Name of Emerging Center (EC): State Second General Hospital of Mongolia

City: Ulaanbaatar

Country: Mongolia

Main Contact at EC: Sodnomdarjaa Baigalmaa, Erdenebileg Narnygerel

ISN Ambassador: Atta G Mohamed and Lois Arrend

ISN Ambassador’s nationality: USA

 

Main topic of Training:

Advancing the diagnosis and treatment of kidney diseases through renal biopsy

Duration of the training:

1 week

 

Details about the Institution:

The State Second General Hospital is one of main three clinical hospitals in Mongolia. The hospital has long history since 1930s and used to serve to high level officials including parliament members, ministers and also those who have state awards. Our hospital was granted the ISO 9001 2000 since 2011.
Currently, there are approximately 30 000 clients are treated within our serving community. As for the outpatients clinics, approximately 117 000 patients are served annually. Recently our hospital has divided its internal medicine wards into specialties as Cardiology, Nephrology and Endocrinology, Gastroenterology and Pulmonology departments respectively. Currently the hospital operates with 200 inpatient beds in addition to above General surgery, Neurology, Pediatrics, Pathology, and Traditional Medicine departments. There are about 450 medical staffs working for the clients’ well-being and their better quality of life. We initiated the ISN Education Ambassador program since 2014 at our hospital. The Nephrology and Endocrinology department aims to advance the diagnosis and treatment of kidney diseases through renal biopsy. In particular, glomerulonephritis, hypertensive nephropathy and diabetes nephropathy, leading cause of the end stage renal diseases locally, need optimal treatment in their early stage to prevent from their devastating complications.

 

Training Plan: 

The main objectives of the training is to:

  • improve the local nephrologists and pathologists knowledge and skills
  • advance the diagnosis and treatment of kidney diseases
  • contribute to develop the nephrology field locally

The training will be conducted in two part: clinical nephrology by Dr.Atta G Mohamed from Johns Hopkins Hospital and renal pathology by Dr.Lois Arend from Johns Hopkins Hospital. All local nephrologists and pathologists will be participated. The renal biopsy will be done by nephrologists under the supervision of EA. Biopsy sample preparation and interpretation will be reviewed by the EA. This year, it is noteworthy of conducting onsite renal pathology training at first time. We believe that this training will be of great importance to improve the current practice of renal biopsy and renal pathology and to improve the diagnosis and treatment of kidney diseases.

 

Picture LimaName of Emerging Center (EC): Hospital Guillermo Almenara

City: Lima

Country: Perú

Main Contact at EC: Antonio Fernandez Burga

ISN Ambassador: Carmen Avila-Casado

ISN Ambassador’s nationality: Mexican

 

Main topic of Training:

Renal patology

Duration of the training:

1 week

 

Details about the Institution, Training plan and Objectives:

  • Promote the growth of the local nephrology practice and improve the quality of patient´s care.
  • Update our knowledge in renal pathology with emphasis on the findings by electron microscopy 

IMG 20150717 WA0003

picture KarnatakaName of Emerging Center (EC): Department of Paediatric Nephrology,
St. John’s Medical College Hospital

City: Bengaluru

Country: India

Main Contact at EC: Dr. Arpana Iyengar

ISN Ambassador: Dr.Rukshana Shroff

ISN Ambassador’s nationality: British

 

Main topic of Training:

“ESRD Care-Dialysis and Comorbidities in Children”

Duration of the training:

1 week 

Details about the Institution and Objectives:

Our Institution:
St John’s National Academy of Health Sciences consists of a Medical College, counted as one of the best in the nation, a state of the art Hospital with 1350 beds for all medical and surgical departments including super-specialty departments, College of Nursing, a Research Institute - the first in a medical school and an Institute of Health Care Management and Paramedical Studies, all spread over 132 acres of verdant campus in the City of Bangalore.

Our Department:

The Department of Pediatric Nephrology, being one of the leading referral centers for care of children with kidney disease in India, has a 20 bedded general ward including dedicated/isolated beds for children on dialysis, Pediatric ICU with dedicated facilities for acute dialysis and maintainenace hemodialysis and peritoneal dialysis care units shared with the adult nephrology unit. The department has the fortune of receiving support from the ISN through the Sister Renal Centre Program (2007-2014) winning the “Schrier Award” towards the outstanding collaborative activities with Montreal Children’s Hospital, Montreal, Canada.
We strive to strengthen our renal transplant program under the umbrella of the ISN-TTS Sister Transplant Centre Program with Bambino Gesu children’s Hospital,Rome, Italy (2015 till date). The department has 4 full time faculty a Medical Social worker a pediatric nephrology nurse and a CKD coordinator. The department currently offers outpatient and inpatient care for acute and chronic diseases of the kidney in newborns, infants and children with specialty clinics for CKD, ESRD, Renal Transplantation and Nephro-Urology, critical care nephrology including acute dialytic therapyand community Outreach programs for screening and spreading awareness on pediatric kidney diseases.
It is one of the few centers for pediatric renal transplantation in India The Department has a Pediatric Renal Laboratory for Basic Science Research. We conduct Clinical and Basic Science research activities funded by Department of Biotechnology, Indian Council of Medical Research and the International Society of Nephrology.

