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The Australian

and New Zealand

Society of Nephrology

Issue Date

ANZSN ASM – DARWIN IN THIS ISSUE

1. Editorial 2 .President’s Report 3. Treasurer’s Report 4. SPEC 5. 2017 LOC Report Darwin 6. 2018 LOC Report Sydney 7. CPAC Report 8. DNT Workshop 9. RAC Report 10. DAC Report 11. GNAT Report 12. AKTN Report 13. ANZPNA Report 14. Workforce Report 15. ANZDATA Report 16. ATC in Nephrology 17. ANZSIN 18. Nephrology Journal 19. International Affairs Report 20. APSN Report 21. ISN Report 22. KHA Report 23. KHA – CARI Report 24. Kidney School 25. ANZSN ASM Awards 26. Special Awards 27. Jacquot Awards 28. Travel Grant Reports 29. Sponsors 30. ANZSN Contact Details

ALSO IN THIS ISSUE

Editorial GERMAINE WONG ANZSN HONORARY EXECUTIVE OFFICER

It has been a year of progress and relentless innovation, developing new initiatives while improving communication and addressing the specific needs in workforce, education, research and gender equity/diversity issues within the Society and beyond. With special thanks to Nicholas Gray and the workforce working group, a detailed strategic and implementation plan has been developed addressing the key workforce issues raised by trainees and fellows. The SPEC team (led by Muh Geot Wong and Rob MacGinley) and Kidney School (Amali Mallawaarachchi and John Saunders) has also transformed adult learning in clinical nephrology. Using a three-pronged approach, which includes two basic/advanced teaching weekends, E-learning Hub and an interactive monthly face to face teaching program, the team has established a comprehensive educational program for all trainees and fellows in Australia and New Zealand.

The combined and tireless efforts of the local organizing committee (Paul Lawton and William Majoni) and SPEC (Frank Ierino and team) have ensured this year’s annual scientific meeting in Darwin a true success, showcasing the best and the brightest young scientific talents across Australasia. We were also privileged to host our many excellent international speakers from the United States, Canada, Japan and India. All have provided amazing insights and diverse knowledge ranging from data science, clinical trials to the epigenetics of acute kidney injury.

With gratitude to Paul Lawton, Jaqui Hughes, William Majoni, the Kidney Health Australia, and generous support from Industry and other

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philanthropic sources, for the first time in ANZSN history, the voices of Aboriginal and Torres Strait Islander patients with chronic kidney disease and their caregivers were heard.

As a Society, we recognize the importance of ensuring gender equity and diversity in research and the workforce. But more importantly, we acknowledge our patients are heterogeneous, and that research agenda, clinical care and policies should provide benefits for all affected by kidney disease, regardless of gender, race and age. Our newly formed gender equity and diversity working group, chaired by Kate Wyburn, will identify where gender, age and cultural-based differences are significant, and how to ensure more equitable outcomes for our patients.

I would like to sincerely thank all those who had made the Society as it is today. First and foremost, Anna Golebiowski, our Executive Officer, is working tirelessly behind the scenes with Jourdan Pinnell, our Administrative Officer, to ensure all aspects of the Society are in order. Anna is a remarkable person and the pillar of the Society. Anna, best of luck wherever your new journey takes you. To my fellow council members, thank you so very much for your incredible energy, passion and talents in driving the revolutionary changes in Council and the broader Society over the past four years. On a very final note, this will be my very last time writing to you as HEO of the Society. I have enjoyed every moment of this role and am very grateful for this wonderful opportunity to serve.

Germaine Wong Honorary Executive Officer, Australian and New Zealand Society of Nephrology

2017 has delivered a large number of highlights, activities and outcomes but the Society would be nothing without its members, and so let’s begin there. The ANZSN is a Society of

diversity, and in so many domains – career stage, gender, spectrum of work, field of research, and geographical location to name just some. The ANZSN will grow and be vibrant directly proportional to its capability in making the professional lives of its members better. The changes in the ANZSN that have occurred over the last 1-2 years have all been about building a fit for purpose structure to support our

members – all of our members – in research, education, and policy. As a Council, we recognise that need to do better in supporting our members, both our existing members, and those that we aspire to be members particularly those in regional/remote locations, trainees, researchers, Aboriginal and Torres Strait Islander people and women. We also recognise that we need to provide greater support to our nephrology colleagues in the Pacific Region. Ultimately however, we have an obligation to our patients – to provide better, evidence-based, consumer-focussed care – and the ANZSN should support its members to deliver that care.

