15^th International Conference on Nephrology & Therapeutics August 28-30, 2017 Philadelphia, USA

Renal failure refers to temporary or permanent damage to the kidneys those results in loss of normal kidney function. There are two different types of Renal failures-acute and chronic. Acute renal failure has an abrupt onset and is potentially reversible. Chronic renal failure progresses slowly over at least three months and can lead to permanent renal failure. The causes, symptoms, treatments, and outcomes of acute and chronic are different. Chronic kidney disease, as defined since 2002 by the presence of kidney damage or reduced Glomerular filtration rate (GFR), affects 10% of the adult population worldwide and more than one-third of the elderly. A recent large Meta analysis of 46 general population, high risk and CKD, including more than 2 million participants, showed that both low estimated GFR and high albuminuria were associated with increased risk of all-cause mortality, cardiovascular disease and progression to End-stage renal disease (ESRD) regardless of age.

The small geographic variation in CKD prevalence and the large variation in ESRD incidence, three times higher, for example, in the USA than in Europe. Finally, quality of life and patient rating of healthcare remain under studied in early-stage CKD despite increasing recognition of the importance of patient-reported outcomes in clinical trials and public health. Thus, chronic kidney disease conferences was identification of new predictive markers is also necessary to improve risk assessment in CKD. Several biomarkers emerging from epidemiological studies are promising, but further evidence is needed before they can be routinely used to predict outcomes.

In general, patients with Anemia of chronic illness or chronic kidney disease can be treated on an outpatient basis. Confounding factors that need to be addressed in both diseases include concomitant blood loss, iron deficiency, or deficiencies of vitamin B12 and/or folic acid. When kidneys start to fail, little or no Erythropoietin (EPO) is produced and this results in a failure of red cell production. Another factor causing anaemia in kidney disease can be iron deficiency as iron is not absorbed so the kidneys start to fail this leads to Renal anaemia. Several million patients with chronic kidney disease (CKD) have benefited from the use of erythropoiesis-stimulating agents (ESAs) to correct severe anemia. Sometimes Haematopoies the formation of blood cellular components. All cellular blood components are derived from haematopoietic stem cells and Kidney biopsy is a medical procedure in which a small piece of kidney is removed from the body for examination, usually under a microscope. Microscopic examination of the tissue can provide information needed to diagnose, monitor or treat problems of the kidney. However, mortality data now suggest that treating CKD patients to achieve a haemoglobin (Hb) level >13 g/dl can be harmful.

In 2004, the report of the Dialysis Outcomes and Practice Patterns Study, which used data from >11,000 patients in 12 countries, showed an association with a significantly higher mortality when patients with an Hb level low were compared with those with higher levels this finding was reflected in the European experience.

Diabetic's nephropathy Diabetic nephropathy also known as Kimmelstiel–Wilson syndrome, or nodular diabetic glomerulosclerosisand intercapillary glomerulonephritis, is a progressive kidney disease caused by angiopathy of capillaries in the kidney glomeruli. It is characterized by nephrotic syndrome and diffuse glomerulosclerosis. It is due to longstanding diabetes mellitus, and is a prime indication for dialysis in many developed countries. It is classified as a small blood vessel complication of diabetes. Clinically, diabetic nephropathy is characterized by a progressive increase in proteinuria and decline in GFR,Hypertension, and a high risk of cardiovascular morbidity and mortality. Diabetes has become the primary cause of End-stage renal disease (ESRD) in the United States, and the incidence of type 2 diabetes mellitus continues to grow in the United States and worldwide as described in Nephritis conferences.

Approximately 44% of new patients entering dialysis in the United States are diabetics. Early diagnosis of diabetes and early intervention are critical in preventing the normal progression to renal failure seen in many type 1 and a significant percentage of type 2 diabetics. Approximately 20.8 million people, or 7.0% of the population in the United States, are estimated to have diabetes, with a growing incidence. Roughly one third of this population, 6.2 million, is estimated to be undiagnosed with type 2 diabetes. The prevalence of diabetes is higher in certain racial and ethnic groups, affecting approximately 13% of African Americans, 9.5% of Hispanics, and 15% of Native Americans, primarily with type 2 diabetes.1, 2 approximately 20% to 30% of all diabetics will develop evidence of nephropathy, although a higher percentage of type 1 patients progress to ESRD.

