Scientific Program

Day 1 :

  • Nephrology and Hypertension | Pediatric Nephrology | Chronic Kidney Disorders
Location: Holiday Inn Atrium Singapore

Session Introduction

John D. Sullivan

Boston University, USA

Title: The State of kidney failure in the United States in 2018
Speaker
Biography:

Dr. Sullivan is an expert in health care policy, finance, and asset valuation. Prior to joining Boston University, he worked for Fresenius Medical Care, completing the acquisitions of over one hundred health care companies with an estimated value of over $5 billion. In 2008, Sullivan co-founded Reliant Renal Care with private equity funding. He has provided strategic guidance for many of the largest health care organizations in the United States. Sullivan presently teaches mergers and acquisitions, corporate finance, investments, and financial markets and institutions.

Abstract:

End Stage Renal Disease (ESRD) impacts the lives of over 700,000 American patients (including transplant recipients) and their families and costs United States taxpayers approximately $32.8 billion in annual Medicare expenditures.  Spending continues to rise each year, likely due to an increase in various comorbid conditions which contribute to ESRD, including diabetes and hypertension in the context of an aging population. In 1972, President Nixon created an ESRD program in response to ‘God panels’ that were tasked with determining a patient’s eligibility for hemodialysis based on their social worth, since dialysis was seen as too costly to perform universally for all patients with ESRD.  Unfortunately, the government grossly underestimated the future cost of this program, since it assumed that most patients who are medically suitable for dialysis are under age 54 with few if any comorbidities and that only one in five ESRD patients are eligible for dialysis. In hindsight, it was an altruistic but economically infeasible plan.  In addition, while this program provides funding to the Center for Medicare Services (CMS) to treat patients under 65 with ESRD, it doesn’t help defray the cost of disease prevention.  Medicare spends $32.9 billion per year on the treatment of ESRD but only $564 million annually on research geared towards the prevention and treatment of kidney disease. In contrast, in 2015 the NIH had a $3 billion research budget for the study of HIV/AIDS.  As a result, there hasn’t been a significant improvement in dialysis delivery systems over the past four decades.

The payment structure for dialysis therapies remains complex, with Medicare bearing the brunt of the responsibility.  Upon initiation of dialysis, if a patient is already a Medicare recipient, Medicare becomes the primary payer for dialysis service and covers approximately 80% of the cost, leaving supplemental insurance to cover the balance.  For those who only have private employer-based insurance, their insurance is the primary payer for the first 33 months of care (a.k.a. the ‘waiting period’), after which time they are eligible for Medicare.  Private insurance companies typically reimburse dialysis organizations at a significantly higher rate than Medicare or Medicaid.  Therefore, it is during the waiting period that the dialysis organizations accrue the most financial benefit.  Without employer insurance, a gap in payment would exist until the patient moved over to Medicare insurance after the standard waiting period.

 

Jeeno Jay C. Frani

College of Nursing of De La Salle Medical and Health Sciences Institute, Philippines

Title: Effectiveness of pediatric health source book for teachers of children with health impairment: Basis for enhancement
Speaker
Biography:

Jeeno Jay C. Frani is a nurse by profession. He is currently teaching as a faculty and a clinical instructor at the College of Nursing of De La Salle Medical and Health Sciences Institute. Also, he is a Certified Nephrology Nurse (CNN). He is a graduate of Master of Arts in Nursing major in Medical-Surgical nursing. Likewise, he is a volunteer instructor of the Philippine Red Cross-Cavite Chapter under Safety Services teaching First Aid and Basic Life Support-Cardiopulmonary Resuscitation with Automated External Defibrillator. Furthermore, the author is also an Emergency Medical Technician (EMT). In addition, the author is also a Licensed Professional Teacher major in Biological Sciences. He had just graduated Cum Laude for the degree of Doctor of Philosophy in Education major in Special Education. At present, he is the Vice President, National Red Cross Youth Advisers' League.

