Invited to "Narayan Health" for "Symposium on Pediatric Liver Transplantation"

This weekend, I shall be at Narayan Health- Mazumdar Shah Medical Center, for taking a lecture on "Long term Kidney Issues in Pediatric Liver Transplantation".

It shall be interesting to have audience as Pediatric Liver transplant physicians and Pediatric Liver transplant surgeons, and trying to create awareness about renal issues in all kinds of Pediatric Transplantation.

It shall also be an honor to talk after well renowned Pediatric transplant physicians of the country!

Free Online articles on Pediatric Nephrology

This month ERA-EDTA provides free online articles for all for childhood renal disorders.

Following are my favourites:

• Editorial on "World Kidney Day"
• Excellent prospective study on biomarkers and renal angina index in critically ill children by Dr Goldstein's group
• A chapter on Pediatric AKI by Dr Rees
• A chapter on Pediatric transplantation by Dr Minnie Sarwal
• Plasmapheresis experience from CMC Vellore, India
• A chapter on Pediatric Hypertension

Kidney transplantation in children with congenital anamolies: improved outcomes

Congenital uropathy included chronic pyelonephritis/reflux, prune belly syndrome and congenital obstructive uropathy. Congenital pediatric kidney disease included polycystic kidney disease, hypoplasia, dysplasia, dysgenesis, agenesis and familial nephropathy.

Analysis of trends in the last 14 years in SRTR (Scientific Registry of Transplant Recipients)demonstrates that patients with both lower and upper tract congenital anomalies experienced delayed time to the first renal transplant. Furthermore, patients had similar age matched graft and patient survival whether the primary source of renal demise was the congenital lower or upper tract. These findings may indicate that improved urological and nephrological care are promoting renal preservation in both groups.

Encouraging indeed! 

Take home message: 
Important to screen CAKUT and manage them well early to prevent renal deterioration. 

Need for more studies on drug monitoring of MMF

As Pediatric Nephrologists, we do not do routing therapeutic drug monitoring of MMF, and neither it is available as a part of routine lab test. Current edition of Pediatric Nephrology reviews this topic, and makes us feel that maybe we should be doing more studies on this aspect, and do this in addition to Tacrolimus in Pediatric renal transplantation in the world.

The paper says- ' In terms of short-term efficacy, there is strong evidence that a MPA area under the time-concentration curve of >30 mg × h/L reduces acute rejection episodes early after renal transplantation, and there is evolving evidence that aiming for the same exposure over the long term may be a viable strategy to reduce the formation of donor-specific antibodies.'
Link to the Original Review
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