National Pharmaceutical Returns, Inc. Achieves NABP-Drug Distributor Accreditation for 12th Straight Year

Reverse Distributor

Pharmaceutical Reverse Distributor

National Pharmaceutical Returns, Inc. is proud to have maintained the National Association of Boards of Pharmacy (NABP) Drug Distributor Accreditation.

URBANDALE, IOWA, USA, June 6, 2020 / — National Pharmaceutical Returns, Inc. is proud to have maintained the National Association of Boards of Pharmacy (NABP) Drug Distributor Accreditation, formerly known as Verified-Accredited Wholesale Distributors® (VAWD®), since 2009. NABP’s Drug Distributor Accreditation is for facilities engaged in the act of wholesale drug distribution and operated by the National Association of Boards of Pharmacy, assuring that national standards for our industry are consistently followed.

To obtain the NABP Drug Distributor Accreditation, NPR underwent a criteria compliance review, which included a rigorous review of our policies and procedures, licensure verification and survey of our facility’s site.

NPR is licensed by the DEA to accept and process schedule I-V products and NPR’s Drug Distributor Accreditation plays a pivotal role in helping remove unusable pharmaceuticals from the drug supply chain. It helps protect the public from drugs that have been contaminated, diverted, or counterfeited. The U.S. supply of prescription drugs is produced and delivered to patients via a complex path, and this accreditation helps ensure that a reverse distribution facility operates legitimately, is licensed, in good standing, and is employing security and best practices for safely removing these pharmaceuticals from the supply chain.

About National Pharmaceutical Returns:
National Pharmaceutical Returns (NPR) is a full-service reverse distributor of pharmaceuticals. NPR helps take expired, unwanted or recalled product and ship it back to the manufacturer for a refund. NPR team helps its customers with everything from inventory to keeping up with ever-changing regulations that govern the industry. NPR has the knowledge, expertise and resources to streamline your return and refund process.

NPR is the national leader in pharmaceutical returns and has pioneered many of the practices that currently keep us on top of the industry. The company was established in 1995 by Amber Hollar and is 100% women-owned. Amber and her team have decades of experience in the returns business and have the knowledge to help any company navigate the regulations governing the industry.

Reverse pharmaceutical distribution is a highly-regulated industry, and NPR works diligently to address our environmental responsibility and the safety of our employees. NPR complies with all local, state and federal environmental laws and implement required programs to continuously improve our processes.

NPR is committed to ensuring that all waste is handled in an environmentally sound manner, to protect our employees and the community. National Pharmaceutical Returns is well versed in all applicable regulatory agencies rules (DEA, DOT, EPA, OSHA, FDA, State Pharmacy Boards, State Environmental Boards). Please contact Steven Sandon at (800) 470-7725 or visit our website at if you have questions about NPR products and services or our environmental practices.

Steve Sandon
National Pharmaceutical Returns, Inc.
+1 8004707725
email us here

Source: EIN Presswire

SoLo GI Nutrition Takes on Pandemic Through Prevention

SoLo GI Nutrition Takes on Pandemic Through Prevention

SoLo GI Nutrition Takes on Pandemic Through Prevention

Saul Katz, SoLo GI Nutrition Founder and his family, Ariel Katz, Genoa Katz and Elia Katz

Saul Katz and family, Ariel Katz, Genoa Katz and Elia Katz

With COVID-19 threatening an already vulnerable population, Katz has rolled up his sleeves in the test kitchen and is excited to drive change in the way we eat.

Diabesity is preventable. This is one pandemic that is within our control!”

— Saul Katz

KELOWNA, BC, CANADA, June 6, 2020 / — COVID-19 has created new impetus for the battle against Diabesity. The need to resolve the interlinked epidemics of diabetes and obesity, which the WHO calls the 21st Century Plague, is more dire than ever. COVID-19 is opportunistically exploiting an underlying susceptibility of those living with these chronic health conditions. According to the CDC, and as reported in a study published in the Journal of the American Medical Association (April 22, 2020), comorbidity resulting from hypertension (56.6%), obesity (41.7%) and diabetes (33.8%) increase the risk of infection and serious outcomes from COVID-19 including invasive medical ventilation, kidney replacement and death.