Renal dialysis (process the blood when the kidneys have failed) will require access to the blood stream. This procedure involves either insertion of a catheter and/or creation of a transmission between an artery and a vein beneath the skin. Usually this is accomplished in the patient’s arm and is often accomplished as an outpatient procedure. Dialysis treatments replace some of these functions through diffusion there are two main types of dialysis: haemodialysis and peritoneal dialysis. Haemodialysis and peritoneal dialysis are both used to treat kidney failure. Haemodialysis uses a man-made membrane (dialyzer) to filter wastes and remove extra fluid from the blood. Peritoneal dialysis uses the lining of the abdominal cavity (peritoneal membrane) and a solution (dialysate) to remove wastes and extra fluid from the body. Both haemodialysis and peritoneal dialysis can cause side effects. During this 5 year study the investigators would like to test if a different nutrition and diet can explain better survival of minority dialysis patients. The investigators will also test if in additional to nutrition there are 2 other reasons for better survival of minority dialysis patients, namely differences in bone and minerals and differences in social and psychological and mental health. The investigators plan to study 450 haemodialysis patients every 6 months in several dialysis clinics in Los Angeles South Bay area. These subjects will include 30% African Americans, 30% Hispanics, 30% non-Hispanic Whites and 10% Asians. In the HEMO study, the incidence of infection-related deaths was not reduced by higher dose of dialysis or by high-flux dialyzers, and most infection-related hospitalizations were not attributed to vascular access.

Nephrology-2017 Targets, CEO’s , Directors, Scientists, Professors, Students, Diabeticians, Directors & Brand Manufacturers/ Marketers of Consumer Products globally. Nephrology associated Universities are 55 nearly in USA and Major Nephrology Societies are 17 around the globe. Large scale research development is being conducted in the field of nephrology for the past two decades. Tripled in value from USD 560 million is being funded on Kidney diseases alone per year. Baltimore (Maryland) also bears a total 3,500 hospitals working on Nephrology & Therapeutics. Hence it’s considered to be one of the finest places for a Conference on Nephrology.

Hypertension, also known as high blood pressure or arterial hypertension is a chronic medical condition in which the blood pressure in the arteries is elevated. This session mainly covers the different types of hypertension and their assessment. There are two primary hypertension types. For 95% of people with high blood pressure, the cause of their hypertension is unknown — this is called essential, or primary, hypertension. When a cause can be found, the condition is called secondary. Isolated systolic hypertension, malignant hypertension, and resistant hypertension are all recognized hypertension types with specific diagnostic criteria.

Assessment of hypertension basically includes: Confirmation of hypertension, Risk factors, Underlying causes, End organ damage & Indications and contraindications for antihypertensive drugs.

Hypertension is a major risk factor for heart disease and stroke. Globally, the overall prevalence of raised blood pressure in adults aged 25 and over was around 40% in 2008. Because of population growth and ageing, the number of people with uncontrolled hypertension rose from 600 million in 1980 to nearly 1 billion in 2008.The national Million Hearts initiative endeavours to increase the number of persons whose hypertension is under control, by 10 million, as part of its goal to prevent 1 million heart attacks and strokes by the year 2017.

Urogynecology is a fairly new subspecialty and a fast-growing one, with increasing rates of pelvic floor disorders fueling a high demand for its services. In 1996, there was one board-accredited fellowship program for advanced training in urogynecology. By June 2010, according to the American Journal of Obstetrics and Gynecology, the number of accredited fellowship programs offered by leading academic institutions had grown to 37, and membership in societies associated with the sub-specialty had doubled.

