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Vol. LXV, No. 25
December 6, 2013

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NIH-Funded Study Finds Donor Age Not a Factor in Most Corneal Transplants

In a traditional corneal transplant, the central part of the cornea is removed and a donor cornea is sutured in its place.

In a traditional corneal transplant, the central part of the cornea is removed and a donor cornea is sutured in its place.

Photo: Dr. Edward Holland/ University of Cincinnati

Ten years after a transplant, a cornea from a 71-year-old donor is likely to remain as healthy as a cornea from a donor half that age, according to a study funded by NIH. Corneas from donors over age 71 perform slightly less well, but still remain healthy for the majority of transplant recipients after 10 years, the study found.

The Cornea Donor Study, funded by the National Eye Institute, found that 10-year success rates remained steady at 75 percent for corneal transplants from donors 34-71 years old. In the United States, three-fourths of cornea donors are within this age range and one-third of donors are at the upper end of the range, from 61-70 years old. When the study began in 2000, many surgeons would not accept corneas from donors over 65.

The study found that success rates were slightly higher for donors under 34, and somewhat lower for donors over 71. The results were published online in Ophthalmology, the journal of the American Academy of Ophthalmology, on Nov. 15.

Growth More Stunted in Lower-Income Youth With Kidney Disease

Even with more prescriptions for growth hormone, children and adolescents with chronic kidney disease were less likely to grow to normal height ranges if they came from lower-income families, according to research funded by NIH. Results from the Chronic Kidney Disease in Children (CKiD) Study are published in the December issue of the American Journal of Kidney Diseases.

Unlike findings from studies in adults, kidney disease progressed at similar rates across all income groups in CKiD. This came as a surprise to investigators, who expected faster kidney function decline with lower socioeconomic status (SES), as is found in adult CKD. Disease progression was defined by a decline in estimated glomerular filtration rate—a measure of kidney function.

CKiD, the largest study of children with CKD, is the first to study the effects of income on kidney disease progression and complications in this population. The current study examined growth failure, common in children with CKD, because the disease can interfere with the normal effect of a child’s own growth hormone.

“Since these lower SES children received higher proportions of prescriptions for growth hormone, it’s possible that these families are not filling all their prescriptions or are filling them but not sticking to their treatment regimen as closely as higher-income families are,” said Dr. Marva Moxey-Mims, a pediatric kidney specialist at the National Institute of Diabetes and Digestive and Kidney Diseases, the study’s primary funder. “Although there also could be other issues like nutrition or household finances contributing to this difference, the main lesson is that we may need to learn how to help families better follow treatment plans for their children with CKD.”

Survey Identifies Barriers to Effective Patient-Provider Dialogue About COPD

Lack of communication between patients and health care providers about chronic obstructive pulmonary disease (COPD) remains a major barrier to diagnosis of this disease, according to results of a web-based survey released Nov. 15 by the National Heart, Lung, and Blood Institute. More Americans, particularly smokers, are talking to their doctor or health care provider about the symptoms of COPD, which is an encouraging sign that awareness efforts are taking hold. Patients and providers, though, can still do more.

“A good conversation between patients and providers about COPD can make a real difference for disease sufferers. It’s no secret that early diagnosis and treatment can improve daily living for those who have COPD—but you can’t get there without an open line of dialogue in the exam room,” said Dr. James Kiley, director of NHLBI’s Division of Lung Diseases. “That’s why patients and providers need to be aware of COPD, its risk factors and symptoms, how it affects daily life and what can be done to help get them back to doing the things they love.”

COPD, which in 2010 surpassed stroke to become the third leading cause of death in the United States, is a serious lung disease that over time makes it harder to breathe. It affects an estimated 24 million Americans, but as many as half of those affected remain undiagnosed.

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