The importance of providing customized medical information to individual health conditions
Due to the recent aging of the population, the number of patients with chronic diseases such as hypertension, diabetes, and chronic kidney disease is rapidly increasing. However, those patients with chronic diseases have difficulty managing the diseases due to a lack of ability to access and utilize the correct information per stage of the disease. Thoughtless information that does not fit the individual's health condition can be rather poisonous. To solve this medical illiteracy, we met Professor Lee Sang-ho of the Department of Nephrology at Kyung Hee University Hospital in Gangdong, who is leading the way in providing customized medical information based on patients' health records.
Q. Medius Queen: I met today Prof. Lee Sang-ho, a nephrologist who recently provides various information on kidney disease through the YouTube channel Literacy M’. As of 2020, the rate of increase in the incidence of chronic kidney disease in Korea is the highest in the world, and the rate of dialysis patients is also increasing every year. Please introduce the causes of chronic kidney disease and treatment methods according to the stage of progression.
A. Lee Sang-ho, Professor of Nephrology, Gangdong Kyunghee University Hospital (Lee Sang-ho): According to the recently announced statistics on the aging rate, the rate of increase in the elderly population in Korea is reported to be the fastest among OECD member countries. Since kidney function inevitably declines as aging progresses, the aging of the population can be said to have the greatest impact on increasing chronic kidney disease. The main causes of chronic kidney disease are diabetes, hypertension, and glomerulonephritis. Among them, the incidence of glomerulonephritis has not yet increased significantly, while the number of diabetic and hypertensive patients in Korea is rapidly increasing. In addition, chronic kidney disease due to population aging is also showing a rapid increase. Chronic kidney disease is classified into stages 1 to 5 according to the degree of deterioration of kidney function. Up to the 3rd stage of CKD, which is the early stage, if the cause is accurately diagnosed and treated well, further deterioration in renal function can be prevented or minimized. Because of this, the factors that cause the disease must be well-managed and treated. It is also very important to prevent the kidneys from working a lot and getting tired quickly and aging. Therefore, high salt intake or unnecessary medication should be avoided. If the disease progresses beyond stage 4, it is important to receive drug treatment to delay dialysis or transplant treatment as much as possible, but more thorough management is needed to prevent complications.
Q. MEDIEUS QUEEN: Chronic kidney disease is known to have a high mortality rate due to complications, and, surprisingly, it is closely related to diabetes and high blood pressure. What is the significance of chronic kidney disease in kidney disease?
A. Lee Sang-ho : As diabetes and high blood pressure commonly cause damage to blood vessels in our body, the occurrence of cardiovascular complications increases. In this respect, since chronic kidney disease is mainly caused by diabetes or high blood pressure, the mortality rate is inevitably high. In particular, when kidney function decreases to stage 4 or higher, waste products that need to be excreted from the body accumulate and act as urea, and an increase in waste in the body further damages blood vessels and causes anemia, increasing the burden on the heart. In addition,
Calcium, and phosphorus control disorders aggravate
the calcification of blood vessels. As a result, if diabetic or hypertensive patients suffer from chronic kidney disease, the cardiovascular mortality rate will inevitably increase significantly as the disease progress.
Q. MEDIEUS QUEEN: I heard that chronic kidney disease has no symptoms, so it is difficult to detect until the kidneys are severely damaged. I'm curious about how to prevent it. Also, please explain if there are any foods or medications to be careful of to prevent the worsening of the disease.
A. Lee Sang-ho : That's right. Chronic kidney disease is often asymptomatic even if it progresses to stage 4. Therefore, early diagnosis through blood and urine tests is of utmost importance. In order to prevent chronic kidney disease, the primary prevention is to control diabetes or high blood pressure and reduce salt intake, which burdens the kidneys. It is often known that patients with chronic kidney disease must consume less protein, potassium, and phosphorus, but this is not true. Of course, patients with more than stage 4 progression should consume less potassium or phosphorus, and patients with excessive proteinuria should also limit excessive protein intake, but the salt restriction is sufficient for most patients in the early stages. In other words, chronic kidney disease patients must remember that the foods to be careful of may differ depending on the function of the remaining kidney. Medications to be wary of are primarily anti-inflammatory drugs and antibiotics. It is important to use the appropriate dose for kidney function only when absolutely necessary. Of the drugs we ingest, those excreted by the kidneys must be dosed according to remaining kidney function. Patients with poor kidney function are advised to take as few necessary medications as possible and to take them after consulting with a doctor.
