9th International Conference on Nephrology & Therapeutics September 29-30, 2016 Orlando, USA

Biography:

Sadhna Nandwana is an Abdominal Imaging Radiologist who began her career at Rush Medical School and completed her Residency at Beth Israel Deaconess Medical Center. Her research endeavors have been in Quality Assurance and Clinical Research. She has several peer-reviewed published articles and has been an invited Lecturer for multiple national and international meetings.

Abstract:

Review the issue of NSF in renal failure patients with usage of gadolinium based contrast agents (GBCAs) and provide an update of current literature regarding risks of NSF with certain GBCAs. Also, This presentation will discuss the current national/international recommendations and explore eliminating screening of at-risk patients. Presentation will include the timeline of NSF discovery, types of GBCAs, known cases of NSF and current research on commonly used GBCAs in renal impaired patients. Recent landmark papers regarding risk of NSF with gadobenate dimeglumine will be specifically discussed. The controversy of renal failure patients receiving MRIs with contrast will be explored and the risks and benefits will be discussed.

Biography:

Christiane Peuckert has completed her PhD at the University of Jena, Germany, where she studied Eph-Ephrin signaling during embryonal brain development. In 2007, she joined the Department of Neuroscience at Uppsala University in Sweden for her postdoctoral studies to investigate neurotransmission in brain and spinal cord and the role of Eph-mediated signaling in early kidney development. Since 2012, she is a senior researcher at Uppsala University and is focusing on cell-cell communication during organogenesis.

Abstract:

Obstructive nephropathy belongs to congenital anomalies of the kidney and the urogenital tract (CAKUT), which are the most frequent causes of early renal failure. Several developmental abnormalities can underlie obstructive nephropathy such as ectopically or blind ending ureters, a duplex collecting system or duplex kidney and posterior urethral valves. Although recent research using mouse models suggests roles for several genes in facilitating proper ureter insertion and development, underlying molecular mechanisms for congenital obstructive nephropathy in humans remain poorly understood. Eph receptors constitute the largest known family of receptor tyrosine kinases and are involved in the modulation of the cytoskeleton. Consequently, Eph signaling regulates cell adhesion and migration, which are important for mechanisms as cell segregation, border formation, adhesion during embryonic fusion events and axon guidance in the developing embryo. We have performed a detailed analysis of a battery of different Eph and ephrin mutant and signaling deficient mice. Impaired Eph signaling leads to severe hydronephrosis and hydroureter. We found that Eph-mediated signaling is crucial for a number of developmental steps, as ureteric bud induction, ureter muscularization, innervation and insertion, all processes which, if disturbed individually, can potentially lead to impaired urine drainage. Our data suggest that the ligands EphrinB2 and EphrinA5 interact redundant with several Eph receptors in forward and reverse mode. Based on our and on the studies of others, genes coding for Ephrins and Eph receptors should be considered in the etiology of CAKUT

Biography:

EM Ranivoharisoa received Bachelor’s degree with Scientific-option in 2002 ; studied human medicine in University of Madagascar and received Doctorate Degree in 2012 ; then studied internal medicine with nephrology orientation in the same University ; started nephrology training in Bordeaux- France in 2013 and has got Diploma of Specialized Medical Training in Nephrology in 2014 in France; studies also « Systemic disease and Kidney » with the University of Strasbourg, France. Nowadays, she has published some nephrology papers in national and international journals. She is member of SMN Madagascar, SFNDT and ISN education.

Abstract:

Patients with Chronic kidney Disease (CKD) are fragile. Hemodialysis, the most useful Renal Replacement Therapy (RRT) in the world is the only one treatment available in Madagascar. It is an invasive act that may expose various and several complications. This present study aims to assess the prevalence of the bacterial complication in patients who lived with chronic hemodialysis. We have conducted a retrospective, exhaustive, descriptive single center study. Record based study was carried in Befelatanana Hemodialysis Center, University Hospital of Antananarivo, the Capital of Madagascar. All patients underwent a chronic hemodialysis who presented an infection sign from 10th May 2006 to 31st July 2010 were included. The Center received 84 patients with End stage of CKD who started chronic hemodialysis. Over 136 infections have been suspected but only 33,8% (n= 45) benefited a bacterial identification. In 42.65% of cases, infection begun in 20 days following the first hemodialysis session. Access vascular using catheter is the principal source of infection in 49,06%, followed by pulmonary (21.3%), urinary (12.5%), and digestive (7.4%) infection. Staphylococcus aureus (34.3%), Escherichia coli (9,4%), Enterococcus spp (9,4%) were the bacteria frequently encountered. Sepsis appeared in 98.52% of cases and any patients presented a septic choc. All patients received an adjusted antibiotic therapy according to susceptibility testing. The survival rate was in 100%. Treatment of CKD is very expensive in Madagascar and less than 3% who need chronic hemodialysis have the opportunity to do it. That explains our few studied population. In our cohort, access vascular related to catheter represents the common source of infection (49.06%). This prevalence is higher than another american studies. Almost of all patients arrive lately at the hospital with an End-stage of CKD imposing starting hemodialysis in emergency with catheter. Another sources of infection have been seen in another sites. Patients can also contract infection independently of hemodialysis. Antibiotic therapy allowed a favorable evolution in almost of the cases. To conclude, using access vascular with catheter is inescapable in our center, inducing bacterial complication, high morbidity in Chronic Hemodialysis. To fix that, promoting native fistula with early nephrology medical follow could be a solution. Renal transplantation with living donor, the best and less expensive RRT than chronic hemodialysis is now in progress, in collaboration with Malagasy Government.

Biography:

Cao Qiong has completed her Master of Science Degree in Medical Science in 2003 from The First Military Medical University . She is the director of Division of Tissue Typing Center, Nanfang Hospital, the largest transplantation center of Southern China. She has published more than 20 papers in reputed journals.

Abstract:

Background: End-Stage Renal Disease (ESRD) is a worldwide public health problem. Currently, many genome-wide association studies have suggested a potential association between human leukocyte antigen (HLA) and ESRD by uncovering a causal relationship between HLA and glomerulonephritis. However, previous studies, which investigated the HLA polymorphism and its association with ESRD, were performed with the modest data sets and thus might be limited. On the other hand, few researches were conducted to tackle the Chinese population with ESRD. Therefore, this study aims to detect the susceptibilities of HLA polymorphism to ESRD within the Cantonese community, a representative southern population of China. From the same region, 4541 ESRD patients who were waiting for kidney transplantation and 3744 healthy volunteer bone marrow donors (controls) were randomly chosen for this study. Polymerase chain reaction-sequence specific primer method was used to analyze the HLA polymorphisms (including HLA-A, HLA-B and HLA-DRB1 loci) in both ESRD patients and controls. The frequencies of alleles at these loci and haplotypes were compared between ESRD patients and controls. A total of 88 distinct HLA alleles and 1361 HLA A-B-DRB1 haplotypes were detected. The frequencies of five alleles, HLA-A*24, HLA-B*55, HLA-B*54, HLA-B*40(60), HLA-DRB1*04, and one haplotype (HLA-A*11-B*27-DRB1*04) in ESRD patients are significantly higher than those in the controls, respectively. Five HLA alleles and one haplotype at the HLA-A, HLA-B and HLA-DRB1 loci appear to be associated with ESRD within the Cantonese population

Biography:

Ayman Aly Seddik was born in 1972,Graduated from in Shams University school of medicine 1996 very good with honour ,interenship and residency programm in Internal medicine and Nephrology 1997-2001 Assistant lecturere and Nephrology specialist in ain Shams University hospital , Nasser institute for research 2001-2006 , after obtaining md degree in Internal Medicine & Nephrology 2006 ain Shams University , work as consultant Nephrologist and lecturer Nephrologist in Ain Shams University hospitals ,senior specialist Nephrologist king fahd armed force hospital jeddah saudia arabia 2006-2008,consultant Nephrologist Northeren area armed force hospital 2009-2011 , programme director of Internal medicine residency programme in northeren area armed force hospital ,degree of assistant profeessor of Internal Medicine and Nephrology Ain Shams University, cairo, egypt 2012.Currently working as Nephrologist , Dubai hospital - Dubai health authority 2011-present .

