A session on diabetic kidney disease was held on the concluding day of the 6th International Symposium of Urology, Nephrology and Transplantation of SlUT here on Saturday. During the session Professor K.S. Chugh talked about diabetic nephropathy to be the commonest cause of renal failure.
He said that early diagnosis leads to lack of prevention. Screening for diabetic kidney disease includes evaluation of albumin in the urine, presence of diabetic eye changes and type 1 diabetes of 10 years duration. Also investigated are high blood pressure, blood sugar and cholesterol levels, smoking habits and family history of heart disease or stroke.
Professor Chugh said that it is important to use blood pressure and cholesterol lowering drugs and reduction of dietary proteins. Patients reaching the end stage renal failure require dialysis or transplantation. Dr Fatema Jawad of SlUT described the scenario of diabetes and kidney disease in the Institute and added that to date 84 (74 males and 10 females) diabetics have been transplanted.
Patients for transplant surgery are evaluated in detail and eventually as they achieve the required criteria they receive a kidney from a matched relative. The patient and graft survival at 1 and 5 years in the institute matches the international results. Dr Magdi Shehata from Nottingham University UK spoke on injury to transplanted kidney due to toxicity of immunosuppressive drug calcineurin inhibitor.
Studies have shown that the graft function and survival could be maintained safely without drugs, he said. Dr Georgi Abraham has said that over 90 per cent of patients with ESRD in south-Asian countries die within few months of diagnosis because of unaffordability of treatment cost. He said that hemodialysis is the most common cause of renal replacement therapy in Asia.
He told that approximately 500,000 patients are receiving maintenance hemodialysis therapy in the region adding that kidney transplantation varies from country to country because immunosuppressive are expensive and infections are a common cause of mortality. He stressed upon a need to raising awareness on kidney disease, facilitate early detection, prevention and establishing renal replacement programmes are important to root out this deadly disease from region.
Professor Qasim Mehdi, Director Centre for Human Genetics and Molecular Medicine, SIUT, said that migrants from Africa to other parts of the world faced challenges to climate and diseases and amongst those who were genetically strong survived. He also discussed the diversity of the highly polymorphic human leukocyte antigen, which is important for matching organs in the field of transplantation.
Professor Sajjad Hussain of the Pakistan Association of Urological Surgeons talked on the development of lithotripsy for kidney stone management. He said it was a new technology introduced in the 21st century, which has reduced the incidence of open surgery. He said that flexible endoscopes are used for managing open urinary tract stones. He urged that medical treatment is important as alpha-adrenergic blockers increase the speed of passage of ureteric stones.
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