10^th European Nephrology Conference October 24-26, 2016 Rome, Italy

Maya N Clark Cutaia received her PhD from the University of Pittsburgh, School of Nursing, and completed her Post-doctoral work at the University of Pennsylvania, School of Nursing. She is faculty in the Adult Gerontological Acute Care Nurse Practitioner Program, while conducting research that will lead to development and testing of bio-behavioral interventions for symptom management based on explicating biological mechanisms. Her current focus is symptom management in ESRD, with an interest in the impact of recommended dietary sodium intake restrictions on symptoms experienced by hemodialysis patients.

Aim: In hemodialysis, patients need to have intercurrent sodium and water intake removed by ultrafiltration, increases disease burden through the symptoms and signs that occur during hemodialysis (HD). This added burden may be mitigated by reduction of dietary sodium. The National Kidney Foundation (NKF) recommends 2400 mg of dietary sodium daily for patients on HD, and the American Heart Association (AHA) suggests 1500 mg, evidence is lacking, however, to support these recommendations in HD. Moreover, little is known about the relationship of specific levels of dietary sodium intake and the severity of symptoms and signs during ultrafiltration. Our goal will be to determine the effects of carefully-monitored levels of sodium-intake as set forth by the NKF and AHA on symptoms and signs in patients undergoing (HD). Methods: We designed a 3-group (2400 mg, 1500 mg, unrestricted), double blinded randomized controlled trial with a sample of 42 HD participants to determine: Whether symptom profiles and interdialytic weight gain vary among 3 sodium intake groups; the effect of HD-specific on the symptom profiles vary among the 3 groups; and whether total body water extracellular volume and intracellular volume measured with bioimpedance varies across the 3 groups. We will also examine the feasibility of recruitment, enrollment and retention of participants for the 5-day inpatient stay. Conclusion: Curbing sodium intake may lead to improvement in intradialytic symptom amelioration and potential for better long-term outcomes. Generating empirical support will be critical to ascertain and espouse the appropriate level of sodium intake for patients receiving HD.

Khalid Al Matham finished Nephrology Fellowship at Toronto University Canada in 2014. Currently, he is working as Consultant Nephrologist at King Fahad Medical City, and also is the Internal Medicine Residency Training Program Director.

Introduction: Glomerulonephritis (GN) is the inflammation of the capillaries of the glomeruli, characterized by albuminuria, edema and hypertension. The complications of GN can vary from acute renal failure to end stage renal disease. Objective: To evaluate the prevalence and pattern of GN at a single tertiary care center to be an informative and valid evidence to establish a national registry. Methods: A retrospective chart review was conducted of kidney biopsies taken between the period 2007 to 2015. Results: 166 patients were identified for biopsies as GN. The mean age of patients was 28.4±13.23. The most frequent primary GN type was Focal and Segmental Glomerulosclerosis (FSGS) 37 (20.2%). And the most frequent secondary GN was lupus nephritis (LN4) 30 (16.4%). Lupus nephritis 4 (25 cases: 83.3%) and lupus nephritis 3 (18 cases: 82%) were more prevalent among females than males, with a statistically significant difference between genders (p=0.001) and (p=0.012), respectively. Interestingly, Heavy proteinuria was found among MPGN and PIGN patients. Conclusion: Our results support the literature in the high prevalence of FSGS in Saudi Arabia. LN was more prevalent in females, which should be investigated thoroughly in future.

Takashi Hara graduated from Kumamoto University of Medicine. He has worked for a Nephrologist for 7 years.

Objectives: There has been a few data about seasonal variation in blood pressure for chronic kidney disease (CKD) patients, but the role of volume status in seasonal blood pressure variations remains controversial. Therefore, we investigated the seasonal variation in blood pressure and fluid status for CKD patients. Methods: 50 CKD patients (27 males and 23 females, age 66.7±13.3 years) in a single center were followed between December 1, 2014 and November 30, 2015. We measured monthly the parameters such as their office blood pressure (BP), fluid status and amount of estimated salt intake by 24-hour urinary sodium excretion. Bioelectrical impedance analysis was used to assess their fluid status and they were expressed in extracellular/total body water (ECW/TBW). We examined their seasonal variation. Results: The causes of renal disease in 50 patients were chronic glomerulonephritis 19 (38%), diabetic nephropathy 16 (32%), hypertensive nephrosclerosis 12 (24%), polycystic kidney disease 2 (4%) and gouty kidney 1 (2%). There were no difference in their office blood pressure, fluid status and amount of estimated salt intake significantly (Spring: 122.8±13.5/67.5±9.8 mmHg, 0.4122±0.1056, 6.1±2.9 g/day, Summer: 123.6 ±12.9/68.0 ±10.3 mmHg, 0.3922±0.0202, 5.6±2.6 g/day, Autumn: 125.9±12.0/70.3±9.0 mmHg, 0.3939±0.0087, 5.8±2.7 g/day, Winter: 126.1±9.5/68.6±9.9 mmHg, 0.3938±0.0099, 5.9±2.3 g/day). Conclusions: Our results suggest that the blood pressure and the fluid status of CKD patients don’t vary with the seasonal variation. Appropriate fluid control may contribute to well blood pressure regardless of season.

