26^th Global Nephrology, Urology and Kidney Failure Congress

Global perspectives on kidney health reveal a diverse landscape shaped by socioeconomic factors, healthcare systems, and cultural beliefs. Chronic kidney disease (CKD) and its complications are significant public health issues worldwide, with varying prevalence rates influenced by factors such as diabetes, hypertension, and access to healthcare. In high-income countries, advancements in early detection and treatment have improved outcomes, yet disparities remain for marginalized populations. In contrast, low- and middle-income countries often face challenges related to limited resources, inadequate healthcare infrastructure, and a lack of awareness about kidney health, resulting in late-stage diagnoses and poor outcomes. International organizations, such as the World Kidney Day initiative, promote awareness and advocacy for kidney health globally. Collaborative efforts, including research partnerships and knowledge sharing, are essential for developing effective prevention and treatment strategies tailored to diverse populations. Emphasizing the importance of kidney health education, early screening, and integrated care approaches can significantly enhance outcomes across different regions. Ultimately, a global perspective fosters a comprehensive understanding of kidney health, promoting equitable access to care for all individuals.

Recent advancements in kidney transplantation have significantly improved patient outcomes and expanded eligibility criteria. The introduction of more sophisticated immunosuppressive regimens has enhanced graft survival rates, reducing the risk of rejection. Innovations in donor organ preservation techniques, such as hypothermic machine perfusion, have allowed for the successful transplantation of previously marginal organs. The use of living donors has also surged, facilitated by enhanced surgical techniques and donor-recipient matching processes. Furthermore, research into xenotransplantation the transplantation of organs from genetically modified pigs—holds promise for alleviating donor shortages. In addition, advancements in bio printing and tissue engineering are paving the way for the future creation of artificial kidneys. The incorporation of machine learning and AI in donor-recipient matching is optimizing outcomes by predicting transplant success rates. As these technologies continue to evolve, the future of kidney transplantation appears more promising than ever, aiming for improved accessibility, reduced wait times, and enhanced quality of life for recipients.

Managing chronic kidney disease (CKD) involves a multifaceted approach aimed at slowing disease progression and minimizing complications. Early diagnosis is crucial, with regular screening for at-risk populations, such as individuals with diabetes or hypertension. Treatment strategies focus on controlling underlying conditions through medication, lifestyle changes, and dietary modifications. Blood pressure management, typically using ACE inhibitors or ARBs, is vital for renal protection. Additionally, dietary intervention, including reduced protein and sodium intake, helps alleviate the burden on kidneys. Regular monitoring of kidney function and laboratory tests assists healthcare providers in adjusting treatment plans effectively. Patient education plays a key role, empowering individuals to understand their condition and adhere to treatment regimens. Furthermore, integrating multidisciplinary teams—comprising nephrologists, dietitians, and social workers—enhances comprehensive care. As CKD progresses, preparations for potential renal replacement therapy, including dialysis or transplantation, become essential. Overall, a proactive, patient- centred approach can significantly improve outcomes for individuals living with CKD.

Telehealth has revolutionized urology by enhancing access to care and improving patient outcomes. This technology facilitates remote consultations, allowing patients to receive expert advice without the need for in-person visits. Particularly beneficial during the COVID-19 pandemic, telehealth has become a vital tool for managing urological conditions while minimizing exposure risk. Through secure video conferencing and messaging platforms, urologists can conduct follow-ups, review lab results, and discuss treatment plans with patients from the comfort of their homes. Telehealth also addresses geographic barriers, enabling patients in rural or underserved areas to access specialized care. It enhances continuity of care, allowing for timely interventions and monitoring of chronic conditions like benign prostatic hyperplasia and urinary incontinence. Additionally, telehealth platforms can integrate wearable technology and mobile health apps, providing real-time data on patients’ symptoms and overall health. However, challenges such as technology access, digital literacy, and reimbursement policies remain. Overall, telehealth represents a transformative shift in urology, promising improved accessibility and convenience for patients.