The post COVID-19 world will result in shifting priorities and new adaptations. COVID-19 has increased the stakes at all levels, requiring a consolidated effort by individuals, health professionals and politicians to tackle Diabesity at its source. While we currently lack the tools to combat COVID-19, we do have the knowledge and opportunity to win the battle against diabetes and obesity.

Diabesity is accelerating worldwide in tandem with the adoption of the modern fast food diet and lifestyle. The WHO estimates that the number of adults living with diabetes worldwide has quadrupled since 1980, moving from 108 million in 1980 to 422 million in 2014. In North America 1 in 3 children are projected to develop diabetes during their lifetime, 70 percent of the population is overweight or obese, 9 out of 10 who are living with diabetes are also obese, and 95% of those diagnosed with diabetes are type 2, they are not born with it.

The Lancet 2015 obesity series identifies the international food system as the principal driver of the global obesity epidemic. Modernization and rising incomes have made way for the globalization of unhealthy foods and beverages and the switch from active to sedentary lifestyles. The prevalence of obesity as a precursor to diabetes, is highest among lower-income groups, who often live in urban areas littered with fast-food outlets serving up calorie-dense, nutrient-void foods. Driven by economics rather than health, grab-and-go products have become the new global food staple.

Diabesity is accelerating with the increase of convenience foods developed for an on-the-go society. To sweeten and bind these foods, grains are milled into fine powders and syrups. These highly refined (high-glycemic index) fast-releasing carbs are effectively “predigested” through the milling process, leaving very little work for the body to convert them to glucose, perpetuating a cycle known as the “spike, crash and crave”. In contrast, the carbs our ancestors ate such as roots and bark, were high in fibre and low in starch making them slow-digesting and slow releasing (low glycemic index).

Saul Katz, Founder of SoLo GI Nutrition, is promoting a consumer shift to consider the blood sugar impact, equal to nutritional content, when selecting a food or beverage. “High glycemic foods cause us to use more insulin, to store more fat, for starvation periods that never come. Science has shown us that blood sugar management is key to managing weight, sustaining energy and preventing disease.” Katz continued, “We established SoLo GI to slow and reduce the interlinked epidemics of diabetes and obesity through education and the development of low glycemic alternatives to the blood-sugar-spiking products driving Diabesity”.

With COVID-19 threatening an already vulnerable population, Katz has rolled up his sleeves in the test kitchen and is excited to announce his commitment to expand the range of SoLo Low Glycemic Index products including beverages, breakfast foods and pastas.

Diabesity is preventable. This is one pandemic that is within our control!

Saul Katz, B.A., LL.L, LL.B
Founder of SoLo GI Nutrition
2019 Top 100 Health Influencers in Canada

Ioanna Wilde
Solo Nutrition
+ +1 250-491-1720
email us here

Source: EIN Presswire

Robert Bailey UC Berkeley Responds to the Corona Virus Outbreak

Robert Bailey UC Berkeley

Robert Bailey UC Berkeley

BERKELEY, CA, USA, June 5, 2020 / — Years in Singapore gives him a unique perspective on the culture surrounding the virus

Robert Bailey UC Berkeley former director of admissions is very familiar with Southeast Asia. Before coming to Berkeley he spent many years traveling in Southeast Asia and had many trips to China.

It is believed the Coronavirus that is currently infesting every nation in the world, began in Wuhan. Robert Bailey UC Berkely believes the popularity of exotic meat in the Wuhan area may have been the breeding ground for the virus.

"It (Coronavirus) was first discovered in a local wholesale food market," Robert Bailey said.

Wuhan was also the starting point of the SARS epidemic that started in 2003. This was two years after Robert Bailey UC Berkeley had left Singapore to begin working in British Columbia, Canada.

Robert Bailey UC Berkeley has been an administrator all over the world and has long been interested in making college registration efficient and easy for students.

Wuhan is a historic city that has a 350-year-old Guiyuan Temple and a pagoda-like yellow crane tower. But Robert Bailey notes that it is also an important education city as well. It has53 universities, and the largest one, Wuhan University, has 60,000 students.

While the virus has faded some in China, Robert Bailey UC Berkeley is interested in how those universities will make the needed transition to electronic record keeping.

“How does a city that large, and that old, dating back as far as 1460 BC, keep their records, and move them into 2020?” he asks, somewhat rhetorically.
Robert Bailey UC Berkeley's former registrar would naturally be interested in that question as he has more than 20 years of experience in records management. That experience has involved innovation that has followed Robert Bailey UC Berkeley through the years.