Q. MEDIEUS QUEEN: I wonder if it is okay for patients with kidney disease to get vaccinated amid the ongoing COVID-19 crisis, especially if they have had a kidney transplant while taking immunosuppressants.
A. Lee Sang-ho: It is true that dialysis patients with reduced immunity or patients receiving immunosuppressive drugs after a kidney transplant have slightly less protective effects than normal people even if they are vaccinated. But that's why it is necessary to get the vaccine under more thorough management. Patients taking dialysis or immunosuppressants not only have an increased chance of being infected with the coronavirus but also the chance of progressing to severe disease or increasing the mortality rate. Therefore, it is recommended to get vaccinated. However, there are definitely people who cannot expect sufficient antibody formation with COVID-19 vaccination because their immunity is too low. Patients who have been taking high-dose immunosuppressive drugs within 4 months of transplantation or who have received B-lymphocyte suppression treatment within the last 2 months usually fall into this category. However, fortunately, Evusheld, a prophylactic antibiotic, has recently been introduced for sufficient preventive effects.
Q. MEDIEUS QUEEN: You are not only participating in various research projects to develop new diagnoses and treatments for intractable renal disease, but you are also continuing research activities. Recently, I understand that you have been selected as the official leader of the task in the field of ‘(new concept) inoculation technology’ in the 1st vaccine-based technology development project hosted by the Global Vaccine Technology Leading Project Group. Please explain in detail about your current R&D activities.
A. Lee Sang-ho: We are developing vaccine administration technology using soluble microneedles. It may sound a little unfamiliar, but microneedle is a drug delivery technology that attaches fine needles thinner than hair to the body in the form of patches to absorb drug ingredients into the body. Compared to the existing intramuscular injection, it has the advantage of being less painful and preventing side effects such as external injury or secondary infection. As the solubility under development is a method in which the needle part of the solid microneedle dissolves in the skin, it is another advantage that it is stable at room temperature and easy to store and distribute because it is solid. However, there have been few cases in which various injection drugs, especially vaccines, have been used to prove effective. Therefore, we are currently developing a technology that allows the flu vaccine to be inoculated through the microneedle, and our goal is to develop the technology so that it can be applied to various vaccines such as corona vaccine in the future.
Q. MEDIEUS QUEEN: Recently, I heard that you are accelerating the development of a patient education program to deliver medical information to patients in an easy-to-understand manner and to provide assistance. As the CEO of K-Bio Healthcare Co., Ltd., please explain how you started your business and the program you are developing.
A. Lee Sang-ho: The biggest problem I have not been able to solve while practicing medical treatment is that many patients, especially those with chronic diseases, cannot access and utilize the correct information. In fact, most of the patients around us are close to illiterate in terms of medical care. Regardless of personal medical literacy ability, medical problems during overseas travel or visits inevitably cause medical illiteracy due to language and system differences. While thinking about it, I came across a shocking article that says patients get 70% of their medical information through YouTube, etc., and I started looking for related literature in earnest. As a result, I surprisingly found that 20% of medical YouTube videos, regardless of field, contained information that could harm patients. At the same time, we found that patients clicked the “likes” button more for YouTube content that contain incorrect information rather than true information, and that was more provocative than useful. The problem is that experts point out these facts only through papers that general patients cannot understand.
Because of this, I thought about the need for an evaluation system where the right information is delivered through the platform and where the right content is to be recognized. In addition, I started to develop a program thinking that this problem would be solved by allowing experts to directly curate the content currently exposed online. Information that would benefit all patients is often not very useful. Many patients are curious about information or management tips that are suitable for their current condition but often get into trouble because they do not know what information will be helpful to them. Therefore, in order to provide customized YouTube health content curation according to each patient's health condition, I concluded that personal health records are needed first. In other words, I have found a solution to ‘providing customized medical information based on personal health records’. Awareness of the problem of medical literacy and the desire to implement a solution to provide customized medical information to patients in the medical field are the reasons why I founded the company.
