Some Important Points covered in CKD Webinar. Basics of Kidney disorders (Acute and Chronic nephrology) Global impact of Kidney diseases Current treatments methods Can we avoid Kidney dialysis? Role of stem cells in treatment of Chronic Kidney Disease Precautions and lifestyle major to avoid CKD

1. ADVANCING GLOBAL NEPHROLOGY: NEW
INNOVATIONS AND TRENDS
Dr. Sachin Kadam
Advancells,
A102, Sector 5, Noida, India

2. HUMAN KIDNEY: OVER VIEW
https://www.youtube.com/watch?v=BodnYcHGt
iA

3. KIDNEY: FUNCTIONS AND PHYSIOLOGY
 Kidney removes waste product from the body by
filtering them from blood.

4. KIDNEY DISEASE: RAPIDLY GROWING
PROBLEM

5. Symptoms
• Hematuria
• Flank pain
• Edema
• Hypertension
• Signs of uremia
• Lethargy and fatigue
• Loss of appetite
• If asymptomatic may have elevated serum
creatinine concentration or an abnormal
urinalysis

6. KIDNEY AND ITS ASSOCIATED DISEASES
Examples of systemic diseases affecting
the kidney
Examples of primary
kidney diseases (absence
of systemic diseases
affecting the kidney)
Glomerular
diseases
Diabetes, systemic autoimmune diseases,
systemic infections, drugs, neoplasia (including
amyloidosis)
Diffuse, focal or crescentic
proliferative
glomerulonephritis; focal and
segmental
glomerulosclerosis;
membranous nephropathy,
minimal change disease
Tubulointerst-
itial diseases
Systemic infections, autoimmune, sarcoidoisis,
drugs, urate, environmental toxins (lead,
aristolochic acid), neoplasia (myeloma)
Urinary-tract infections,
stones, obstruction
Vascular
diseases
Atherosclerosis, hypertension, ischemia,
cholesterol emboli, systemic vasculitis,
thrombotic microangiopathy, systemic sclerosis
ANCA-associated renal
limited vasculitis;
fibromuscular dysplasia
Cystic and
congenital
diseases
Polycystic kidney disease, Alport’s syndrome,
Fabry’s disease
Renal dysplasia, medullary
cystic disease,
podocytopathies

7. CHRONIC KIDNEY DISEASE
CKD
death
Complications
Screening
for CKD
risk factors
CKD risk
reduction;
Screening for
CKD
Diagnosis
& treatment;
Treat
comorbid
conditions;
Slow
progression
Estimate
progression;
Treat
complications;
Prepare for
replacement
Replacement
by dialysis
& transplant
Normal
Increased
risk
Kidney
failure
Damage  GFR

8. CLINICAL DEFINITION
 GFR of less than 60 ml/minute per 1.73m2
per body surface area (normal is 125ml/min)
.
 GFR Calculator:
http://www.kidney.org/professionals/kdoqi/gfr_cal
culator.cfm
 Presence of kidney damage, regardless of
the cause, for three or more months

9. WHAT ARE THE STAGES OF CHRONIC KIDNEY
DISEASE (CKD)?

10. WHAT YOU SHOULD NOT FORGET:
 Early chronic kidney disease has no signs or
symptoms.
 Chronic kidney disease usually does not go away.
 Kidney disease can be treated. The earlier you
know you have it, the better your chances of
receiving effective treatment.
 Blood and urine tests are used to
check for kidney disease.
 Kidney disease can progress to
kidney failure.

11. KIDNEY DISEASES ARE COMMON, HARMFUL
AND OFTEN TREATABLE
 1 in 10 people have some degree of CKD
 Undetected CKD at initial stage can cause kidney
failure
 Early detection and proper treatment can control
CKD

12. STEM CELL THERAPY
 Stem cell therapy is use of stem cells to the
treatment of disease and condition
 It is also known as regenerative medicine, prompts
the raparative response of diseased, dysfunctional
or injured tissue using stem cells or their derivatives
 It is the next chapter of organ transplantation and
uses cells instead of organ donor, which are limited
in supply

13. A stem cell has the ability to continuously divide and differentiate into various
other kind(s) of cells / tissues
WHAT ARE STEM CELLS?

14. STEM CELLS AND THEIR POTENTIAL

15. WHAT STAGE STEM CELL ARE BENEFICIAL?

16. TYPE OF STEM CELLS FOR YOU
Cell therapy
approach
Cell
sourcing
Mode of
Application
Need for
immunosup
pression?
Clinical
Studies
MSC autologous injection
portal vein,
systemic
administratio
n
no Phase
I/II[42,43]
ES allogeneic to be
determined
no none to date
iPS autologous to be
determined
no none to date
Primary
renal cells
allogeneic encapsulate
d,
extracorpore
al circuit
no Phase I/II
[81,82]
Metanephroi allogeneic/x
enogeneic
Implanted yes none to date

17. HOW STEM CELLS ACT IN KIDNEY DISORDER?

18. TESTS TO MEASURE KIDNEY FUNCTION,
DAMAGE AND DETECT ABNORMALITIES
 Blood Tests
 Serum Creatinine
 Glomerular Filtration Rate(GFR)
 Blood Urea Nitrogen (BUN)
 Imaging Test
 Ultrasound
 CT Scan
 Kidney Biopsy
 Urine Tests
 Urinalysis
 Urine Protein
 Microalbuminuria
 Creatinine Clearance

19. WHAT CAN YOU DO FOR YOUR KIDNEYS?
 Maintain a healthy fluid intake
 Keep fit and active
 Control your blood sugar level
 Monitor your blood pressure
 Eat healthy, weight in check
 Do not smoke
 Do not take over-the-counter pills on a regular basis
 Get your kidney function checked if you have one
or more of the ‘high risk’ factors

21. CKD BURDEN ON WORLD ECONOMY
 CKD affects 26 million Americans
 Prevalence is 11-13%
 It consumes 28% of the Medicare Budget
 This was 6.9% in 1993
 Costs for 2013 were $42 Billion
dollars
 DM+ CKD increases mortality rate 6 fold
 CKD disproportionally affects African
Americans and Hispanics
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