5

7
8
Under the patronage of His Highness Prince
Saud bin Abdullah bin Thunayyan Al-Saud
Chairman of the Royal Commission for
Jubail and Yanbu (RCJY)
On the occasion of Jubail International Kidney Conference 2011 held in Jubail
Industrial City, under the motto “Challenges and Hope” organized by the Royal
Commission in Jubail, represented by the Royal Commission Health Services
Program, we welcome your participation in this event. This medical conference is
organized to cope with the acceleration of medical information and technology,
and in line with the Government of the Kingdom of Saudi Arabia and the Royal
Commission for Jubail and Yanbu objectives to upgrade medical care services
provided to patients. The conference will contribute to the achievement of
scientific communication on the latest technology in nephrology and exchanging
ideas and views among relevant bodies and organizations inside and outside the
Kingdom to develop the treatment of kidney patients, and help them understand
the illness, treatment methods, and how to use the best and easiest ways of
treatment.
This conference confirms the Royal Commission’s care for health services aiming
at providing high quality excellent services for all residents in Jubail and Yanbu
Industrial Cities, in line with the evolution of medical services in the Kingdom,
and to complement efforts made by including health awareness, and organizing
conferences and seminars in different areas of medicine, in order to exchange
experiences and to be acquainted with latest information and technology in this
respect.
Finally, we pray to God that the conference will achieve its objectives, wishing
everyone success and prosperity.
Health Services Program
Royal Commission for Jubail

11
ORGANIZING
COMMITTEE
12
Executive Committee
Mr. Abdulaziz A. Al-Musend
Conference Director
Mr. Abdulrhman S. Al-Huwar
Head of the Executive Committee
Mr. Faisal H. Al-Dhfeeri
Director of Public Relations Department
Dr. Fahad Al-Kharashi, M.D
Chairman of Medical Committees
Saudi Board, Arab Board and Jordanian Board Paediatric
King Saud Fellowship Paediatric Pulmonology , Consultant Paediatric Pulmonologist
Mr. Hatem M. Al-Zahrani
Public Relations Department
Scientific Committee
Chairman
Dr. Yousef Ibrahim, MRCP
Consultant Int. Med. & Nephrology
Royal Commission Hospital, Jubail
Co-Chairman
Dr. Samir M. Mabrouk, MD
Consultant Int. Med. & Rheumatology
Royal Commission Hospital, Jubail
13
Members
Dr Yousif Ibrahim Tel: 00966508359610
Chairperson (RCHJ) Email : fadly_neph@yahoo.com
Dr Samir Mabrouk Tel: 00966557025923
Member (RCHJ) Email : mabrooks@fh.med.sa
Dr Fahd Al Kharashi Tel: 00966505485435
Member (RCHJ) Email : fkharashi@yahoo.com
Dr. Khalid Saeed Tel. 0506363707
Member (RCHJ) Email : kh_m_saeed@hotmail.com
Dr. Yaser Sheta Tel: 0504649496
Member (RCHJ) Email : shetay@fh.med.sa
Dr. Rokia Kaddoura Tel:0504459392
Member (RCHJ)
Dr. Shereen A. El Sahazly Tel: 0509696331
Member (RCHJ) Email : Drshereeahmed@gmail.com
14
DAY 1 - TUE APRIL 5 2011
08:00 - 09:00 Registration
09:00 - 10:00 Opening Ceremony
09:00 - 09:10 Opening Remarks and Welcome | RC Health Services Progr Director | Abdulrahman S. Al Howar
09:10 - 09:20 Dr. Saleh Al Tayyar Vice Executive President for Medical Devices Sector Saudi FDA
09:20 - 09:30 Chronic Kidney Diseases in KSA (in Arabic) | Prof. Faisal Shaheen
09:30 - 09:50 Recognition to Sponsors
09:50 - 10:00 Exhibition
10:00 - 05:00 SCIENTIFIC PRESENTATIONS
SESSION 1: 10:00 -11:10
MODERATOR: Dr. Yousif Ibrahim (Dialysis related issues)
10:00 - 10:20 Renal Replacement Therapy in KSA | Prof. Faisal Shaheen
10:20 - 10:40 Dialysis options | Prof. Ayman Karkar
10:40 - 11:00 Dialysis in the elderly | Prof. Michel Jadoul
11:00 - 11:10 Discussion
SESSION 2: 11:10 -12:00 Noon
MODERATOR Dr. Haily Dalvi
11:10 - 11:30 Initiating a PD progr in Sudan | Prof. Hasan Aboaisha
11:30 - 11:50 Hemodialysis in KSA | Prof. Abdullah Al Doghaither
11:50 - 12:00 Discussion
12:00 - 01:00 Prayers/Lunch
SESSION 3: 13:00 - 14:10
MODERATOR: Prof. Ayman Karkar (Dialysis/Systemic Disease & the Kidney issues)
13:00 - 13:20 Renal Replacement Therapy for acute kidney injury | Prof. Hasan Abuaisha Hed
