Renal Experts Meet to Present their Latest Breaking Research

The American Society of Nephrology has recently held its annual meeting and research conference. Taking place from October 31st to November 5th, at the Moscone Center in San Francisco, California, the 40th meeting was one of the largest and most successful to date. Over 13,900 delegates were in attendance including a variety of esteemed guest speakers, clinicians and international experts. State-of-the-Art research in the fields of kidney physiology and nephrology was presented.1

The theme of this year’s American Society of Nephrology’s Annual Meeting and Scientific Exposition was entitled “The Kidney and Its Diseases: Understanding Mechanisms, Discovering Treatments.”¹ The 40th meeting presented a stimulating academic program consisting of plenary lectures, workshops, oral presentations, poster sessions, symposia and an awaited return of the interactive debates and questionnaires. Topical issues were discussed in a comprehensive framework, providing delegates with an adequate balance between laboratory, theory and clinical data. Four State-of-the-Art addresses were also featured during the conference. David Altshuler, MD, PhD presented the first of these at the opening plenary session. His talk, entitled “Genome Sequence Variation and the Inherited Basis of Type 2 Diabetes”, provided insight into human genetic variation (using information from the Human Genome Project) and its application to diabetes.² This was followed by superb addresses from Abraham Verghese, Roger Kornberg and Neil Powe (all authorities in their respective fields) on each of the subsequent days respectively. An overview of the highlights of the conference and important information is provided below. Chronic kidney disease is associated with numerous complications, morbidity and heightened mortality. It is often co-morbid with other cardiovascular disorders (including coronary heart disease and stroke) which increase in frequency as kidney function declines. Diabetes mellitus accounts for a significant proportion of chronic kidney disease cases and almost half of all patients receiving renal replacement therapy. It is thus fitting that diabetes was a focus of several plenary presentations. In particular, the pathogenesis of diabetic nephropathy was reviewed and emerging therapies were discussed. Sulodexide, Antifibrotics, AGE Inhibitors, PKC Inhibitors, PPAR Gamma, Thiazolidinediones and Incretins were all highlighted as potential therapies for diabetic patients with renal disease.³ Management of progressive renal disease remains a challenge to renal physicians. New therapies and techniques are continuously emerging. For example, one study administered magnetically labelled stem cells to rats to determine the role of Haemopoitic Stem Cells in chronic renal failure.⁴ Preliminary results of this study found that the stem cells reduced anaemia, proteinuria, glomerulosclerosis and macrophage infiltration via differentiation into various specialised cells in the kidney.⁴ This is evidence that stem cell infusions may be a potential therapy to decrease renal injury. Besides introducing potential novel therapies, the conference also provided updates on the more traditional methods of management of chronic kidney disease. The role of kidney transplantation in end stage renal disease was reviewed, including presentation of the highlights of the 2007 American Transplant Congress (ATC). Although transplantation causes vast improvements in renal function in most patients, several other medical issues may become apparent in the post-transplantation period.⁵ A session moderated by Dr. Richard Formica and Dr. Simin Goral aimed to provide insight into the aetiology and management of common medical complications following renal transplantation. Four guest speakers presented their knowledge and experience regarding infertility, malignancy (associated with immunosuppression), metabolic bone disease and overall management respectively.⁵ A subsequent session chaired by Dr. Brian J. Gallay and Simin Goral offered an interesting patient perspective on the above issues. Entitled “Real Life After Transplantation”, this symposium discussed personal costs for transplant patients associated with impaired reproduction, increased risks for other diseases, difficulties maintaining employment and nagging side effects of immunosuppressant agents.⁶ This was an enlightening presentation that encouraged clinicians to consider treatment from the patient’s angle and develop strategies to allow transplant patients to successfully integrate back into mainstream life. A debate session on the final Sunday provided yet another alternative scope on this topic. It addressed ethical positions regarding renal transplantation. Unfortunately, scarcity of donor kidneys relative to the large numbers of end stage renal disease (ESRD) sufferers is a worldwide phenomenon.⁷ The debate therefore aimed to provoke thoughts surrounding potential mechanisms for increasing our limited donor pools. New regulations, legislation, allocation systems and approaches were balanced by concerns of financial incentives, disparities in access and possible coercion of vulnerable populations.⁷ Practical (such as allocation and evaluation methods) and ethical issues of renal transplantation will need to be addressed in the future. This article provides just a select snapshot of the vast array of clinical research and experience presented throughout Renal Week 2007. Overall, the conference was highly successful, informative and stimulating. The new knowledge and experience obtained by delegates will hopefully translate into improved patient outcomes for chronic renal disease in the future. Medical professionals are encouraged to browse the dedicated conference website (http://www.asn-online.org/education_and_meetings/Renal Week/renal_week.aspx) for further information and access to abstracts. The next Nephrology meeting is already set to be held from November 4th to 9th 2008 at the Pennsylvania Convention Center, Philadelphia, Pennsylvania.References:

1. American Society of Nephrology, Renal Week 2007, San Francisco, California. Available [online] at URL: http://www.asn-online.org/education_and_meetings/Renal Week/renal_week.aspx
2. Altshuler D, Genome Sequence Variation and the Inherited Basis of Type 2 Diabetes (State of the Art Lecture – Presented 2nd November), Renal Week, ASN 2007.
3. Nelson R, Sharma K, Bakris G, Zinman B. New Treatments for Diabetes Mellitus: Implications for Clinicians. (Clinical Nephrology Conference Session – Presented 2nd November), Renal Week, ASN 2007.
4. Alexandre C, Volpini R, Sanches T, Shimizu M, Seguro A, Andrade L. The Role of Hematopoietic Stem Cells (SCs) in Chronic Renal Failure [F-FC032], Advances in the Pathogenesis and Therapy of Chronic Kidney Disease Nephrology. (Free Communication – Presented 2nd November), Renal Week, ASN 2007.
5. McKay D, Kasiske B, Weisinger J, Tomlanovich S. New Insights into Common Problems After Kidney Transplantation. (Clinical Nephrology Conference Session – Presented 2nd November), Renal Week, ASN 2007.
6. McKay D, Adey D, Meng M, Woodward R. Real Life After Transplantation. (Symposium – Presneted 3rd November), Renal Week, ASN 2007.
7. Matas A, Ross L, Removing Disincentives to the Dearth of Kidneys for Patients in Need of Transplant. (Debates in Renal Disease – Presented 4th November), Renal Week, ASN 2007.