Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 6th Annual conference on Clinical & Pediatric Nephrology New Orleans,Louisiana, USA.

Day :

  • Pediatric Nephrology
    Nephrology- Diagnosis, Treatment, Prognosis
    Diagnostic techniques
Speaker

Chair

Dario Xavier Jimenez Acosta

Central University of Ecuador, Ecuador

Speaker

Co-Chair

Maxime Bouchard

McGill University, Canada

Speaker
Biography:

Dr. Bouchard received his PhD from Laval University, Canada and pursued his postdoctoral studies at the Institute for Molecular Pathology, Vienna, Austria. He joined McGill University in 2003 and is currently Associate Professor at the Goodman Cancer Research Centre and in the Department of Biochemistry. His research focuses on the developmental genetics of renal diseases using the mouse as a model system.

Abstract:

Rho family GTPases act as molecular switches regulating actin cytoskeleton dynamics. Attenuation of their signaling capacity is provided by GTPase-activating proteins (GAPs), including p190A, that promote the intrinsic GTPase activity of Rho proteins. We recently identified a novel loss of function allele of the p190A gene Arhgap35, which introduces a Leu1396 to Gln substitution in the GAP domain. This change results in decreased GAP activity for the prototypical Rho-family members, RhoA and Rac1. Consequently, Arhgap35-deficient animals exhibit hypodysplastic and glomerulocystic kidneys. We show that p190A is required for appropriate primary cilium formation in proximal tubules. P190A localizes to the base of the cilia to permit axoneme elongation, which requires a functional GAP domain. Pharmacological manipulations further reveal that inhibition of either Rho kinase (ROCK) or F-actin polymerization is able to rescue the ciliogenesis defects observed upon loss of p190A activity. We propose a model in which p190A acts as a modulator of Rho GTPases in a localized area around the cilia to permit the dynamic actin rearrangement required for cilia elongation. Together, our results establish an unexpected link between Rho GTPase regulation, ciliogenesis and glomerulocystic kidney disease.

Ronak Lakhia

University of Texas Southwestern Medical Center, USA

Title: Title: miR-21 promotes cyst growth in polycystic kidney disease

Time : 11:30-12:00

Speaker
Biography:

Dr. Ronak Lakhia completed her M.D. form the University of Texas Southwestern Medical School in Dallas, TX in 2008. She then completed her residency in Internal Medicine at Baylor College of Medicine in Houston, TX. In 2012, she came back to the University of Texas Southwestern Medical Center in Dallas for nephrology fellowship. After her clinical year, Dr. Lakhia joined Vishal Patel’s laboratory where she is working on understanding the role of micro-Rna’s in polycystic kidney disease. Dr. Lakhia is funded by a NIH T-32 training grant. She has recently published her findings in the Journal of American Society of Nephrology.

Abstract:

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the presence of numerous fluid-filled cysts in the kidney. MicroRNAs (miRNAs), short noncoding RNAs that regulate gene expression, have emerged as promising new therapeutic targets for many diseases, but the role of these noncoding RNAs in ADPKD pathogenesis is still poorly understood. Here, we investigated the role of miR-21, an oncogenic miRNA, in kidney cyst growth. We found that transcriptional activation of miR-21 is a common feature of murine models of PKD. Furthermore, compared with renal tubules from kidney samples of normal controls, cysts in kidney samples from patients with ADPKD had increased levels of miR-21. cAMP signaling, a prominent pathogenic pathway in PKD, transactivated the miR-21 promoter in kidney cells and enhanced miR-21 expression in cystic kidneys of mice. Furthermore, genetic deletion of miR-21 reduced cyst burden, attenuated kidney injury, and prolonged survival of an orthologous model of ADPKD. RNA sequencing analysis and additional in vivo studies showed that miR-21 inhibits apoptosis of cyst epithelial cells, likely through direct repression of its target gene programmed cell death 4 (Pdcd4). Thus, miR-21 functions downstream of the cAMP pathway and promotes cyst growth in a mouse model of ADPKD. Our results suggest that inhibiting miR-21 is a potential new therapeutic approach to slow cyst growth in PKD.

