2^nd Global Summit on Nephrology, Urology and Kidney Transplantation August 28-30, -0001 Philadelphia, USA

The diabetic kidney disease sometimes also called as diabetic nephropathy is a renal related complication usually occurs in some people with diabetes mellitus. In diabetic nephropathy filters of the kidneys and glomeruli become damaged. In this condition the kidneys leak abnormal quantity of protein from blood into the urine.

If anyone has diabetes, the blood glucose, or blood sugar levels are very high. For prolonged period, this can damage the kidneys. The role of kidney is to clean your blood. In case they are damaged, waste and fluids accumulate in your blood with out of leaving from your body.

If the kidney damage by diabetes is called diabetic nephropathy. Usually it starts long before you have notice symptoms. The beginning sign of it is small quantity of protein in urine. By urine test we can detect diabetic nephropathy or blood test can also determine the functioning of kidneys.

If the damage continues for prolonged period the kidneys may fail. Actually, diabetes is the most common cause of renal failure in the U S. People with kidney failure should go for dialysis or kidney transplantation.

Kidneys are very important for survival with their large network of blood vessels and capillary network of tubes and tubules that filter blood excrete excess water and waste products. The role of kidneys is to maintain fluid, acid-base balance and electrolytes in our body, these functions are interrupted by many disease conditions as well as medicines and toxins.  Glomerular diseases that affect the micro filtering systems of the kidneys termed as the glomerulus, abnormalities urine like excess loss of protein, sugar, casts, and blood crystals through the urine. Tubulointerstitial diseases affect the tubules of the kidneys, renal vascular diseases affecting the networks of blood vessels within the kidneys, kidney failure that can be either sudden, acute or long term or chronic, renal and bladder stones, infections of kidney, kidney cancer, urethra, and bladder, Effects of diseases such as diabetes and high blood pressure on kidneys, imbalances of acid base, Nephrotic syndrome and nephritis, Ill effects of drugs and toxins on the renal system, The long term complications of dialysis- dialysis includes peritoneal dialysis as well as hemodialysis, The autoimmune diseases like lupus, autoimmune vasculitis, etc. The cystic diseases of kidney where large cysts or fluid filled sacs are generated within the kidney diminish its functions; this is an inherited and congenital or genetic condition.

Acute renal failure (ARF), previously called acute kidney injury (AKI), is a sudden and unexpected loss of kidney function that develops within a week. Acute renal failure (formerly known as acute kidney injury) is a disease distinguished by the acute loss of the kidney's eliminatory function and is commonly diagnosed through the accumulation of urea and creatinine or reduced urine output, or both. Acute kidney injury may lead to a number of kidney problems, including high potassium levels, metabolic acidosis, changes in body fluid balance, uremia, also effects on other body systems ultimately leads to death. People who have experienced acute kidney injury may have high incidence of chronic kidney disease in the future. Controlling measures includes treatment of the root cause and supportive care, such as kidney transplantation.

End-stage renal disease also termed as chronic kidney diseases (CKD) comprise conditions that damage kidneys and impair their ability to keep you hygienic by abnormal function. On condition kidney disease gets worse; wastes can accumulate to high levels in your blood and make you feel ill. You may develop issues like anemia, high blood pressure, weak bones, nerve damage and poor nutritional health. Also, kidney disease elevates your risk of having coronary disease and heart problems. These problems may occur slowly for a long period of time. Diabetes and high blood pressure are the two main causes of chronic kidney disease.

Kidney cancer (also called renal adenocarcinoma or renal cell cancer) is a disease in which cancer cells are found in the lining of tubules in the kidney. We have two kidneys, behind the peritoneum one on each side of the spinal cord, just above the waist. Small tubules in the kidneys purify the blood. Unabsorbed products formed as urine. The formed urine passes in to bladder through long tube called bladder. The urine stored in bladder until leaves from body through urethra. Kidney cancer perhaps remains clinically occult for most of its course. Immunomodulatory agents and targeted therapy are the standard of care in metastatic disease patients.

Kidney cancer: The most common malignant disease affecting kidney is kidney cancer. One of the most common causes for kidney cancer is smoking.

The most common form of kidney replacement therapy is dialysis, is a way of cleaning the blood with artificial kidneys. There is of types of dialysis they are:

1. Haemodialysis  

2. Peritoneal dialysis.

Haemodialysis

Hemodialysis required with the patients of renal failure. In this process of hemodialysis, an artificial kidney purifies blood. We should make an "access," usually in the forearm where blood can easily be taken from the body and sent to the artificial kidney for purification. The access collects blood from patient body and undergoes purification in artificial kidney and again injected the purified blood in to patient body.

Peritoneal dialysis

In peritoneal dialysis no artificial kidney is used. The peritoneum (lining inside your abdomen) is used as a filter instead of artificial kidney. Peritoneal dialysis is of two types they are continuous cycling peritoneal dialysis and continuous ambulatory peritoneal dialysis. Peritoneal dialysis is used in kidney failure patients.

