13^th World Nephrology Conference October 18-19, 2017 Dubai,UAE

Clinical Nephrology is a specialty of medicine and pediatrics that concerns itself with the study of normal kidney function, kidney diseases, the treatment of kidney diseases and renal replacement therapy (dialysis and kidney transplantation). Kidneys play a vital role for life with their complex network of blood vessels and intricate network of tubes and tubules that filter blood of its waste products and excess water. Kidneys maintain fluids, electrolytes, and acid-base regulation that are altered by several disease conditions as well as drugs and toxins. Nephrology deals with study of the normal working of the kidneys as well as its diseases. Kidney infections, Cancers of the kidneys, bladder, and urethra, Effects of diseases like diabetes and high blood pressure on kidneys, Acid base imbalances, Nephrotic syndrome and nephritis, Ill effects of drugs and toxins on the kidneys, Dialysis and its long term complications - dialysis includes hemodialysis as well as peritoneal dialysis, Autoimmune diseases including autoimmune vasculitis, lupus, etc. Polycystic kidneys diseases where large cysts or fluid filled sacs are formed within the kidney impairing its functions - this is a congenital and inherited or genetic condition.

In the pediatric and neonatal intensive care units Acute kidney injury (AKI) is a common complication where Renal replacement therapy (RRT) is frequently implemented in children in whom the supportive therapy is not to the mark to touch the metabolic demands. In majority, peritoneal dialysis is more preferred for children in the times of renal replacement because of the non-complexity of the procedure. In most of the pediatric end stage renal disease, peritoneal dialysis is more preferred as it can be done even in home.

Diabetics 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 (Renal function test) as represented by an abnormality in serum creatinine, calculated creatinine clearance, or glomerular filtration rate (GFR). Patients with all types of kidney disease and hypertension. This includes kidney stones, chronic or acute kidney diseases due to any cause, resistant or secondary hypertension, unexplained proteinuria or hematuria, cystic kidney diseases, inherited kidney diseases, fluid and electrolyte homeostasis abnormalities, pregnancy related Kidney Diseases, vascular kidney diseases, nephritic syndrome, glomerulonephritis, and others. High blood pressure (also called hypertension) occurs when the force of your blood against your artery walls increases enough to cause damage. For people who have diabetes or chronic kidney disease, blood pressure of 130/80 or more is considered high. Have a family history of high blood pressure. Your chances of developing high blood pressure may be increased if you have chronic kidney disease (CKD), Are overweight and Are African American. Use a lot of table salt, eat a lot of packaged or fast foods, Use birth control pills, Have diabetes, Use illegal drugs, Drink large amounts of alcohol (beer, wine, or liquor). Some types of kidney failure may cause high blood pressure. More often it is high blood pressure that causes kidney Diseases.

Kidney stones are otherwise called as a “Nephrolith” or “Renal calculus”, which are formed in the urine due to the accumulation of excessive minerals. One cannot confine stones to form only in the kidney but there are many cases where the formation of stones included urethra, bladder and ureters. In 2013, 49 million cases of kidney stones have been reported. As a result around 15,000 were dead throughout the world. The preliminary symptoms of kidney stone presence include the unbearable pain in the area between the abdomen and the upper thigh on either side of the body or between the ribs and the hip which is referred to as Renal Colic.

The most common form of kidney replacement therapy is dialysis, is a way of cleaning the blood with artificial kidneys. There is of types of dialysis they are:

1. Hemodialysis 2. Peritoneal dialysis.

Hemodialysis: Hemodialysis required with the patients of renal failure. In this process of hemodialysis, an artificial kidney purifies blood. We should make an "access," usually in the forearm where blood can easily be taken from the body and sent to the artificial kidney for purification. The access collects blood from patient body and undergoes purification in artificial kidney and again injected the purified blood in to patient body.

Peritoneal dialysis: In peritoneal dialysis no artificial kidney is used. The peritoneum (lining inside your abdomen) is used as a filter instead of artificial kidney. Peritoneal dialysis is of two types they are continuous cycling peritoneal dialysis and continuous ambulatory peritoneal dialysis. Peritoneal dialysis is used in kidney failure patients.

