Joint ABCD-RA Meeting

Ana Pokrajac reports on the Fourth Joint ABCD and Renal Association (RA) meeting, Birmingham, 13th February 2019

The Fourth Joint ABCD and Renal Association (RA) meeting took place in Birmingham on 13th February 2019 and it was a great success. There was an unprecedented number of attendees (121) from both specialties as well as from general practice. We were particularly pleased to see a significant proportion of trainee doctors developing an interest in this complex but prevalent area of clinical practice.

Helen Eddington provided a very useful overview of hyperparathyroidism in chronic kidney disease (CKD) – a very challenging and understudied problem. Vitamin D replacement remains to be researched, but there is a case for ensuring vitamin D replete status before embarking on treatment with the 1-alpha hydroxylated form of vitamin D.

Carel Le Roux delivered one of the most praised talks on renal outcomes of obesity surgery in people with diabetes. Equally highly regarded was the talk about post-transplantation diabetes by Adnan Sharif, who gave an overview of clinical trials and outlined the need for further research challenging the notion that insulin was the safest treatment option. The important take-home message is that most patients post-transplantation have an abnormal blood glucose result, but the diagnosis of diabetes should not be made too early.

Richard Haynes presented a novel concept of the benefit of neprilysin inhibition to cardio-renal disease in people with diabetes and gave a flavour of new agents being studied, some of which offer a treatment potential.

Oral presentations were an eclectic mix of a very high standard on the use of technology to improve care and efficiency in people with diabetes and CKD and basic science on the role of new markers of kidney damage.

Our guest speaker, Patrick Rossignol, delivered an excellent talk on hyperkalaemia in patients with CKD treated by renin angiotensin system inhibitors and angiotensin II receptor blockers that are otherwise renoprotective. He offered some practical tips applicable to clinical practice.

Anaemia is a frequent feature of advanced CKD and it was a pleasure to listen to Iain MacDougall’s talk on the importance and ways to manage anaemia to improve cardiovascular outcomes.

The final intriguing talk about factors influencing real-life prescribing of antidiabetic agents around the UK was given by Laurie Tomlinson and sparked reflection and lots of discussion from the audience. Apart from known factors studied in clinical trials, it appears that socioeconomic status has a significant and unjustified impact on clinical decision making. Food for thought!

We look forward to our next meeting in 2 years’ time.

Correspondence: Ana Pokrajac
Br J Diabetes 2019;19:77

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