Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 15th International Conference on Nephrology and Hypretension Istanbul,Turkey .

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Scientific Program Day 1
Scientific Program Day 2

Day 1 :

Keynote Forum

Baris Cankaya

Marmara University Pendik Training Hospital, Turkey

Keynote: Perioperative renal injury: Is fluid management the only determinant?

Time : 9:00-10:00

Conference Series Nephrologists Congress 2019 International Conference Keynote Speaker Baris Cankaya photo
Biography:

Baris Canaya is an Anesthesiologist at Marmara University Pendik Training Hospital in Istanbul, Turkey. He has deep interest for resuscitation, acute critical illness, trauma anesthesia, pediatric congenital cardiovascular anesthesia and perioperative patient safety. 

Abstract:

Perioperative fluid therapy management is a very difficult process. Perioperative morbidity is associated with the amount of intravenous fluid delivered and consequent postoperative complications. Not only fluid, its component and hemodynamic parameters also play important role. Studies have shown that combining fluid therapy with the goal of hemodynamic stabilization can minimize postoperative complications. Perioperative hypovolemia leads to organ dysfunction, since adaptive mechanisms cause peripheral vasoconstriction to maintain blood flow to the vital organs. Anesthetized patients often present with a functional intravascular volume deficit depending on many factors. Fluid management is a key topic for achieving advanced recovery after surgery. It is important to plan a tailor-cut fluid resuscitation for the patient perioperatively avoiding postoperative complications.
 

  • Haemodialysis| Clinical Nephrology | Renal Nutrition & Metabolism | Hypertension With Diabetic Kidney Disease| Renal Transplantation | End-Stage Renal Disease
Location: Istanbul, Turkey

Chair

Hany Helmy Saad Attia

Shobra General Hospital, Egypt

Session Introduction

Hany Helmy Saad Attia

Shobra General Hospital, Egypt

Title: Permcath: Is it a first line or a final line for hemodialysis patients in Egyptian patients
Biography:

Hany Helmy Saad Attia has completed his Master degree in Internal Medicine and a Master Degree in Nephrology From Ain Shams University in Egypt. He is currently working as the Head of Nephrology at the department of Shobra General Hospital
 

Abstract:

Aim: Permcath. Is a known vascular acess for haemodialysis patients, which may last for 2 years or more.it is a 1st line for hemodialysis for patients who were not prepaired by AVF few months before starting dialysis ,but in Egypt most of patients start dialysis with temporarily catheters (cheap)but causes stricture or occlusion of the used central vein. Method: We studied 146 patients who were submitted for permcath. Insertion in our hospital as regard:the vein used-cause of insertion –failure of insertion or using it in dialysis and longevity. Result: The results were as following: *64 (rt, int. jugular) 1- 16 were 1st prick 2-26 were waiting for maturity of AVF 3-20 due to cardiac causes 4-02 due to failed multiple AVF *30(rt. Subclavian) 1-09 were waiting for maturity of AVF 2-11 due to cardiac cuses 3-10 due to failed multiple AVF *15(left jugular) all has thromosed rt. Int. jugular 1- 06 were waiting for maturity of delayed AVF 2- 09 due to failure of multiple AVF *07(left subclavian) all were due failure of multiple AVF *30(femoral vein ) all of them has no available vascular access and 12 of them had cardiac causes Conclusion: From this study we found that most patients who were referred for permcath .insertion had a history of single or multiple temporarily catheter insertion that caused single or multiple central vein occlusion Suggestion: we recommend to use permcath. As a first prick in patients who are not prepared by AVF and avoid using temporarily catheters to save veins of patients, because the use of temporarily catheters causes stricture or occlusion of central veins

Punit Gupta

Sharda University, India

Title: A study of inflammatory markers in chronic kidney disease patients from Central India
Biography:

Dr Punit Gupta is MBBS, MD (Medicine), DM (Nephrology) and PhD. He is the member of many important academic and management committees of various medical institutions in the country.He has presented papers in many national and international conferences 

Abstract:

