8th World Nephrology Conference August 15-16, 2016 Sao Paulo, Brazil

Diabetic nephropathy (DN) is typically defined by macro albuminuria—that is, a urinary albumin excretion of more than 300 mg in a 24-hour collection—or macro albuminuria and abnormal renal function as represented by an abnormality in serum creatinine, calculated creatinine clearance, or glomerular filteration filtration rate (GFR). Clinically, diabetic nephropathy is characterized by a progressive increase in proteinuria and decline in GFR, hypertension, and a high risk of cardiovascular morbidity and mortality. Diabetic nephropathy is a clinical syndrome characterized by the following: Proteinuria was first recognized in diabetes mellitus in the late 18th century.

By the 1950s, kidney disease was clearly recognized as a common complication of diabetes, with as many as 50% of patients with diabetes of more than 20 years having this complication Currently, diabetic nephropathy is the leading cause of chronic kidney disease in the United States and other Western societies. It is also one of the most significant long-term complications in terms of morbidity and mortality for individual patients with diabetes. Diabetes is responsible for 30-40% of all end-stage renal disease (ESRD) cases in the United States. Generally, diabetic nephropathy is considered after a routine urinalysis and screening for micro albuminuria in the setting of diabetes. Patients may have physical findings associated with long-standing diabetes mellitus. Good evidence suggests that early treatment delays or prevents the onset of diabetic nephropathy or diabetic kidney disease. Regular outpatient follow-up is key in managing diabetic nephropathy successfully. Recently, attention has been called to atypical presentations of diabetic nephropathy with dissociation of proteinuria from reduced kidney function. Also noted is that micro albuminuria is not always predictive of diabetic nephropathy

Dialysis is the artificial process of eliminating waste (diffusion) and unwanted water (ultrafiltration) from the blood. Our kidneys do this naturally. Some people, however, may have failed or damaged kidneys which cannot carry out the function properly - they may need dialysis. In other words, dialysis is the artificial replacement for lost kidney function (renal replacement therapy replacement therapy).Dialysis may be used for patients who have become ill and have acute kidney failure (temporary loss of kidney function), or for fairly stable patients who have permanently lost kidney function When we are healthy our kidneys regulate our body levels of water and minerals, and remove waste. The kidneys also produce erythropoietin and 1,25-dihydroxycholecalciferol (calcitriol) as part of the endocrine system. Dialysis does not correct the endocrine functions of failed kidneys - it only replaces some kidney functions, such as waste removal and fluid removal. Dialysis and altitude - A study published in February 2009 found that death rates for dialysis patients are 10%-15% lower for those whose homes are higher than 4,000 feet, compared to those who live at sea level. Some countries, such as the UK, are predicting a doubling of the number of patients on dialysis machine. Approximately 1,500 liters of blood are filtered by a healthy person's kidneys each day. We could not live if waste products were not removed from our kidneys. People whose kidneys either do not work properly or not at all experience a buildup of waste in their blood. Without dialysis the amount of waste products in the blood would increase and eventually reach levels that would cause coma and death. Dialysis is also used to rapidly remove toxins or drugs from the blood.

There are two main types of dialysis - hemodialysis and peritoneal dialysis. The blood circulates outside the body of the patient - it goes through a machine that has special filters. The blood comes out of the patient through a catheter (a flexible tube) that is inserted into the vein. The filters do what the kidney's do; they filter out the waste products from the blood. The filtered blood then returns to the patient via another catheter. The patient is, in effect, connected to a kind of artificial Kidney. Peritoneal dialysis (PD) is a therapy that typically is managed by patients at home. The therapy works by cleaning the blood of toxins and removing extra fluids through one of the body’s own membranes, the peritoneal membrane.

The kidneys are bean-shaped organs located on either side of the lower back. They are extremely important for the body in that they process waste and toxins before they are sent to the bladder as urine. If the kidney becomes damaged or fails completely, it becomes unable to properly process this waste. This lack of function causes kidney failure, also called renal failure. The kidneys play a vital role in maintaining every day bodily function. They not only filter the blood and get rid of waste, but they also balance out electrolyte levels in the body which help encourage the production of red blood cells and normalize blood pressure. Understanding what kidney failure is will help you better prevent it from occurring. Kidney failure, also known as renal failure, may not present many symptoms in the beginning.

