Screening for kidney disease at 35 would save lives

Screening all US residents over 35 for chronic kidney disease would increase life expectancy, reduce the number of people requiring dialysis or transplant, and save money, according to a new study.

Chronic kidney disease (CKD) affects 37 million people in the United States, or 15% of US adults. Diabetes and high blood pressure are responsible for two-thirds of cases. Annual Medicare spending on chronic kidney disease is $87 billion and an additional $37 billion is spent annually on kidney replacement therapy.

“CKD is often clinically silent until patients reach late-stage kidney disease, so many people with early-stage CKD are unaware they have it,” says Marika Cusick, a PhD candidate in health policy at Stanford Medicine and lead author of the study in the Annals of Internal Medicine.

“By screening for CKD, we can diagnose and treat it at an earlier stage, improving life expectancy, and reducing the risk of progressing to late-stage kidney disease, which is deadly and costly.”

A new class of drugs, sodium-glucose cotransporter-2 inhibitors, have been found to slow disease progression. These drugs, used to treat type 2 diabetes and approved by the Food and Drug Administration about 10 years ago, changed the discussion over whether screening for early-stage chronic kidney disease improves clinical outcomes, Cusick says.

Screening for chronic kidney disease involves testing for albuminuria, the presence of albumin, a type of protein, in urine. Its presence in urine is an indicator of the disease.

For the study, the researchers used data from the National Health and Nutrition Examination Survey, an annual nationally representative survey by the National Center for Health Statistics to assess the health of some 5,000 adults and children in the United States.

They then extrapolated their results to the full US adult population aged 35 years and older, conducting a cost-effectiveness analysis of screening for albuminuria with and without SGLT2 inhibitors to the current standard of care for chronic kidney disease.

The authors assessed costs, quality-adjusted life years, and incremental cost-effectiveness ratios. They found that screening, in addition to using SGLT2 inhibitors, the 158 million persons aged 35 to 75 years in the United States would prevent the need for dialysis or kidney transplant in 398,00 to 658,000 individuals during their lifetime, depending on the frequency of screening.

Though the researchers found that adding a one-time screening that included SGLT2 inhibitors would increase total lifetime health care costs from $249,800 to $259,000 for 55-year-olds, they believe the intervention provides good value when considering the dollars spent on treating chronic kidney disease and the health benefits.

“Advanced kidney disease harms the health of Americans, places burdens on families and caregivers, and is extremely costly for the health care system to manage,” says senior author Jeremy Goldhaber-Fiebert, professor of health policy.

“This analysis shows that, while it is a substantial undertaking, screening to detect chronic kidney disease before it advances and providing effective new treatments improves health and represents good value for the money and resources used.”

The Agency for Health Research and Quality, the Veterans Administration Office of Academic Affairs Advanced Fellowship in Health Services Research, and the National Institute of Diabetes and Digestive and Kidney Diseases supported the work.

Source: Stanford University


LA reinstates controversial zero bail policy as judge rules holding those who can't pay is unconstitutional

Los Angeles has reinstated a controversial zero bail policy after a judge ruled that holding suspects in prison because they can’t pay violated their constitutional rights.

Los Angeles Superior Court Judge Lawrence Riff granted a temporary injunction earlier this month stopping the city and county from requiring bail in a class action lawsuit that seeks to end cash bail.

The policy only impacts individuals arrested for misdemeanors and non-violent felonies.

“Those arrested for sexual offenses, domestic violence and offenses involving weapons will be exempt from the zero-bail policy,” ABC 7 reported. “Those with repeat offenses while out on no bail can be made subject to a cash payment.”

A man pays cash bail in the bond office to secure his brothers release on Dec. 21, 2022, at Division 5 of the Cook County Jail.

A Los Angeles Superior Court judge granted a temporary injunction in a class action lawsuit seeking to end cash bail. (Brian Cassella/Chicago Tribune/Tribune News Service via Getty Images)


The plaintiffs argued in the lawsuit that secured money bail does not reduce crime and is unjust to the poor.

The judge said the defendants had offered “no evidence” to disprove any of the plaintiffs’ evidence and had declined to testify at the hearing. He gave the county, city and plaintiffs 60 days to develop alternative pretrial detention rules.

Los Angeles adopted an emergency zero bail policy during the pandemic to reduce crowding in jails to deter the spread of COVID-19. It was lifted in July 2022.

The L.A. County Sheriff’s Department told Fox News Digital it would comply with the policy while prioritizing public safety.

Police officers and an LAPD vehicle

A recent study found no bail policies resulted in a spike in violent crime from reoffenders. (AP Photo/Ringo H.W. Chiu)


“The Department is aware of the preliminary injunction regarding the cash bail system, and of course will comply with any court-ordered bail schedule. The County is also working with the court and other stakeholders to explore ways to reduce the number of people held before arraignment because they can’t afford bail and to provide the Sheriff greater release options to safely reduce the jail population, while always prioritizing public safety,” it said in a statement.

