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Thursday, 28 May 2020 10:50

ISN Welcomes New Chairs for the:

 Kidney Health Professionals Working Group

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Sister Renal Centers Committee

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ISN Advancing Clinical Trials (ACT) Committee

KIDNEY HEALTH PROFESSIONALS WORKING GROUP

Outgoing Chair

Paul Bennett
(Australia)
2018-2020

“Nephrology nurses and allied health professionals are the largest professional nephrology group, and the development of the ISN Kidney Health Professionals Working Group has been an important ISN initiative recognizing this group’s vital role. It has been an honor to serve as the working group’s Chair from 2018 to 2020. The commitment of the working group’s members in these foundation years has produced a momentum that will no doubt be enhanced under the leadership of Michele Trask.”

Incoming Chair

Michele-Anne Trask
(Canada)
2020-2022

“I am excited for the future of the Kidney Health Professionals Working Group. We have an amazing team and I know we are going to make incredible things happen. It is truly an honor to have been elected Chair of this group.”

SISTER RENAL CENTERS COMMITTEE

David Harris, Chair of ISN Programs, offers thanks to Peter Kerr and welcomes Marcelo Orias: 

 

 

“On behalf of the ISN and the ISN Programs Committee, I would like to thank Peter Kerr for his outstanding leadership of, and commitment to, the Sister Renal Center Program over the last three years. With Peter at the helm, the SRC program has gone from strength to strength. We are very grateful for the generous personal time commitment he has made to ensure the success of the SRC program.”
Outgoing Chair
Peter Kerr
(Australia)
2017-2020
“Marcelo Orias will be replacing Peter as Committee Chair, with Chih-Wei Yang, as Deputy Chair. Together with the SRC Committee Members, they will guide implementation and provide advice related to the SRC Program, which is a key component of the overall capacity building effort of the ISN and strives to bring essential teaching and training to doctors and healthcare practitioners in low resource countries. We congratulate them on their appointment and look forward to working with them.”
Incoming Chair
Marcelo Orias
(Argentina)
2020-2022

ISN RESEARCH WORKING GROUP

Adeera Levin, Chair of the ISN Research Working Group, offers thanks to Vlado Perkovic, outgoing Chair of the ISN-ACT Committee and Louise Moist, Outgoing Chair of the ISN-H4KH Initiative, and welcomes Thomas Hiemstra as Incoming Chair of the ISN-ACT Committee:

 

“ISN and the Research Working Group extend heartfelt thanks to Vlado Perkovic. His renowned expertise in clinical trials and leadership role have been critical over the last five years in the setting-up and development of the Committee aimed at facilitating high-quality clinical trials and studies in nephrology. During his leadership, great initiatives such as the Global Focus List and the ISN-ACT Toolkit have emerged. He has made an outstanding contribution in his support of the ISN.”
Outgoing Chair
Vlado Perkovic
(Australia)
2015-2020
“I welcome Thomas Hiemstra as the new Chair of the ISN-ACT Committee, taking over from Vlado Perkovic. Thomas Hiemstra was the Deputy Chair of the ISN-ACT Committee. Based at the University of Cambridge in the United Kingdom, Thomas has co-led the development of the ISN-ACT Toolkit. A clinical trialist, with expertise in trial design, conduct, analysis, and reporting, he co-leads the UK Renal Trials Network (UKRTN). Alongside the ISN-ACT Committee members, he will continue to improve global nephrology community participation in clinical trial research through a series of activities and initiatives.”
Incoming Chair
Thomas Hiemstra
(United Kingdom)
2020-2022

“The ISN thanks Louise Moist as the outgoing chair of the ISN-H4KH (Hydration for Kidney Health) Initiative. Her leadership has been essential in implementing this initiative aimed at stimulating the interest of established and new researchers to explore the role of hydration in kidney health. With the support of the ISN-H4KH Committee members and her precious guidance, all selected ISN-H4KH grant awardees successfully carried out their projects. Her commitment and energy have been greatly appreciated.”
Outgoing Chair
Louise Moist
(Canada)
ISN-H4KH initiative Chair
2015-2020

The ISN Global Kidney Care Podcast (GKCP) , to be launched this month, will initially focus on the COVID-19 pandemic.

Over time, the GKCP will provide content on science, research, and clinical aspects of nephrology, including:

  • Case-Based Discussions
  • Paradox Nephrology
  • Everyday Nephrologists
  • Latest Kidney International and Kidney International Reports Papers

The GKCP will be available via numerous podcast platforms and apps, including Apple, Stitcher, Spotify, and Google Podcast. All episodes will be free and open access.

Listen to ISN Podcast

On May 17th 2020, the ISN was proud to attend the 73rd World Health Organization General Assembly as the global leading society representing nephrology and renal healthcare. Due to the current COVID-19 pandemic, the Health Assembly is taking place as a de minimis meeting,

At the Assembly, ISN joined discussions on the adoption of the COVID-19 Resolution. As part of our dedicated advocacy campaign to advance kidney health worldwide, ISN participation is crucial in calling for a timely treatment of acute and chronic kidney disease: due to the current pandemic, renal patients are likely to face interruption or unavailability of life-saving treatments such as dialysis and transplant.

To download our statement, please click here.

Has someone you know made a true difference to kidney care or research? Are they especially dedicated to the patient cause in their country or region? Show your appreciation by nominating them for an ISN award.

As an ISN member, you can nominate candidates for the following awards:

Award winners will be recognized at The ISN World Congress of Nephrology 2021 taking place from April 15-18 in Montreal, Canada. ISN Pioneer Awards are handed out during regional events throughout the year.

Nominations are open until August 27, 2020.

  • Review the links above for each award’s nomination requirements
  • Send all nominations, supporting materials, and questions to the Awards Coordinator
  • Candidates do not need to be ISN members
  • You must be an ISN member to nominate a colleague. If you are not yet a member, learn about our membership packages and join the ISN community today!

We look forward to receiving your nominations!

The majority of patients with kidney disease in low- and middle-income countries (LMICs) are thought to present to sub-tertiary hospitals. Therefore, the capacity of these healthcare facilities to manage kidney disease is an important consideration.

Young ISN Member, Dr. Grace Igiraneza (Rwanda), who undertook an ISN Fellowship at Yale University, recently investigated the capacity of sub-tertiary hospitals to manage kidney disease in Rwanda. Her research findings, published in Kidney International Reports, can be read here.

Two other Young ISN Members, Dr. Rhys Evans (United Kingdom), ISN Young Nephrologist Committee Member, and Dr. Chimota Phiri (Malawi), ISN African Regional Board Member, comment on the importance of this work in this associated article.

Dr. Igiraneza outlines the key findings from her research in response to the questions below:

Why did you undertake this research?

While pursuing my nephrology fellowship, the more I learned about the complexity of kidney diseases and the economic burden related to its management or lack thereof, I realized how quality kidney care is an important health need especially in developing countries that are already struggling with limited resources.

 Acute kidney injury, if diagnosed and treated on time, can be reversed. As a nephrologist working in LMIC, I like to think that if we focus on optimizing the prevention and management of AKI, we will save many lives despite limited resources. There are international and national guidelines to diagnose and treat AKI, but are hospitals in LMIC equipped to follow those guidelines?

 Therefore, my study tried to address important questions such as: “What is the existing capacity for and what challenges do health facilities and providers face in managing AKI patients?” These questions inspired me to undertake the study to understand the current state of AKI care in sub-tertiary hospitals

What did you do?

The study was designed to assess ten sub-tertiary hospitals across the country, including at least 2 hospitals in each of the 4 provinces of the country. Using a pre-designed checklist, partly inspired by KDIGO AKI guidelines, we evaluated the capacity of the hospitals to provide accurate and appropriate diagnosis and management of AKI. Simultaneously, we conducted a knowledge assessment survey on AKI prevention, diagnosis, and treatment of providers using clinical vignettes.

What did you find?

The findings show that sub-tertiary hospitals have limited capacity in terms of diagnosis and treatment of AKI, especially in dialytic treatment. The providers at these facilities demonstrated substantial knowledge gaps in both the recognition and management of AKI.

How do you hope the findings of your work will impact kidney care in Rwanda and other LMICs in the region?

Understanding the challenges and gaps in health systems in LMIC is key in guiding interventions needed to improve kidney care. The study highlighted the urgent need to train healthcare providers. This is likely to be the next project for the Rwanda Renal Society and other stakeholders.

When a country identifies an urgent need, it is up to them to determine how best to address it and how quickly to do so. The findings of this study can guide policymakers and nephrologists in LMICs to develop sustainable and achievable strategies to improve AKI care at a sub-tertiary level.

How did your ISN Fellowship facilitate this work?

The ISN offered me the opportunity to train at Yale University, a renowned and outstanding training program. Training under dedicated and knowledgeable mentors has not only allowed me to learn clinical nephrology but also to look at kidney care from a global health standpoint and appreciate the disparities in health care access. The initial one-year training program was extended to 18 months which allowed me to incorporate research into my training. I am grateful to the ISN for believing and investing in me!

Join an informational webinar presented by ISN President, Vivek Jha on the ELP program on May 20:

Webinar May 20 at 5 pm CEST Register here.

Find out more about the ISN Emerging Leaders Program and apply here.

The application session is open until June 15, 2020.

The ISN welcomes early-career professionals interested in shaping the direction of kidney health to work alongside a network of international healthcare experts to develop leadership skills.


The ISN Emerging Leaders Programs (ELP) is supported by unrestricted educational grants by Janssen, The Boehringer Ingelheim and Lilly Alliance.

The call for nominations to receive ISN Awards in 2021 is open until August 27, 2020.

All ISN Members can nominate candidates for:

Discover more on ISN Awards and the requirements for nominations HERE.

Award winners will be recognized at The ISN World Congress of Nephrology 2021 taking place from April 15-18 in Montreal, Canada. ISN Pioneer Awards are handed out during regional events throughout the year.

Support and honor your peers: Send your nominations, supporting materials, and questions to the ISN Awards Coordinator.

As part of the ISN-TTS Sister Transplant Centers and the Continuing Medical Education (CME) Programs, the ISN supported the 1st Primer on Pediatric Renal Transplant and Immunology Workshop alongside the International Society of Pediatric Nephrology (IPNA).

The workshop was held from March 5-7, 2020 at the Christian Medical College and Hospital (CMCH) in Vellore, India.

This three-day meeting, the first of its kind, focused on:

  • transplants in special situations,
  • ABO-incompatible and paired donor transplants,
  • surgical techniques and perioperative care,
  • post-transplant immunosuppression and infection management,
  • ethical issues in renal transplant and donor selection and long term outcomes in donors.

