End Stage Kidney Disease: Decoding How Patients Decide to Forgo Dialysis

MedicalResearch.com Interview with:

Susan P. Y. Wong, MD MS Assistant Professor Division of Nephrology University of Washington VA Puget Sound Health Care System 

Dr. Wong

Susan P. Y. Wong, MD MS
Assistant Professor
Division of Nephrology
University of Washington
VA Puget Sound Health Care System 

MedicalResearch.com: What is the background for this study?

Response: Patients who reach the advanced stages of kidney disease  must often face the difficult decision of whether to undergo maintenance dialysis.

While maintenance dialysis is a remarkable therapy that has extended the lives of many patients, its benefits do not necessarily accrue in older patients with significant comorbidity and functional impairment. It is also a very demanding form of therapy that comes with its own burdens and complications. Based on our prior research in the national VA health system, 1 in 7 patients with very advanced kidney disease (or their decision makers) do not pursue dialysis. We wanted to understand how these decisions to forgo initiation of maintenance dialysis unfold.

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Strong Genetic Component to Psychotic-Like Experiences with Cannabis

MedicalResearch.com Interview with:
Dr. Nicole Karcher, PhD
Post-doctoral scholar with the NIMH Training in Clinical Sciences fellowship
Department of Psychiatry
Washington University School of Medicine  

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: For over fifteen years, researchers have debated the role that cannabis use plays in the development of both psychotic disorders as well as subthreshold psychotic symptoms, such as psychotic-like experiences (PLEs). There is still a lack of consensus regarding the nature of the association between cannabis use and psychosis risk, with some research finding evidence for genetic overlap, while other research finds evidence for potentially causal pathways.

The current study examined data from twins and siblings from two different samples, the U.S.-based Human Connectome Project and the Australian Twin Registry, with a total of 4,674 participants. Overall, psychotic-like experiences were associated with three separate cannabis use variables [frequent (≥100 times) use, a Cannabis Use Disorder diagnosis, and current cannabis use]. Furthermore, the current research found evidence for both shared genetic and individual-specific contributions to the association between PLEs and these three cannabis use variables. More specifically, while the association between cannabis use and psychotic-like experiences was largely attributable to shared genetic factors, cannabis users were more likely to endorse PLEs in comparison to the relative who used cannabis less.  Continue reading