About a decade ago, Debbie Kaschik checked into the hospital for an appendix removal. Not a pleasant experience, but she got rid of the problem and recovered without incident. However, Kaschik discovered that she had another health problem – one that she and millions of others face. A CT scan before the appendectomy showed cysts in her kidneys. Her family doctor immediately referred her to a nephrologist (kidney specialist) for an examination. The diagnosis: Autosomal dominant polycystic kidney disease (ADPKD). It is a genetic disorder that is passed on from only one parent and that produces fluid-filled sacs in the kidney. Over time, the sacs or cysts take up more space in the kidneys, enlarging and weakening them. The stress can lead to a variety of health problems, including kidney failure. Study participant Debbie Kaschik discovered her ADPKD after routine appendicectomy and participated in studies to find ways to slow the progression of ADPKD. Photo courtesy Debbie Kaschik. This all came as a surprise to Kaschik, now 56, who owns a group of preschools in suburban Houston and a clinic for children with autism. She hadn’t felt any symptoms, but immediately contacted her family to alert them to the need for genetic testing. It turned out that her mother and brother have ADPKD. All three are successfully treating their disease, despite the fact that their mother, who is now 80, had a kidney transplant seven years ago. That bad appendix turned out to be a good friend. “We were all asymptomatic,” she says. “Neither of us would have known if I hadn’t had the appendix removal.” A “quick” study on slowing the progression of ADPKDSince her diagnosis, Kaschik has participated in several ADPKD clinical trials, all at the University of Colorado – Anschutz Medical Campus. The latest is a small, randomized, annual study of the use of time-limited diets – the reduction of the hours people eat each day – as a way to slow the progression of ADPKD in overweight and obese individuals. It is led by Dr. Kristen Nowak, Associate Professor of Medicine in the Department of Kidney Disease and Hypertension at the University of Colorado School of Medicine. Nowak’s research focuses on how the body’s metabolism can help slow or promote the progression of ADPKD. All study participants receive information and advice on healthy eating habits, including group sessions led by registered dietitians with the Anschutz Health and Wellness Center. The study group that Kaschik is enrolled in also follows a fasting scheme that limits their food intake to an eight-hour window per day. Participants can eat whatever they want in this window, but they’ll document their entire intake over the seven-day periods with photos and timestamps of their meals, said Cortney Steele, a postdoctoral fellow working on the project under Nowak’s mentorship. Diet as a possible deterrent to cyst growthThe primary outcome of the study is simply whether participants stick to the eight-hour meal window, Nowak said. But beyond that, the study is part of a growing research group investigating the role of being overweight, obese, and belly fat in the progression of ADPKD – and, conversely, whether changes in diet and lifestyle could slow it down. Dr. Kristen Nowak is leading a new study on the use of time-limited diets to potentially slow the progression of ADPKD. Photo by UCHealth. “On the whole, we are examining whether temporary feeding is a viable nutritional approach,” said Nowak. If so, the pilot study could lead to a much larger study examining the biology of ADPKD. The work began a few years ago with studies on rodents suggesting that cell signaling in normal-weight animals is linked to kidney cyst growth – and that diet restrictions like fasting or restricting calories could curb this by changing the signals the body receives. Nowak co-authored a 2018 article that analyzed data from approximately 400 patients who participated in the HALT study Progression of Polycystic Kidney Disease. This study looked at ways to control blood pressure in patients with ADPKD; Nowak and her colleagues concluded from their analysis that “overweight and especially obesity are strongly and independently linked to the rate of progression in early-stage ADPKD”. She added that MRIs so far analyzed by a small number of the HALT study participants suggest that belly fat is another powerful predictor of cyst growth. The suspected metabolic link: cyst growth signals from the cells (adipocytes) that store the fat. Combating the financial and human costs of ADPKDIn addition to her own scientific curiosity, many factors drive Nowak’s work with ADPKD. It affects approximately 10 million people worldwide and is a lifelong disease with only one FDA-cleared treatment available only to those whose condition worsens rapidly, Nowak said. It is a leading cause of kidney failure, so dialysis or transplantation remain the only treatment options. It is estimated that ADPKD has direct and indirect costs of $ 7.3 billion annually in the United States alone. With all of this in mind, it is not surprising that many ADPKD patients and their caregivers are interested in a “dietary approach” to treating the disease, Nowak said. This is clearly reflected on the PKD Foundation’s website – the funder of Nowak’s current attempt – which has dozens of entries on nutrition and nutrition. For Debbie Kaschik, the decision to enroll in Nowak’s current trial was not a difficult one. She also participated in the HALT study and several others, including Nowak’s previous study, which looked at daily calorie restriction and intermittent fasting to slow cyst growth in ADPKD patients. This has been completed and the results will be published shortly, said Nowak. Kaschik’s main reasons for studying are close to home: her 19-year-old son, who has a 50-50 chance of developing ADPKD, and her brother’s three children. Neither of them have yet had a genetic test, but Kaschik wants to improve their chances of good health if they have the disease. “I would like [researchers] to find out if these kids get older and maybe find a cure, ”she said. “If they learn something from my volunteering, that’s great.” Lots of support for study participantsAs for the logistics of the process, Kaschik admitted that she was initially worried about the long fasting periods, but found that she quickly got used to everyday student life. Participants must have their first meal of the day within three hours of getting up. Kaschik said she was eating as late as possible within the three-hour window. This is usually around 11am. She can eat whatever she wants for eight hours, then she turns things off until the next day, aside from water and calorie-free drinks. (She said she drinks a lot of tea, but a nice new find was a no-calorie creamer for her coffee.) Kaschik said it was easy for her to complete other study requirements as well. She carries her cell phone to the table to take before-and-after photos of her food plates and beverage containers, along with note cards that she puts next to them for size comparison. She also regularly sends the study team her weight with a wireless scale and provides her blood pressure values along with blood samples from local providers. For the first month, Kaschik met weekly with her registered nutritionist Kristen Bing and two other study participants through Zoom. The meetings are now held monthly. Discussions follow a curriculum that focuses on topics such as managing food servings, identifying “triggers” for food cravings, and finding ways to eat healthy. Kaschik said she also appreciates trading experiences and ideas with her fellow students, both at the meetings and through regular email exchanges. She recently sent the group a photo of her calorie-free latte discovery. “That was helpful because we’re all in the same boat,” she said. “You have a team.” Take control of the progression of ADPKDThe study program could help her lose weight, but Kaschik said her main concern – besides knowing about ADPKD and protecting her family – is finding ways to keep her kidneys as healthy as possible. The study reinforces what she’s already doing, including checking her blood pressure and visiting her nephrologist every six months to monitor her kidney function. “I don’t do anything without his permission,” she added. “He is always aware of what I take and put in my body.” Nowak said she hopes her research will help “highlight the importance of studying diet and ADPKD and the burden placed on the health system and society”. Regardless of the results, people with ADPKD can use diet to play a stronger role in their own care. “For many patients it is attractive to look at lifestyle and meals as a way to slow down the time to dialysis,” said Nowak. “At least there are general health benefits.” For more information on the study, contact Diana George at 303-724-1684. Via https://dailyhealthynews.ca/can-fasting-slow-adpkd-progression/
0 Comments
Leave a Reply. |
About UsFind the latest news on food & diet, healthcare and healthy living on Daily Healthy News including wellness, fitness, diet and weight loss. |