13:20 - 13:40 Lupus Nephritis | Prof. Michel Jadoul
13:40 - 14:00 Parathyroid Disorders in Hemodialysis Patients | Dr. Yousif Ibrahim
14:00 - 14:10 Discussion
14:10 - 14:20 Break
SESSION 4: 14:20 - 15:30
MODERATOR: Dr. Samir Mabrook (Systemic Diseases & the kidney issues)
14:20 - 14:40 Diabetes & the Kidney (the Sword & the Shield) | Dr. Yasser Sheta
14:40 - 15:00 Cardio-renal syndrome | Dr. Khalid M. Said Othman
15:00 - 15:20 Viral Hepatitis in CKD | Dr. Haily Dalvi
15:20 - 15:30 Discussion
15:30 - 16:00 Prayers
SESSION 5: 16:00 - 16:50
MODERATOR: Dr. Shereen El-Shazly
16:00 - 16:20 Pregnancy & The Kidney | Dr. Shameela Habib
16:20 - 16:40 Cracks in the CKD model | Dr. Nasrulla Abo Talib
16:40 - 16:50 Discussion
16:50 - 17:00 Closure Dr. Yousif Ibrahim
End of First Day
15
SESSION 1: 08:30 - 10:40
MODERATOR: Dr. Yousif Fadl/Dr. Haily Dalvi (Kidney Transplantation issues)
08:30 - 8:50 Novel mechanisms of graft rejection | Prof. Mohamed Al Sayegh
08:50 - 9:10 case Presentation “Jaundice in a Renal Transplant Patient” | Dr. Yousif Ibrahim
09:10 - 9:30 Evolution of immunosuppression to tolerance in transplantation | Prof. Mohed Sayegh
09:30 - 09:40 Discussion
09:40 - 09:50 Break
MODERATOR: Prof. Jal Al Wakeel
09:50 - 10:10 The Metabolic Syndrome & CKD | Prof. Mohed Hassan
10:10 - 10:30 Hypertension & the Kidney | Dr. Faisal Hashim
10:30 - 10:40 Discussion
10:40 - 10:50 Break
SESSION 2: 10:50 - 12:00 Noon
MODERATOR: Dr. Al Sakati / Dr. Fahad Al-Kharashi (Pediatric Nephrology issues)
10:50 - 11:10 Saudi Guidelines for Pediatric Hypertension | Prof. Saleh Al Shorafaa
11:10 - 11:30 Genetic kidney diseases | Prof. Sadeq ALOmran
11:30 - 11:50 Acid Base Disorders | Prof. Si Sinjad
11:50 - 12:00 Discussion
12:00 - 13:00 Prayer/Lunch
SESSION 3: 13:00 - 14:10
MODERATORS: Dr. Khaled Saeed / Dr. Shereen El-Shazly (Complications of CKD)
13:00 - 13:20 DEBATE: ACEI/ACRB or both for patients with Proteinuria | Prof. Jal Al-Wakeel
13:20 - 13:40 Vascular Access for Hemodialysis | Prof. Ahmed Chaballout
13:40 - 14:00 Renal Burden of Rheumatic Diseases | Dr. Samir Mabrouk
14:00 - 14:10 Discussion
14:10 - 14:20 Break
SESSION 4: 14:20 - 15:30
MODERATOR: Dr. Faisal Hashim (Miscellaneous issues)
14:20 - 14:40 Membranous Nephropathy an Update | Dr. El Badri Abdul Gadir
14:40 - 15:00 Skin Manifestation of CKD | Dr. Abdelazim Al Malik
15:00 - 15:20 Obstructive Uropathy | Dr. Moemen A/Raheem
15:20 - 15:30 Discussion
15:30 - 16:00 Prayers
SESSION 5: 16:00 - 16:50
MODERATOR: Dr. Yousif Ibrahim (Miscellaneous issues)
16:00 - 16:20 Salt & Pepper | Prof. Ahmed Gasim Elzubair
16:20 - 16:40 Dyslipidemia & CKD | Dr. Hamdy Abo Zenah
16:40 - 16:50 Discussion
16:50 - 17:00 Conclusions & Closure | Dr. Yousif Ibrahim
End of Second Day
DAY 2 - WED APRIL 6 2011
16
LIST OF
SPEAKERS
17
1. Dr. Faisal Abdulrahim Shaheen
2. Dr. Ayman Karkar
3. Prof. Michel Jadoul
4. Prof. Hassan Aboaisha Hamed
5. Prof. Abdullah Al Doghaither
6. Dr. Yousif Mohamed Ibrahim Fadl
7. Dr. Yasser Sheta
8. Dr. Khaled Mohamed Said Othman
9. Dr. Haily Ganpat Dalvi
10. Dr. Shameela Habib
11. Dr. Nasrulla Abo Talib
12. Prof. Mohamed H. Sayegh
13 Prof. Ahmed Chaballout
14 Prof. Mohamed H. Hassan
15 Dr. Faisal Abdalla Hashim
16. Dr. Saleh Al Shorafa
17. Dr. Sadeq Al Omran
18. Dr. Sami Sinjad
19. Prof. Jamal Al Wakeel
20. Dr. Samir M. Ibrahim Mabrook
21. Dr. El Badri Abdul Gadir
22. Dr. Abdelazim al Malik
23. Dr. Moamen Addulrahim
24. Prof. Ahmed Gasim Elzubair
25. Dr. Hamdy Abo Zenah
26 Prof. Nadia Sakati
NO. NAME
18
19
SPONSORS
20
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
MEDISERV
Osama Abd al wahed AL Kahlah
Eastern Province Manager and Imaging Country
Manager
0505294031 / 03/8987504
o.kahlah@mediserv.com.sa
www.mediserv.com.sa
21
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
Saudi International Petrochemical Company (Sipchem)
Mohammed Al-Dohaim
Public Relations Representative
359-9644
359-9610
maldohaim@sipchem.com
www.sipchem.com
22
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
Industrialization & Energy Services Co. ( TAQA )
Tarek A. Muaikel
Public Relation Manager
01-2911111
01-2918555
PR@TAQA.COM.SA