Recent innovations in dialysis techniques have significantly enhanced the efficacy and patient experience of renal replacement therapy. Traditional haemodialysis has evolved with the introduction of high-efficiency dialyzers and advanced machines that allow for better toxin removal and shorter treatment times. The development of portable dialysis units is revolutionizing home-based treatments, enabling patients to manage their therapy in familiar environments, thus improving adherence and quality of life. Peritoneal dialysis (PD) has also seen advancements, including automated PD systems that optimize fluid exchange during the night while patients sleep. Additionally, wearable dialysis devices are in experimental stages, promising continuous, discreet treatment without the need for traditional setups. Moreover, research into biocompatible materials aims to reduce the complications associated with dialysis, such as infections and vascular access issues. Continuous renal replacement therapy (CRRT) is being refined for critically ill patients, allowing for gentle and efficient fluid and electrolyte management. These innovations not only enhance clinical outcomes but also empower patients, making dialysis a more manageable aspect of living with kidney disease.

Nutrition plays a pivotal role in maintaining kidney health and managing chronic kidney disease (CKD). A well balanced diet can significantly influence the progression of kidney disease and overall wellbeing. For individuals with CKD, dietary modifications are essential, focusing on reducing sodium, potassium, and phosphorus intake to minimize the kidneys' workload. Emphasizing high-quality proteins, healthy fats, and fibre-rich carbohydrates helps to optimize nutritional status while limiting potential toxins. Foods rich in antioxidants, such as berries and leafy greens, can further support kidney function by combating oxidative stress. Hydration is also crucial, though fluid intake may need to be monitored based on individual circumstances and disease stage. Additionally, understanding food labels and portion control aids in managing caloric intake, which is vital for those with comorbid conditions like diabetes. Collaborating with a renal dietitian ensures personalized dietary plans that align with medical treatment goals. Ultimately, prioritizing kidney-friendly nutrition fosters better health outcomes, enhances quality of life, and empowers patients to take charge of their kidney health.

Urological emergencies require prompt recognition and intervention to prevent complications and preserve renal function. Common emergencies include acute urinary retention, kidney stones, testicular torsion, and renal trauma. Acute urinary retention can lead to bladder distension and kidney damage; immediate catheterization is often necessary to relieve pressure. Kidney stones may cause severe pain and obstruction, necessitating timely imaging and potential surgical intervention if conservative measures fail. Testicular torsion, a surgical emergency, demands rapid assessment and surgical correction within hours to salvage the affected testicle. Renal trauma, whether from blunt or penetrating injuries, requires a thorough evaluation to determine the extent of injury and the need for surgical intervention. Healthcare providers must be trained to recognize the signs and symptoms of these emergencies, ensuring quick and effective management. Implementing protocols for triage and emergency care can enhance outcomes for patients facing urological crises. Ultimately, fostering a swift response in urological emergencies is essential for preserving kidney function and safeguarding patient health.

Artificial intelligence (AI) is transforming nephrology by enhancing diagnosis, treatment, and patient management. Machine learning algorithms can analyse vast amounts of patient data to identify patterns and predict outcomes, aiding in early detection of chronic kidney disease (CKD) and acute kidney injury (AKI). AI-driven tools can enhance risk stratification, helping healthcare providers to prioritize patients for intervention based on their likelihood of disease progression. Moreover, AI is improving the personalization of treatment plans, enabling tailored therapies that consider individual patient characteristics and preferences. In dialysis, AI can optimize treatment schedules and monitor patient adherence, thereby improving outcomes. Additionally, AI’s ability to analyse imaging data supports the diagnosis of urological conditions, facilitating timely interventions. As telehealth expands, AI can enhance virtual consultations by analysing patient symptoms and history for more accurate assessments. While the potential of AI in nephrology is significant, ethical considerations, data privacy, and the need for robust validation of AI tools remain paramount. Overall, AI promises to revolutionize nephrology, making it more precise and patient-centred.

