5^th Global Nephrologists Annual Meeting April 01-02, 2016 Valencia, Spain

Veena Joshi (M.Sc; Ph.D) has completed her education in India. She has over 25 years of experience in Epidemiology and social research at Ministry of Health in Singapore and various hospitals in India. She has published several papers in reputed journals and has been serving as reviewer board member of repute.

Aim of the study was to conduct a systematic review to summarize the outcome of renal transplantation in adult patients with history of DM [DMRTx] in 1.DMRTx , 2. type 2 DMRTx 3.DM and type 2 DM in comparisons with Non-DMRTx, 4. Type2DMRTx vs dialysis and 5. Preemptive Kidney Transplant (prekTx) vs non prekTxrnMEDLINE, EMBASE, Renal transplant registries were searched for observational / cohort/ case-control studies from 1980 to 2014.rnWe identified 22 studies reporting survival after RTx [in DM (1),DM vs Non-DM (10), Type 2DM (2), Type2DM vs Non-DM (6), Type2DMRTx vs Dialysis (1), PreKTx vs Non PreKTx (2)] 16, 7, 12 and 3single center studies showed 1,3, 5 and 10 year patient survival respectively. rnSeven studies in DM group have reported 5 yr graft and patient survival where one study showed graft survival was significantly better in Non-DM group compared to DM group. Patient survival did not differ. In five type2DM studies, one and three studies showed graft and patient survival in non-DM to be significantly (p<.05) better than type2DM group. 5 yr survival after RTx was significantly (p=.001) better in RTx patients compared to patients on dialysis. At 10 year, patient survival of non-DM was significantly better than DM or type 2 DM (p<.05).and survival of preemptive was similar to non-preemptive. rnThere is an urgent need for multi-center studies with prediabetes, especially type2DM patients to look at long term survival after renal transplant.rn

Ma. Eugenia Martínez is a doctoral candidate in Biochemical Engineering Sciences, focusing her thesis in Plant Biotechnology using Taraxacum as a scientific model for bioactives compounds recuperation and biomass valorization. She is currently working in the FP7 DISCO Project for bioactives production under \"green chemistry\" and further market commercialization

Currently, the most effective treatment for recurrent urinary tract infections in women is the use of antibiotics. However, limitation for this treatment is the duration and dosage of antibiotics and the resistance that bacteria develop after a long period of administration. Therefore, alternatives approaches need to be consider. The most common is the use traditional botanical remedies or preparations, in which the use of dandelion (Taraxacum sp.) has several references in treating bacterial infections. These properties have been attributed to the large number of bioactive compounds in their tissues, particularly triterpenes such as amyrin and lupeol, antioxidants and phenolics compounds. Antibacterial activity was evaluated in vitro by serial microdilution using a hexane extract from T. officinale leaves against Escherichia coli, Klebsiella pneumoniae and Proteus mirabilis as uropathogens, showing 100% inhibition at 400 mg/L for E. coli and 1600 mg/L for the other tested strains. Phytochemical analysis of plant tissue grown in vitro revealed the presence α-amyrin and lupeol both in leaves and in callus cultures, which extract would be further tested in rats. These results corroborate the folkloric use is given to the use of dandelion against bacterial infections and suggest the potential of these compounds for its potential use in the pharmaceutical industry, related to the formulation of natural products associated with improving urinary tract diseases. On the other hand, it can set the groundwork for a potential production system of these compounds for medicinal purposes, using biotechnology techniques that stimulate the synthesis and accumulation of these triterpenes into the plant cell.

Maria Gonzalez Suarez has completed her PhD at the age of 30 years from Universidad Autonoma de Nuevo Leon in Mexico, and also has completed training in Internal Medicine at Jackson Memorial Hospital in Miami, Florida. She is currently a Nephrology fellow at Mayo Clinic in Rochester, Minnesota. One of her main interests is in quality improvement. This abstract forms part of a larger quality improvement project for one of the Mayo Clinic dialysis units that she is currently working in conjuction with the other authors.

Integration of palliative medicine into dialysis programs offers opportunities to improve the quality of end-of-life (EOL) care. Hospice services (HS) are underutilized in the end-stage renal disease population. This retrospective study evaluates the palliative care (PC) and HS involvement in hemodialysis (HD) population. We reviewed medical records of deceased patients who had dialyzed at a single dialysis unit between 2010 to 2015. Timing and frequency of palliative/hospice consults and location of death were analyzed. 114 deaths were reviewed; 58% were men and median age 79. PC and HS were involved in 72% and 8% of the cases respectively. PC has increased from 38% (2010) to 92% (2015). HS also increased from 0% (2010) to 17% (2015). Median timing for PC referral was 91 days prior to death and 16.5 days for HS. 98% of first PC consultations were done in the inpatient setting. There was no difference in location of death between those who received PC versus who didn’t. However, patients who had PC involved were less likely to receive life sustaining measures (i.e. cardiopulmonary resuscitation, mechanic ventilation or pressors) prior to death (9% vs 33%; p=<0.001). PC and HS utilization has increased over the past 5 years in this unit. They may help improve the quality care by ensuring that patients’ care matches their goals as evidenced by fewer patients receiving aggressive treatment in the peri-mortal period. Systematic approach to proactively identify patients with poorer prognoses is necessary to determine goals of care and maximize EOL quality.

Aikaterini Papagianni is Assoc. Professor of Nephrolgy at the Aristotle University of Thessaloniki, Greece. She is currently Vice-President of the Hellenic Society of Nephrology and Editor-in-Chief of its official journal. She has published more than 70 papers in international journals and she is an Editorial Board member in several international journals. She serves as a reviewer in several scientific journals, she participates in the evaluation of research projects submitted for funding by National and International Programs. She was a member of the Organizing and/or Scientific Committees of several National and International Congresses. She has more than 1,500 citations (June 2014).

Adynamic bone disease (ABD) is characterized by low bone turnover and absence or a reduced number of osteoblasts and osteoclasts and its prevalence in chronic kidney disease (CKD) patients is increasing steadily over the last years. This high prevalence has been attributed to many factors, such as diabetes, use of drugs down-regulating parathormone release, high calcium intake, advanced age and chronic inflammation. Treatment of ABD imposes a serious challenge, since this condition is accompanied by a considerable increase in fracture risk and mortality. Current treatment concepts focus on limiting daily oral calcium intake as well as intradialytic calcium but reliable guidelines are lacking. Administration of teriparatide, the recombinant N-terminal region of human parathyroid hormone (PTH1−34), would theoretically improve ABD in CKD patients, since in these patients the condition is attributed to PTH deficiency or an intrinsic bone resistance to PTH. However, the use of this agent in CKD is limited to 2 small studies which showed that teriparatide treatment may increase bone mineral density, assessed by bone densitometry. Moreover, there are two case reports, one from our group, which showed that this treatment restored bone metabolism assessed by bone histomorphomery. Furthermore, it has been demonstrated that the pharmacokinetics of teriparatide in hemodialysis patients are similar to those observed among postmenopausal women with normal kidney function, likely due to hepatic clearance of the drug. Large prospective randomized controlled trials in CKD patients are urgently needed to determine the safety and efficacy of teriparatide administration and the optimal duration of treatment.