The objectives of the ISN Ambassadorship Training program are:

  • To strengthen dialytic care for children and infants with ESRD.
  • To recognize and manage unique comorbidities relevant to Indian children on maintenance dialysis
  • To improve the paramedical services and skills in pediatric dialysis management.

 

The Training plan:

Beneficiaries: Pediatric Nephrology Faculty and trainees, Pediatric trained Nurses, CKD coordinators and Dialysis Technicians Training format and methods:

The format includes workshop and hands – on demonstration on principles of dialysis and functioning of the machine with trouble shooting in various clinical scenarios, clinical case presentations in order to understand and manage practical issues in children on dialysis, small group discussions to help develop protocols for challenging issues like phosphate control, gastrostomyfeeding and infection control and lectures on dialysis adequacy and data base management.

Expected Outcomes of the training program:

  • Establishing clear clinical protocols for dialytic therapy for ESRD
  • Improvement in multidisciplinary care of comorbidities of ESRD
  • Pursuing clinical research in the area of CKD and ESRD relevant to our community and region under the mentorship of the ISN Ambassador

 

picture hanoi vietnamName of Emerging Center (EC): Viet Duc Hospital

City: Hanoi

Country: Vietnam Main

Contact at EC: Ha Phan Hai An

ISN Ambassador: Nobuaki Yamanaka

ISN Ambassador’s nationality: Japan

 

Main topic of Training:

Renal Pathology, Chronic Kidney Disease management

Duration of the training:

One week

 

Details about the Institution and Objectives:

Viet Duc hospital is a main surgical center which is located in Hanoi, Vietnam. Department of Kidney Diseases and Dialysis at Viet Duc is young and is a single medical department in this surgical environment. Almost all staff members of Department are young and enthusiastic, very keen to learn and to improve their qualification. The Department is also part of a teaching hospital where many other health professionals from other health facilities come for training. The hospital is a referral health facility where the most severe patients come to seek for health care services.

To present, the Department of Kidney Diseases and Dialysis has 3 units including: Dialysis Unit (capacity 30 HD machines, room for training PD patients); In-Patient Unit (20 beds for patients with kidney and medical problems); Renal Clinic (follow-up for kidney transplant patients, other patients with kidney and medical problems at out-patient basis).
The department is working closely with Hanoi Medical University to train both undergraduate and graduate students. The staff members of department are actively participating into research and clinical trials in Kidney field. Along with requirements of population and of Ministry of Health of Vietnam, the hospital in general and the Department in particular must be developed to reach the regional and international standards in Nephrology Care.

Objectives: Improving the diagnosis and management for kidney patients and Strengthening the collaboration and link between health care professionals in Vietnam and with those from Japan

 

Training plan:

  • Lectures on Renal Involvement and Renal Morphological features in extra-renal diseases such as infectious diseases, systemic diseases
  • Case study based on real cases
  • Practise the staining techniques for kidney specimens

picture hanoi vietnam 2

picture argentinaName of Emerging Center (EC): SANATORIO ALLENDE


City: CORDOBA


Country: ARGENTINA


Main Contact at EC: Marcelo Orias


ISN Ambassador: Aldo Peixoto


ISN Ambassador’s nationality: AMERICAN

 

Main topic of Training:

ACUTE KIDNEY INJURY

Duration of the training:

2 Weeks 

Details about the Institution and Objectives:

Our institution is a tertiary care hospital and we asist a wide and heterogeneous group of patients, including acute and chronic hemodialysis, peritoneal dialysis and kidney transplantation. We have a 4 years fellowship program.
Acute kidney injury is a challenging area in nephrology, specially in developing countries as Argentina. Our objectives include developing a more comprehensive view of prevention and early therapeutic strategies in AKI. Our final goal is to develop an “AKI workgroup” as we think nephrologists are usually not the first ones involved in AKI patients care. We feel that clinicians, ER doctors, and specially critical care doctors have different approaches to AKI diagnosis and early therapy and that joining efforts and experience would result in patients best interest and care.

