17^th International Conference on Nephrology & Urology March 12-13, 2018 London , UK

Biography:

Abstract:

Biography:

Laura Lunardi is a highly qualified health practitioner with 20 years of consolidated experience working predominantly with renal patients in Public and Private Health Sector in Australia and Argentina. She has proven ability and experience in clinical assessment, management and treatment of renal diseases, including different modalities of dialysis and conservative management for patients with ESKD.

Laura works currently as a Nephrology Nurse Practitioner Candidate subspecialised in Renal Supportive care at Central Northern Adelaide Renal and Transplantation Service in South Australia.

In 1996 she completed the Bachelor Degree in Medicine at the University of Buenos Aires in Argentina, and become Nephrologist and Specialist in General Medicine in 2002.

In 2006, she moved permanently to Australia where she completed the Bachelor of Nursing, Renal Certificate and Master in Clinical Nursing in 2015. In 2017 she is completing the requirements for Nephrology Nurse Practitioner and will apply for Nurse Practitioner Registration in 2018. 

Abstract:

A Renal Supportive Care Nurse Practitioner (NP) role was created in Adelaide, Australia in October 2014. The integration of the role has brought with it service-wide changes in clinical practice and culture within our unit.  There is now a closer integration with the local palliative care team, a greater emphasis on quality of life and active management of symptoms with more informed choices and care planning now available. This paper aims to describe the role of the NP in Renal Supportive Care (RSC) as it has emerged in South Australia.  It also identifies barriers and strategies used by the RSC NP to enhance appropriate decision-making and conservative care for patients facing End Stage Kidney Disease (ESKD).   Differing models of RSC are emerging across Australasia. The strengths and weaknesses of the South Australia approach will be elucidated as will the challenges facing RSC in the future. The transformative effects of the role will be explored, and key enablers for success identified.  The full integration of a meaningful supportive care pathway for patients facing ESKD involves more than fine words and good intentions. It requires significant leadership, considerable resources and service-wide cultural, and clinical practice changes. The emergence of RSC is the key to a comprehensive renal service, demonstrating maturation of our shared aspirations in providing: interdisciplinary care that fine-tunes the balance between organ-based and whole-of-person care, engagement in full and open decision-making support with people facing renal treatment options and recognising and respecting the natural endpoint of an end-stage disease process.

Biography:

Md. Abdul Masum has completed his MS degree at the age of 26 years from Bangladesh Agricultural University. He worked as assistant professor in the faculty of Animal Science and Veterinary Medicine, Sher-e-Bangla Agricultural University. He has published more than 9 papers in reputed journals. Now he is Japan Govt. Scholar and doing his PhD course in Graduate School of Veterianry Medicine, Hokkaido University, Japan.

Abstract:

Renal vasculatures have important roles in both homeostasis and pathology as kidney is a highly vascular organ. This study examined the pathological correlation between local capillary and lesion in respective area in the mouse kidneys. The glomerular lesions (GLs) of six-months old autoimmune disease-prone BXSB/MpJ-Yaa (Yaa) mice and tubulointerstitial lesions (TILs) of nine-weeks old C57BL/6 (B6) mice treated by unilateral ureteral obstruction (UUO) for 7 days were focused in this study. Collected kidneys were examined by histopathological and electronmicroscopic techniques. Yaa mice developed severe autoimmune glomerulonephritis, and the number of  capillary positive for CD34 was significantly decreased in GLs rather than TILs compared with healthy control mice. On the other hand, UUO-treated B6 mice showed severe TILs, and CD34-positive capillaries were significantly decreased in the TILs with the progression of fibrosis but not in glomerulus, compared with untreated kidneys. Infliltrated T-cells and macrophags were significantly increased in the kidneys of both disease models compared to respective controls (P < 0.05). Vascular corrosion cast examined under scanning electron microscopy revealed segmental absences of capillaries in GLs and TILs of Yaa and UUO-treated B6 mice, respectively. Peritubular capillary visualized by Microfil-rubber perfusion were also segmentally absent in UUO-treated B6 mice. Further, transmission electron microscopy revealed the alternations of capillary endothelium, such as thickened cytoplasm and detaching to capillary lumen. The number of CD34-positive glomerular capillary was negatively correlated with that of infiltrated T-cells, injured renal tubules, podocytes, and total glomerular cells and size in Yaa (P < 0.05). In UUO-treated mice, the number of CD34-positive peritubular capillary negatively correlated with that of all examined histopathological parameters for inflammation and fibrosis in TILs (P < 0.01).  Inflammatory process would affect the quantity and/or functional phenotype of local renal capillary, resulting in the progression of lesions in respective area of kidneys.