B Guerd is a Medical Doctor graduated from the University of Algiers in November, 2005. She worked on emergencies from August, 2006 till October, 2007. She began her Specialty in November, 2007 and is Specialist in Nephrology from the University of Algiers (April, 2013). She is also Senior Assistant at the Medical Department, University of Algiers (April, 2015). She is working as Nephrologist at the Central Hospital of the Army, Algiers from April, 2013 till now.

The incidence of the thyroid cancer to chronic kidney disease (CKD) was estimated to be 02% twice as frequent in the women; the coverage does not differ from that of the patient with normal renal function. The prescription of an I131 therapy as therapeutic complement is possible in theory, and despite a low risk of external radiation; we dispose of very few data and no recommendation exists for this category of patients. We report the case of a 29-year-old female patient with end stage renal disease (ESRD) dialyzed 3 times in week, in whom a thyroid papillary carcinoma was discovered during an assessment for transplantation or a treatment by I131 therapy was indicate advenged then of two cures.

L Azouaou is a Teacher Assistant of Nephrology in College of Medicine of Algiers. She is a Graduate of the University of the Sorbonne in Paris in Nephropathology IUD, and Founder of the genetic study of SNCR in Algeria. She participated actively in several nephrology congresses in the world.

Introduction: Corico-resistant idiopathic nephrotic syndrome is a heterogeneous entity. Its prevalence is unknown in Algeria and has immunological side forms in connection with a circulating factor. There are genetic forms that require early diagnosis. The aim of this study is an early diagnosis of SNI Corico-resistant in these different forms for therapeutic and prognostic fast charge. Patients & Methods: We identified in our study, 67 children with idiopathic steroid-resistant nephrotic syndrome over a period of 3 years from January 2012 to January 2015. Nous patients have received the 4-pediatric nephrology Algiers services. Results: Mean age was 07 years with a sex ratio of 1.45 (male). 15 children belonged to families of SNCR and 5 children had Galloway. la inbreeding syndrome is present in 54% of cases. L' histological study was found 19.4% LGM, 57.4% of HSF and the rest forms with mesangial proliferation. The therapeutic protocol involving cyclosporine and prednisone resulted in complete remission in 35% of cases and partial in 30% of cases. 25% of cases have resisted treatment and the rest of the cases evolved into ESRD very quickly. Discussion: Aetiology and pathogenesis of SNI is still unknown, but many arguments suggest the existence of an immune dysfunction disease involving T cells as in 35% of cases in our series. Regarding patients who have not responded to treatment or who have rapidly progressed to ESRD, a genetic study is essential for such cases and all patients who have a family or SNCR Galloway syndrome. We found no statistically significant relationship between treatment response and histological type. Conclusion: Our study confirms the clinical, histological and evolutionary heterogeneity of SNICR. The early diagnosis is best for better care for patients.

Introduction: Cardiovascular disease remains the leading cause of mortality in patients with end stage renal disease. This is especially due to observed hardening (sclerosis) and thickening of the artery walls, often asymptomatic revealing a symptom or sometimes fatal acute accidents. Materials & Methods: Our study is prospective, observational comparative and mono-centric. It is to assess cardiovascular risk by measuring the VOP (pulse wave) through a non-invasive method with our terminal chronic renal failure patients on hemodialysis and peritoneal dialysis. We studied 60 dialysis patients divided into 2 groups: Group 1: 30 hemodialysis patients and Group 2: 30 patients on peritoneal dialysis. The recording of the VOP in patients was made outside the dialysis sessions and concerned patients on dialysis for more than 02 years. Discussion: In our series, the initial nephropathy was the most frequently found vascular nephropathy. We have them over lesions type of arterial stiffness in hemodialysis patients. Conclusion: Arterial stiffness increases with age and worsen in the presence of risk factors (hypertension, diabetes, obesity, smoking, chronic inflammatory syndrome, etc.). A pharmacological therapeutic intervention (anti hypertensives, antidiabetic statins) and non-pharmacological (reduction in salt intake, weight loss, exercise, etc.) can stop this arterial stiffness in our patients on peritoneal dialysis or hemodialysis.