19^th Global Nephrologists Annual Meeting May 14-15, 2018 Rome, Italy

Wioletta Dziubek-Rogowska completed her Master of Physiotherapy at University of Physical Education in Wroclaw in 1999 and PhD in Physical Education at University of Physical Education in Wroclaw in 2005. She is Scientist and Adjunct in the Department of Physiotherapy at University of Physical Education in Wroclaw from 2005. From 2007-2016, she was Senior Lecturer and from 2016 to present working as a Professor at Karkonosze College in Jelenia Gora, Faculty of Natural Science and Technology. 2005 - Present - Head of Laboratory of Functional Tests in Internal Diseases, Department of Physiotherapy, and University of Physical Education in Wroclaw. From 01.09.2016-present she is Head of the Scientific Research Laboratory Department of Physiotherapy, University of Physical Education in Wroclaw, from 01.09.2016-present - Rector's Plenipotentiary for the Lower Silesian Science Festival 2007 - Chairman of the Organizing Committee of the VI International Days of Physiotherapy, Wroclaw 2017 - Chairman of the Scientific Committee of the X International Days of Physiotherapy, Wroclaw. Her area of scientific interest includes “Improvement of outcomes in physical and psychological area of patients with end-stage renal disease (ESRD) on dialysis and after kidney transplant; impact of exercises in dialysis patients on reduction of symptoms of anxiety and depression, improved quality of life and better functioning in everyday life”.

Frequent dialysis and a number of comorbidities that accompany patients with chronic renal failure (CRF) cause a reduction in their overall fitness. A decrease in muscle mass and malnutrition not only increases the likelihood of injuries, but also limits the performance of everyday activities, reducing the quality of life of patients. Programming rehabilitation, considering the progressive process of skeletal myopathy in patients with CRF, it is directed to increase muscle strength and endurance, that is, factors conditioning physical exercise tolerance, and consequently also the quality of life and physical fitness in the patient's everyday life. That is why the importance of physical exercise is so important, not only in the period between dialysis, but also in non-dialysis days. The main aim of the research is to assess the impact of six-month training on muscle function, physical efficiency and the quality of life of patients undergoing dialysis. The dialysis patients were divided into three groups. Trainings with each of the three groups were conducted for six months, three times a week (1st and 2nd group) and twice a week (3rd group), 60 minutes. 90 people were qualified for the study; 45 patients aged 40 to 80, completed the training cycle. The average age of the respondents was 62.2 years. Patients were divided into three groups: group I – patients with endurance training (16 people); group II - patients with strength training (15 people); group III - patients who trained Tai Chi (14 people). At the beginning of the program and after six months, the patients were subjected to the following tests: Strength of the lower limbs in the statics and dynamics - isokinetic and isometric tests (multi joint 4 by Biodex); exercise stress test (VO2max) on the Cosmed K4b2 ergospirometer; assessment of the quality of life- KDQoL questionnaire. All tests were performed with the participation of a nephrologist and cardiologist. The research was carried out as part of a project from the National Science Center - grant no. 2011/03/B/NZ7/01764. As a result of six months of training in all groups of patients, the endurance parameters and muscle strength-speed parameters improved their quality of life and the cardiovascular system's performance improved. After six months of training, hemodialysis patients showed an increase in the strength-speed and spiroergometric parameters. In some cases these differences were statistically significant. There were no significant differences between group I (training on the rotor) and group II (resistance training) in strength-speed parameters. In group I there was a significant increase in the average values of all spiroergometric parameters after six-month training on the rotor. The peak torque at both speeds of movement correlated with the spiroergometric parameters. The age of subjects tested negatively correlated with all strength-speed parameters. Improvement in the quality of life has been observed in all groups studied.

Noha Adel Mitwally has completed her Master degree in Biochemistry and Molecular Biology from Medical Research Institute, Faculty of Pharmaceutical Sciences, Alexandria University, Egypt. She is an Assistant Lecturer and Clinical Research Coordinator at College of Medicine, Dar Al Uloom University, Riyadh, KSA. She has long experience in clinical research and participated in many clinical researches of reputed international pharmaceutical companies.

Diabetic nephropathy (DN) is the most common cause of end stage renal disease that is associated with high rates of morbidity and mortality. It is characterized by abnormal angiogenesis that results in new vessels, which are often immature and play a pathological role in nephropathy. The progression of nephropathy is related to vascular growth factor signaling through receptor tyrosine kinases, specifically the vascular endothelial growth factor (VEGF) and angiopoietin families. Novel therapies that target angiogenic factors such as VEGF-A and angiopoietins could be an appealing option to treat DN. One of them is statin which is mainly known to reduce low-density lipoprotein cholesterol level. Although, there are growing evidences suggesting that statins may offer renoprotective effects, many trials failed to demonstrate the angiogenic effect of statin on kidney. Our objective was to assess the effects of statin on renal outcomes in DN by evaluating the alteration of angiogenesis in DN patients and assessing its pleiotropic effect on VEGF-A and Angiopoietine-2. To reach these objectives, we evaluated the level of VEGF-A and Angiopoietin-2 in 50 diabetic patients with increased urinary albumin excretion rate before and after the administration of 80 mg fluvastatin for 14 weeks using Enzyme-Linked Immunosorbent Assay (ELISA). Our results demonstrated that VEGF-A and angiopoietin-2 are increased in type 2 diabetic nephropathy patients. Administration of high dose fluvastatin demonstrated significant reductions in serum levels of VEGF-A and angiopoietin-2. In conclusion, the use of fluvastatin should be considered for patients with DN particularly in the early stages of the disease.