End-stage kidney disease is also known as the end-stage renal disease (ESRD). ESRD is mostly caused by diabetes and hypertension. The kidneys of people having ESRD function below 10 percent of their normal ability, which may mean they are barely functioning or not functioning.

Kidney disease is generally progressive. The length of each stage changes and depends on how the kidney disease is being treated, especially in relation to diet. Chronic kidney disease typically does not reach the end stage until 10 to 20 years after dignosis.The treatments for ESRD include dialysis or a kidney transplant.

Acute renal failure, previously called acute kidney injury (AKI), is a sudden and unexpected loss of kidney function that develops within a week. Acute renal failure (formerly known as acute kidney injury) is a disease distinguished by the acute loss of the kidney's eliminatory function and is commonly diagnosed through the accumulation of urea and creatinine or reduced urine output, or both. Acute kidney injury may lead to a number of kidney problems, including high potassium levels, metabolic acidosis, changes in body fluid balance, uremia, also effects on other body systems ultimately leads to death. People who have experienced acute kidney injury may have high incidence of chronic kidney disease in the future. Controlling measures includes treatment of the root cause and supportive care, such as kidney transplantation.

The Kidney is the most commonly transplanted organ from a living donor and the decreased donor transplantation is a transplant where the donated kidney takes from died person.  Immunosuppressive medications that help suppress the immune system. Pediatric  kidney transplantation is accepted as the treatment option for children with final stage of renal disease. HLA and ABO incompatible transplantations conduct in end-stage kidney disease individuals. Hyper acute rejection usually takes place within the first 24 hours after transplantation. Chronic acute kidney rejection occurs months to years following transplantation. Nephrology  treatment will depend on the stage of kidney diseases. Stages one, two and three can usually be treated. Treatment involves making changes to the lifestyle and, in some cases, taking medication to control the blood pressure and lower your blood cholesterol levels. This should help prevent further damage to the kidneys and circulation. Immunologic deregulation leads to the development of autoimmune diseases both limited to the kidney or as part of systemic illness. These include primary glomerular diseases and interstitial nephritis.

Kidney cancer (also called renal adenocarcinoma or renal cell cancer) is a disease in which cancer cells are found in the lining of tubules in the kidney. We have two kidneys, behind the peritoneum one on each side of the spinal cord, just above the waist. Small tubules in the kidneys purify the blood. Unabsorbed products formed as urine. The formed urine passes in to bladder through long tube called bladder. The urine stored in bladder until leaves from body through urethra. Kidney cancer  perhaps remains clinically occult for most of its course. Immunomodulatory agents and targeted therapy are the standard of care in metastatic disease patients. Kidney cancer: The most common malignant disease affecting kidney is kidney cancer. One of the most common causes for kidney cancer is smoking.

Nephropathy is kidney disease or damage. Diabetic nephropathy is damage to the kidneys caused by diabetes. In severe cases it can also lead to kidney failure. The causes of diabetic nephropathy include high blood sugar, advanced glycation end product formation.

The problem is diagnosed using tests that check for a protein called albumin in the urine. Urine does not usually contain protein. But in the early stages of kidney damage some protein may be found in the urine, because the kidneys do not filter it out the way they should.

Onco nephrology is an emerging subspecialty of nephrology. The American Society of Nephrology (ASN) created a forum dedicated to the field of onconephrology in 2011 to improve collaborative care for cancer patients with kidney disease. Randomized controlled trials in a subspecialty like onco nephrology can only be possible when there is collaboration amongst nephrologists and cancer physicians from cancer centers around the world that interact and share research ideas at international meetings. This has led nephrologists to encounter new and partially unrecognized treatments of the targeted therapy agents with kidney adverse effects. These agents fall mainly into 2 categories affecting the vascular endothelial growth factor and endothelial growth factor pathways. An exciting era in the diagnosis and treatment of cancer has emerged in the last 2 decades. What was once an often deadly disease has, for many patients, become a chronic disease with longer survival than ever before. However, with the prolongation of life there are further associated complications, such as chronic kidney disease (CKD). This disease has impacts on the patients’ treatments, dosage of medications, quality of life, and overall survival. Nephritis is inflammation of the kidney the most important prevalent  to acute nephritis is glomerulonephritis. Pyelonephritis that affects in adults more than children and it is recognized as inflammation of the kidney and upper urinary tract. A third type of nephritis is hereditary nephritis, a rare inherited condition.