While director of Registration at the University of Oklahoma he identified a single site for registration. Thie eliminated long lines during registration which was the traditional method at the time. In addition, he was able to implement a system that cut grading and reporting time for instructors, which allowed students to get their grades and reports faster.

Robert Bailey UC Berkeley former director was also in Singapore for eight years doing similar work.

"I served as the dean of American College, the vice president for records at Transnational, and as a senior lecturer for Temasek Polytechnic in its information studies program,” said Robert Bailey UC Berkeley former registrar and director of admissions,
While stationed in Singapore he went to 33 countries and made many trips into China, but Robert Bailey UC Berkeley said he does not remember hearing much about the city at that time.

“Now,” Robert Bailey UC Berkeley former director said, “Wuhan is in the news worldwide; the historical city has become ground zero of the new coronavirus outbreak.”

He would like to go there at some point in the future, and he still has some connections in Singapore that could help him make that happen. Robert Bailey UC Berkeley said he would wait until the medical crisis settles down before making such a trip.

Caroline Hunter
Web Presence, LLC
+1 786-233-8220
email us here

Robert Bailey UC Berkeley

Source: EIN Presswire

Vibe Announces First Annual “Community Vibes” Event Sunday, June 7th, 2020 11am-5pm • 455 Capital Mall • Sacramento, CA

First Annual “Community Vibes” Event Sunday, June 7th, 2020 11am-5pm
455 Capital Mall, Sacramento, CA”

— Vibe By California

SACRAMENTO, CALIFORNIA, USA, June 5, 2020 / — Vibe Bioscience Ltd. (CSE:VIBE)(OTC:VBSCF) (the “Company” or “Vibe”), a Sacramento based, vertically integrated cannabis retailer and marijuana cultivator is organizing a pop-up initiative in downtown Sacramento where its employees are pitching in to assist with clean-up efforts in the community, and providing supplies to assist with rebuilding.

The pop-up initiative is looking for volunteers to assist with the clean up of damages to downtown. Along with spreading good vibes to allow the community to heal together. The “Community Vibes” event, hosted by Vibe, will be held as below:

Location: 455 Capital Mall, Sacramento, CA
Date: Sunday, June 7th, 2020
Time: 11:00 am – 5:00 pm
Details: Instagram @vibebycalifornia

Volunteers are encouraged to bring snacks, water, garbage bags, hand sanitizer and basic tools to assist with clean up tasks. Follow Vibe by California on Instagram to keep up with community events at for updates on Community Vibes and other initiatives. Volunteers looking to provide support or those interested in performing, please email Katie at Drewskis Food Trucks will be onsite and refreshments will be provided courtesy of Vibe and thanks to the generous donations from our partners: Ember Valley, Moxie, Matt’s High Soda, Nectr and more to come.

About Vibe Bioscience Ltd.
Vibe is a vertically integrated cannabis company delivering exceptional retail experiences with its Vibe by California brand and ethos, premier cultivation product and high-efficiency delivery, and online sales. The Company’s management team brings expertise in retail, cannabis cultivation and mergers and acquisitions to support its U.S. expansion through accretive acquisitions and organic growth. For more information, please visit
Forward-Looking Information

This press release does not constitute an offer to sell or a solicitation of an offer to buy any of the securities in the United States. The securities have not been and will not be registered under the United States Securities Act of 1933, as amended (the “U.S. Securities Act”) or any State securities laws and may not be offered or sold within the United States or to U.S. Persons unless registered under the U.S. Securities Act and applicable State securities laws or an exemption from such registration is available. Not for distribution to U.S. Newswire Services or for dissemination in the United States. Any failure to comply with this restriction may constitute a violation of U.S. securities laws.

Unlike in Canada which has Federal legislation uniformly governing the cultivation, distribution, sale and possession of medical cannabis under the Cannabis Act (Federal), readers are cautioned that in the U.S., cannabis is largely regulated at the State level. To the knowledge of Vibe Bioscience Ltd., there are to date a total of 33 states, plus the District of Columbia, that have legalized cannabis in some form. Notwithstanding the permissive regulatory environment of medical cannabis at the State level, cannabis continues to be categorized as a controlled substance under the Controlled Substances Act in the U.S. and as such, cannabis-related practices or activities, including without limitation, the manufacture, importation, possession, use or distribution of cannabis are illegal under U.S. Federal law. Strict compliance with State laws with respect to cannabis will neither absolve Vibe Bioscience Ltd. of liability under the U.S. Federal law, nor will it provide a defense to any Federal proceeding, which may be brought against Vibe Bioscience Ltd. Any such proceedings brought against Vibe Bioscience Ltd. may adversely affect its operations and financial performance.