A total of 120 delegates attended the course, including residents, Fellows, and practicing pediatric and adult nephrologists from remote parts of India, as well as from Sri Lanka and Nepal. In addition to faculty from India, teaching was provided by international faculty from the US and Australia.

Due to the travel restrictions imposed as a result of the COVID-19 pandemic, ISN sponsored speaker Dr. Basu Gopal, a transplant nephrologist at the Alfred Hospital and Associate Professor at the Monash University in Melbourne Australia, recorded his talk for broadcast at the course and answered questions via video conference.

One of the highlights of the course was a session on deceased donor transplant: a talk on its status in India, as a model for the developing world, was delivered by Dr. Georgi Abraham, Chief of Nephrology at the Madras Medical Mission hospital.

A teaching coursebook was released by Dr. V. Tamilarasi, former Head of the Nephrology Department at CMCH. The Tamil Nadu Dr. MGR Medical University awarded 30 CME credit points for the program.

                                               

The ISN is pleased to support innovative events through a range of programs that promote kidney care in emerging regions.

By Rachael C Walker, Ph.D., NP, MN, RN

Eastern Institute of Technology, Hawke’s Bay, New Zealand. Member of the ISN Kidney Health Professionals Working Group

For a variety of reasons, many countries are unable to accommodate those with end-stage kidney disease on hemodialysis in hospitals or in-centre dialysis units.1 Home dialysis offers an alternative to this with several advantages to both patients and the health systems, particularly regarding access to treatment and extended-hour dialysis.2-7 However, countries that have active home dialysis programs have noted that the uptake of home dialysis is often lower in Indigenous, ethnic minority, and more socio-economically disadvantaged groups.8,9,10 This is despite home dialysis being acknowledged as a kidney replacement therapy option that helps to maintain a sense of individual and cultural identity and involvement.11

In New Zealand, a country with high rates of home dialysis, the first community hemodialysis houses were set up to support patients from both urban and remote areas whose housing and/or utilities were barriers to home hemodialysis.12 Community house hemodialysis is a sub-modality of home hemodialysis that enables patients to perform hemodialysis independent of nursing or medical supervision in a shared house somewhere within their local community.

When researching patients who have chosen to use community house hemodialysis, we found that this alternative treatment option often better aligns with the treatment preferences of a group of patients who otherwise may not utilize home hemodialysis.13 In this study, this sub-modality was more acceptable for Indigenous and minority groups, who typically have lower uptake of home dialysis. The community houses supported patients to achieve hemodialysis best practice by providing them with the ability to extend their treatment hours as they could access the houses when it suited them and provided them with a safe and comfortable environment to do so. The community houses also provided many other benefits over both home and facility dialysis, including reduced burden on family, flexibility, and freedom (particularly in respect to the ability to maintain employment); this sub-modality also encouraged personal health, sense of community, and peer support.

For countries who want to promote the use of home dialysis and encourage equitable access to home dialysis, community house hemodialysis should be explored. This sub-modality may also support extended-hour hemodialysis and therefore be more ideal for some subgroups such as younger patients or those awaiting transplantation.

Benefits of Community House Hemodialysis:

 Benefits of Community House Hemodialysis

References:

  1. Liyanage T, Ninomiya T, Jha V. Worldwide access to treatment for end-stage kidney disease: a systematic review. Lancet. 2015;385:1975–1982.
  2. Marshall MR, Hawley CM, Kerr PG, Polkinghorne KR, Marshall RJ, Agar JW, et al. Home hemodialysis and mortality risk in Australian and New Zealand populations. Am J Kidney Dis. 2011;58(5):782-93.
  3. Kooistra MP, Vos J, Koomans HA, Vos PF. Daily home haemodialysis in The Netherlands: effects on metabolic control, haemodynamics, and quality of life. Nephrol Dial Transplant. 1998;13(11):2853-60.
  4. McFarlane PA, Pierratos A, Bayoumi AM, Redelmeier DA. Estimating preference scores in conventional and home nocturnal hemodialysis patients. Clin J Am Soc Nephrol. 2007;2(3):477-83.
  5. Vos PF, Zilch O, Jennekens-Schinkel A, Salden M, Nuyen J, Kooistra M MP, et al. Effect of short daily home haemodialysis on quality of life, cognitive functioning and the electroencephalogram. Nephrol Dial Transplant. 2006;21(9):2529-35.
  6. Wyld M, Morton RL, Hayen A, Howard K, Webster AC. A systematic review and meta-analysis of utility-based quality of life in chronic kidney disease treatments. PLoS Med. 2012;9(9):e1001307.
  7. Johansen KL, Zhang R, Huang Y, Chen SC, Blagg CR, Goldfarb-Rumyantzev AS, et al. Survival and hospitalization among patients using nocturnal and short daily compared to conventional hemodialysis: a USRDS study. Kidney Int. 2009;76(9):984-90.
  8. New Zealand National Renal Advisory Board. New Zealand Nephrology Activity Report 2016. Publisher Ministry of Health, Wellington, New Zealand. 2018.
  9. McKercher C, Jose MD, Grace B, Clayton PA, Walter M. Gender differences in the dialysis treatment of Indigenous and non‐Indigenous Australians. Australian and New Zealand Journal of Public Health. 2017;41(1):15-20.
  10. Mehrotra R, Soohoo M, Rivara MB, Himmelfarb J, Cheung AK, Arah OA, et al. Racial and Ethnic Disparities in Use of and Outcomes with Home Dialysis in the United States. J Am Soc Nephrol. 2016;27(7):2123-34.
  11. Walker RC, Howard K, Morton RL, Palmer SC, Marshall MR, Tong A. Patient and caregiver values, beliefs and experiences when considering home dialysis as a treatment option: a semi-structured interview study. Nephrol Dial Transplant. 2016;31(1):133-41.
  12. Marshall MR, Supershad S. Health Related Quality of Life (HRQoL) in Community House Hemodialysis (CHHD) versus Home Hemodialysis (Home HD). J Am Soc Nephrol. 2013;24 (Suppl):4 41A.
  13. Walker RC, Tipene-Leach D, Graham A, Palmer SC. Patients’ Experiences of Community House Hemodialysis: A Qualitative Study. Kidney Med. 2019;1(6):338-346.

Over 5,000 people worldwide have already visited ISN's recently launched, open-access, online resource to assist you in trial design, study conduct, data management, data analysis, and publication.

More than ever, clinical trials in nephrology are needed to generate high-quality evidence to inform all aspects of care for patients with or at risk of kidney disease, including with COVID-19.

Access the ISN-ACT Toolkit to help carry out meaningful and robust clinical trials, or to become involved as a trial site.

Find key results from your region through scorecards.

Available here

Share the results from your region via social media or other media and press channels to support discussions on and advocate for kidney health care.

In collaboration with the World Health Organization (WHO), the ISN i3C (International Consortium CKDu Collaborators) group has developed the ISN Observatory of CKDu to facilitate the exchange of information and knowledge to raise awareness of the urgent issue of Chronic Kidney Disease of unknown etiology.

The input of experts in the field of CKDu provides both the ISN and the WHO with an understanding of the global burden of kidney disease, addressing kidney disease in the context of global, regional, and national NCD (Noncommunicable disease) strategies.

Access the ISN Observatory of CKDu and share your data on CKDu.

Dear colleagues,

On behalf of the ISN membership, it is my very great pleasure to announce this year’s recipients of the Jean Hamburger Award, the Bywaters Award, and the Lillian Jean Kaplan International Prize for Advancement in the Understanding of Polycystic Kidney Disease. The winners have made outstanding contributions to nephrology and patient care as scientists, educators, clinicians, and leaders, and we extend our gratitude and appreciation for their efforts.

Nominated by the ISN membership and selected by the ISN Awards Committee and Lillian Jean Kaplan Prize Advisory Committee, the 2020 winners are proudly honoured for their commitment to nephrology. They will be officially presented with their awards at WCN’21 in Montreal, QC, Canada in April 2021.

JEAN HAMBURGER AWARD

The Jean Hamburger Award recognizes outstanding research in nephrology with a clinical emphasis. This year’s winner is Prof. William Couser.

This award is the greatest honor of my professional career and highlights the exceptional work done by the many fellows from nine countries who worked with me over the years to better understand and treat immunologic renal diseases."
    Dr. Couser is Affiliate Professor of Medicine at the University of Washington in Seattle, Washington, USA. He is a past president of both the American Society of Nephrology (ASN) and the International Society of Nephrology (ISN) and served on the Executive Committee of the ISN from 2001-2013 as Head of its Global Outreach Programs and as Chairperson of the World Kidney Day Steering Committee. He also served as Editor-in-Chief of the Journal of the American Society of Nephrology (JASN).

He is a recipient of the David Hume Award from the US National Kidney Foundation, the Joel Kopple Award from the International Federation of Kidney Foundations, and the John Peters Award from the ASN.

Dr. Couser’s area of expertise is pathogenic mechanisms and clinical management of glomerulonephritis (GN). His research showed that most forms of GN were autoimmune and resulted from in situ formation of immune complexes involving self-antigens rather than circulating immune complex trapping involving foreign antigens, and that the complement membrane attack complex (C5b-9) was a critical mediator in several forms of GN and interstitial diseases. He has lectured in over 60 countries and published over 360 papers including multiple reviews, editorials, and book chapters on these topics.

 

BYWATERS AWARD

The Bywaters Award is a life-time achievement award recognizing outstanding contributions to the understanding of Acute Kidney Injury. This year’s winner is Prof. Karl Nath.

This is the greatest honor I have ever been privileged to receive in my entire career! Eric Bywaters has been a tremendous inspiration to me in multitudinous ways throughout my career, and to be the recipient of this award is a dream come true!"
    Dr. Nath was born and raised in Trinidad, West Indies. He attended the University of Edinburgh, Scotland, where he was the most distinguished graduate in medical school (1978). He completed training in Internal Medicine (1982) and Nephrology (1985) at the University of Minnesota (MN), Minneapolis, MN, USA. He has served at Mayo Clinic, Rochester, MN, USA since 1996 where he is a Professor of Medicine, Consultant in Nephrology, and the Robert Joseph Patnode Professor in Nephrology (appointed 2018).

Dr. Nath is the recipient of an NIH Merit Award for his research on heme oxygenase and the nephrotoxicity of heme proteins, and has been NIH-research funded continuously since 1988. He is the recipient of the Karis Award for outstanding patient care, Mayo Clinic (2005); the Distinguished Alumnus Career Achievement Award, University of Minnesota (2006); the Research Career Achievement Award, Department of Medicine, Mayo Clinic (2016); and Mayo Clinic’s Distinguished Investigator Award (2016).