The Annual Meeting, held in Darwin this year was an outstanding success. With the Scientific Program developed by Scientific Program and Education Committee (SPEC), chaired by Angela Webster and Frank Ierino, and the Conference organised by Paul Lawton and William Majoni, many happy memories and new knowledge were generated. The “Patient Voice” symposium was an important first. An opportunity to hear from Aboriginal and Torres Strait Islander people affected by CKD on what mattered to them. This was a landmark occasion, and represents growing participation of patients and their caregivers in the ANZSN.

SPEC has worked hard to on their educational portfolio, with the Kidney School continuing to produce high quality content for advanced trainees (led by John Saunders and Amali Mallawaarachchi), the highly successful inaugural weekend nephrology course conceived and run by Rob MacGinley and Muh Geot Wong, and advanced plans for an E learning hub in development.

The Research Advisory Committee (Chaired by Carol Pollock), has gone from a concept to a fully constituted group and a developed strategy within 6 months. Partnership with KHA will be critical to increase funding into the nephrology community across the full spectrum of research, from basic science through to health services research.

The Clinical Policy Advisory Committee (CPAC, chaired by Martin Gallagher) is beginning to develop a work plan to improve the practice of nephrology, and is tasked with overseeing ANZDATA and KHA-CARI on behalf of the ANZSN. The Dialysis Advisory Committee (chaired by Fiona Brown) is working towards the biennial Home Dialysis conference in Auckland in February 2018.

In recognition of the need to proactively manage important issues, and to grow and evolve, Council has formed a number of working parties on Gender Equity (Kate Wyburn), Environmental Sustainability

JONATHAN CRAIG -ANZSN PRESIDENT

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(Katherine Barraclough), Workforce (Nick Gray), Indigenous (Jaqui Hughes) and Industry Partnerships (John Knight) whose reports will inform Council Strategy.

2017 was also the year of departures - of Paolo Ferrari who got an offer in his homeland of Switzerland that was so good that he resigned as President of the Society 1-year into a 2 year term, and Anna Golebiowski is moving onto other opportunities after 5 years of service to the ANZSN. Both have made enormous contributions to Australian-New Zealand Nephrology and will leave a void.

The work of Council also needs recognition. Germaine Wong has been a remarkably efficient and hard-working HEO, and Girish Talaulikar has energetically generated a balanced budget and improved our accounting practices. Nigel Toussaint (President- elect), Katherine Barraclough, Ross Francis, David Mudge, Murray Leikis, Jaqui Hughes, and Josh Kausman have all contributed substantially in their respective portfolios. Jaqui should be specially recognised as the first Torres Strait Islander woman appointed to Council as we commit to better care and outcomes for Aboriginal and Torres Strait Islander people.

2017 was about people and progress. Much more is needed but it’s a promising start.

Jonathan Craig ANZSN President

The Society is in a stable financial situation with $3.1 million in cash reserves. These provide a safe position to deal proactively with a changing environment where

industry sponsorship is not likely to be maintained at levels seen in the past.

We have responded to this challenge, proactively, by introducing cash flow prediction and aim to deliver a balanced budget for each financial year. Simultaneously we are actively exploring new sources of revenue through better investment opportunities for its cash reserves and developing an E-Hub for educational resources. All of this will enable continued support to education, research and policy initiatives that speak to the mission and vision of the Society.

The Council will also be proactive in monitoring Scientific Meeting Budgets to ensure that the meetings are financially independent of support funds from the Society Reserves.

Finally, I would like to thank Prof John Knight for agreeing to lead a working group that will help us explore new opportunities for revenue generation through engagement with industry.

The year has been a period for setting goals and deciding on the best way to achieve them. Next year will be about the progress made in achieving them.