Introduction & Objective: Inflammation is common in chronic kidney disease, specialty patients on hemodialysis or CAPD. C-reactive protein is normally present in serum and serves as an important inflammatory marker as its concentration increases within hours of acute injury, tissue necrosis and any other inflammatory process. We studied the level of inflammatory markers (C-reactive protein, serum albumin, serum cholesterol) in patients with chronic kidney diseases with respect to these markers. Method: 105 patients with chronic kidney disease admitted in nephrology unit were studied. All patients were subjected to renal function tests, serum electrolytes, complete blood count, C-reactive protein (qualitative assessment by agglutination method), serum albumin, serum cholesterol and all other relevant routine investigations. Results: 56% were males and 44% females in studied population. Among the patients studied 30% were diabetic and 70% non-diabetic. Mean age of the patients was 51+11.53 years. Mean hemoglobin among the patients was 9.56+2.45 gm/dl. CRP was found to be positive in 55.4% while 44.6% patients were CRP negative. Serum albumin was <3.5 gm/dl in 62.25% and 37.75% patients had albumin level >3.5 gm/dl. Serum cholesterol >200 mg/dl in 54.66% and <200 mg/dl in 45.34%. Among diabetic patients, 70% were CRP positive and 30% CRP negative. 58.33% had cholesterol >200 mg/dl among diabetic patients. Serum albumin < 3.5 gm/dl was found in 83.33% patients with diabetes. Conclusion: CRP was positive in a significant proportion of chronic kidney disease patients (53.4%). And diabetic subjects, 70% were CRP Positive. Hypoalbuminemia (S. albumin <3.5 gm/dl) is found in a great majority of chronic kidney disease patients (62.25%). Majority of chronic kidney disease patients (54.66%) have hyperlipidemia (serum cholesterol >200 mg/dl). This percentage is still higher in diabetics (58.33%). A significantly higher proportion of subjects with Diabetes (83.3%) have hypoalbuminemia (Serum albumin <3.5 gm/dl).
 

Serpil Çolak

Istanbul Medipol University, Turkey

Title: The effect of dynamic lumbar stabilizatıon exercises on dialysis adequacy in hemodialysis patients
Biography:

Serpil Çolak has completed her Bachelor's degree from Istanbul University and has completed her PhD in 2017 from Istanbul Medipol University, Turkey. Until 2015, she has worked as a Physiotherapist in the clinic. She has been a Faculty Member at Istanbul Medipol University since 2015 and is a Member of the Health Science Education Programs Accreditation Association for Assessment, the Turkey Physiotherapists Association and the Turkey Association of Hand Therapists.
 

 

Abstract:

The aim of this study was to investigate the effect of Dynamic Lumbar Stabilization Exercises (DLSE) on physical activity level, dialysis adequacy and quality of life. The second aim of the study was to evaluate the residual kidney function and the effect of hemodialysis on acute complications among the cases. Thirtyseven (37) patients aged 25-45 years old who underwent hemodialysis treatment for 4 hours a day for at least 6 months were divided randomly into two groups. The DLSE group (n=17) participated in the intradialytic exercise program under physiotherapist supervision for 3 days a week for 10 weeks. The usual nephrological therapy was continued in the control group (n=20). The measurements were done before the start of the exercise program and at the end of the 10th week. Participants' quality of life was obtained by the Kidney Disease Quality of Life-36 questionnaire, functionality and physical activity level was obtained by Six Minute Walking, Timed Up and Go and Five Times Sit-to-Stand test, International Physical Activity Questionnaire. At the end of the treatment, there was no significant difference (p>0.05) in dialysis adequacy of the groups and acute complications of hemodialysis. In the DLSE group, the number of daily urination and the amount of urine increased significantly compared to the other group. Unlike the control group, the frequency of smoking tended to increase in the exercise group and there was a significant increase in physical activity level indicators, disease symptoms, problems and physical components of the quality of life.
 

