Day 2 :
Keynote Forum
Dmitry Zorov
Moscow State University, Russia
Keynote: Mitochondria in kidney pathologies (ischemic kidney, rhabdomyolysis, pyelonephritis)
Time : 10:00-10:40
Biography:
D B Zorov has completed his PhD in 1974 from Lomonosov Moscow State University and his Doctor of Science in 1988 from Moscow University. He is the Chief of the Department of Functional Biochemistry of Biopolymers and the Chief of the Laboratory of Mitochondrial Structure and Functions in A N Belozersky Institute at Moscow State University. He has published more than 150 papers in high rank journals and has been serving as an Editorial Board Member of Heart, Lung and Circulation. He is a Member of European Academy (Academia Europea).
Abstract:
Mitochondria play a key role in the pathogenesis of various diseases, including renal pathologies, especially those that occur with the participation of oxidative stress. Among these are kidney ischemia, rhabdomyolysis and pyelonephritis. Mitochondria are not only a cause but also a target of oxidative stress as a result of insufficient tissue supply of oxygen and nutrients, and a hyperinflammatory response associated with these pathologies. As a result, the mitochondria respond by enhanced generation of reactive oxygen species (ROS) (ROS-induced ROS release) and by activation of production of proinflammatory cytokines, whose redundancy is fatal. In the case of pyelonephritis, pathogenic factors are not only bacterial antigens that activate innate immune response through activation of toll-like receptors of leukocytes and epithelial cells, but also proinflammatory cytokines and ROS. The strategy of treatment for such pathologies is that primary targets of pharmacological action must be the mitochondrion with the final goal to retain normal mitochondrial structure and function as a mandatory requirement which can provide renal protection. In the case of ischemic renal damage, one of the most effective approaches to protect the organ is ischemic preconditioning. All protective signaling pathways converge on mitochondria, namely on GSK-3β, which gives the possibility of targeted influence on the end effector of protective signaling. Pharmacological preconditioning is just an imitation of ischemic preconditioning. In most types of protective and destructive signaling pathways, the key role is played by ROS, the maintenance of which at the optimum level is a primary goal for normal functioning of renal tissue.
Keynote Forum
Tadashi Yamamoto
Niigata University, Japan
Keynote: Proteomics of kidney biopsy tissues for understanding pathophysiology
Time : 10:40-11:20
Biography:
Tadashi Yamamoto has received his PhD in 1981 from Niigata University, School of Medicine and did Post-doctoral studies in the Scripps Research Institute, CA, USA. He is the Director of the Biofluid Biomarker Center, Niigata University. He has been chairing the Human Kidney and Urine Proteome Project of Human Proteome Organization and has published more than 25 papers in reputed proteomics journals.
Abstract:
Currently proteomics has been introduced for analysis of pathophysiology of kidney tissues and biopsy specimens, and also discovery of urine biomarkers. Understanding pathophysiology of kidneys in physiologic or pathologic conditions is significant to select treatments for the diseases or to develop new therapies. By a laser microdissection system and liquid chromatography-mass spectrometry (LC-MS) we have established a method to analyze proteomes of both kidney glomerulus and other nephron compartments obtained from formalin-fixed paraffin-embedded (FFPE) sections. Thousands of proteins with high confidence were identified by LC-MS of each nephron compartment and they were semi-quantified by a non-labeled quantitation method, normalized spectral index. Bioinformatics tools for function and pathway analyses of the proteome data depicted characteristic functions of each nephron. By the proteomics analysis of 50 sections prepared from a single biopsy specimen also depicted interesting pathways in the glomerulus of each kidney disease. Proteomics and bioinformatics analysis of normal or disease kidney tissues provide new insights into molecular functions of nephron segments and pathologic pathways of glomerular diseases and may promote efficient personalized medicine and pathogenesis-based new drugs in the near future.