Abstract:

Introduction:
Central Line associated Blood Stream Infection CLABSI as defined a single blood culture for organisms not commonly present on the skin and two or more blood cultures for organisms commonly present on the skin in a patient who has a central line at the time of infection or within the 48-hour period before development of infection. CRBSI constitutes a major clinical and economic problem and Antimicrobial lock therapy is commonly used for CVC management in a prophylactic modality in patients with protracted central venous access for hemodialysis (HD), chemotherapy, or total parenteral nutrition

Patients And Methods:
A prospective, open-label randomized trial conducted at a single medical center at Hemodialysis unit Ain Shams university hospital . 41 Patients were randomly assigned to receive interdialytic catheter locking with either vancomycin/ heparin or taurolidine/citrate; Taurolock at the end of each dialysis session and continuously since catheter insertion.

Biography:

Sujit Bhattacharya is currently working as a faculty of medicine in Department of Endocrinology (Medicine) at SCB Diabetes & Hormone Research Foundation and Calcutta Medical Research Institute, Kolkata.

Abstract:

Diabetes affects the kidneys and once it is clinically evident it is like a perfect storm, one of the most dreaded micro vascular complications. It not only increases the morbidity and mortality. It shortens the life span by more than 20 years and severely affects the quality of life. It also has significant socioeconomic implications. Currently approximately 50% of ESRD or dialysis patients are Diabetic and the figures are increasing because of the increasing incidence of Diabetes itself.

The epicenter of the storm is the altered metabolic milieu in Diabetes which drives the changes in the glomerular capillaries with consequent glomerulosclerosis coupled with tubule interstitial inflammation, atrophy and fibrosis mainly mediated by TGF-beta and other intermediate molecules. The changing concept of glomerular and tubular injury as well as the pathogenic mechanisms will be unraveled.

The changing epidemiology along with genetic, ethnic and other intercurrent or concurrent metabolic or other risk factors will be discussed. The gold standard of diagnosis is micro albuminuria but it lacks specificity and sensitivity and hence the need for markers for early diagnosis, progression or preservation of renal function.

The duration and the degree of glycemic control can modify the natural history of the storm. Once evident, control of all the modifiable risk factors is the only option. We will discuss the general measures and effective control of hypertension, diabetes and lipid parameters along with other metabolic changes. Emerging strategies of glucose control and its efficacy and benefit with optimal RAAS blockade is an area of interest as it may improve long-term hard endpoints including death. However, we are still short of achieving any improvement beyond a third and yet to overcome the residual risk of the tsunami in the years to come. Hence the way forward is better understanding of the epidemiology, cause and the natural history of the Diabetic nephropathy to find out the most effective multifactorial strategy which can save millions of dollars and thousands of life. Till then, the best control of the storm is primary prevention in the backdrop of the grim forecast of the twin epidemic of Diabetes and Obesity for the next few decades.

Biography:

Shuk-Man Ka has completed her PhD from National Defense Medical Center, Taipei, Taiwan and postdoctoral studies from the Department of Pathology, Tri-Service General Hospital, Taipei, Taiwan and the Initiative of Gene Therapy, Harvard Medical School. She is working as an associate professor at the Academy of Medicine, National Defense Medical Center, Taipei, Taiwan. She has published more than 50 papers in reputed journals.

Abstract:

Lupus nephritis (LN) is a major complication of systemic lupus erythematosus. Development of a novel molecular pathogenesis-oriented therapeutic remedy preventing progression is clinically warranted. The development of accelerated and severe LN (ASLN) has been attributed to a wide range of pathogenic
pathways, such as overt activation of T and B cells, NLRP3 inflammasome and oxidative stress. Unfortunately, the current treatment of ASLN is insufficient. Therefore, to establish novel yet practical therapeutic agents for ASLN is clinically warranted. Xenon (Xe), a noble gas, has been used as an anesthetic, with very low toxicity. In present study, Xe was used to test its renoprotective effects in an ASLN model induced by repeated injections of lipopolysaccharide to SLE-prone NZB/Wf1 mice. The results showed that (1) Xe significantly ameliorated the proteinuria, hematuria, severe renal lesions and improved renal function; (2) Xe suppressed renal inflammation via blocking of the activation of NLRP3 inflammmasome and NF-ĸB; (3) Xe inhibited renal cells apoptosis via blocking Bax/Bcl-2 mediated apoptotic pathway; (4) Xe decreased mitochondrial injury in macrophage, including mitochondrial ROS generation and mitochondrial DNA release into the cytosol. Our data suggest that Xe alleviated the mouse ASLN model by inhibiting the activation of NLRP3 inflammasome and mitochondrial ROS production. Xe may be useful for the treatment of human ASLN.

Biography:

Hoda EL-Attar has completed her MBBS in 11/1979, MS in Chemical Pathology 4/1987 ,MD in Chemical Pathology in 4/2001. She worked as an assistant Professor in Chemical Pathology from 28/8/2006 .Now She is working as a professor in Chemical Pathology since 30/8/2011 in Alexandria University Egypt. She is a member of the European Society of Cardiology (ESC): Working Group on Atherosclerosis and Vascular Biology. She has published 27 papers.

Abstract:

Background:
The first cloned long pentraxin is Pentraxin 3(PTX3) and C-reactive  protein is a human short pentraxin. Pentraxin 3 has a bigger molecular size (40.6 KDa) compared to CRP (21.5 KDa).The long PTX3 is produced by diverse cell types in response to primary inflammatory signals and specific neutrophil granules store PTX3 .

 Aim:
Evaluation of serum levels of long Pentraxin 3 and high sensitivity C-reactive protein in patients with chronic  kidney disease treated with or without haemodialysis.

The study included 75 subjects,25 heathy controls(group1),50 patients without cardiovascular disease subdivided into:25 patients with chronic kidney disease (CKD) on conservative therapy(group 2a) and 25CKD patients on maintenance hemodialysis (group2b).To all studied subjects the following was done :electocardiography,carotid intima media thickness, fasting serum glucose ,renal, liver and lipid profiles,high- sensitivity C-reactive protein (hsCRP) and PTX3by ELISA.

Biography:

Fizza Hassan is a student of Karachi Medical and Dental College. She has been a keen researcher since High School and took part in many scientific projects at city level. She is now a research associate and has helped in the intellectual contribution, data collection, and data entry, summarization of results and presentation of research papers. She is a medical student researcher and has contributed in a couple of papers in international medical journals. She has attended several national and international seminars and conferences. She is looking forward to a bright future in medical career.

Abstract:

Introduction:

Worldwide, there is an increase in number of people suffering from Chronic Kidney Disease (CKD). CKD can give rise to a wide spectrum of oral manifestations, affecting the hard or soft tissues of the mouth, which affect the quality of life adversely. Research has also shown that high titers of antibodies against bacteria, which are found in increased amount due to oral diseases like Periodontitis, are associated with an increased risk of reduced renal function.

