22^nd European Nephrology Conference October 15-16, 2018 Warsaw, Poland

Nephrology is a branch of medical science that deals with function and diseases of the kidneys and it focuses on the diagnosis and treatment of kidney diseases. The kidneys are paired retroperitoneal organs that lie at the level of the T12 to L3 vertebral bodies. The kidney has a fibrous capsule, which is surrounded by pararenal fat. The kidney itself can be divided into renal parenchyma, consisting of renal cortex and medulla, and the renal sinus containing renal pelvis, calyces, renal vessels, nerves, lymphatics and perirenal fat. The renal parenchyma has two layers: cortex and medulla. The renal cortex lies peripherally under the capsule while the renal medulla consists of 10-14 renal pyramids, which are separated from each other by an extension of renal cortex called renal columns. The kidneys serve important functions, including filtration and excretion of metabolic waste products (urea and ammonium); regulation of necessary electrolytes, fluid, and acid-base balance; and stimulation of red blood cell production. They also serve to regulate blood pressure via the renin-angiotensin-aldosterone system, controlling reabsorption of water and maintaining intravascular volume.

Dialysis works on the objective of the diffusion of solutes and ultrafiltration of liquid over a semi-penetrable layer. Diffusion is a property of substances in water substances in water tend to move from a territory of high fixation to a range of low focus. The two primary sorts of dialysis, Hemodialysis and Peritoneal dialysis removes wastes and water from the blood in various ways. Hemodialysis removes waste water by circling blood outside the body through an outer filter called a dialyzer that contains a semipermeable layer. There are five types of dialysis three are primary and two are secondary types of dialysis: Hemodialysis and peritoneal dialysis, hemofiltration are primary types of dialysis and were as hemodiafiltration, and intestinal dialysis is secondary type of dialysis.

The most common procedure of kidney replacement therapy is dialysis, is a method of cleaning the blood with artificial kidneys. There is of types of dialysis they are:

1. Hemodialysis 2. Peritoneal dialysis.

Hemodialysis: Hemodialysis required with the patients of renal failure. In this process of Hemodialysis, an artificial kidney purifies blood. We ought to make an "access," usually in the forearm where blood can easily be taken from the body and directed to the artificial kidney for purification. The access collects blood from patient body and undergoes purification in artificial kidney and again injected the purified blood in to patient body.

Peritoneal dialysis: In peritoneal dialysis no artificial kidney is used. The peritoneum (lining inside your abdomen) is used as a filter instead of artificial kidney. Peritoneal dialysis is of two types they are continuous cycling peritoneal dialysis and continuous ambulatory peritoneal dialysis. Peritoneal dialysis is used in kidney failure patients.

Renal nutrition is concerned with the special nutritional needs of kidney patients. Renal nutrition is concerned with ensuring that kidney patients eat the right foods to make dialysis efficient and improve health. Dialysis clinics have dieticians on staff that who help patients plan meals. Standard guidelines are: eating more high protein foods, and less high salt, high potassium, and high phosphorus foods. Patients are also advised on safe fluid intake levels.

Kidney transplantation or renal transplantation is the organ transplant of a kidney into a patient with end-arrange kidney diseases. Kidney transplantation is commonly named deceased donor known as cadaveric or living donor transplantation relying upon the wellspring of the giver organ. Living donor kidney transplants are formerly differentiated as non-related living transplants or, living related transplants contingent upon whether a biological relationship exists between the kidney donor and kidney recipient. Exchanges and chains are a novel way to deal with grows the living donor pool.

Hypertensive kidney disease is a medical condition referring to impairment to the kidney due to chronic high blood pressure.HN can be divided into two types: benign and malignant. Benign nephrosclerosis is common in individuals over the age of 60 where malignant nephrosclerosis is uncommon and affects 1-5% of individuals with high blood pressure, that have diastolic blood pressure passing 130 mm Hg. It should be illustrious from renovascular hypertension, which is a form of secondary hypertension. In addition, HN can be referred to as hypertensive nephrosclerosis, benign nephrosclerosis, and nephroangiosclerosis.