Dr. Nath served as the Program Director of the Clinician Investigator Training Program, Mayo Clinic (1998-2018). He is the Editor-in-Chief of Mayo Clinic Proceedings, prior to which Dr. Nath served as Editor-in-Chief of Journal of the American Society of Nephrology (JASN).

 

LILLIAN JEAN KAPLAN INTERNATIONAL PRIZE

The Lillian Jean Kaplan International Prize recognizes individuals for excellence and leadership in Polycystic Kidney Disease (PKD) clinical or basic research whose seminal scientific work has advanced knowledge and treatment of PKD. This year’s winner is Prof. Arlene Chapman.

The Lillian Jean Kaplan Prize is the most prestigious award for a clinician or clinician scientist working in the area of autosomal dominant polycystic kidney disease. This is a beautiful honor and the most cherished of my career. The encouragement this recognition gives extends beyond expectations and gives further support to find a cure for this life threatening disorder. I am humbled and extremely appreciative."
    Dr. Chapman is the Chief Section of Nephrology at the University of Chicago and a physician scientist who has worked in the field of autosomal dominant polycystic kidney disease (ADPKD) for over 30 years.

With continuous NIH funding for over 20 years, she has led the PKD Foundation as Chair of the Scientific Advisory Committee, creating new funding mechanisms for fellowships and establishing the FASEB research conference in PKD, now in its 15th year.

She established the role of the renin-angiotensin-aldosterone system in hypertension and the increased incidence of asymptomatic intracranial aneurysms (5.5%) in ADPKD. She led efforts to develop an FDA-approved prognostic imaging biomarker (MR-based total kidney volume) in the CRISP study. TKV measurement of cyst burden has led to new treatments including rigorous blood pressure control (the HALT PKD trial) and vasopressin V2 antagonist therapy (the TEMPO trials) where inhibition of the vasopressin V2 receptor slows disease progression.

Her efforts have resulted in worldwide approval for the first disease modifying therapy for ADPKD.

 

Vivekanand Jha

 ISN President

As part of its Collaboration Plan with the World Health Organization (WHO), the ISN i3C (International Consortium CKDu Collaborators) group has developed a CKDu Observatory Map to facilitate the exchange of information and knowledge in order to raise awareness of the urgent issue of Chronic Kidney Disease of unknown etiology.

Be the first to access the Observatory Map as well as additional comprehensive information on CKDu from May 7, 2020.

The ISN and the International Pediatric Nephrology Association (IPNA) have agreed to extend and formalize their existing partnership to include collaboration on a number of ISN programs and activities, demonstrating a mutual commitment to the global advancement of pediatric nephrology.

This partnership seeks to increase and strengthen the links between both societies through the ISN-IPNA Fellowships and the ISN’s Sister Renal Centers (SRC) Program. The next application deadline for the Fellowship and the Sister Renal Centers Program is October 1.

Pediatric representation on the ISN Regional Boards will help ensure that pediatric nephrology-specific issues can be shared with ISN leadership so that the ISN-IPNA collaboration is able to enhance kidney care for children around the globe.

Through this collaboration, all IPNA members will now receive full access to ISN’s Academy portal to explore over 8000 hours of educational with selected content in 7 languages.

In addition, both organizations will jointly organize up to 3 webinars per year and develop new e-learning materials to expand and improve the quality and quantity of online educational content available on pediatric nephrology.

ISN President, Vivek Jha explains: “Both ISN and IPNA are committed to building the capacity of healthcare professionals. Ultimately, this is to improve patient care – especially in areas where care is needed most through education and training.

Bradley Warady, IPNA Treasurer, comments “It is very rewarding to see something so positive for the nephrology community arise in the setting of the pandemic and all of the associated unfortunate outcomes.”

Applications to the ISN Emerging Leaders Program are now open, apply here. The application session is open until June 15, 2020.

The ISN welcomes early-career professionals interested in shaping the direction of kidney health to work alongside a network of international healthcare experts to develop leadership skills.

Find out more about the ISN ELP Program here.

A webinar will be broadcast on May 18 and 20 to provide more information on the program including scope, opportunities, eligibility criteria, applications, and program timeline.

Please choose the time and date that is most convenient and register before the webinar:

Webinar May 18 at 11 am CEST

Webinar May 20 at 5 pm CEST

 Register now
 Register now

 

ISN President, Vivek Jha (India), will be the main presenter and moderator. Members of the ELP Steering Committee, including Rumeyza Kazancioglu (Turkey), Adrian Liew (Singapore), and Saraladevi Naicker (South Africa), will be present to guide you through the program and answer questions.

Contact Marie-Pierre Smal at mpsmal@theisn.org for more information.

The ISN-TTS STC Program was launched in 2013 as a joint initiative between the ISN and the Transplantation Society (TTS) to develop transplantation services in low and middle-income (LMIC) countries either by pairing an experienced center to help build on an existing low-level transplant program; or by assisting an established regional nephrology service to develop a renal transplant program.

The STC Program has proved to be extremely popular and successful, growing substantially to include centers that continue to progress to successive levels of the program.

Here are just two examples of the significant impact the program has had on centers:

Emerging Institution: the Foundation for Children with Kidney Diseases in Guatemala (FUNDANIER)

Supporting Institution: the University of California in Los Angeles (UCLA)

In 2013, a sister center partnership was established between the University of California in Los Angeles (UCLA) and the Foundation for Children with Kidney Diseases in Guatemala (FUNDANIER). The ultimate goal of this collaboration is to establish a deceased donor program in Guatemala.

A general pathologist received training in nephropathology at UCLA to gain the skills required to set up a local nephropathology laboratory at the National University of Guatemala.

A team from UCLA was invited to train local surgeons in laparoscopic donor nephrectomy. Local professionals were also trained in human leukocyte antigen (HLA) typing and cross-matching. UCLA donated a Luminex system to the FUNDANIER center.

A local physician was trained as a transplant coordinator to head the national committee of donations at the Roosevelt Hospital in Guatemala. The aim is to set up a transitional clinic to decrease the number of renal transplant rejections.

FUNDANIER is ensuring that all programs in the country adhere to the Declaration of Istanbul.

Dr. Randall Lou Meda, a pediatric nephrologist from Fundanier, praised the support from TTS and ISN, stating that this type of collaboration “is key in the developing world” and can “change the shape of the world and the lives of many people.” He confirms that, having graduated, the next step is to share the experience gained from the relationship with UCLA by providing training to other centers in the region.

Watch the video here.

Emerging Institution: Al-Shifa Hospital, Gaza

Supporting Institution: Royal Liverpool University Hospital (RLUH)

Since 2013, a collaboration sponsored by the ISN-TTS Sister Transplant Centers Program has been established between a team from the Royal Liverpool University Hospital in the UK and the Al-Shifa Hospital in Gaza permitting the transfer of skills, technology, and education.

El Shifa is the largest hospital in Gaza and treats over half of the region's 500 kidney failure patients. According to staff from RLUH, many patients there are in desperate need of transplants but because doctors are unable to leave the region, they cannot access the training they need to carry out transplant operations. During the 2008 war, half of all patients in need of dialysis died because they were unable to reach a hospital in time.

In 2013, the Royal Liverpool hospital traveled to the Gaza strip to complete the first-ever kidney transplant in the region. They faced a specific set of challenges including a lack of equipment, simple medication, and the constant threat of war.

51 kidney transplants have since been carried out in Gaza, with a 94 percent one-year graft survival rate. The team also set up the first tissue-typing lab in the region and provided crucial transplantation equipment such as a plasma exchange machine and specialist theatre equipment.

This pairing has helped educate local healthcare professionals toward the goal of establishing a transplant center in Gaza so that kidney transplantation can become a regular activity in the region, giving every patient with kidney failure the chance of a normal life.

Watch the video here.

Prof Paul N Bennett (Australia), Prof Marie Richards (UAE), Michele Trask (Canada), A/Prof Rachael C Walker (NZ), Stefaan Claus (Belgium), Henriette Nygard (Norway), A/Prof Reena George (India), Dr. Ying Xu (China), Prof Ana Figueiredo (Brazil), Constance Monote (Senegal), Nashon Kagwe (Tanzania), Reena Moodley (South Africa) and Jo-Ann Donner (Canada).

2020: The Year of the Nurse and the Midwife

 In 2020, the world has witnessed unprecedented chronic disease rates, the COVID-19 outbreak, and mass population displacement caused by conflicts. Nurses provide vital care in each of these circumstances with the world needing them working and optimizing their education and training.

The first State of the World’s Nursing Report from the WHO and its partners celebrates the nursing workforce.1 Nurses from the International Society of Nephrology Kidney Health Professionals Working Group (ISN KHPWG) join this celebration by presenting an overview of the global nephrology nursing workforce and identifying global issues in nephrology nursing care to mark the Year of the Nurse and Midwife.

 

Global Kidney Disease

Kidney disease affects over 850 million people throughout2 the world signifying its status as a global public health priority. An estimated 1.7 million people die annually from acute kidney injury (AKI) and over 2 million people die from chronic kidney disease (CKD) because of limited access to kidney disease care and renal replacement therapies. These mortality data highlight inequities in kidney disease prevention and kidney care globally, driven by social determinants of health and political factors.3

 

Nephrology Nursing Practice

Globally, nephrology nurses are the largest professional group responsible for the provision of care for AKI, CKD, and advanced kidney disease, known as end-stage kidney disease (ESKD). Nephrology nursing scope of practice is responsible for kidney care across the continuum, ranging from disease prevention, treatment, dialysis, supportive therapy, kidney transplant care, and palliative care. Patients with kidney disease have complex needs and many comorbidities, therefore in many parts of the world, the nurse’s role is broad including nutrition, social work, vascular access, primary care, family support, infection control, safety and quality, technical and water treatment expertise. The responsibilities for nephrology nurses can range from health promotion and prevention on a larger scale, to independently running dialysis centers without on-site medical support.

Expanded autonomous roles for nurses in nephrology, such as patient and nurse education, transplant coordinator, home peritoneal dialysis and home hemodialysis, dialysis access (including catheter placement), anemia management, pre-dialysis or CKD care and the advanced role of Nurse Practitioner reflect the very high expertise and varied roles of nephrology nurses. Furthermore, nurses play a major role in early screening and kidney prevention, ensuring strict control of blood sugars and blood pressure to prevent or limit chronic kidney damage.