Methodology:

Two study groups of total 150 patients were made. Group A had 75 patients which were admitted with complain of chronic kidney failure. Group B had the same number of subjects with severe generalized Periodontitis recruited from Dental OPD. Patients aged 30-70 years old of no specific gender were part of the study. Patients on medications or treatments for any other condition or any hereditary disease that could provide false positive results were excluded.

Periodontal parameters were evaluated prior to and 4 months after delivery of standard non-surgical periodontal therapy and proper oral hygiene instruction to all patients and improvements were noted.

Biography:

Nicolas VIALLET is a thirty-year-old medical doctor. He completed his medical study in Montpellier University, France. Since November 2014, he is nephrologist in Felix Guyon University Hospital, St Denis, Reunion island, France.

Abstract:

The RenalGuard system helps to achieve a high diuresis while simultaneously balancing urine output and venous fluid infusion to maintain euvolemia. This strategy has revealed to be beneficial to prevent contrast-induced acute kidney injury. We hypothetise it could be extended to kidney transplantation as a renoprotective action to prevent delayed graft function. The objective of our pilot study was to evaluate the feasibility and safety of RenalGuard in kidney transplant. Between december 2013 and september 2014, eleven kidney transplanted patients had a forced diuresis by Furosemide with matched hydratation by RenalGuard during the first 36 hours post transplantation (DF group). They were retrospectively compared to eleven similar patients who had spontaneous diuresis (DS group). The 11 patients of the DF group were transplanted from 7 deceased donors (4 with extended criteria) and 4 living donors. Their urine output was 265 (154-350) ml/h versus 69 (51-107) ml/h in the DS group. The diuresis quantification by RenalGuard appeared strongly correlated with the nurse measurement (R² = 0.96, p<0.001) and real-time matched hydration allowed no significant change in weight of patients. Three patients of DF group had major hyperglycemia when using glucose 5% as compensation. Hypokalemia were significantly more frequent in DF group. Use of Ringer lactate with the addition of 1g of KCl per liter should prevent the occurrence of electrolyte disturbances. There was no difference of renal function. We report for the first time the RenalGuard experience in renal transplant patients. Some precautions seem necessary in this population to prevent hyperglycemia, hypokalemia or disorders of bladder emptying.

Biography:

Carolina Becerra is currently a student in the Master of Epidemiology at the Universidad Industrial de Santander. She additionally completed her Global Health and Infectious Disease postgraduate diploma at the University of Edinburgh in 2011. Actually she is part of the INEFAC and CARDIECOL workgroup and is in charge of supporting the recruitment, measurement and interviewing processes of the participators in the 2016 follow up. According to the aforementioned, her dissertation is related to the INEFAC database and thus the master student formation process is enhanced with every roll she has had in the investigation. 

Abstract:

The INEFAC cohort was initiated in 2000 in Bucaramanga, Colombia to estimate the incidence of cardiovascular diseases (CVD) and their risk factors. Follow-up evaluations were conducted in 2007 and 2013. Currently, we are completing the second follow up. Chronic kidney disease (CKD) is a risk factor for cardiac events and involves high mortality rates as a consequence of progression to kidney failure. Recent studies have found that the triglycerides/high-density lipoprotein cholesterol (TG/HDL-c) ratio is an independent risk factor for CKD. The objective of the present study was to evaluate the association between the TG/HDL-c ratio and CKD in the 2007 evaluation of the cohort. The methodology included questionnaires and anthropometric measures in every assessment. CKD was defined as having a glomerular filtration rate <60ml/min/1.73m² with the use of CKD-EPI equation. A stepwise forward logistic regression was done to assess the association adjusted by other covariates. The prevalence of CKD in the population was 2.46% among which only 0.55% knew their condition at the time of the evaluation. The results demonstrated that the odds for having CKD increases 10% for every unit  augmentation of the ratio (p=0.002) when adjusted for independent variables as diabetes, hypertension and age. Additionally, the ROC curve of the fitted model revealed an AUC=91.6%. The model showed an excellent adjustment evidenced through the diagnostic test. In conclusion, the TG/HDL-c ratio was an independent factor associated with the prevalence of CKD in the INEFAC cohort.

Biography:

Michelis has been Director of the Division of Nephrology at Lenox Hill Hospital for more than three decades. He is Clinical Professor of Medicine at the New York University School of Medicine. Dr. Michelis received a B.A. at Columbia College, Columbia University in New York City, and his M.D. degree at George Washington School of Medicine in Washington, D.C. He received his nephrology training at the University of Pittsburgh School of Medicine. Dr. Michelis has been selected for inclusion in the listing of top doctors in New York for the past several years. He is the co-Editor of several medical textbooks, and he has published dozens of articles in the area of general nephrology, electrolyte disorders, hypertension, and geriatric renal disease. He has lectured extensively throughout the United States, Hawaii, Japan, and in various European cities. He has served on the editorial board of several medical journals, and he also reviews articles for established journals in nephrology. He has received many awards and lectureships for his work in nephrology.

Abstract:

A variety of therapeutic interventions are available to alter the abnormalities
seen in patients with chronic kidney disease (CKD).  Programs can now be developed to slow the progression of CKD. This delay can be achieved by using accepted recommendations for optimal diabetes therapy (HbA1c target 7%), goals for blood pressure levels, reduction of proteinuria and the proper use of ACE/ARB therapies. For example, limits on dietary sodium and protein intake and reduction of body weight will be decrease proteinuria. Proper treatment for elevated serum phosphorus and parathyroid hormone levels as well as therapy for dyslipidemias and anemia can mitigate renal loss. Other less widely appreciated measurable abnormalities such as elevated FGF-23 levels, hyperuricemia and metabolic acidosis have more recently been recognized to be associated with progressive renal insufficiency. Efforts aimed at correction of these disorders may have an important role in altering the course of renal dysfunction. Data will be presented to support this strategy.

Biography:

Mitul Bora has doing his sepicilization in International Hospital of Guwahati located in Inda.

Abstract:

Cardiovascular disease (CVD) is the leading cause of death in the general population and a major cause of morbidity and mortality in chronic kidney disease (CKD) and end stage renal disease (ESRD) patients . The high prevalence of CVD in incident dialysis populations suggests that CVD begins during or before the stage of chronic renal insufficiency. However the cause of the increased in the CVD in patients of CKD including those who are on dialysis is not explained by the traditional risk factors alone. Various nontraditional factors such as hyperhomocysteinemia, hyperparathyroidism, inflammation (indirectly measured with highly selective CRP), acute phase reactants (albumin and fibrinogen), oxidative stress and endothelial dysfunction have all been proposed for this increased incidence of CVD. In fact oxidative stress, endothelial dysfunction, and inflammation represent a key triad serving as the foundation for the development and progression of atherosclerosis. Chronic kidney disease patients, peritoneal and haemodialysis patients, as well as renal transplant patients all show an equal susceptibility in oxidative stress, indicative of a higher degree of inflammatoty activity in these patients. N – acetylcysteine (NAC) serves as an antioxidant by virtue of its interaction with reactive oxygen species. The drug acts on atherosclerosis through several mechanisms including decreased apoptosis, vasoconstriction and endothelial dysfunction

Biography:

Dwijen Das has completed his MBBS at the age of 23 years from Gauhati University and MD in general Medicine from Dibrugarh University, Assam, India in 2004. He is working as Associate Professor and In Charge dialysis unit in Silchar Medical College, a premier Medical Institute in north eastern India. He has published more than 15 papers in reputed journals and has been serving as an editorial board member of Assam Journal of Internal Medicine. He is also a peer reviewer in 2 national reputed journals

Abstract:

