Losing Weight Helps Reduce Risk of Urinary Incontinence, Study Shows
Thursday, January 29, 2009 Article by: D.K. Mangusan Jr., PTRP
The Program to Reduce Incontinence by Diet and Exercise (PRIDE), conducted in Birmingham, Alabama, and Providence, Rhode Island, recruited a total of 338 obese and overweight women who leaked urine at least 10 times per week. The women were randomly assigned to either an intensive six-month weight-loss program of diet, exercise and behavior modification or to a group that received information about diet and exercise, but no training to help them change habits.
The investigators report that women in the intensive weight-loss group lost an average 8 percent of their body weight (about 17 pounds) and reduced weekly urinary incontinence episodes by nearly one-half (47 percent). In contrast, women in the information-only group lost an average 1.6 percent of body weight (about 3 pounds) and had 28 percent fewer episodes.
Urinary incontinence affects more than 13 million women in the United States and accounts for an estimated $20 billion in annual health care costs, according to the paper. Obesity is an established and modifiable risk factor for urinary incontinence, but conclusive evidence for a beneficial effect of weight loss on urinary incontinence has been lacking. The PRIDE trial provides evidence supporting weight loss as a treatment for incontinence.
NIDDK Director Griffin P. Rodgers, M.D. said, "Clearly, weight loss can have a significant, positive impact on urinary incontinence, a finding that may help motivate weight loss, which has additional health benefits such as preventing type 2 diabetes."
An important finding of the study is the difference between the two groups in the reduction of incontinence. Among women in the weight-loss group, 41 percent achieved a clinically relevant reduction of at least 70 percent of total incontinence episodes per week, whereas 22 percent of women in the information-only group achieved the same level of reduction.
At six months, women in the weight-loss group were significantly more satisfied with the change in their incontinence than were women in the information-only group. This was assessed through self-reported perceived change in frequency of incontinence, volume of urine loss, the degree to which incontinence was a problem, and satisfaction with the change in incontinence.
"Studies have documented that behavioral interventions help people lose weight, which helps decrease the risk of developing type 2 diabetes and high blood pressure, improve control of high blood pressure and cholesterol levels, and enhance mood and quality of life," said Leslee L. Subak, M.D., of the University of California, San Francisco (UCSF) and lead author of the study. "Our results suggest that a decrease in urinary incontinence is another health benefit associated with weight loss and that weight reduction can be a first-line treatment in overweight and obese women."
Weight loss in PRIDE is comparable to that observed in the Diabetes Prevention Program (DPP) and in the ongoing Action for Health in Diabetes (Look AHEAD), two NIDDK-sponsored clinical trials in people with type 2 diabetes. The PRIDE intensive weight-loss program was modeled after these two trials.
Co-authors on the PRIDE paper were Deborah Grady, M.D., M.P.H., professor of medicine at UCSF and the San Francisco Veterans Affairs Medical Center; Rena Wing, Ph.D., of The Miriam Hospital and the Warren Alpert Medical School of Brown University, Providence, R.I.; Delia Smith West, Ph.D., of the University of Arkansas for Medical Sciences, College of Public Health, Little Rock, Ark.; and Frank Franklin, M.D., Ph.D., of the University of Alabama at Birmingham.
Source: NIH News Release. National Institutes of Health (NIH). U.S. Department of Health and Human Services
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Measurement of Kidney Function in Children with Kidney Disease Improved
Thursday, January 22, 2009 Article by: D.K. Mangusan Jr., PTRP
"This study illustrates the importance of our commitment to research on chronic kidney disease in children," said NIDDK Director Griffin P. Rodgers, M.D. "As NIDDK-supported research discovers more accurate methods of diagnosing and monitoring biomedical conditions, our ability to treat those conditions, reduce suffering, and prolong life also continues to improve."
Glomerular filtration rate (GFR), the flow rate of fluid through the tiny capillaries in the kidney (glomeruli) that filter waste materials out of the blood and into the urinary system, is the most useful indicator of kidney function. However, determining true GFR is costly, time-consuming, and difficult to perform at regular clinical office visits. As a result, different methods of estimating GFR using biochemical markers of kidney function have been developed.
One of those methods, the Schwartz formula, estimates GFR from an equation that uses serum creatinine (a waste product in the blood from meat protein in the diet and from muscle metabolism) and height. GFR estimated by this formula has been used as one of the enrollment criteria for the CKiD study, which assesses children with mild to moderate chronic kidney disease. The current study, led by George Schwartz, M.D., who originated the formula in the mid-1970s, used data from baseline CKiD visits of 349 children aged 1 year to 16 years to evaluate the existing GFR prediction equations.
The investigators compared the Schwartz formula with a highly successful Scandinavian method of measuring GFR using disappearance of the X-ray dye iohexol from the blood. The Schwartz formula overestimated GFR. Because the iohexol method is only used every two years after the first two visits in the CKiD trial, an accurate assessment of GFR is needed during the annual visits when the iohexol method is not performed.
