Dr Main stressed that most people exposed to silica in this way do not get significant renal disease.

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Epogen's main use is to treat anemia in patients with kidney failure, also known as end-stage renal disease.

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Congress expanded Medicare in 1972 to cover dialysis for all patients with end-stage renal disease, then jiggered the reimbursement rates to encourage the use of home dialysis techniques that were theoretically less expensive.

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People with long term heart, renal or liver disease, neurological disease and diabetes.

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They are currently being sold for cosmetic and reconstructive procedures and research as well as being evaluated for a range of applications, including heart attack, urinary incontinence, renal failure and liver disease.

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These include heart disease and stroke, renal failure and opportunistic infections.

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Dr Charlie Tonson, chairman of the Royal College of Physicians renal medicine committee, said chronic kidney disease was an important public health problem.

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Greater than 90 percent of those diagnosed with renal cancer still confined to the kidney are alive and disease-free five years after diagnosis.

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