 

Nephrology Nursing Workforce Challenges

Nephrology nurse shortages are present in over 80% of low-income countries (LICs) and over 60% of lower-middle-income countries (LMICs).4 The involvement of nephrology nurses worldwide is, however, vital to provide equitable kidney care for all. Nephrology nurses in many parts of the world that lack access to kidney specialists can provide care through standard algorithms and advanced practice that can increase prevention and treatment capacity, which positively impacts the public health burden posed by kidney disease. Nurse practitioner care improves renal outcomes in patients with chronic kidney disease (CKD).5-7

Unfortunately, nephrology nurses are frequently undervalued, underpaid, and poorly resourced. Challenges in nephrology nursing include a lack of specialized education, professional recognition, attractive career paths, and education in quality improvement, research, and leadership, particularly in low- and middle-income countries.

 

What can be done

  1. PRIMARY HEALTHCARE AND PEOPLE-CENTERED CARE
    • Strive for health systems that deliver people-centered, integrated, multisectoral, and comprehensive primary healthcare services aimed at prevention, early detection, and treatment of NCDs and their risk factors
  2. WORKFORCE POLICY AND PRACTICE
    • Enhance and recognize nephrology nursing’s role in the early detection and management of AKI and CKD by investing in resources to build an integrated nursing workforce development1,8
    • Recognize that registered nurses must be major participants in the decision-making, planning, delivery, and evaluation of care9
  3. EDUCATION AND CAREER DEVELOPMENT
    • Training for nurses in symptom assessment, communication skills, advanced care planning, supportive care, and the use of prognostic models needs to be developed. Of particular importance is additional training of those caring for children and young people in LMICs, where ESKD care options are limited10
    • Prepare specific skill sets/resource hub for the delivery of both hemodialysis and peritoneal dialysis utilizing inter alia nurses10
  4. WORKFORCE MANAGEMENT
    • Undertake efforts to resolve the nursing shortage, including measures to assure appropriate funding to address the shortage of nursing faculty and the availability of nursing mentors for new graduates and nurses with limited practice experience9
  5. PARTNERSHIPS
    • Strengthen collaboration between doctors, the nursing sector, patients, healthcare authorities and all stakeholders involved to increase understanding of what is locally feasible to reduce the burden and consequences of kidney disease and improve kidney care11

Nephrology nurses are well placed to deliver integrated care for diseases that are common among patients with kidney disease including hypertension, diabetes, cardiovascular disease, and multiple infectious diseases and therefore can be key individuals engaged in leading the delivery of complex, high-quality holistic care.

References

  1. World Health Organization. State of the world's nursing 2020: investing in education, jobs and leadership. Geneva: World Health Organisation;2020.
  2. Jager KJ, Kovesdy C, Langham R, et al. A single number for advocacy and communication – worldwide more than 850 milliion individuals have kidney diseases. Kidney Int. 2019;96(5):1048-1050.
  3. Bello A, Levin A, Lunney M, et al. Global Kidney Health Atlas: A report by the International Society of Nephrology on the Global Burden of End-stage Kidney Disease and Capacity for Kidney Replacement Therapy and Conservative Care across World Countries and Regions. Brussels, Belgium2019.
  4. Bennett PN, Walker RC, Trask M, et al. The International Society of Nephrology Nurse Working Group: Engaging Nephrology Nurses Globally. Kidney Int Rep. 2019;4(1):3-7.
  5. Gaietto KJ, Brooks MV. The Shortage of Expert Nephrology Nurses in Hemodialysis: A Literature Review. Nephrol Nurs J. 2019;46(6):577-585.
  6. Peeters MJ, van Zuilen AD, van den Brand JA, et al. Nurse practitioner care improves renal outcome in patients with CKD. J Am Soc Nephrol. 2014;25(2):390-398.
  7. Walker RC, Marshall MR, Polaschek NR. A prospective clinical trial of specialist renal nursing in the primary care setting to prevent progression of chronic kidney: a quality improvement report. BMC Fam Pract. 2014;15:155.
  8. Berns JS, Saffer TL, Lin E. Addressing Financial Disincentives to Improve CKD Care. J Am Soc Nephrol. 2018;29(11):2610-2612.
  9. American Nephrology Nurses Association. American Nephrology Nurses Association 2020 HEALTH POLICY STATEMENT. 2020; https://www.annanurse.org/download/reference/health/position/healthPolicyStatement.pdf. Accessed 24th April 2020.
  10. Harris DCH, Davies SJ, Finkelstein FO, et al. Increasing access to integrated ESKD care as part of universal health coverage. Kidney International. 2019;95(4): S1-S33.
  11. Yousif KI, Abu-Aisha H, Abboud OI. The effect of an educational program for vascular access care on nurses' knowledge at dialysis centers in Khartoum State, Sudan. Saudi J Kidney Dis Transpl. 2017;28(5):1027-1033.

World Kidney Day (WKD) has released its Impact Report from the WKD 2020 Campaign which highlighted the importance of lifestyle interventions to prevent kidney diseases.

On March 12, 2020, over 1200 WKD activities in almost 100 countries raised awareness of accessible approaches toward kidney health.

Diverse regional activities marking WKD around the world are showcased in additional in-depth reports provided by individual countries demonstrating the dedication and innovation of participants as well as the tangible impact they make by raising awareness of kidney health in the media and within local communities.

In 2018, Sandra Wagner (France), Angie Aguilar-Gonzalez (Guatemala), and Amarasiri de Silva (Sri Lanka/USA) received ISN-H4KH (Hydration for Kidney Health) Grants for their respective projects.

All three recipients had their abstracts accepted for presentation at WCN’20 and, consequently, published in Kidney International Reports.

Sandra Wagner et al. investigated the association between Uosm and eGFR decline; and the risk for end-stage kidney disease (ESKD) in patients with moderate or advanced CKD.

SAT-095 Urine Osmolarity And Chronic Kidney Disease Progression In The Ckd-Rein Cohort, Wagner, S. et al., Kidney International Reports, Volume 5, Issue 3, S43

Angie Aguilar-Gonzalez et al. evaluated the fluid intake in healthy Guatemalan children and adolescents; considering volumes and types of fluid and timing of consumption in an area of high prevalence of kidney disease of unknown cause.

SAT-125 Hydration Patterns In Guatemalan Children And Adolescents In An Area With High Prevalence Of Chronic Kidney Disease Of Unknown Cause, AGUILAR, A. et al., Kidney International Reports, Volume 5, Issue 3, S53 - S54

Amarasiri de Silva examined whether the prevalence and progression of CKDu in patients were reduced as a result of introducing reverse osmosis (RO) water as an alternative form of drinking water and how affected people in the region perceived the changes brought about by the new source of drinking water.

SUN-133 The Effects On Patients With Chronic Kidney Disease Of Unknown Etiology In Sri Lanka Of The Use Of Purified And Reverse Osmosis Water For Drinking, DE SILVA, A., Kidney International Reports, Volume 5, Issue 3, S256 - S257

The Hydration for Kidney Health (H4KH) Research Initiative was supported by Danone Nutricia Research.

Young ISN members have been at the forefront of the global fight against COVID-19. In this article, Marina Wainstein, Rolando Claure-Del Granado, and Chimota Phiri share their experience of managing COVID-19 patients in Australia, Bolivia, and Malawi respectively highlighting the challenges young nephrologists face.

Brisbane, Australia (Marina Wainstein)

As for most people around the world, I think few of us here could imagine the impact this outbreak would have, not just on our health system, but on the daily rhythm and comforts of our lives. Australia has, thus far, been spared from the large-scale infection and death rates seen in other places around the world. Nevertheless, we continue to be in a state of partial lockdown and our health structures and operations are only just contemplating a return to the traditional models of care. In our hospital, wards were geographically re-structured to minimize staff traffic and to accommodate a burden of COVID-infected patients that has yet to come. Our outpatient clinics changed almost completely to phone consultations, forcing us to audit and triage our lists to select only the very few that required in-person attention. I found this especially difficult working with a predominantly home dialysis and transition group of patients for whom close follow-up, planning, training, and importantly, reassurance and support are key. Despite these challenges, I have been overwhelmed by our patients’ gratitude and empathy and the dedication and steadfastness of our staff. As a pregnant clinician through these times, I have felt the protection and concern of my colleagues for my well-being and the enormous solidarity that exists among our medical community.

Cochabamba, Bolivia (Rolando Claure-Del Granado)

I think one of the most important aspects of the COVID-19 pandemic has been the psychological impact on nephrologists and other healthcare workers due to lack of organization and clear directives from health care authorities in terms of outpatient dialysis operations, the organization of a referral center for COVID-19 positive patients, the lack of PPE, and false information (unreliable sources from social media). All of these issues have caused them to feel anxious and distressed. The workload has dramatically increased especially for young nephrologists and fellows, and some of them have started to show early signs of burnout. This is partly because the Bolivian Minister of Health has withdrawn personnel over 60 years old from hospitals and health care centers if they have chronic diseases such as diabetes and hypertension, and any pregnant personnel. This has had a significant impact on the physicians and other health care workers who remain working at hospitals and health care centers in Bolivia.

We have to take practical steps to prepare our nephrologists, fellows, and nurses to give the best care possible for patients with kidney disease during the COVID-19 pandemic and to prevent transmission by giving them online lectures on COVID-19 and kidney disease, create infographics in Spanish of different practical issues like how to educate patients, and how to organize hemodialysis units.

Fortunately, so far we haven’t had any COVID-19 positive patients with ESKD on chronic dialysis; I think this could be explained in part by education campaigns - launched for patients and their families, social distancing, and the early lockdown established by the national government just 2 weeks after the first 2 cases of COVID-19 were reported.

Blantyre, Malawi (Chimota Phiri)

Malawi has not been spared from the COVID-19 pandemic. So far we have recorded 33 confirmed cases with 3 deaths, but the actual number of infections may be underestimated as testing is not happening on a large scale. As a response to COVID-19, most of the clinics have been scaled down including general nephrology and hypertension clinics but patients on immunosuppression will be seen as per schedule.

With the government issuing restrictions on public gatherings and transport, the public transport fee has gone up rendering it difficult for health workers and patients to get to and from the hospital. Recently, government health workers went on strike to demand availability of personal protective equipment (PPE) and help to mitigate rising transport costs. This had an impact on patients with kidney disease who could not be properly cared for in the ward or access renal services appropriately. Luckily, this has been sorted out swiftly by the government and now services have returned to normal.