WWW.TAQA.COM.SA
23
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
AMGEN
MOHAMMED SAMIR
NATIONAL SALES MANAGER
0554665464
014612695
msamir6@hotmail.com
www.amgen.com
24
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
Methanol chemical company (chemanol)
Sumeet Paralkar
Sr. M & S Product Specialist
3581111-401 Mobile: 0553078399
3583592
SumeetP@chemanol.com
www.chemanol.com
25
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
Sanofi-Aventis
Mohamed Ghazal
Medical Representative
0564095230
038821279
mmghazal@hotmail.com
http://sa.sanofi-aventis.com/live/sa/en/index.jsp
26
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
MEDGULF
Mohammad Alyaseen
HR Manager
03-8147667 x 385 / 0569211419
03-8147665
melyassine@medgulf.com
www.medgulf.com.sa
27
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
Dar Re›ayat AL-Jazirah
Walid Aweda
Sales Supervisor
03 8140056 Mobile: 0562101060
03 8140057
w.aweda@drajehgroup.com
www.drajehgroup.com
28
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
Janssen
Mohamed Madian
Product Specialist
+966 55 4949 680
mmadian@its.jnj.com
www.jnj.com
29
Company Name:
Contact Person:
Title:
Telephone:
Fax:
Mail:
Websites:
The Saudi Investment Bank
Jamal Mohammad Al Thukair
Regional General Manager - Eastern Region
+966-3-882-7999
+966-3-882-2801
P.O. Box 1581 - Al Khobar 31952
ww.saib.com.sa
30
Company Name:
Contact Person:
Title:
Telephone:
Fax:
E-mail:
Websites:
Al jeel medical & Trading CO.
Osama El hosainy
Product Specialist
0509008514- 03/8874790 Ext. 325
03/8874771
ohosainy@aljeel.com
www.aljeel.com.sa
31
Company Name:
Contact Person:
Title:
Telephone:
Fax:
Mail:
Websites:
Novartis Pharma
Mohamed Zada
Professional Medical Representative
+966 503419568
+966 3 8344200
P.O. Box 6503 , Dammam 31452
www.novartis.com
32
Company Name:
Contact Person:
Title:
Telephone:
Fax:
Mail:
Websites:
MSD
Mohamed Aref
Customer Manager
050 30 84 785
03 859 17 44
mohamed_abdel_karim@merck.com
www.merck.com
33
ABSTRACTS
PODIUM
PRESENTATIONS
34
ABSTRACT
The number of patients on the waiting list for kidney transplantation in kingdom of Saudi Arabia (KSA) is exceeding
6,500 with 17 potential donors per million populations (pmp) and a procurement rate of about 20%. Thus, one of
the main issues seems to be how we can increase the number of positive consents for organ donation. Obtaining
consent from the next of kin for organ donation is mandatory in Saudi Arabia. New strategies have been laid down in
Saudi Arabia under the auspices of the Saudi Center for Organ Transplantation (SCOT).
his center, established in 1985, is the central co-ordinating body for the delivery of medical care to patients with
end-stage renal as well as other organ diseases. Several scientific committees have been established comprising
eminent physicians and surgeons
working in different parts of the KSA. These committees cover various aspects of
organ donation including brain-death, transplantation and co-ordination and could establish a directory that regulated
the practice of organ donation and transplantation from the living and cadaver donors in the KSA. Strict priority
guidelines have been laid down for the transplantation of each organ from cadaver donors.
This ensures that deserving candidates do not have to wait for too long for life saving transplantation. A unique
“urgent waiting list” has been created for each organ. Furthermore, SCOT has formed a zonal distribution system for
the hospitals in the KSA. All the donating hospitals in each zone are attached to a parent transplant center, which
offers assistance in diagnosis and management of brain-death as well as performing transplantation. From 1985
to 2010, more than 6667 renal transplants (2227 deceased and 4440 living have been performed in 14 transplant
centers in Saudi Arabia, 930 livers ( 572 cadaver, and 358 living), 187 whole hearts, 517heart valves, 632 corneas,
18 pancreases, 51 lungs, and 1500 bone marrow transplants have also been performed in the KSA. Despite these
achievements, there is still a large gap between demand and supply and efforts are ongoing to improve the donor
pool and bridge this gap.