Kidney Transplantation is the way toward putting a solid kidney which assumes control over the work of cleaning blood by performing surgery in patients with kidney failure. It is delegated living contributor transplantation or perished benefactor transplantation on the wellspring of organ of the giver.

Kidney transplantation is the decision of treatment when kidneys fall flat alongside hemodialysis and peritoneal dialysis. kidney transplants are arranged into two sorts: those that originate from living contributors and those that originate from inconsequential givers who have kicked the bucket (non-living donors).Kidney transplant should be possible to patients who : withstand the impacts of surgery, immunosuppressant pharmaceutical, transplant has great shot of accomplishment, medicines after transplantation. Not at all like numerous different sorts of organ gift, it conceivable to give a kidney while you are alive on the grounds that you just need one kidney to survive.

The field of transplantation is at a cross roads for sure. On one hand are the new and exciting discoveries that are helping promote longer and better graft function and patient survival. On the other hand are the challenges that health-care professionals and more importantly our patients, face. The lack of available organs and the ever increasing wait-times lead to a suboptimal quality of life for many, and for others, this discrepancy has robbed patients of their only chance for survival. The system of health care financing adds an additional layer of complexity and stress in the lives of all those involved in this area.

Pediatric Nephrology is a specialization in the diagnosis and management of children with different types of acute and chronic kidney-related diseases. The division assesses and treats hypertension, proteinuria, hematuria, renal tubular acidosis, glomerulonephritis, nephrolithiasis, and kidney disorders. Various kidney diseases like pediatric nephritis is clinically and hereditarily heterogeneous substance portrayed by backsliding, and interminable course with noteworthy dreariness and mortality coming about because of intricacies of the sickness itself, and its treatment.

The Pediatric nephrology research clinical perceptions relating to any part of the wide range of intense and incessant maladies that influence renal capacity in kids and in addition on hypertension and liquid and electrolyte digestion system.

Patients with a wide range of kidney infection and hypertension this also includes chronic or acute kidney diseases, kidney stones, because of  any cause, resistant or secondary hypertension, cystic kidney diseases, inherited kidney diseases, unexplained proteinuria or hematuria, fluid and electrolyte homeostasis abnormalities, pregnancy-related kidney disorders, nephrotic, glomerulonephritis, vascular kidney diseases, and others. Hypertension occurs when the pressure of blood on the walls of blood vessels increases enough to bring about harm. For individuals who have diabetes or unending kidney infection, circulatory strain of 130/80 or more is viewed as high. A few sorts of kidney sickness may bring about hypertension. All the more frequently it is hypertension that causes kidney illness. Hypertension can accelerate the loss of kidney capacity in individuals with kidney disease.

Kidney disease may also lead to heart disease or coronary illness because of this more than 20 million people died in the U.S. with chronic kidney disease. Chronic kidney disease induces the risk of death from cardiovascular disease. Coronary disease result for more than half of all deaths among individuals with CKD (Chronic kidney diseases).  Indeed, even early or mellow renal disease ailment puts a man at higher danger of heart ailments and heart attacks and also heart disease-related death.  Kidney dialysis patients who also have cardiovascular disease are died 10 to 30 times more than in the general cardiovascular patients. Diabetes and hypertension are major risk factors for heart disease and chronic kidney disease. Kidney disease (acute kidney disease or chronic kidney disease) can induce the danger of cardiovascular ill, even with hypertension, high cholesterol and concurrent diabetes. Recent researches show that kidney diseases (renal diseases) induces heart disease, even before the kidneys are harmed to the point of requiring dialysis or transplantation

Abnormal glomerular function may leads to damage of glomerulus components such as capillary endothelium, mesangium and epithelium basement membrane. In renal biopsy we can see cellular and structural pattern of glomeruli injury by using electron microscopy, light microscopy.

The compartment of tubulointerstitial is damaged in all the forms of kidney disease. As per the time of examination and the intensity of the lesions, in vascular diseases and glomerular we can identify tubular damage in glomerular, interstitial inflammation, tubular atrophy, fibrosis or edema. Tubular or acute interstitial damage can lead acute kidney failure, and prolonged changes are a best investigation of irreversible lesions and then they are great anticipation variables in vascular /glomerular diseases.

Renal or bladder stones are the crystals of such as calcium, oxalate and uric acid. If a kidney stone obstructs in urethra or the ureter, cause hematuria (blood in the urine), constant and severe pain in the back or side, fever, vomiting, or chills. Nephrolithiasis (Kidney stones): Minerals in urine form stones, which may build big enough to block flow of urine. Most kidney stones pass through urine on their own but some kidney stones are too large they cannot pass and should be treated.

Bladder stones are hard masses of minerals in your bladder. Bladder stones create when urine in your bladder gets to be concentrated, bringing about minerals in your urine to take shape. Concentrated, stagnant urine is regularly the aftereffect of not having the capacity to totally exhaust your bladder. On the off chance that bladder stones are sufficiently little, they can go all alone with no detectable indications. In any case, once they get to be bigger, bladder stones can bring about incessant inclinations to urinate, excruciating or troublesome pee and hematuria.