Inbar Bandach is a second year PhD student under the supervision of Prof. Segev and Prof. Landau in Department of Microbiology and Immunology at Ben-Gurion University of the Negev in Israel. In her master's thesis, she worked on “Anemia of chronic kidney disease and mainly focused on the role of IL-1 in anemia of CKD”.

Anemia of chronic kidney disease (CKD) may be due to impaired renal erythropoietin (EPO) synthesis, EPO resistance and hepcidin mediated iron malabsorption. Interleukin (IL-1), an important pro-inflammatory cytokine, is normally controlled by a receptor antagonist (IL1Ra). IL1Ra-KO (RaKO) mice show arthritis and excessive inflammation. The aim of this study was to characterize the anemic state of RaKO mice with CKD. RaKO and wild type (WT) mice were divided into four groups: WT-C, WT-CKD, RaKO-C, RaKO-CKD. CKD or control states were induced by 5/6 nephrectomy or sham operations. Mice were sacrificed after 12 weeks from surgery. RaKO animals developed chronic arthritis, in association with increased levels of liver CRP and kidney IL6. Serum creatinine and urea levels were similar in the 2 CKD groups, but RaKO-CKD had higher degrees of renal inflammation and fibrosis vs. WT-CKD. Hematocrit levels were decreased only in RaKO-CKD (but not in WT-CKD). Serum iron levels were reduced in both RaKO groups and were even lower in RaKO-CKD vs. RaKO-C. Liver hepcidin mRNA levels were equally increased in both RaKO groups vs. WT-C, but were more increased in WT-CKD vs. RaKO. Renal HIF2 levels were not increased in RaKO CKD. Bone marrow EPO-R mRNA levels were significantly decreased in RaKO-CKD compared to all other groups. Thus, anemia appeared only in RaKO-CKD and not in WT-CKD. Systemic inflammation was higher in RaKO-CKD; leading to hepcidin mediated iron malabsorption, inhibited kidney HIF2 response and decreased bone marrow EPO-R. Reducing IL-1 effects may be an additional therapeutic strategy in CKD-associated anemia.

Banan Abbas Mustafa Osman is a British urology trainee joined University of Medical Science and Technology. She is an Honorary Clinical Tutor for the Severn School of Surgery. She is also a teaching faculty member at Royal College of Surgeons England. She was appointed annually over three years as a Surgical and Urology trainee representative in Junior’s Doctor’s Forum in the Royal Marsden NHS Foundation Trust & North Bristol NHS Trust. She was a Clinical Investigator in VORTEX Clinical Trial. She held a position of Assistant Director of training in SMA International Training School.

Kidney transplantation is the treatment of choice for end stage renal failure (ESRD). Several studies have investigated factors that may affect kidney function at one year. Low preoperative Body Mass Index (BMI) is considered a strong marker of poor nutritional status with inferior outcomes in such patients demonstrated across multiple surgical disciplines. There is a relative lack of evidence concerning the outcome of underweight recipients following renal transplantation. Aim of our study is to compare the long-term graft outcomes for underweight recipients with an age and sex matched cohort of patients with ideal BMI. A retrospective single centre paired analysis of 1095 consecutive kidney transplant recipients over 10 years in one transplant centre in England. All kidney transplant (KTx) patients with low BMI<18.5 kg/m2 were included (n=33). Those patients were age and sex matched with ideal weight (BMI 18.5–25 kg/m2) counterparts. Results showed 33 of 1095 (3.0%) patients were underweight of which 60.6% were females with mean age of 27.0. There was no difference in one-year graft or patient survival between the underweight and matched ideal weight groups (P=1.00). Kaplan-Meier analysis demonstrated no difference in dialysis free patient survival between the two groups (P=0.955). Graft outcomes for underweight patients undergoing renal transplantation in this study were comparable to a matched ideal weight cohort. There is no significant difference in one-year graft or patient survival between the groups. Therefore, low BMI in itself should not be a barrier to renal transplantation.

Amir Abbas Farshid is a Professor of Veterinary Pathology, Faculty of Veterinary Medicine, as well as Head of Electron Microscope Center, Urmia University, Urmia, Iran, with more than 85 research papers published in reputed journals.

Male Wistar rats were divided into five groups of six rats each kept under standard experimental conditions. All the administrations were given intraperitoneally. Group I, received normal saline 1 ml/kg body weight for seven days. In group II, kidney lesions (congestion, hemorrhages and tubular degenerations and necrosis) induced by doxorubicin at the dose of 15 mg/kg body weight following normal saline administration for seven days. Rats in group III, given histidine 100 mg/Kg body weight for seven days followed by administration of doxorubicin and in group IV, N–acetylcysteine at the dose rate of 100 mg/Kg body weight given for seven days and followed by doxorubicin administration. In group V, both histidine and N-acetylcysteine were given for same period and the same dose levels prior to doxorubicin. The semi-quantitative histopathology results indicated that histidine and N-acetylcysteine when given alone could significantly only reduce the congestion but when given together had significant protective effects on all kidney lesions caused by doxorubicin.