Renal Replacement Therapy in KSA
Prof. Faisal Shaheen
General Administrator of the Saudi Center for Organ Transplantation (SCOT)
35
ABSTRACT
Heamodialysis Modalities:
Patients with chronic renal failure usually progress through different stages before they reach end-stage renal
disease and consequently the requirement for renal replacement therapy (RRT) in the form of Hemodialysis (HD),
peritoneal dialysis or kidney transplantation. HD remains the most prevalent modality of RRT worldwide. The basic
principle of conventional HD is based on diffusion of small molecular weight (MW) solutes through a semi-permeable
membranes using low flux dialysis membranes; a treatment session that usually lasts for 4 hours and performed on
average three times/week.
Despite the significant reduction of mortality that has been achieved by conventional HD, recent studies have shown
that conventional HD fails to restore the patient to fully functional normality and longevity. There have been different
approaches to improve the quality of HD in order to achieve optimal dialysis. This includes the use of dialyzers with
large surface area or high mass transfer coefficient or both, adsorption dialysis membranes, bicarbonate dialysate,
high blood and/or high dialysate flow rates and longer duration and frequency of dialysis sessions. However, the
main advancement in the quality of HD has been achieved by using larger pore size dialysis membranes. The
high flux membranes are capable of removing middle and large size MW toxic solutes, which have been shown to
improve dialysis performance and quality of patients’ life. The recent innovation of using the physiologic principle of
convection, with or without diffusion and the implantation of on-line haemofiltration and haemodialfiltration has had a
positive impact on patients’ haemodynamic stability and the achievement of HD quality in chronic regular HD patients
as well as in critically ill acute kidney injury patients with multi-organ failure in intensive care units.
DR AYMAN KARKAR PHD, FRCP
MSc 1987 (UK), MRCP (UK) & PhD 1994 (UK), FRCP (Edinburgh 2004, Ireland, 2005, Glasgow 2005)
Consultant Physician & Nephrologist
Director/Dammam Medical Complex
Director/Kanoo Kidney Centre, Dammam
Supervisor/Renal Units and Renal Services, Eastern Province
Chairman/Nephrology Club, Eastern Province - KSA
MEMBER OF:
ISN/ERA-EDTA/ASN/NKF, USA/SCOT
Dialysis options
Prof. Ayman Karkar PhD, FRCP
36
ABSTRACT
TOPIC 1: DIALYSIS IN THE ELDERLY
The primary treatment of elderly end stage renal disease (ESRD) patients (greater than 75 years
of age) is in-center hemodialysis. Continuous ambulatory peritoneal dialysis or continuous cycler
peritoneal dialysis (CAPD/CCPD) is another option, while a lesser number are treated with home
hemodialysis.
The average age of the patient undergoing dialysis has been steadily increasingly over the last several
decades.
The number of elderly initiating dialysis is also increasing.
Important points to consider when evaluating the treatment of elderly patients with ESRD include:
• The life expectancy of such patients
TOPIC 2: LUPUS NEPHRITIS
Optimal care of lupus nephritis patients should include the treatment of proteinuria and
hypertension, other measures to delay the progression of chronic kidney disease, the vigorous
management of cardiovascular risk factors and finally, the treatment of advanced chronic kidney
disease and its consequences. These topics are briefly reviewed , with particular emphasis on the
recent progresses in antiproteinuric treatment.
Dialysis in the elderly
Prof Michel Jadoul MD
Head of Nephrology Department, Cliniques Universitaires Saint-Luc. 2003 - Present
37
ABSTRACT
TOPIC 1 : PARATHYROID DISORDERS IN HEMODIALYSIS PATIENTS
Parathyroid Disorders are common in Chronic Kidney Disease Patients resulting from disturbances in calcium,
phosphate, vitamin D & PTH. It is recently recognized to contribute to the high cardiovascular risk which is the major
cause of morbidity and mortality in CKD population.
This presentation will discuss the our experience in managing Parathyroid Disorders in the Royal Commission
Hospital Dialysis Unit.
The pathogenesis of the Mineral Bone Disorder in CKD (MBD-CKD) will be reviewed highlighting the recent
development of this topical issue.
TOPIC 2 : CASE PRESENTATION “JAUNDICE IN A RENAL TRANSPLANT PATIENT”
Renal Transplantation is the best treatment option for End Stage Renal Failure, recipients should be screened for
serious complications, this case discusses highlight this issue in an interactive session.
TOPIC 3 : CONCLUSIONS & CLOSURE
The Scientific committee chairman will conclude by summarizing the achievements of the conference
Dr Yousif Ibrahim Fadl- FRCP
38
ABSTRACT
The situation of Chronic Kidney Disease (CKD) patients in the Kingdom of Saudi Arabia and the role of “KELANA”
Organization in providing free dialysis and medications will be discussed.
Hemodialysis in KSA
Prof. Abdullah Al Doghaither
ABSTRACT
Despite its outstanding success, the CKD model has multiple cracks that need to be addressed by the nephrology
community.. The basis of the CKD model should be scientifically correct and appropriate in addition to being general
(i.e. non-disease specific) and simple. Studies revealed several odd and unexpected findings that have developed as
a result of current CKD model. Examples of these findings, here, include the epidemiological findings that more than
half the total CKD population are CKD3a patients, lower risk of developing ESRD among CKD3 patients than among
patients with CKD 1 & 2 and even lower risk than general population, higher female gender proportion among CKD3
patients but lower among ESRD patients, CKD3 stage is not a risk factor for CVD while CKD1 & 2 are.. Etc. Refining
current CKD model to avoid such non-logical findings needs to be considered.
