The WCN’23 was built on three themes Kidney Failure (KF), Chronic Kidney Disease (CKD) and Acute Kidney Injury (AKI). This symposium covers six areas in KF including; conservative care, APOL1, equity and access, anemia and uremic toxicity. This session brings latest science and broad international perspectives on CKD.
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APOL1 and Kidney Failure
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People of recent West African descent have exceptionally high rates of kidney failure, which is in part attributable to inheritance of genetic variants in the APOL1 gene. While much has been learned about the epidemiology and disease mechanisms related to APOL1 risk variants, much remains to be discovered especially from a therapeutic perspective. This session will describe the latest information on epidemiology and biology of APOL1, the potential implications of APOL1 gene status for kidney transplant outcomes, and current best practices for returning genetic information related to APOL1 in both clinical and research settings.
Conservative Care in Kidney Failure
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There is increasing recognition that kidney dialysis and transplantation are extraordinary therapies for kidney failure. While life sustaining, these treatment modalities do not always provide a high quality of life, especially in frail, elderly patients with substantial comorbidities. This has led to recognition that conservative care is appropriate and in fact an active treatment approach encompassing holistic care practices. This session will review best practices in both disease management with a focus on dignity and compassionate care.
Equity and Access to Patient-centred Care
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There are many forms of disparities in both access to and quality of care in kidney disease. Geography, social determinants of health and racial-ethnic factors may all contribute to these disparities. In addition, it is important that care be centered on individual patient needs and desires. This session will examine some of the determinants of inequities in kidney care, and focus attention on the role of the patient voice in articulating patient needs and directing care strategies.
Kidney Failure and Anemia
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One of the most common complications of kidney disease is the development of anemia, as the hormone erythropoietin is produced in the kidney. Recombinant erythropoietin and analogues of the hormone have been the mainstay of anemia management in kidney disease for the past 40 years. In recent years an increased understanding of erythropoiesis in kidney has led to new therapeutic advances, and the recognition of new biological pathways affecting anemia in kidney disease. This session will describe the latest advances in the biology of anemia and its therapy in kidney disease.
Kidney Failure and Mineral Bone Disease
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As kidney function is lost, the balance of minerals in the body (in particular calcium and phosphate) are altered. This results in hormonal changes attempting to restore balance which can become maladaptive and lead to significant complications, including alterations in bone and in calcification of blood vessels. This session will describe what is currently known about bone-mineral disorders in kidney disease, including a review of current clinical practice guideline for best management practices.
The Spectrum of Uremic Toxicity
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The kidneys, when healthy, efficiently eliminate many toxic compounds from the body, keeping concentration low in the blood. In kidney failure these uremic toxins are retained in the blood and the body, causing many complications. This session will describe the families of toxic compounds, the dietary and other precursors from which they are generated, and will focus on what is known for how these toxins cause cardiovascular and other complications.