VA kidney doc refers to shocking chronic kidney disease (CKD) VISN 2 study (New York region)


“Dr. Anna Jovanovich is a nephrologist at the VA Eastern Colorado Health Care System in Denver. Her research focuses on cardiovascular health in Veterans who have chronic kidney disease. (Photo by Shawn Fury)” VA text and photo CLICK to see abstract, then choose full text.

 

Sometimes VA emails contain information and news about their research that is valuable for us to read.  For example, 34.3-47.3% of veterans in VISN 2 network have chronic kidney disease (CKD).  The ROs are located in Buffalo and New York City and Buffalo was very involved in this targeted regional research. The BVA also seems unaware of these remarkable and terrible statistics based on the decisions I’ve read.

Study population: VISN 2 individuals seen.  Number: 75,787  Scope: One year in 2007.

Study title:

Prevalence of various comorbidities among veterans with chronic kidney disease and its comparison with other datasets  (link to study in Journal Renal Failure Volume 38, 2016 – Issue 2–published online Dec. 15, 2015.)

“The prevalence of CKD varied depending on the number of eGFR values used. Based on the MDRD equation using two values of eGFR, the prevalence of CKD was 34.3%, while it was 47.3% by MDRD equation using one eGFR value. The prevalence of CKD in the veteran population is much higher than estimated in US population from the NHANES and KEEP datasets.”

VISN 2 New York area CLICK IMAGE to go to this

Definitions:

Definition of CKD calls for two consecutive measurements of eGFR < 60 mL/min per 1.73m2 that are at least three months apart… we have also calculated prevalence of CKD as the ratio of patients with at least two outpatient eGFRs less than 60 mL/min/1.73m2, at least 90 days apart, prior to the end of March 2008 (the numerator) to the total number of the study population (MDRD-2).

Ten years on–How are the RO’s applying this information, if at all, for VISN 2 vets?  With up to 47.3% of veterans diagnosed by the VA with chronic kidney disease, are they getting justice or are they likely to live long enough to get justice?

Let’s look at four kidney cancer BVA decisions based on claims originally rejected by VISN 2 ROs.

RO NYC:  Citation Nr: 1815713 ( 03/16/18)  Kidney cancer; DAV did not do their homework;  RO lost his records;  Vet suspects asbestos exposure; Had two IMOs.  Benefit-of-the-doubt? Denied by Lesley A. Rein, VLJ

Buffalo RO:  Citation Nr: 1734058 (08/18/17) VVA–renal (kidney) and prostate cancer +

Remanded by Michael Martin, VLJ.

RO NYC/RO Kentucky Citation Nr: 1806565 (02/01/18)

Atty, Stephen J. Wenger, Camp Lejeune CUE WIN with

Matthew W.  Blackwelder, VLJ

Buffalo RO–Citation Nr: 1749918 (11/02/17).

kidney cancer, secondary to prostate; VVA

” Veteran may establish service connection based on exposure to herbicide agents with proof of actual direct causation.”  Second remand
Nathan Kroes, VLJ

Somehow I doubt that this old study is going to be updated any time soon–it’s too damning.  With statistics like this, CKD should be presumptive in VISN 2 and would be if similar studies have been done elsewhere.  There may be unpublished and published studies out there.  How likely are non-VA kidney doctors to know about research?

This year we learned that my old Marine has stage three kidney disease and therefore his diet has had to change. We are in VISN 1.  Plattsburgh NY is about 26 miles from our place by road, causeway and ferry.  My guess is that VISN 1 also has high CKD numbers because it takes many weeks to get an appointment with a private specialist.

Thank you to VA Dr. Anna Jovanovich for your interview and for your work in Denver, Colorado.  We need more people like you to help veterans. If you’re shocked at the data, so should we be.  This study provides backup for the VISN 2 veterans who suspect that their CKD is service-connected.  They are probably right based on the 2007 statistics in comparison with the civilian population in their region for the same period as shown in the study tables.  If anyone thinks I’m reading this all wrong, do comment because I have zero training in any field related to medical science.

Kiedove

This entry was posted in All about Veterans, BvA Decisions, Camp Lejeune poisoning, CUE, Food for thought, Future Veterans, General Messages, Guest authors, Lawyering Up, Medical News, non-va care, Remanded claims, research, Uncategorized, VA Health Care, vA news, VA statistics, VSOs and tagged , , . Bookmark the permalink.

3 Responses to VA kidney doc refers to shocking chronic kidney disease (CKD) VISN 2 study (New York region)

  1. John says:

    VA participates in lots of research. You can look at their research site for specific issues.

    https://www.research.va.gov

  2. Michael Oliver says:

    Numerous “EPA Super” sites have been closed, converted and resold to an unsuspecting public.
    El Toro MCAF and the LTA at Tustin were merely two of this batch, I knew this having been stationed there in 1968. Tons of volatile chemicals were buried there before the USMC surrendered it to move to MCAF/MCAB Miramar, San Diego County. Tustin’s H2O wells were affected measurably. Volatiles, coffee, tobacco, alcohol and more may work synergistic-ally to complicate this CKD; regarding exacerbation.

    • Kiedove says:

      You are right. There are many possible exposures just in this country alone. Camp Lejeune is the one best studied therefore, CUE was justified in one decision. With CKD at almost the 50% figures, you know that there were probably more than 50% in 2007 because not all VISN 2 vets are enrolled in VA. Those is private care would be boosting up the civilian numbers.

      In the last case, VLJ Kroes lays out the conditions he has to work with. He leaves bread crumbs when he refers to a VA study about AO and CKD that suggests a nexus. Will have to find that study on PubMed. Reading his decision leads me to believe that he also suspects a nexus and so this vet is getting a 2nd chance. But will he live long enough to get more evidence?
      Every VISN has probably already run the numbers. Can we gather the information, do some addition, and petition Congress for a definitive study. Give Americans the facts they need to make intelligent decisions.

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