Labeo rohita, commonly known as “Rohu” an Indian variety of the fish belonging to the carp species is a fresh water fish and is commonly consumed in north eastern India. The raw fish gall bladder is consumed by some people with different beliefs ranging from visual improvement, cure for gastric related diseases, rheumatism or aphrodisiac especially among the younger population. The toxicity induced by the fish bile leads to a variety of manifestations ranging from gastro intestinal upset, hepatic and renal dysfunctions which can be fatal and may lead to mortality unless timely intervention is done. We, report a series of three consecutive cases of fish bile toxicity all of whom had similar presentations of acute onset abdominal pain, cramps, nausea, vomiting with tachycardia, tachypnoea, abdominal distension followed by hepatic dysfunctions like jaundice, raised alanine aminotransferase and aspartate aminotransferase and nephrotoxic manifestations in the form of acute kidney injury leading to oliguria or anuria and raised creatinine levels. All the cases recovered with intravenous fluid replenishment, symptomatic management and supportive hemo- dialysis. Apart from the established nephrotoxins like paraphenylenediamine hair dye, snake venom, paraquat, paracetamol, herbal medicines, cotinarius mushrooms leading to acute kidney injury, lesser known substances like various bile components namely cyprinol, a C-27 alcohol found in the bile of cyprinid fish and 5α cyprinol sulfate has a deleterious effect on the kidneys. 5α cyprinol sulfate found in 5 species of fish belonging to the order cypriniformes have been associated with bile induced hepatitis and renal failure

Biography:

Graduated from School of Medicine, Keio University (MD), and obtained PhD degree from Keio University. Clinical fellowship in Transplant Surgery, MCV, USA. Licensed in USA (Virginia Board of Medicine and Surgery). Emeritus Professor, University of the Ryukyus after professorship and chair, Department of Urology. Consultant, Tokyo-West Tokushukai Hospital.

Abstract:

The organ donor shortage is a serious problem in Japan and leads to an increase in transplant tourism to Asian countries. Restored kidneys after nephrectomy for small renal tumor (low-risk of cancer transmission) have been considered as a source for potentially solving the problem. Approximately 100 cases as such were collected by Yu. We are performing two prospective clinical trials that utilize restored kidneys after resection of renal tumors for transplanting into unrelated (20 cases estimated) and related recipients (5 cases).

Twelve unrelated patients and four related donors donated kidneys with renal tumors (14 RCCs and 2 AMLs). The kidney nephrectomized was restored and transplanted into unrelated and related recipients. Unrelated transplant was performed in 12 patients including 4 with transplant history, and related transplant in 4 patients (ABO-incompatible in 2). Ten recipients experienced rejection episodes and the latest serum creatinine levels ranged from 1.10 to 3.19 mg/dl at 2 months to 6 years after transplant. One returned to dialysis, one unrelated recipient died of infection and uremia at 5 months and another related recipient died of unknown cause with functioning graft at 2 months. Four restored kidneys from donors over 70 years old are functioning well. There is no RCC recurrence in the recipients so far.

In conclusion, selected candidates can benefit from restored kidney transplant, achieving good renal function without recurrence of RCC.

Biography:

Anil K Mandal is a native of India and a naturalized citizen of the United State of America. He is board certified in Internal Medicine and Nephrology (not yet recertified in nephrology). Diabetes Mellitus is the most common cause of kidney failure in the USA and worldwide. This strong association between diabetes and kidney failure has inspired Dr. Mandal to develop the framework of Mandal Diabetes Research Foundation to assist diabetic patients in living a good life with medical treatment, and avoiding dialysis. He is a published author/editor of 12 books and more than 100 articles on research indiabetes and kidney disease. He is a two-time Fulbright Scholar and a visiting professor of 23 countries which permitted lectures on diabetes, high blood pressure and kidney diseases on five continents of the world. His astute knowledge and total dedication help patients get better and to live a good life. His convictions are that in the office patients come first, at home children come first. Roses are his love, hence rose gardening is his hobby.

Abstract:

This treatise of chronic kidney disease (CKD) describes association of hypertension, diabetes and congestive heart failure (CHF) with CKD. CKD is defined by estimated glomerular filtration rate (eGFR) of less than 60ml/min for three months or more. CKD is generally irreversible but not necessarily progressive. Thus progression of CKD into end stage renal disease (ESRD) is the concern here and what can be done to reduce the progression of CKD. Exact data of CKD with progression is unavailable but high incidence of ESRD (dialysis) eleven times more in 2011 than in 1980 accordingly to United States (US) Renal Data System is a testimonial to progression of CKD in patients with diabetes, hypertension, CHF and other renal diseases. US Renal Data System reveals that ESRD has soared in parallel with marketing of angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) drugs, providing strong indirect evidence that these drugs are someway instrumental in the progression of CKD into ESRD. These drugs produce acute renal failure which is an independent risk factor for CKD. Thus shift in therapy with enthusiastic use of ACEI/ARB drugs has led to dialysis bonanza throughout the world benefiting the professionals and corporations at the expense of vegetative life of the patients associated with family and societal burdens. The ways to turn the pendulum is to treat diabetes with insulin and hypertension with beta blocker, calcium channel blocker and diuretic therapy, and avoid the use of ACEI/ARB drugs. It is important to understand that diuretic orally, by intravenous boluses or by continuous infusion is the cornerstone of therapy for CHF, whereas ACEI/ ARB drugs markedly impair the efficacy of diuretics by lowering the blood pressure to a very low level thereby reducing renal perfusion. An evidence for that is marked elevation of BUN with comparatively slight increase of serum creatinine. Thus with the approaches stated above, CKD is less likely to progress; hence rate of ESRD is likely to decrease.

Biography:

Ayman Aly Seddik was born in 1972,Graduated from in Shams University school of medicine 1996 very good with honour ,interenship and residency programm in Internal medicine and Nephrology 1997-2001 Assistant lecturere and Nephrology specialist in ain Shams University hospital , Nasser institute for research 2001-2006 , after obtaining md degree in Internal Medicine & Nephrology 2006 ain Shams University , work as consultant Nephrologist and lecturer Nephrologist in Ain Shams University hospitals ,senior specialist Nephrologist king fahd armed force hospital jeddah saudia arabia 2006-2008,consultant Nephrologist Northeren area armed force hospital 2009-2011 , programme director of Internal medicine residency programme in northeren area armed force hospital ,degree of assistant profeessor of Internal Medicine and Nephrology Ain Shams University, cairo, egypt 2012.Currently working as Nephrologist , Dubai hospital -Dubai health authority 2011-present.

Abstract:

Introduction: Peritonitis in the peritoneal dialysis (PD) patient is defined by the International Society for Peritoneal Dialysis (ISPD) as the presence of two of the following three criteria: (1) signs and symptoms such as fever, abdominal pain/tenderness; (2) >100 white blood cells/mL dialysate fluid, of which >50% are neutrophils; and (3) identification of the organism in the PD fluid (1). Peritonitis still represents the main acute complication of peritoneal dialysis (PD) and is a leading cause of hospitalization catheter loss, and technique failure (2).

Patients and Methods: Quantitative approach, retrospective study. We analyzed a database of patients from the Nephrology Service at Dubai hospital, Dubai health authority from January 1999 till December 2012 The analysis included patients in PD for more than 3 months and with complete information. We collected data regarding the catheter and patient outcome following recorded peritonitis episodes. The rate of peritonitis was expressed as risk of a peritonitis episode per year (ep./year) and calculated in accordance with the  ISPD recommendations.