Cracks in the CKD model
Dr. Nasrulla Abutaleb MRCP,
Consultant Nephrologist, KFSH-Dammam
39
ABSTRACT
TOPIC 1 : INITIATING A PD PROGR IN SUDAN
Initiating Peritoneal Dialysis Program in Sudan beside Hemodialysis and Renal Transplantation, Peritoneal Dialysis
(PD) is an important modality of Renal Replacement Therapy.
The Challenges of implementing a new PD Program in a developing country (Sudan) will be discussed and experiences
shared during the discussion.
TOPIC 2 : RENAL REPLACEMENT THERAPY FOR ACUTE KIDNEY INJURY
This presentation will discuss the management of patients with Acute Kidney Injury in an intensive care setting and
attempts to reduce the igh mortality associated with this condition.
Prof Hasan Abu-Aisha Hamed – FRCP,
Professor of Nephrology
Chair, Alribat Al Watani University, Khartoum, Sudan
40
ABSTRACT
The Kidney is always forgotten as a vital player in the immortal symphony of glucose metabolism. Its role looks like
the sword and the shield in the same time. It guards against hypoglycemia and also hyperglycemia by many complex
mechanisms.
Diabetologists face unfair battle in control of blood sugar in diabetic patients with significant renal impairment. In
the other side diabetes attacks the kidney with sever violence in many ways including the famous example; diabetic
nephropathy which’s now one of the leading causes of end stage renal disease requiring dialysis.
Diabetes & the Kidney (the Sword & the Shield)
Dr. Yasser Sheta MD
ABSTRACT
The management of viral hepatitis in the peritransplant period of kidney disease is particularly challenging. The use
of the commonly used drugs in hepatitis is restricted in these patients either because of toxicity or due to increased
chances of rejection. Newer drugs are on the horizon. However their effect on patients with renal disease remains
unclear.
Viral Hepatitis in CKD
Dr. Haily Ganpat Dalvi
41
ABSTRACT
Renal dysfunction is the strongest predictor of poor outcomes in patients with HF, regardless of whether systolic
function is decreased or preserved. The term cardio-renal syndrome (CRS) increasingly has been used to include the
vast array of interrelated derangements, and to stress the bidirectional nature of heart-kidney interactions. CRS can
be generally defined as a pathophysiologic disorder of the heart and kidneys whereby acute or chronic dysfunction
of one organ may induce acute or chronic dysfunction of the other.
The CRS recently has been classified according to whether the impairment of each organ is primary, secondary
or whether heart and kidney dysfunction occurs simultaneously as a result of a systemic disease into; Type I CRS
reflects an abrupt worsening of cardiac function (eg. Acute Cardiogenic Shock or Decompensated Congestive Heart
Failure)) causing progressive chronic kidney disease. Type 3CRS consists of an abrup worsening of renal function
(e.g. Acute Kidney Ischemia or Glomerulonephritis) causing Acute Cardiac Dysfunction (e.g. heart failure, arrhythmia
and ischemia). Type 4 CRS describes a state of chronic kidney disease (e.g. chronic glomerular disease) contributing
to decreased cardiac function, cardiac hypertrophy and/or increased risk of adverse cardiovascular events. Type 5
CRS reflects a systemic condition (e.g. Sepsis)causing both cardiac and renal dysfunction.
Cardio-renal syndrome
Dr. Khalid M. Said Othman MD
42
ABSTRACT
In transplantation immunity, recognition of donor antigens is crucial in developing antigen-specific clones of T and B
cells, which then direct an even larger array of cellular and humoral responses, many of which do not use specific
antigen receptors. Fundamentally, the “firestorm” of allograft rejection does not occur in the absence of cell-mediated
immune responses initiated by specific T lymphocytes, but the full force of the rejection uses components of the
natural/innate immune system. Furthermore, the innate immune response against tissue injury (such as ischemia)
augments antigen-specific immune responses, thus contributing ultimately to graft destruction. A better understanding
of the mechanisms of graft rejection is crucial for the development of more effective and safe agents.
DR. MOHAMED H. SAYEGH
Dr. Mohamed H. Sayegh is the Raja N. Khuri Dean of the Faculty of Medicine and Vice President of Medical Affairs
at the American University of Beirut
He is currently a Visiting Professor of Medicine and Pediatrics at Harvard Medical School, and is the Director of the
Schuster Family Transplantation Research Center, Brigham and Women’s Hospital and Children’s Hospital Boston
In 2005, he was named the Warren E. Grupe and John P. Merrill Endowed Chair in Transplantation Medicine at
Harvard Medical School
Dr. Sayegh is a world leader in transplantation, renal medicine and transplantation immuno-biology research.
Visiting Professor of Medicine and Pediatrics, Harvard Medical School
Dr. Sayegh served as Council Member and President (2000 - 2001) of the American Society of Transplantation
(AST). He served as the chair of the Transplant Advisory Board of the American Society of Nephrology (ASN). He
also served as the Chair of the AST Program, Education and Development Committees, as the chair of the 2005
ASN Program Committee, and the chair of the Program Committee of the 2006 World Transplant Congress and the
2007 World Congress of Nephrology. He served as co-chair of the Steering Committee of the NIH Immune Tolerance
Network and member of the Executive Committee. He also served as chair of the Steering Committee of the NIH
consortium, Clinical Trials in Organ Transplantation (CTOT).