As all the patients attending chronic hemodialysis come from the community, we have trained our dialysis team to screen patients when they access the service as there is community transmission already of COVID-19. The challenge that we have now is dialysis of COVID-19 patients (either those on chronic hemodialysis or those who develop acute kidney injury as a complication of COVID19). Ideally, we should have a portable dialysis machine that could be moved around for patients in isolation who may benefit from dialysis.

Malawi is a landlocked country and is dependent on supplies being transported from other countries, like South Africa. Hence, lockdown measures and limitations on movement might negatively impact dialysis supplies. We are uncertain of how long the lockdown measures in neighboring countries will last so that we can replenish our supplies.

The ISN and Kidney International surveyed nephrologists across six continents, representing the ten ISN Regions, to assess the impact of COVID-19 on dialysis patients and staff and health system responses to the pandemic specific to dialysis.

Access the reports here.

The ISN Global Kidney Health Atlas team has prepared summary slides of the ISN GKHA 2019 focusing on each ISN region individually.

ISN invites members to share the results from their region with colleagues and key stakeholders to support discussions on and advocate for kidney health care with relevant national and regional health/policy/education officials.

The new material contains background information on the project as well as desk research and survey data from 2019. A user manual and narrative script, in support of the PowerPoint presentation, are also available to download.

 The documents* for each region (Africa, Eastern and Central Europe, Latin America, Middle East, NIS and Russia, North America and the Caribbean, North and East Asia, Oceania and South East Asia, South Asia, Western Europe) are

 Available here

.

 

Use region-specific presentations during the current global novel Coronavirus (COVID-19) pandemic: Find key results from your region through scorecards (available in the presentation) and share via social media or other media and press channels.

 The ISN welcomes your input on these presentations. Please contact us at globalatlas@theisn.org.

* user manual; ISN GKHA 2019 presentation slides of each ISN region; presentation script on each ISN region.

Tuesday, 28 April 2020 08:26

ISN stands with the WHO

The International Society of Nephrology (ISN), with its mission to improve kidney health worldwide and ensure that all people have equitable access to sustainable kidney health, has noted with concern the decision by President Donald Trump to suspend funding to the World Health Organization (WHO).

As an organization in official relations with the WHO, the ISN recognises the important role played by the agency in promoting the message of essential healthcare and universal health coverage to all people around the world through a range of activities that include coordinating the global response to infectious disease outbreaks, ensuring system-level response to care with protection of the worst off through optimal sharing of expertise, and better access to diagnostics and medicines.

The global healthcare community has appreciated the constant support by the United States of America to WHO. Withdrawal of support would seriously destabilise the ongoing global response to the COVID-19 pandemic, especially in terms of protection to the poorest and the most vulnerable. We also need to support and work together with the WHO to ensure that the health systems around the world are able to support fully also the patients with pre-existing chronic conditions, including kidney disease. The ISN, representing the global kidney health community, stands with the WHO and reiterates the need for a global health agency more than ever.


Thursday, 23 April 2020 09:45

 ISN General Academy

Notice to attend meeting of the ISN General Assembly
(via online webinar)

Dear Member,

The ISN General Assembly meeting was due to take place at 7:00 am on 28 March 2020 during the World Congress of Nephrology 2020 in Abu Dhabi. We regret that the current global health situation did not allow for the WCN’20 to proceed as planned, and that we were not able to hold the ISN General Assembly meeting in person.
 
I am pleased to notify you that the ISN General Assembly meeting will instead take place via online webinar. 2 sessions will be held to allow for all time zones:

  • Friday, 22 May 2020 from 7:00 to 8:00 CEST, and
  • Friday, 22 May 2020 from 19:00 to 20:00 CEST.

Convert these times and dates to your own time zone here.

To register for the ISN General Assembly meeting webinar please click HERE.
Thank you for registering by 21 May 2020.


Please note:

  • You will need to attend only ONE of the sessions.
  • After registering, you will receive a confirmation email containing information about joining the webinar.
  • Only ISN members in good standing at the time of the session will be entitled to attend the meeting.

Please see below the agenda for the meeting:

  1. Welcome & Introductions
  2. ISN Financial Report
  3. ISN Membership
  4. ISN Activities update
     a.    Bridging the Gaps
     b.    Building Capacity
     c.    Connecting Community
  5. ISN 2020-2021
  6. Q&A

I look forward to speaking with those of you who are able to join us next month.
 
Yours sincerely,

 

Vivekanand Jha

 ISN President

The ISN and the Asian Pacific Society of Nephrology (APSN) have sustained a successful collaboration over the last decade working together to advance nephrology in the Asia-Pacific region, notably through the ISN Fellowship, Sister Renal Centers (SRC), Clinical Research (CR), and Continuing Medical Education (CME), and Kidney Care Network Programs.

Since 2010, 5 Clinical Research projects; 13 CME meetings; 17 Fellows; and 9 SRC pairs have been co-sponsored by ISN and APSN. A small sample of the outstanding results are highlighted below.

Nattachai Srisawat, an investigator from Thailand, received funding in 2015 for his Clinical Research project on AKI epidemiology in Southeast Asia. The project, completed in 2019, led to the publication of two articles (available here and here)in peer-reviewed journals. Dr. Srisawat won 3rd prize in the Clinical Research Awards organized at WCN 2019 in Melbourne, Australia. These awards recognize the three best posters derived from ISN Clinical Research projects.

Seow Yeing Yee, a Fellow from the Kuala Lumpur Hospital in Malaysia, trained at the Royal Prince Alfred Hospital in Australia from 2018-2019. She trained in clinical transplantation and plans to set up a kidney-paired exchange program in Malaysia to improve transplant rates. According to host mentor, Prof. Steven James Chadban, Dr. Yee is a potential future leader in transplantation in Malaysia and Asia, experienced to manage pre-transplant workup and post-transplant patient care.

The Viet Duc Hospital in Vietnam and the Juntendo University Hospital in Japan partnered between 2014 and 2019 through to the Sister Renal Centers Program and graduated in 2020. Training was received through six Continuing Medical Education (CME) courses in Renal Pathology throughout the partnership. Further courses took place in nephrology, dialysis, and transplantation covering all aspects of kidney diseases. Staff from the Pathology and Kidney Diseases and Dialysis departments of the Viet Duc Hospital attended short-term training courses in Japan.

The number of kidney biopsies carried out per year in the Viet Duc Hospital increased from 50 cases in 2014 to 300 cases in 2019. The Viet Duc Pathology department has become a center of reference for seven other hospitals in the region. Collaborative relationships between nephrologists and other specialists in Hanoi and Northern Vietnam have been established as well as between local and international specialists creating the potential for future research projects and motivating young professionals to work in the field.

As the implementation arm of the ISN 0by25 initiative, the Kidney Care Network (KCN) project consists of a series of implementation interventions that support centers in low-resource settings to develop integrated kidney care services. One of the four sites worldwide to have successfully launched the project is the Dharan Site in Nepal. An official partner of the ISN 0by25 Initiative, APSN has supported the Nepal KCN unit to become a well-established local ‘Network’ providing training in integrated kidney care across the region. Local advocacy efforts have increased in Nepal to ensure that good practices in integrated kidney care are sustained in the region.

In 2019, under the leadership of then ISN president, David Harris, and APSN Program Chair, Masaomi Nangaku (current APSN President), the APSN and the ISN co-organized WCN in Melbourne, Australia, alongside the Australian and New Zealand Society of Nephrology (ANZSN). The congress focused on glomerulonephritis, integrated end-stage kidney disease, and topics relevant to global and Asia-Pacific nephrology and offered hands-on courses on the clinical aspects of these topics prior to the scientific program.

ISN President, Vivek Jha, comments: “APSN and ISN have had a long-lasting and wide-ranging partnership aimed at supporting capacity building and research in all aspects of nephrology in the Asia-Pacific region. In addition to advancing kidney health through training and education, this partnership has fostered innovations, such as the Affordable Dialysis Prize.

The ISN looks forward to a continuing fruitful partnership with the APSN.

Thursday, 16 April 2020 13:54

Global Trials

Every month the ISN-ACT Team lists interesting new randomized controlled trials from around the world.

Highlights:

  • Keeping it simple with restriction: fluid restriction as good as diuretics and oral salt for SIAD
  • Deciding HDF or HD: nothing to lose sleep over

See the latest trials here.

New WCN’20 Content Available on the ISN Academy

Additional WCN’20 posters, provided by presenters, are now available online at the ISN educational portal, the ISN Academy: consult posters, poster talks, and visual abstracts.

The ISN Educational Ambassadors Program (EAP) was launched in 2009 to provide renal centers in developing countries with visiting international experts, recognized by the ISN, to provide specific hands-on training and help develop new skills or services needed in the host institution.

Through this program, centers around the world receive the guidance needed to develop new services and community-based research or screening programs.

For one to four weeks, Educational Ambassadors visit an emerging center to help lay the groundwork for a potential long-term collaboration between the host center and the ISN ambassador, extending the mentorship via teleconferences or videoconferences where necessary.

ISN Ambassadors advise on clinical cases and research, assist in the implementation of new projects and initiatives in the emerging centers, as well as help empower local professionals, including nurses and technicians, to improve the quality of life and survival rate of patients. Some host centers have started dialysis programs after the visit of the ISN ambassador.

The overall impact of the program is demonstrated through these recent collaborations made possible through the EAP.

Dr Picca gives training to staff at Bambino Gesù Hospital.

Dr Picca gives training to staff at Bambino Gesù Hospital.

Dr Stefano Picca, pediatric nephrologist and former Head of Dialysis Unit at Bambino Gesù Children's Hospital in Italy, has been an active ISN Educational Ambassador often linking his educational role to the Saving Young Lives project.

In 2018, Dr. Picca collaborated with Laurence Adonis-Koffy at Abidjan’s Centre Hospitalier Universitaire in Yopougon, Ivory Coast, to design a much-needed lecture on pediatric acute kidney injury, its causes, and treatment.

In 2019, he joined forces with Younoussa Keita, one of only two trained nephrologists at Hôpital Aristide Le Dantec in Senegal, to hold a week-long course specifically focused on training doctors and nurses in hemodialysis and peritoneal dialysis treatment for children with acute kidney injury, providing guidance that was central to setting up a long-awaited pediatric unit.

Dialysis and transplant training session at Yangon Children’s Hospital, Myanmar.

Dialysis and transplant training session at Yangon Children’s Hospital, Myanmar.