A. Lee Sang-ho, Professor of Nephrology, Gangdong Kyunghee University Hospital (Lee Sang-ho): According to the recently announced statistics on the aging rate, the rate of increase in the elderly population in Korea is reported to be the fastest among OECD member countries. Since kidney function inevitably declines as aging progresses, the aging of the population can be said to have the greatest impact on increasing chronic kidney disease. The main causes of chronic kidney disease are diabetes, hypertension, and glomerulonephritis. Among them, the incidence of glomerulonephritis has not yet increased significantly, while the number of diabetic and hypertensive patients in Korea is rapidly increasing. In addition, chronic kidney disease due to population aging is also showing a rapid increase. Chronic kidney disease is classified into stages 1 to 5 according to the degree of deterioration of kidney function. Up to the 3rd stage of CKD, which is the early stage, if the cause is accurately diagnosed and treated well, further deterioration in renal function can be prevented or minimized. Because of this, the factors that cause the disease must be well-managed and treated. It is also very important to prevent the kidneys from working a lot and getting tired quickly and aging. Therefore, high salt intake or unnecessary medication should be avoided. If the disease progresses beyond stage 4, it is important to receive drug treatment to delay dialysis or transplant treatment as much as possible, but more thorough management is needed to prevent complications.
Q. MEDIEUS QUEEN: Chronic kidney disease is known to have a high mortality rate due to complications, and, surprisingly, it is closely related to diabetes and high blood pressure. What is the significance of chronic kidney disease in kidney disease?
A. Lee Sang-ho : As diabetes and high blood pressure commonly cause damage to blood vessels in our body, the occurrence of cardiovascular complications increases. In this respect, since chronic kidney disease is mainly caused by diabetes or high blood pressure, the mortality rate is inevitably high. In particular, when kidney function decreases to stage 4 or higher, waste products that need to be excreted from the body accumulate and act as urea, and an increase in waste in the body further damages blood vessels and causes anemia, increasing the burden on the heart. In addition,
Calcium, and phosphorus control disorders aggravate
the calcification of blood vessels. As a result, if diabetic or hypertensive patients suffer from chronic kidney disease, the cardiovascular mortality rate will inevitably increase significantly as the disease progress.
Q. MEDIEUS QUEEN: I heard that chronic kidney disease has no symptoms, so it is difficult to detect until the kidneys are severely damaged. I'm curious about how to prevent it. Also, please explain if there are any foods or medications to be careful of to prevent the worsening of the disease.
A. Lee Sang-ho : That's right. Chronic kidney disease is often asymptomatic even if it progresses to stage 4. Therefore, early diagnosis through blood and urine tests is of utmost importance. In order to prevent chronic kidney disease, the primary prevention is to control diabetes or high blood pressure and reduce salt intake, which burdens the kidneys. It is often known that patients with chronic kidney disease must consume less protein, potassium, and phosphorus, but this is not true. Of course, patients with more than stage 4 progression should consume less potassium or phosphorus, and patients with excessive proteinuria should also limit excessive protein intake, but the salt restriction is sufficient for most patients in the early stages. In other words, chronic kidney disease patients must remember that the foods to be careful of may differ depending on the function of the remaining kidney. Medications to be wary of are primarily anti-inflammatory drugs and antibiotics. It is important to use the appropriate dose for kidney function only when absolutely necessary. Of the drugs we ingest, those excreted by the kidneys must be dosed according to remaining kidney function. Patients with poor kidney function are advised to take as few necessary medications as possible and to take them after consulting with a doctor.
Q. MEDIEUS QUEEN: I wonder if it is okay for patients with kidney disease to get vaccinated amid the ongoing COVID-19 crisis, especially if they have had a kidney transplant while taking immunosuppressants.