Contact Information
Company Contact:
Mark Waldron, CEO
Phone: +1 833-420-VIBE

Investor Relations Contact:
Glen Nelson
Phone: +1 833-420-VIBE x 107

Michal Holub
Vibe Bioscience Ltd.
+1 833-420-8423
email us here

Source: EIN Presswire

Nathan Heddleston “Teacher” and USTFCCCA Coach of the Year Discusses the Impact of Track and Field on Troubled Youth

Nate Heddleston Teacher

Nate Heddleston

ALLIANCE, OHIO, USA, June 5, 2020 / — Nathan Heddleston “teacher” and three-time USTFCCCA Coach of the Year has a passion for track and field.

“Running has changed my life – taught me discipline and patience and endurance. It’s like therapy,” enthuses Nathan Heddleston “teacher” and coach. “And it’s not just me – this sport has an impact on everyone who joins it.”

This may be especially true of young people who suffer from misplaced aggression and other troubled youth. “Some of these kids don’t have the support they need at home, so they lash out. There’s nowhere else to put those negative feelings,” explains Nathan Heddleston “teacher” and former coach of 18 years. “But track and field can have such a positive effect. The benefits are tangible within weeks.”

Nathan Heddleston “Teacher”, Says Track and Field Improves Ability to Deal with Anxiety

Exercising releases dopamine and other stress-fighting chemicals into the body. It also creates new neuron pathways in the area of the brain that deal with anxiety. “The track is a place to leave your problems behind and just be in your body,” says Nathan Heddleston “teacher” and coach. “Having an outlet for whatever stress they’re dealing with helps them relax, communicate more easily, and really focus on just themselves for once.”

Better Decision Making As a Result of Track and Field Finds Nathan Heddleston “Teacher” and Coach

Nathan Heddleston “teacher” and former award-winning track and field coach comments,

“It’s hard enough being a teenager without family problems, bullying, or mental health issues adding to the load.” Studies have found that challenging workouts, like those in track and field, increase BDFN levels in the brain. Brain-derived neurotrophic factor (BDFN) is a protein that aids decision making.
“If we can help them make better decisions, we can change their outcomes. It’s so important to consider the impact of physical health and movement when we’re dealing with at-risk youth,” urges Nathan Heddleston “teacher” and advocate for youth sports.

Nathan Heddleston Teacher and Youth Sports Advocate Sees Increased Learning Capacity

People who exercise regularly have, in general, greater volume in their prefrontal cortex–the prefrontal cortex aids thinking, memory, and other aspects that affect learning. Studies have also found that working out for 30 minutes a day, three times a week can keep your mind active longer and helps your brain function better overall.

“I can’t tell you how many teachers comment on the difference they see in their problem kids after they join track and field – or any other sport. There’s something about physical activity that helps clear the mind and focus the energy,” shares Nathan Heddleston “teacher” and running enthusiast. “It’s amazing and inspiring to watch someone change their life and improve themselves through a newfound passion.”

Caroline Hunter
Web Presence, LLC
+1 786-233-8220
email us here

Nathan Heddleston Teacher

Source: EIN Presswire

Nitro Pinball Partners with Variety – The Children’s Charity to Provide Covid-19 Masks


Nitro Pinball Partners with The Children’s Charity to Supply COVID19 Masks

Nitro Pinball has partnered with Variety – The Children’s Charity to produce Covid-19 masks with proceeds donated to Variety’s “COVID-19 Heart of Variety Fund”.

ABBOTSFORD, BRITISH COLUMBIA , CANADA, June 5, 2020 / — Nitro Pinball is pleased to announce a new partnership with Variety – the Children’s Charity. Nitro Pinball will be making their COVID-19 masks and selling them on their website, with all proceeds being donated directly to Variety – The Children’s Charity’s fund “COVID-19 Heart of Variety Fund”.