Sara Mokhtari

Mohammed VI University Hospital, Morocco

Title: Lower extremity permanent dialysis vascular access: A lifeline option for hemodialysis patients
Biography:

Sara Mokhtari is a doctor of medicine; is a residency student in Vascular Surgery at Mohammed VI University Hospital in Oujda. After successfully completing the internship competition in2016, she decided to spend a full academic year in the Department of Vascular Surgery at the Mohammed VI University Hospital. During her medical studies, Sara Mokhtari has assisted many national and international medical conference and meetings.
Sara Mokhtari is a doctor of medicine; is a residency student in Vascular Surgery at Mohammed VI University Hospital in Oujda. After successfully completing the internship competition in2016, she decided to spend a full academic year in the Department of Vascular Surgery at the Mohammed VI University Hospital. During her medical studies, Sara Mokhtari has assisted many national and international medical conference and meetings.
 

 

Abstract:

Hemodialysis remains the most widely used means for the treatment of advanced chronic kidney disease. Technological advancement, accessibility and quality of care have led to improve the survival of chronic hemodialysis patients. Maintaining a functional vascular access for hemodialysis at the upper limb for an extended period of time continues to present a challenge for caregivers, hence the interest in knowing other choices for Vascular Access (VA), such as those named exotic. VA for hemodialysis at the lower extremity is the most successful choice of exotic VA when there is an exhaustion of VA site at the upper limb. Within the department of vascular surgery in the university hospital center Mohammed VI (Morocco), 2 VA at the lower extremity were created. The first case concerns a 40 years woman who was admitted for an infection of arteriovenous graft. No post-operative complications were reported, the patient is currently being dialysis thanks to the alternative VA without any issues at 4 years of follow up. A second case of VA at the lower extremity was confectioned in a 75 years old woman, with the vascular factors following: Age, obesity, menopause, high blood pressure and ischemic heart disease. The patient presented a lymphorrhea postoperatively, a few weeks after the intervention, the patient died due to a cardio-circulatory arrest on state of shock in per-dialysis. VA at the lower limb is used infrequently, but it has a good patency. However, it requires frequent revisions in order to detect complications to provide durable access for the dialysis lifetime of the patient.
 

Nada Elgriw

Biotechnology Research Center, Libya

Title: Hypertensive nephropathy as a cause of end stage renal disease: Report from 37 hemodialysis centers in Libya
Biography:

Nada Elgiw currently is working in Department of Genetic Engineering, Biotechnology Research Center, Tripoli, Libya.

Abstract:

Background & Aim: Data on the hypertensive nephropathy in Libya and particularly among hemodialysis patients are scarce. The aim of this study was to review the demographic features as well as the etiologic factors in this specific health-care setting at 37 dialysis centers in Libya. Patients & Methods: The present cross-sectional study included a total of 2358 patients at 37 dialysis centers in different cities across the three main regions of Libya (Western, Eastern and Southern regions), the majority of them from west. There were 902 (38.3%) female and 1456 (61.7%) male with mean age 51.30±16.30 years. Results: Overall of the study population had renal failure but the causes of renal failure differ, 598 (25.4%) of patients due to hypertension, 560 (23.7%) due to diabetes mellitus, blood pressure and diabetes in 305 (12.9%), blood pressure and glomerular disease 16 (0.7%), blood pressure and urinary tract obstruction 21 (0.9%), genetic diseases 193 (8.2%), glomerular diseases 141 (6.0%), inflammation of the tract 8 (0.3%), obstruction of the urinary tract 95 (4.0%), unclear reasons 421 (17.9%). All these risk factors were diverse underlying causes of end-stage renal disease in these patients. Conclusion: The present study showed that the highest number of renal failure patients due to hypertension and diabetes. It also showed that the male sex is more affected by diabetic nephropathy and the overall frequency of nephropathy was higher in western region.
 

Sanae Ezzaki

CHU Ibn Rochd, Morocco

Title: Stevens-Johnson syndrome induced by allopurinol in patients with chronic kidney disease
Biography:

Sanae Ezzaki has completed her Graduation from the University of Medicine and Pharmacy of Rabat, Morocco. She is currently Resident in Nephrology Hemodialysis at the Ibn Rochd University and Hospital Center in Casablanca, Morocco. 