Novel mechanisms of graft rejection
Mohamed H. Sayegh M.D., FAHA, FASN, ASCI, AAP
43
ABSTRACT
Disturbances in acid base balance are relatively common in many disease processes in sick children and tend to occur
whenever exogenous or endogenous sources of acid or base disrupt the delicate constancy of free hydrogen ion
concentration in the extracellular fluid (ECF). Both chemical and physiologic processes are involved in maintaining this
constancy which allows for optimal function of the cellular and subcellular function of the organism. The chemical processes
represent the first line of defense to an acid or base load and include the extracellular and intracellular buffers. The
physiologic processes modulate acid-base composition by changes in cellular metabolism and by adaptive responses in the
excretion of volatile acids by the lungs and fixed acids by the kidneys
DEBATE: ACEI/ACRB or both for patients with
Proteinuria
Prof. Jamal Al-Wakeel
ABSTRACT
Many systemic diseases can affect both kidney & skin and skin signs may help establishing a diagnosis e.g SLE
Skin affection in Chronic Kidney Disease may reflect a more serious condition, e.g. hyperparathyroidism. Uremic
pruritus affects quality of life in CKD & is a challenging condition which faces both the dermatologist & the nephrologist.
A variety of real cases & an interactive session will follow this review.
DR. ABDELAZIM TAHA ELMALIK
American Board of Lazer Surgery
ABLS – USA
Fellow of American Academy of Dermatology
Skin Manifestation of CKD
Dr. Abdelazim Al Malik
Consultant Dermatologist , AL MANA HOSPITAL – JUBAIL
44
ABSTRACT
Consultant Nephrologist at SKMC, Chair of Renal Disease Management and Research
committee, SEHA Abu Dhabi
Graduated from Alexandria Medical School, joined University of Minnesota as an honorary
fellow in Nephrology and Transplantation
Dr Hassan has many awards including the Ronald M. Franz, MD award for high academic
attainment and quality that characterized the fine physician in1996; teacher of the year
in York Hospital, Pennsylvania, USA 2002, and Physician of the year by the Pennsylvania
advisory Board USA 2003.
The Metabolic Syndrome and CKD (Chronic Kidney Disease)
The metabolic syndrome, characterized by abdominal obesity, hypertriglyceridemia, low
high-density lipoprotein cholesterol level, high blood pressure, and high fasting glucose
level, is a common disorder. The prevalence in USA is 23.7% of adults 20 years of age or
older. In UAE the prevalence of the metabolic syndrome based on the modified ATP III
criteria is 25.2%.
CKD has become an important public health challenge. The prevalence is 13% of adults 20
years of age or older according to data from NHANES III study. CKD is a major risk factor
for ESRD (end-stage renal disease), cardiovascular disease, and premature death.
Recent studies found a significant relationship between the metabolic syndrome and
risk for CKD and microalbuminuria. The risk for CKD and microalbuminuria increased
progressively with a higher number of components of the metabolic syndrome.
My talk will focus on the link between the metabolic syndrome and CKD, the specific
glomerular pathological features Obesity Related Glomerulopathy , the mechanism of
renal injury, treatment strategy and effect of weight reduction on CKD related to metabolic
Syndrome.
The Metabolic Syndrome & CKD
Mohamed H. Hassan, MD, FACP, FASN
45
ABSTRACT
Immunologic tolerance is a natural state, found in healthy individuals, in which a harmful immunologic response
toward self-antigens is absent. This condition is more than a passive state of unresponsiveness, rather it is a complex,
active condition in which responses to self-proteins are carefully modulated, by a number of different and nonmutually
exclusive mechanisms. As a result of these, autoimmunity is prevented, but it may develop if perturbations in one or
more of these mechanisms occurs.
Manipulating the immune system to achieve such a state would be desirable in the context of treating autoimmunity,
and hence preventing pathologic relapsing-remitting or progressive conditions and in the context of transplantation,
in which the foreign graft, treated as “self,” would be accepted without the risk of rejection. Both situations would allow
for the treatment of the patients while avoiding the need for continuous immunosuppression, with all the established
associated adverse effects. In addition, in the context of transplantation, the ongoing graft loss due to chronic rejection
may be avoided and the half-life of the grafts may be extended beyond their current limitations.
Clinical induction of tolerance is not yet reproducibly achievable, although cases of tolerance induction, Understanding
the basis for such changes is necessary in order to develop clinically applicable regimens that would allow tolerance
to be induced in a coordinated manner and in wider patient populations. In order to understand the methods used
to achieve clinical immunologic tolerance, a review of the mechanisms underlying natural tolerance is required. In
this presentation, we detail the basis for immune tolerance and the methods used to achieve clinical tolerance in
transplantation, and describe some potential future directions.