There are several hospitals offering kidney treatments including dialysis and transplantation. They are well known for health care and fast recovery is promised from the hospital combined with a pleasant and suitable caring atmosphere. According to the global statistics they were nearly 12000 Hospitals in cites associated with kidney treatments and 17790 doctors of USA working in the hospitals.

Several renal diseases like Polycystic Kidney Disease are result from genetic factors. In polycystic kidney disease number of cysts improves in the kidney, these cysts gradually replace the mass of kidney. Impairing kidney function and leading to renal failure.

Your nephrologist will work to slow or control the reason of your kidney disease. Depending on the root, some types of kidney disease can be cured. Frequently, chronic kidney disease has no prevention. In the event that your kidneys turn out to be extremely harmed, you may require treatment for end-stage kidney diseases. In the event that your kidneys can't stay aware of waste and liquid freedom all alone and you create finish or close kidney disease, you have End-stage renal disorder. By then, dialysis or a kidney transplant is required. Since no particular in option and Ayurveda prescription for kidney can treat kidney disappointment effectively, the best technique is to join them. Immunotherapy, as one extraordinary leap forward in treating end-stage kidney sickness, is only a blend of cutting edge western restorative advances and customary home grown drugs

Clinical Nephrology covers the conclusion and treating of renal syndromes, including primary and secondary hypertension and electrolyte disturbances, and the care of those requiring renal replacement treatment, including dialysis and renal transplant patients. Numerous diseases influencing the kidney are systemic scatters not constrained to the organ itself, and may require uncommon treatment. Illustrations incorporate procured conditions, for example, systemic vasculitides and immune system diseases, lupus and innate or genetic conditions, such as, polycystic kidney diseases. Patients are referred to clinical nephrology doctors after a urinalysis, for different reasons, such as, acute kidney failure, hematuria, proteinuria, chronic kidney diseases, kidney stones, hypertension, and disarranges of acid/base or electrolytes.

The study of pediatric nephrology determines diagnosis and management of infants with an chronic and acute kidney disorders. The division of pediatric nephrology assesses and treats hypertension, hematuria, proteinuria, renal tubular acidosis, nephrolithiasis, glomerulonephritis and kidney damage in children. It also includes complete care to pediatric patients with end stage kidney syndromes, including consideration to patients experiencing peritoneal dialysis, hemodialysis and kidney transplantation in infants.
 

Glomerular disease reduces the ability of the kidneys to sustain a balance of certain substances in bloodstream. Normally, the kidneys should filter toxins out of the bloodstream and emit them in the urine, but should keep red blood cells and protein in the bloodstream. In individuals with glomerular disease, red blood cells and protein might be excreted into the urine, while toxins may be retained.

Glomerular disease can occur by itself or may be associated with an fundamental medical condition that affects other organ systems, such as lupus nephritis, diabetes, or certain infections. Glomerular disease can develop rapidly or develop gradually over a period of years. Treatment of glomerular disease depends upon its cause and type.

Kidney disease may also lead to heart disease or coronary illness because of this more than 20 million people died in the U.S. with chronic kidney disease. Chronic kidney disease induces the risk of death from cardiovascular disease. Coronary disease result for more than half of all deaths among individuals with CKD (Chronic kidney diseases).  Indeed, even early or mellow renal disease ailment puts a man at higher danger of heart ailments and heart attacks and also heart disease-related death. Kidney dialysis patients who also have cardiovascular disease are died 10 to 30 times more than in the general cardiovascular patients. Diabetes and hypertension are major risk factors for heart disease and chronic kidney disease. Kidney disease (acute kidney disease or chronic kidney disease) can induce the danger of cardiovascular ill, even with hypertension, high cholesterol and concurrent diabetes. Recent researches show that kidney diseases (renal diseases) induce heart disease, even before the kidneys are harmed to the point of requiring dialysis or transplantation.

A branch of medicine which deals with the study of normal  kidney function, kidney problems & their treatment. It also involves Renal replacement therapies .

Acute kidney failure: Disfunction of the kidneys to filter the waste from the blood. Decreased urinary output, swelling due to urinary retention, nausea, shortness of breath are some of the symptoms. Acute tubular necrosis was death of the tubular epithelial of the renal tubules in the kidneys. Consumption of nephrotoxic drugs & low blood pressure are the common causes. Diabetes insipidus-  A condition in which kidneys prevent the excretion of water. Hypocalcaemia & Several Other Case Reports Related to Nephrology.