The LAPD also reaffirmed their commitment to public safety and protecting individuals’ constitutional rights.

“The Los Angeles Police Department is reviewing the courts recent ruling regarding modifications to the existing Superior Court Standardize Bail Schedule. The Los Angeles Police Department remains committed to safeguarding the constitutional rights of all individuals while also  working with our criminal justice partners in addressing the community safety concerns related to individuals accused of serious crimes,” the department said in a statement.

Fox News Digital also reached out to attorneys in the lawsuit for comment.

Police officers at an intersection

The L.A. County Sheriff’s office said it would comply with the no bail policy while prioritizing public safety. (AP Photo/Ringo H.W. Chiu)


The lead attorney in the case argued that the no bail policy reaffirms the presumption of innocence in our legal system.

“We’re supposed to have a presumption of innocence in this country. It’s not much of a presumption of innocence when you’re in a jail cell,” attorney Salil Dudani said in the lawsuit.

A recent study found California’s zero bail policies resulted in a spike in violent crime from repeat offenders in one county.

Suspects released without bail were rearrested on 163% more charges than those who posted bail, and they reoffended 70% more often. Those reoffenses resulted in felony charges 90% more often — and they were accused of three times as many violent crimes, according to the study.

Fox News’ Michael Ruiz contributed to this report.


The least-visited national parks in the United States in 2022

Editor’s Note: Monthly Ticket is a CNN Travel series that spotlights some of the most fascinating topics in the travel world. In March, we’re heading to the great outdoors.


America’s least-visited national park is quite a distance from mainland US shores. Almost 5,000 miles away, in fact.

The National Park of American Samoa in the South Pacific is the only National Park Service site south of the equator. In 2022, it had just 1,887 visits, according to new visitation figures released this week by the National Park Service.

Compared with 2021, that number is down by 78%. The park had several Covid-19 closures last year, NPS said.

The national park stretches over three islands with tropical rainforests, volcanic slopes, pristine beaches and thousands of acres of marine habitat, and it’s interwoven with a rich culture.

“In keeping with the meaning of the word Samoa – ‘sacred earth’ – the park helps protect fa’asamoathe customs, beliefs, and traditions of the 3,000-year-old Samoan culture,” the park’s website says.

A 93-year-old woman and her grandson recently achieved their mission – more than seven years in the making – of seeing all 63 headliner US national parks with a visit to the far-flung archipelago.

The island park is far from the only uncrowded NPS site.

Nearly 400 of the 424 National Park Service sites count visitors. And three quarters of all visits are to just 64 sites. So there are lots of less-visited spots to explore.

Even among the 63 natural expanses that have “national park” in their proper names, there are parks where visitors number in the thousands or tens of thousands – far short of the nearly 13 million that visited Great Smoky Mountains National Park in 2022. It was the most visited of the 63 national parks last year.

Gates of the Arctic National Park covers a whopping 8.4 million acres in Alaska. Plenty of room to spread out ...

The vast state of Alaska – which covers 665,384 square miles – is home to five of the 15 least-visited national parks in 2022.

“Alaska’s national parks are some of the least visited for a good reason – they are hard to get to,” said Peter Christian, chief of public and legislative affairs in the National Park Service’s Alaska Region

But while they may be sparsely visited compared with other parks, several of them saw substantial jumps in visitor numbers last year, with increases of 30% to 50% over 2021, another step toward recovering from dramatic pandemic declines.

And one Alaska park that was among the least visited in 2021 – Glacier Bay National Park and Preserve – has catapulted out of the list with a 500% increase in visitors, thanks to a more robust return of cruises. But visitation still hasn’t reach pre-pandemic levels, Christian said.

With more and more travelers heading out for the busy spring and summer seasons, the least-visited national parks have a lot to offer those who venture off the most well-worn paths.

1. National Park of American Samoa – 1,887 recreation visits

Most parkgoers will need a passport to visit this spot in a remote part of the South Pacific. Hawaiian Airlines offers direct flights to American Samoa twice a week from Honolulu. Covid-19 travel requirements were relaxed at the end of last year, and the first cruise ship in three years arrived in January.

The park has units on three islands and stretches across 13,500 acres, some 4,000 of which are marine acres that are mostly coral reefs.

2. Gates of the Arctic National Park & Preserve, Alaska – 9,457 recreation visits

With no roads, no trails, no cell service and no established campsites, this massive expanse is a true wilderness experience. The park and preserve has six designated Wild Rivers.

“Visitors may wander at will across 8.4 million acres of superlative natural beauty,” the park’s website says. Visitors must be self-sufficient, flexible and “able to execute self-extraction and communication, should an emergency situation arise.” Arrive prepared.

3. Kobuk Valley National Park, Alaska – 16,925 recreation visits

There are no roads, campgrounds or entrance gates for this 1.8 million-acre expanse’s human visitors. Half a million caribou migrate through this park, crossing the Kobuk River and Onion Portage, according to the National Park Service. An 8,000-year tradition of hunting caribou here continues today.

