiome, including a gut microbiome that was more likely to excrete toxins to the kidneys, but also that they were antibiotic resistant,”

ketogenic diet and polycystic kidney disease (PKD)

A December 2023 study by the University of California, Santa Barbara said they were,

• “… really happy about these clinical trial results … We now have the first evidence in humans that the cysts really don’t like to be in ketosis and that they don’t seem to grow.”

•  “If you have PKD, the dogma is that it’s a genetic disease … And no matter what you do, you progress toward kidney failure and diet doesn’t make any difference, which unfortunately most patients are told to this day.”  

•  “To everyone’s great surprise, kidney function actually improved with the ketogenic diet … And that was a hard outcome of statistical significance.” 

•  “Doctors often assume that their patients cannot adhere to a diet anyway, so they don’t even try. Clearly, this is not true. People with PKD are highly motivated to do something about their condition,”  

•  “A keto diet just means very low carbs,”

• “If you make a discovery in animals, but you don’t check it in actual people, you’ll never quite know if it’s going to be meaningful … There’s always going to be the doubt, and people are going to say animal experiments don’t always translate to humans.”

Mapping kidney stones

A May 2021 study by the University of Illinois Urbana-Champaign, Mayo Clinic said,

• "The process of kidney stone formation is part of the natural process of the stone formation seen throughout nature,”

• "We are bringing together geology, biology and medicine to map the entire process of kidney stone formation, step by step. With this road map in hand, more effective and targeted clinical interventions and therapies can now be developed."

• "If we can identify these phase transformations, what makes one step to go to another and how it progresses, then perhaps we can intervene in that progression and break the chain of chemical reactions happening inside the kidney tissues before a stone becomes problematic,"

• "Stone formation is part of a natural, healthy process within kidneys where these tiny mineral deposits are shuttled away and excreted from the body,”

• "But then there is a tipping point when those same mineral deposits start to grow together too rapidly and are physically unable to leave the kidney."

• "Looking at a cross-section of a kidney stone, you would never guess that each of the layers was originally a bunch of little balls that lined up and coalesced. These are revolutionary new ways for us to understand how these minerals grow within the kidney and provide specific targets for stone growth prevention,"

• "Ultimately, our vision is that every operating room would have a small geology lab attached. In that lab, you could do a very rapid diagnostic on a stone or stone fragment in a matter of minutes, and have informed and individualized treatment targets,"

Chinese Medicine: Mothers

“The Blood is the Mother of Qi.”

“The Kidney is the Mother of the Liver.”

Such statements from Chinese Medicine theory seem at odds with current Western Medicine theory (and practice).  But the approach in Chinese Medicine is altogether more holistic, systemic and interrelated.

Sugar, Longevity, Uric Acid, Gout and Stones

A March 2020 study by the MRC London Institute of Medical Sciences and Kiel University said,

• "Just like humans, flies fed a high-sugar diet show many hallmarks of metabolic disease - for instance, they become fat and insulin resistant."

• "Obesity and diabetes are known to increase mortality in humans, and so people always assumed that this was how excess sugar is damaging for survival in flies".

• "Water is vital for our health, yet its importance is often overlooked in metabolic studies. Therefore, we were surprised that flies fed a high-sugar diet did not show a reduced lifespan, simply by providing them with an extra source of water to drink. Unexpectedly, we found that these flies still exhibited the typical metabolic defects associated with high dietary sugar".

The researchers found that the excess sugar is related to a build up of uric acid but that,

• "the sugar-fed flies may live longer when we give them access to water, but they are still unhealthy. And in humans, for instance, obesity increases the risk of heart disease. But our study suggests that disruption of the purine pathway is the limiting factor for survival in high-sugar-fed flies. This means that early death by sugar is not necessarily a direct consequence of obesity itself".

• "Strikingly, just like flies, we found that dietary sugar intake in humans was associated with worse kidney function and higher purine levels in the blood."

• "It will be very interesting to explore how our results from the fly translate to humans, and whether the purine pathway also contributes to regulating human survival."

• "There is substantial evidence that what we eat influences our life expectancy and our risk for age-related diseases. By focusing on the purine pathway, our group hopes to find new therapeutic targets and strategies that promote healthy ageing".

Kidneys and Hydration

An October 2019 study by the University of Waterloo looked at impaired kidney function and hydration in a new computer model that, “simulates the muscle contractions that move urine from the kidney to the bladder.”

"People who have high blood pressure are typically given a water pill, so they pee a lot to lower their blood volume and in so doing lower their blood pressure … These patients are frequently also given another drug that targets a hormonal system which will affect the kidney as well.

"A lot of people are on these two drugs, and they will be fine. But one day they might have a headache and take an aspirin, and the three of these drugs together can hurt your kidneys."

“that unless a patient is properly hydrated, taking the two blood pressure drugs and an aspirin concurrently could cause acute kidney injury. The injury happens when there is an insufficient water balance, which can lead to concentrated urine from a build-up of waste in the body.”