The 42nd Annual Meeting and Scientific Exposition took place in San Diego and included talks from Drs. Vimal Derebail, Maria Ferris, and Amy Mottl.
The American Society of Nephrology held its 42nd Annual Meeting and Scientific Exposition under sunny skies in San Diego this year. There was a strong showing from UNCKC faculty during the daily poster sessions, and several were invited to present current research projects.
Vimal Derebail, MD, presented recent findings of a local study demonstrating a high prevalence of sickle cell trait among African-Americans receiving dialysis. Hemoglobin phenotyping was reviewed in 188 African-American dialysis patients. Sickle cell trait was twice as common among African-Americans with ESRD, present in nearly 15% or one in seven patients. Sickle cell trait may be causative to the development of renal disease or accelerate a primary disease such as diabetes mellitus. Additionally, sickle cell trait has been associated with venous thromboembolism and could also impact anemia treatment. Although these findings require confirmation, the contribution of sickle cell trait and other hemoglobinopathies to the progression of ESRD and their impact upon the course and management of ESRD patients deserve further study.
Amy Mottl, MD, gave her talk, “Update on Pathogenetic Risk Factors of Development and Progression of Diabetic Nephropathy” to a packed room as part of a longer session on Diabetic Nephropathy. Dr. Mottl contends that proteinuria may not be as reliable a predictor of progression in diabetic kidney disease as has been traditionally thought. Research has shown that even nephrotic range proteinuria frequently regresses spontaneously. In fact, many type 2 diabetics with biopsy proven diabetic glomerulosclerosis do not have microalbuminuria prior to the onset of decreased GFR. Other type 2 diabetics with non proteinuric kidney disease, however, have biopsies more consistent with interstitial and vascular disease. It may be that there are multiple pathways through which diabetes can affect the kidney, and more research in this arena is indicated.
Maria Ferris, MD, MPH, PhD, described the work her multidisciplinary team has done to help transition pediatric patients with chronic kidney disease to adult care. The UNC Transition program has developed tools to identify, measure, and provide tools for young adults to better manage their disease. Three tools have been developed to measure the process of health care transition over time. These tools include 1) the medical passport, 2) transition readiness survey and 3) the transition scale. Data is being collected on nearly 300 adolescents serves at UNC Hospitals.