19^th Annual Conference on
Nephrology

Pediatric Nephrology is dedicated to care of children with renal diseases like urinary tract infection, bowel bladder dysfunction, nephrotic syndrome, chronic glomerulonephritis, acute and chronic renal failure, congenital renal anomalies, tubular disorders, systemic severe and progressive renal disorders. Pediatric nephrology covers a large field of medical developments, including genetics, care strategies, and renal preservation. Most of the pediatric kidney diseases are congenital, some of them familial with a precise heredity. Chronic dialysis remains a life event for most of the children on end-stage renal disease despite the growing place of preemptive kidney transplantation. A recent population-based study in the Gironde region of France reported an incidence of about 2.3 pediatric cases of idiopathic nephrotic syndrome for every 100,000 children <15 years of age. Pediatric nephrologist have the special skills and experience to treat child. Pediatric nephrologists treat children from infancy through late adolescence and in some centers up to young adulthood. 

A person with Chronic kidney disorder loses the kidney function gradually and also have cardiovascular failure and premature death. It is most commonly caused by diabetes and high blood pressure. There are four different stages in Chronic Kidney Disorders. Eventually the patient with Chronic Kidney Disease have permanent kidney failure. It is important that people at high risk of developing kidney disease must have their kidney functions regularly checked. Early detection of CKD can significantly help prevent serious kidney damage. A person with End stage Kidney Disorder must undergo Dialysis or Kidney transplant to survive. In a recent study, it is proved that women with CKD will have menopause before age 45.

The kidney is also affected by genetic disorders like Polycystic Kidney Disease, Alport Syndrome which are generally called Hereditary Kidney Diseases. Some diseases are caused by the mutations in the gene. In some cases, a person may inherit a gene with a mutation that usually leads to a disease, but never get that disease. In these cases, either unrelated genes that a person inherits can protect from developing the disease, or else both  the mutation in the gene and some environmental exposure are required to get the disease, and the person without the disease just never had that environmental exposure. In recent days Polycystic Overian Disease is found very common among women.

Acute Kidney Injury is the sudden failure of kidney or kidney damage that happens in few days or weeks. AKI causes a build-up of waste products in your blood and makes it hard for kidneys to keep the right balance of fluid in body. Most cases of AKI are caused by reduced blood flow to the kidneys, usually in the person who is already unwell with another health condition. The most common cause is dehydration and sepsis combined with nephrotoxic drugs, especially following surgery or contrast agents. The causes of acute kidney injury are commonly categorized into pre renal injury, intrinsic, and post renal injury. Many advances have been made in Phenotyping for AKI.

Glomerular disease can result from many inherited or acquired disorders and can manifest in a variety of ways, ranging in severity from asymptomatic urinary abnormalities to acute kidney injury (AKI) or end-stage renal disease. A kidney biopsy is often required to secure the underlying diagnosis in a patient with suspected Glomerular disease, particularly in patients with nephrotic syndrome or suspected Glomerulonephritis. Rarely, a biopsy cannot be performed or is not needed to secure a diagnosis.

Renal Cell Carcinoma is the most common type of kidney cancer often seen in adults. This affects the small tubes in kidney that helps to transport urine. The treatment for this removal of parts. RCC is caused by the tumor hormones and also by the body’s attack on tumor cells. There are generally four stages in RCC. It accounts for approximately 3% of adult malignancies and 90-95% of neoplasms arising from the kidney. Multilocular cystic is a rare tumor that affects the young children and adults which is proved in the survey. Renal Medullary Carcinoma is rare, aggressive and serious type of tumor which is difficult to diagnose and treat.

Certain diseases are known to trigger Glomerulonephritis and damage your kidney. Certain antibodies attack your kidney and lungs which disturbs the kidney functions and causes kidney failure gradually. An auto immune disease means the person’s immune system produces antibodies that attacks and destroy the healthy organs making them failure. For example, Lupus Nephritis occurs when auto antibodies form or are deposited in the glomeruli. Children with auto immune kidney disease are often so sick  they will need intensive treatment for 3 to 6 months.  When a person’s kidney delivers large amount of dilute, odorless kidney then that person can undergo the diagnosis for Diabetes Insipidus.

During pregnancy, the uterus become large that compress the ureters. This change lead to the problem of draining urine from the kidney causing the urine to remain stagnant. As a result, the bacteria accumulates in the kidney rather than washing out. This causes infection. Usually, kidney disorders worsen only in pregnant women who have high blood pressure that is not well-controlled. Having a chronic kidney disorder before becoming pregnant increases the risk that the fetus will not grow as much as expected or be stillborn. Having a severe kidney disorder usually prevents women from carrying a baby to term.

Imaging is increasing its role in monitoring and diagnosing kidney disorders especially renal cell carcinoma. Size, location, margins, lesion homogeneity, and consistency, presence or absence of septations or mural nodules, presence or absence of calcification, intratumoral fat or central stellate scar, echogenicity on US, vascularity on Doppler, degree of enhancement on CT, phase of maximum enhancement on CT, signal characteristics on MRI, tumor stage, and presence or absence of tumor growth are the factors required for imaging. Multiplexed Fluorescence Microscopy is one of the advances in imaging of Renal Cell Carcinoma.

