(HealthDay News) -- Remote ischemic preconditioning can reduce the rate of acute kidney injury among high-risk patients undergoing cardiac surgery, according to a study published online in the Journal of the American Medical Association. The research was published to coincide with the European Renal Association-European Dialysis and Transplant Association Congress.

Alexander Zarbock, M.D., from the University Hospital Münster in Germany, and colleagues conducted a randomized trial involving 240 patients at high risk for acute kidney injury who were undergoing cardiac surgery at 4 hospitals in Germany. Patients were randomized in a 1:1 ratio to receive remote ischemic preconditioning or sham remote ischemic preconditioning (control).

The researchers observed a significant reduction in acute kidney injury with remote ischemic preconditioning versus control (37.5 versus 52.5%; P = 0.02). Renal replacement therapy was received by fewer patients receiving remote ischemic preconditioning (5.8 versus 15.8%; P = 0.01). Furthermore, remote ischemic preconditioning correlated with a reduction in intensive care unit stay (3 versus 4 days; P = 0.04). 

Remote ischemic preconditioning had no significant effect on myocardial infarction, stroke, or mortality, but correlated with a significant attenuation in the release of urinary insulin-like growth factor-binding protein 7 and tissue inhibitor of metalloproteinase 2 after surgery (P < 0.001). There were no adverse events reported with remote ischemic preconditioning.

"The observed reduction in the rate of acute kidney injury and the need for renal replacement warrants further investigation," the authors write.

Two authors disclosed financial ties to the biotechnology industry; 2 authors reported filing a patent application on the use of biomarkers together with remote ischemic preconditioning.

Sources

1. Zarbock, A, et al. JAMA. 2015;313(21):2133-2141. doi:10.1001/jama.2015.4189.
2. Szu-Chin Pan, J, et al. JAMA. 2015;313(21):2124-2125. doi:10.1001/jama.2015.5085.

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With the rise in income levels of developing countries, disease profiles are shifting to include the higher prevalence of lifestyle-related diseases such as diabetes, which can have a strong causative correlation with renal disorders. Over the past decade, developing countries have demonstrated significant growth in the prevalence of diabetes and kidney disease. These emerging markets have a strong demand for renal care-related medical devices and services. Given the high prevalence of kidney disease such as chronic and end-stage renal disease, the availability of resources for meeting the demand is still inadequate, indicating a strong presence of untapped opportunities in the global renal care market.

Several developing countries worldwide have demonstrated strong growth in renal disease cases over the past few years. Growth in causative factors such as diabetes seems to go side-by-side for these countries.

Many of these countries have low imports of renal care devices, even though they have a high prevalence of kidney disease, signaling a lack of ample facilities to meet the demand for renal care.

The lack of healthcare facilities does not ensure growth potential. Governance effectiveness, in terms of converting healthcare spending to growth in healthcare infrastructure and workforce, indicates potential for growth in healthcare business.

Turkey and Chile are destinations with a high number of patients needing renal care and with strong government support towards boosting the healthcare scenario.

Both Turkey and Chile have a high demand for renal treatment from domestic patients. In addition, these locations are sought after destinations for medical tourism for various other forms of treatment.

Given the strong inflow of medical tourists in certain cities, along with the existing number of domestic patients needing renal care, these cities are the most lucrative locations for investment in renal care.

Key Topics Covered:

1. Why You Cannot Afford to Overlook Turkey and Chile for Opportunities in the Global Renal Care Market

2. Executive Summary

- Mega Trends to Micro Booms - Definitions and Tie-ins

- Emerging Market Innovations (EMI) - A Journey from Macro to Micro

- What Are Economic Insights - Micro Booms?

- Economic Insights - Micro Booms: What is the Structured Approach?

3. Introduction - Scope and Research Methodology

- Issue-based Brainstorming around Mega Trends and Emerging Markets

- Research Methodology

4. Business Insights

- Global Kidney Disease Scenario - Where Do We Stand?

- Growth in Diabetes versus Growth in ESRD in Developing Countries

- Renal Care Market - Synopsis: 2014

- Renal Care Market - Snapshot

5. Growth Insights

- Renal Market Potential - Import/Export Story

- Argentina - Healthcare Expenditure Growth versus Infrastructure Development

- Brazil - Healthcare Expenditure Growth versus Infrastructure Development

- Chile - Healthcare Expenditure Growth versus Infrastructure Development

- Turkey - Healthcare Expenditure Growth versus Infrastructure Development

- Healthcare Industry Growth Drivers - Heat Map: 2009 to 2014

- Reimbursement Trends

6. Profit Insights

7. A Sneak Peek at Renal Care Opportunities in Turkey

- Dialysis Equipment by Ownership

- Demand/Supply Gap for Kidney Transplants

- Population Distribution in Turkey

- Regional Concentration of Hospitals and Hospital Beds

- Opportunities of Medical Tourism in Turkey

- Turkey - Growth in Demand for Healthcare from Medical Tourists

- Important Dialysis Centers

- Hospitals by Ownership

8. Renal Care Opportunities - The Case of Chile

- Demand for Renal Care in Chile

- Population Distribution in Chile

- Medical Tourism in Chile

- Hospitals in Chile

9. Conclusion and Key Takeaway

10. Appendix

- Important Definitions

For more information visit http://www.researchandmarkets.com/research/48cpm8/why_you_cannot

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PAGO PAGO, American Samoa - American Samoa's only medical centre has temporarily closed its dialysis clinic after a voluntary recall by the manufacturer of a product used in the treatment of renal failure.

LBJ Medical Center CEO Taufete'e John Faumuina said hospital managers first learned of the recall of NaturaLyte Liquid Bicarbonate Concentrate from off-island supplier Fresenius Co. on Tuesday. They closed the clinic Wednesday morning, angering patients who showed up for their appointments only to discover a closure notice on the doors.

Faumuina has said an emergency shipment of the product is scheduled to arrive Friday afternoon on a weekly cargo flight from Honolulu.

Dialysis unit nurse manager Olita Tafiti said Thursday that the clinic will reopen at 1 a.m. Saturday and will stay open all weekend, with scheduled appointments resuming Monday. The hospital is hoping a Hawaiian Airlines flight from Honolulu on Monday will bring another shipment.

Until Saturday, there are no other options for dialysis patients on the U.S. territory about 2,300 miles south of Hawaii. American Samoa has a population of about 55,000.

Faumuina told lawmakers earlier this year that the clinic serves around 160 patients. During the closure, they are being told to follow diet and fluid restrictions, and to go to the hospital emergency room with any complications.

As of late Thursday morning, no one had checked into the ER because of health problems caused by the closure, according to emergency room nurses.

In an announcement on state-run television Wednesday night, Faumuina said the supplier requested the products be returned to the manufacturer, which was not identified.

"We have tried our best to check every unit (of the product) in our stock, but unfortunately every one of them falls under the category that has been cited to be returned," Faumuina said in the announcement.

At the clinic, a handful of elderly patients were upset that the closure notice was in English and not in their Samoan language. Patients had to ask hospital security guards for a Samoan translation.

The clinic also faces a shortage of dialysis machines and chairs, Faumuina has said.

A $1.8 million grant from the U.S. Department of Interior is funding an expansion at the clinic, with an additional 16 dialysis stations set to be completed this month. The expansion will bring the total number of dialysis stations to 35, according to a recently released local government report.

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