Speaker
Biography:

Ahmed Abdel Samie Mahmoud has completed his Master’s degree in Radiology from Cairo University and MD from Alazhar University School of Medicine. He is an Assistant Professor and Head of Radiology Department in Theodor Bilharz Research Institute, Cairo, Egypt. He has published 10 papers in reputed journals and has been serving as a Reviewer for the Egyptian Journal of Radiology and Nuclear Medicine.

Abstract:

Objective: To observe MRI features about renal corticomedullary differentiation in the assessment of renal allograft complications during the post transplantation period. Materials & Methods: 30 patients with post transplantation complications underwent MR T_1 weighted fat saturation (T_1 FS) and contrast enhanced gradient echo scan. The signal intensity of the cortex and medulla were measured on the coronal scans and the cortio-medullary contrast (CMC) was calculated. Results: All the patients with acute rejection showed loss of the corticomedullary differentiation with a negative CMC% with a sensitivity of 75%, a specificity of 31% and a positive predictive value of 11% and a negative predictive value of 92%. One of the 2 cases with ATN showed a decreased CMD with a CMC% of 6% and the other one showed a negative CMC% of -3%, having a sensitivity of 100%, a specificity of 36%, a positive predictive value of 15% and a negative predictive value of 100%. The cases with cyclosporine nephrotoxicity showed a wide variability in their CMD, where 40% showed normal CMC% of >9%, 17% showed a decreased CMD ranging between 0-9% and 43% showed loss of CMD. The MR assessment by this modality showed a sensitivity of 63%, a specificity of 28% and a positive predictive value of 18% and a negative predictive value of 75% in detection of this type of medical complication. On the other hand, all patients with CAN showed decreased CMD ranging from 0-9% with a sensitivity of 100%, a specificity of 32%, a positive predictive value of 7% and a negative predictive value of 100%. There was a statistically significant decrease in the CMD seen in patients with chronic allograft rejection and those of the controls (p=0.02). Conclusion: In conclusion, alteration in CMC is a sensitive but nonspecific indicator of renal disease.

Break: 12:30-13:15
Speaker
Biography:

Dr. Xiaorong Liu is currently a professor and Chief Physician, Director of Department of Nephrology, Beijing Children's Hospital affiliated with Capital Medical University, Director of the Beijing Children's Blood-Purification Center. She is a member of Beijing Blood Purification Center of Quality Control and Improvement Committee, a member of nephropathy rheumatology group, Pediatrics Branch, Beijing Medical Society, a member of Kidney Disease Committee of Beijing Traditional Chinese Medical Society, and a member of Therapeutic Medicine Research Committee of Pharmacological Society of China. Dr. Liu is a Standing Committee member of Physicians Association of China, an Editorial Board member of Chinese Journal of Applied Clinical Pediatrics, Chinese Journal of Practical Pediatrics, Journal of Pediatric Grand Rounds. She has participated in and presided over National 863-Projects, Fifteenth-Five Year Plan of China Projects, the Beijing Municipal Science and Technology Commission’s Characteristics of the Capital Projects, Development of Capital’s Business and Industry Projects. Prof. Liu has published more than 40 papers, and ten of them in Pediatric Nephrology, Pediatric Pulmonlogy, Medicine and other high-caliber journals and have been included in SCI.

Abstract:

Background:Early diagnose of minimal change disease(MCD)in nephrotic syndrome (NS)patients remains challenge.We often make a diagnose of MCD by invasive kidney-biopsy.CD80,is a transmembrane protein, present on podocytes in a number of experimental models of nephrotic syndrome.Urinary CD80 is significantly elevated in MCD but not in focal segmental glomerulosclerosis(FSGS)or other glomerulopathies. The aim of this study was to investigate the role of the urinary CD80 as a biomarker for diagnosis of MCD. Materials and Methods:A total of 165 subjects,129 males and 36 females were enrolled in this study. Urinary were collected from 37 patients with active MCD, 27 patients with FSGS,30 patients with other glomerulopathies and 71 healthy people. Using ELISA, compared values with the result of kidney-biopsy. Results: The concentration of urinary CD80 was significantly higher in the active MCD group (689.66±378.21ng/g creat) than those in the FSGS group (123.49±167.88ng/g creat p <0.001) ,other glomerulopathies group(152.37±220.14ng/g creat,p <0.001) and the control group(81.83±23.01 ng/g creat; p < 0.001).A cut-off value of 328.98(ng/g creat) was proposed,with an sensitivity of 81.1% and specificity of 94.4 %.The area under the ROC (receiver operating characteristic) curve for the urinary CD80 to diagnosis MCD was 0.925(95% confidence interval: 0.873-0.978). Conclusions: This experiment has preliminarily confirmed urinary CD80 as a non-invasive diagnostic biomarker which owned a practical and significant value in the diagnosis of MCD