I wish all members and their families a peaceful and enjoyable festive season.

Girish S. Talaulikar Honorary Treasurer

GIRISH TALAULIKAR TREASURERS REPORT

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ANZSN Scientific Program and Education Committee (SPEC) Report

SPEC has been very active over the last 12 months with

our commitment to core business which includes delivery of quality science (both clinical and basic), education, awards and promotion of equity/diversity. Each and every member of SPEC should be thanked for continued time and effort in contributing to our Society’s programs in Science and Education. SPEC works closely with a range of ANZSN subcommittees under Council’s leadership, affiliated societies (ANZSIN and ANZPNA) and a range of other close Societies (TSANZ, APSN, ISN), Organizations (KHA) and Working Groups – more detailed listing of other Professional Organizations and Working Groups can be found on the ANZSN Website (AKTN, Cochrane Collaborative, CARI, KidGen, RSA, and others). Close collaborative links are becoming increasingly important as our Society grows. Continuing strategic planning and new ideas also remain on our agenda as a standing item. I would also like to underscore the continuing drive of the committee to provide for the broad membership in all aspects of clinical and basic science in nephrology, and furthermore, to promote the younger upcoming future leaders of our society.

On behalf of ANZSN, I wanted to first thank Angela Webster who has very ably and professionally led SPEC as Chair. Although Angela steps down as Chair, we are fortunate that she remains on the committee as a member until the end of 2018 to provide an efficient transition.

This year’s ANZSN Annual Scientific Meeting in Darwin was an excellent program and venue (See Paul Lawton’s LOC report). Congratulations and thanks to the ASM co-conveners, Paul Lawton and William Majoni, as well as other members in the Local Organizing Committee, for a meeting that ran very smoothly from a scientific and social perspective. Registration and Abstract submissions were very strong and a record number of abstracts were submitted. The Darwin backdrop provided a very relaxed atmosphere. ANZSN would like to thank all invited International speakers - Professor Laura Dember; A/Professor Camille Kotton and Professor Charmaine Lok and the three International APSN speakers - Professor Motoko Yanagita, Professor Masaomi Nangaku and Dr Basu Gopala. All speakers were very interactive with excellent plenaries and sessions. We should also recognize and thank all our local speakers and note that our own local speakers

have both national and international profiles, which reflects on the quality of the local nephrology scene in Australia and New Zealand. Our members who reviewed abstracts should be acknowledged with thanks and provided the necessary support to ensure the program was successful.

Highlights of the Annual Scientific Meeting include the Award sessions and I would like to congratulate all researchers in their respective session. Special congratulations to all the awardees – (a) TJ Neale joint winners – Professor Josephine Forbes, and Dr Merlin Thomas; (b) Past Don Jacquot awardees - Drs. Natasha Rogers and Katherine Barraclough; (c) ANZSN Young Investigator Awards (a) Clinical Science; Winner – Dr Andrea Viecelli; Runner up – Dr Eric Au and (b) Basic Science; Winner – Dr Holly Hutton; Runner up Dr Keren Grynberg; (c) KHA Clinical Science Award – Professor Alan Cass; (d) Basic Science Award; Winner - Dr Joshua Ooi; Runner up – Dr Poh Yi Gan; (e) Rural Award - Dr Paul Lawton; (f) Shaun Summers Advanced Trainee award – Dr Emily See; and (g) ANZSN Interventional Nephrology Science Award – Dr Lai Wan Chan. The standard of presentations by our Young Investigators and Advanced Trainees was outstanding and the future of our Society is in good hands. The mentors of these young investigators should also be congratulated.

The Update Course continues to be a major attraction (180 attendees this year) and congratulations goes to Muh Geot Wong on SPEC and supporting SPEC members who have made this course a very successful educational program.

As always, the contribution by our Sponsors is greatly appreciated. ANZSN has secured a conference organizer - Conference Design – which is a major step forward in running an efficient meeting and extended thanks goes to Anna Patterson from Conference Design.