Biography:

Helene is Managing Vice-President and Global Head of Real-World Modeling at LASER Analytica, a cutting-edge population health consultancy with operations in 8 countries. She develops and coordinates LASER’s offer in analytics, and has 15 years of experience in quantitative methods applied to impact decisions in health care – as an academic, a drug developer, a start-up board member, and a consultant. In particular, she gained hands-on drug development experience in roles of increasing responsibility at Novartis from discovery to market launch. Hélène holds a physics degree from Ecole Polytechnique, France and a PhD in computer science and biology from MIT, USA.

Abstract:

The present study aims to compare overall survival (OS) in metastatic RCC (mRCC) between nivolumab and cabozantinib from two recent pivotal studies comparing, respectively, each one of the two emerging treatments against everolimus in patients who relapse following first-line treatment. Comparison is traditionally carried out using the Bucher method, which assumes proportional hazard. Since OS curves intersected in one of the pivotal studies, models not assuming proportional hazards were also considered to refine the comparison. Four Bayesian parametric survival network meta-analysis models were implemented on overall survival (OS) data digitized from the Kaplan-Meier curves reported in the studies. Three models allowing hazard ratios (HR) to vary over time were assessed against a fixed-HR model. The Bucher method favored cabozantinib, with a fixed HR for OS vs. nivolumab of 1.09 (95% confidence interval: [0.77, 1.54]). However, all models with time-varying HR showed better fits than the fixed-HR model. The log-logistic model fitted the data best, exhibiting a HR for OS initially favoring cabozantinib, the trend inverting to favor nivolumab after month 5. Numerical differences in study-adjusted OS estimates between the two treatments remained small. This study evidences that HR for OS of nivolumab vs. cabozantinib varies over time, favoring cabozantinib in the first months of treatment but nivolumab afterwards, a possible indication that patients with poor prognosis benefit more from cabozantinib in terms of survival, nivolumab benefiting patients with better prognosis. More evidence, including real-world observational data, is needed to compare effectiveness between cabozantinib and nivolumab

Biography:

Paulo Roberto Santos is Associate Professor at Federal University of Ceará, Brazil, and coordinates the Graduate Program in Health Sciences of the Sobral Faculty of Medicine. His main research interests are self-perceived outcomes (quality of life, depression, coping strategies and sexuality) among end-stage renal disease patients.

Abstract:

End-stage renal disease (ESRD) is associated with several stressors that affect family dynamics and social relationships of hemodialysis (HD) patients. Social support is well known to influence quality of life and mortality among ESRD patients. Thus, it is crucial to understand the association between social support given to ESRD patients and demographic and clinical variables commonly used in clinical practice. We aimed to verify the association of social support perceived by ESRD patients undergoing HD with demographic and clinical variables. We studied 161 patients submitted to HD in the only two dialysis centers in northern Ceará state, northeast Brazil. We excluded patients under 18 years of age and on HD for less than three months. Social support was measured by The Medical Outcomes Study Social Support Survey (MOS-SS). MOS-SS comprises 19 items and generates scores from 0 (worst) to 100 (best) related to five dimensions of social support: Instrumental Support, Affection, Positive Social Interaction, Emotional Support and Informational Support. The following demographic variables were collected: gender, age, religion, marital status and economic class: E (lowest economic class) to A (highest). The clinical variables were etiology of renal disease, time on HD and an index based on comorbidity, as described by Khan: low-, medium- or high risk. We compared scores generated by the MOS-SS related to the five dimensions of social support between men and women; patients younger 60 years vs. 60 years or older; married vs. unmarried; Catholics vs. non-Catholics; economic classes B and C vs. D and E; time on HD up to 36 months vs. more than 36 months; diabetics vs. non-diabetics; low-risk vs. medium- and high-risk. Comparisons were performed by Student’s t test. Statistical significance was considered to be P < 0.05. The sample was formed mostly by men (65.3%), had mean of age of 50.3 years, and mostly came from economic classes C and D (91.3%). The main etiology of ESRD was hypertension (34.2%) followed by glomerulonephritis (25.2%) and diabetes (21.7%). Patients were undergoing HD for a mean of 46.2 months. More than half of them (50.9%) presented low risk based on comorbidity. Among five dimensions of social support, Affection was the best scored (mean score=87.7) and Positive Social Interaction the worst (mean sore=73.5). The demographic variables associated with social support were: age, marital status and economic class, in the following way: older patients perceived higher Instrumental Support; married patients perceived higher and Emotional Support compared to unmarried; patients from high economic classes perceived better Affection. Among clinical variables, only longer time on maintenance HD was associated with lower Instrumental Support. We concluded that  younger patients, single patients and patients from low economic class should be seen as having higher risk of receiving poor social support. For them, educational intervention, search for community resources and strengthening of patients’ interaction with family and friends should be promoted by social workers.

Biography:

Praveen Kumar Kolla has completed his graduation in Medicine from Kurnool Medical college , Kurnool and post graduation in Internal Medicine from Manipal Academy of Higher Education . He was trained in Nephrology from Sri Ramachandra University, Chennai, India. He is the Professor and Head , Department of Nephrology, Narayana Medical College, Nellore. He has published more than 20 papers in reputed journals.

Abstract:

Introduction: Invasive fungal infections cause significant morbidity and mortality in renal transplant recipients. The opportunistic pathogens such as Candida, Aspergillus, Mucormycosis, Cryptococcus, Histoplasma,Coccidioides are known to infect the kidneys in predisposed individuals with serious complications. Recipients of solid organ transplants have 24-40% incidence of opportunistic fungal infections with a very high mortality of 70-100%. Objective: To report the spectrum of fungal infections in renal allograft recipients at Narayana medical college -Nellore , Andhra Pradesh, INDIA. Materials and Methods: 70 patients who underwent kidney transplantation between march 2010-feb 2016 were reviewed. Among these, 65 were live related and 5 were deceased donor transplants. Only 16 patients received induction therapy with either ATG or Basiliximab and all were on triple immunosuppression with Tacrolimus, MMF and Steroids. Patients who were diagnosed having fungal infections were included in our study. Diagnosis was based on clinical, radiological, culture and histopathological examination. Results: Out of 11 patients with various fungal infections 4 were found to have aspergillus, 2 were infected with Candida , 3 with Pneumocystis, 1 with mucor mycosis,1 with chromoblastomycosis. Of these 3 were in the form of cutaneous nodules, 7 were invasive fungal infections, One had aneurysm of graft renal artery. Inspite of appropriate antifungal therapy 4 of these patients with invasive fungal infection expired . Conclusion: The mortality of invasive fungal infections is still high in renal allograft recipients despite newer antifungal agents. Early detection of invasive fungal infections and prompt initiation of therapy are important in reducing mortality.

Biography:

Tomasz KamiÅ„ski graduated Medical University of BiaÅ‚ystok (Poland) with a master degree in pharmacy and currently is a PhD student at international Interdisciplinary Doctoral Studies in English at Medical University of Bialystok and Hasselt University. Presently he is the principal investigator of two projects supported by Leading National Research Centre (The Centre for Innovative Research at Medical University of Bialystok) and the project supported by the Polish National Science Centre. All above-mentioned projects focus on searching connections between kidney diseases and hemostatic disorders. Furthermore, he has been granted with the award of Rector of Medical University of BiaÅ‚ystok for outstanding scientific achievements.

Abstract:

Objectives: Patients with chronic kidney disease (CKD) are at higher risk of incidence of thromboembolic events. The effect of continuous loss of function of nephrons is a progressive accumulation of uremic toxins. Indoxyl sulfate (IS) is an aggressive uremic toxin exerting proinflammatory and prooxidative properties, which affects multiple signaling pathways.

Aim: We examined the association between indoxyl sulfate and activation of the coagulation system in predialysis patients with CKD.