Speaker
Biography:

He is a pioneer in the field of Peritoneal Dialysis Internationally and Cadaver Kidney Transplantation (http://blogs.hbr.org/2012/11/a-great-ideafor-lowering-cost/) and well known in the areas of Chronic Kidney Disease Management, Critical Care Nephrology including CRRT, Liver Dialysis (MARS & FPSA; Prometheus: Largest series in the Country).He was responsible for the Country’s first Simultaneous Heart and Kidney Transplantation (SHK). A Member of various Task Forces & Committees that has developed Best Practice Guidelines CKD and Anemia management. He is the Chief Co-ordinator of the Asia Pacific Chapter for ISPD and Past Councillor of ISPD. He successfully held the prestigious 2nd Asian Chapter Meeting Of the ISPD, Hyderabad in January 2005 and Co-Director of the 3rd Haemodialysis UniversityTMof ISHD at Hyderabad, March 2014(http://hdu2014.com/).He is an internationally Acknowledged expert in Telemedicine in Dialysis (http://blogs.hbr.org/2012/04/how-telemedicinesaves-lives-a/), reverse ‘Medical’ Innovation & Medical Tourism. He has contributed extensively in International Journals such as KI,AJKD,JASN,NDT,Transplantation Proceedings,PDI, Nephrology, American Journal of Gastroenterology, Contributions to Nephrology etc, and also, Harvard Business Review, Invited Editorials and Book Chapters and has delivered invited lectures worldwide, including regularly at the ‘Ronco’meetings in Vicenza, Italy, International society of Peritoneal Dialysis(ISPD),World Congress of Nephrology, Annual Dialysis Conference, USA, International Society of Haemodialysis(ISHD),the prestigious Salzburg Global Seminar(http://www.salzburgglobal.org/current/sessionsc.cfm?nav=faculty_tab&IDSPECIAL_EVENT=3898) etc. The Harvard Business Review Magazine cited his dialysis work at Deccan Hospital as having world class

Abstract:

Introduction: A low protein diet (0.6 G/Kg BW) and a very low protein diet(0.3 G/Kg BW) supplemented with ketoanalogues have been shown to be even more efficacious in further improving the benefits of a low protein diet in CKD patients. Material & Methods: 164 adult patients with Stage 3 to Stage 5 (Predialysis) were initiated on ketoanalogue supplemented low protein diet (sLPD) after informed consent and the necessary Institutional Ethics Committee approvals. Based on their affordability, 116 patients randomly were assigned to the sLPD group whereby they received 0.6gm/kg BW of dietary proteins supplemented by ketoanalogues (Renolog: La RenonHealthCare, Ahmedabad, India) at a dosage of one tablet per 10 Kg body weight. 48 patients received 0.3 gm/kg BW supplemented by Renologat a dose of one tablet per 5 Kg body weight. Renal, metabolic, nutritional parameters and anthropometric analysis were done in both groups at the start of the study, at the end of six months and at the end of twelve months of treatment. Results: Total number of patients in the study group were 164 of which 116 were on sLPD and 48 were on sVLPD regimen. Period of study was twelve months. The number of Renolog tablets consumed per day in the sLPD group was 6.10+_1.03 and 12.19 +_1.83 in the sVLPD group. The difference was statistically significant (p <0.001 ).