DR. MOHAMED H. SAYEGH
Dr. Mohamed H. Sayegh is the Raja N. Khuri Dean of the Faculty of Medicine and Vice President of Medical Affairs
at the American University of Beirut
He is currently a Visiting Professor of Medicine and Pediatrics at Harvard Medical School, and is the Director of the
Schuster Family Transplantation Research Center, Brigham and Women’s Hospital and Children’s Hospital Boston
In 2005, he was named the Warren E. Grupe and John P. Merrill Endowed Chair in Transplantation Medicine at
Harvard Medical School
Dr. Sayegh is a world leader in transplantation, renal medicine and transplantation immuno-biology research.
Visiting Professor of Medicine and Pediatrics, Harvard Medical School
Dr. Sayegh served as Council Member and President (2000 - 2001) of the American Society of Transplantation
(AST). He served as the chair of the Transplant Advisory Board of the American Society of Nephrology (ASN). He
also served as the Chair of the AST Program, Education and Development Committees, as the chair of the 2005
ASN Program Committee, and the chair of the Program Committee of the 2006 World Transplant Congress and the
2007 World Congress of Nephrology. He served as co-chair of the Steering Committee of the NIH Immune Tolerance
Network and member of the Executive Committee. He also served as chair of the Steering Committee of the NIH
consortium, Clinical Trials in Organ Transplantation (CTOT).
Evolution of immunosuppression to tolerance in
transplantation
Prof. Mohamed H. Sayegh M.D., FAHA, FASN, ASCI, AAP
46
ABSTRACT
Hypertension in Children Abstract
B.P. increases gradually with age and height, therefore Standard normograms are necessary for the interpretation of
Hypertension in children. Most children track in a constant percentile around the mean [4, 6].
The Epidemic of childhood Obesity, the risk of developing left ventricular hypertrophy, and evidential development
of atherosclerosis in children would make the detection of and intervention in childhood hypertension important to
reduce long term health risks. However, supporting data is lacking. [1, 3, 5, 8, 7]
Secondary HTN is more common in young children, while Essential HTN is more common in older children and
adolescents, a stead fast reason why clinicians should be alert to possibility of identifiable causes in young children:
[2]
Most Hypertensive children are asymptomatic or have a variety of non-specific symptoms; measurements of BP with
the appropriate sized cuff should be a part of the routine pediatric evaluation in every clinic with visits in children of 3
years or older and of all age level’s and in children<3years with specific conditions [2, 3]:
Prevalence in eastern province and Saudi Bp percentiles standards of Bp measurements, causes as well as Saudi
guidelines of pediatric hypertension are going to be discussed.
PROF. SALEH AL SHORAFA
Arab Board Pediatrics 1994
DCJ 1988
Fellowship Pediatric Nephrology 1996
Saudi Guidelines for Pediatric Hypertension
Prof. Saleh Al Shorafaa
47
ABSTRACT
Hypertension is a worldwide problem. The kidney is one of the major organ that
plays a major role in blood pressure control through the RAAS Sytem and one of the
target organ for hypertension damage.
As more epidemiologic and clinical evidence regarding the risk of hypertension
accummulate, a pronounced shift in how hypertension is viewed and defined. So,
elevated blood pressure should not be viewed or treated in isolation, but considered
in the context of the whole patient care. It should take into account the presence of
other risk factors (cardiac, renal and cerebrovascular).
Hypertension is either essential or secondary. Most of the secondary hypertension
is due to renovascular disease. Understanding the cause and pathohysiology of
hypertension help to direct medical therapy. Therefore the following should be
considered:
o 1) Volume regulation
2) Sympathetic nervous system
3) The RAAS system
4) Other vasoconstrictive substances
The RAAS system is very important to consider in kidney disease. The kidney is a very
selfish organ, it always try to take 20 - 25% of the cardiac output and will do everything
to get that. However, it mainly does that through vasoconstriction by the RAAS system
and volume expansion. So treatment of hypertensive renal disease should be directed
towards these two systems.
Hypertension & Kidney
Dr. Faisal A. Hashim, MBBS, PhD, FRCP
Consultant Physician, Almana General Hospital, AGH - Jubail
48
ABSTRACT
Disturbances in acid base balance are relatively common in many disease processes in sick children and tend to
occur whenever exogenous or endogenous sources of acid or base disrupt the delicate constancy of free hydrogen
ion concentration in the extracellular fluid (ECF). Both chemical and physiologic processes are involved in maintaining
this constancy which allows for optimal function of the cellular and subcellular function of the organism. The chemical
processes represent the first line of defense to an acid or base load and include the extracellular and intracellular
buffers. The physiologic processes modulate acid-base composition by changes in cellular metabolism and by
adaptive responses in the excretion of volatile acids by the lungs and fixed acids by the kidneys
I will present various examples of acid base disturbances commonly encountered in infants and children including
the compensatory mechanisms involved in trying to protect plasma pH. I shall also discuss importance of the plasma
and urine anion gap in the differential diagnosis of metabolic acidosis and lastly I will discuss briefly the therapeutic
approach and controversies involved in the management of these various abnormalities.
Acid Base Disorders
Prof Sami Sanjad
49
ABSTRACT
Genetic Kidney Diseases
The Congenital Kidney Diseases in Children will be discussed.
DR. SADEK ABDULLA AL OMRAN
Maternity and Childrens Hospital-Al-Hasa
SCHS #: -R-M-2415 EXP DATE: AUG 24, 2011 E-mail: alsadekeen@gmail.com
PROFESSIONAL ORGANIZATIONS:
Member of Saudi Pediatric Association (SPA).Riyadh- Saudi Arabia.