- Kidney Disorders | Diabetic Nephrology | Etiology and Pathogenesis of Kidney Diseases
Location: Appia 1 & 2
Session Introduction
Vinod C Tawar
Kwantlen Medical Clinic, USA
Title: Prevention of the development of diabetes by early intervention a retrospective study
Biography:
Vinod C Tawar has earned BSc Hons. and BSc Tech. Pharmaceuticals from University of Bombay. He was offered a Teaching Assistantship at the School of Pharmacy, University of Manitoba, Canada, where he achieved a Post-graduate (MSc) degree in Pharmacology followed by working as a Toxicologist at a university hospital in Winnipeg for a duration of 10 years. In due course, he developed a toxicology laboratory for patient management and forensic purposes. This later became a reference laboratory for the Province of Manitoba. In 1981, he decided to study medicine and graduated Medicine in 1985. Subsequently, he joined Douglas Hospital Research Centre at McGill University as a Psychiatry Research Consultant with participation in projects on depression, Alzheimer’s disease, alcoholism and schizophrenia. Here he had co-authored many research papers. After 5 years, he was offered a two year Residency Position for licensure in general practice. Currently, he has been in an office based group family medicine practice for 16 years. Eight years ago, he has completed Post-graduate studies in Family Medicine for the specialty while working. During his practice, he had conducted research on depression, hypertension, GERD and asthma. At present, he has maintained his interest on nephropathy and challenging tasks of medicine.
Abstract:
The current research, a retrospective study on early stage intervention on the development of diabetes, is based on a concept discussed in 2011 by Ralph A De Fronzo and Muhammad Abdul-Ghani in a publication by American Diabetes Association. The research comprises of early recognition of the patients at the stage of developing IGT and initiation of treatments with oral hypoglycemic agents in order to reach a normal HbA1C. The overall numbers of patients in practice were 5000 and those with IGT were 26. The research was started 7 years ago and has resulted in these patients reaching an HbA1C of 5.2; the target of treatment was maintaining lower than 5.2. Metformin has been mostly effective in patients reaching the target value, however in rare cases Gliclazide was needed. In one case Actos and insulin treatment was essential for a female patient with polycystic ovarian syndrome. The current success has resulted in preventing further complications from diabetes. In earlier years, clinicians were advised to start oral hypoglycemic agents, once the patients had shown an HbA1C of 7.5. However, the evidences have shown that by this stage many complications from diabetes would have occurred.
Pradip Chowdhury
Peritoneal Dialysis Center of America, USA
Title: Superiority of peritoneal dialysis
Biography:
Pradip Chowdhury has graduated from Kharkov Medical Institute, Ukraine. He did his Residency in Internal Medicine at Beth Israel Medical Center, Newark, New Jersey. After that, he finished is Fellowship in Nephrology under New York Medical College at San Vincent Hospital, Staten Island New York, and Metropolitan Hospital, New York City, New York. Then he worked as an Attending Nephrologist at Kaiser Permanente, Sacramento, California. Since 2001, he has been working as an Attending Nephrologist at different hospitals in the Los Angeles, and also different dialysis units of DaVita, Fresenius, US Renal Care, and Free Standing Dialysis Unit, Los Angeles. He is the Assistant Medical Director of Peritoneal Dialysis Center of America.
Abstract:
Currently 1.9 million of people in the world are undergoing dialysis. This data is based on only people who registered for RRT. We do not know the exact percent of people reaching ESRD, and also who can afford dialysis. Some data suggests initiation of RRT in developing regions is restricted to fewer than a quarter of patients projected to developing ESRD. One of the big factors is the cost of RRT. Peritoneal dialysis may be cheaper, but it is clinically proven to be equivalent or even slightly superior to hemodialysis. This modality is under-utilized in most parts of the world. If we can promote this modality, more people will be benefitted by the effects of peritoneal dialysis. Materials for this talk are based on the articles of ASAN International Peritoneal Dialysis Journal, National Kidney Foundations and Nephrology Dialysis Transplant.
Areej Mohamed
Ain Shams University, Egypt
Title: Benefits of omega-3 fatty acids supplementation in pediatric patients on regular hemodialysis
Biography:
Areej Mohamed Ateya has completed her study at the Faculty of Pharmacy, Ain Shams University, Cairo, Egypt in 2013. She got her Pre-Master’s and started working as a Teaching Assistant at the Clinical Pharmacy Department of the same university in 2014. She had attended multiple conferences in different clinical pharmacy disciplines and was a guest speaker in one.