Lamiaa Adel Salah El Din

Cairo University School of Medicine, Egypt

Title: Diagnostic value of fetal MRI in evaluating fetal urinary anomalies

Time : 14:15-14:45

Speaker
Biography:

Lamiaa adel salah el din has completed her masters degree in radiology at the age of 30 years and MD at age of 35 years from Cairo University. She is currently assisstant professor at radiology department, cairo university. she has published more than 20 papers in reputed journals and has participated in many national and international conferences. (Up to 100 words)

Abstract:

Purpose To detect the accuracy of fetal MRI in diagnosing urinary tract anomalies in comparison with ultrasonographic findings and fetal outcome. Methods We examined 30 fetuses with sonographically suspected congenital urinary tract anomalies by 2D/3D ultrasound and MRI. The gestational age range was 18–36 weeks. 43% of the women were in the second trimester. The diagnosis was confirmed by postnatal ultrasound, cystogram and biopsy in born babies and autopsy in still born or abortus fetuses. Results We found different urinary tract anomalies including: bilateral autosomal recessive polycystic kidney disease (n = 8), unilateral autosomal recessive polycystic kidney disease (n = 1), dilated collecting system (n = 8), renal agenesis (n = 3), bilateral enlarged multicystic dysplastic kidneys (n = 5), unilateral enlarged multicystic dysplastic kidney (n = 4) and renal dysplasia (n = 1). MRI changed the US diagnosis in 6 cases and added information in 4 cases. MRI changed the patient’s management in 3 cases. MRI confirmed US diagnosis in 20 fetuses. Ultrasound was superior to MRI in one case of renal failure. Associated extrarenal anomalies were detected in 9 cases (30%). MRI showed 96% accuracy in diagnosis. Mortality rate reached 56%. Conclusion Fetal MR imaging may be used as a complementary modality to US in diagnosing inconclusive or equivocal fetal urinary abnormality.

Break: 14:45-15:00
  • Nephrology- Diagnosis, Treatment, Prognosis
  • Diagnostic techniques
  • Nephrology and Hypertension
    Clinical Nephrology
Speaker

Chair

Xiaorong Liu

China Medical University, Taiwan

Speaker

Co-Chair

Falguni Das

University of Texas Health Science Center, USA

Session Introduction

Ahmed Abdel Samie Mahmoud

Theodor Bilharz Research Institute, Egypt

Title: The role of Doppler in evaluation of systemic lupus erythematosus nephritis

Time : 10:15-10:45

Speaker
Biography:

Ahmed Abdel Samie Mahmoud has completed his Master’s degree in Radiology from Cairo University and MD from Alazhar University School of Medicine. He is an Assistant Professor and Head of Radiology Department in Theodor Bilharz Research Institute, Cairo, Egypt. He has published 10 papers in reputed journals and has been serving as a Reviewer for the Egyptian Journal of Radiology and Nuclear Medicine.

Abstract:

Objective: To evaluate role of renal Doppler in assessment of systemic lupus erythematosus nephritis. Materials & Methods: The study included 32 systemic lupus erythematosus patients with renal affection and pathologically proven lupus nephritis (LN) by renal biopsy and pathological classification was divided into five different classes of lupus nephritis LN according to the 2003 International Society of Nephrology (ISN)/Renal Pathology Society (RPS) classification. Ultrasound and Doppler for both kidneys were performed for all of them; ultrasound assessed renal size, parenchymal thickness and echogenicity, corticomedullary differentiation and back pressure changes. Doppler examination evaluated general renal vascularity; kidney vascularity was assessed by measuring 3 different segmental arteries, approximately at the junction of renal sinus and parenchyma. Resistivity indices were calculated from segmental, lobar and interlobar arteries. Our radiological findings were correlated with clinical, laboratory and pathological findings. Results: The patients’ age ranged from 13-45 with a mean 28.19±8.026 SD there was a significant increase in renal resistivity index RI in LN patients when compared with SLE patients without renal affection and normal group, P value 0.022. Only 2 cases (6.3%) of LN cases showed a decrease in vascularity of the kidneys which showed no significant correlation with the disease severity or duration, distribution of renal pathologic findings according to International Society of Nephrology and the Renal Pathology Society classes within the LN group. Class II represented 9%, class III represented 38%, class IV represented 31% and class V represented 16% and class IV represented 6% of LN patients according to biopsy results. There is positive correlation between RI and renal biopsy classification with high significance, P value 0.001 with r=0.794. Conclusion: Color Coded Doppler play an important role in diagnosis of different lupus nephritis classes and RI could be used as a marker of severity in SLE patients with kidney involvement, suggesting the possible use of RI as a marker in the assessment of outcome and treatment.