Biography:

Abstract:

Biography:

Khamisa Almokali is a pediatric nephrologist consultant working in king Abdullah specialized children hospital, Riyadh. She did her MD at King Saud University. And pediatric residency programme at king Abdulaziz medical city, Riyadh. Then she did her fellowship at Sick Kid Hospital, Toronto, Canada. And currently she is working as consultant pediatric nephrologiast as well she is the program director of the pediatric nephrology fellowship

Abstract:

Bladder augmentation it is a surgical procedure done when the bladder loses its function and become contracted, spastic and lead to leakage. It is an effective method by which we can increase bladder capacity and reducing pressure on the urinary system.  

 Bladder augmentation is used in an attempt to preserve and improve renal function. In spite of this, There is a lot of controversy regarding wither this procedure is suitable to maintain kidney function or might increase the risk of hasten the renal deterioration to end stage renal failure 

Biography:

Abstract:

Introduction:

Kidney transplant is a fair option for treatment of a chronic renal failure, although the outcome and results of kidney transplant are good but it may be associated with some complications. One of the important complications is urinary infection. The aim of this study was to investigate the role of early removing of the catheter in renal transplant patients on the reduction of urinary tract infections.

Materials and Methods:

This study was conducted as a clinical trial. 88 transplanted patients were enrolled and randomly divided into two groups. In the first group, the Catheter of patients were taken 3 days after the transplant, and in the second group, the catheter of  patients were removed 7 days after the transplantation. Urine culture was performed on two occasions. Then, the patient data entered the SPSS v20 statistical analysis program and analyzed the data.

Results:

In this study, 25 patients (56.8%) were male in the first group and the mean age of the patients was 43.52 ± 13.6 years. In the second group, 25 patients (56.8%) were female and the mean age of the patients was 43.20 ± 14.39 years. After examining patients' urine tests and analyzing data with T test, the incidence of infection on the day after catheter exits (P = 0.000) and 7 days after the expulsion of the catheter (P = 0.009) in the patients in the first group (three days) It was significantly less than the second group.

Conclusion:

Early removal of Catheter has fundamental effects on UTI post kidney transplant and it seems that early removal of urethral catheter may be safe and reasonable in renal transplant of the recipient patient.

Keywords: Kidney transplant, Cather, Infection, UTI 

Biography:

Andi Praja Wira Yudha Luthfi is a resident of Orthopaedic and Traumatology in University of Indonesia and Cipto Mangunkusumo hospital in Jakarta. This is his 3rd year of residency. The article he is about to present has already published in Journal of Medical Case Reports (2017)

Abstract:

Chronic renal failure is an important clinical problem with significant socioeconomic impact worldwide. Thoracic spinal cord entrapment induced by a metabolic yield deposit in patients with renal failure results in intrusion of nervous tissue and consequently loss of motor and sensory function. Human umbilical cord mesenchymal stem cells are immune naïve and they are able to differentiate into other phenotypes, including the neural lineage. Over the past decade, advances in the field of regenerative medicine allowed development of cell therapies suitable for kidney repair. Mesenchymal stem cell studies in animal models of chronic renal failure have uncovered a unique potential of these cells for improving function and regenerating the damaged kidney. We report a case of a 62-year-old ethnic Indonesian woman previously diagnosed as having thoracic spinal cord entrapment with paraplegic condition and chronic renal failure on hemodialysis. She had diabetes mellitus that affected her kidneys and had chronic renal failure for 2 years, with creatinine level of 11 mg/dl, and no urinating since then. She was treated with human umbilical cord mesenchymal stem cell implantation protocol. This protocol consists of implantation of 16 million human umbilical cord mesenchymal stem cells intrathecally and 16 million human umbilical cord mesenchymal stem cells intravenously. Three weeks after first intrathecal and intravenous implantation she could move her toes and her kidney improved. Her creatinine level decreased to 9 mg/dl. Now after 8 months she can raise her legs and her creatinine level is 2 mg/dl with normal urinating.

Biography:

Abstract:

Biography:

Abstract:

Biography:

Diana Laila R has completed his PhD at the age of 30 years from Universiti Sains Malaysia. She is the head of department of pharmacist programme Universitas 17 Agustus 1945 Jakarta. She has published more than 30 papers, 100 case reports either national, international and reputed journals. She has published 2 books about clinical pharmacy as internationally. She is the active member of pharmacy organization in Indonesia. She had experience as a speaker in national and international forum and 2 times got grants from Indonesian government for clinical pharmacy research

Abstract:

  Isolation and using special hemodialysis machine are not necessary for hemodialysis patients who has been infected by hepatitis C viral from the association of Nephrologist in Indonesia (Pernefri) recommendation meanwhile Ministry of Health Malaysia gives recommendation that hepatitis C patients will be dialyzed in a separate room or a separate area with a fixed partition and dedicated machines. To identify the correlation between the recommendation which had been followed by two hemodialysis centers in different countries and the impact of that to the hepatitis C infection issue. A cohort prospective and retrospective study was done in this research. The study included hemodialysis patients who had followed up for 9 months and who died in last 5 years. Universal sampling were used to select the inclusion criteria. There was a significance relationship between HCV first checked and HCV second checked among 9 months followed up hemodialysis patients in HD center Jakarta, Indonesia. The total number of patients who had hepatitis C in the second checked increased around 30% of total hemodialysed patients who infected HCV in the first check in this HD center. Besides, provide special hemodialysis rooms and machines for hemodialysis patients with hepatitis C, minimizing blood transfusion to the patients on hemodialysis is important to reduce the chance for the patients to get hepatitis C and to increase the percentage of the survival.