Established in 2012, Nitro Pinball is Canada’s most diverse pinball distributor with a decorated reputation of supporting the pinball community and communities throughout Western Canada. Their number one priority at the moment is supplying customers with a safe space to view machines, while providing competitive pricing and essential after-purchase support.

Variety – The Children’s Charity is a nonprofit organization that provides direct help to children with special needs in British Columbia.

At this time, Nitro Pinball is selling their COVID-19 masks on their website and in store for pickup only.

“We are proud to do our part and help our communities stay safe and to support Variety – The Children’s Charity,” says Tommy Floyd, co-founder of Nitro Pinball.

During this time, Nitro Pinball’s outstanding showroom is open by appointment only and clients are able to schedule a visit by signing up on Nitro Pinball’s website.

For more information, to schedule a visit, or to purchase a mask, please visit

About Nitro Pinball

Tommy and Suzanne Floyd launched Nitro Pinball in 2012. With the best selection in modern era pinball machines from major manufacturers and cutting-edge boutique companies, Nitro quickly became Canada’s leading pinball distributor. Nitro Pinball expanded operations from a small storefront in Mission, British Columbia to a fully staffed office and warehouse facility in Abbotsford in early 2017. In 2018, the company launched Nitro Pinball USA to better serve their American customers.

About Variety – the Children’s Charity

For more than 50 years, Variety – the Children’s Charity has been stepping in where health care ends, providing direct help to children with special needs in BC. The organization ensures that children have the support to reach their potential and thrive. Since 2010 alone, Variety has distributed more than $33 million in funding to families and organizations in communities across the BC.

To learn more, visit

Tommy Floyd
Nitro Pinball
+1 855-366-4876
email us here

Source: EIN Presswire

Joyous Montessori Speaks About the Importance of Proper Childhood Development and Socialization


Joyous Montessori featured in exclusive online interview.

In a recent interview, the founder of Joyous Montessori, Vandana Semwal, shared the vision of the school and the lengths it takes to educate students

KELLER, TEXAS, UNITED STATES, June 5, 2020 / — The founder and owner of Joyous Montessori, Vandana Semwal, recently spoke on behalf of the school in an interview with Thrive Global. She shared various insights as well as the importance of proper childhood development and socialization.

Following the Montessori philosophy, Joyous Montessori provides children with valuable early education. Each location is independently owned and operated. Locations have trained and certified staff members that are passionate about children and focus on quality care.

In the interview, Vandana Semwal shared how Joyous Montessori has supported staff members throughout the COVID-19 pandemic.

“Employees are the most important component for any business to succeed, care for your employees and they will help you grow,” said Mrs. Semwal.

“We did not let go any employee during the COVID-19 virus situation despite the low attendance of children in the school.”

She also shared how Joyous Montessori is working to make the world a better place through education.

“Children of today will be the leaders of tomorrow and we are doing our part by giving them a good education so that they become responsible citizens of the world,” she said.

For more information, please visit

About Joyous Montessori

Joyous Montessori is a unique school that provides children with early education based on the Montessori philosophy. The school currently has locations in Keller, Lewisville, and Fort Worth, Texas. Each location is independently owned and operated and has trained and certified staff members that are passionate about children and focus on quality care. Joyous Montessori strives to motivate each child to explore his or her full potential with quality materials and curriculum as well as an extensive enrichment program that addresses the children’s emotional, physical, and social needs. The organization envisions growing and expanding to partner with like-minded families and professionals who are passionate about children and love to make a difference in their lives through wholesome education.

Vandana Semwal
Joyous Montessori
+1 817-431-6661
email us here

Source: EIN Presswire

Acute kidney injury and end stage kidney disease in severe COVID-19

Kidney involvement seems to be frequent in COVID-19 patients and might have prognostic value

PARMA, ITALY, June 5, 2020 / — Germany was not hit as hard by the SARS-CoV-2 pandemic as many other European countries. The reason for this is that the wave of infection reached Germany later, that the authorities were warned by the situation in Italy and Spain and at an early stage ordered a lockdown and conducted extensive testing. Up to June 2, 2020, there were 182,028 cases of COVID-19 and 8,522 deaths. As in other countries, dialysis patients were at high risk, due to the fact that they often are of older age, have more comorbidities and, of course, suffer from an impaired immune system. A practical problem which adds to the risk is that they cannot stop their treatment and they have to go to a dialysis unit 3 times a week, this means: strict home isolation is not possible for these patients at risk.