The planning and organization for the 54th Annual Scientific Meeting and Update Course, which will be held from 8th to 12th September 2018 in Sydney at the International Convention Centre, is well underway. SPEC and ASM LOC (Martin Gallagher as Chair) have been working closely to provide an outstanding program. The themes for the ANZSN ASM in 2018 include personalized nephrology, clinical and diagnostic genomics, complement related diseases, cutting edge translational research and global kidney health. Our invited International speakers include Barbara Murphy (USA) and David Kavanagh (UK), and our APSN International speakers, Angela Wang (Hong Kong), Adrian Liew (Singapore) Sydney Tang (Hong

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Kong). Collaborative efforts with KidGen who are running their own workshop over the weekend should allow sharing of the International speakers so that ANZSN will have two additional international speakers (to be finalized). We also have a number of high profile Local Speakers to be announced soon. More will be forthcoming as the planning unfolds and we anticipate the program will be in near final format by the end of year.

The 2019 ISN meeting will be located in Melbourne and early planning from SPEC’s perspective and involvement has commenced. More information will follow.

Rob McGinley’s efforts on the Educational front should be acknowledged. A series of new initiatives have been implemented or currently in the planning phase. The Update Course will be complemented by two further Educational Courses. The inaugural “Basic Course in Nephrology - Unravelling the Secrets of Kidneys” for early Advanced Trainees - was held in Sydney July 8th-9th and had excellent feedback from the attendees. An Advanced Course in Nephrology is being designed for 2018 with the main focus of targeting senior Advanced Trainees and preparing them for future clinical practice (both public and private) and those considering academic careers in nephrology. Also, plans for a separate e-Learning Hub to the ANZSN website is progressing and will eventually provide a comprehensive educational platform for Advanced Trainees. Finally, work with Kidney School is in progress to further develop existing educational Webinars. These initiatives will significantly enhance the educational opportunities for our members. Please contact SPEC or ANZSN Administration if you have any questions.

In concluding this report, we thank Council, led by Jonathan Craig, for the leadership, and Administrative Staff (Anna Golebiowski and Jourdan Pinnell). The future of ANZSN’s science and education looks very exciting.

Frank Ierino SPEC Chair

ANZSN SPEC Members - Angela Webster, Sharon Ricardo, Peter Trnka, Greg Tesch, Andrew Mallett, Wai Lim, Gopi Rangan, John Irvine, Muh Geot Wong. Robert MacGinley, Martin Gallagher (LOC ASM 2018)

LOC Report for ANZSN ASM 2017 in Darwin

This year, the Australian and New Zealand Society of Nephrology (ANZSN) Annual Scientific Meeting was held from the 4th-6th of September

in Darwin, which obliged with the usual warm welcome.

Once again the Scientific Program and Education Committee (SPEC) of the Society, chaired by Angela Webster followed by Frank Ierino, designed a first rate scientific program with a particular focus on Equity and Diversity in the Society. All three plenary speakers (Laura Dember, Camille Kotton and Charmaine Lok) were equally very highly rated. Similarly, all nine seminar speakers, including three invited Asian Pacific Society of Nephrology speakers for the first time (Basu Gopal, Masaomi Nangaku and Motoko Yanagita) were very well received. Of the 330 abstracts accepted (a record for the ASM), 28 were selected for prize session presentation and a further 126 for mini-oral presentation.

The meeting was attended by 485 delegates; 83% of respondents rated the ASM overall as good or very good, and 90% felt that the overall program content was useful to their work. As well as the Renal Dieticians Workshop on the Sunday (attended by 43), the pre-conference weekend Nephrology Update Course, coordinated by Muh Geot Wong for SPEC and attended by 186 delegates, received particularly positive feedback.

Innovations at the meeting were also popular, including the Monday Film Night at the Deckchair Cinema and the Patients’ Voices Symposium on the Wednesday (which is likely to continue in some form in future meetings). The Gala Dinner under the stars on Tuesday night was also well attended, not only by conference delegates, but also Patients’ Voices Symposium VIPs; those hoping for a farewell speech from outgoing Society President Paolo Ferrari were nevertheless entertained, both by a masterclass in “naming and shaming” from incoming Society President Jonathan Craig and by the dulcet tones of B2M from the Tiwi Islands.