Understanding the genetics of kidney disease has opened new avenues for diagnosis, treatment, and prevention. Genetic factors play a crucial role in the predisposition to various kidney disorders, including polycystic kidney disease (PKD), focal segmental glomerulosclerosis (FSGS), and congenital anomalies of the kidney and urinary tract. Advances in genomic technologies, such as next-generation sequencing, have enabled the identification of specific genetic mutations associated with these conditions, facilitating earlier and more accurate diagnoses. Genetic counselling can provide patients and families with valuable information about inheritance patterns and potential risks for future generations. Additionally, ongoing research into gene therapy and precision medicine holds promise for developing targeted treatments that address the underlying genetic causes of kidney diseases. Understanding the genetic basis of these conditions also aids in the identification of biomarkers for disease progression, allowing for personalized monitoring and management strategies. As the field of nephrology embraces genetic insights, it heralds a new era of tailored interventions aimed at improving outcomes for individuals with kidney disease.

Patient-centric kidney care emphasizes the active involvement of patients in their treatment journey, fostering collaboration between healthcare providers and individuals. This approach recognizes the unique needs, preferences, and values of each patient, tailoring care to enhance engagement and satisfaction. Shared decision-making is a cornerstone of patient-centric care, empowering patients to participate in discussions about their treatment options, risks, and benefits. Comprehensive education about kidney disease, available therapies, and lifestyle modifications equips patients with the knowledge needed to make informed choices. Incorporating mental health support and addressing social determinants of health are essential components of holistic care, as they significantly impact treatment adherence and outcomes. Additionally, integrating technology, such as telehealth and mobile health apps, facilitates ongoing communication and monitoring, allowing for timely adjustments to care plans. Building strong patient-provider relationships fosters trust and ensures that care aligns with individual goals. Ultimately, patient-centric kidney care leads to improved health outcomes, enhanced quality of life, and a more empowering healthcare experience for individuals living with kidney disease

Minimally invasive urological surgery has revolutionized the treatment of various urological conditions, offering significant advantages over traditional open surgical techniques. These procedures, including laparoscopic and robotic-assisted surgeries, utilize smaller incisions, resulting in reduced postoperative pain, shorter recovery times, and minimal scarring. Conditions such as kidney stones, prostate cancer, and bladder tumours are now often treated with these techniques, enhancing patient outcomes. For instance, robotic-assisted laparoscopic prostatectomy allows for greater precision and control, improving cancer removal rates while preserving nerve function. Additionally, minimally invasive approaches often lead to shorter hospital stays and quicker return to normal activities, greatly enhancing patients’ quality of life. Innovations in surgical instruments and imaging technology have further enhanced the safety and effectiveness of these procedures. While not all cases are suitable for minimally invasive techniques, ongoing research continues to expand their applications. As the field evolves, the focus remains on optimizing patient care through innovative surgical methods, reducing the physical and emotional burden associated with urological surgeries.

Preventing acute kidney injury (AKI) is crucial in safeguarding kidney function and improving patient outcomes. AKI can arise from various causes, including dehydration, sepsis, and exposure to nephrotoxic medications. Early identification of at-risk patients—such as those undergoing major surgeries, individuals with pre-existing kidney conditions, or patients on certain medications—is essential for prevention. Implementing strategies such as optimizing hydration before and after procedures, adjusting drug dosages, and monitoring renal function can significantly reduce the incidence of AKI. Additionally, utilizing protocols for early detection, including regular kidney function assessments, aids in identifying AKI at its onset. Educating healthcare providers and patients about risk factors, symptoms, and the importance of adherence to treatment plans further enhances prevention efforts. In high-risk settings, employing nephrology consultation can help guide management strategies tailored to individual patient needs. By fostering a proactive approach to kidney health, healthcare systems can effectively mitigate the risks associated with AKI, ultimately preserving renal function and enhancing overall patient care.

