Ryan MJ, Tuttle KR. Elevations in serum creatinine with RAAS blockade: Why isn't it a sign of kidney injury? Curr Opin Nephrol Hypertens 17:443-449,2008.
Steele C, Short RA. Centralized infant formula preparation room in the neonatal intensive care unit reduces incidence of microbial contamination. J Am Diet Asso. 2008; 108:1700-1703.
Katherine R. Tuttle, MD, Lynn A. Shuler, RN, MA, Diane P. Packard, MS, RD, Joan E. Milton, MS, RD, Kenn B. Daratha, PhD, Douglas M. Bibus, PhD, Robert A. Short, PhD
The American Journal of Cardiology
Volume 101, Issue 11, Pages 1523-1530 (1 June 2008)
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Chapter Author: Milton Joan E. "The RD as Part of the Health Care Team". In<u> Nutrition Essentials for the Home Care Dietitian.</u> Carolyn Yanosko (Ed.) Consultant Dietitians in Health Care Facilities a dietetic practice group of the American Dietetic Association, 2008.
Tuttle KR. Protein kinase C-beta inhibition for diabetic kidney disease. Diabetic Res & Clin Practice 13:S70-S74,2008.
Amid the rapidly rising number of people with diabetes worldwide, the prevalence of diabetic kidney disease (DKD) is expected to increase considerably despite available treatments. Consequently, novel therapeutic agents are urgently needed. Ruboxistaurin mesylate is a bisindolylmaleimide that specifically inhibits the β isoform of protein kinase C (PKC). In experimental models of DKD, ruboxistaurin normalized glomerular hyperfiltration, decreased urinary albumin excretion, preserved kidney function, and reduced mesangial expansion, glomerulosclerosis, and tubulointerstitial fibrosis. These beneficial effects of ruboxistaurin, both alone and combined with renin-angiotensin system inhibition, have been observed in a variety of experimental models of DKD. A phase 2 study of PKC-β inhibition in persons with type 2 diabetes and DKD already treated with angiotensin converting enzyme inhibition and/or angiotensin receptor blockade has been conducted. Addition of ruboxistaurin for 1 year reduced urinary albumin, prevented an increase in urinary transforming growth factor-β, and stabilized estimated glomerular filtration rate. Based on secondary analyses of clinical trials in patients with diabetic retinopathy or neuropathy, ruboxistaurin appears safe and may also prevent onset of DKD. PKC-β inhibition holds promise as a new strategy to improve kidney disease outcomes in diabetes. Large-scale clinical trials will be required to confirm safety and to validate prospective benefits of ruboxistaurin on relevant clinical endpoints in DKD.
Link to On Line Article
Tuttle KR and Nelson RG. The New KDOQITM guidelines for diabetes and chronic kidney disease(CKD). NKF Family Focus 16:14-15, 2008.
Nearly 21 million Americans have diabetes. Five to 10 percent of them have Type 1 diabetes, which develops because of the body's failure to make insulin. Most others have Type 2 diabetes, which develops because of the body's failure to properly use the insulin it makes.
It is predicted that the number of people with diabetes will increase 165 percent between 2000 and 2050, with the greatest increases occurring in people over 75 years of age and African Americans (1). Children are also increasingly affected by diabetes. Mostly, these increases are due to the alarming rise in obesity rates.