A registry has been created in Germany to investigate the prevalence and outcome of SARS-CoV-2 infected dialysis patients. By the end of May, about 2% of the registered dialysis patients (about 300 people out of 14,000) had been tested positive for SARS-CoV-2, and, as it turned out, these patients had a poor prognosis: The mortality rate was around 20%. Phase 2 of the Registry will also include patients with acute kidney injury and chronic kidney disease, and will investigate outcomes and prognostic factors.

However, not only are patients with kidney disease at a higher risk of becoming infected with the coronavirus and have a more severe course of COVID-19 – data also suggest, that the kidneys might be a target organ of this viral disease.

Early data from China on COVID-19 included some startling revelations: Kidney involvement seems to be frequent in people who have been tested positive and have developed symptoms. A consecutive cohort study [1] of COVID-19 patients admitted in a tertiary teaching hospital with 3 branches following a major outbreak in Wuhan in 2020 analysed hematuria, proteinuria, serum creatinine concentration and other clinical parameters as well as the incidence rate for acute kidney injury (AKI). On admission, 44% of the patients had proteinuria and 26.7% had hematuria. AKI occurred in 5.1% patients. After adjustment for confounders, all kidney impairment indicators were associated with higher risk of in-hospital death. The authors recommended already in February that clinicians should increase their awareness of kidney impairment in hospitalized COVID-19 patients.

Indeed, one other study [2] showed that the incidence of AKI is significantly increased among hospitalized patients: Of 4259 patients not requiring mechanical ventilation, 925 had AKI (any stage) and nine needed kidney replacement therapy. The rate was significantly higher among ventilated patients – of 1190 patients, 276 (23.2%) needed dialysis treatment. The main conclusion drawn by the authors is that “AKI occurs frequently among patients with COVID-19. It occurs early and in temporal association with respiratory failure and is associated with a poor prognosis.”

It is obvious that the COVID-19 causes kidney injury. In an autopsy study conducted in Hamburg [3], samples from different organ tissues of 27 autopsied COVID-19 patients were analyzed for viral load. It was found that, although the lungs are worst affected by the novel virus, other organs and especially the kidneys are also affected. The samples from seven patients were also used to investigate which renal compartments are particularly affected, and it was shown that the renal tubules and especially the glomerular cells had a high viral load. “These findings are consistent with clinical observations. The glomeruli perform the filtration function of the kidneys and the tubules are responsible for reabsorption. It has been found that, early in the course of Covid-19, many patients had abnormalities in their urine, in particular proteinuria”, explained Dr. Hoxha at the press conference to launch the ERA EDTA Congress. “The question is how these findings can be used.”

A study group from Göttingen [4], which cooperates closely with groups in Hamburg, Cologne and Aachen, is currently investigating whether early signs of kidney involvement, such as proteinuria, hypoproteinemia and antithrombin III deficiency allow early risk assessment and stratification of patients. Such patients would be at higher risk for developing complications such as lung oedema and thrombembolisms, such as the dreaded pulmonary embolisms. Both could then be treated prophylactically in patients at risk. A recently launched study [5] is now being conducted to investigate the prognostic significance of kidney parameters.

[1] Cheng Y, Luo R, Wang K, et al. Kidney impairment is associated with in-hospital death of COVID-19 patients. February 20, 2020. doi:
[2] Hirsch JS, Ng JH, Ross DW et al. Acute kidney injury in patients hospitalized with COVID-19. Kidney Int. May 16, 2020. doi: 10.1016/j.kint.2020.05.006
[3] Puelles VG, Lütgehetmann M, Lindenmeyer MT et al. Multiorgan and Renal Tropism of SARS-CoV-2. NEJM. May 13, 2020. DOI: 10.1056/NEJMc2011400
[4] Gross O, Moerer O, Weber M et al. COVID-19-associated nephritis: early warning for disease severity and complications? The Lancet 2020. Published:May 06, 2020DOI:

With more than 7,000 active members, the ERA-EDTA is one of the biggest nephrology associations worldwide leading European nephrology and one of the most important European Medical Associations. It organizes annual congresses and other educational and scientific activities. ERA-EDTA also produces guidelines, collects data, and performs epidemiological studies through its Registry. The Society supports fellowships and educational/research projects through its committees and working groups. Its publications are NDT, CKJ (Open Access journal), and the online educational journal NDT-Educational.