Methods: Studies have been conducted on a group of 53 patients with CKD on conservative treatment and 18 healthy volunteers. For the determination of parameters of coagulation ELISA-immuno-enzymatic kits were used,  whereas the IS levels were determined by HPLC. The hematological and biochemical parameters were assessed using standard laboratory methods.

Biography:

MaÅ‚gorzata Karbowska graduated Jagiellonian University Medical College with a master degree in pharmacy and currently is a PhD student at Medical University of Bialystok. As a young scientist she received Scholarship from the Minister of Science and Higher Education for outstanding achievement. Presently she is managing project supported by Leading National Research Centre (The Centre for Innovative Research at Medical University of Bialystok) and is co-investigator of Preludium project supported by the Polish National Science Centre – both projects focus on nephrology.

Abstract:

Objective: Chronic kidney disease (CKD) is associated with higher risk for thromboembolic events compared with general population. Indoxyl sulfate (IS) is a potent uremic toxin associated with the appearance of cardiovascular disease prevalence. However, mechanism underlying IS association with thromboembolic events is not fully understood.

Material and methods: We evaluated the effect of IS on thrombotic process after acute treatment in electrical current-induced arterial thrombosis in Wistar male rats. IS doses: 3, 10, and 30 mg/kg of body weight were administered intravenously. We assessed IS influence on parameters of coagulation, fibrinolysis, collagen-induced platelet aggregation and blood morphology.

Biography:

Beata Znorko completed her Master degree in Laboratory Medicine in 2013 at Medical University of BiaÅ‚ystok. Currently I am PhD student at Faculty of Pharmacy with the Division of Laboratory Medicine at Medical University of Bialystok. I am head of the project funded by National Science Centre Poland entitled: ‘Osteoprotegerin - ally or enemy of blood vessels calcification in the experimental model of chronic kidney disease in rat? ‘ and ‘Molecular mechanisms of vascular calcification in chronic kidney disease as a link between bone and vasculature’ funded by KNOW The Leading National Research Centre and The Centre for Innovative Research (CIR).

Abstract:

Chronic kidney disease-mineral and bone disorders (CKD-MBD) are common during the course of CKD and related to disturbances in bone strength and metabolism. Recent research shows that the osteoprotegerin (OPG) and receptor activator of NF-κB ligand (RANKL) play a significant role in the development of CKD-MBD. The aim of the study was to investigate if the OPG/RANKL system affects biomechanical properties in young, growing rats with experimental model of chronic renal failure (CRF). The animals were divided into two groups: sham-operated and subtotal nephrectomized rats. Left femurs were excised one and three months after nephrectomy for determination of biomechanical properties: three-point-bending test in femoral diaphysis and bending test in femoral neck. Soluble RANKL(sRANKL) and OPG were measured in homogenates from trabecular and cortical bone tissue. Trabecular and cortical OPG was increased in CRF in comparison to control three months after surgery, whereas trabecular sRANKL was increased one month after nephrectomy. At the level of femoral neck, OPG in trabecular bone tissue
correlated positively with stiffness (r=0.539,p=0.017) and ultimate load (Fu) (r=0.611,p=0.05), and inversely with work to fracture (W) (r=-0.465,p=0.044). sRANKL in both and cortical bone tissue was positively correlated with W (r=0.648,p=0.01; r=0.420;p=0.05, respectively) and inversely with stiffness (r=0,474,p=0.026). At the level of femoral diaphysis, sRANKL was inversely associated with Fu  (r=-0.503,p=0.017) and there were no associations between cortical OPG levels and these parameters in both femoral neck and diaphysis. In young, rapidly growing rats OPG and sRANKL exerts opposite effect on biomechanical bone strength in experimental CRF.

Biography:

Rajendra Bhimma, MB, ChB, MD, DCH (SA), FCP (Paeds)(SA), MMed (Natal), is Associate Professor of Pediatrics, Principal Specialist, Department of Pediatrics and Child Health, Nelson R Mandela School of Medicine,  University of KwaZulu-Natal, South Africa. He has published over 50 articles in peer-reviewed journals. He is a member of the following Societies: American Association for the Advancement of Science, International Pediatric Transplant Association, International Society of Nephrology, South African Medical Association, South African Paediatric Association, South African Transplant Society. Research interest in glomerular diseases, especially HIV associated kidney diseases. He is also a long-standing member of the Biomedical Research Ethics Committee of the University of KwaZulu-Natal and an editorial board member of two international journals.

Abstract:

To review the changing paradigms in the diagnosis, investigation and management of urinary tract infections (UTIs) in children beyond the neonatal period.

UTIs are the second most common cause of serious bacterial infections in early childhood, thus placing a huge financial burden on the health budget.  Despite increasing resistance to several first-line antibiotics, appropriate antibiotic treatment has almost eliminated mortality. 

Early guidelines advocated aggressive treatment and extensive imaging studies, particularly for the detection of serious ureteric reflex and kidney scarring. Treatment in the acute episode is aimed at eradication of bacteriuria and alleviation of symptoms.  Long-term goals include prevention of recurrent attacks of UTIs, kidney scarring and correction of urological lesions that may predispose to recurrent infections.   Although there is increasing evidence to show that long-term antimicrobial prophylaxis may be associated with a reduced risk of recurrent infection in selected groups of patients, but not renal scarring, more studies are needed to confirm this.

Surgical intervention is now restricted to cases with severe vesicoureteric reflux and failed medical management with endoscopic surgery being increasingly used in most centres compared to open surgery.

Biography:

Sudip Kumar Datta has completed his MD in Clinical Biochemistry and currently working as an Assistant Professor in the Department of Laboratory Medicine, AIIMS, India since 2014. He has published more than 10 papers in national and international journals of repute and is also serving as Assistant Editor for the Journal of Laboratory Physicians. His area of interest is gene-environment interaction in CKD patients so as to identify potential biomarkers for the disease progression.

Abstract:

Till date there is no clear answer regarding whether high levels of organochlorine pesticides (OCP) found associated with chronic kidney disease (CKD) cause kidney damage or they get accumulated due to falling glomerular function rate (GFR). We have observed that blood OCP levels as analyzed by gas chromatography, show significantly higher levels in CKD patients. Spearman’s correlation analysis of OCP levels with eGFR exhibited significant negative correlation for most individual OCPs which persisted even after statistical adjustments for age, sex, BMI, total cholesterol and triglycerides. Another of our studies pointed out association of higher OCP loads in patients with genetic polymorphisms involving CYP1A1. Subjects carrying at least one mutant allele of CYP1A1*2A (TC, CC) and *2C (AG, GG) were found to have a modest rise of odds (1.4-2) of association with CKD. However, genotypic combinations of heterozygous/homozygous mutants were found to be significantly associated with CKD with odds ratios ranging from 1.8-3. Another of our studies, where we also analyzed genetic polymorphisms of GSTM1 and GSTT1, showed similar results. We observed that, presence of GSTM1(-)/GSTT1(-) genotype was associated with 1.8-fold higher odds of association with CKD compared to wild genotypes i.e., GSTM1(+)/GSTT1(+). Logistic regression analysis by taking wild genotypes GSTM1(+)/GSTT1(+) as reference revealed that, in CKD patients several pesticides showed significant association with either null or both null genotypes. The above results suggest that decreasing GFR and genetic polymorphisms involving xenobiotic metabolising genes both play a role in accumulation of OCPs in CKD patients.

Biography:

Mustafa Kumru was doing his specialization from Fatih University located in Turkey.