However, as the kidneys continue to decrease in function, they become unable to regulate water and electrolyte balances, clear waste products from the body, and promote red blood cell production which leads to the onset of symptoms including: lethargy, weakness, shortness of breath and occasional swelling. If left untreated, then life-threatening symptoms can occur, which range from heart failure to coma.When kidney function gets significantly reduced due to kidney failure, the damage cannot usually be reversed. However, if the proper steps are taken early enough, then it could slow down the progress of kidney failure or even halt it altogether. The treatment for kidney failure differs depending on what phase the kidney failure is and other individual factors. For those whose kidneys no longer function well enough on their own without renal therapy, specialist will typically recommend either renal dialysis or a kidney transplant.

Home Therapies serve as the primary health care providers in many settings.Home Therapies manage in advanced health assessment, illness and disease management, health promotion, pathophysiology and pharmacology. They work in a family-oriented approach that emphasizes health promotion and health maintenance.

Home Therapies serve as primary and specialty health care providers under a physician. Much like a family doctor, Family Nurse Practitioners work with patients throughout their lives, diagnosing illness, conducting exams, and prescribing medication. These nurses can also serve as their patients’ sole health care provider and run their own private practices.

Kidney Transplantation is the process of placing a healthy kidney which takes over the work of cleaning blood through an operation or a surgery in patients with end stage renal disease. It is classified as living donor transplantation or deceased donor transplantation on the source of organ of the donor.

kidney transplantation is the choice of treatment when kidneys fail along with hemodialysis and peritoneal dialysis. kidney transplants are classified into two types: those that come from living donors and those that come from unrelated donors who have died (non-living donors).Kidney transplant can be done to patients who : withstand the effects of surgery, immunosuprresant medication, transplant has good chance of success, treatments after transplantation.Unlike many other types of organ donation, it is possible to donate a kidney while you are alive because you only need one kidney to survive.

Surgery can remove a cancer that is only in the kidney (early kidney cancer) or that has spread into nearby tissues (locally advanced kidney cancer). In these situations the surgery aims to cure the cancer.

Surgery can also be used to remove cancers that have spread to other parts of the body (secondary cancers) to control the growth of the cancer and relieve symptoms.

Clinical Nephrology involves medical treatment of kidney diseases and conditions. This may entail working with other areas of the body that also are influenced by the kidneys.

Kidney problems can cause electrolyte imbalances in the bloodstream, resulting in serious symptoms including excess fluid in the tissues, mental confusion or irregular heartbeat. Clinical nephrology also can help patients who have high blood pressure, because hypertension can be destructive to the kidneys.

Nephrology Nursing is the field of nursing with a focus on the most extreme consideration of the discriminatingly sick or unsteady chronic kidney patients. Contamination revultion and nursing consideration is the control concerned with turning away nosocomial or health awareness related disease, a functional (as opposed to scholastic) sub-order of the study of disease transmission. Infants who need escalated restorative consideration are regularly conceded into a unique region of the clinic called the Neonatal serious care and nursing consideration. The part of backing in discriminating nursing consideration: Critical consideration medical attendants work in a wide assortment of settings, filling numerous parts including bedside clinicians, attendant teachers, medical caretaker analysts, medical caretaker supervisors, clinical medical caretaker authorities and medical attendant professionals. Measurements of Renal Care Nursing's mission is to give attendants exact, current, and applicable data and lodging to exceed expectations in discriminating consideration rehearse.

Nephrology is the medical specialty which focuses on kidney conditions and abnormalities, involving the study of normal kidney function, kidney problems, the treatment of kidney problems and renal replacement therapy i.e dialysis and kidney transplantation. A Nephrologist, also called a renal physician, is a medical doctor who specializes in diseases and conditions related to human kidneys. In most cases, patients are referred to Nephrologists by other physicians. Though Nephrology is a subspecialty of internal general medicine, the branch of medicine involved in diagnosing and treating diseases mainly in adults, it also deals with kidney abnormalities in children. Nephrologists diagnose and treat a variety of conditions such as kidney disease, electrolyte disorders, renal failure, high blood pressure and kidney stones. They perform various tests like blood tests, urine tests and biopsies to find out diseases that affect the kidney. Their treatment includes regulation of electrolyte and blood pressure, medication and dialysis. Excluding procedures such as kidney biopsies and catheter placements, they do not do surgery, though they often work closely with urologists who perform medical as well as surgical intervention. Nephrologists must have a solid understanding of nephrology and the diagnosis and treatment of a variety of conditions.