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Monday, 19 September 2016 12:08

Fellow: Hermann Bamidele Biao From Benin

WP 20160218 001Name of Fellow: Hermann Bamidele Biao

Home Centre: Aristide le Dantec University Hospital, Dakar

Host Centre: University Hospital of Grenoble

Mentor:  Lionel Rostaing

Training Duration: 12 months, by the 15th October 2016

 

Learning objectives: 

  • To know the general organizational framework for organ transplantation
 and organ allocation systems
  • To conduct a pre-transplant consultation and ask adequate paraclinical explorations
  • To know the pathology of transplantation, graft elementary lesions
  • To know the strategies of immunosuppressive therapies in kidney transplantation
  • To identify and treat different types of rejection in kidney transplantation
  • To treat infections that occur after kidney transplantation

 

Profile Description and Training plan: 

The transplantation unit at Nephrology department in Grenoble university hospital (France) performs >120 kidney transplantations/year, amongst which some are HIV-positive. The medical team comprises four senior transplant nephrologists. They have more than 500 patients on the kidney-transplant waiting list, amongst which about 200 yearly de novo listed-patients. They follow-up more than 1500 kidney transplant patients. Amongst the yearly transplanted-patients >30% are from living-donors, and about 15% are either ABO-incompatible or HLA-incompatible pairs. They perform kidney-allograft surveillance biopsies. Some of their de novo kidney-transplant patients are included in clinical trials (phase 2, 3, and 4 studies).

Every morning there are kidney-transplant patients attending the outpatient clinic.
Thanks to this organization I will be able to learn many things:

• How to make the medical work-up of a kidney-transplant candidate
• How to make the medical work-up of a potential living-kidney donor
• How to handle posttransplant immunosuppression, particularly in those who are HIV (+)
• How to handle posttransplant complications
• How to perform a kidney-allograft biopsy
• How to prepare an ABO-incompatible kidney-transplant candidate
• How to conduct a clinical trial in kidney-transplant patients

In Benin, kidney-transplant program will begin soon, based on living-kidney transplantation. There is an urgent need to have nephrologists well-trained in order to prepare the kidney-transplant candidates and to follow-up them properly at posttransplant. Also I will be able to learn how to handle immunosuppression in HIV (+) kidney-transplant patients. Finally, if we are facing ABO-incompatible kidney transplantation I will know how to manage it.

 

Monday, 19 September 2016 09:41

Fellow: Pakesh Baishya From India

Dr Pakesh Baishya1Name of Fellow: PAKESH BAISHYA

Home Centre: Central Nursing Home, Guwahati, Assam, India

Host Centre: UNIVERSITY OF ALBERTA, EDMONTON, CANADA

Mentor: DR KIM SOLEZ

Training Duration: 12 MONTHS

 

Learning objectives:

  • Expand the knowledge on various native and transplant renal biopsies.
  • Exposure to electron microscopy and ancillary techniques
  • To understand the molecular basis of renal diseases
  • To acquainted and carry out clinical research work
  • To get updated with the recent advances and future directions in the field of nephrology

 

Profile Description:  

At the very beginning I would like to give my background. I belong to India’s north eastern state Assam. My state is a naturally beautiful state at the foothills of Himalayan Mountain and ninety percent of people are from tribal community. Though it is a very beautiful state still we are lacking in basic infrastructure and the health scenario is still poor. While I was studying and working in Gauhati medical college, a tertiary care referral centre located at the capital of the state I observed that there is a huge population of patients suffering from kidney disorder. But unfortunately most the patient underwent renal failure without having a proper diagnosis. When I closely monitored the situation I realised that though we have few very good nephrologist but the problem was with lack of proper renal histopathology service. As we know renal histopathology is the back bone of nephrology I decided to develop renal pathology service in my region. It is a matter of fact that entire north eastern India there is not a single certified and skilled renal pathologist and all the patient need to rely on clinical diagnosis only.

 

Training plan:

By the end of the rotation the trainee will have acquired the skills necessary to:

  • Conduct, plan, and write up a clinically relevant research project related to transplantation pathology
  • Prepare a manuscript for publication related to the research conducted
  • Present the research at resident research day
  • Discuss the fine points of electron microscopic interpretation
  • Discuss the indications for renal biopsy.
  • Describe the process of preparing biopsy tissue for interpretation.
  • Describe the normal histologic structure of the kidney.
  • Describe the common histopathologic features in the nephritides.
  • Describe the common findings in renal transplant biopsies, and the Banff Classification.
  • Participation in research leading to high quality scholarly publication

 

Sponsors: 

ISN-ANIO 

Monday, 19 September 2016 08:53

Fellow: Ahmed Mohamed Zahran From Egypt

AhmedName of Fellow:  Ahmed Mohamed Zahran

Home Centre: Faculty of Medicine, Menoufia University, Egypt

Host Centre: Sheffield Kidney Institute, Northern General Hospital, UK

Mentor: Ahmed Halawa 

Training Duration: 6 Months

 

Learning objectives:

Training and obtaining experience in field of kidney transplantation in order to establish a transplant program in our center (Emerging center SRC level c)
• Get benefits of all available educational materials in Sheffield Kidney Institute.
• Sharing in some research projects
• Addressing the issue of future cooperation and continuous support for our center regarding clinical activities and research projects

 

Profile Description and Training plan:

Ahmed Mohamed Zahran: Assistant Professor, Nephrology Unit, Internal Medicine Department, Faculty of Medicine, Menoufia University, Egypt.
Our center is a member of tri Renal Sister Center (RSC) with Damanhour Kidney Institute, Egypt and Sheffield Kidney Institute, UK under the umbrella of International Society of Nephrology (ISN). Through this partnership we can share the experiences of two other centers.

As ISN do its best to improve nephrology services all over the world especially in emerging centers, we received a fully sponsored grant under ISN fellowship program for 6 months in our mentor center Sheffield Kidney Institute, UK.
• During this period we can get experience of field of kidney transplantation through following patient’s preparation, operative, immediate post-operative and long term follow up.
• Also we can attend inpatient clinical rounds and outpatient clinics.
• We will be exposed to all available educational materials like CMEs, clinical meetings and library materials
• We can share in some research project and prepare for future co-operative research projects
• Through observation of the system as a whole we will try to transfer Sheffield Kidney institute experience to our center including regulations and administrative issues.

 

Name: Alfonso M. Cueto-Manzano

Hospital / Affiliation: Hospital de Especialidades, CMNO, IMSS

Home Country: Mexico

Host Country: Mexico

Year: 2015

Status of your program: IN PROGRESS

 

Title of the project: 

The Impact of Creatinine Standardization on the Identification of Patients with Kidney Disease in Mexico

Topic: 

Chronic Kidney Disease 

 

Short description of the project or abstract:

Patients and physicians routinely rely upon the results they generate for making decisions on the diagnosis and management of disease. In the case of creatinine, there is high variability in its measurement as most of current techniques overestimate its real value; moreover, results show inter- and intra-laboratory, and intra-individual variations, with several important implications. The impact of laboratory error is better exemplified when decisions in evidence-based guidelines are triggered on the basis of a laboratory test result: if the test result is inaccurate, some patients will be treated unnecessarily while others that should be treated will not be. The uniform application of such guidelines requires that all laboratories operating under the guideline utilize testing methods that have been standardized to produce uniformly accurate test results. In Mexico, there is no widespread standardization of creatinine measurement and the impact of such adjustment has not been evaluated yet.
The study will examine the testing error associated with the measurement of creatinine. Detailed information form each participating laboratory, including the method currently being used, will be collected. Each laboratory will be shipped 3 sets of human serum samples (matrix insensitive, commutable, each set to consist of 3 samples) for a total of nine samples.

Concentration of creatinine will cover the clinical range of interest for diagnosis of CKD stage 3. Creatinine target values will be assigned using an isotope dilution gas chromatograph mass spectrometry (ID|GC|MS) Reference Method approved by the IFCC Joint Committee on Traceability in Laboratory Medicine. Laboratories will be asked to measure creatinine in these samples 3 times on each of 3 days and to submit test results to the study coordinating office. Such results will be used to calculate precision , bias and total error (TE) for the measurement of creatinine in each of the participating laboratories.
In addition, each laboratory will be asked to provide a list of creatinine results that they reported the preceding 2 months, including the patient’s age and gender. Assignation of values by the IDMS reference method will be performed by a reference laboratory (HealthMetrx, Vancouver), responsible for sending samples, collecting information, and evaluating laboratories’ performance. Laboratory testing performance will be assessed on the basis of the assigned target value and a fixed TE limit. Patient data will be used to provide an estimation of the number of test results that the laboratory produces for creatinine measurement, and will be subsequently used to calculate eGFR. The number of patients with an eGFR <60 ml/min/1.73m2 will be determined before and after post-analytical standardization of the creatinine results. These data will then be used to determine the rate of eGFR miss-classification in each laboratory. The costs of the treatment of kidney disease can then be used as an estimation of health care costs associated with false positive/false negative rates of miss-classification.

 

Learning or Research objectives:

To evaluate the accuracy of laboratories in measuring serum creatinine, and to establish their respective correction factor after standardization with an ideal methodology (IDMS). Additionally, we will evaluate the impact of creatinine standardization on identifying individuals who could be diagnosed with CKD on the basis of an estimated GFR.

 

Monday, 27 June 2016 13:31

Saving Young Lives in Uganda

ugnda

Program 

Starting date: An official opening ceremony was held on 28 March 2014
with KCCA Executive Director Jennifer Musisi.

Leadership: Judith Aujo and Dr Peter. Dr. Peter is a adult nephrologist from Kisenyi Health Center
and Dr. Judith Aujo is a pediatric nephrologist.The first shipment of supplies has arrived and the program is ready to begin.

Data in 2016: TBC, no patients have been recorded to date

 

Settings

The PD for AKI program was started initially in the capital of Uganda, in the smaller Kampala Capital City Authority (KCCA)’s Kisenyi Health Centre. Cooperation with the larger Mulago Hospital as the main teaching and referrals center with 1500 beds capacity, is underway. The Mulago Hospital was founded in 1913, and is the main National Regional Hospital for the entire country and a teaching hospital for the Makerere College of Health Sciences. It also serves as a general hospital for the Kampala metropolitan.

 

Trainings:

  • 2 nurses had a 7 weeks training on acute PD in Khartoum in 2015, under the SYL program.
  • Judith Aujo a went to the annual training  course in Cape Town in 2012, at the Red Cross Children hospital on PD catheter insertion: 5 days of training

 

Monday, 27 June 2016 12:58

Saving Young Lives in the Ivory Coast

yopougon2

Program:

Starting Date: 2013

Leadership: Dr. Laurence Adonis-Koffy, a fully IPNA trained paediatric nephrologist
The start of the program was initiated during a regional pediatric nephrology
meeting held in Abidjan and co-sponsored by IPNA

Data in 2016: average of 1 patient a month

 

Settings:

Ivory coast

The PD for AKI program was started at the The University Hospital of Yopougon, in the Ivory Coast. It is a public hospital, open since 1990 and one of the three main centers in the country.

It is divided into three blocks, two of which are devoted to internal medicine, general surgery, imaging and neurology while a block is reserved for pediatrics and gynecology - obstetrics.

 

Trainings:

  • In 2013: two persons, a doctor and nurse, have attended the annual course in Cape Town, at the Red Cross Children hospital on PD catheter insertion: 5 days of training (Gnenefoly Diarrassouba and N'guessan Thérèse Yobouet)
  • Dr. Laurence Adonis-Koffy was sponsored by IPNA and SKCF to attend the 16th International Conference on Dialysis and the 6th Senior Pediatric Nephrology Fellows program and the Global Health Workshop in Las Vegas (USA) in January 2014, followed by an Obervership at the University of North Carolina (UNC) Pediatric Nephrology Division under the auspices of Dr. Maria Ferris.

 

Monday, 27 June 2016 12:27

Saving Young Lives in Mwanza, Tanzania

mwanda

Program: 

Starting date: First WKD screening in 2014

Leadership: Two fully trained nephrologists are currently on site, Drs. Mubarak Janmohd and Dr. Fatma Bakshi.

 

 

bmc

Settings: 

The PD for AKI program is underway at the Bugando Hospital in Mwanza. The hospital has 900 beds and a catchment zone of 13 million.

 

Trainings: 

Dr. Fatma Bakshi will be working on her Master thesis project locally in Mwanza, probably on the epidemiology of AKF, incidence/prevalence.
Dr. Bakshi was sponsored by IPNA and SKCF to attend the 16th Int’l Conference on Dialysis and the 6th Senior Pediatric Nephrology Fellows program and the Global Health Workshop in Las Vegas in Jan. 2014, followed by an Obervership at the University of North Carolina (UNC) Pediatric Nephrology Division under the auspices of Dr. Maria Ferris.
In 2014, they held their 1st and most successful WKD screening in 2015, where >1,000 people showed up for screening which included, BP, glucose and urine checks, with money raised locally by Drs. Mubarak & Fatma, both trained at Rogosin Institute (Weill Cornel University-USA) by Dr. Roxana Bologa. They have full administrative support from the hospital which is 51% government/49% catholic charity owned.

 

 

Monday, 27 June 2016 10:01

Saving Young Lives in Kumasi, Ghana

Ghana Kumasi1

Program

Started date: 2013

Leadership: Dr. Sampson Antwi, fully IPNA trained pediatric nephrologist, 

Data in 2016: Since 2013, they are treating an average of 2-3 patients per month.

 

The program is dedicated to children with a planned expansion to adults in the future.The program is expanding to raise community awareness and increase referrals of cases to the hospital.
The success of our PD program has been presented extensively at scientific conferences and continuous medical education programs throughout the country and beyond. This has afforded many health personnel in the districts to either consult our center on phone or refer cases to us. Hands-on PD training program has been organized for Emergency Physicians in the hospital as well as some residents and district doctors.
Plans are underway to organize more PD training workshops for district doctors across the regions of Ghana.

 

Settings

Ghana Kumasi

The PD for AKI program was started at the Komfo Anokye Teaching Hospital (KATH), in Kumasi. The hospital is located in the city of Kumasi in the Ashanti Region of Ghana, West Africa. KATH is the second largest hospital in Ghana with approximately 1000 beds. The geographical location of KATH, the road network of the country and commercial nature of Kumasi make the hospital accessible to all the areas that share boundaries with Ashanti Region and others that are further away. As such, referrals are received from all the northern regions (namely, Northern, Upper East and Upper West Regions), Brong Ahafo, Central, Western, Eastern and parts of the Volta Regions.

 

Trainings

  • 2012: Participation of Dr. Sampson Antwi in the annual course in Cape Town, at the Red Cross Children hospital on PD catheter insertion: 5 days of training
  • Summer 2013: Educational ambassador training during a week in Kumasi. Mr. Seth Johnson trained 40+nurses and medical professionals on kidney disease, and dialysis.
  • Fall 2013: Participation of Dr. Elliot Tannor in the annual course in Cape Town, at the Red Cross Children hospital on PD catheter insertion: 5 days of training
  • December 2015: Dr. Antwi participated in the first international dialysis course of West Africa in Dakar
  • Dr. Sampson Antwi is now developing a pilot project to raise community awareness and capacity building in Kath Hospital’s catchment area.

 

Thursday, 23 June 2016 15:33

Saving Young Lives in Accra, Ghana

Ghana.Accra

Program:

Started date: 2012

Leadership: Victoria May Adabayeri.
3 paediatricians and a nurse form now the core of the PD team in the department

Data in 2916: PD fluids arrived in November 2013 and the first patient was treated in April 2014.
The hospital has treated on average 1 patient per month.

 

Settings:KorleBu logo

The PD for AKI program was started in Accra at the Korle Bu Teaching Hospital. The Population of Accra is about 2.2 million but as the flagship tertiary center, Korle-Bu caters to the whole country with a capacity of 2,000 beds.
It is currently the third largest hospital in Africa and the leading national referral centre in Ghana.

 

Trainings:

Several doctors have been trained in various short term training programs and a nephrology nurse, Seth Johnson, NP, from the Renal Research Institute in NYC (USA) taught in Accra for a week in the summer 2013.

  • 2012: Participation of Dr. Victoria Adabayeri, a paediatric nephrologist as well Dr. Samuel Osei –Nketia, a surgeon in the annual course in Cape Town, at the Red Cross Children hospital on PD catheter insertion: 5 days of training
  • 2013: Participation of Charlyne Kilba in the annual course in Cape Town, at the Red Cross Children hospital on PD catheter insertion: 5 days of training
  • 2015: Participation of Dr. Beatrice Nyann and Nurse Emma Odarchoe Hammond in the annual course in Cape Town, at the Red Cross Children hospital on PD catheter insertion and the WCN of Nephrology
  • December 2015: Dr. Adabayeri participated in the first international dialysis course of West Africa in Dakar
  • Educational ambassador training during a week in Accra. Mr. Seth Johnson trained nurses and medical professionals in Accra and Kumasi.
  • ISN has established a Sister Renal Centre Quattuor with Accra (Charlotte Osafo) and Kumasi (J Plange Rhule) + Queen Elizabeth Hospital, Birmingham (Graham Lipkin) + St. George's Hospital, University of London (John Eastwood.).

 

Thursday, 23 June 2016 14:48

Saving Young Lives in Ethiopia

Ethiopia

Program:

Started date: 2015

Leadership: Yewondwossen Tadesse, a fully trained nephrologist.

Data in 2016: The fluids and catheters have arrived in 2015 and the first patients have been treated.

 

Settings:

The PD for AKI program was started at the The Black Lion University Hospital. The center is located in the nation’s capital Addis Ababa, and is Ethiopia’s largest general public hospital and one of only two university hospitals in the country. The faculty is the oldest and the largest among the health training institutions in the country, staffed with the most senior specialists.
The hospital provides a tertiary level referral treatment and is open 24 hours for emergency services. Black Lion hospital offers diagnosis and treatment for approximately 370,000- 400,000 patients a year. The hospital has 800 beds, with 130 specialists, 50 non-teaching doctors. The emergency department sees around 80,000 patients a year.

 

Trainings:

  • November 2012: Participation of Y. Tadesse in the annual course in Cape Town, at the Red Cross Children hospital on PD catheter insertion: 5 days of training
  • November 2013: Participation of Dr. Addisu Melkie Ejigu and sister Elizabeth Workineh Ayele annual course in Cape Town, at the Red Cross Children hospital on PD catheter insertion: 5 days of training
  •  2 AKI papers were published in 2013. Several short trainings have been organised for the various supporting staff. There is a strong relationship with the university of Toronto Global Health program.
  • January 2014: Drs. Damte Shimelis and Muluwok Denberu went for a week of training to Sudan at the Soba University hospital in conjunction with Dr. Watson's ISN educational Ambassadors' training.

 

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