The Maryland Commission on Kidney Disease has released it’s latest newsletter.  It is full of interesting information for patients and medical providers alike.  Dialysis units that received a citation free survey are also listed, and include both FMC Robinwood and the FMC Hagerstown (Oak Hill) facilities.  Congratulations!

Download the newsletter here, or from the Maryland Commission on Kidney Disease website.

Are you taking Zantac for reflux (GERD)? It is also known by its generic name, ranitidine. Ranitidine, in all forms, has been recalled by the FDA due to the potential to form carcinogens.

https://www.fda.gov/news-events/press-announcements/fda-requests-removal-all-ranitidine-products-zantac-market

What should you do if you are on ranitidine? Per the FDA, you should stop taking it and throw out any remaining medication.

Contact your physician for another recommendation. For many people, famotidine (Pepcid) would be a good substitute. This is available over the counter, is inexpensive, and is in the same class as ranitidine, but without the concern about carcinogen formation. The best alternative for any particular person may vary – please contact your physician.

You may have received a call from Meadow Kidney Care regarding your appointment recently.  With the spread of the novel coronavirus (COVID-19), we have all been taking steps to practice social distancing and limit the spread of this virus.

Governor Hogan of Maryland has released a number of executive orders to limit the spread, including earlier today, which closes most businesses.  As a medical office, we are not being closed by the order, but we are limiting our activities in accordance with the orders.  

All elective and non- urgent medical procedures and appointments shall cease effective at 5 p.m., Tuesday, March 24, 2020 and shall not be performed for the duration of the catastrophic health emergency.”

Many patients are seen in our Pennsylvania and West Viriginia orders.  While the above order does not apply to those offices, other states are taking similar precautions, and COVID-19 is present in Western Maryland, Franklin County, and the Eastern Panhandle of WV. 

What does this mean for you?  If you have an appointment at Meadow Kidney Care coming up in the next few days, you will likely get a call from our office staff.  Physicians are reviewing labs and charts in an attempt to get urgent issues in to be seen, while delaying stable patients. 

We can also do many appointments now with telehealth using Skype. Please let us know if you are interested in using this option. 

If you are called and asked to delay your appointment, but feel you have an urgent issue that needs to be addressed in person, please let us know. 

Our goal is to remain open and able to provide care for urgent issues while minimizing the number of people that are in the office at any one time, as well as the number of people who need to leave their homes. 

 

In light of the ongoing COVID-19 pandemic, the US government has changed the requirements for providing telehealth services. 

As a result, Meadow Kidney Care is now able to provide telehealth services to our existing office patients. Some of our more stable patients may be able to delay their office visits until circumstances stabilize.  Other patients may choose to take advantage of a video call using the Skype platform.  Instructions can be found our our Forms page or by clicking HERE

At this time, Dr. Yospin is ready to start using the Skype platform, and it should be available to other patients shortly. 

If you are unable to utilize a video call, an audio only call may be available to certain patients. 

Telehealth services may not be available to all patients or from all providers.  Please call the office if you are interested. 

By having some patients utilizing these services, it will help keep those patients at home and limit their exposure to others, but it will also limit the exposure of the patients that do need to be seen in the office by minimizing the number of patients in the waiting room at any one time. 

We appreciate the understanding and flexibility of our patients at this difficult time. 

 

 

At this time, all offices of Meadow Kidney Care remain open.  The dialysis units are currently taking extra precautions more stringent than those required in other settings.  Some of our offices waiting rooms and some common space with the dialysis facility. 

As a result, patients may be asked to follow these extra precautions.  This may include wearing a mask throughout the visit and the inability to have anybody with you in the waiting room/office. 

We apologize for any inconvenience, but this is an evolving situation and it will require adjustments from everyone until the situation stabilizes. 

I’m including this link below which is a well written comparison of novel coronavirus (2019-NCOV) and influenza.

As of this writing, there are no confirmed cases of 2019-NCOV in Maryland, West Virginia, or Pennsylvania.

The physicians at Meadow Kidney Care are keeping up to date on the developments and are working with the staff in the dialysis units in the event the virus becomes more widespread and is found in our area.

As stated in the article, it still isn’t too late to get your flu vaccine – it’s been a nasty flu season as well this year and flu activity is still high.

 

Diabetic kidney disease is the number one cause of end stage kidney disease in the United States.  It typically presents with protein in the urine.  Initially, the kidneys’ ability to filter is good, but with time, will deteriorate.  Ultimately, the kidneys fail, and many patients end up needing dialysis. 

Use of ACE inhibitors (lisinopril, benazapril, etc.) and ARBs (losartan, valsartan, etc.) have been the main tool to slow the progression of diabetic kidney disease.  These are blood pressure medications that also reduce the protein in the urine and slow the damage in the kidneys. 

Recent studies have shown a role for SGLT2 inhibitors. These are medications originally approved for diabetes – canagliflozin, dapagliflozin, empagliflozin, and ertugliflozin.  The CREDENCE trial was recently published.  This looked at the use of canagliflozin for diabetic kidney disease.  This showed a 34% reduction in the risk of “renal-specific composite of end-stage kidney disease, a doubling of the creatinine level, or death from renal causes.”    

This fall, the FDA added this indication to the canagliflozin label, and can be initiated in patients throughout stage CKD stage 3.  Additionally, patients can remain on this medication when they progress to CKD stage 4 – although it does need to be stopped if a patient is on dialysis. 

This is an exciting new option for treating diabetic kidney disease.  Like all medications, there are potential side effect.  In the next post, we will discuss some of the other benefits and potential side effects of this treatment option. 

Happy 2020! With the new year come new resolutions. Hopefully, everyone is thinking of ways to improve their kidney health. Here at Meadow Kidney Care, we are going to try to make this site a more useful place to find news and tips. Hopefully, information will be posted on a weekly basis – look for something new every Tuesday. Don’t forget to discuss your particular circumstances with your personal health care team.