The event managers Conference Design, led by Anna Patterson, handled all aspects of meeting management smoothly and professionally, even in the face of the occasional unexpected AV glitch. Their continued involvement, together with SPEC’s oversight and the flair of the local organizing committee led by Martin Gallagher, will no doubt make the ANZSN Annual

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Scientific Meeting in Sydney, 10-12 September 2018, an event not to be missed!

Paul Lawton and William Majoni LOC Darwin 2017

LOC Report for ANZSN ASM 2018 to be held in Sydney.

The Local Organizing Committee has been busy working with SPEC to develop

the Annual Scientific Meeting for 2018. The meeting will be held in Sydney at the new International Convention Centre, which is an amazing venue on Darling Harbour, from September 8-12 2018. We have been building on the knowledge and work of Paul Lawton and William Majoni and their fantastic organization of the Darwin meeting this year, but also looking at ways in which we can develop and enhance the meeting. We are also looking to build upon the success of the Update Course and exploiting the synergies between this course and the overall meeting. We’ve also been in discussions with international renal society representatives as we endeavor to attract more people from overseas to the meeting. Whilst in these straitened times it’s likely that the registration fees will need to rise slightly for this year’s meeting, we remain confident that we will have a fantastic array of local and international speakers that will make for an entertaining and educational meeting for all.

Martin Gallagher LOC Sydney 2018

Clinical Policy Advisory Committee (CPAC) Report.

The CPAC Committee, charged with developing and promoting clinical policy and practice tools to

guide care in ANZ nephrology, is now in place with our first meeting being at the Annual Scientific Meeting in Darwin in September. The remit of the Committee is broad and we are still finding our way in addressing the important and urgent issues as well is setting up a structure for the future. There are a number of organizations who contact the ANZSN seeking our input into various policies at both the government and non-government levels. It’s a challenge for us to

provide meaningful input into these policy decisions and we will need to work out ways in which we can do that in a timely way. Often these requests for input have 14 day timelines which makes consultation across the membership difficult, if not impossible.

CPAC has a number of committees that report to us, including the new Key Performance Indicator Working Group, CARI and the ANZDATA Registry. One of the key tasks that remains with this Committee, inherited from the previous Dialysis and Transplant Subcommittee, is the organization of the DNT Workshop. One thing members should be aware of is that the next DNT Workshop would usually occur early in 2019 and would clash with the ISN meeting in Melbourne. As such, we are likely to move the meeting to later in the year (around September) to avoid such a clash. The feedback from the previous DNT Workshop was overwhelmingly positive and supportive of the idea of returning to Adelaide for the next meeting. Normally the next meeting would be in Queensland so we are likely to ask our Queensland colleagues to assist in the organization of the next workshop.

The membership of the Committee consists of myself, A/Prof Kevin Polkinghorne, Dr Paul Collett, Prof Robert Walker and Dr Geoff Kirkland. Ex officio members include Dr Shilpa Jesudason and Marie Ludlow (from Kidney Health Australia) and Fiona Donnelly from the RSA.

The Committee, its members and ANZSN Council will continue to work hard in establishing a framework by which we can add most value to the policies and practices across the Society. We are open to suggestions and input from across the Society about how we can best to do this.

Martin Gallagher CPAC Chair

2017 DNT Workshop Report

At a time when the DNT Subcommittee was being transformed into CPAC (Clinical Policy Advisory Committee), this Committee

presided over one of the best DNT Workshops. As Chair of the DNT Subcommittee, Dr Martin Gallagher was keen to put together a Program for the Workshop that would reflect the changing nature of this Subcommittee.

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The 2017 DNT Workshop was held at the end of February (Sun 26th to Tues 28th of February) in the Grand Ballroom of the Stamford Grand. The views out to sea were mesmerizing and the weather was very pleasant. There were approximately 230 attendees with 77 of 81 Heads of ANZ Renal Units at the Workshop along with all of ANZSN Council and the DNT/CPAC Subcommittee. There was an expression of interest process for ANZSN members to attend (not inclusive of affiliates) and this was honoured in most cases.