Glomerular disorders that affect the tiny filtering systems of the kidneys called the glomerulus, Urine abnormalities such as excess excretion of protein, sugar, blood, casts, crystals etc. Tubulo interstitial diseases affecting the tubules in the kidneys, Renal vascular diseases affecting the blood vessel networks within the kidneys, Kidney failure that can be sudden or acute or long term or chronic, Kidney and bladder stones, Inflammation of the tiny filters in the kidneys leads to a state called Glomerulonephritis also known as glomerular nephritis .Glomeruli helps in the removal of excess fluid, electrolytes and waste from your bloodstream and pass them through the urine  maintaining the stability of the body. Albuminuria, haematuria, reduced glomerular filtration rate, hypoproteinemia, edema are the symptoms of this disease.

The stages of kidney disease are determined by the glomerular filtration rate. Glomerular filtration is the process by which the kidneys filter the blood, removing excess wastes and fluids. Glomerular filtration rate (GFR) is a calculation that determines how well the blood is filtered by the kidneys. It is one way to measure kidney types. They are Acute kidney disease is the sudden loss of kidney function that occurs when high levels of waste products of the body's metabolism accumulate in the blood. Chronic Kidney Disease is a gradual development of permanent kidney disease that worsens over a number of years. Pediatric Kidney Disease can affect children in various ways, ranging from treatable disorders without long-term consequences to life-threatening conditions. Polycystic Kidney Disease is characterized by the growth of numerous kidney cysts, which cause abnormalities in both the kidney structure and function. Hypertension Uncontrolled hypertension can damage many organs in the body including kidneys. The purpose of the kidney disease diet is to limit the amount of protein in the diet so that less urea is produced.

Diagnostic imaging is a strategy and procedure of making the visual representations of the interior of a body for clinical analysis and demonstrative intervention. Diagnostic looks to reveal internal structures  hidden by the skin and bones, as well as to analyze and treat ailment. Although imaging of removed organs and tissues can be performed for medical reasons, such procedures are usually considered part of pathology instead of medical imaging. Radiation treatment might be conveyed remotely or inside. Interior radiation, or brachytherapy, is the implantation of a little measure of radioactive material (seeds) in or close to the kidney disease. Angiography is the test of choice for the renal hypertension or high blood pressure caused by narrowing of the renal arteries that carry blood to the kidneys. Initial evaluation could be done by the use of ultrasound. MRI involves a large and powerful magnet in kidney diseases. Hydrogen ions  in the body are used to obtain pictures of the body parts. But in regard to the kidney, an MRI gives the same information as a CT scan.

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 renal failure, also called Kidney 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. There are two kinds of dialysis—Hemodialysis and Peritoneal Dialysis (Ambulatory Peritoneal Dialysis). Dialysis does some of the things a normal kidney does, such as: removes extra water from the body and removes the waste products that have built up in the blood. Hemodialysis is usually done in a dialysis center; however there are some patients who use this therapy at home. Nurses and technicians do your dialysis treatment.

Renal nutrition is a diet which is prescribed during chronic renal failure. The principal sources of energy are Carbohydrates and fats. A renal diet is one that is low in sodium, phosphorous and protein. A few patients may likewise need to breaking point potassium and even calcium. Each people body is distinctive, and in this manner, it is vital that a renal dietician work with every patient to think of an eating regimen that is custom-made to his or her needs. Renal nutrition is concerned with ensuring that patients with kidney disorders eat the right foods to make dialysis efficient and improve health.

Urinary Tract Infection defines that your bladder and kidneys and the tubes that connect them. When germs get into the body they can cause an infection. Most of the urinary tract infections (UTIs) are bladder infections. A bladder infection usually is not a serious infection if it’s treated in the right away. If you do not take care of a bladder infection, it can spread to your kidneys. A kidney infection is serious and can cause permanent damage to the body. Bacteria that usually cause these infections in large intestine and are found in your stool and it cause an infection to the bladder and kidney.