Kidney Week

Educational Symposium

Removal of Large Middle Molecular Uremic Toxins: Room for Innovation

October 23, 2020 | 01:00 PM - 02:00 PM

Location: Simulive

Session Description

Hemodialysis remains the most common form of kidney replacement therapy worldwide for patients with ESKD. Despite advancements in dialysis technologies, morbidity, and mortality remain high for hemodialysis patients.

Urea clearance is the gold standard for measuring adequate dialysis clearance. The current technology for hemodialysis therapy (high-flux membranes) can clear uremic toxins up to 12,000 Daltons (12 kDa) but has very poor capacity to remove large middle molecular uremic toxins (25-60 kDa). These large middle molecules have been associated with chronic inflammation, atherosclerosis and calcification, structural heart disease, and secondary immunodeficiency.

This symposium discusses a potential role for the removal of these large middle molecules, including consideration of the available technology.

Support is provided by an educational grant from Baxter Healthcare Corporation.

Learning Objective(s)

• Describe the clinical relevance of large middle molecular uremic toxins in ESKD
• Discuss the available technologies to remove large middle molecules

Learning Pathway(s)

• Dialysis

Moderator

• Sahir Kalim, MD, FASN

Presentations

• Introduction: Current Gaps in Therapies to Remove Large Middle Molecules: The Need for Innovative Approaches
  01:00 PM - 01:10 PM
  Sahir Kalim, MD, FASN 
  
  

  Sahir Kalim, MD, FASN

  Sahir Kalim is a physician scientist at the Massachusetts General Hospital (MGH) in Boston, Massachusetts, USA. He is an Assistant Professor of Medicine at Harvard Medical School, and co-director of the MGH Kidney Research Center. His clinical interests include managing late stage chronic kidney disease (CKD) as well as caring for patients with end stage kidney disease (ESKD) on dialysis. In addition to seeing patients, his research focuses on understanding the fundamental causes of the excess morbidity and mortality seen in patients with CKD in an effort to develop new targeted therapies. He has been awarded multiple NIH grants focused on proteomics, metabolomics, and clinical trials in CKD/ ESKD. Recently, Dr. Kalim’s work has linked a protein modification known as carbamylation to several adverse outcomes such as resistance to erythropoietin and mortality in patients with kidney disease. Similarly, using high throughput screening, his group has identified a number of novel metabolite derangements associated with cardiovascular disease in dialysis patients. He is now studying ways to correct these metabolic disturbances and determine, through clinical trials, if doing so results in improved patient outcomes.

Introduction: Current Gaps in Therapies to Remove Large Middle Molecules: The Need for Innovative Approaches

October 23, 2020 | 01:00 PM - 01:10 PM

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• Biology and Clinical Significance of Large Middle Molecular Uremic Toxins in ESKD
  01:10 PM - 01:35 PM
  Peter Stenvinkel, MD, PhD, FASN 
  
  

  Peter Stenvinkel, MD, PhD, FASN

  Peter Stenvinkel serves as a professor and senior lecturer at Dept. of Renal Medicine Karolinska University Hospital, Karolinska Institutet, Stockholm, Sweden. He has published about 560 original publications and reviews and 30 book chapters on various aspects of inflammation, wasting and metabolism in chronic kidney disease patients. His Hirsch index is 86 according to PubMed and 108 according to Google Schoolar. He has given more than 400 invited lectures at various international meetings and congresses in about 30 different countries. He has received prize for the best Swedish thesis in diabetology 1994 and was a Baxter Extramural Grant awardee 1996. He was a Karolina Price awardee 2005 and a Vizenca price awardee 2009. He received the Addis Gold medal by the ISRNM for nutritional research 2010. He is a member of the council of International Society of Nephrology (2007-) and ERA-EDTA (2007-2010). He is an associate Editor of NDT and was editor-in-chief on NDT-E 2010-2013. He received an honorary membership of the Australian and New Zealand Society of Nephrology 2010 and of the Polish Society of Nephrology in 2012. He was an international NKF awardee 2012. He is a fellow of ERA-EDTA and ASN.

Biology and Clinical Significance of Large Middle Molecular Uremic Toxins in ESKD

October 23, 2020 | 01:10 PM - 01:35 PM

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• Dialysis Modalities and Technologies to Remove Large Middle Molecules
  01:35 PM - 02:00 PM
  Colin A. Hutchison, MBChB, PhD 
  
  

  Colin A. Hutchison, MBChB, PhD

  Dr Colin Hutchison is a graduate of Leicester University, UK and undertook his nephrology training in the West Midlands where he gained his PhD in Medical Sciences from the University of Birmingham. Dr Hutchison has been involved in dialysis research for a number of years in both acute kidney injuries and maintenance dialysis programs. He was Chief Investigator for the multi-national REMOVAL-HD study. He currently practices in Hawke's Bay, New Zealand.

Dialysis Modalities and Technologies to Remove Large Middle Molecules

October 23, 2020 | 01:35 PM - 02:00 PM

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