Member of the International Pediatric Nephrology Association (IPNA).Bronx, New York, USA.
Member of the International Society for Peritoneal Dialysis (ISPD).Washington, D.C., USA.
Member of the American Society of Nephrology (ASN).Washington, D.C., USA.
Member of European Renal Association-European Dialysis and Transplant Association (ERA-EDTA).Caltana, Italy.
Member of the International Society of Nephrology (ISN).Malden, MA, USA.
Member of National Kidney Foundation. New York, USA.
Genetic kidney diseases
Prof. Sadeq ALOmran
Consultant Pediatric Nephrology
50
ABSTRACT
Membranous nephropathy (MGN) is one of the more common forms of nephrotic syndrome in the adult population. It
can be idiopathic or secondary (30%). The two can be distinguished by clinical, laboratory, and histological features.
An update & new therapies of MGN will be discussed in an evidence-based review of the topic.
Membranous Nephropathy an Update
Dr. El Badri Abdul Gadir FRCP,FACP
ABSTRACT
Obstructive Uropathy
Definition of Obstructive Uropathy, hydronephrosis and obstructive nephropathy.
Etiology of obstructive uropathy
Pathogenesis of obstructive uropathy
New modalities in Management of obstructive uropathy
Prognostic criteria after relief of obstructive uropathy.
Obstructive Uropathy
Dr. Mowmen A/Raheem PhD,Fellowship & LMCC (Canada)
51
ABSTRACT
Renal disease was often considered to be a contra indication to pregnancy in past but now many women
with significant renal problems embark on a pregnancy presentation will bring with a brief description of
renal physiology and anatomical changes focus in normal pregnancy. It will then focus on likely pregnancy
outcome and counseling of women regarding important issue as progress of kidney disease during pregnancy
and likelihood of live birth.
Then the key principles of antenatal care in women with pre existing chronic renal disease will be outlined.
Problems in pregnancy such as UTI; Calculi will be touched.
Finally unique issues such as acute renal failure in pregnancy, dialysis in pregnancy and renal transplantation
in pregnancy will be discussed.
Kidney & Pregnancy
DR. SHAMILA HABIB FCPS, MRCOG
52
ABSTRACT
- The Relationship between Lipid Disorders & Chronic Kidney Disease
- Will be discussed with an up-do-date review of the topic.
Dyslipidemia & CKD
DR. HAMDY ABO ZENA, MD
Consultant Internist Nephrologist , Jubail Military Hospital
ABSTRACT
The link between the kidney and musculoskeletal disorders is mutual and although kidney disorders can adversely
affect the musculoskeletal system and immune system, yet serious rheumatologic and immunological conditions
could dramatically jeopardize the kidney function in short time. This presentation is meant to address the effects of
some rheumatologic and immunological disorders and their treatment on the kidneys
PROF. SAMIR M. IBRAHIM MABROOK
Consultant Rheumatologist / Internist
Royal Commission Hospital, Jubail, KSA
Prof. Rheumatology / Internal Medicine, Ain-Shams University, Cairo, Egypt
M.B.B.,cH, Ain-Shams University, Cairo. 1987,
Master Degree of Internal Medicine, Ain-Shams University, Cairo. 1992.
MD Internal Medicine, Ain-Shams University, Cairo. 1998.
Member of the Clinical Ain-Shams Medical Society, 1992.
Member of the Egyptian Rheumatology Association, 1998
Member of the Egyptian Society of Endocrinology and Diabetes Mellitus, 1998
Member of the Egyptian Society of Nephrology, 1998
Member of the American Diabetes Association, professional section, 2004.
Renal Burden of Rheumatic Diseases
PROF. SAMIR M. IBRAHIM MABROOK
53
ABSTRACT
Prof Ahmed Gasim Elzubair (FRCP)
The Public health Approach to Increased Salt Consumption
Salt is one of the oldest foods flavoring substance dating back to several thousands of years B.C. The human salt
consumption has increased dramatically over time since the beginning of its use as a food preservative some five
thousand years ago in China.
Today, human salt consumption amounted to fifty times that of the ancient caveman. This increase is not solely
due to the habit of adding table salt, but rather to a major extent due to consumption of processed foods. The food
industry is profiting in many ways from adding salt to its processed foods. This increased salt consumption, directly
or indirectly, has imparted a huge burden on the human body homeostatic mechanisms regarding salt excretion by
the kidneys. The consequences of such increased consumption were the increase in the prevalence of hypertension
and morbidity and mortality from cardiovascular diseases and cerebro-vascular accidents.
Increased human salt consumption also has been linked to other diseases such as renal stones, osteoporosis and
possibly stomach cancer.
Most physicians restrict their advice to patients, regarding salt consumption, to not adding table salt through the
salt shaker. But recently awareness of physicians is directed towards volunteering agencies (such as WASH) and
government’s effort to collaborate with the food industry to gradually reduce the salt content of processed foods. There
is evidence that such initiative could result in significant reduction in morbidity and mortality due to cardiovascular
disease. This review sheds light on the global public health and preventive approach to increased salt consumption.
Salt & Pepper
Prof. Ahmed Gasim Elzubair



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