In 2018, Dr Yi Yi Khin, from Yangon Children’s Hospital (YCH) in Myanmar, organized an EA visit from Ambassador Kar Hui Ng from the National University of Singapore. Dr. Ng spent a week at the host center to give training in dialysis and transplantation and to provide local medical professionals with the confidence and infrastructure to perform their first pediatric renal transplantation.

This event was widely featured in the local press bringing it to the attention of Burma's Ministry of Health who pledged to increase resources into pediatric nephrology.

Dr. Ng commented on her greatest reward from the visit: “The big smile on the transplanted patient!”, explaining that the young patient “no longer has to stay in the hospital for years to receive chronic hemodialysis. She can go home and go to school.” 

Dr. Martin Lewis (far right) with staff members at University of Port Harcourt Teaching Hospital (UPTH) in Nigeria.

Dr. Martin Lewis (far right) with staff members at University of Port Harcourt Teaching Hospital (UPTH) in Nigeria.

ISN Educational Ambassador Malcolm Lewis, pediatric nephrologist at the Royal College of Surgeons in Ireland, gave two weeks of training, organized by Dr Felicia Elke, at the University of Port Harcourt Teaching Hospital (UPTH) in Nigeria in August 2019, as a follow-up to previous visits in 2015, 2017, and 2018.

Instruction focused on formal nephrology teaching, detection and prevention of renal disease with a community focus, and practical clinical nephrology with teaching and practice on the wards. Dr. Lewis’ prolonged visit enabled him to oversee the complete management of some patients and, thus, directly impacted the quality of their care.

Dr. Lewis helped develop a pediatric Renal Registry for Nigeria in collaboration with a local registry committee. All 38 pediatric units in Nigeria are now enrolled. Data entry tools were created on a secure website, easily accessible by mobile phone, and data collection began on September 1, 2019.

This data is an invaluable tool for securing state and federal funding for the service. The response to the project from the Transplant Association of Nigeria was so favorable that Dr. Lewis was asked to assist with the development of an adult registry.

According to Dr. Lewis, the presence of an Ambassador in UPTH allowed the translation of standard practices into what was feasible with available resources, commenting: “I can vouch for the value of having an experienced pediatric nephrologist going to places of limited resources and working through problems with the local teams…on the ground, dealing with problems as they occur is enlightening and can lead to innovative solutions as well as a strategic plan for development.”

The University of Port Harcourt Teaching Hospital in Nigeria is also in a partnership with a center in New York and another one in the UK as part of the ISN SRC Program.

Rea Judit Jerabekne Vegh (center right) demonstrating hemodialysis techniques to nurses at the Charak Memorial Hospital (CMH) in Nepal.

Rea Judit Jerabekne Vegh (center right) demonstrating hemodialysis techniques to nurses at the Charak Memorial Hospital (CMH) in Nepal.

Rea Judit Jerabekne Vegh, a registered nurse from Diaverum and Guys and St Thomas NHS Hospital in the UK, spent two weeks as an ISN Educational Ambasssador at the Charak Memorial Hospital (CMH), in Pokhara, Nepal, in November 2019. The visit was organized by Dr. Klara Paudel from the host institution.

The aim of the EAP visit was to increase the quality of care in the dialysis center and to provide advanced training to nurses at CMH, empowering them to become leading trainers in the region who are able to make decisions and suggestions concerning their patients and mentor junior staff.

The training centered on hemodialysis and focused on advanced techniques, improvements, and infection control. New techniques, procedures, and infection control measures were implemented immediately improving overall trouble-shooting and critical thinking capacity and positively affecting patient safety.

An interactive theory and practice training course was organized as part of the EAP visit to include nurses from other centers within the region. A patient education program for dialysis patients, “Positive Thinking on Dialysis,” also took place addressing diet, tiredness, and positive thinking. This event appeared in the local newspaper because of the favorable impact it had on the patients.

According to Rea Vegh, the nurses were eager to learn and responded positively to the encouragement to follow new procedures and to become confident enough to make decisions and try new approaches in case of problems. She comments that a highlight of her experience at CMH was: “To see the staff accepting and understanding the new practice as they took the initiative, and from one day to another, started to use some new techniques proving that their critical thinking has improved.”

Rea Vegh plans to establish a WhatsApp group with the nurses to share problems, solutions, and lessons learned. She hopes to visit again when the new unit is in operation saying: “It would be beneficial to spend a whole week on infection control, to help the senior management team with writing standard operating procedures, and start an auditing program.”

ISN is pleased to announce that selected WCN’20 posters as PDFs, poster talks, and visual abstracts will go online at the ISN educational portal, the ISN Academy from April 9 and released in stages throughout the month.

The Young Nephrologists Committee (YNC) is excited to welcome seven new members representing different regions of the globe:

  1. Alexandra Cambier, from France, is a pediatric nephrologist and immunologist with a specialty in pediatric IgA nephropathy. Her primary research interest is the identification of biomarkers for IgA nephropathy in children. She joined the YNC partly to share and explore differences in treatment between children and adults with kidney diseases.
  2. Yosuke Hirakawa is assistant professor of Nephrology in Tokyo, Japan. He joined the ISN and the YNC to gain an international perspective on nephrology and contribute to the advancement of both the ISN and the Asian Pacific Society of Nephrology (APSN).
  3. Shankar Prasad Yadav is a pediatric nephrology Fellow from Nepal who joined the ISN to contribute to the world of Nephrology. He later joined the YNC as a way to network and to get more involved in ISN’s work.
  4. Nikolay Bulanov, a nephrologist and researcher at Sechenov University in Russia, acknowledges that the ISN takes the needs of young nephrologists into account providing good opportunities to improve skills and knowledge in nephrology.
  5. Lili Zhou is currently a professor of nephrology at the Nanfang Hospital at the Southern Medical University in Guangzhou, China. She has devoted the last 17 years to researching the underlying mechanisms of kidney diseases and designing better therapeutic strategies. By serving on the ISN YNC she hopes to foster her career development and contribute to and benefit from an efficient platform for promoting exchange and communication within an international network of young nephrologists.
  6. Caner Alparslan works in a regional hospital in the southeastern part of Turkey where he has established a pediatric nephrology division including a kidney biopsy facility and a pediatric dialysis center. By joining the YNC he aims to promote interventional nephrology among young nephrologists and create a bridge between the YNC and other societies for mutual scientific benefit.
  7. Sabine Karam is an assistant professor of Nephrology at Saint George Hospital University Medical Center in Beirut, Lebanon. She hopes to enhance nephrology education and care in her country through the academic support that the ISN and the YNC can offer. She looks forward to contributing as much as she can to the expansion of ISN missions in the region and worldwide.

The 12th Annual International Conference on Nephrology & Hypertension was organized by the Caribbean Institute of Nephrology, in Kingston, Jamaica, in January 2020.

The conference, themed “Targeting Together Caribbean Kidney Issues,” was coordinated by Dr. Everard Barton from the University of the West Indies, Jamaica. Through its Continuing Medical Education (CME) Program, the ISN supported two speakers at the event: Dr. Frank Brosius, Professor of Medicine and Interim Chief of Nephrology at the University of Arizona; Professor Emeritus-Active Internal Medicine and Physiology at the University of Michigan, USA; and Dr. Guillermo Garcia Garcia, Hospital Civil de Guadalajara,Mexico; Co-Chair of the World Kidney Day Steering Committee and member of ISN Education Working Group,

The conference addressed issues such as cardiovascular and sickle cell disease in the Caribbean, new advances in the management of diabetic kidney disease in patients in the Caribbean, the status of kidney transplant, acute kidney injury and metabolic diseases in the Caribbean, peritoneal dialysis, mineral bone disease, the Caribbean Renal Registry and the scaling up of the Caribbean health care system.

The aim was to enhance collaboration between Caribbean states on kidney diseases and to educate health care providers on risk factors, prevention, and management of kidney diseases, as well as to improve peritoneal dialysis and maintain a regional kidney transplant program within the Caribbean.

ISN is pleased to have been able to support the Caribbean Institute of Nephrology toward improving nephrology care in the region.

At the World Congress of Nephrology 2017 in Mexico, ISN Fellows from around the world created a WhatsApp group to share experience and progress.

Dr. Mohammed Elrggal, from the Nephrology Department at the Kidney and Urology Center in Alexandria, Egypt, initiated a collaborative research project exploring AKI practice patterns in all the Fellows’ home countries. The study was accepted for a poster presentation at WCN19.

In 2019, the group of Fellows continued collaborating to explore disparities in access to kidney transplantation in their respective countries, with a special interest in the data from low-income countries. Initially, 11 Fellows agreed to participate, and the results were submitted as an abstract for WCN20.

Since then, more ISN fellows on the platform have contributed data from their own countries relating to transplantation access. This led to the creation of an ISN Fellows Collaborative Review set up to identify the challenges different regions face in providing universal access to kidney transplantation.

All ISN Fellows, and colleagues who got involved in the project, described data from his/her country on national transplant programs, national kidney transplant registry data, as well as from nephrology societies' databases and data collected from previous publications. The majority of colleagues contributing to the project* are former ISN Fellows or members of the ISN Young Nephrologists Committee.

The research group is confident that this collaborative study will be of value to the ISN community and a manuscript is currently underway to be submitted to Kidney International for consideration.

*Past ISN Fellows:
- Sibel Gokcay Bek (Turkey);
- Elliot Koranteng Tannor (Ghana);
- Aristide Eric Nono Tomta (Cameroon);
- Yannick Mayamba Nlandu (DR Congo);
- Ismoil Rashidov (Tajikistan);
- Khalida Bulhan-Soki (Kenya);
- Maisarah Jalalonmuhali (Malaysia);
- Abduzhappar Gaipov (Kazakhstan).

ISN members:
- Mohamed Essam Elrggal (Egypt);
- Aiperi Asanbek Kyzy (Kyrgystan);
- Sherzod Abdullaev (Uzbekistan).

During the COVID-19 pandemic, it is more important than ever to gather data to advocate for people with kidney disease. Recognizing this, the ISN’s SharE-RR (SHARing Expertise to support the set-up of Renal Registries) group, led by Fergus Caskey, has been working with its global network of registry experts to identify plans to establish COVID-19 surveillance systems and share experiences.

Responses to date have been summarized in a new section on COVID-19 on the ISN website with contact details for more detailed information.

The team is working alongside Thomas Hiemstra at the University of Cambridge, and Chair of the ISN-ACT group, to develop a data entry portal that will allow anonymized data to be collected on people with kidney disease and COVID-19 infection in countries without infrastructure.

This is a rapidly moving field; if you are aware of any activity not included here, or just want to get involved, please get in touch at triva@theisn.org.

