Day 1 :
Via Medis Dialysis Center, Germany
Time : 09:30-10:00
Thomas Ryzlewicz is a Nephrologist since 40 years with regular clinical work with RRT patients. In 1974 he used several of the first Dialysis Set-Up’s (Travenolrn120 Batch System, Milton Roy B II, Gambro AK 3) and in 1978 Bag-Hemofiltration was done (with the Equipment of 3 Blood Pumps, one Bed Scale and a Cup tornmeasure the Filtration Rate (with a Stop-Watch).
The worldwide use of acidification with 3 mmol/L of acetate is critical, as there is a big problem of calcification. The majorityrnof the CKD-5 patients has own big problems with calcification. After each Dialysis it is necessary to descale the monitor.rnOnly the patient never will be descaled. To elevate the dosage of acetate is no good idea as the production of CO2 becomesrnbigger. This is a problem for cold patients as well as for patients weaning from the respirator. The alternative prescription withrn1 mmol/L citrate has the same amount of CO2 production as 3 mmol/L acetate but the dialysis fluid with citrate never has arnproblem of calcification. There is a second principle of working, the chelate binding of the two problems ions Ca++ and Mg++.rnUnfortunately, this essential problem will not well understand by the doctors and by the FDA Department, medical productsrnas it is a problem of chemical solubility. Dialysis concentrate is a medical product and so there is no follow-up concerning thisrncalcification problem. First target is to reach a chemical evaluation; second target is the prohibition of dialysis concentrate byrn3 mmol/L acetate.
Ronald Reagan UCLA Medical Center, USA
Time : 10:00-10:30
Phuong-Thu Pham is a Professor of Medicine and Director of Outpatient Services of the Kidney Transplant Program at UCLA Medical Center. Her major areas of interest include recurrence of glomerular diseases following primary renal transplantation, new onset diabetes after transplantation, BK virus screening andrnmanagement after kidney transplantation, the link between hypomagnesemia and renal function decline in patients with diabetes mellitus type 2 as well asrnin recipients of kidney transplant and acute and chronic kidney injury following liver transplantation. Her interests have resulted in publications in well-known Nephrology textbooks and journals as well as invitations to speak at both national and international meetings. She has written over 20 book chapters for major Nephrology and solid organ transplantation textbooks including Comprehensive Clinical Nephrology, Textbook of Organ Transplantation, Transplantation of thernLiver, Pancreas, islet and stem cell transplantation for diabetes, Chronic Kidney Disease: Dialysis and Transplantation, and Handbook of Kidney Transplantation.rnShe has also served as Moderator for transplant-related conferences at the American Society of Nephrology and World Congress of Nephrology, EditorialrnBoard Member for the Case Reports in Nephrology and Transplantation Technologies and Research journals and Member of the Organizing Committee for thernInternational Conference on Nephrology and Therapeutics.
With the introduction of the MELD score for the allocation of orthotopic liver transplant (OLT) in February 2002, arnstriking 278% increase in the number of simultaneous liver-kidney transplants (SLKT) was observed during the 9-yearrnperiod post-MELD when compared with the preceding 9-year in the pre-MELD era (pre- vs. post-MELD era, n=1049 vs. 2914rnrespectively). For OLT candidates with simultaneous end-stage kidney failure, SLKT is a well-established effective therapeuticrnoption for virtually all suitable candidates. However, there have been no well-defined guidelines to determine whether a kidney rntransplant should be offered to OLT candidates who have chronic kidney disease (CKD) or prolonged acute kidney injuryrn(AKI) secondary to hepatorenal syndrome (HRS) or acute tubular necrosis (ATN) while awaiting a liver transplant. Specificrnchallenges in the decision making process include the accurate assessment of the degree of existing renal dysfunction in thosernwith CKD, progression of established CKD and the prediction of the extent of renal function recovery in those with AKI withrnor without underlying CKD. Currently existing consensus guidelines for SLKT in OLT wait-listed candidates are presentedrnfollowed by the author’s opinion on identification of candidates who are best suited for double-organ transplantation.