Abstract:

In this study, seven human urinary stones were collected from Istanbul, Turkey. They labeled S1 to S7, their XRD, FT-IR, FT-Raman and EDX spectra as well as SEM images have been recorded to determine their chemical compositions, morphologies, crystal structures, and crystallite sizes. XRD and vibrational (FT-IR and FT-Raman) analyses indicate that S1 is apatite and S2 contains both calcium oxalate monohydrate and apatite, S3–S7 are composed of calcium oxalate monohydrate. The ratios of organic and inorganic contents of the stones have been determined by their thermogravimetric analyses and these analyses also demonstrate characteristic peaks for the dehydration and the decomposition of calcium oxalate and apatite. The present characterization study is especially useful for the future classification studies of renal studies needed for treating urinal diseases

Biography:

Varun Kumar Bandi has completed his PhD from Ramachandra University, India in the Department of Nephrology and he has published more than 25 papers in reputed journals.

Abstract:

Patients receiving a solid organ transplant have an increased risk of developing post-transplant lymphoproliferative disorder (PTLD). Incidence of PTLD is 1% in renal allograft recipients. Most of the PTLDs are of B cell origin, and are found to have evidence of Epstein–Barr virus (EBV) infection. The immunosuppressant mediated decrease in activity of the natural cytotoxic T-cells is probably one of the contributing factors. We report a case of PTLD occurring in the transplanted kidney of a 45 year old male, 7 years after transplant who presented with graft dysfunction. The graft biopsy revealed presence of lymphoid proliferation, confirmed by histochemistry and a diagnosis of monomorphic B-cell lymphoma was made. He was treated by reducing the immunosuppression and is doing well on follow up with stable graft function at 8 months follow up. We suggest that allograft dysfunction in renal transplant recipients should have a detailed evaluation, including for PTLD involving the allograft. PTLD limited to the renal allograft in renal transplant patients has a benign behavior; therefore it is important to screen renal recipients with allograft dysfunction for early diagnosis of PTLDs.

Biography:

Otgonchimeg Rentsendorj has more than 15 years of research-based experience in “Endothelial molecular biology, biomarkers, blood products, renal and lung injuries, toxicology, and virology”. She completed her PhD (Molecular biology) at the Hungarian Academy of Sciences in Szeged in 2006. She was a Visiting Scholar, Post-doctoral and a Research Associate at the Johns Hopkins University. In January 2015, she joined the Laboratory of Biochemistry and Vascular Biology, Division of Hematology Research and Review at CBER, FDA. Her current research focuses on “Animal models and tissue injuries induced by hemoglobin-mediated oxidative stress”. She has authored 50+ abstracts and papers.

Abstract:

Polymerized cell-free hemoglobins are being developed as oxygen and plasma volume-expanding therapeutics though their potential to promote oxidative tissue injury has raised safety concerns. Using a guinea pig exchange transfusion model, we explored oxidant mechanisms of polymerized bovine hemoglobin (HbG) in renal injury. Several renal injury markers including oxidative stress and inflammation markers were targeted. HbG infusion increased tubular injury markers including neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury marker-1 and reduced the transcription of glomerular filtration barrier components including podocin, and nephrin. Increased renal heme oxygensase-1 (HO-1) and decreased enzymatic antioxidants including SOD isoforms 1-3, GPx1, GPx3, GPx4, and CAT were also detected at the mRNA, protein, and activity levels. Furthermore, DNA methylation analyses identified CpG hypermethylation in the gene promoters for all enzymatic antioxidants that we studied suggested an epigenetic-based mechanism underlying the observed gene repression. HbG also induced oxidative stress as evidenced by increased renal lipid peroxidation end-products and 4-HNE immunostaining, which could be the result of the depleted antioxidant defenses and/or serve as a trigger for increased DNA methylation. Together, these findings provide evidence that the renal exposure to HbG suppresses the function of major antioxidant defense systems which may have relevant implications for understanding the safety of hemoglobin-based products and may serve as sensitive and specific biomarkers in kidney injury.

Biography:

Mohamed Siyab Eldin Elsadig Ahmed has completed his doctorate at the age of 39 years from University of Tuebingen. He is the head department of molecular biology. He has published about 10 papers in reputed journals. Ahmed is also an editorial and advisory board member of JBRC.

Abstract:

Anemia is a major complication of end stage renal disease. It is mainly the result of impaired formation of erythrocytes due to lack of erythropoietin and iron deficiency. However, compelling evidence points to the contribution of accelerated erythrocyte death, which decreases the life span of circulating erythrocytes. Erythrocytes may enter suicidal death or eryptosis, which is characterized by cell shrinkage and by cell membrane scrambling with phosphatidylserine-exposure at the erythrocyte surface. Triggers of eryptosis include increase of cytosolic Ca²⁺-activity ([Ca²⁺]i). Erythrocytes could be sensitized to cytosolic Ca²⁺ by ceramide. In end stage renal disease, eryptosis may possibly be stimulated by uremic toxins. The present study explored, whether the uremic toxin acrolein could trigger eryptosis.

Cell volume was estimated from forward scatter, phosphatidylserine exposure from annexin-V-binding, hemolysis from hemoglobin release, [Ca²⁺]i from Fluo3-fluorescence, and ceramide from fluorescent antibodies.

In results a 48 h exposure to acrolein (30 – 50 μM) did not significantly modify [Ca²⁺]i but significantly decreased forward scatter and increased annexin-V-binding. Acrolein further triggered slight, but significant hemolysis and increased ceramide formation in erythrocytes. Acrolein (50 μM) induced annexin-V-binding was significantly blunted in the nominal absence of extracellular Ca²⁺. Acrolein augmented the annexin-V-binding following treatment with Ca²⁺ ionophore ionomycin (1 μM).

Finally we concluded that acrolein stimulates suicidal erythrocyte death
or eryptosis, an effect at least in part due to stimulation of ceramide formation with subsequent sensitisation of the erythrocytes to cytosolic Ca²⁺.

Biography:

Ms. Emilda Judith Ezhil Rajan has completed her M.Phil in Clinical Psychology in Sri Ramachandra University. She is currently perusing her Ph.D. in profiling the psychological and the physiological indicators in ESRD patients. Currently working as a Clinical Psychologist in Sri Ramachandra University, her area of work is in Behavior analysis and therapy with focus on Cognitive Behavior Therapy, and has over five years of experience in these areas. She is part of the Transplant team specific to Liver and Kidney Transplant and also member of the Quality Cell of the University and Medical College.

Abstract:

Disease of the Kidney has a large impact not only on the physical condition of the patient but also on the psychological and psyco-social dimension of their life. It is more variedly intrusive to an individual as it requires a major lifestyle change that is to be brought about aggressively for one to cope with the treatment process, its recovery and maintenance. The resultant psychological entities have shown to have a marked effect on the individual’s treatment outcome. The increase in psychological distress has indicated changes in key physiological aspects of individual’s with kidney disease. Depression, anxiety, illness intrusiveness with combined impact on the quality of life of individuals with kidney disease has shown to have marked variations in the physical out of treatment for kidney disease. This is most of them the result of inability to adhere to the lifestyle changes and develop adaptive behavior and coping mechanisms that can ease the process of treatment and provide an healthy transaction as to living with kidney disease and avert the fast progression of the resultant decline of the individual’s health resulting from the treatment plan for the kidney disease. Further studies must focus on developing an effective plan of care process and identification and early intervention of psychological and psychosocial aspects of kidney disease along with the medical regimen that the patient is to follow. 

Biography:

Ana Maria Suarez Conejero, 2nd degree Internal Medicine Specialist  and  Auxiliar Professor in Faculty of Medical Sciences “Fainlay Albarran” at Mecial Sciences University of Havana.