Every nephrologist has received extensive training in general internal medicine, and many nephrologists will treat their patients for other things besides kidney problems. It’s important that patients tell their kidney doctors if they notice any changes in their health.

Acute kidney injury (AKI) is an unexpected incident of kidney failure or kidney damage that occurs within a few hours or a few days. AKI causes a build-up of waste products in your blood and makes it tough for your kidneys to keep the right balance of fluid in your body. AKI can also distress other organs such as the brain, heart, and lungs. Acute kidney injury is common in patients who are in the hospital, in intensive care units, and especially in older adults.

End-stage renal disease also termed as chronic kidney diseases (CKD) comprise conditions that damage kidneys and impair their ability to keep you hygienic by abnormal function. On condition kidney disease gets worse; wastes can accumulate to high levels in your blood and make you feel ill. You may develop issues like anemia, high blood pressure, weak bones, nerve damage and poor nutritional health. Also, kidney disease elevates your risk of having coronary disease and heart problems. These problems may occur slowly for a long period of time. Diabetes and high blood pressure are the two main causes of chronic kidney disease.

Kidney cancer, also known as renal cancer, is a type of cancer that starts in the cells in the kidney. The two most common types of kidney cancer are renal cell carcinoma and transitional cell carcinoma of the renal pelvis. These names mirror the sort of cell from which the disease developed. The different types of kidney cancers are renal cell carcinoma, Transitional cell carcinoma, Sarcoma, Wilms tumor, Lymphomaand the types of kidney cancer cells are clear cell, Papillary, Sarcomatoid features, Medullary/collecting duct, Chromophobe, Oncocytoma, Angiomyolipoma.

Tubulointerstitial is used commonly to refer the kidney diseases that consist of structures in the kidney outside the glomerulus. These diseases commonly involve tubules and/or the interstitium of the kidney and spare the glomeruli. Glomerular diseases are regularly associated with projecting tubulointerstitial variations in the scientific appearance is dominated by the consequences of glomerular damage.

The kidneys are often targeted by pathogenic immune responses against renal auto antigens or by local manifestations of systemic autoimmunity. For the diagnosis renal pathologists use special tests and electron microscopes to detect the cells involved in diseases affecting the kidneys.

Kidney biopsies permit us to analyse renal disorders; review anticipations; help in the resolve of a precise restorative approach; and screen ailment movement in both local and allograft transplant kidneys. To maximally abuse renal biopsy examples, a blend of light, immunofluorescence and electron microscopy is used. Each microscopy requires distinctive strategies for fixation and preparing, so each renal biopsy centres are commonly separated into three sections. Contingent upon the length of the biopsy centre or suspected illness process; in any case, the strategy for partitioning the biopsy centre might be altered.

The diabetic kidney disease sometimes also called as diabetic nephropathy is a renal related complication usually occurs in some people with diabetes mellitus. In diabetic nephropathy filters of the kidneys and glomeruli become damaged. In this condition the kidneys leak abnormal quantity of protein from blood into the urine.

If anyone has diabetes, the blood glucose, or blood sugar levels are very high. For prolonged period, this can damage the kidneys. The role of kidney is to clean your blood. In case they are damaged, waste and fluids accumulate in your blood with out of leaving from your body.

If the kidney damage by diabetes is called diabetic nephropathy. Usually it starts long before you have notice symptoms. The beginning sign of it is small quantity of protein in urine. By urine test we can detect diabetic nephropathy or blood test can also determine the functioning of kidneys.

The renal system uphold homeostasis in the body avoiding significant alterations in the balance of fluid electrolyte or acid–base equivalence until the Glomerular filtration rates reduced to below 25 ml/min because of  a series of versatile changes, both Renal and extra renal. With dynamic decrease in renal capacity these components are overpowered bringing about unsettling influences in water digestion system adding to hypernatremia and hypernatremia. The modified control of sodium transport causes irritated volume status including volume over-burden and exhaustion. The rate of Hyperkalaemia and metabolic acidosis is more incessant in Chronic Kidney Disease (CKD) with GFR beneath 10 ml/min. In this survey article we will endeavour to audit the renal and supplementary renal adjustment components looking after liquid, electrolyte and corrosive base equalization in endless kidney illness alongside variables which cause disappointment of these instruments.