Break: 10:45-11:00
Speaker
Biography:

Dario Xavier Jimenez Acosta MD. Nephrologist Born in 1977, October 03. Medical Doctor at Central University of Ecuador (1994-2001). Nephrologist by Pichincha Medical College, at Eugenio Espejo Specialty Hospital (2002-2007). Did Nephrology mini fellowship at Colorado University, Denver (2007).He is the Past Secretary of Ecuadorian Society of Nephrology (2012-2015), Medical Director of DIALNEF (Critical Nephrology) Quito-Ecuador (2012-actually). Nephrology Chief at Enrique Grace’s General Hospital (Ecuadorian Health Public Ministry). One book published (coauthor), 16 paper published..

Abstract:

Introduction: AKI is a serious problem in critically ill patients with sepsis; in Ecuador it has a prevalence of 10% and a high undocumented mortality rate. The type of renal replacement therapy used is also very discussed in countries with several options. In Ecuador there are no continuous treatments available for patients. Objective: The aim was demonstrate advantages in AKI treatment between hemodiafiltration with an own scheme vs. intermittent hemodialysis. The primary outcomes were mortality, vasoactive drugs, mechanical ventilation dependence and time of ICU stay. Results: Cohort and tracing study in ICUs in patients with sepsis and AKI. Two groups undergoing treatment for intermittent hemodialysis GA (n30) vs. hemodiafiltration GB (n21). 51 patients were observed. The general mortality was 54.9%, (63% GA vs. 42.8% GB p=0.09) had no statistical significance. Apache and SOFA index media were 26 and 11 respectively without statistical significance between both groups (p=0.65). Time ICU stay (GA: 18.33, GB: 10.76 p=0.027) vasoactive drugs dependence (GA: 9.77, GB: 4.19 p=0.089) MV dependence (GA: 12.13, GB: 6.62 p=0,036). Conclusions: HDF showed benefits in vasoactive drugs, MV dependence and ICU stay. The mortality was not statistically significative. We recommended HDF with our scheme for AKI treatment in critically ill patients with sepsis independent of mortality results.

Speaker
Biography:

Falguni Das has received his PhD from University of Calcutta, India. He has joined the Department of Medicine’s Division of Nephrology as a Post doctoral fellow at University of Texas Health Science Center at San Antonio. He has worked extensively in areas of kidney physiology, signal transduction, gene regulation and the fundamental pathogenic mechanism of injury to kidney. He has produced several exciting findings which have been published in highly reputed journals. He has received several prestigious awards from his own institutes and also like New York Academy of Sciences.

Abstract:

Protein kinase C beta II (PKCβII) has been implicated in diabetic nephropathy (DN). Mesangial cell (MC) hypertrophy is a pathologic feature of DN. PKCβII undergoes phosphorylation at the hydrophobic motif site Ser-660 for its activity. We have shown that mTOR complex 1 (C1) regulates MC hypertrophy. How activation of PKCβII by Ser-660 phosphorylation fits into mTOR signaling to control MC hypertrophy is not known. HG significantly increased phosphorylation of PKCβII at Ser-660 in a PI 3 kinase dependent manner. siRNAs against PKCβII, dominant negative PKCβII and non-phosphorylatable mutant of PKCβII, PKCβIIS660A, blocked mTORC1 activity due to lack of PRAS40 phosphorylation, resulting in significant inhibition of HG induced MC protein synthesis and hypertrophy. Also, PKCβIIS660A attenuated phosphorylation of Akt at Ser-473, a putative mTOR complex 2 (C2) site. Specific inhibition of mTORC2 by shRNAs against rictor or Sin1, two exclusive and required components for its activity, suppressed HG induced phosphorylation of PKCβII Ser-660 and Akt Ser-473, resulting in attenuation of mTORC1 activity leading to inhibition of MC hypertrophy. Constitutively active (CA) Akt or CA mTORC1 reversed shRictor or shSin1 mediated inhibition of HG induced MC hypertrophy. Furthermore, CA PKCβII reversed the shRictor or shSin1 induced inhibition of HG stimulated Akt Ser-473 phosphorylation and MC hypertrophy. Finally, we show increased phosphorylation of PKCβII Ser660, PRAS40 and Akt Ser-473 in association with activation of mTORC1 in renal cortices of OVE26 mice with type-1 diabetes. These results provide the first evidence that HG induced activation of mTORC2 phosphorylates and activates PKCβII to increase the phosphorylation of Akt at Ser-473 to finally activate mTORC1 to induce MC hypertrophy. Thus, we uncover a specific role of mTORC2 for Akt/mTORC1 activation via PKCβII Ser-660 phosphorylation.

