Archive for month: June, 2024

Despite prior uncertainty about its prognostic value in IgA nephropathy (IgAN), the findings suggest that time-averaged serum uric acid is an independent risk factor associated with IgAN progression.

Results showed that time-averaged serum uric acid levels were associated with triglyceride levels, renal function, complement component levels, and pathological severity, highlighting its potential value as a prognostic indicator in patients with IgA nephropathy.

IgA nephropathy, also known as Berger’s disease, is a chronic kidney condition characterized by the buildup of immunoglobulin A (IgA) deposits in the kidneys, leading to inflammation and impaired kidney function. Despite its widespread prevalence, identifying factors that influence disease progression and outcomes has remained a challenge until now.

Against the above background, Mengjie Weng, Department of Nephrology, Blood Purification Research Center, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian, China, and colleagues aimed to investigate the relevant factors affecting time-averaged SUA (TA-SUA) and to assess its prognostic value in IgAN.

For this purpose, the researchers conducted a retrospective study comprising 152 patients with IgAN. They analyzed the relationships between TA-SUA and clinicopathological features and renal outcomes (defined as the doubling of the baseline serum creatinine level or end-stage renal disease) in groups divided by quartiles of TA-SUA levels, the presence of hyperuricemia, and sex.

The study led to the following findings:

• Patients with high TA-SUA levels had higher levels of baseline SUA, blood urea nitrogen (BUN), triglycerides, serum C3, and serum C4, and were more likely to be male and have proteinuria, hypertension, poor renal function, and pathological injuries, including high grades of tubular atrophy/interstitial fibrosis (T1–T2). These patients had a poorer prognosis compared with patients with low TA-SUA levels.
• The TA-SUA level was positively correlated with baseline age and BUN, triglycerides, serum C3, and serum C4 levels and negatively correlated with baseline eGFR.
• Survival curve analysis indicated that persistent hyperuricemia was associated with significantly poorer renal outcomes than normo-uricemia in both men and women.
• The TA-SUA level was an independent predictor of renal outcome in patients with IgAN, with optimal cutoû values of 451.38 µmol/L (area under the curve (AUC) = 0.934) for men and 492.83 µmol/L (AUC = 0.768) for women.

The results showed that TA-SUA level is associated with serum TG, C3, and C4 levels, as well as renal function and the pathological severity of IgAN.

“According to our data, hyperuricemia significantly promotes IgAN progression, particularly in female patients, whereas its persistence in significant amounts is an independent risk factor for renal function loss in male and female patients,” the researchers wrote. “We recommend considering these findings in treatment planning and the design of prospective therapeutic trials.”

Reference:

Weng M, Fu B, Zhuo Y, Lin J, Zou Z, Chen Y, Cui J, Li G, Chen C, Xu Y, Jiang D, Wan J. 2024. Association of time-averaged serum uric acid level with clinicopathological information and long-term outcomes in patients with IgA nephropathy. PeerJ 12:e17266 https://doi.org/10.7717/peerj.17266

New Delhi: Union Health Secretary Apurva Chandra on Monday commends India’s role in the global health security agenda at the 77th World Health Assembly which agreed to the package of amendments to the International Health Regulations (IHR 2005) based on 300 proposals made by member countries after the COVID-19 pandemic.

“Finally, on 1st (June), the IHR was concluded, which was a big achievement… India’s contribution in that sense was good, getting the people together. Since we are respected by the global south and global north, I think we play a good mediatory role,” said Chandra, news agency ANI reported. 

The Union Health Secretary noted that these IHRs were first approved in 2005, and they are like international law, which all countries need to follow in terms of epidemics and pandemics.

After the COVID pandemic, some of the amendments were proposed, and over 300 amendments were proposed by various countries, he said, adding that, however, these discussions had been going on for the past two years and there was not a conclusion on what these amendments were to be approved and in what form.

“Simultaneously, there is also a pandemic treaty, specifically for vaccines, and how these things will take place in the case of a pandemic,” he added.

The Union Health Secretary emphasised that these two agreements were being negotiated by two different groups.

“…We discussed this with all the stakeholders, and we proposed that instead of two groups, let there be one group, one drafting group. And that proposal was moved by me, which was accepted by all the countries,” he said.

“Then those, that one group, burned the midnight oil. Our delegates also participated. Most of the day the meetings went on until midnight. One day it went on till 02:00 am also. And finally, on the last day, that is, at 11:00 pm, the IHR was concluded, which was a very big achievement. This has been discussed for more than two years. And finally, this was approved,” he emphasised.

Referring to the other treaty, Health Secretary Chandra said that it was decided that the pandemic treaty would be taken up in the next World Health Assembly.

India is now respected a lot at the World Health Summit, as it has provided health facilities to 220 crore people, he said.

“We were able to give it to people in just 6 months and our entire digital format was such that people have an idea about it, everyone respects it a lot and honours the way we did this work in India,” he said.

“That is why today everyone listens to us in the World Health Seminar, whether it is from the Global North or the Global South, and in the Global South, we have delivered Covaxin to so many countries, so we have a good reach there too,” Chandra added.

According to an ANI report, The targeted amendments to the International Health Regulations (IHR) aimed at improving countries’ ability to prepare for and respond to Public Health Emergencies of International Concern (PHEIC) and Pandemic Emergencies (PE).

They included provisions for facilitating equitable access to relevant health products during PHEIC and PE, as well as mobilising financial resources to support developing countries in building, strengthening, and maintaining the core capacities required under the IHR (2005).

The Working Group on International Health Regulations (WGIHR) and Intergovernmental Negotiating Body on Pandemic treaty with country representations began the negotiation process in two separate groups almost two years ago and met several times including many resumed sessions on the issue.

The processes witnessed many close calls with seeming deadlocks over positions taken by the various stakeholders.

To finalise the package of amendments to IHR, a proposal was put forward in the form of a White Paper by Chandra as Chair of Committee A of the World Health Assembly on May 28, 2024.

It proposed to establish a single drafting group, to be co-chaired by one Bureau member from the Intergovernmental Negotiating Body (INB) and the Working Group on Amendments to the International Health Regulations (2005) (WGIHR) respectively, to consider the matters related to some of the most critical agenda items – the proposed amendments to the IHR (2005), followed by consideration of procedural matters on way forward related to INB negotiations on the Pandemic treaty. The said proposal was approved by all member states by consensus.