Abstract:

Introduction: Allopurinol is a xanthine oxidase inhibitor that prevents the production of uric acid to reduce plasma uric acid levels to a normal range. It is the most frequently used anti-hyperuricemic agent in the world due to its long-term pharmacological effect. However, allopurinol is also one of the most frequent causes of Severe Cutaneous Adverse Drug Reactions (SCAR) including Stevens–Johnson Syndrome (SJS), therefore, SJS is a serious problem in allopurinol therapy, in spite of the ideal anti-hyperuricemia effect of allopurinol. We report two cases report of Stevens-Johnson syndrome induced by allopurinol in patients with chronic kidney disease (CKD). Case Report-1: N.E 70 years old, followed for CKD stage-IV for three months put on allopurinol 300 mg/day for one month for asymptomatic hyperuricemia, admitted for Stevens Johnson syndrome, he was conscious, feverish at 38.5 °C, hemodynamically stable, having a prominent bullous detachment on the back, anuric for 24 hours. He had kidney failure at 76 mg/l of serum creatinine, urea at 3.34 g/l, a hyper eosinophilia at 720 e/mm3. Allopurinol was stopped; he was put on antihistamines, corticosteroids and hyperhydration. He received a total of three hemodialysis sessions. The evolution was marked by the aggravation of the dermatological lesions with improvement of the renal function. The evolution was marked by the aggravation of skin lesions with improved renal function, but he died seven days after admission in an array of multiple organ failure. Case Report-2: S.O 74 years old, followed for CKD stage-IV for three years, turning on allopurinol 300 mg/ day for five weeks for asymptomatic hyperurcemia, admitted to Stevens Johnson syndrome. She was conscious, feverish at 38 °C, hemodynamically stable, she had bilateral conjunctivitis, cheilitis, and macular lesions with early skin peeling and preserved diuresis. She had kidney failure at 66 mg/L of serum creatinine, urea 2.21 g/l. Allopurinol was arrested and she was put on antihistamines and corticosteroids and hyperhydaration. The evolution was marked by the return of the glomerular filtration rate to baseline value after 15 days. Discussion: Allopurinol is the first xanthine oxidase inhibitor to be marketed more than 40 years ago. It constitutes the reference treatment of symptomatic hyperuricemia. Although it is generally well tolerated, the severe toxidermias associated with it constitute a major risk when it is used. Thus, allopurinol is currently the leading cause of severe bullous toxidermia including Lyell and Stevens-Johnson syndromes in Europe and one of the first providers of Drug Reaction with Eosinophilia and Systemic Symptoms (DRESS) in the world. The action is due to a hypersensitivity reaction type-III probably triggered by the Oxipurinol, main metabolite of allopurinol. The clearance of Oxipurinol depends mainly on renal function, which explains the high frequency in patients with CKD. Conclusion: These cases illustrate the significant morbidity associated with the irrational use of allopurinol in patients with chronic kidney disease

Sana Tariq

Shaheed Zulfikar Ali Bhutto Institute of Science and Technology, Pakistan

Title: 1Organ donation and transplantation in Pakistan: Religious perspective and where do we stand6:00-16:45
Biography:

Sana Tariq is Medical Physiologist, Researcher, Trainer and Speaker. She is currently pursuing MS in Public Health from Shaheed Zulfikar Ali Bhutto Institute of Science and Technology (SZABIST), Pakistan. She had 04 years of experience working in an internationally recognized institute Sindh Institute of Urology & Transplantation (SIUT) and joined Tabba Kidney Institute in 2019 has engaged the organization in number of research projects nationally and internationally

Abstract:

In the last decade, approximately 50,000 people have died every year because of end-stage organ failure in Pakistan. An amount this high needs urgent manifestations and accelerated solution. Some institutes in Pakistan are working day and night to make transplantation and organ donation accessible and understandable for everyone because there is a large population in desperate need of organ donation for living including children. This article reviews the possible strategies to understand the attitude towards alive or deceased organ donation and transplantation in Pakistan and how we can change this negative perspective. We strongly believe that the lack of understanding of transplant procedure and the fear of being rejected by the almighty prevent most people from donating their organs. Correct knowledge, family consultation, sympathetic medical staff and easy access to health care institutes may change this situation.