ISN-GO CME Post Meeting Report

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ISN-GO CME Post Meeting Report Please note that this report will be posted on the International Society of Nephrology (ISN) Gateway under the respective ISN Global Outreach Regional Committee webpage. Photos are welcome. Please also send the final program and the delegates list with their e-mail addresses to Mrs Isabel Van Dorpe (ivandorpe@theisn.org) Meeting Name: International Society of Nephrology - GO CME Programme December 3,5 2012 Name of Organising Society/Institutions: Post Graduate Institute of Medical education and research and St Georges Healthcare NHS Trust Start Date: December 3 End Date: December 5 Web-site: City: Chandigarh and Delhi Contact Person: Vivek Jha and Debasish Banerjee Country: UK Tel: 44 0287251673 E-mail Address: debasish.banerjee@stgeorges.nhs.uk Outside Speakers: Debasish Banerjee UK and David Oliveira UK Fax: 44 2087252068 Number of delegates and regions covered: Post Graduate Institute of Medical Education and Research Chandigarh India Institute of Liver Disease Delhi India Did any former ISN Fellow attend or give a lecture? If yes, please provide his/her name and e-mail address. A former ISN fellow Dr Suman Lata was involved in the visit to the Liver Institute in Delhi Additional Comments: See below PLEASE SEND THIS FORM TO : Prof. Dr. Norbert Lameire ISN GO CME OFFICE 4K4 (ISN GO) University Hospital Ghent De Pintelaan 185 9000 Gent, Belgium Tel: +32/9/240 4402, Fax: +32/9/240 4403 ivandorpe@theisn.org

Report International Society of Nephrology - GO CME Programme December 3-5 2012 Venue: Postgraduate Institute of Medical Education and Research, Chandigarh, India Organisers: Dr Debasish Banerjee and Prof Vivek Jha The ISN-GO CME programme was held at the Postgraduate Institute of Medical Education and Research (PGIMER) in Chandigarh, India on December 3rd and 4th, 2012. It was followed by a morning visit to the Institute of Liver Diseases by the same team on Wednesday 5th December 2012. Upon arrival at the Postgraduate Institute of Medical Education and Research on 3rd December 2012, the visiting team; including Dr Debasish Banerjee and Professor David Oliveira were taken to the unit to interact with several senior nephrologists and the junior nephrology physicians. The team met with the head of the Department Professor Vinay Sakhuja. The first symposium of the CME was held on the afternoon of 3rd December 2012. The first presentation was by Professor David Oliveira with an update on mechanisms of vasculitis. This CME was well attended by the nephrology, rheumatogy and medicine trainees from the PGIMER, the senior faculty from PGIMER, faculty from the Department of Pathology at PGIMER and also faculty from the Department of Rheumatology at the PGIMER. Professor Oliveira presented his thoughts on the mechanisms of vasculitis with up-to-date evidence, with a special emphasis on ANCA positive vasculitis. Following the CME there was a interesting discussion between the nephrologists, trainees and faculty and the faculty from rheumatology with Professor David Oliveira. The next presentation was by Dr Debasish Banerjee on haemodialysis catheter related infections. Dr Banerjee emphasised the importance of good catheter care to prevent infections and also the importance of trying to avoid catheters being used in incident haemodialysis patients. After the presentation there was a lively discussion between the nephrology junior faculty, nephrology senior faculty, nephrology residents and Dr Banerjee regarding the best possible way of using catheters in dialysis patients and avoiding infections. The next morning the visiting team was involved in the ward round with the faculty and several nephrology and medicine residents at the PGIMER. The residents there presented their cases. The differential diagnosis and the management plan was discussed in detail for the host and visiting teams to learn from each other. It was realised that there are certain things that can be done better with vascular access care; trying to prevent multiple accesses, multiple catheters and access related complications such as infections. There was also discussion regarding the best treatment for lupus nephritis, vasculitis and post transplant immunosuppresion. Some unusual cases were discussed and the visiting team learned about these unusual cases with acute and chronic kidney injury, with which the visiting team were not familiar, practising in the United Kingdom. The residents enjoyed the discussion and reported to have learned from the discussion with the visiting experts. The second afternoon CME symposium organised at the PGIMER was chaired by Professor Jha. It was attended by the residents and the Fellows and senior members of the faculty and members of staff from research laboratory at the PGIMER. The first topic of discussion was the importance of having a working fistula as vascular access. Dr Banerjee, during his presentation, wished to raise awareness amongst practising nephrologists in the region about the importance of having a fistula in prevalent haemodialysis patients. He discussed the difficulties in having a working fistula, i.e. making the fistula work in the first instance and then maintaining the fistula. He emphasised the importance of good fistula care after the fistula was placed and when it was used for haemodialysis. He discussed the good practice in his own unit with a vascular access team. He also emphasised the importance of having a vascular catheter team to place catheters and maintain catheters as a means of preventing infections. There was a lively discussion between the visiting team and the local nephrologists regarding the best possible ways to deliver vascular access, thereby reducing complications in the patients and cost for the providers. The second presentation was on mechanisms of membranous nephropathy. Professor Oliveira discussed the emerging knowledge on anti PL2 antibodies in membranous. It was realised that one of the senior faculty member was interested and was conducting a study on the role of anti PL2 antibodies in membranous nephropathy. This led to further discussions and possible collaborations in improving the understanding of the pathology.

On the morning of Wednesday 5th December, Professor Oliveira and Dr Banerjee visited the renal unit at the Institute of Liver Diseases in Basant Kunj Delhi. This visit was hosted by Dr Suman Lata who is an ex-international Society of Nephrology Fellow and presently a consultant nephrologist at the Institute. Upon arrival Dr Lata took Professor Oliveira and Dr Banerjee to her own renal unit. The visiting team discussed the importance of proper vascular access, routine dialysis care including prevention of infections, proper management of anaemia and mineral bone disease. Following which, Professor Oliveira and Dr Banerjee met several other members of the Institute including the interventional nephrology team, the viral pathology team, the clinical pathology team and other radiologists. Professor Oliveira and Dr Banerjee also met the surgeon, Mr Jain, who is responsible for creating vascular access and kidney transplants in the Institute. Professor Oliveira and Dr Banerjee visited the interventional radiology suite and the intensive care unit for the post-transplant patients. They had a long chat with the nurses in the ITU and the nurses in the haemodialysis unit. The team discussed the possibility of nurses from the Institute of Liver Diseases visiting St George's to learn about best practice in dialysis and kidney transplantation. Professor Oliveira with the Nephrology team discussing management of difficult cases

Professor Oliveira presenting at the CME in PGI Chandigarh

Professor Oliveira and Dr Lata and her resident from Institute of Liver Diseases during visit to Delhi