Multidisciplinary Research and Practice Conference “Acute Kidney Injury”
On 15 March 2013 in Kiev the multidisciplinary research and practice conference “Acute Kidney Injury” was held at the P.L. Shupik National Medical Academy of Post-graduate Education; it was dedicated to World Kidney Day in Ukraine.
The conference had been organized by the Department of Nephrology and Renal Replacement Therapy (head of the department: D. Ivanov) and the Ukrainian Association of Nephrologists. During the conference practical aspects of renal diseases treatment and multidisciplinary issues were discussed in view of recently updated manuals on acute kidney injury, 2012-2013. The main scientific and practical areas of the conference included:
- acute kidney injury;
- kidneys and arterial hypertension;
- kidneys and diabetes;
- antibiotics in the nephrology;
- kidneys – multidisciplinary aspects.
The conference joined the specialists of different disciplines: nephrologists, cardiologists, physicians, family doctors, endocrinologists.
The representatives of the Ministry of Health of Ukraine and the administration of P.L. Shupik NMAPE, as a tradition, made a welcoming speech, wishing success and productive work to all the participants of the conference.
The important problem of the modern nephrology is kidney injury (development of chronic renal diseases - CRD) combined with arterial hypertension and diabetes mellitus, that is why special attention at the conference was paid to various aspects of interrelation between kidney and cardiovascular pathologies. This issue was discussed in the report of D.D. Ivanov, professor, head of the Department of Nephrology and renal replacement therapy of the P.L. Shupik NMAPE, as well as in the report of E.P. Svischenko, professor and scientific director of the Department of Hypertension of the National Scientific Center "M.D. Strazhesko Institute of Cardiology”, MAS of Ukraine. During the presentation of the reports, up-to-date possibilities to influence the rennin-angiotensin-aldosterone system were considered, as its activation is the main factor of cardiorenal pathology development. To prevent or to slow down the CRD progression, it is recommended to achieve the target level of the arterial tension (AT) <130/80 mmHg, and if there is proteinuria - <125/75 mmHg. In this case special attention was paid to the application of inhibitors of the angiotensine transforming enzyme (IATE), as they had been proved to be effective in AT lowering, and also they have pronouncing organ-protective effect. Ramipril is a gold standard in the treatment of patients with CRD among the IATE representatives, as it has the biggest convincing evidential base in treatment of patients of this category. The portfolio of “Ananta Medicare” company has the medicine from the IATE group - Cardipril® (ramipril), which is available in capsules at doses of 2.5 mg, 5 mg and 10 mg. Cardipril® is the most optimal IATE for the treatment of patients with CRD, as, besides the antihypertensive activity, it has a pronounced nephroprotective effect. Due to these effects, Cardipril® (ramipril) can lower growth of albuminuria, progression of nephropacy, and it also reduces risk of renal failure development. Besides, Cardipril® (ramipril), compared to other IATE (enalapril, lisinopril, captopril, perindopril), has double pathway (60% - kidneys, 40% - liver), that is why it is well eliminated from the organism even if the renal excretory function is low.
The program of the conference also included several reports, devoted to the antibacterial therapy of acute and chronic renal diseases. The report of D.D. Ivanov, professor, the head of the Department of Nephrology and renal replacement therapy of the P.L. Shupik NMAPE, was focused on recent European recommendations on the treatment of urinary infections: acute cystitis and pyelonephritis. The first line drugs, especially for male patients, are fluoroquinolones: ciprofloxacin, gatifloxacin and levofloxacin. There is a medicine from the fluoroquinolone group in the portfolio of “Ananta Medicare” – Gatilin (Gatifloxacine). It is available in tablets at doses of 200 and 400 mg. Gatilin has a wide spectrum of antibacterial action (Gram-positive, Gram-negative, anaerobic and atypical microorganisms), which blocks clinically significant agents of urinary infections. Besides, Gatilin has beneficial pharmacokinetic parameters: high bioavailability in oral administration (96%), good distribution in organs and tissues. The important thing in treatment of urinary infections is that Gatilin is eliminated through the kidneys, thus creating high antibacterial concentration in the urine. Double mechanism of action of Gatilin (arrest of DNA-gyrase and topoisomerase-4) guarantees slow development of microorganism resistance. For the treatment of acute cystitis and acute urethritis Gatilin is used at a dose of 400 mg on the first day, and then at a dose of 200 mg/day for the following two days. For the treatment of acute and chronic pyelonephritis, chronic cystitis and chronic urethritis Gatilin is used at a dose of 400 mg once a day or at a dose of 200 mg twice a day for 10-14 days.
According to the European recommendations, 2012, the medicines of choice in the treatment of pyelonephritis, especially in children, are cephalosporins of the III and IV generation. Among the cephalosporins, cefepime (Cefotrin) occupies a special place in the treatment of urinary infections. Cefotrin has a balanced spectrum of antimicrobial action by influencing both Gram-positive and Gram-negative flora, as well as anaerobic microorganisms. Cefotrin surpasses other cephalosporins in the influence on hospital microorganisms, causing severe pyelonephritis and nephrapostasis. For the treatment of urinary infections, including pyelonephritis, Cefotrin is prescribed at a dose of 0.5-1 mg twice a day with 12-hours interval. In case of pyelonephritis in children Cefotrin is used at a dose of 50 mg/kg every 8 hours. The drug is administered via the intravenous or intramascular route.
The pharmaceutical exhibition was organized traditionally during the conference; 10 pharmaceutical companies took part in it. At this exhibition “Ananta Medicare” company presented the drugs, which are widely used in the nephrology practice. The drugs from the cardiological group: Cardipril® (ramipril), Limistin (atorvastatin) and Azi-Ator (combination of atorvastatin with ezetemibe); antibacterial drugs: fluoroquinolone of the IV generation – Gatilin (gatifloxacin), the drug from the macrolide group - Aziclar® (clarithromycin), cephalosporin antibiotic of the IV generation – Cefotrin (cefepime), Clavametine® (combination of amoxicillin and clavulanic acid), Zoloxacin® (combination of norfloxacin with tinidazole), antifungal drug – Intrungar (itraconasole), carbapenem antibiotic – Ifem (meropenem). Application of highly effective and modern drugs, recommended by leading world recommendations, in clinical practice will ensure provision of qualitative assistance in treatment of renal diseases.