Researchers Create Nanoparticle for Treating Kidney Disease

Dr. Rex Mahnensmith serves as an internal medicine physician at the StayWell Health Center in Waterbury, Connecticut. Dr. Rex Mahnensmith comes to this position as the former clinical director of nephrology and the medical director of dialysis at the Yale Medical Group, where he cared for numerous patients with kidney disease.

Chronic kidney disease has traditionally been a difficult condition to treat. Conventional options have been limited to dialysis, kidney transplantation, or strong systemic medications, all of which are intensely demanding on the body. Recently, however, researchers at the University of Southern California have begun to explore the option of targeted drug delivery. 

The research team began by developing a nanoparticle known as a micelle. Created from a peptide chain that includes glutamic acids and lysine, it is 10 to 20 times smaller than the typical nanoparticle. Its size enables it to pass through the kidney filtration system, while the peptide component allows the kidneys to retain the particle instead of excreting it as waste. 

Retention of the nanoparticle by the kidneys is crucial, as it allows for the release of the drug at the site of the disease. This in turn minimizes side effects and may increase the likelihood that the drug will have its intended effects. 

In vivo testing has shown that when injected into mice, the nanoparticles concentrated in the kidneys and were safely expelled within a week. This promising result suggests that the method may be effective not only in treating disease but also in preserving other organs.

Five Life Habits That Make a Difference for Health and Survival

A graduate of Yale University School of Medicine, Dr. Rex Mahnensmith is a professor emeritus at the university, where he began teaching a clinical track more than 15 years ago. In addition, he leverages his training and experience to serve as internal medicine physician at StayWell Health Center in Waterbury, Connecticut. Also an author, Dr. Rex Mahnensmith has written a number of articles, including a piece titled Five Life Habits That Make A Difference for Health and Survival.

Public health researchers have published five habits that correlate to poor health: cigarette smoking, excessive alcohol consumption, inadequate exercise, obesity, and inadequate sleep. When it comes to the first habit, doctors recommend complete abstinence from tobacco, as toxic chemicals irritate respiratory tissues and can lead to various forms of cancer. Physicians also recommend abstinence from alcohol or consuming only moderately on occasion to avoid damage to the liver and other organs.

In terms of exercise, five days of rigorous exercise per week can help burn calories and strengthen the heart, in addition to improving circulation and reducing stress. Finally, doctors recommend maintaining a body mass index of less than 25 kg. of weight per square meter of height and getting at least seven hours of sleep per night.

Kidney Disease Causes and Risk Factors

Dr. Rex Mahnensmith stands out as the former clinical director of nephrology and medical director of dialysis for Yale Medical Group, which he served for more than 20 years. Now an internal medicine physician at the StayWell Health Center in Connecticut, Dr. Rex Mahnensmith brings an in-depth knowledge of kidney disease and its risks.

Approximately 33 percent of adults in the United States have an elevated risk of kidney disease. Patients with this condition experience a gradual decrease in the kidney's ability to filter excess fluid and waste products from the blood. As kidney function becomes severely impaired, the level of waste, fluid, and electrolytes can build up in the body to dangerous levels.

This condition typically develops in response to other conditions. Diabetes and high blood pressure are the most common root causes, but recurring kidney infections can also cause the kidneys to fail. Other causes include extended obstruction of the urinary tract, inflammation of the kidney's internal structures, and the presence of polycystic kidney disease.

Patients who have a family history of kidney disease are at higher risk of developing kidney disease. The condition is also more common in individuals of Hispanic, African-American, Asian, and Native American heritage.

Stages of Chronic Kidney Disease

As a physician and chief medical officer at the StayWell Health Center in Waterbury, Connecticut, Dr. Rex Mahnensmith draws on more than 40 years of clinical practice experience. Dr. Rex Mahnensmith served for 20 years as medical director of dialysis and clinical director of nephrology at the Yale Medical Group, through which he treated numerous patients with kidney disease.

The course of chronic kidney disease involves five stages, which differ based on the kidneys' level of function and the amount of protein in the urine. Clinicians determine the former by testing the glomerular filtration rate, or GFR, which is defined by the amount of blood that the nephrons of the kidney can filter per minute.