Abstract:

Background: Sudden cardiac death is frequent in patients with end-stage renal disease. It seems to be ventricular arrhythmias may contribute to mortality. For that reason, would be important to estimate the frequency of significant intradialytic ventricular arrhythmias in patients with end-stage renal disease on hemodialysis and the relationship between the grade of ventricular arrhythmias and clinical, laboratory, electrocardiogram and echocardiogram parameters.

Methods:  Case-control study was performed. 57 patients with end-stage renal disease on maintenance hemodialysis were studied. Holter monitoring was performed the first and second days of dialysis during all hemodialysis session. 114 recordings were analyzed.

Results: Ventricular arrhythmias during hemodialysis were noted in 57 recordings (50%). In 24% of them, complex ventricular arrhythmias were found. In logistic regression analysis age > 45 (OR: 19.75), male (OR: 12.34), left ventricular hypertrophy (OR: 7.46), bundle branch blocks (OR: 10.98), post-dialysis urea > 9 mmol/L (OR: 5.04) were independent predictors associated with complex ventricular arrhythmia.

Conclusions: Complex ventricular arrhythmias were detected in a significant proportion of patients with end-stage renal disease during hemodialysis. Age, male, left ventricular hypertrophy, bundle branch blocks and postdialysis urea were predictors of complex ventricular arrhythmia.

Key words: Hemodialysis, Ventricular arrhythmias, End-Stage Renal Disease, Holter monitoring, Electrocardiography.

Biography:

Jin Uk Jeong has completed his master’s degree at the age of 23 years from Ulsan University School of Medicine. He is an assistant professor of Eulji University School of Medicine.

Abstract:

A 58-yr-old man presented with leg edema and subacute weakness of his bilateral lower extremities. Urinary and serum immunoelectrophoresis revealed the presence of lambda-type Bence Jones proteins. He was ultimately diagnosed with monoclonal gammopathy of undetermined significance (MGUS). A renal biopsy specimen showed fibrillary glomerulonephritis (FGN), which was randomly arranged as 12–20 m nonbranching fibrils in the basement membranes. Immuno- fluorescence studies were negative for immunoglobulin (Ig)G, IgM, IgA, C3, and kappa light chains in the capillary walls and mesangial areas. Fibrillary glomerulonephritis (FGN) is an idiopathic glomerular disease characterized by randomly arranged, Congo rednegative fibrils, 16–24 nm in diameter . FGN is sometimes associated with autoimmune diseases or lymphoproliferative disorders, and is associated with serum or urine monoclonal gammopathy . A Congo red stain for amyloid was negative. Electromyography and nerve conduction velocity examinations results were compatible with the presence of demyelinating polyneuropathy. This case showed a rare combination of FGN, without Ig deposition, and MGUS combined with chronic inflammatory demyelinating polyneuropathy (CIDP).

Biography:

Keisuke Sugimoto have completed M.D at the age of 27 years, and Ph.D at the age of 34 years from Kindai University Faculty of Medicine. I worked as a research fellow at Department of Nephrology, Vanderbilt University in USA. I obtained a position as a assistant professor of Deaprtment of Pediatrics, Kindai University Faculty of Medicine. I have published more than 20 papers associated with nephrology.

Abstract:

Background. Nephronophthisis (NPH) is a disease characterized by renal medullary cyst formation . NPH accounts for 4 to 5% of end-stage renal disease occurring in childhood.

Method:
We investigated the clinical context and characteristics of renal and extrarenal symptoms, as well as the NPHP genes with genomic DNA extraction, PCR, and determination of NPHP gene sequence, in 35 Japanese patients with clinical and histologic features suggesting NPH.

Results:
NPH occurred fairly uniformly throughout Japan irrespective of region or gender. In 3 families, NPH affected siblings. Age of patients ranged from 2 to 38 years (median; 12.5. Renal abnormalities attributable to NPH discovered through mass screening, such as urine tests in school. However, NPH accounted for less than 50% of children with abnormal findings, including incidentally discovered renal dysfunction during evaluation of extrarenal symptoms or during routine check-ups. Typical extrarenal manifestations leaded to discovery including anemia and delayed physical development. The urine often showed low gravity specific density and low-molecular-weight proteinuria. Frequent renal histologic findings included cystic dilation of tubules, mainly in the medulla, and irregularity of tubular basement membranes. Genetically abnormalities of NPHP1 were not common, with large deletions frequently noted. Compound heterozygotes showing single abnormalities in each of NPHP1, NPHP3, and NPHP4 were observed.

Conclusions:
Our findings resemble those reported in Western populations.

Biography:

Apeksha Niraula is currently a Junior Resident (III Year) in Department of Biochemistry at BPKIHS, Dharan. She will be completing her MD at the end   of August 2016. She has completed her undergraduate from the same university(BPKIHS) itself. She has keen interest in researches and exporing new areas of biochemical and molecular biology. Few of her researches is on the way of publication. She has also presented paper and poster in various national level conferences. She is one of the finest and budding biochemist from our institute. She is sincere, hardworking and devoted to her work.

Abstract:

Background:
Preeclampsia (PE); a multisystem disorder of unknown etiology is characterized by development of hypertension to the extent of 140/90 mm Hg or more with proteinuria after the 20^th week in a previously normotensive and non-proteinuric woman. This study was done to compare and evaluate the diagnostic efficiency of  serum Cystatin-C, Creatinine and Uric Acid levels in PE and Normal pregnant women.

Materials and Methods:
This is a hospital based comparative cross-sectional study conducted in BPKIHS. One hundred and two study participants who provided the written consent were enrolled; of  which fifty one participants were diagnosed cases of PE and fifty one served as Control. Serum Cystatin-C was done by Immunoturbidimetry method in Accent 200 Autoanalyser.  Creatinine and Uric Acid was done  by Jaffe’s  and Uricase method in cobas c311  Autoanalyser respectively. ROC curve was used to   evaluate the diagnostic efficiency of Cystatin-C in PE. p value < 0.05 was considered to be significant.

Biography:

Rahaf attar has completed her bachelor degree of general medicine and surgery at the age of 23 from king Abdulaziz university of jeddah. She is currently training at king abdulaziz university hospital of pediatric major. She has worked on several researches. Hard worker, a learner.

Abstract:

Background:
Systemic lupus erythematosus is an autoimmune multisystemic disease that can be present in myriad of ways. Thrombotic microangiopathy is a rare complication of SLE. Even more rare if it was the initial presentation of the disease. Infection has been suggested to be one of the triggers for such an event. There are few cases reported on SLE patients initially presenting as HUS. Other few cases on HUS triggered by a streptococcal infection.

Methods:
We describe a case of a 9 year old boy who had a history of pharyngitis, two weeks later he presented to the hospital with symptoms of severe anemia, hematuria and abnormal renal function. Investigations showed positive ASO , ANA , dsDNA antibodies. 

Results
Biopsy revealed a picture of thrombotic microangiopathy in addition to a diffuse thickening of the glomerular basement membrane with membrnoproliferative pattern of proliferation. Diagnosis of SLE and aHUS was made. The patient was improved after the treatment with prednisone and cyclophosphamide. No plasma exchange was required.

Conclusions
aHUS is a type of thrombotic microangiopathy that might present as a vascular complication of SLE. infection is not only an important risk factor for SLE exacerbation but also a common trigger for thrombotic microangiopathic events in these patients. There are several cases reported in the literature of SLE patients first presenting as aHUS. However, the occurrence of aHUS triggered by streptococcal infection as the first presentation in an SLE patient haven't been reported to the extent of our knowledge. The outcome is generally favorable.