Abstract:
Background: Cardiovascular disease is the leading cause of death in patients with end stage renal disease on maintenance hemodialysis (HD). Omega-3 fatty acids are beneficial in preventing atherosclerosis and reducing the cardiovascular events. Patients undergoing HD are susceptible to inadequate omega-3 intake due to renal dietary restrictions. This study evaluates the effects of omega-3 on serum lipid profile, oxidative stress and cardiovascular manifestations in children undergoing HD.
Methods: A single blinded randomized placebo-controlled trial including 49 pediatric patients (mean age=14.6 years) on regular HD, who were randomly assigned into omega-3 group (n=25) who received 1 g oral omega-3 capsule once daily for 16 weeks or placebo group (n=24) who received 1 g matching oral placebo capsule once daily for 16 weeks. Total cholesterol (TC), triglycerides, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, malondialdehyde, glutathione peroxidase (GP) and superoxide dismutase (SOD) were measured at baseline and after 16 weeks of supplementation. Cardiovascular manifestations (chest pain, shortness of breath, palpitations, and feeling of fainting or dizziness) were also examined at baseline and at the end of the study.
Results: By the end of the study, children in omega-3 group showed a highly significant reduction (p<0.001) in TC and a highly significant increase (p<0.001) in GP and SOD. There was also a highly significant reduction in the number of children suffering from palpitations and chest pain in omega-3 group.
Conclusion: Omega-3 has a highly beneficial effect on serum lipid profile, oxidative stress and clinical manifestations of cardiovascular complications in pediatric patients on regular HD.
Rahaf Z Attar
King Abdulaziz University, Saudi Arabia
Title: SLE patient with an initial presentation of HUS triggered by PSGN: Case report and review
Biography:
Rahaf Z Attar has completed her Bachelor’s degree of General Medicine and Surgery from King Abdulaziz University of Jeddah. She is currently taking training at King Abdulaziz University Hospital in Pediatric Major. She has worked on several researches.
Abstract:
Background & Aim: 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 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 and dsDNA antibodies.
Results: Biopsy revealed a picture of thrombotic microangiopathy in addition to a diffuse thickening of the glomerular basement membrane with membranoproliferative 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 hasn’t been reported to the extent of our knowledge. The outcome is generally favorable.
Daniel Schock Kusch
MediBeacon GmbH, Germany
Title: Transcutaneous measurement of glomerular filtration rate in conscious laboratory animals: State of the art and future perspectives
Biography:
Daniel Schock Kusch finished his Doctoral thesis dealing with the development of novel markers for GFR measurement and their transcutaneous measurement at University of Heidelberg in 2008. He further participated in the development of that technique as Research Scientist at Innovation Lab GmbH, Heidelberg and Post-doc at University of Heidelberg and University of Applied Sciences Mannheim. In 2011, he became Co-founder of Mannheim Pharma & Diagnostics GmbH bringing the first system for transcutaneous measurement of kidney function for preclinical research to market. He is now Site Director at Medibeacon GmbH.
Abstract:
Transcutaneous measurement of glomerular filtration rate (tGFR) is now frequently used in preclinical in vivo animal studies. tGFR allows consecutive measurements on the same animal, including multiple measurements on a daily basis. A description of the measurement device and its many applications, along with examples from the recent literature will be given. We will highlight the fields of interest in which the system is used and give an overview about its performance versus endogenous and other exogenous methods of GFR measurement. A special focus will be put on the precision of tGFR compared to standard measurements employed in the research setting. A novel kinetic model for the description of transcutaneously measured excretion kinetics of the fluorescent GFR tracer FITC-Sinistrin was recently described. Using this new kinetic model designated tGFR3cp.b.m), tGFR measurements in the rat model reached comparable precision as GFR measurements assessed using a gold standard technique based on constant infusion (cGFR). The precision of tGFR assessment when using tGFR3cp.b.m, coupled with the capability of consecutive GFR measurements in the same animal over a long time span should enhance the quality of, and reduce the cost of, preclinical assessment of renal function in pharmaceutical research.