Abstract:

This quasi-experimental research design is focused on the effectiveness of pediatric health sourcebook for teachers of children with health impairment.
Two groups of respondents were included in the research: the experimental group, where the pediatric health sourcebook was used to impact the knowledge and skills of teachers teaching children with asthma, diabetes mellitus and epilepsy; and the control group where said intervention was not used.
Findings showed that among the control group, pre-test scores for asthma and epilepsy is high and the scores are low for diabetes. For the pre-test scores of the treatment group, both scores from the respondents is high in asthma and epilepsy and low in diabetes. After 2 weeks of intervention, scores from the control group remained high in asthma and epilepsy and low in diabetes whereas for the treatment group, scores in asthma revealed very high and scores in diabetes and epilepsy remained low and high respectively. In addition, after 4 weeks of intervention, scores from the control group in asthma and epilepsy remained high and low in diabetes. For the treatment group, scores in asthma remained very high, scores in diabetes became high and scores in epilepsy remained high. Furthermore, there is no significant difference between the mean scores of the pre-test and first post-test of the control group and there is a significant difference between mean scores of the pre-test and second post-test scores of the control group. There is a significant difference between the mean scores of the pre-test and first post-test of the treatment group and there is a significant difference between mean scores of the pre-test and second post-test scores of the treatment group.
In conclusion, the pediatric health sourcebook is found to be effective as basis of asthma, diabetes and epilepsy specifically on the disease itself and in caring and educating a child diagnosed with such health impairment.
In addition, enhancements can be made on the causes and diagnosis of asthma, causes, diagnosis and the different types of diabetes, and seizure attack and its management and the different health teachings for epilepsy can be given emphasis or reinforcement.
 

Speaker
Biography:

Dr Thilanga Ruwanpathirana was public health clinician attached to the Ministry of Health Sri Lanka before joining the Centre of Cardiovascular Research & Education (CCRE) in Therapeutics/The Clinical Informatics and Data Management Unit (CIDMU). He is supervised by Professor Chris Reid and Dr Alice Owen.
Dr Ruwanpathirana’s thesis looked at low birth weight (LBW) and its risk factors. He developed the first Sri Lankan weight for gestational age curves to identify Small for Gestational Age (SGA) babies. According to his doctoral research, the Low Birth Weight (LBW) rate is 14.7%, pre-term birth rate is 5.4% and SGA rate is 18.6% in rural areas.
Dr Ruwanpathirana is currently undertaking a project to assess the effectiveness and cost-effectiveness of strategies for addressing the problem of vitamin D deficiency in an Australian setting. His aim is to improve the understanding of epidemiological modelling techniques which he can utilize in other settings in the future.

Abstract:

Chronic kidney disease of unknown aetiology (CKDu) is known as a problem among paddy farmers of the North Central province. Ministry of Health published a three-tiered epidemiological case definition in 2016 as suspected, probable and confirmed CKDu. Suspected CKDu provides a uniform method to estimate the burden in epidemiological studies and is defined as the presence of essential criteria of eGFR < 60mL/min AND/OR albuminuria >=30mg/g. Among those satisfying essential criteria, those with urine protein:creatinine ratio >2g/g creatinine OR urine albumin:creatinine ratio >0.3g/g creatinine; hypertensive on >2 drugs OR untreated blood pressure >160/100mmHg; history of diabetes OR being on treatment OR capillary random plasma glucose >200mg/dL were excluded.

 

Speaker
Biography:

Professor Dr. Punit Gupta is MBBS, MD (Medicine), DM (Nephrology) and PhD. He is the Honorary Nephrologists to the Governor of Chhattisgarh State since 2009. He is Chairman and Members of many important academic and management committees of various Government Medical Institutions in the country and the Pt. Deen Dayal Upadhyay Health Sciences University, Raipur.He has guided over 100 Postgraduate & Technologist student for their thesis & Project in Nephrology & Research and also severed as an examiner for the university examinations.A man of researches and publication, he has presented more than 160 research papers and abstracts on Kidney Diseases in Tribal populations at Renowned National and International Conferences. He was felicitated for being the only research scholar who had presented 29 abstracts in Indian Society of Nephrology conference, Pune and 11 research papers at Asia Pacific congress of Nephrology, 2008 in Malaysia on tribal kidney diseases.His Oral Paper was awarded first prize in ISNCON 2007, New Delhi. He was awarded internationally prestigious APCN Developmental awards in Malaysia  2008 and a Follow Scholarship by International Society of Peritoneal Dialysis in Turkey 2008. His paper was recognized as a best Paper in API 2014, Bhilai. He was awarded Certificate of Excellence awards by the Times of India groups 2016. His work was appreciated with certificate of appreciation by Indian Dietician association 2016. He was felicitated by Agrasen Agrawal Samaj for his excellent work in Tribal Population 2016. He was honoured with excellence award by ‘Z’ TV Chhattisgarh for this distinguish work in kidney disease in rural population of Chhattisgarh in 2017. He has developed a concept of Teledialysis, first of its kind in Asia.He has developed Portable dialysis Machine (MAKE-D) for 60 billion kidney patients in world who require dialysis many times in a week. He has developed an abdominal Pressure Measurement Scale, which is very useful of Continuous Ambulatory Peritoneal Dialysis Patients (type of dialysis). He has developed and economic, efficient and effective walkie talkie system for consultation and directions to the hospital staff and doctors. He has been awarded Dr. B. C. Roy National Award for his research to give Aid or Assistance to Research Project for the year 2016.

 

Abstract:

Sickle cell nephropathy is defined as structural and functional abnormalities of kidney function seen in patients with Sickle cell haemoglobinopathy (SCA or Sickle cell Disease; SCD) in the absence of other secondary causes of kidney disease is common and contributes to mortality (CIN 2011). Sickle cell nephropathy consists of a variety of renal abnormalities, i.e. tubular changes and glomerulopathy .The hallmark  of sickle cell nephropathy  is the combination of an impaired renal concentrating capacity and a normal diluting capacity.Maximum number of patient were in the age group between 15-25 years in patients of Sickle cell disease with nephropathy and Sickle cell disease without nephropathy. The mean age in our study was 25.31 ± 8.47 years and the mean age   in patients of sickle cell disease with nephropathy was 29.26 ± 9.30 years, while it was 21.36 ± 9.30 in patients of sickle cell disease without nephropathy.16 (53.33%) were male and 14 (46.67%) were female. 

 

  • Hereditary Kidney Disease | Glomerular Disease | Renal Replacement Therapy
Speaker
Biography:

A.Ganesan is currently the Research Officer at The Tamilnadu Dr.MGR Medical Univeresity. He have 18 years experiences in the medical field and published 10 articles in the peer reviewed journals. He presented/published 15 articles in both National and International conferences and gained knowledge from national and international labs related laboratory testings.

Abstract:

Peroxisome proliferator-activated receptor gamma (Pro12Ala PPARγ) has beneficial effects on renal structure and function in models of diabetes as well as chronic kidney diseases. We studied PPARγ nephrotic syndrome (NS) among children and compared with controls. This study included NS children which are divided into steroid sensitive NS (SSNS) and steroid resistant NS (SRNS) and controls.

 

Speaker
Biography:

Dr. Sihem Attou is the Nephrologist working in CHU Nefissa Hamoud Parnet Hussein Dey, Algiera for 10 years.

Abstract:

We report the case of a 13-year-old child with total vascular depletion, the only alternative of which was a renal rescue transplant.
After a complete assessment before the renal transplant, the induction treatment required central administration, the only possibility was a hepatic catheter placed in the emergency. We decided to use an unconventional vascular approach  in per and immediate postoperative despite its high thrombogenic risk.The patient received all of his induction therapy by sushepatic  without incidents but, however, under effective anticoagulants administered for preven thrombotic risk.
The use of unconventional central pathways in kidney transplantation is increasingly coveted, given the defects of renal transplant recipients who have been purified by hemodialysis and are subject to vascular peripheral depletion.
The transhepatic route is a good alternative in this case while waiting for renal transplantation (1) as well as for the use of renal transplant induction treatments and has already been used in a patient with high immunological risk who required bortezomib and Of central eculizumab with complete vascular exhaustion on highly thrombogenic terrain in order to prepare for a rescue transplant