Monday, 06 April 2020 08:39

New COVID-19 Resources Available

Please see the latest visual abstracts on COVID-19-related topics in English, Spanish, Portuguese, and French.

Kidney International paper examines therapeutic options for patients with kidney disease.

Henriette Tyse Nygård reports on Anemia in Dialysis Patients in Zanzibar as the first in a series of Nurses’ blog posts in recognition of 2020 as the Year of the Nurse and the Midwife.

Anemia in dialysis patients in Zanzibar

Henriette Tyse Nygård

Dialysis nurse, Haukeland University Hospital, Norway; Dialysis nurse/teacher, MMH, Zanzibar; Student, Masters of Public Health, UIT, Norway; Member of the ISN Kidney Health Professionals Working Group

Anemia is a big challenge in the Mnazi Mmoja Hospital (MMH) in Zanzibar (a group of islands in Tanzania). Most of the anemic patients I saw during my 10 years working as a nurse was during my 2 years in Zanzibar. Getting blood for transfusion is very difficult due to lack of adequate supplies.

The dialysis unit in MMH opened in May 2017. Before this time, patients had to pay for private dialysis or move to the capital of Tanzania. The costs related to private dialysis or traveling to the capital made access to care very difficult for most people.

Dialysis in MMH is free: patients are offered dialysis twice a week. The kits used with the dialysis equipment include erythropoietin (EPO), but not iron sucrose. As a result, patients receive EPO at every treatment without iron sucrose. Iron sucrose is free if it is available in the hospital, but it is often out of stock.

The price for iron sucrose in a private pharmacy is around 6 USD. The cost of checking serum ferritin levels, which must be analyzed at a private laboratory, is around 30 USD and few patients can afford it. Some patients can afford to buy the iron they need, but many cannot. The standard prescribed dose of serum ferritin is 100 mg for 10 treatments for anemic dialysis patients who are started on iron sucrose.

It is hoped that iron sucrose will become available free of charge or at an affordable cost as administering EPO when serum ferritin is low is poor anemia management.

I also hope serum ferritin testing will be available in the laboratory in MMH soon. We know that giving too much iron is dangerous, but we also know that anemia can be fatal.

The staff in Zanzibar are positive, hard-working people that do their best for patients every day despite many challenges. I will forever be grateful for the time I have spent with this amazing crew.

World Kidney Day (WKD) organizers, ISN and IFKF, wish to thank all partners and collaborators who helped advance the WKD 2020 message highlighting the importance of preventive measures and the need for increased awareness in kidney disease prevention during this year’s event.

The 15th edition of WKD was marked worldwide on March 12 by stakeholders, regional and local authorities, the WHO, patients, and the general public, raising the profile of kidney diseases and generating solidarity among the nephrology community.

WKD reached 327 million people via social media: WKD content was liked, commented on, shared, and clicked 43 thousand times, and #worldkidneyday gained 154 million impressions.

The extent and variety of worldwide activities, which were adapted where necessary due to concerns surrounding the COVID-19 pandemic, are a testimony to the strength and engagement of the WKD community.

Inspiring campaign activities can be viewed, added to the WKD 2020 photo stream, or mapped here.

The Editorial Team of Kidney International would like to reassure our readership that we will continue to bring you high quality information throughout the COVID-19 pandemic to help all of us deal with the crisis and provide high quality care to our patients. We have a mechanism in place to rapidly review and arrive at publication decisions for papers on the kidney implications of COVID-19, and release these papers in an open access format within one week after acceptance. We believe the best way nephrologists can contribute to the fight against this disease is by arming ourselves with the best and most up-to-date data possible.

The Editors of Kidney International would also like to thank all of our Reviewers for their outstanding work in guiding the publication of high impact papers. We understand that for most of us now many of our academic activities have been curtailed as we focus our efforts on combating the virus. We apologize to our Authors for any delays encountered in the reviewing process for non-COVID-19-related articles. Normal turnaround time for Kidney International averages 14 days for all original manuscripts, and we will make every effort to maintain a short review process during this time of stress.

During the first quarter of 2020 the number of submitted manuscripts to Kidney International has increased by 15% and we are grateful to the authors for choosing to publish with us despite the pandemic. We are very much aware of the huge professional and personal difficulties Authors are facing, including the shut down of laboratories and the virtual stand-still of most clinical trials, and we will take these difficulties into account during the reviewing process.

Despite all of these challenges, The Editorial Team remains dedicated to the mission of Kidney International and we are proud to serve the kidney community and contribute, together with the International Society of Nephrology, to global kidney health. We are happy to hear from our readership and will appreciate any suggestions of how we can help you manage during this crisis.

To celebrate World Kidney Day (WKD), the ISN dressed the Manneken Pis fountain in Brussels in WKD colors to raise awareness of kidney health issues and activities.

The ISN team explained to onlookers the significance of the costume as it was unveiled, encouraging the public to use #worldkidneyday to accompany photographs taken of the WKD Mannekin Pis.

The ceremony was preceded by a meeting at Brussels City Hall alongside the Collège du Bourgmestre, the Echevin de la Ville de Bruxelles, the Echevin de la Culture, and representatives of the President of the Order of Friends of Manneken-Pis.

ISN Executive Director, Charu Malik, thanked city representatives for bringing the cause to the heart of Brussels and gave a short speech outlining the impact of kidney disease worldwide, calling for concrete measures in every country to promote and advance kidney disease prevention.

The Head of the Nephrology Department at the Cliniques Universitaires of Saint Luc and long-time ISN member, Professor Michal Jadoul, also addressed the audience to highlight simple preventative strategies available to healthcare professionals to identify kidney diseases in patients at an early stage.

ISN Kidney Health Professionals Working Group (KHP WG) members Rachel Walker and Paul Bennett submitted a paper that has been published as an editorial letter in the Renal Society of Australasia Journal 2020.

The KHP WG is a comprehensive and complementary nursing and allied health professional group formed by ISN in 2017 to address the gap in the non-nephrologist workforce and to encourage nursing involvement in program delivery and development.

The paper addresses the urgent need to develop nephrology nursing leadership within low- and middle-income countries to improve the management, safety, and quality of kidney care.

The development of a strong renal nursing and allied health workforce will increase the capacity to better meet the needs of people with kidney disease worldwide.

At a meeting held in December 2019 in Delhi, India, between the ISN President and Executive Director, and the Indian Society of Nephrology Governing Body, ISN and the Indian SN agreed to extend and formalize their existing partnership to include collaboration on all ISN programs and activities, demonstrating their mutual commitment to the advancement of nephrology in the South Asia region and globally.

This partnership seeks to advance regional capacity building through the ISN-Indian SN Fellowships, Sister Renal Centers (SRC), Educational Ambassadors (EAP), Continuing Medical Education meetings (CME), Scientific Writing Courses (SWC) and Interventional Nephrology Scholarships and a joint session at the ISN World Congress of Nephrology.

ISN President, Vivek Jha comments: ”This ongoing joint partnership continues to help reinforce the specialty of nephrology in the South Asia region and globally. It will help people become more aware of nephrology and kidney disease across the world, which is one of the missions of the ISN.”

In particular, this partnership is intended to encourage the training of South Asian and African Fellows in India, and Indian Fellows abroad, and to build partnerships between emerging and supporting Sister Renal Centers from the region. In both cases, the long-term objective is to create Regional Training Centers of excellence in India.

Indian Society of Nephrology President Prof. K.L. Gupta says: “We are committed to working for the advancement of nephrology in India, but also in low-and-middle-income countries from the South Asia Pacific region and around the world, and look forward to our continued collaboration with the ISN.”

As a result of this partnership, ISN and the Indian Society of Nephrology will co-jointly support the following Sister Renal Centers collaborations:

  • Pair between the Christian Institute of Health Sciences & Research in Dimapur, and the Christian Medical College in Vellore, both in India.
  • Pair between the University of Nigeria Teaching Hospital in Enugu, Nigeria and the George Institute for Global Health in Delhi, India.
  • Trio between the Hospital Central de Maputo, Mozambique, the Christian Medical College in Vellore, India and the University of California in Los Angeles, United States.

The next application deadline for the Fellowship Program is May 1. For the Sister Renal Centers Program, the deadline is October 1.

Monday, 16 March 2020 11:21

Attend the ISN 2020 Frontiers Meeting

The International Society of Nephrology, in collaboration with the Mario Negri Institute for Pharmacological Research, will hold the ISN 2020 Frontiers Meeting on ‘Complement-related kidney diseases: classification, genetics, and treatment’ from October 1-3, in Bergamo, Italy.

This specialist meeting will focus on the two prototypical complement-mediated kidney diseases: atypical hemolytic uremic syndrome (aHUS), and C3 Glomerulopathies/Membranoproliferative Glomerulonephritis (C3G/MPGN), giving scientists engaged in rare diseases the opportunity to speed up research and drug development in the field.

All ISN members are cordially invited to register to experience cutting-edge science presented by a global panel of clinical and scientific experts.

ISN encourages those directly involved in this area of expertise to reach a greater audience by submitting an abstract for the event.

High water intake and low urine osmolality are associated with favorable metabolic profile at a population level: low vasopressin secretion as a possible explanation” by ISN Hydration For Kidney Health (ISN-H4KH) Research Grant awardee, Sofia Enhörning, was published in the European Journal of Nutrition in February.

Sofia Enhörning et al, investigated if low total water intake or high u-Osm correlated with high fp-copeptin and components of the metabolic syndrome at the population level finding that low concentrations of the vasopressin marker copeptin were linked to high water intake, low u-Osm, and a favorable metabolic profile.

In 2015, Dr. Sofia Enhörning, from Skåne University Hospital in Malmö, Sweden, received an ISN Research Grant, with support from Danone Nutricia Research, for her project: "Plasma copeptin as a predictor of, and copeptin associated loci in, cardiorenal disease – population based prospective cohort studies and a mendelian randomization approach.” 

Prof. Philip KT Li
Prof. Philip KT Li

Honorary Professor of Medicine, Chinese University of Hong Kong and President of Hong Kong College of Physicians, and represents ISN on the WKD Joint Steering Committee 

Dr.Guillermo García García
Dr.Guillermo García García

Research Professor, University of Guadalajara Health Sciences Center, and Director of Nephrology, Hospital Civil de Guadalajara, Mexico, and represents IFKF on the WKD Joint Steering Committee

Preventive interventions – put in place in every country – could be the most suitable means of reducing the prevalence of chronic kidney disease (CKD) and the costs associated with it.