Dr. Bettina Albers
+49 3643 776423
email us here

Source: EIN Presswire

Are kidney transplant patients at higher risk? The European experience

Professor Luuk Hilbrands reports outcomes from ERACODA, the largest international COVID-19 database of kidney transplant and dialysis patients.

PARMA, ITALY, June 5, 2020 / — Experience throughout the world, including in Europe, shows that advanced age is the most important risk factor for death in COVID-19: people aged over 70 years are over 10 times more likely to die compared to those aged below 50. Other factors increasing the risk of death include male sex and comorbidities, including obesity, hypertension, cardiovascular disease, diabetes, chronic lung disease and cancer.

Until now, data on COVID-19 in kidney transplant patients have been limited. In response to the pandemic, ERACODA was established as a European database to investigate COVID-19 outcomes in patients with kidney failure. ERACODA is now the largest international database with detailed follow-up, and unlike some other databases, contains data on kidney transplant as well as dialysis patients.

“There are several reasons why kidney transplant patients could be at higher risk. Not only do they often have known risk factors for severe COVID-19, but they also take daily immunosuppressive drugs that impair their immune response,” said Professor Luuk Hilbrands. “At the same time, these patients know that they are vulnerable, and must protect themselves from infection and seek medical help for fever or other symptoms. Immunosuppressive drugs may also reduce the hyperinflammatory response in severe COVID-19, and some immunosuppressants (for example, cyclosporine) inhibit corona virus replication in the laboratory.” Professor Hilbrands was speaking at the press conference held during the run-up to the ERA-EDTA Congress.

By June 1st, a total of 1073 patients with COVID-19 and complete 28-day follow-up had been entered on to the ERACODA database by 197 physicians from 98 centres in 26 countries, mainly in Europe. Of patients included on the database, 305 (28%) were kidney transplant recipients. By 28 days, 21% of these patients had died—a case fatality rate only slightly lower than the 25% case fatality rate seen in dialysis patients. In patients managed outside the hospital, mortality was low at 3% of kidney transplant patients compared to 5% of dialysis patients. Following admission to hospital, 24% of transplant patients died compared to 33% of dialysis patients. Of those treated in the intensive care unit (ICU), 45% of kidney transplant patients died compared with 53% of dialysis patients.

As in the general population, age over 75 years was the most important risk factor for death in kidney transplant patients, but male sex, diabetes and cardiovascular disease were not associated with mortality risk. There was also no evidence of benefit from treatment with antiviral drugs, or reduction or withdrawal of immunosuppressive therapy.

Professor Hilbrands commented: “With longer-term follow-up, we will be able to evaluate the consequences of COVID-19 for long-term kidney graft function. In the meantime, younger, relatively healthy kidney transplant patients do not seem to be at particular risk of death as long as they strictly follow social distancing and hygiene rules. However, risk is individual, and I strongly advise all patients to talk to their physicians before making decisions about work, social life or travel.”

This ERACODA database was established in March 2020 and is endorsed by the European Renal Association-European Dialysis and Transplantation Association (ERA-EDTA. Participating physicians submit data voluntarily on all consecutive adult (≥18 years) kidney transplant and dialysis patients treated at their centre for COVID-19, either as outpatients or in hospital. A further expansion of the database with more patient data and longer follow-up will allow additional analyses to support clinical decision-making.

With more than 7,000 active members, the ERA-EDTA is one of the biggest nephrology associations worldwide leading European nephrology and one of the most important European Medical Associations. It organizes annual congresses and other educational and scientific activities. ERA-EDTA also produces guidelines, collects data, and performs epidemiological studies through its Registry. The Society supports fellowships and educational/research projects through its committees and working groups. Its publications are NDT, CKJ (Open Access journal), and the online educational journal NDT-Educational.