Nearly 25% of all females experience frustrating and embarrassing symptoms unnecessarily. Bladder and bowel control, pelvic prolapse, pelvic pain, cystitis and vaginal cosmetic issues are conditions that  Dr. Porter, a fellowship trained urogynecologist, and his staff are dedicated to improving. Many treatments provide excellent success rates and do not require surgery. When surgery is necessary, most are performed utilizing the latest minimally invasive procedures. Not all doctors have the same training and experience to address urogynecological problems. Research shows that it is important to seek an expert evaluation from the start. On April 29, 2014, the FDA issued two proposed orders for surgical mesh for transvaginal pelvic organ prolapse (POP) repair that put forth changes to address the risks associated with these devices. Once final, manufacturers will be required to provide clinical data in a premarket approval (PMA) application to support the safety and effectiveness of surgical mesh for transvaginal POP. Also, manufacturers of the tools specifically for implanting surgical mesh will be required to obtain premarket clearance (510(k))

The Division of Pediatric Nephrology specializes in the diagnosis and management of children with a variety of acute and chronic kidney-related disorders. The division evaluates and treats hypertension, hematuria, proteinuria, renal tubular acidosis, nephrolithiasis, glomerulonephritis, and kidney failure.
Pediatric Nephritis is clinically and genetically heterogeneous entity characterized by either relapsing and course with significant morbidity and mortality resulting from complications of the disease itself, and its therapy. Pediatric Kidney stones are a group of crystals that are difficult to pass from the body.
 

Transplantation is the act of transferring cells, tissues, or organs from one site to another. The malfunction of an organ system can be corrected with transplantation of an organ example: kidney from a donor. Since the first successful Renal transplantation (RT) performed between the identical twins in the Peter Brent Brigham Hospital, Boston on 23rd December 1954 by Murray et al., RT has become a routine for the patients with end-stage renal disease. When a kidney is transplanted from a Non-identical individual, the allograft; the recipient mounts a Immuneresponse termed as an immune response. The immune response is initiated by the T cell recognition of the alloantigen and process is commonly known as the allorecognition. The first step of the complex events that leads to T lymphocyte activation, antibody production, allograft rejection and Transplant failure. This review highlights the fundamental principles of Transplant immunology and modern immunological assay techniques, which have important application in practice.

Understanding of the immunology related advances in the techniques of detection and characterisation of antibodies before and after renal transplantation and the cross match techniques have significantly improved the outcomes of renal transplantation over last two decades. Approval was based on two randomized studies involving 1,093 patients with organ rejection in kidney transplant recipients. Currently, 1-year graft survival rates after renal transplantation are exceeding 90%. However, the life-long administration of Immunosuppressive drugs is accompanied by many side effects. These renal failure events findings may contribute to the development of in vitro monitoring tools to identify transplant patients in whom immunosuppressant can be safely reduced in order to avoid long term side effects.

The kidneys are vital for life with their complex network of blood vessels and intricate network of tubes and tubules that filter blood of its waste products and excess water.The kidneys maintain the fluid, electrolyte, and acid-base regulation that are altered by several disease conditions as well as drugs and toxins. Nephrology(from Greek νεφρÏŒς nephros "kidney", combined with the suffix -logy, "the study of") is a specialty of medicine and pediatrics that concerns itself with the study of normal kidneyfunction , kidney problems, the treatment of kidney problems and renal replacement therapy (dialysis and kidney transplantation). Nephrology deals with study of the normal working of the kidneys as well as its diseases. The diseases that come under the scope of nephrology include:-

Glomerular disorders that affect the tiny filtering systems of the kidneys called the glomerulus, Urine abnormalities such as excess excretion of protein, sugar, blood, casts, crystals etc.Tubulointerstitial diseases affecting the tubules in the kidneys, Renal vascular diseases affecting the blood vessel networks within the kidneys, Kidney failure that can be sudden or acute or long term or chronic, Kidney and bladder stones, Kidney infections, Cancers of the kidneys, bladder, and urethra, Effects of diseases like diabetes and high blood pressure on kidneys, Acid base imbalances, Nephroticsyndrome  and nephritis, Ill effects of drugs and toxins on the kidneys, Dialysis and its long term complications - dialysis includes hemodialysis as well as peritoneal dialysis, Autoimmune diseases including autoimmune vasculitis, lupus, etc. Polycystic kidneys diseases where large cysts or fluid filled sacs are formed within the kidney impairing its functions - this is a congenital and inherited or genetic condition.

