Johns Hopkins Gazette: April 7, 1997

In Brief
Medical News

New hope for sufferers of kidney disease

Ketoconazole, an antifungal drug, has been around for a long time. Now a study suggests that its use in treating three of four kinds of chronic kidney diseases may promote healing and delay the need for dialysis or a kidney transplant.

"Our findings are early but promising," said Mackenzie Walser, professor of pharmacology and molecular sciences and medicine at the School of Medicine. Walser, lead author of a study published in the April issue of the American Journal of Kidney Diseases, said that treatment with ketoconazole slowed the progress of kidney disease in patients with glomerular disease, interstitial nephritis and diabetic nephropathy. Ketoconazole accelerated polycystic kidney disease, however.

Researchers knew a decade ago that chronic kidney diseases progressed fastest in patients whose adrenal glands produced large amounts of cortisol, one of a group of hormones that control the body's use of nutrients and the excretion of salts and water in urine. They also knew that kidney disease progressed more slowly in patients who produced less cortisol. Ketoconazole was selected for kidney disease study because it had been shown to partially suppress the production of cortisol.

Some merchants still sell cigarettes to minors

Working "undercover" for a Hopkins study, boys and girls, ages 14 to 16, tried to buy cigarettes in 83 neighborhood stores in low-income parts of Baltimore City. They found that a high percentage of urban "mom and pop" merchants heavily advertised cigarettes and regularly sold them to teenagers.

The city teens bought cigarettes successfully in 86 percent of the stores where they shopped. Most of the stores that sold cigarettes to minors also had several cigarette poster ads in their windows.

"It's discouraging that so many merchants enhance sales by aggressively displaying seductive advertising that targets minors," said Carolyn C. Voorhees, assistant professor of medicine at the School of Medicine and lead author of a study published in the April issue of the American Journal of Public Health. "We've seen nothing to suggest that tobacco advertisers and merchants have done anything of late to stop these dangerous and illegal sales."

The study was conducted in 1994. In February 1996, the U.S. Food and Drug Administration made it illegal to sell cigarettes to children under the age of 18. Using "undercover" minors to test compliance with the law is now illegal in Maryland.

Kidney disease treatment in children varies by race

An analysis of data on more than 1,400 children treated for kidney disease has shown that African American children with end-stage renal disease were 2.5 times more likely than white children to receive cumbersome and time-consuming hemodialysis rather than peritoneal dialysis, a simpler treatment now considered optimal.

Hemodialysis, which requires several hours and complicated equipment, uses a filter to remove, clean and replace the blood of kidney disease patients whose kidneys are not properly cleansing wastes from the blood. Peritoneal dialysis filters blood through a cleansing solution that is introduced into the abdomen by a catheter. According to researchers, peritoneal dialysis can be done in the home, requires no special equipment and requires minimal supervision. Peritoneal dialysis has been associated with better growth and improved metabolic control, better school attendance, better psychosocial coping skills and less depression.

"We need to understand why such a wide disparity in treatment occurs," said Susan L. Furth, an instructor in the Division of Pediatric Nephrology who, along with colleagues in the Johns Hopkins Children's Center, analyzed data from the 1990 Medicare end-stage renal disease registry. "Possible explanations include cultural differences in attitudes or preferences for one treatment, or racial differences in access to care," Furth said.

The results are published in the April issue of Pediatrics.

Other News

APL wants to expand, add new office buildings

The Applied Physics Laboratory has filed with the Howard County Department of Planning and Zoning for a site development permit to install four modular office buildings and to build onto several existing buildings at its Laurel, Md., site. If granted, APL's construction request will add 75,000 square feet of office and lab space to its existing 1.5 million square feet of space on a 365-acre campus.

With the county's approval, four leased, temporary modular buildings will go up in June, and construction to add a fourth floor to an existing building will start in August for completion at the end of 1998. Construction on a new two-story office building, to be known as building 26, will commence during the winter for completion by the end of 1999.

The Johns Hopkins Trustees Committee on the Applied Physics Laboratory approved the approximately $11.8 million building program on Feb. 24.

April staff recognition receptions scheduled

Eight separate receptions will be held to present awards to Hopkins staff with five, 10 and 15 years of service. Five-year awardees will receive a personalized certificate embossed with a gold Hopkins seal in a blue presentation folder, while 10-year recipients will receive an etched Gorham crystal paperweight. Staff with 15 years of service will receive a Regency arch clock with a jewelry crest of the Hopkins seal. The awards scheduled for April are:

School of Medicine, April 9, 3 to 5 p.m., Turner Concourse

Homewood, April 17, 3 to 5 p.m., Glass Pavilion

School of Hygiene and Public Health, April 18, 3 to 5 p.m., Atrium

Receptions for staff from SAIS, the School of Nursing, the Milton S. Eisenhower Library, the Press and JHPIEGO will be scheduled for May and June.

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