Benign tumors are not real cancers, though some of them can change into cancer any time. A major problem is they can be confused with real cancers since benign tumor often require no treatment. They often found by investigations through MRI scans, CT or by ultrasound. Benign kidney tumor never causes symptoms but difficult to distinguish from renal cell carcinoma. They are common in women of middle age or later. The tumors can eventually multiply in both the kidney and causes renal failure.

It is an inherited, developmental, acquired kidney disorder. It causes symptoms like high blood pressure, back pain, blood in urine, frequent kidney infections. Polycystic kidney diseases are the most prevalent kidney cysts. The two prevalent subtypes of polycystic kidney diseases are: Autosomal Recessive and Autosomal Dominant Polycystic Kidney diseases. Non-cancerous cysts can be cured and rarely cause complications. Simple cysts are not same as the cysts that form with polycystic kidney disease.

Renal Replacement Therapy is a life saving treatment for the renal failure patients. Renal failure becomes more common in recent days because of food and day to day culture which is pushing scientists to bring up with more innovations. It replaces non endocrine kidney function in patients with renal failure. RRT does not correct the endocrine abnormalities of renal failure. The choice of technique depends on multiple factors, including the primary need underlying indication vascular access, hemodynamic stability, availability, local expertise, and patient preference and capability. A person with Acute Renal Failure requires renal replacement therapy (RRT) when he or she has an acute fall in glomerular filtration rate and has developed, or is at risk of developing clinically significant solute imbalance/toxicity or volume overload.

Congenital Renal Anomalies identified in the prenatal period. Defects can be bilateral or unilateral, and different defects often coexist in an individual child. It play a causative role in 30 to 50 percent of cases of end-stage renal disease in children, it is important to diagnose these anomalies and initiate therapy to minimize renal damage, prevent or delay the onset of End Stage Renal Disorders, and provide supportive care to avoid complications of End Stage Renal Disorders. Patients with malformations involving a reduction in kidney numbers or size are most likely to have a poor renal prognosis.

Developmental anomalies of the kidneys and ureters are numerous and not only potentially render image interpretation confusing but also, in many instances, make the kidneys more prone to pathology. Some may have numerous kidneys and some have pancake like shaped kidneys. Those with Bilateral Renal Agenesis often have additional birth defects, both associated with, and a result of the absence of kidneys. With no kidneys, the fetus is unable to produce urine, which is necessary to form amniotic fluid resulting anhydromnios.

When kidneys fail, treatment is needed to replace the work of kidneys can no longer do. When you get a kidney transplant, a healthy kidney is placed inside body to do the work of kidneys can no longer do. There are fewer limits on what you can eat and drink, but you should follow a heart-healthy diet. Your health and energy should improve.  In fact, a successful kidney transplant may allow you to live the kind of life you were living before you got kidney disease. Studies show that people with kidney transplants live longer than those who remain on dialysis. Decesed donor kidneys and living donor kidneys can be used for transplantation. Bio Artificial Transferable Kidneys are the new artificial kidney discovered which made revolution in kidney transplantation.

Kidney function tests look for the level of waste products, such as creatinine and urea, in blood. Analyzing a sample of urine may reveal abnormalities that point to chronic kidney failure and help identify the cause of chronic kidney disease. Kidney biopsy is often done with local anesthesia using a long, thin needle that's inserted through your skin and into your kidney. The biopsy sample is sent to a lab for testing to help determine what's causing your kidney problem. Ultrasound is used to assess your kidneys' structure and size. Diagnosis method vary for different conditions.

Cardiovascular disease is the leading cause of death which is caused by chronic kidney disease and cardiometabolic risk. It is closely related to kidney diseases and causing dysfunction of both organs. Patients with End Stage Renal Disease are at much higher risk of mortality due to cardiovascular disease. The risk factors are hypertension, hyperlipidemia and diabetes. Acute Kidney Injury is strongly related to cardiovascular Disease and its early diagnosis and treatment will have significant positive effect.

Nephrology and hypertension involves the diagnosis and the treatment of all kinds of diseases that are related to the kidney. This field of medical science contains everything starting from the outpatient care to the kidney transplantation and at the same time management of hypertension or high blood pressure. There are several patients across the globe who suffer from kidney diseases and infection of the urinary tract that is caused due to hypertension, diabetes, drugs and cancer. Several of these patients have chances of kidney failure and requires kidney transplantation or dialysis. All these treatments are covered under the scope of nephrology

Successful kidney transplantation offers the best possible quality of life for patients with end stage renal disease. Despite this, the successful renal transplantation rates in the developing world are considerably lower than in the developed world. When identified reasons for this include lack of awareness, low education levels, lack of a clear national policy, absence of functional dialysis and transplant units with adequately trained staff, and absence of an organized system of organ retrieval from deceased donors and lack of opportunities to fund long-term immunosuppression. Some of Challenges include Acute Rejection, Graft Loss, Graft Survival.