 

Training Plan:

  • Every morning "workrounds" in the ICU with hands-on training.
  • Every noon 2 hours lectures with renal fellows and ICU residents
  • Talk with all members of Cordobas society of Nephrology.
  • Training in US guided cathether placement.

 

Picture cape townName of Emerging Center (EC): Groote Schuur Hospital

City: Cape Town

Country: South Africa

Main Contact at EC: Erika Jones 

ISN Ambassador: William O’Neill

ISN Ambassador’s nationality: American

 

Main topic of Training:

Interventional Nephrology

Duration of the training:

1 week

 

Details about the Institution, Training plan and Objectives:

GSH is a tertiary hospital in one of the major cities in South Africa. The hospital is attached to the University of Cape Town and is a major training facility in South Africa.
UCT and GSH provide postgraduate training for registrars and fellows in nephrology from all of Africa.
The objectives are to improve skills and training ability in order to improve patient care and service in Africa. 

 

image Capoe town JashiraPicture cape town 2Picture cape town 3PIC Cape Town South Africa Bianca Davidson

PIC Cape Town South Africa Brian RaynerPIC Cape Town South Africa Erika Jones PIC Cape Town South Africa Ike Okpechi PIC Cape Town South Africa Phetho Mangena 

Name: IGIRANEZA Grace

Hospital / Affiliation: University of Rwanda / University Teaching Hospital of Butare

Home Country: Rwanda

Host Country: Rwanda

Year: 2014

Status of your program: COMPLETED

 

Title of the project:

Incidence, risk factors and outcome of Acute kidney injury
in tertiary teaching Hospitals in Rwanda

Topic: 

Acute Kidney Injury

 

Short description of the project or abstract:

Introduction:Acute kidney injury (AKI) is a major global health concern in both developed and developing countries. Although etiologies and risk factors of AKI in high and low income settings vary, a shared feature is the significant morbidity and mortality associated with AKI in both settings . There is limited data from East Africa including Rwanda on the epidemiology, risk factors and clinical implications of AKI among hospitalized patients.

Objectives: The overall objective of this study was to assess the features of AKI in Rwandan tertiary teaching hospitals .
Specific aims were: 

  • To determine the profile AKI patients
  • To determine the medical comorbidities associated with AKI
  • To determine causes and risks factors of AKI
  • To determine the mortality rate and the length hospital for AKI patients in Rwandan tertiary teaching hospitals.

Methods: This is a prospective observational study conducted at four referral teaching hospitals in Rwanda between September 1, 2014 and January 31, 2015. All admitted patients >age 15, with serum creatinine >= 1.4 mg were screened for evidence of AKI. During the study period, serum creatinine levels were reviewed on a daily basis at all study sites. Patients that met study criteria had demographic and clinical information collected and were followed until the end of hospital stay. Epidata 9 and Stata 11 softwares were used for data entry and analysis respectively. Demographic and clinical variables were expressed as frequencies. Statistical analyses were done using two sample T test or Wilcoxon rank sum test for continuous variables depending on the underlying distributions of the variables and Pearson chi square test for categorical variables.

Results: Four hundred and twenty seven participants met study criteria for AKI. Fifty-six percent (56.2%) of individuals with AKI were within ages 15 to 50 years, while the elderly (>65 years of age) constituted 20.6% of study patients. The mean age of AKI patients was 47 years. Male to female ratio was 1:1.4. AKI had complicated Infectious diseases in 68.9% of patients. The most frequent non communicable comorbidity in AKI patient cohort was hypertension (24.8%). Pregnancy related AKI made up 12.4%. The average length of hospital stay was 15 days and all-cause mortality among patients with AKI was 31.9%.

Conclusion: AKI in tertiary teaching hospitals in Rwanda complicates mostly infectious diseases and AKI patients experience significantly prolonged length of hospital stay compared to patients without AKI. Further research is needed to understand the etiologies of AKI in Rwanda in order to guide strategies to prevent and/or reduce AKI-related morbidity and mortality.

 

Learning or Research objectives:

Briefly, the research objectives were to evaluate the burden of AKI and its outcome in referral teaching hospitals in Rwanda. Long term outcomes have been difficult to assess due to the high rate of loss to follow up patients after one year.

 

image GuzmanName of Fellow: Maria Alejandra Guzman MD.