 

  • Young Research Forum
Speaker
Biography:

Rachell Ann C. Siute experienced Nephrologist with a demonstrated history of working in the hospital & health care industry. She is undergoing internship at Fe Del Mundo Medical Center for the past 3 months. She is also working as Nephrology consultant at De Los Santos Medical Center. She is skilled in Research, Hospitals, Medicine, Healthcare, and Healthcare Management. Strong healthcare services professional, competent, commited and compassionate with a Doctor of Medicine - MD degree from University of Santo Tomas.

Abstract:

As the population continues to age and prevalence of kidney disease increases, clinicians are frequently faced with the decision of whether or not to initiate renal replacement therapy for their patients. Many clinicians believe that age is a barrier for initiation of renal replacement therapy because dialysis in elderly patients has been associated with increased risk of mortality. However, data regarding outcomes of elderly patients undergoing hemodialysis are limited. This present study evaluated the median survival time in hemodialysis patients initiated at ≥ 60 year old and the factors that affect mortality were also analyzed.

Speaker
Biography:

Dr. Kishore Kumar is a physician by profession with major experience in Nephrology. Currently serving in Seychelles with Advance Renal Care International but also worked as medical officer in start of career with two most renowned organizations Agha Khan University & Save The Children int: in Pakistan and later on joined Pakistan Institute of Medical Sciences as resident Nephrology for 5 years. Awarded and latter completed an international fellowship in Peritoneal Dialysis at Madras Medical Mission Hospital Chennai India by International Society of Peritoneal Dialysis. Awarded ISN-ANIO certification of Fellowship in Clinical Nephropathology in 2017 by International Society of Nephrology. 

 

Abstract:

Peritonitis is one of the leading complications of PD peritonitis. A rapid and accurate microbiological diagnosis helps in the appropriate management of PD related infections. A retrospective analysis of 97 samples from 73 patients from 3 centers (Madras Medical Mission, Railway Hospital and Rajiv Gandhi Government General Hospital) with PD related peritonitis was done. Automated culture techniques, special stains and molecular techniques were used in the diagnosis of the organisms. The aim of this study was to determine the causes of culture positive and negative peritonitis and throw light on the microbiological profile of PD peritonitis.

 

Kishore Kumar

Advance Renal Care Seychelles Private Limited, Seychelles

Title: Comparison of severity of rentinopathy in diabetic vs non-diabetic CKD patients
Speaker
Biography:

Dr. Kishore Kumar is a physician by profession with major experience in Nephrology. Currently serving in Seychelles with Advance Renal Care International but also worked as medical officer in start of career with two most renowned organizations Agha Khan University & Save The Children int: in Pakistan and later on joined Pakistan Institute of Medical Sciences as resident Nephrology for 5 years. Awarded and latter completed an international fellowship in Peritoneal Dialysis at Madras Medical Mission Hospital Chennai India by International Society of Peritoneal Dialysis. Awarded ISN-ANIO certification of Fellowship in Clinical Nephropathology in 2017 by International Society of Nephrology. 

 

Abstract:

The global burden of Chronic Kidney Disease has increased in recent years and its major causes are increased sedentary lifestyle practices along with growing numbers of diabetics, hypertensive and obese people. Retinopathy is defined as the presence abnormal changes in the micro vessels of the eye. These abnormal changes can predict the micro vascular changes in other vital organs of body which usually share a similar morphological pattern. Retinopathy is being considered as a predictor as early predictor a vascular changes, as it can prematurely detect micro vascular abnormalities in, vital organs that have a micro vascular structure similar to the retina. Reasonable amount of research work has been done to study the association between retinopathy and CKD. It is now a proven fact that the type of retinopathy and its severity have a directly proportionate relation with the progression of CKD or decline eGFR in both diabetics and non-diabetic patients. But the proliferation rate may differ in both.