A person with mild symptoms of kidney disease but normal or better GFR (90 percent or greater kidney function) receives a classification of Stage 1, which suggests potential kidney damage but normal levels of kidney function. Stage 2 correlates with a reduced GFR and 89 to 60 percent kidney function.

As GFR drops and kidney function decreases, the patient progresses through Stages 3a, 3b, and 4. A patient with Stage 5 chronic kidney disease, also known as end-stage kidney disease, has complete or near-complete loss of function, to the degree that there is a dangerous accumulation of water and waste in the blood. This causes a variety of symptoms including headache, cognitive disturbances, digestive distress, and changes in skin color.

Patients who reach Stage 5 chronic kidney disease typically need intensive treatment in order to survive. This may take the form of dialysis or a kidney transplant.

Challenges to Post-Acute Care

Dr. Rex Mahnensmith is an internal medicine physician at StayWell Health Center in Waterbury, Connecticut. Over the course of his long career, Dr. Rex Mahnensmith has also served in emergency, outpatient, nephrology, and geriatric settings. While employed in skilled nursing facilities, Dr. Mahnensmith participated in post-acute rehab care. Skilled nursing facilities face several challenges in providing post-acute care to patients recently released from a hospital setting.

Many patients, upon release from the hospital, need post-acute care in a skilled nursing facility before they are able to return home. In these types of situations, additional care and rehab services are necessary. While an important part of a patient’s healing process, skilled nursing facilities face several challenges that revolve around coordination of care and conflicting orders and documentation.

In facing these difficulties, medical professionals are seeking greater coordination between general practitioners, hospitals, specialists, and other involved parties. Utilizing electronic health records can help with essential communication. In addition, emerging technologies such as tracking devices that can detect decline and medication adherence can help. 

By embracing solutions to the challenges of care coordination, the medical community at large will be able to reduce preventable readmissions, strengthen partnerships, and increase the quality of care that post-acute patients receive.

What Is Glucose Intolerance?

Internal medicine physician Dr. Rex Mahnensmith has specialized in primary care for more than three decades. Since 2015, Dr. Rex Mahnensmith has been providing full-time primary care at StayWell Health Center in Waterbury, Connecticut.

Glucose intolerance is a condition where the level of glucose in a person’s bloodstream rises above 140 mg or remains above 100 mg more than two hours after the ingestion of glucose. Normally, after eating, the blood glucose concentration rises from below 100 mg to about 110 or 120 mg. The glucose is then transferred into cells and tissues by insulin in approximately 60 to 90 minutes. It is then utilized by our organs as energy or stored as glycogen. 

In a case of glucose intolerance, however, the body does not handle the glucose intake in the normal time frame. Thus, the ingested glucose is not fully used up by the cells and tissues for energy. This condition occurs as a result of insufficient secretion of insulin or resistance to its action. While not diabetes mellitus, glucose intolerance can be regarded as a prediabetic condition and requires swift action and remedy.

Maintaining Hemostability during Renal Therapy

Yale-educated internal physician Dr. Rex Mahnensmith is an award-winning doctor at the StayWell Health Center in Waterbury, Connecticut. Dr. Rex Mahnensmith earned an ABIM Subspeciality Certification in Nephrology and has written several peer-reviewed papers on renal diseases and treatments. 

When determining the best course of treatment for kidney failure, nephrologists must balance between the duration of treatment and the level of hemostability maintained during treatment. To reduce hospitalization time for patients with chronic kidney disease, faster versions of intermittent rental therapy may be preferred. 

However, acute kidney injuries in critically ill patients often are treated with continuous renal replacement therapies (CRRT). CRRT filters blood at a slower rate than other rental therapies, making it ideal for patients who are more sensitive to large fluctuations in fluids. 

This type of hemodialysis is considered safer for patients with high risks of hypotension. CRRT was first pioneered in the 1990s and uses a series of tubes and membranes to pass blood through a hemofilter, removing excess water and waste. To meet the needs of hospitals and dialysis patients, smaller and more economical versions of CRRT are currently in development.