Daniel M. Keller, PhD

November 04, 2014

PHILADELPHIA — When an all-time high of about 13,000 kidney professionals converge on Philadelphia for Kidney Week 2014, their biggest problem will be how to decide which lectures and sessions to attend. The meeting, running from November 11 to 16, will be rich with state-of-the-art basic and clinical science lectures, clinical nephrology conferences, high-impact trial results, and late-breaking presentations.

At least nine important clinical trials will be presented in an oral abstract session on Saturday. Two concern the HALT Progression of Polycystic Kidney Disease trial, which is testing whether interruption of the renin-angiotensin-aldosterone system can slow the loss of renal function in early-stage and moderately advanced disease. A presentation on the ADVANCE-ON follow-on trial will report on the long-term benefits of intensive glucose control for end-stage kidney disease.

The ACT-AKI phase 2 trial should begin to shed light on the potential for stem cell therapy. The trial tests mesenchymal stem cells as a potential treatment for acute kidney injury in cardiac surgery patients.

In addition to these oral presentations and hundreds of posters, more than a dozen late-breaking posters will give attendees a chance to chat with researchers about their work.

 
Nephrology is now almost facing a mid-life crisis.
 

The theme of this year's meeting is Building New Paths to Kidney Health, because "nephrology is now almost facing a mid-life crisis" in light of the changing healthcare landscape and rapidly advancing science, said Sharon Moe, MD, from Indiana University School of Medicine in Indianapolis, who is president of the American Society of Nephrology (ASN).

The prescription for moving forward is to take new roads in new directions, she told Medscape Medical News. One of those directions is to think in terms of health, rather than just treating disease.

Another is to bring society members up to speed on the latest science that will soon affect the practice of nephrology. A precourse called From Stem Cells to Function will explore stem cell transplantation to repair or even rebuild a kidney. There will be "lecturers from all over the world who are experts in this area, not necessarily just in kidney," Dr Moe said. Many of them will stay on to give more talks during the main meeting.

Pioneering Work

The 2-day stem cell course will "really cover every aspect, from what we know about stem cells in the kidney to how we can reprogram a skin cell to make a kidney in a patient," said Susan Quaggin, MD, from Northwestern University in Chicago, who is the ASN program committee chair. These issues have long-term implications for the problem of shortages of organs for transplantation and the amount of immunosuppression needed.

The session is cosponsored by the National Institutes of Health, and details about a large funding opportunity in the area will be announced.

Enhancing the stem cell curriculum will be a State-of-the-Art Lecture by Douglas Melton, PhD, from Harvard. He will talk about using stem cells to understand and treat diabetes. Dr Quaggin describes him as a pioneer in islet stem cell transplantation, and his work is close to being commercialized.

Other State-of-the-Art Lectures will be: What We Can Learn From the Genetic Past, presented by Eske Willerslev, DSc, from the Natural History Museum of Denmark in Copenhagen; Realizing the Promise of Nanomedicine, presented by Chad Mirkin, PhD, from Northwestern University; and Autophagy and Metabolic Diseases, presented by Beth Levine, MD, from the University of Texas Southwestern Medical Center in Dallas.

Another new path, forming a new abstract category, will focus on how to lessen some of the healthcare disparities that kidney patients often face, in terms of genetic risks for kidney disease and its progression and how well health systems take care of these patients. Lisa Cooper, MD, from the Johns Hopkins Bloomberg School of Public Health in Baltimore, will deliver a special lecture on what social science can tell us about the healthcare system.

Another new abstract category this year will be vascular calcification, the mechanisms, diagnostics, epidemiology, and clinical trials.

Ebola and Dialysis

A very timely and recently organized session will cover dialyzing patients with Ebola virus. A nephrologist who has cared for Ebola patients will present. The session will include US Centers for Disease Control and Prevention recommendations and information on how dialysis can affect viral load.

Dr Quaggin said the session will not be restricted to Ebola, but will be a very practical, clinically oriented approach "really dealing with some of these highly infectious and difficult pathogens." She said there has already been a lot of interest in the session on the ASN website.

