Day 1 :
Keynote Forum
Huang Wei Ling
Medical Acupuncture and Pain Management Clinic, Brazil
Keynote: Chakras Energy Deficiency as the Cause of Kidney Cancer
Biography:
Huang Wei Ling, born in Taiwan, raised and graduated in medicine in Brazil, specialist in infectious and parasitic diseases, a General Practitioner and Parenteral and Enteral Medical Nutrition Therapist. Once in charge of the Hospital Infection Control Service of the City of Franca’s General Hospital, she was responsible for the control of all prescribed antimicrobial medication and received an award for the best paper presented at the Brazilian Hospital Infection Control Congress in 1998. Since 1997, she works with the approach and treatment of all chronic diseases in a holistic way, with treatment guided through the teachings of Traditional Chinese Medicine and Hippocrates. Researcher in the University of São Paulo, in the Ophthalmology department from 2012 to 2013.Author of the theory Constitutional Homeopathy of the Five Elements Based on Traditional Chinese Medicine. Author of more than 100 publications about treatment of variety of diseases rebalancing the internal energy using Hippocrates thoughts.
Abstract:
Introduction: Malignant kidney tumors account for 2% of the global cancer burden, and its incidence is on the rise. The treatment of patients with renal tumors all underwent the same surgical procedures and patients with advanced disease were treated with similar drugs, none of which were effective. In traditional Chinese medicine cancer is caused by energy deficiencies and Heat retention.
Purpose: The purpose of this study is to demonstrate that one possible cause for kidney cancer development could be the chakras energy deficiency.
Methods: through one case report of a 69-year-old woman who discovered an enlargement of the left kidney during a routine computer tomography. She underwent a surgery to take out the kidney and it was not necessary chemotherapy or radiotherapy. After the surgery, she discovered that the tumor was compromising the bladder and she need to do BCG weekly injection inside the bladder. After, she need to do a radical cystectomy and urostomy. Due to anxiety, depression, fear and weak state she sought a Chinese medicine treatment to recover her energy that was debilitate. The Chinese doctor measured all her chakras energy that were completely depleted in energy, rated 1 out of 8. She began her treatment with Chinese dietary counseling, auricular acupuncture with apex ear bloodletting, systemic acupuncture and moxibustion. It was also used highly diluted medications according to the theory Constitutional Homeopathy of Five Elements Based on Traditional Chinese Medicine and crystal based medications.
Results: The patient begin to feel stronger physically and emotionally to continue her treatment in Western medicine that was aggressive due to the need urinating through the collection bag that held in the abdomen, feeling ugly and physically altered.
Conclusion: Through this case report, the author demonstrates the chakras energy deficiencies in a patient with kidney cancer. The replenishment of the chakras energy is very important to recover the energy of the patients that is leading to cancer formation.
Keynote Forum
Majid Mirzazadeh
Wake Forest School of Medicine, USA
Keynote: A New Gold Rush: A Review of Current and Developing Diagnostic Tools for Urinary Tract Infections
Biography:
Dr. Mirzazadeh has completed his MD and urology residency in Iran University of Medical Sciences. He has had fellowship trainings in Institute of Urology & Nephrology, University College London, UK, University of California Los Angeles, Los Angeles, USA and Wake Forest University, Winston Salem, USA. He is associate professor of urology and gynecology and director of Urology Teaching Clinic in Wake Forest School of Medicine. He has more than 50 publications
Abstract:
Urinary tract infections (UTIs) are one of the most common infections in the world and consequently are responsible for significant healthcare expenditure. The standard urine culture is the current gold standard for diagnosing urinary tract infections, however there are limitations of the test that directly contribute to suboptimal patients’ treatment and increased healthcare costs. As a result, new and innovative techniques have been developed to address the inefficiencies of the current standard. It remains to be seen whether these tests should be performed in adjunct to, or perhaps even replace the urine culture. This review aims to analyze the advantages and disadvantages of the newer and emerging diagnostic techniques such as PCR, expanded quantitative urine culture (EQUC), and next generation sequencing (NGS).
- Kidney Transplantation
Location: Webinar
Session Introduction
Shahmeen Rasul
St George’s, University of London, UK
Title: A comparison of outcomes between retro-peritoneal and trans- peritoneal approach in laparoscopic live donor nephrectomies over a two-year period.
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.
Naveen Kumar
University of Delhi, India
Title: Role of donor derived cell free DNA in monitoring graft health and identifying rejection in kidney transplant patients
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.
Ana Carolina Conchon Costa
Toxicological Information and Assistance Center, Brazil
Title: Role of renal drug transporters on gabapentin renal excretion and influence of hyperglycemia on gabapentin population pharmacokinetics
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