Glomerular diseases encompass a diverse group of conditions affecting the kidney's filtering units, the glomeruli. These diseases can lead to significant kidney damage and are characterized by symptoms such as proteinuria, haematuria, and renal dysfunction. Understanding the underlying mechanisms of glomerular diseases is crucial for effective diagnosis and treatment. Conditions like minimal change disease, focal segmental glomerulosclerosis (FSGS), and glomerulonephritis can result from various etiologist, including autoimmune disorders, infections, or genetic factors. Diagnosis typically involves a combination of clinical evaluation, laboratory tests, and often renal biopsy to ascertain the specific type and cause of the disease. Treatment options vary widely, ranging from corticosteroids and immunosuppressant’s to more advanced therapies like monoclonal antibodies targeting specific pathways. Emerging research focuses on identifying biomarkers for early detection and monitoring of disease progression, aiming to tailor therapies to individual patients. With advancements in understanding glomerular pathophysiology, there is hope for more effective management strategies and improved outcomes for those affected by these complex kidney disorders.

Paediatric nephrology faces unique challenges in diagnosing and managing kidney diseases in children, requiring specialized knowledge and approaches tailored to this population. Kidney diseases in children can differ significantly from those in adults, often presenting with distinct symptoms and underlying causes. Conditions such as congenital anomalies, urinary tract infections, and glomerular diseases demand careful consideration of growth, development, and psychosocial factors in treatment plans. Early diagnosis is critical, as timely intervention can greatly impact long-term outcomes. However, limited availability of paediatric specialists and appropriate diagnostic tools can hinder effective management. Additionally, the rarity of some paediatric kidney disorders poses challenges in research and clinical trials, making it difficult to establish standardized treatment protocols. Parents’ concerns about their child's health and the complexities of chronic disease management add to the emotional burden. Multidisciplinary care teams, including nephrologists, dietitians, and mental health professionals, are essential to address these challenges holistically. By fostering collaboration and ongoing education, paediatric nephrology can continue to improve care for children with kidney disease.

Clinical trials play a vital role in advancing kidney therapy by evaluating the safety and efficacy of new treatments and interventions. These trials help bridge the gap between research and clinical practice, offering patients access to cutting-edge therapies. Kidney-related clinical trials may focus on various areas, including pharmacologic treatments for chronic kidney disease (CKD), novel dialysis techniques, or innovative approaches to transplantation. Rigorous study designs ensure that findings are robust and applicable to diverse patient populations. Patient enrolment is critical for the success of these trials; however, recruitment can be challenging due to factors such as eligibility criteria, patient awareness, and willingness to participate. Additionally, ensuring that trials are conducted ethically and inclusively is essential for generalizing results across different demographic groups. Recent trends show an increase in the use of real-world evidence and digital health technologies in trials, enhancing data collection and patient monitoring. Ultimately, successful clinical trials pave the way for improved kidney therapies, benefiting patients and the broader nephrology community.

Chronic kidney disease (CKD) and diabetes frequently coexist, creating a complex interplay that complicates management and worsens patient outcomes. Diabetes is a leading cause of CKD, as prolonged hyperglycaemia can damage the blood vessels in the kidneys, impairing their filtering ability. Diabetic nephropathy, characterized by proteinuria and declining renal function, often progresses silently, making early detection crucial. Managing this dual burden requires a comprehensive approach that focuses on glycaemic control, blood pressure management, and lifestyle modifications. Medications such as ACE inhibitors or ARBs not only control hypertension but also provide renal protection. Regular monitoring of kidney function, including serum creatinine and urine albumin levels, is essential for assessing progression and adjusting treatment plans. Additionally, education about dietary restrictions, such as sodium and protein intake, plays a vital role in managing both conditions. Integrating care among healthcare providers, including nephrologists and endocrinologists, fosters a multidisciplinary approach that enhances patient outcomes. By prioritizing effective management of diabetes and CKD, healthcare systems can significantly improve the quality of life for affected individuals.