Dr. Bettina Albers
+49 3643 776423
email us here

Source: EIN Presswire

COVID-19 mortality alarmingly high in dialysis patients

Dr. Maria Jose Soler Romeo talked about the Spanish COVID-19 Dialysis/Transplantation Experience at the Opening Conference of the ERA-EDTA Congress

PARMA, ITALY, June 5, 2020 / — Spain is one of the European countries besides the UK and Italy that was particularly hard hit by the coronavirus pandemic in March. Early on, it was not possible to predict the extent of the outbreak. The first case in Spain was a German tourist who brought the virus to La Gomera in the Canary Islands at the end of January; a second case, this time a British tourist, was identified on Mallorca on February 10. Three days later, the first patient in Spain died of COVID-19 (however it was diagnosed later on postmortem)– followed by a rapidly rising death toll. By the end of March, there were more than 238,000 confirmed cases and 29,000 deaths in Spain, out of a total population of almost 47 million. The UK, with a total population of 66 million, had 38,000 deaths at that time, while Italy, with 60 million, had more than 33,000 deaths.
On March 31, 789 COVID-19 patients were receiving treatment at the Hospital Vall d’Hebron in Barcelona, 168 of them on the ICU. But what were the outcomes among end-stage renal disease/ESRD patients (dialysis patients and transplanted patients)? At what rate did they fall ill and what was their prognosis?

At the Opening Conference of the ERA-EDTA Congress, Dr. Maria Jose Soler Romeo presented data gathered at the Hospital Vall d’Hebron. Of 400 dialysis patients with the Vall d´Hebron as a reference hospital, 21 or a good 5% had COVID-19. In the whole of Spain, 238,000 out of 47 million people (about 0.5%) had contracted the disease at that time. The figures obtained from the Hospital Vall d’Hebron on the incidence of COVID-19 are not representative, of course, as it is only one center, but they do indicate a significantly higher rate of infection for dialysis patients. Of the 21 dialysis patients who contracted COVID-19, 15 were discharged, one was on the ICU at the time of the survey, and five had died. The mortality rate in this center was 24%. This high death rate among infected dialysis patients was also verified in an analysis of the Spanish COVID-19 Dialysis/Transplantation Registry, which included a total of 1572 ESRD patients, including 998 HD patients, 51 PD patients and 523 kidney transplant patients. The mortality rate among HD patients was more than 27% for the whole Spain, but was also more than 23% for kidney transplant patients. PD patients had a significantly lower mortality rate of 15%, but their number is so small in proportion that it is almost impossible to make statistically valid statements about this patient group.

The high mortality rate among dialysis patients was also verified in a study that monitored the course of disease in 36 HD patients between March 12 and April 10 in Hospital Gregorio Marañón in Madrid. The death rate here was as high as 30.5%, but what is particularly interesting about this study is that it analyzed predictors of mortality. The conclusion was that, in addition to patient older age and pneumonia, there are three factors that significantly influence the mortality rate among coronavirus-positive dialysis patients: (1) the number of years on dialysis (dialysis vintage), (2) lymphopenia, which describes a low number of special white blood cells (lymphocytes) that protect the body from infections, and (3) elevated LDH levels, a surrogate for tissue damage.

“What we had to learn from nephrologists in Spain is that dialysis patients are more susceptible to the virus and that the risk of patients dying is very high at a rate of 1:4. These patients need special protection. Many studies have shown that even people without symptoms or with asymptomatic symptoms can carry and pass on the virus. In dialysis units, therefore, we cannot rely on always being able to detect infected patients and to isolate them in time. To protect our highly vulnerable patients, it is essential that all the patients and staff be tested on a regular basis in order to minimize the risk of infection in COVID-19 outbreaks. We must continually remind ourselves that, of four coronavirus-positive dialysis patients, one will not survive. Outbreaks in dialysis units must therefore be prevented at all costs”, Dr. Soler concluded.

[1] Marian Goicoechea, Luis Alberto Sánchez Cámara, Nicolás Macías et al. COVID-19: Clinical course and outcomes of 36 maintenance hemodialysis patients from a single center in Spain.
Kidney Int. 2020 May 11. doi: 10.1016/j.kint.2020.04.031

With more than 7,000 active members, the ERA-EDTA is one of the biggest nephrology associations worldwide leading European nephrology and one of the most important European Medical Associations. It organizes annual congresses and other educational and scientific activities. ERA-EDTA also produces guidelines, collects data, and performs epidemiological studies through its Registry. The Society supports fellowships and educational/research projects through its committees and working groups. Its publications are NDT, CKJ (Open Access journal), and the online educational journal NDT-Educational.

Dr. Bettina Albers
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Source: EIN Presswire