A midlands meeting for nephrology

Dr Julio Chevarria, Consultant Nephrologist at Midland Regional Hospital, Tullamore, and member of the organising committee for the Irish Nephrology Society Winter Meeting, speaks to the Medical Independent about the varied programme

The Irish Nephrology Society (INS) Winter Meeting takes place at the Tullamore Court Hotel in Co Offaly on Saturday 20 January. The agenda features a range of topical issues in nephrology that will be discussed by distinguished national and international clinicians.

Member of the organising committee Dr Julio Chevarria, Consultant Nephrologist, Midland Regional Hospital, Tullamore, said an NCHD workshop (Friday 19 January) preceding the main meeting will focus on the important area of vascular access for dialysis. Dr Jennifer Hanko, Consultant Nephrologist, Belfast City Hospital, Northern Ireland, will contribute her sub-specialist expertise at this workshop. Dr Hanko has a special interest in vascular access and is strongly involved in the Vascular Access Society of Britain and Ireland.

The INS meeting will welcome speakers from Ireland, the UK, Spain, and Mexico. The opening presentation will focus on the role of advanced nurse practitioners (ANPs) and specialised nursing staff in renal services. The presenters are Dr Eoin Bergin, Consultant Nephrologist, Midland Regional Hospital, Tullamore, and ANPs in the hospital’s renal service, Ms Sani George and Ms Jini Jacob.

Ms George and Ms Jacob were appointed as renal ANPs at Tullamore in 2021. They commenced working in the hospital in 2006 and have strongly contributed to the development and expansion of renal services since that time. As ANPs they are autonomous practitioners with advanced specialist knowledge and skills in providing optimal care to renal patients. Dr Bergin has provided ongoing professional clinical advice to develop and support the role.

Dr Chevarria said Tullamore was the first hospital in Ireland to have renal ANPs and there are now renal ANPs appointed to other institutions. He said the presentation at the INS meeting will showcase the positive experience and benefits that ANPs and specialised nursing staff bring to renal services.

MDT approach

The multidisciplinary approach in the cardio-renal outpatient clinic at St George’s Hospital, London, England, will be discussed by Consultant Nephrologist Prof Debasish Banerjee. Prof Banerjee is recognised internationally for his vast expertise in the management of patients with chronic kidney disease (CKD) who also have one or more of the following conditions – cardiovascular disease, hypertension, and diabetes.

The final presentation of the morning will outline the rationale for primary prevention of CKD. This topic will be presented by Prof Alberto Ortiz, Chief of Nephrology, Health Research Institute, Jiménez Díaz Foundation, Madrid, Spain. Prof Ortiz is also strongly involved in the European Renal Association. He will present comprehensive and up-to-date guidance on best practice approaches to CKD primary prevention.

Dr Chevarria noted the importance of this topic as the incidence of CKD is rising due to ageing populations and increased prevalence of risk factors. In Ireland, for example, a recent study conducted by TILDA researchers at Trinity College Dublin found CKD was present in 15.6 per cent of people aged over 50, which equated to approximately 226,000 people. New cases of CKD in Ireland in people aged 50 years and over are occurring at a rate of 16 people per 1,000 person-years of follow up, which will likely also contribute to substantial demand on nephrology services and hospital inpatient stay now and in the future, according to the study conducted with the HSE National Renal Office (NRO).

Dr Sharlene Greenwood, Consultant Renal Physiotherapist, King’s College Hospital, London, England, will inform delegates about an app she co-founded called Kidney Beam. It aims to encourage greater physical activity in people with kidney disease. Dr Chevarria noted the app has received good reviews and he looked forward to Dr Greenwood’s presentation.

The opening presentation will focus on the role of advanced nurse practitioners and specialised nursing staff in renal services

Sustainable kidney care will be the topic of a presentation by Dr Eleanor Murray, Consultant Nephrologist, NHS Greater Glasgow and Clyde, Scotland. Dr Chevarria noted this important issue is particularly topical at the moment.

The Irish Kidney Association recently highlighted the significant ecological footprint associated with treatment of kidney failure, especially via dialysis. A single haemodialysis treatment’s carbon emissions are comparable to those of an average vehicle’s 100 kilometre drive and a patient typically requires 156 treatments per year, according to the Association.

The first half of the programme will round-off with a presentation on POCUS and VEXUS for volume management by Dr Eduardo Argaiz, Internist and Nephrology Fellow,  National Institute of Medical Science and Nutrition Salvador Zubiran, Mexico. Dr Argaiz has a special interest in point-of-care ultrasonography.

NRO update

Following lunch, the meeting will resume with an update from the National Clinical Lead for renal services and Clinical Director of the HSE NRO, Prof George Mellotte. He will inform delegates of the NRO’s work to promote access to home dialysis therapies through the support of the HSE modernised care pathway initiative. The NRO has recently achieved funding for additional nurses and dieticians to support early education of patients in respect of home dialysis therapies.

Home dialysis therapy offers substantial improvement to the quality-of-life for patients and has been proven to reduce the risk of patients developing infections, including Covid-19. Currently, only 12 per cent of patients in Ireland receive home dialysis, but the hope is to increase this to 20 per cent.

Following Prof Mellotte’s presentation, Dr Hanko will discuss the vascular registry and vascular access in the UK.

The topic of home dialysis in Ireland will be further examined by Dr Claire Kennedy, Consultant Nephrologist, St James’s Hospital, Dublin. Dr Kennedy’s presentation will be followed by an update from the INS research committee, provided by Prof Peter Conlon, Consultant Nephrologist, Beaumont Hospital, Dublin; Prof Austin Stack, Consultant Nephrologist, University Hospital Limerick; and Dr Conor Judge, Consultant Nephrologist, Galway University Hospital.

INS President Prof Liam Plant will deliver the closing remarks at the event, which will be followed by a networking and collaborative research meeting. Dr Chevarria said the INS looked forward to welcoming up to 100 delegates to the meeting, including nephrologists and other valued healthcare staff working in the field.