Day 1 :
Fine Treatment, UK
Keynote: Thermobalancing therapy® and Dr Allen's Devices as an innovative treatment for prostate enlargement, chronic prostatitis and kidney stones
Time : 10:00-10:40
Dr. Allen obtained PhD in Medicine in 1978. For many years he was treated patients with chronic internal diseases, including various kidney problems: nephritis, nephrosis, chronic kidney failure and kidney stones, developing diets for them. Later Dr Allen headed health clinic for the treatment of chronic internal conditions. Then he devoted two decades to further medical research and developed Thermobalancing therapy® and Dr Allen’s Devices for chronic internal diseases, which received a patent in the USA, as “Therapeutic device and method”. He is Director of Fine Treatment, United Kingdom, the Company that distributes these devices worldwide.
Thermobalancing therapy® (TT) and Dr Allen’s therapeutic devices (DATD) provide a side effects free treatment for common chronic urological diseases, such as benign prostatic hyperplasia (BPH), chronic prostatitis and kidney stone disease. TT and DATD received a US patent as “Therapeutic device and method”.
TT is based on a new understanding of the origin of diseases that states that all chronic internal diseases have the same root, the pathological activity of capillaries. As a result of changes in small blood vessels, the focus of hypothermia becomes a continuous trigger in the affected tissue, which gradually increases the pressure in the affected organ that leads to its malfunction.
Therapeutic device applies a natural thermoelement, which accumulates the body heat, to the projection of the affected organ eliminating the focus of hypothermia. For prostate problems thermoelement must be applied to the coccyx area and to dissolve kidney stones 2 thermoelements - to the projection of kidneys. Dr Allen’s Device is a class 1 medical device, so it can be used by everyone at home.
Two clinical trials on TT confirmed its effectiveness. After 6-month use of DATD in 124 men with BPH, the prostate volume (mL) decreased from 45.1 to 31.8 and urinary symptoms score - from 14.3 to 4.7. In men with chronic prostatitis, after 6-month use of DATD pain reduction ranged from 10.3 to 3.5, and prostate volume (mL) from 31.7 to 27.0. There were no changes in the control groups. Thus, TT is an effective tool for urological conditions.
Yale School of Medicine-Yale University, USA
Keynote: Renal outer medullary potassium channel knockout models reveal bartter’s syndrome and dysfunction of potassium homeostasis
Time : 10:40-11:20
Tong Wang completed her M.D. and clinical trainings at Beijing University, School of Medicine in China. She then spent two postdoctoral training periods in the United States, first at the University of Illinois at Chicago and later at Yale University School of Medicine (with Dr. Gerhard Giebisch). Currently, she is a full Professor, Director of the Small Animal Physiology Core in the Department of Cellular and Molecular Physiology and is co-Director of the Renal Physiology Core in the George M O'Brien Kidney Center at Yale University. She has published more than 100 papers in reputed journals and has been serving as an active member of NIH KMBD study section
The renal outer medullary potassium channel (ROMK) is an ATP-sensitive inward-rectifier potassium channel (Kir1.1 or KCNJ1) highly expressed in the kidney. We have demonstrated that ROMK -/- mice show a similar phenotype to Bartter’s syndrome of salt wasting and dehydration due to reduced Na-K-2Cl-cotransporter activity in the thick ascending limb (TAL). Patch clamp studies showed that ROMK is required to form both the small-conductance (30-pS, SK) K and the 70-pS (IK) K channels in the kidney. At least three ROMK isoforms have been identified in the kidney; however, unique functions of any of the isoforms in nephron segments are still poorly understood. We have generated a mouse deficient only in ROMK 1 by selective deletion of the ROMK 1-specific first exon using an ES cell Cre-LoxP strategy and examined the renal phenotypes, ion transporter expression, ROMK channel activity and localization under normal and high K intake. Unlike ROMK -/- mice, there was no Bartter’s phenotype with reduced NKCC2 activity and increased NCC expression in ROMK1-/- mice. The SK activity showed no difference of channel properties or gating in the collecting tubule (CCD) between ROMK1+/+ and ROMK1-/- mice. High K intake increased SK channel number per patch and the ROMK channel intensity in the apical membrane of the CCD in ROMK1+/+, but such regulation was diminished with significant hyperkalemia in ROMK1-/- mice. These results are consistent with previous studies that ROMK1 does not localize in the TAL, and that ROMK1 is a key target of PTK-mediated ROMK trafficking in response to K+ intake.
West Virginia University, USA
Time : 11:40-12:20
Dr. Mohamad W. Salkini, is an Associate Professor of Urology and Chief of Urologic Oncology. He also is dirctor of simulation and robotic Surgery programs at West Virginia University.
Mohamad W. Salkini earned his MD from Damascus University in 1998, and completed urology residency at Damascus University Urology Residency Program in 2003. He was fellow with Heidleberg University and University of Cininnati for the years 2003-2004 and 2007-2009 respectively. He served as research fellow with University of Arizona from 2004-2007.
Percutaneous Nephrolithotripsy (PCNL) is considered the standard treatment for large kidney stone (>2 cm) and large stone burdon. However, and in certain patients, the technique can be challenging and fails. We utilized the da Vinci® surgical robotic system to remove kideny stone in certain circumstansis. Robotic assisted laparoscopic pyelolithotomy (RALPL) was performed at our institute to treat large kidney stones (>2 cm) in morbidly obese patient (BMI >35), patients with skelital deformity that prevent percutaneous access to the kidney or positioning for the access, and after PCNL failure. We, also, performed RALPL whenever the robotic system was used for other perpose like pyeloplasty, partial nephrectomy, utereal reconstruction on the same kidney. RALPL allowed us to utilize other endoscopic intruments to achieve high rate of stone clearance.
Seventeen patients underwent RALPL at our institute including 19 renal units. Average BMI in all patients was 38.5 kg/m2 (range 17.7-61.4 kg/m2), and all had prior abdominal surgeries The indication for RALPL was morbid obesity (n=8, mean BMI 56.4 kg/m2¬), need for concurrent renal surgery (n=3), severe contractures limiting positioning for retrograde endoscopic or percutaneous nephrolithotripsy (n=2), symptomatic calyceal diverticular stone with failed endoscopic approach (n=2) and patient preference over percutaneous nephrolithotripsy after failed PCNL (n=2). Patients had a mean of 2.3 stones and total stone volume of 16.5 cm3 (range 0.7-75 cm3) per kidney. Average blood loss was 57.8 mL and mean operative time was 180 minutes. Mean hospital stay was 3.5 days. Mean follow-up was 54 days and 91 % of patients were rendered stone free.
- Nephrology | Dialysis | Kidney Transplantation | Urology | Pediatric Nephrology
Christian Hospital, USA
Time : 12:20-12:50
Royal Adelaide Hospital, Australia
Title: Strategies, barriers and significance for renal supportive care: role of the nurse practitioner
Time : 13:50-14:20
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.
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.
Hokkaido University, Japan
Title: Local CD34-positive capillary decreased with the progression of lesion in respective area of kidney in mice
Time : 14:20-14:50
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.
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.
Hospital Ramón YCajal, Spain
Time : 14:50-15:20
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
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
Department of Kidney Transplant, Iran
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.
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.
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
Cipto Mangunkusumo Hospital, Jakarta, Indonesia
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)
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.