Lake Clark National Park & Preserve had fewer than 20,000 visits in 2022.

4. Lake Clark National Park & Preserve, Alaska – 18,187 recreation visits

Stretching across more than 4 million acres, this national park and preserve is home to three designated Wild Rivers and two National Natural Landmark volcanoes. The land holds 10,000 years of human history and preserves the ancestral homelands of the Dena’ina people.

5. Isle Royale National Park, Michigan – 25,454 recreation visits

An isolated archipelago in Lake Superior, Isle Royale boasts 165 miles of trails and more than 30 campgrounds. It’s open from mid-April through the end of October. Ferry and seaplane service typically runs from mid-May through the end of September, according to NPS.

There are fewer mammal species here – only 18 – than on the mainland because animals must cross at least 14 miles of Lake Superior. Wolves and moose are among the notable animal residents.

Trail of the Cedars leads through giant ferns and mossy cedar trees in North Cascades National Park.

6. North Cascades National Park, Washington – 30,154 recreation visits

Peaks crowned by more than 300 glaciers tower over this alpine landscape. More than 1,600 species of plants have been identified on this land that spans temperate rainforest to a dry ponderosa pine ecosystem. There are more than 400 miles of trails.

7. Katmai National Park & Preserve, Alaska – 33,908 recreation visits

Katmai is an important habitat for thousands of brown bears. One of the world’s premier bear-viewing spots, according to the Park Service, Katmai is home to an estimated 2,200 brown bears. Brooks Camp along the Brooks River is one of the most popular viewing spots to observe bears feasting on salmon.

Most of Wrangell-St. Elias National Park & Preserve is rugged backcountry with limited visitor services.

8. Wrangell-St. Elias National Park & Preserve, Alaska – 65,236 recreation visits

America’s largest national park, Wrangell-St. Elias encompasses 13.2 million acres – or about the size of Yellowstone National Park, Yosemite National Park and Switzerland combined, the Park Service says. Most of the park is backcountry, and visitor services are limited. There are some maintained trails in the frontcountry Nabesna and McCarthy areas.

9. Dry Tortugas National Park, Florida – 78,488 recreation visits

About 70 miles (113 km) west of Key West, Dry Tortugas is mostly open water with seven small islands. Garden Key is home to one of the nation’s largest 19th-century forts, Fort Jefferson. The park is accessible by boat or plane and is host to nearly 300 species of birds. Bush Key closes every year from February to September so that sooty terns and brown noddies can breed there undisturbed.

10. Great Basin National Park, Nevada – 142,115 recreation visits

Mountain peaks meet hot desert valleys here. Great Basin National Park is home to 13,063-foot Wheeler Peak, ancient bristlecone pines, about 40 caves and a wide array of plants and animals. The elevation ranges from 5,000 to 13,000 feet with hiking trails for all levels.

Virgin Islands National Park, with Trunk Bay pictured, saw a nearly 40% drop in visits last year.

11. Virgin Islands National Park – 196,752 recreation visits

About two thirds of the US Virgin Island of St. John is national park, with sandy beaches, rich marine life, petroglyphs from the indigenous Taino people and sites related to the island’s troubled history of enslaved labor. There are more than 20 trails in the park, which is typically busiest from November to April.

12. Congaree National Park, South Carolina – 204,522 recreation visits

Congaree National Park’s landscape is “defined by the presence of both flood and flame,” the Park Service says.

Floodwaters from the Congaree and Wateree rivers regularly cover the park’s old-growth bottomland hardwood forest, and the upland pine forest depends on wildfires to clear out competing vegetation. Canoeing and kayaking are popular ways to explore the park. There’s a 15-mile marked canoe trail.

Guadalupe Mountains National Park is home to the four highest mountains in Texas.

13. Guadalupe Mountains National Park, Texas – 219,987 recreation visits

This park boasts the four highest peaks in Texas and the world’s most extensive Permian fossil reef. Guadalupe Mountains Wilderness has more than 80 miles of trail including a hike in the Salt Basin Dunes that rise 100 feet from the desert floor.

14. Voyageurs National Park, Minnesota – 221,434 recreation visits

Billed as a park of “water, islands and horizons,” Voyageurs covers 218,055 acres – 84,000 of which is water. There are more than 500 islands and four large lakes, plus more than two dozen smaller lakes in the park, which is best experienced by boat. Voyageurs shares its northern boundary with Canada, and lucky visitors may even see the northern lights.

15. Pinnacles National Park, California – 275,023 recreation visits

Pinnacles was formed when volcanoes erupted some 23 million years ago. Talus caves and towering rock spires draw hikers and climbers; there are more than 30 miles of hiking trails and hundreds of climbing routes.

While Pinnacles may rank among the 15 least-visited national parks, it gets very busy on weekends, holidays and throughout the spring, according to a notice on the park’s website. Arrive early to beat the crowds.

baker family screengrab vpx

CNN talks to 8-year-old climber from the side of El Capitan