After comparing various estimated GFR models using a testing data set of 168 children in the CKiD trial, the investigators found that a modified Schwartz formula using height, serum creatinine, cystatin C (a small protein expressed throughout the body), blood urea nitrogen, and gender came the closest to replicating the results of the iohexol method, widely regarded as the gold standard in measuring GFR.
Use of estimated GFR allows the investigators to describe the trajectory of declining kidney function and to adjust the dose of medications so they don't become toxic to the kidneys. However, the investigators also point out that the revised formula may not be useful in the general pediatric population because the children they studied have reduced growth rates and delayed puberty.
"The relationship between estimated GFR and the biochemical markers may be different in this population than in a population with more normal kidney function and without poor skeletal growth," said Schwartz. "Although we did not observe that our formula changed with puberty, other populations with more normal physique and health status should be examined to evaluate the estimated GFR for adolescents."
Additional funding for the CKiD clinical trial was provided by NIH's National Institute of Neurological Disorders and Stroke; Eunice Kennedy Shriver National Institute of Child Health and Human Development; and National Heart, Lung, and Blood Institute.
For more information on the CKiD trial, visit
For more information on chronic kidney disease in children, go to
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This NIH News Release is available online at: http://www.nih.gov/news/health/jan2009/niddk-21.htm.
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Kidney Health Care News
Thursday, January 22, 2009 Article by: D.K. Mangusan Jr., PTRP
- Kidney Cancer Drug Approved by the FDA
- Losing Weight Helps Reduce Risk of Urinary Incontinence, Study Shows
- Measurement of Kidney Function in Children with Kidney Disease Improved
- Supplements Fail to Prevent Prostate Cancer
- Common Chronic Prostatitis Drug Not Effective in Reducing Symptoms
- Certain Bowel Cleansers and the Risk of Kidney Damage
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Talking to Your Doctor About Kidney Disease
Monday, January 19, 2009 Article by: D.K. Mangusan Jr., PTRP
- Do you have diabetes?
- Do you have high blood pressure?
- Did anyone in your family ever have kidney disease or kidney failure?
- Has a doctor ever told you that you had protein in your urine?
Some Tips On What To Ask Your Doctor Or Health Care Professional
- Based on my medical and family history, am I at risk for kidney disease?
- Would lowering my blood pressure help reduce my risk of developing kidney disease?
- Do my blood and urine tests show signs of kidney disease?
- How can I prevent or control kidney disease?
- Know as much as you can about your family's medical history.
- Write down the answers you get and ask more questions if you need to.
- Bring someone else with you for support and to help you remember what you learn.
- Control your blood pressure and diabetes.
- Ask your doctor or health care professional to test your blood and urine for kidney disease.
- If these tests show kidney disease, special medicines called ACE- Inhibitors or ARBs can help. Talk to your doctor about these medications.
Early kidney disease is a silent problem, like high blood pressure. Kidney disease can become kidney failure with little or no warning, and is usually discovered right before the kidneys fail.
If you have diabetes, high blood pressure, or a family member with kidney failure, a doctor or health care professional should test your blood and urine for early signs of kidney disease. You can take steps to keep your kidneys working if the tests show kidney disease.
Source: Adapted from the National Kidney Disease Education Program (NKDEP)
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Kidney Disease: Are You at Risk?
Monday, January 19, 2009 Article by: D.K. Mangusan Jr., PTRP
- Learn more about kidney disease, testing, and treatment
- Talking To Your Doctor About Kidney Disease
- Caring For Your Kidneys When You Have Diabetes
- Ways to Protect Your Kidneys
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Supplements Fail to Prevent Prostate Cancer
Tuesday, January 06, 2009 Article by: D.K. Mangusan Jr., PTRP
Previous studies had suggested that vitamin E or selenium supplements might reduce prostate cancer risk. Smaller studies also hinted that vitamin C might help to prevent prostate and other cancers.
NIH-funded researchers tested how prostate cancer and total cancer risk is affected by the dietary supplements. One research group recruited more than 35,000 men, age 50 and older, who had no evidence of prostate cancer. The men were randomly assigned to receive selenium, vitamin E, both or inactive placebo pills.
The study was cut short in late 2008, after an average follow-up of about 5.5 years. That’s because the supplements seemed to offer no cancer-related benefits.
The second trial looked at vitamin E and C supplements. More than 14,000 male doctors, age 50 or older, were randomly assigned to take either vitamin E, vitamin C, both or a placebo. After an average follow-up of about 8 years, neither vitamin—alone or in combination—significantly reduced the risk of prostate or other cancers compared to the placebo group.
Dietary supplements can often seem beneficial in small studies. The new studies highlight the fact that large, carefully controlled trials are needed to test whether they really live up to their hoped-for benefits.
Source: NIH News in Health (http://newsinhealth.nih.gov)
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