Glomerular disease can occur by itself (eg, affecting only the kidney), or may be associated with an underlying medical condition that affects other organ systems, such as lupus, diabetes, or certain infections. Glomerular disease can develop suddenly (called Acute), or develop slowly over a period of years (called Chronic). Treatment of glomerular disease depends upon its cause and type. Many diseases affect kidney function by attacking the glomeruli, the tiny units within the kidney where blood is cleaned. Glomerular diseases include many conditions with a variety of genetic and environmental causes, but they fall into two major categories:

Glomerulonephritis (gloh-MEHR-yoo-loh-nef-RY-tis) describes the inflammation of the membrane tissue in the kidney that serves as a filter, separating wastes and extra fluid from the blood.

Glomerulosclerosis (gloh-MEHR-yoo-loh-skleh-ROH-sis) describes the scarring or hardening of the tiny blood vessels within the kidney.

Acute Renal diseases, previously called Acute renal failure (ARF), is an abrupt loss of kidney function that develops within 7 days. Acute kidney injury (formerly known as acute renal failure) is a syndrome characterized by the rapid loss of the kidney's excretory function and is typically diagnosed by the accumulation of end products of nitrogen metabolism (urea and creatinine) or decreased urine output, or both. AKI may lead to a number of complications, including metabolic acidosis, high potassium levels, uremia, changes in body fluid balance, and effects on other organ systems, including death. People who have experienced AKI may have an increased risk of chronic kidney disease in the future. Management includes treatment of the underlying cause and supportive care, such as renal replacement therapy.

The stages of kidney disease are determined by the glomerular filtration rate. Glomerular filtration is the process by which the kidneys filter the blood, removing excess wastes and fluids. Glomerular filtration rate (GFR) is a calculation that determines how well the blood is filtered by the kidneys. It is one way to measure kidney types.

They are Acute kidney disease is the sudden loss of kidney function that occurs when high levels of waste products of the body's metabolism accumulate in the blood. Chronic Kidney Disease is a gradual development of permanent kidney disease that worsens over a number of years. Pediatric Kidney Disease can affect children in various ways, ranging from treatable disorders without long-term consequences to life-threatening conditions. Polycystic Kidney Disease is characterized by the growth of numerous kidney cysts, which cause abnormalities in both the kidney structure and function. Hypertension Uncontrolled hypertension can damage many organs in the body including kidneys.

The purpose of the kidney disease diet is to limit the amount of protein in the diet so that less urea is produced.

Electrolytes play a vital role in maintaining homeostasis within the body. Some minerals—especially the macro minerals (minerals the body needs in relatively large amounts)—are important as electrolytes. The kidneys help maintain electrolyte concentrations by filtering electrolytes from blood, returning some electrolytes to the blood, and excreting any excess into the urine. Thus, the kidneys help maintain a balance between daily consumption and excretion. The physician should first explore all treatable causes of renal failure, example: Dehydration, Obstruction, Infection, Heart failure, Potassium depletion, and others. Approximately 90 percent of cases of end-stage renal disease are attributable to diabetes mellitus, glomerulonephritis, or hypertension. Kidney failure results in Fluid and Electrolyte imbalances, the build up of nitrogenous wastes, and reduced ability to produce renal hormones. The two treatment options are transplantation or dialysis. Kidney stones can also form from uric acid, which is a breakdown product of protein, or from struvite (ammoniomagnesium phosphate) or cystine.

 The prevalence of kidney stones is three times higher in men than women, and is higher among Caucasians than Asians or African Americans, for reasons that are not clear. They are especially likely to strike between the ages of 40 and 60.Encourage patients to avoid animal products. Their proteins and sodium content increase the risk of stones.

Kidney or bladder stones are solid build-ups of crystals made from minerals and proteins found in urine. Bladder diverticulum, enlarged prostate, neurogenic bladder and urinary tract infection can cause an individual to have a greater chance of developing bladder stones. If a kidney stone becomes lodged in the ureter or urethra, it can cause constant severe pain in the back or side, vomiting, hematuria (blood in the urine), fever, or chills.