Speaker
Biography:

Jacques Vigan is a Nephrologist, currently working as an Assistant in the Faculty of Health Sciences at Abomey-Calavi University, Benin.

Abstract:

The purpose of this study is to determine the level of knowledge and the means of communication for early detection of diabetic nephropathy. This is a prospective study which took place from 06 February to 31 May 2012, in the Academic Clinics of Nephrology- Hemodialysis and the Endocrinology and Metabolic Diseases. Included all patients with diabetes mellitus in two sexes, older than fifteen years and hospitalized in one of these two clinical or received in consultation during the study period. A questionnaire is used for data collection. Statistical analysis was performed by Stata 11 in its English version. One hundred sixty patients were enrolled. More than 4 out of 5 patients had reported knowledge of diabetes mellitus while only 26.67% had acknowledged that manifests itself by high glycemia. More than half of the patients (57.50%) had said that diabetes mellitus can be complicated by renal impairment. Three out of four diabetics (75.63%) did not know that it is possible to make a nearly diagnosis of diabetic nephropathy. The radio and television broadcasts and sensitizations during medical consultations represented the best means of communication for early detection of diabetic nephropathy. The combination of several means of communication will raise awareness on early detection of diabetic nephropathy.

Break: 12:30-13:15
Speaker
Biography:

Punit Gupta has completed his MD (General Medicine), DM (Nephrology) & PhD from Pt. Ravishankar Shukla University, India. He has been awarded with two international fellowships from American Society of Nephrology & International Society of Peritoneal Dialysis. He is the Head & Medical Superintendent of DKS Post Graduate Institute & Research Centre, a premium institute of India in health sector. He has more than 170 papers & abstracts published in national & international journals. He has developed two unique machines in the field of dialysis which has been appreciated in Nephrology Committee.

Abstract:

Introduction: Idiopathic nephrotic syndrome affects 1-3 per 100,000 children <16 years of age; whereas most children will be responsive to corticosteroid therapy, approximately 20% will be classified as steroid resistant i.e., failure to achieve complete remission after initial therapy with corticosteroids. Method: The study was conducted in the Department of Medicine, Pt. J.N.M. Medical College and Dr. B.R.A.M. Hospital, Raipur. 28 patient of pediatric age group of nephrotic syndrome were included for the purpose of study admitted in Nephrology Unit, Pt. J.N.M. Medical College Raipur from was studied. All patients were subjected to routine investigations like complete blood counts, urea, creatinine, serum bilirubin, liver enzymes, electrolytes (sodium, potassium, chloride and calcium), urine routine microscopy, 24 hour urinary protein; thyroid function test, chest X-ray and ultrasonography of abdomen. Results: A total no of patients included in study are 28. The mean age of the patient is 11±2.86 years. Out of 65% patients are male while 35% patients are female. All patients have hypoalbuminea. The mean 24 hour urine protein is 3.1±1.2 grams. 46% patients are hypothyroid; out of them 62% was male & 38% was female. 72% patients shows electrolyte imbalance. 97% patients shows abnormal usg findings in which, ascites, increased echotexture pleural effusion seen in 43.5%, 28%, 28.5% respectively. Average weight of the nephrotic syndrome patient is 28±13.69 kg. Average weight reduction in week duration is 6.78±0.78 kg; dose of deflazacort used is 1 mg/kg body weight. Dose of mycophenolate mofetil used is 12 mg/kg body weight. No patients’ shows complication related to mycophenolate mofetil. 96.4% patients’ showed improvement in 6 month follow up & only 1 patient had relapse because of irregular medication. Conclusion: Male shows greater improvement than female. Maximum weight reduction was from 69 kg to 59 kg at the time of discharge. Hypoalbuminemia and hypothyroidism was common in female than male. 96.4% patients showed improvement with deflazacort & mycophenolate mofetil. Deflazacort & mycophenolate mofetil shows better results in treatment of nephritic syndrome.