One in three people in the general population (an estimated 850 million people) is at increased risk of CKD. Worldwide, an estimated 10% of people have CKD, and estimates suggest nine in ten of those are unaware of their condition. The global burden of CKD is rapidly increasing with a projection of becoming the fifth most common cause of years of life lost globally by 2040.

Read the article

E-print version available here

Novel coronavirus disease (COVID-19) is a newly discovered contagious disease caused by SARS-CoV-2 virus, primarily manifesting as an acute respiratory illness with interstitial and alveolar pneumonia, but can affect multiple organs such as kidney, heart, digestive tract, blood and nervous system. The rapidly spreading outbreak which first emerged in Wuhan, Hubei Province in China in December 2019 has raised concerns about a global pandemic.

Read More

English Version Spanish Version

As part of the Saving Young Lives (SYL) project, 17 doctor-nurse pairs from eight countries across Africa received a week-long training in Acute Peritoneal Dialysis during the SYL Renal Skills Course at Red Cross Children’s Hospital in Cape Town, South Africa, from February 17 to 21, 2020.

The course directors, Red Cross’s Mignon McCulloch and Alp Numanoglu, conducted workshops on Pediatric Life Support Resuscitation, Vascular Access, PD for Nurses, and AKI.

The course included: a hands-on PD insertion workshop, and clinical stations in acute PD, automated PD, hemodialysis (HD), and Continuous Veno-Venous Hemofiltration (CVVH).

The 34 doctors and nurses in attendance left the course with increased capacity to provide acute PD services in adults and children with AKI in hospitals where access to treatment was not previously available.

Data collected by ISN from former SYL workshop participants indicates that over 500 patients with AKI have received treatment for acute PD through the SYL project and a 65% survival rate is reported.

After graduation, ISN Sister Renal Centers or ISN-TTS Sister Transplant Centers partnerships can opt to support a third emerging center within the region through the ISN SRC Trio Program.

Three recently graduated Trio partnerships demonstrate the valuable impact these collaborations can have on local nephrology capacity.

 

Emerging Institution: Nephrology Institute, Zhengzhou University, Zhengzhou (NIZU), China; Supporting Institution: Institute of Nephrology, Peking University, Beijing (INPU), China; Mentoring Institution: Renal Division, Brigham and Women’s Hospital (BWH), Harvard University.

Prior to 2014, the NIZU had a large number of patients with kidney disease but lacked diagnostic expertise and equipment in renal pathology. With the help of INPU and the BWH, they were able to set up their own pathology department for kidney diseases in Henan Province. Nurses and doctors received training in clinical and pathology skills to improve expertise and accuracy in the diagnosis and treatment of rare and complex diseases, and their prognosis.

The hospital wards grew from three to six, increasing bed capacity from 193 to 308. The renal replacement therapy center expanded to include two blood purification centers and two peritoneal dialysis centers. Equipment increased to include 132 blood dialysis machines, over 170 blood purification machines, and 45 continuous renal replacement therapy units. A peritoneal dialysis hotline was set up to provide better services for patients.

NIZU joined the TESTING and C-STRIDE clinical research trials initiated by INPU. 36 national projects were allocated to NIZU by various organizations including the Ministry of science and technology, the Medical Management Institute of National Health and Family Planning Commission, and the National Natural Science Foundation of China. 200 articles were published in Chinese medical journals.

In 2018, NIZU established the first Dialysis Pathway Operation Center for Uremia in the Henan Province. According to China Hospital Science and Technology Influence Ranking, the institute rose from 17th place in 2016 to 11th place in 2018.

 

Emerging Institution: Tikur Anbessa Specialized Hospital (TASH), Ethiopia; Supporting Institution: St. John’s Medical College, India; Mentoring Institution: Montreal Children's Hospital, Canada.

The goal here was to establish a pediatric nephrology service in Ethiopia, transfer knowledge and skills, and equip the emerging center in data collection and analysis to produce reliable, reputable studies.

The emerging center, initially run by only one senior pediatric nephrologist, expanded to acquire two additional pediatric nephrologists trained through the SRC Program. Two renal follow-up centers have now been set up, one in the emerging center and an additional institution in the capital as an outreach program. The supporting center provided acute PD and HD catheters, biopsy guns, and BP apparatus for all age groups. Children who have received transplants abroad can now receive post-operative care within the emerging center. The total number of pediatric nephrologists has increased to five in Ethiopia.

A pediatric nephrology subspecialty curriculum was developed for the emerging institution. Teaching materials were produced and Continual Medical Education (CME) meetings were held to reach pediatricians caring for children with kidney diseases.

With the support of the program, TASH made multiple poster presentations both nationally and internationally. In 2019, they received the best abstract award at the AFPNA congress in India for sharing their experience of using improvised acute PD solutions to provide RRT via rigid catheters. A research grant was awarded to TASH through the ISN Clinical Research Program to conduct the first large prospective AKI study in Ethiopia.

Bezaye Abebe, liaison officer at the emerging center, states: “The bright faces we see when our children beat death and come back for [a] follow-up, is a reason to push through every day against all the limitations in the country.”       

 

Emerging Institution: Susana López de Valencia, Colombia; Supporting Institution: Fundación Valle del Lili (FVL), Colombia Mentoring Institution: Boston Children’s Hospital.

The goal was to improve pediatric nephrology in the Southwest region of Colombia by:

  • creating an outpatient clinic Learning Center Program to support children with renal diseases,
  • training healthcare professionals in detection, prevention, and treatment innovations for renal diseases,
  • developing strategies to improve AKI treatment,
  • setting up an in-utero CAKUT database,
  • evaluating patients to detect early hypertension and proteinuria.

Through the program, staff from SLV were able to visit Boston Children’s Hospital to receive training. The emerging center benefitted from additional ISN programs, including fifteen Continuing Medical Education (CME) meetings hosting international speakers, and an Educational Ambassador (EA) Program visit from Dr Guido Filler, from the Children’s Hospital of Eastern Ontario, Canada.

Support from the urology and nephrology teams from Boston Children’s Hospital helped develop a myelodysplasia clinic as well as a pediatric nephrology unit in Popoyàn for the assistance and follow-up of pediatric patients with renal pathology. An approved AKI network was established in Cali and Popayàn Intensive Care Units.

Both the supporting and mentoring institutions provided training to two transplant surgeons, one adult nephrologist, one pediatric nephrologist, and one pediatric intensivist as well as three nurses enabling the development of a pediatric renal transplant service at Hospital San Jose-Popayàn including a transition program for adolescents with kidney transplants.

Several research studies were carried out and a research group on kidney diseases in the indigenous population was initiated as part of an effort to increase awareness and associated risks of renal diseases in children in the TOTORO aboriginal community.

In a final report on the impact of the program, the emerging center stated: “We have always received permanent and timely support for everything requested from the ISN…We believe that ISN is an example of excellent support for the entire nephrology community that encourages people to work in an organized way, impacting the prevention of kidney disease in the world.”

Celebrating ISN’s 60th anniversary, Kidney International’sMilestones in Nephrology” series continues with a review of some of the original articles it has published on the treatment of glomerular disease, publications that helped make significant changes in patient management:

  • Shorter term corticosteroids are equally effective as longer term in primary nephrotic syndrome in children (Yoshikawa N, Nakanishi K, Sako M, et al.)
  • Calcineurin inhibitors in focal segmental glomerulosclerosis and membranous nephropathy (Cattran DC, Appel GB, Hebert LA, et al.)
  • High-dose melphalan and autologous stem cell transplantation is feasible in end-stage kidney failure patients with amyloid light-chain (AL) amyloidosis (Casserly LF, Fadia A, Sanchorawala V, et al.)
  • Renal effects of enzyme replacement therapy in Fabry disease (FD) (Thurberg BL, Rennke H, Colvin RB, et al.)

Read more

The ISN is pleased to announce this year’s recipient of the Schrier Award, which recognizes the most deserving partnership from recently graduated ISN Sister Renal Centers (SRC) Program and ISN-TTS Sister Transplant Centers Program pairs.

The ISN Sister Renal Centers Program chair and deputy chair, the ISN-TTS Sister Transplant Centers Program co-chairs, and the ISN Programs chair reviewed the applications of six SRC pairs and three trio partnerships. All nine collaborations earned significant merit but the jury recognized notable excellence from the SRC Tanzania-Canada partnership between the Kilimanjaro Christian Medical Centre (KCMC) in Tanzania and the Queen’s University in Canada. This pair availed of additional ISN Programs to build a strong and durable partnership, achieving successful and sustainable outcomes.

The SRC Program played a crucial role in developing a number of programs at KCMC that aimed to build sustainable and high-quality diagnostic and treatment facilities for kidney diseases, as well as set up research projects in line with local priorities:

  • The Program funded Dr. Kilonzo to complete a two-year ISN Fellowship at the University of Cape Town under the mentorship of Prof. Bryan Rainer. The training, and the additional mentorship provided by Dr. Yeates from the supporting center, equipped Dr. Kilonzo to help set up acute PD and Clinic Care programs at KCMC. The initiative included outpatient nephrology clinics built for the follow-up of patients and eventually became part of the Saving Young Lives Project. Trainees Dr. Suda Ghosh and Dr. Huda Akrabi received ISN Fellowship funding in subsequent years further contributing to the strength of the center.
  • A hemodialysis program was launched that has expanded from an initial 7 chairs to 40 chairs in 2020 and is now active 24 hours a day, seven days per week.
  • Dr. Kilonzo and Dr. Yeates, alongside other young nephrologists, founded the Nephrology Society of Tanzania (NESOT), which meets annually for a scientific conference. The strong network created through the Society has increased lobbying power to petition local government to provide ongoing resources, actively promoting the need for improved kidney health in Tanzania.
  • An annual continuing education program for nephrology nurses was developed: Ms. Emy Cowlan, an experienced hemodialysis nurse trainer from Ontario, visited KCMC twice during the program providing mentorship to nurses and organizing an off-site educational meeting.
  • An ISN Clinical Research grant was awarded to KCMC in 2018 to support an ongoing research study, supervised by Dr. Yeates, to identify risk factors and outcomes of community-acquired AKI in adults and children.
  • KCMC will shortly begin a Sister Transplant Centers partnership with Manchester University in the United Kingdom aiming to build capacity for living donor transplants at KCMC over the coming years.

Having graduated, KCMC is now planning to form a trio to support a new emerging center in Northern Tanzania. Dr. Karen Yeates comments “We honestly feel that the SRC funding has had a real and measurable impact on lives saved in Tanzania through the successive and systematic building of the nephrology program though the SRC partnership.”

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