Bladder stones are hard masses of minerals in your bladder. Bladder stones develop when urine in your bladder becomes concentrated, causing minerals in your urine to crystallize. Concentrated, stagnant urine is often the result of not being able to completely empty your bladder. If bladder stones are small enough, they can pass on their own with no noticeable symptoms. However, once they become larger, bladder stones can cause frequent urges to urinate, painful or difficult urination and hematuria.

Kidney stones (nephrolithiasis): Minerals in urine form crystals (stones), which may grow large enough to block urine flow. It's considered one of the most painful conditions. Most kidney stones pass on their own but some are too large and need to be treated.

Medical imaging is the technique and process of creating visual representations of the interior of a body for clinical analysis and medical intervention. Medical imaging seeks to reveal internal structures hidden by the skin and bones, as well as to diagnose and treat disease. Renal Scintigraphy, also known as "Renal scanning" or "Renal imaging," refers to several examinations using radioisotopes that evaluate the function and anatomy of the kidneys. Renal Scintigraphy is one of many imaging methods used to evaluate the kidneys. Ultrasound, Computed Tomography (CT), and Magnetic Resonance Imaging (MRI) can also be used. Your doctor will determine which of these examinations will provide the best information about your kidneys. Because the radiotracer accumulates differently in different kinds of tissue, it can help physicians determine if something is wrong with the kidneys. Renal Scintigraphy can also be used to evaluate a transplanted kidney.

The medical image analysis market is driven by the increasing demand of the imaging modalities across various indications such as Oncology, Cardiology and Nephrology. The medical image analysis market is estimated to be $1.7 billion in 2012 and is growing at a rate of 7.2% from 2012 to 2017 to reach $2.4 billion. The Americas have the largest share in the open MRI market on account of the increasing aging populations who are aware of the benefits of early diagnosis.

As a result of changes in the way we eat and live, some chronic diseases are increasingly affecting both developed and developing countries. Indeed, diet-related chronic diseases such as obesity, diabetes, cardiovascular disease, cancer, dental disease, and osteoporosis are the most common cause of death in the world and present a great burden for society.

A dietary supplement is intended to provide nutrients that may otherwise not be consumed in sufficient quantities. Supplements as generally understood include vitamins, minerals, fiber, fatty acids, or amino acids, among other substances. U.S. authorities define dietary supplements as foods, while elsewhere they may be classified as drugs or other products. The application of nutrition science in the promotion of health, peak performance and individual care. Registered Nutritional Therapists use a wide range of tools to assess and identify potential nutritional imbalances and understand how these may contribute to an individual’s symptoms and health concerns. This approach allows them to work with individuals to address nutritional balance and help support the body towards maintaining health. Nutritional Therapy is recognised as a complementary medicine and is relevant for individuals with chronic conditions, as well as those looking for support to enhance their health and wellbeing.

Surgery is the main treatment for most kidney cancers. The chances of surviving kidney cancer without having surgery are small. Depending on the stage and location of the cancer and other factors, surgery may remove either the cancer along with some of the surrounding kidney tissue (known as a partial nephrectomy), or the entire kidney (known as a radical nephrectomy). The adrenal gland (the small gland that sits on top of each kidney) and fatty tissue around the kidney may be removed as well. Regenerative medicine refers to a group of biomedical approaches to clinical therapies that may involve the use of stem cells. The study of laparoscopy in managing patients with abdominal symptoms from autosomal dominant Polycystic kidney disease (PKD).

From April 1993 to July 1995, four patients with ADPKD underwent seven laparoscopic procedures: five cyst decortications were performed in two patients using a laparoscopic ultrasound unit and two laparoscopic nephrectomies were performed in two patients with end-stage renal failure. The mean operative time was 207 minutes for laparoscopic cyst decortication and 272 minutes for laparoscopic nephrectomy. Many people feel that a successful kidney transplant provides a better quality of life because it may mean greater freedom, more energy and a less strict diet.