Nephrology Nursing is a planned attempt to increase nursing knowledge by the discovery of new facts through systematic enquiry. It includes: Improvement in patient care, Reduced cost of kidney care provision, Accountability and protection against litigation, Addition to the existing body of nursing knowledge, Enhancement of nursing as a profession.

Renal care nursing is the field of nursing with a focus on the most extreme consideration of the discriminatingly sick or unsteady chronic kidney patients. Contamination revultion and nursing consideration is the control concerned with turning away nosocomial or health awareness related disease, a functional (as opposed to scholastic) sub-order of the study of disease transmission. Infants who need escalated restorative consideration are regularly conceded into a unique region of the clinic called the Neonatal serious care and nursing consideration. The part of backing in discriminating nursing consideration: Critical consideration medical attendants work in a wide assortment of settings, filling numerous parts including bedside clinicians, attendant teachers, medical caretaker analysts, medical caretaker supervisors, clinical medical caretaker authorities and medical attendant professionals. Measurements of Renal Care Nursing's mission is to give attendants exact, current, and applicable data and lodging to exceed expectations in discriminating consideration rehearse.

The field of oncology is rapidly changing as new therapies emerge and improve the outcomes for many types of cancer. Not surprisingly, the population with cancer, like the general population, is aging. As a result, patients with cancer are probably receiving diagnoses and treatment in the setting of more comorbid conditions, including CKD. Furthermore, there is an ever-growing list of new antineoplastic treatments, and many of these therapies have kidney-related complications.

The aims of this study were to assess the clinical utility of total and regional bone densitometry in a large continuous ambulatory peritoneal dialysis (CAPD) population and to determine the clinical, biochemical, and radiographic variables that best identified osteopenic CAPD patients.

The diagnostic and prognostic validity of sperm function biomarkers is particularly relevant for males with unexplained infertility in which routine semen analysis fails to detect sub cellular   sperm dysfunctions. In this general review, we examine there are several types of acute nephritis. They are Interstitial Nephritis: The spaces between the renal tubules that form urine become inflamed. Pyelonephritis: This type of acute nephritis produces inflammation in the glomeruli. Interstitial Nephritis: This type is often caused by an allergic reaction to a medication or antibiotic.

The majority of nephritis infections occur from the bacteria Escherichia coli (E.coli), which is found in the intestine.

Although medicine cannot reverse chronic kidney disease, it is often used to help treat symptoms and complications and to slow further kidney damage. Most people who have chronic kidney disease have problems with high blood pressure at some time during their disease. Medicines that lower blood pressure help to keep it in a target range and stop any more kidney damage. You may need to try several blood pressure medicines before you find the medicine that controls your blood pressure well without bothersome side effects. Most people need to take a combination of medicines to get the best results. Your doctor may order blood tests 3 to 5 days after you start or change your medicines. The tests help your doctor make sure that your medicines are working correctly.

Medicines may be used to treat symptoms and complications of chronic kidney disease. These medicines include:

Erythropoietin (rhEPO) therapy and iron replacement therapy (iron pills or intravenous iron) for anaemia.

Medicines for electrolyte imbalances.

Diuretics to treat fluid buildup caused by chronic kidney disease.

ACE inhibitors and ARBs. These may be used if you have protein in your urine (proteinuria) or have heart failure. Regular blood tests are required to make sure that these medicines don't raise potassium levels (hyperkalemia) or make kidney function worse.

Both erythropoietin (rhEPO) therapy and iron replacement therapy may also be used during dialysis to treat anemia, which often develops in advanced chronic kidney disease.

Erythropoietin (rhEPO) stimulates the production of new red blood cells and may decrease the need for blood transfusions. This therapy may also be started before dialysis is needed, when anemia is severe and causing symptoms.

Iron therapy can help increase levels of iron in the body when rhEPO therapy alone is not effective.
Vitamin D helps keep bones strong and healthy