Day 1 :
Lenox Hill Hospital, USA
Keynote: Update on management issues in patients with advanced renal disease breast disease: Diagnostic and clinical implications
Time : 09:30-10:10
Michael F Michelis has been the 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. He received a BA at Columbia College, Columbia University in New York City, and his MD Degree at George Washington School of Medicine in Washington DC. He received his Nephrology Training at the University of Pittsburgh, School of Medicine. He 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.
As patients with advanced renal disease become more complicated with time, due to factors such as complex associated conditions, aging, increasing numbers of available pharmacologic agents and improvement in renal replacement therapies, decision making has become more challenging. Subjects to be evaluated will include proper approaches to blood pressure therapy in patients with pre, inter or intra dialysis blood pressure abnormalities. Medication characteristics will be outlined and the effects of various drugs as they relate to the dialysis procedure will be described. Also metabolic issues such as approaches to hyperuricemia and hyperphophatemia will be reviewed and discussed. New agents and their benefits and limitations will be noted and present goals of therapy will be reviewed. Furthermore the effects of increased body mass and glucose intolerance on survival as well as possible corrective measures will be elucidated. Recent concerns regarding enzymatic predispositions to obesity will be described and possible solutions to these newly recognized abnormalities will be offered. Finally, current approaches to renal replacement therapy will be reviewed and the importance of the timing of interventions and the choice of access and modality will receive consideration. These issues apply particularly to patients of advanced age. Current standards as proposed by various nephrologic entities may not be appropriate for particular age groups with serious comorbidities. Factors influencing such decisions will be presented and critically evaluated.
Vanderbilt School of Medicine, USA
Time : 10:10-10:50
Ghodrat Siami is MD, PhD, Fellow of American College of Physician, and Fellow of American Society of Nephrology, Professor of Medicine and Nephrology at Vanderbilt School of Medicine and was promoted to Professor Emeritus. He served as the President of International Society for Apheresis, and Vice President of Word Apheresis Association. He published more than 100 original papers, book chapters, editorials and abstracts. He presented his original works in more than 160 national and international scientific meetings. He is on the Editorial Board of several journals and Reviewer for FDA. He is a winner of several professional awards including 50 Years’ Service Award from AMA. He chaired the celebration of 100 years of Plasmapheresis in St. Petersburg, Russia. He is still an invited Keynote Speaker around the world.
Introduction: Combination Therapy is for dialysis patients requiring another extracorporeal therapy such as plasmapheresis.
Purpose: of study was to evaluate the safety and efficacy of both procedures.
Methods: We performed Cryofiltration Apheresis which I created 30 years ago, to treat patients with cryoglobulinemia to remove cryoglobulin from blood, LDL- Pheresis for dialysis patients with cardiovascular and coronary artery diseases which can be done by 8 different methods; Immunoadsorptiom to remove immune complex; and dialysis patients may need Plasma Purification and Whole Blood Purification for toxicology. We have developed procedures to do combination therapy safely and effectively.
Result: show all above procedures are safe and effective. Hemodialysis takes 4 hours and Apheresis 3.5 hours if they perform separately with total of 7.5 hours. But the Combination Therapy, if done together takes only 4 hours.
Conclusions: Both procedures take only 4 hours not 7.5 hours, Patients and Dialysis Nurse does not need to be on the machine/working almost all day. This will be less tiring and more acceptable for Patients and Nurses. The cost will be lower compared to doing them separately.