Integrating care for kidney failure is crucial for optimizing outcomes and enhancing the quality of life for patients. As chronic kidney disease progresses to end-stage renal disease (ESRD), individuals often face complex medical and emotional challenges. A coordinated, multidisciplinary approach is essential, involving nephrologists, dietitians, social workers, and primary care providers. This team collaborates to develop comprehensive care plans tailored to each patient's needs, considering factors such as dialysis options, transplantation eligibility, and lifestyle modifications. Effective communication among team members ensures that patients receive consistent information and support, reducing confusion and anxiety. Education about self-management techniques empowers patients to actively participate in their care, fostering adherence to treatment regimens. Telehealth technologies can facilitate ongoing monitoring and communication, particularly for those in remote areas. Furthermore, addressing psychosocial aspects, including mental health support and community resources, is vital for holistic care. By integrating services and prioritizing patient-centred approaches, healthcare systems can improve both clinical outcomes and overall well-being for individuals with kidney failure.

Urology and sexual health are intricately linked, as many urological conditions can significantly impact sexual function and quality of life. Disorders such as erectile dysfunction (ED), benign prostatic hyperplasia (BPH), and prostate cancer often present with sexual health concerns. Urologists play a crucial role in diagnosing and managing these conditions, addressing both physical and psychological aspects. Understanding the underlying causes of sexual dysfunction—ranging from hormonal imbalances to psychological factors—is essential for effective treatment. Patients may hesitate to discuss sexual health issues, so creating a supportive environment encourages open communication. Treatment options vary widely, from medications and lifestyle changes to surgical interventions. Counselling and education about sexual health are integral components of comprehensive care, helping patients navigate the emotional and relational challenges that accompany urological disorders. Moreover, integrating sexual health discussions into routine urological care enhances patient outcomes and satisfaction. As awareness of the connection between urology and sexual health grows, urologists are better positioned to provide holistic care that addresses the needs and concerns of their patients.

Emerging biomarkers in nephrology hold great promise for enhancing the diagnosis, monitoring, and treatment of kidney diseases. Traditional markers like serum creatinine have limitations in early detection and do not fully reflect kidney function or injury. Recent advancements in biomarker research have identified new molecules, such as neutrophil gelatinase-associated (NGAL), interleukin-18 (IL-18), and kidney injury molecule-1 (KIM-1), which offer insights into renal function and damage at earlier stages. These biomarkers can aid in diagnosing acute kidney injury (AKI), chronic kidney disease (CKD), and glomerular diseases more accurately and quickly. Furthermore, research into urinary biomarkers allows for non-invasive assessments, improving patient comfort and compliance. The integration of biomarkers into clinical practice can facilitate personalized treatment approaches, enabling tailored interventions based on individual patient profiles. However, challenges remain in standardizing biomarker tests and ensuring their availability in routine clinical settings. Continued research and collaboration among nephrologists, laboratory scientists, and pharmaceutical companies are essential to fully realize the potential of emerging biomarkers in transforming kidney care

The psychosocial aspects of kidney disease significantly influence patients' health outcomes and quality of life. Living with chronic kidney disease (CKD) or end-stage renal disease (ESRD) presents emotional challenges, including anxiety, depression, and stress related to treatment and lifestyle changes. Patients often face uncertainty about their prognosis and the impact of their condition on daily life, which can exacerbate feelings of isolation and helplessness. Support from healthcare providers, family, and peer support groups is crucial in addressing these emotional burdens. Incorporating mental health assessments into routine nephrology care helps identify patients needing additional support, allowing for timely interventions. Education about the disease, treatment options, and self-management strategies empowers patients, fostering a sense of control and engagement in their care. Furthermore, addressing social determinants of health—such as access to care, financial concerns, and community resources—enhances overall wellbeing. By recognizing and addressing the psychosocial aspects of kidney disease, healthcare providers can promote holistic care, ultimately improving both mental health and clinical outcomes for patients.

