9^th European Congress on Nephrology, Internal Medicine and Kidney Diseases October 25-26, 2021 Paris, France

Biography:

Shahmeen Rasul has completed her MBBS degree at the age of 22 from St George’s, University of London. She is currently working in Oxford University Hospitals NHS Trust as a first year doctor. Throughout her medical journey she has been President of multiple committees in the university which ranged from humanitarian groups such as UNICEF and Doctors without Borders to academia such as Critical Care and Anaesthetics society. She takes a keen interest in surgery and has written around this in journals.

Abstract:

Patients with end-stage renal disease require ongoing dialysis until the damaged kidney is replaced. The new kidney can be taken from either a cadaver or donor, the latter being the preferred choice due to better kidney function in the recipient post-operatively. Kidneys are the highest-donated organ by far so extracting the kidney from a healthy donor must be done as safely as possibly to minimise inconvenience to donors. The aim of this project is to deduce the safest procedure for live donor nephrectomy as it is done by donors as an act of altruism and entirely for the benefit of the recipient. The procedure can be done via open-surgery which involves a long incision between 10- 20 inches through the side of the abdomen. The alternative method is through laparoscopic surgery which uses a small incision and digital guidance to access the kidney, and causes less cosmetic issues and post-operative complications for healthy donors. My aim is to identify which of the laparoscopic approach out of retroperitoneal and transperitoneal yields the best general outcomes for patients undergoing live donor nephrectomy.

Patients with end-stage renal disease require ongoing dialysis until the damaged kidney is replaced. The new kidney can be taken from either a cadaver or donor, the latter being the preferred choice due to better kidney function in the recipient post-operatively. Kidneys are the highest-donated organ by far so extracting the kidney from a healthy donor must be done as safely as possibly to minimise inconvenience to donors. The aim of this project is to deduce the safest procedure for live donor nephrectomy as it is done by donors as an act of altruism and entirely for the benefit of the recipient. The procedure can be done via open-surgery which involves a long incision between 10- 20 inches through the side of the abdomen. The alternative method is through laparoscopic surgery which uses a small incision and digital guidance to access the kidney, and causes less cosmetic issues and post-operative complications for healthy donors. My aim is to identify which of the laparoscopic approach out of retroperitoneal and transperitoneal yields the best general outcomes for patients undergoing live donor nephrectomy.

Biography:

Naveen Kumar is pursuing his PhD from University of Delhi. He is carrying out his fieldwork at Sir Ganga Ram Hospital, Delhi. He is working on identification of non-invasive biomarkers for graft rejection, the impact of COVID-19 vaccination on CKD and transplant patients, quality of life of transplant and CKD patients. Beside this he is involved in projects on COVID-19 prognosis and mucormycosis. He has published 5 papers in reputed journals.

Abstract:

Donor derived cell free DNA (dd-cfDNA) is an emerging non invasive biomarker that is being used in detection of graft rejection and in monitoring the health of the graft.  Organ transplant is not just a transplant of organ but a transplant of genome. Every transplant patient has to undergo regular tests and biopsies for monitoring the graft health. Currently used methods to detect health and rejection of transplanted kidney are late markers which tend to show the signs of rejection or dysfunction at the stage when almost 50% of the function has already been lost. Serum creatinine elevates when the kidney has already lost sufficient functioning. Biopsy being a gold standard for diagnosing rejection has its own set of limitations like high turnaround time, expensive in nature, inconvinient to patients and lastly not recommended for serial testing. Previous studies have reported that the biopsies performed after observing the rise in serum creatinine revealed active rejection in as low as 27% of the cases. Therefore, dd-cfDNA is emerging as a new gold standard for monitoring graft health and for diagnosing rejection in kidney transplant as well as in other solid organ transplant patients. dd-cfDNA has a high sensitivity and specificity, that leads to an effective reporting of the graft health. It does not require donor samples and is applicable to all sex, ethnicity, and organs, which makes its utility very high. Here the author will elucidate the role, utility and applicability of donor derived cell free DNA in kidney transplant patients.

Biography:

Carol has a Bachelors degreee in Pharmacy completed in 2014, and completed her PhD in 2019, in the field of Toxicology, from São Paulo University. She has experience with Clinical Pharmacokinetics and In Vitro Renal Transporters. She now works as a toxicologist pharmacist in the Toxicological Information and Assistance Cenrer in Santa Catarina, Brazil.

Abstract:

The effect of inflammatory diseases on drug pharmacokinetics (PK) and pharmacodynamics (PD) has been demonstrated by various studies. In type 2 diabetes (T2D), major complications are associated with inflammation due to chronic hyperglycemia and hyperglycemic memory. Chronic hyperglycemia can increase or decrease glomerular filtration rate depending on the severity of nephropathy and it can also alter the activity of drug transporters, which was already demonstrated for organic cation transporter 2 (OCT2). Gabapentin (GBP) is an anticonvulsant drug commonly used to treat diabetic neuropathy, and its elimination is primarily renal as unchanged drug. Some studies suggest GBP renal excretion is partially dependent on renal drug transporters, but it is not clear which ones might be involved. Thus, a clinical trial was conducted to evaluate the effect of hyperglycemia or T2D on GBP population pharmacokinetics (PopPk). Besides that, an in vitro study was conducted to evaluate the interaction of GBP with renal drug transporters expressed in HEK-293 cells. The data showed that diabetic patients had a reduction in systemic exposure to GBP, with no changes in renal excretion. PopPk showed that hyperglycaemia or T2D had no impact in distribution or excretion processes of GBP. Also, GBP had a strong affinity for renal transporters multidrug and toxin extrusion protein (MATE) 1 and 2K and organic zwitterion/cation transporter 1 (OCTN1) and a low affinity for organic cation transporter 2 (OCT2). In conclusion, T2D and hyperglycemia had no effect on GBP kinetic disposition, and it is suggested that MATEs and OCTN1 are involved in the excretion process of GBP, but OCT2 is not clinically relevant.

Biography:

Riham has completed her PhD at the age of 25 years at Mansoura University then worked as visitor resident at MUCH for 2 years. Then completed master degree of pediatrics from Al Azhar University, and worked there at Al azhar University hospital as pediatric specialist, then completed a pediatric nephrology diploma from Cambridge University, then worked as pediatric nephrology specialist at MUCH, then she is now the head of pediatric department at Alsoliman specialized hospital 

Abstract:

Covid-19 and acute kidney injury in hospital: summary of NICE guidelines Acute kidney injury (AKI), a sudden reduction in kidney function, is seen in some people with covid-19 infection.A subset of patients develop severe AKI and require renal replacement therapy (RRT). As in many settings, the development of AKI is associated with an increased risk of mortality.  

Although our understanding is incomplete, a picture is emerging from case reports and autopsy series of covid-19 specific causes of AKI. Intrinsic renal pathology including thrombotic vascular processes, viral mediated tubular cell injury, and glomerulonephritis have been reported, as well as AKI resulting from extrinsic factors such as fluid depletion, multi-organ failure, and rhabdomyolysis

Anecdotal reports have emerged of proximal tubular injury with Fanconi syndrome that manifests as hypokalaemia, hypophosphataemia, normal anion gap metabolic acidosis, and hypovolaemia from salt wasting. Importantly, AKI can occur at all stages of covid-19 infection, so clinical vigilance and consideration of risk factors for AKI alongside early detection and diagnosis are essential components of general supportive care. Fluid management is central to this