A. Lee Sang-ho: It is true that dialysis patients with reduced immunity or patients receiving immunosuppressive drugs after a kidney transplant have slightly less protective effects than normal people even if they are vaccinated. But that's why it is necessary to get the vaccine under more thorough management. Patients taking dialysis or immunosuppressants not only have an increased chance of being infected with the coronavirus but also the chance of progressing to severe disease or increasing the mortality rate. Therefore, it is recommended to get vaccinated. However, there are definitely people who cannot expect sufficient antibody formation with COVID-19 vaccination because their immunity is too low. Patients who have been taking high-dose immunosuppressive drugs within 4 months of transplantation or who have received B-lymphocyte suppression treatment within the last 2 months usually fall into this category. However, fortunately, Evusheld, a prophylactic antibiotic, has recently been introduced for sufficient preventive effects.
Q. MEDIEUS QUEEN: You are not only participating in various research projects to develop new diagnoses and treatments for intractable renal disease, but you are also continuing research activities. Recently, I understand that you have been selected as the official leader of the task in the field of ‘(new concept) inoculation technology’ in the 1st vaccine-based technology development project hosted by the Global Vaccine Technology Leading Project Group. Please explain in detail about your current R&D activities.
A. Lee Sang-ho: We are developing vaccine administration technology using soluble microneedles. It may sound a little unfamiliar, but microneedle is a drug delivery technology that attaches fine needles thinner than hair to the body in the form of patches to absorb drug ingredients into the body. Compared to the existing intramuscular injection, it has the advantage of being less painful and preventing side effects such as external injury or secondary infection. As the solubility under development is a method in which the needle part of the solid microneedle dissolves in the skin, it is another advantage that it is stable at room temperature and easy to store and distribute because it is solid. However, there have been few cases in which various injection drugs, especially vaccines, have been used to prove effective. Therefore, we are currently developing a technology that allows the flu vaccine to be inoculated through the microneedle, and our goal is to develop the technology so that it can be applied to various vaccines such as corona vaccine in the future.
Q. MEDIEUS QUEEN: Recently, I heard that you are accelerating the development of a patient education program to deliver medical information to patients in an easy-to-understand manner and to provide assistance. As the CEO of K-Bio Healthcare Co., Ltd., please explain how you started your business and the program you are developing.
A. Lee Sang-ho: The biggest problem I have not been able to solve while practicing medical treatment is that many patients, especially those with chronic diseases, cannot access and utilize the correct information. In fact, most of the patients around us are close to illiterate in terms of medical care. Regardless of personal medical literacy ability, medical problems during overseas travel or visits inevitably cause medical illiteracy due to language and system differences. While thinking about it, I came across a shocking article that says patients get 70% of their medical information through YouTube, etc., and I started looking for related literature in earnest. As a result, I surprisingly found that 20% of medical YouTube videos, regardless of field, contained information that could harm patients. At the same time, we found that patients clicked the “likes” button more for YouTube content that contain incorrect information rather than true information, and that was more provocative than useful. The problem is that experts point out these facts only through papers that general patients cannot understand.
Because of this, I thought about the need for an evaluation system where the right information is delivered through the platform and where the right content is to be recognized. In addition, I started to develop a program thinking that this problem would be solved by allowing experts to directly curate the content currently exposed online. Information that would benefit all patients is often not very useful. Many patients are curious about information or management tips that are suitable for their current condition but often get into trouble because they do not know what information will be helpful to them. Therefore, in order to provide customized YouTube health content curation according to each patient's health condition, I concluded that personal health records are needed first. In other words, I have found a solution to ‘providing customized medical information based on personal health records’. Awareness of the problem of medical literacy and the desire to implement a solution to provide customized medical information to patients in the medical field are the reasons why I founded the company.
#Medieus#interview#nephrology#gangdongkyungheeuniversityhospital#LeeSangho#hypertension#diabetes#chronic kidney disease#chronic disease#health record#customized medical information#literacy M#dialysis patient rate#KBio Healthcare#KoreanRenownedDoctor#Interview with RenownedDoctor#RenownedDoctorRecommendation #interview #MDUS
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