In an attempt to attract more trainees to the field of nephrology, a session will cover ways to boost teaching skills. Dr Moe said she is already excited that more than 300 students and residents will attend the conference on travel grants from the ASN. Posters by fellows will be interspersed with the rest of the posters, giving them an opportunity to showcase their work, polish their presentation skills, and receive feedback and ideas about their research.

Richard Baron, MD, president of the American Board of Internal Medicine, will talk about opportunities and challenges in attracting the next generation of nephrology practitioners. A town hall meeting will allow members to express their concerns about maintenance of the certification process so that the ASN education committee can draft appropriate feedback to the board.

Dr Quaggin pointed to other sessions such as one called Sweet Beginnings, which will cover new therapies for diabetic nephropathy, beyond the current crop of drugs for glycemic control. Some of the therapies are just entering safety trials in people. On the topic of current drugs, she predicts that an entire session of four talks on SGLT2 inhibitors will attract a lot of interest.

Breaking Bad

Continuing with the catchy titles, a Breaking Bad session will explore the new chemistry and metabolomics of cardiovascular disease. Five speakers will cover metabolomics, the microbiome, and more. "This is really the next way that we're going to get biomarkers for kidney disease and understand some new targets," Dr Quaggin told Medscape Medical News. She said nephrology has lagged behind in this area in recent years, but the session should help to spur new thinking about chronic kidney disease.

To address the big issue of sudden cardiac death, "the silent killer" of dialysis patients, one session will be a mix of clinical management and research into the cardiovascular aspects of kidney disease.

Andrey Shaw, MD, from Washington University in St. Louis, Missouri, will deliver the Michelle P. Winn, MD, Endowed Lectureship on the genetics of human focal segmental glomerular sclerosis. Dr Quaggin said Dr Winn, who died this past summer, was a leader in glomerular disease. Dr Winn chose Dr Shaw to give the lecture.

The Pennsylvania Convention Center is near the historic district of Philadelphia and within easy reach of an abundance of restaurants, so convention attendees will be able to visit nearby attractions. The Liberty Bell, Independence National Historical Park, and the National Constitution Center are no more than a 15-minute walk away. Other conveniently located attractions are the Philadelphia Museum of Art, Eastern State Penitentiary, Franklin Institute, Please Touch Museum, and Betsy Ross House.

Old City District

For something less formal, one can roam the streets of the Old City district, bounded by Walnut and Dock Streets to the south, Front Street to the east, and 6th Street to the west. There are many restaurants and pubs, some of which may make you think you are back in Colonial times. Just south of this district is South Street, which buzzes day and night with hippies and preppies, punks and attorneys, all mingling for the food, galleries, cafes, clubs, theater, and other entertainment. The active area runs from Front Street to 10th Street.

For those who want to go the more academic route, the University of Pennsylvania, its Museum of Archaeology and Anthropology, and Drexel University are nearby, as is the Monell Chemical Senses Center. A special attraction for anyone interested in healthcare and its history is the Mütter Museum of the College of Physicians of Philadelphia. Its collection includes medical oddities, anatomic and pathologic specimens (like an 8-foot megacolon and a skeleton showing ossified soft tissue from fibrodysplasia ossificans progressiva), wax models, and antique medical equipment.

Elfreth's Alley, America's oldest continually inhabited residential street, dating to 1702, is a beautiful small street of brick row houses.

Not to be missed is Reading Terminal Market, a thriving public market just across the street from the convention center. Lunchtime is an adventure, with offerings of Pennsylvania Dutch, Indian, Mexican, Asian, Middle Eastern, Greek, Mediterranean, German, deli, and soul foods, as well as hearty breakfasts. And, of course, being in Philadelphia, one might try a cheese steak sandwich. Also within an easy walk is a thriving Chinatown, which is also the home of Vietnamese, Burmese, and other Asian cuisines.

Dr Moe is on the advisory board of Litholink, has received research funding from Novartis, and owns stock in Eli Lilly. Dr Quaggin has disclosed no relevant financial relationships.

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