Under this category includes diseases of the urinary system, prostate gland including the kidneys and bladder. The bladder or urethra usually effected in urinary tract infections, yet more genuine and serious infections include the kidney. A bladder disease may bring about pelvic torment, expanded inclination to urinate, torment with pee and blood in the urine. Renal infection may bring about back agony, sickness, heaving and fever.

The renal system maintain homeostasis in the body avoiding significant modifications in the balance of fluid electrolyte or acid–base parity until the Glomerular filtration rates reduced to below 25 ml/min because of  a series of versatile changes, both Renal and extra renal. With dynamic decrease in renal capacity these components are overpowered bringing about unsettling influences in water digestion system adding to hypernatremia and hypernatremia. The modified control of sodium transport causes irritated volume status including volume over-burden and exhaustion. The rate of Hyperkalemia and metabolic acidosis is more incessant in Chronic Kidney Disease (CKD) with GFR beneath 10 ml/min. In this survey article we will endeavor to audit the renal and additional renal adjustment components looking after liquid, electrolyte and corrosive base equalization in endless kidney illness alongside variables which cause disappointment of these instruments. The article will likewise highlight the normal liquid electrolyte and corrosive base issue in interminable kidney ailment and their treatment.

The mineral and bone metabolism disorders (MBD) are common in patients with chronic kidney disease. Conventionally, these disorders collectively called as renal osteodystrophy. We can see mineral and bone disorders in patients with chronic kidney diseases, Calcium and phosphorus levels in patient’s blood to be out of balance due to imbalance of hormones. This leads to kidney failure and dialysis.

The kidneys assume an essential part in keeping up sound bone mass and structure by adjusting phosphorus and calcium levels in the blood. Sound kidneys actuate a type of vitamin D that a man expends in sustenance, transforming it into calcitriol, the dynamic type of the vitamin. Calcitriol helps the kidneys keep up blood calcium levels and advances the arrangement of bone. The kidneys likewise expel additional phosphorus, adjusting levels of phosphorus and calcium in the blood. Maintain the best possible level of phosphorus in the blood keeps healthy bones.

Some renal diseases like Polycystic Kidney Disease (PKD) are result from hereditary factors. In polycystic kidney disease number of cysts develops in the kidney, these cysts gradually replace the mass of kidney. Impairing kidney function and leading to renal failure.

Geriatric nephrology is a developing subspecialty of old patients. Patients who are living longer may obtain infections that quicken perpetual kidney diseases, which regularly remain undetected until patients are defied with the sudden requirement for dialysis

Renal cystic illness includes an extensive variety of sickness elements. They can be named either (1) inherited or obtained or (2) systemic or renal limited illnesses that have the normal element of numerous renal pimples. Every malady substance contrasts in its presentation, anticipation, and administration. Renal sores are smooth-walled, liquid filled round structures framed by central out pouching of renal tubules. In any case, huge steps have been made as of late. For autosomal predominant and autosomal passive polycystic kidney sicknesses (ADPKD and ARPKD), a photo is beginning to rise. Abandons in the essential ciliary detecting systems, intracellular calcium control, and cell cyclic AMP (cAMP) aggregation all appear to assume a part in the modified cell phenotype and capacities.

Syndrome of protein-energy wasting consists of nutritional and metabolic abnormalities seen in chronic kidney disease. Maintain a healthy lifestyle is essential for people with renal disorders, especially if you have high blood pressure, diabetes, or both. Control and maintain of good blood glucose can help to prevent or postpone diabetic complications, including kidney disease. What you eat and drink may help slow down kidney disease. Dietitian can guide you how to select foods that are easier on your kidneys about protein, potassium, phosphorus, sodium, and how to read food leaflets and labels. 

The kidneys are often targeted by pathogenic immune responses against renal auto antigens or by local manifestations of systemic autoimmunity. For the diagnosis renal pathologists use special tests and electron microscopes to detect the cells involved in diseases affecting the kidneys.

Kidney biopsies permit us to analyze renal disorders; survey anticipations; help in the determination of a particular restorative approach; and screen ailment movement in both local and allograft transplant kidneys. To maximally abuse renal biopsy examples, a blend of light, immunofluorescence and electron microscopy is used. Every type of microscopy requires distinctive strategies for obsession and preparing, so each renal biopsy center section is commonly separated into three sections. Contingent upon the length of the biopsy center or suspected illness process; in any case, the strategy for partitioning the biopsy center might be altered.

Your nephrologist will work to slow or control the reason of your kidney disease. Depending on the root cause, some types of kidney disease can be treated. Frequently, though, chronic kidney disease has no prevention. In the event that your kidneys turn out to be seriously harmed, you may require treatment for end-stage kidney diseases. In the event that your kidneys can't stay aware of waste and liquid freedom all alone and you create finish or close finish kidney disease, you have End-stage renal disorder. By then, dialysis or a kidney transplant is required. Since no particular in option and Ayurveda prescription for kidney can treat kidney disappointment successfully, the best technique is to join them. Immunotherapy, as one extraordinary leap forward in treating end-stage kidney sickness, is only a blend of cutting edge western restorative advances and customary home grown drugs.