Keywords:    Hepatitis C, Hemodialysis, Indonesia, Malaysia

Biography:

Mr. Ahmed A. Khamis is a clinical pharmacist and a medical educationist who believes that education is the most powerful weapon we can use to change the world, and who aspires to inspire before he expires. Mr. Ahmed got his Bachelor of Science degree in Pharmacy from Alexandria University, Alexandria, Egypt in 2007. To Improve his teaching skills, he earned a degree in medical education in 2012 which is the Joint Master of Health Professions Education (JMHPE) from Suez canal University, Egypt jointly with Maastricht university, Netherlands. Four years later he moved to Malaysia where he earned his second master degree but in clinical pharmacy this time in 2016 from Universiti Sains Malaysia, USM. A few months later, early 2017, he started his Ph.D. journey in clinical pharmacy from the same university, USM, and still ongoing. Mr. Ahmed Khamis possesses experience in community, clinical and academic pharmacy settings and institutions. Before pursuing his second master degree, he was a lecturer at the school of pharmaceutical sciences, Qassim university, KSA. In Qassim, Mr. Ahmed founded the medical education and e-learning units and headed the quality and accreditation department. He supervised the undergraduate pharm D curricular development and the implementation of team-based learning (TBL) teaching strategy in the school. Mr. Ahmed is an active member of many international professional clinical pharmacy and medical education organizations and has considerable publications in peer-reviewed journals. He is also open to collaboration in either research activities or training provision in the below mentioned aspects.

Abstract:

In the general population, beneficial effects of statin treatment on cardiovascular endpoints are well established. Chronic kidney disease (CKD) is a status of specific lipid disturbances, dyslipidemia with increased levels of triglycerides, small dense and oxidized LDL (oxLDL), and lower HDL cholesterol levels. In nephrotic syndrome, also total cholesterol and LDL levels are elevated. As patients with CKD and albuminuria have an increased incidence of cardiovascular disease, they should be considered for statin therapy. Currently, however, only 25% of CKD patients are under continuous statin therapy. The indirect and direct effects of lipids on glomerular structure have been described in detail in animal models of renal damage,as well as in patients. Therefore, in theory, beneficial systemic and renal effects of lipid-lowering in CKD by statins could be expected. In fact, there are indeed well-proven general effects of statins in CKD patients, lipid-lowering, anti-inflammatory and anti-oxidative effects.

In a post-hoc subgroup analysis of the CARE study, a randomized trial of pravastatin versus placebo in 4159 participants with previous myocardial infarction and total plasma cholesterol <240 mg/dL, a beneficial effect of statins on the loss of renal function in moderate CKD was found. Here, pravastatin reduced rates of renal loss to a greater extent in participants with than without proteinuria. A systematic meta-analysis found a small beneficial effect of statins on kidney function decline (particularly in patients with cardiovascular disease), and proteinuria.

The hereby analyzed studies, however, showed several limitations. Another meta-analysis using the data from randomized, placebo-controlled trials of statins reporting baseline and follow-up measurements of albuminuria or proteinuria found a reduction of albuminuria or proteinuria. A more recent meta-analysis also investigated the effects of statins in CKD patients and concluded with respect to potential renal effects: ‘Reno-protective effects of statins are uncertain because of relatively sparse data and possible outcomes reporting bias .

Biography:

Hajira Iftikhar is currently an intercalating medical student between years 3 and 4 studying MRes Oncology at the University of Manchester. She undertook a 10-week research project on circadian rhythms as part of her third year and attained a distinction in the written report and presentation.

Abstract:

Kidney transplants are of the few types of operations that can occur at any time over 24 hours. This retrospective observational study explores the impact of circadian rhythms in generating rejection. Data from 974 transplants that occurred in one hospital unit between 2004 and 2014 was collected and time of organ reperfusion and presence of rejection was recorded. From these records, 89 were those that had inconclusive biopsy results and for these, hospital records were investigated to find the diagnosis. 43 of these patients were those of whom notes were not found and these patients were assumed to not have rejection. Statistical analysis using JTK_cycle and circwave was used to determine involvement of circadian rhythms in rejection and found that there was weak circadian contribution. This weak association is not sufficient to conclude that circadian involvement is important enough to be considered in clinical practise. Therefore, more research is required regarding circadian involvement and transplantation to determine whether these results are reliable. By determining the peak times of rejection, these operating times can be avoided or the patients could be primed to minimise rejection post-operatively.  Reliance on patient records may not be the best way to determine circadian involvement due to the heavy dependency on record keeping of other healthcare professionals.