Kidney disease is increasingly prevalent in aging populations, posing unique challenges for healthcare providers. The aging process often leads to a natural decline in kidney function, making older adults more susceptible to chronic kidney disease (CKD) and acute kidney injury (AKI). Comorbidities such as diabetes, hypertension, and cardiovascular diseases further complicate management, as these conditions can accelerate kidney decline. Additionally, age-related changes in drug metabolism necessitate careful medication management to avoid toxicity. Early detection of kidney dysfunction through regular screening is crucial, as many older adults may not exhibit classic symptoms. Tailoring treatment approaches to consider the complexities of aging such as frailty, cognitive impairment, and social support is essential for optimizing outcomes. Furthermore, education about kidney health, diet, and lifestyle modifications can empower older adults to take an active role in their care. Support from multidisciplinary teams, including geriatricians, nephrologists, and social workers, can enhance comprehensive care for this population. By addressing the unique needs of aging individuals, healthcare systems can improve kidney health and overall quality of life.

Pharmacotherapy plays a crucial role in the management of kidney diseases, offering targeted interventions to slow progression, alleviate symptoms, and prevent complications. For chronic kidney disease (CKD), medications such as angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) are essential in controlling blood pressure and providing renal protection. Additionally, erythropoiesis-stimulating agents (ESAs) are used to manage anaemia, a common complication of CKD. The management of mineral and bone disorders in CKD often involves phosphate binders and vitamin D analogues to maintain mineral balance. In cases of end-stage renal disease (ESRD), pharmacotherapy extends to managing dialysis-related complications and optimizing transplant outcomes. Emerging therapies, including SGLT2 inhibitors, have shown promise in both diabetic and non-diabetic kidney disease, indicating a shift toward more personalized approaches. However, careful consideration of drug interactions, especially in patients with multiple comorbidities, is essential. Ongoing research into novel pharmacological agents and treatment regimens continues to evolve, with the goal of improving outcomes and quality of life for individuals with kidney disease.

Urological oncology has seen significant advancements in recent years, improving the diagnosis, treatment, and management of urological cancers such as prostate, bladder, and kidney cancer. One notable trend is the increasing use of minimally invasive surgical techniques, including robotic-assisted surgery, which enhances precision and reduces recovery times. These approaches are associated with less postoperative pain and quicker return to daily activities. Furthermore, the development of targeted therapies and immunotherapy has transformed the treatment landscape, particularly for advanced-stage cancers. Agents that specifically target tumour characteristics offer more effective options with potentially fewer side effects than traditional chemotherapy. Additionally, biomarkers are becoming integral in personalizing treatment plans, allowing for tailored therapies based on individual tumour profiles. Advances in imaging technologies, such as MRI and PET scans, facilitate earlier detection and better monitoring of disease progression. Multidisciplinary care teams are becoming more common, ensuring comprehensive management that addresses not only the cancer but also the physical and emotional well-being of patients. As research continues, urological oncology is poised for further innovations that will enhance patient outcomes and quality of life.

Innovative approaches to managing stone disease are enhancing treatment options and improving patient outcomes. Advances in technology and surgical techniques have revolutionized the management of urinary stones, making procedures less invasive and more effective. Extracorporeal shock wave lithotripsy (ESWL) remains a popular non-invasive option, using sound waves to fragment stones for easier passage. However, for larger or complex stones, ureterostomy with laser lithotripsy is increasingly favoured, allowing for direct visualization and removal of stones with minimal recovery time. Recent innovations also include percutaneous which is particularly effective for large renal stones. Emerging technologies, such as flexible ureterostomy and robotic assistance, further enhance precision and success rates. Additionally, a greater understanding of the metabolic factors contributing to stone formation has led to individualized prevention strategies, including dietary modifications and pharmacotherapy aimed at reducing stone recurrence. Education on lifestyle changes, such as increased hydration and dietary adjustments, plays a crucial role in long-term management. As research continues, innovative techniques and a holistic approach will further advance the field of stone disease management.