Home Centre: Nephrology Service, Hospital Privado Centro Médico de Córdoba

Host Centre: Kidney Disease Medical Research Unit, , Western Medical Center,
Mexican Institute of Social Security (IMSS) Guadalajara, Jalisco, Mexico

Mentor: Dr Alfonso Martín Cueto Manzano

Training Duration: 12 months as from 07/01/2015

 

 

 Learning objectives:

  • Develop skills in prevention, diagnosis and treatment programs of early CKD.
  • Develop educational strategies to health professionals and patients at the primary care
  • Training in clinical research, focused Prevention, Diagnosis and Treatment of Early CKD
  • The management of ESRD with peritoneal dialysis

 

Profile Description and Training plan:

The Kidney Disease Medical Research Unit, makes clinical research in various nephrology areas including prevention, diagnosis and treatment of early CKD, replacement therapy of renal function, ESRD nutritional inflammatory aspects, disorders of mineral metabolism and cost studies in dialysis and early CKD.

The program includes trainings in clinical research, attending classes in research methodology and biostatistics, attendance at meetings and academic activities of the Nephrology Department and finally Fieldwork participations in various projects managed by the research unit.

  

EC Institute: Regional intensive care center of Lutsk City Clinical Hospital

EC Liaison officer: Andrii Smolianinov

SC Institute: Nephrology clinic of Brest regional hospital

SC Liaison officer: Andrei Shestiuk

MC Institue: The Hospital of Lithuanina University of health Sciences Kaunos Klinikos

MC Liaison officer: Inga Bumblyte

 

 Ukraine Belarus LithuaniaUkraine Belarus Lithauania1

Name of SRC Pair: Ukraine-Belarus

SRC Level: Level C

Short description of the project or abstract:

The present nephrology service model in EC is post-Soviet, it requires significant changes to bring it nearer to modern Western model. Outpatient service needs improvement in follow-up program, choosing a dialysis modality and starting dialysis.

There are problems in CKD patient observation, including vascular access complications, hemodialysis procedure efficacy and patient's quality of life control, calcium-phosphorus disturbancies and anemia treatment.

The lack of knowledge in field of CRRT methods and treatment of AKI in intensive care unit required upgrade of clinical service and initiation of transplantations in EC. Clinical staff training will be the keynote accent of the program to improve treatment of nephrological patients in Ukraine. Medical staff will visit to and from EC, including patient's rounds in renal department and outpatient clinic, discussing and transfering recent treatment guidelines, implemention of CRRT (CVVHF, CVVHDF) HDF-online procedures, preparation for beginning of transplantations. Finally, lectures will be given in Russian language during conferences and educational materials will be provided in order to deepen EC's knowledge in relevant nephrology topics.

Activities: 

  • Training in Kaunas University Hospital: one nephrologist from Lutsk and another from Brest, who will serve as "teachers". They will deepen their knowledge in dialysis and intensive care, will be introduced with Kaunas treatment protocols and experience, will look for things suitable for implementation in Lutsk.
  • Training in Brest Clinics for 1 week duration. 3 people from Lutsk (including nurses) for further sharing and widening of knowledge. Together revising treatment protocols, discussing complicated clinical cases, reviewing KDIGO and ERBP guidelines.
  • Regional conference with round tables and interactive discussion in Lutsk with participation of doctors from all region, topics for discussion with clinical case presentation chosen by local physicians
  • speakers from Kaunas, Brest.

 

Learning objectives:

  • Clinical staff training of workers of Lutsk City Clinical Hospital (EC) with work of Lithuanian University of Health Sciences Hospital (MC).
  • Clinical staff training of workers of Lutsk City Clinical Hospital (EC) with work of Brest Regional Hospital (SC)
  • Regional conference with round tables and interactive discussion in Lutsk (EC)

 

image J staniferName: John W Stanifer, MD, MSc

Hospital / Affiliation: KCMC Hospital

Home Country: United States

Host Country: Tanzania

Year: 2013

Status of your program: Completed

 

 

Title of the project:

Comprehensive Kidney Disease Assessment for Risk Factors,
epidemiology, Knowledge, and Attitudes (CKD-AFRIKA) Study

Topic: 

Chronic Kidney Disease

 

Short description of the project or abstract:

The study was a project in Northern Tanzania with the goal of understanding and addressing the health burden of CKD. The specific aim of the study was to estimate the prevalence, evaluate potential etiologies, and examine awareness of CKD so that we can better inform public health efforts directed toward CKD. We also evaluated the used of traditional medicines and explored their impact and implications for individuals living with CKD. We observed a high burden of CKD in Northern Tanzania that was associated with low awareness. Although demographic, lifestyle practices including traditional medicine use, socioeconomic factors, and NCDs accounted for some of the excess CKD risk observed with urban residence, much of the increased urban prevalence remained unexplained and will further study as demographic shifts reshape sub-Saharan Africa.

 

Learning or Research objectives:

Epidemiology of CKD in low-income countries MIxed-methods Community-based research

 

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