Day 2 :
Keynote Forum
Riitta Lassila
Helsinki University Hospital, Finland
Keynote: Locally acting antiplatelet and anticoagulant APAC, a mimic of heparin proteoglycan, inhibits acute ischemic kidney injury
Time : 10:00-10:40
Biography:
Riitta Lassila has completed her MD in 1983 from Helsinki University, PhD in 1989, and postdoctoral studies at Mount Sinai University School of Medicine in N.Y. She is an internist and the Head of Coagulation Disorders Unit in Helsinki University Hospital since 2000 and Professor of Coagulation Medicine in Helsinki University since 2013. She has published more than 220 papers in peer-reviewed journals and has served as editor in Thrombosis Research and editorial board member of Haemophilia. She is the secretary of European Association of Haemophilia and Allied Disorders and steering committee member of EUHANET and EUHASS. She is CSO in Aplagon Oy developing APACs as pharamceutical entities.
Abstract:
APACs are unique dual antiplatelet and anticoagulant molecules, which mimic the vascular tissue residing mast cell heparin proteoglycans. Platelet activation and interaction with vascular wall with ensuing coagulation are important pathogenic mechanisms underlying various diseases, including kidney disease. We have shown that in ANCA-vasculitis kidney function is associated with strong coagulation activity during the acute phase, and that vascular access problems are prevalent in dialysis patients with coagulation abnormalities or thrombophilias. We have studied our potent, naturally occurring, locally acting antithrombotic in prevention of ischemic short- and long-term reversible or irreversible kidney injuries.
APACs show strong inhibition of collagen-induced platelet aggregation and procoagulant activity in association with vascular damage. In various animal models we have shown that APAC is able to target vascular injury site from the circulation and upon local application, having a long vascular retention time. Being highly negatively charged large molecules (MW 200-400 kDa) APACs interact avidly with vascular von Willebrand factor, laminin and collagen, whereas PECAM and podocalyxin positive vascular sites fail to colocalize with APAC. When infused intravenously 10 min prior to arterial clamping APAC protected kidneys from ischemic reperfusion injury, assessed both by clinical and laboratory or pathology findings. Intriguingly, in severe irreversible injury of 60 min ischemia time, APAC provided renoprotection. We are currently working with a diabetic nephropathy mouse model to study the possible role of APAC in the development of streptozotocin-induced diabetes and kidney damage.
Keynote Forum
Afshar Zomorrodi
Imam Reza Hospital-Tabriz University of Medical Sciences, Iran
Keynote: Does early removal of foley cather have any influence on infection of recipient post renal transplantation? Is it safe? A clinical trial study
Time : 10:40-11:20
Biography:
Abstract:
- Chronic Kidney Diseases | Kidney Cancer | Kidney Diseases | Kidney Nutrition | Urinary Track Infections
Session Introduction
Simon Allen
Fine Treatment, UK
Title: Dr Allen's device for kidney care by dissolving renal calculi naturally prevents people with kidney stone disease from the development of secondary high blood pressure or diabetes
Time : 11:40-12:10
Biography:
Abstract:
Nouman Khan
Shaukat Khanum Cancer Hospital Lahore & Research Centre, Pakistan
Title: Ten-year outcome study in a cohort of non-metastatic renal cell carcinoma treated with curative intent at SKCH & RC: survival and progression after radical nephrectomy in 344 patients
Time : 12:10-12:40
Biography:
Abstract:
Diana laila
Jarakata, Indonesia
Title: Why and how? Hepatitis c infection become a common issue among hemodialysis patients in a hemodialysis center Jakarta, Indonesia and a comparison of survival percentage of those hemodialysis patients with hepatitis infection between two hemodialysis centers in Jakarta, Indonesia and Penang, Malaysia
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
Ahmed A. Aly
University of Science, Malaysia (USM), Penang, Malaysia
Title: Statins, beyond lipids in Chronic kidney disease (CKD)
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 .
Hajira iftikhar
University of Manchester
Title: Circadian regulation of rejection after kidney transplantation
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.