eurecam e-Newsletter
Year 2 Issue 1 March 2011
In this issue:
EURECA-m Board Members

Carmine Zoccali, Italy (EURECA-m Chairman)

Adrian Covic, Romania (EURECA-m Secretary)
David Goldsmith, UK (Editor in Chief of EURECA-m Newsletter)
Gérard Michel London, France (ERA-EDTA President)
Bengt Lindholm, Sweden
Alberto Martinez Castelao, Spain
Gultekin Suleymanlar, Turkey
Danilo Fliser, Germany
Andrzej Wiecek, Poland (liaison with National Societies of Nephrology)
Ziad A. Massy, France
Alberto Ortiz Arduan, Spain (Auditor)
Epidemiology and Biostatistics Consultants
Kitty J Jager, The Netherlands
Friedo W Dekker, The Netherlands
Giovanni Tripepi, Italy
Cecile Couchoud, France
May 20-22, 2011 - Groningen, The Netherlands
June 23rd, 2011 (8.30-17.30 hrs)
EURECA-m SYMPOSIUM (in collaboration with ISH)
June 25th, 2011 (17.00-18.30 hrs)-
Priority questions in cardiovascular and renal medicine
More dialysis means more life for more people
The cardio-renal link is a very complex, still poorly understood, pathophysiological and clinical problem.  Indeed, on one hand renal function loss may trigger cardiovascular disease and on the other cardiac

diseases may engender renal damage. The bi-directionality of such a link highlights the difficulties that investigators have when facing the complexity of cardiovascular damage in renal diseases and vice versa. The clinical research questions to be addressed by this new discipline, Cardiovascular and Renal Medicine, are numerous and the EURECA-m board feels that, at this stage of knowledge, it is important to identify research priorities.
The board met twice in 2010 for scoping questions to be shared with EURECA-m members, interested investigators and clinicians. The results of these efforts will be soon presented in 6 brief papers that will be published in a Supplement of Kidney International. Specifically, in these papers we outline current problems for establishing taxonomies in the cardio-renal area and for understanding the parallel death risk of cardiovascular and non cardiovascular disease in end stage renal disease. We list a series of questions to be addressed to better understand the role of endothelial dysfunction, sympathetic over-activity and alterations in the renin-angiotensin system in the high risk of renal and cardiovascular diseases. Furthermore, we describe lingering research issues on arterial stiffness and hypertension as related to clinical outcomes. We hope that the doubts and questions listed in these manuscripts may serve as a stimulus for channeling research into priority themes and as a starting point to openly debate the many intriguing problems posed by this fascinating research area.
We will summarise the questions identified in these brief reviews in forthcoming newsletters and we will also provide access to the related papers to interested clinicians and investigators.
I take the opportunity to invite you to participate in the general assembly of EURECA-m WG that will be held shortly before EURECA-m SYMPOSIUM. The assembly will start at 16:15 and finish at 17:00.

Carmine Zoccali EURECA-m Chair

Dear EURECA-m members,
Welcome to the first of several projected newsletters of 2011. There are exciting plans for EURECA-m with two sessions in Prague at the ERA-EDTA Congress and both

epidemiological and interventional studies in advanced stages of preparation. Details are provided in this Newsletter. In my last Newsletter I mentioned Facebook, and better communication between us EURECA-m members. We are hoping to be able to introduce this during the first half of 2011 and in time for Prague, but the precise details of what we will actually do are not yet clear. To have a series of Blogs, and a common Facebook page we can utilise, currently is the main aim.
I wanted to focus briefly on a paper published in December 2010 in NEJM, as I think it is another simple yet epoch-making piece of work, and, like all simple ideas, it is both exciting and challenging. Nearly 400,000 persons in the United States and 2 million worldwide are dependent on dialysis; of these, approximately 90% in the United States and 70% in Canada undergo hemodialysis, which is typically delivered three times a week. The rationale for thrice-weekly hemodialysis was derived from a combination of physiological experiments, assessments of patient acceptance, feasibility, logistics, and costs. It is therefore, a muddy, messy compromise. Mortality remains high (approximately 18 to 20% per year in the US though signficantly less than that in Japan and Europe) despite improvements in the technology for dialysis, the development of new pharmaceutical agents, and experience over the course of more than 40 years since maintenance dialysis became available. Moreover, although dialysis can sustain life, it rarely restores health; patients undergoing dialysis have considerable complications (including frequent and extended hospitalizations) and relatively poor functional status and health-related quality of life.
If there is an "optimal" dose of HD is it not certain what it is. Optimal to survive a few months, or, to be restored to a good functional status ? The currency of measurement of dialysis has been small solute clearances (urea), mainly because we can measure these accurately, not because they are important mechanistically per se. As such then, another messy, muddy compromise.

Read more

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Useful Links and Important Events

4th Meeting Uremic Toxins and Cardiovascular Disease

This meeting is endorsed by ERA-EDTA

May 20-22, 2011 - Groningen, The Netherlands





XLVIII ERA-EDTA Congress, Prague (Czech Republic), June 23-26 2011

June 23rd, 2011 (8.30-17.30 hrs)

EURECA-m SYMPOSIUM (in collaboration with ISH)
June 25th, 2011 (17.00-18.30 hrs)

June 25th, 2011 (16.15-17.00 hrs)     

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EURECA-m Website: