The original CKD-EPI and MDRD studies showed an association between African-American race with higher measured GFR at the same blood creatinine concentration. However, there have been concerns raised about the application of the race multiplier to all African-American patients. First, there is no clear biological explanation for the association, the identification of Black race was unclear in some of the cohorts used in these studies, and there is vast genetic and ancestral heterogeneity among those who self-identify as black. The use of the race multiplier also ignores the fact that race is a social, not biological construct.
We found that with the removal of the race multiplier, up to one in every three African-American patients would be reclassified as having a more severe stage of CKD, with one-quarter of African-American patients going from stage 3 to stage 4. We also found that with the removal of the race multiplier, 64 patients would have had an eGFR <20, the threshold for referral for kidney transplant, and none of these patients were referred, evaluated or waitlisted for transplant. This is in contrast, to those African-American patients with an eGFR <20 with the race multiplier applied, who had a higher odds of being referred, evaluated or waitlisted for transplant compared to other racial groups (Odds ratio of 2.28, compared to White cohort).(more…)
Around 8% of the population in America experiences sleep bruxism - a disorder characterized by teeth grinding and jaw clenching that leads to headaches, the wearing down of teeth, and jaw pain - to mention just a few effects. A new market research report called COVID-19 Impact on Sleeping Bruxism Treatment Market Overview and Forecast 2020 to 2026 has found that the current health crisis has led to a spike in bruxism. The report forecasts a big rise in the need for treatment of the effects of bruxism owing to currently high levels of stress across the globe.
Why Is Bruxism On The Rise?
It is a stressful time in many ways, and this increases the likelihood of teeth grinding and jaw clenching at night. A study published in the journal Head & Face Medicine showed that nightly gnashing of teeth was especially prevalent among those who tried to cope with stress by escaping from difficult situations. Bruxism can lead to everything from tooth sensitivity to pain in the muscles of the jaw responsible for chewing. While there are many exercises to soothe tight jaw muscles, this is just one approach that should be considered. Because bruxism can actually lead to tooth loss, it should be taken seriously, and if stress is the cause, then this separate issue should also be tackled proactively.