Dr Shilpa Jesudason enlisted as a local co-organizer for this Workshop and focused her efforts on organizing the program and its speakers in a short period of time. The outcome was an exciting two-day program with active audience engagement through the use of Event Poll.

Sessions included workforce training, ANZDATA, marginal dialysis, acceptable risks in transplantation, CKD models of care, indigenous CKD and governance. Updates were presented in the areas of transplantation, AKTN, the Medical Benefits System (MBS) and data linkage. There was also a debate on the value of HDF with Professor Peter Kerr and Professor Carmel Hawley sparring as you have never seen before.

The conference organizers (Dinamics – Alistair McIlwrick and Elizabeth Lynton) were invaluable in delivering a smooth and successful Workshop with a somewhat complicated invitation and registration process, accommodation arrangements and social events.

The Welcome Reception Dinner was on-site at the Stamford Grand and was well attended. The Workshop Dinner was at the National Wine Centre on the Monday evening with special guest speaker Dr Lindsay Barratt. Lindsay spoke about his days as a nephrologist and his transitioning to a successful vigneron which continues 16 years after his retirement as a nephrologist. His wines were available to enjoy on the evening.

The financial success of the Workshop was in large part due to the support provided by the Pharmaceutical industry with 4 major and 5 minor sponsors. Dr David Mudge (ANZSN Treasurer), Anna Golebiowski and Jourdan Pinnell (Executive Officers ANZSN) were integral to the sponsorship process and contributed significantly to the success of this DNT Workshop.

Jeff Barbara Co-organizer 2017 DNT Workshop (Glenelg SA)

ANZSN Research Advisory Committee (RAC) Report

The RAC has continued to be active in implementing the kidney research strategic plan.

In developing the strategic plan for kidney research our objective was that the plan could be used by all organizations with interests in growing both investment and productive research into the broad spectrum of kidney disease. The objective is that a unified voice will be presented to all levels of government and to philanthropic foundations. Kidney Health Australia, The Renal Society of Australia and the PKD Foundation

Polling Time – DNT Workshop

Workshop Dinner – National Wine Centre Dr Lindsay Barratt, Prof Rob Walker, Prof Zoltan Endre and Prof Tim Mathew

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have endorsed our plan and collectively we have agreed to support aligned funding applications. The NZ Kidney Foundation is also supportive of this initiative. To this end we are in final negotiations with Kidney Health Australia to jointly support a part-time project officer to support fund raising and grant administration. We are exploring opportunities with the Federal government, with some States and several organizations re opportunities for research support.

KHA is celebrating its 50th year in 2018 and several events will be held to support research, as well as direct patient support. More information regarding these events will be circulated as it become available. It would be great if society members and their patients supported these activities.

We are keen to advertise research success of our members to increase visibility and support future funding. As we know success begets success. To that end if outstanding papers and grant success could be reported to the ANZSN secretariat for celebration in the ANZSN weekly updates it would be appreciated. We will also be asking for brief descriptions of research activities from members regarding research priorities and to determine who is best placed to pitch for funding when appropriate.

Current clinical trials involving patients with renal disease are now catalogued on the KHA website, with the aim to improve patient recruitment.

Patient involvement in facilitating the research agenda has been supported by the BEAT CKD process with a run in Sydney and Adelaide to support patient and community involvement in designing research questions, facilitating recruitment and disseminating research outcomes.

Workshops have been held to improve utility of access to ANZDATA for registry related research.

Finally, the RAC has been lobbying the RACP to support research experience as a core component of nephrology training. This initiative has been led by Rob Walker and Aron Chakera. We will ensure that Society members are kept abreast of any developments in this area.

Finally thanks to all the committee members (Richard Kitching (Deputy Chair) Rob Walker, Carmel Hawley, Meg Jardine, Stephen McDonald, Tim Hewitson, Aron Chakera and Lisa Murphy and Mikaela Stafrace (KHA ex-officio members) for their commitment to ensuring research into kidney disease remains a priority for the ANZSN.

Carol Pollock ANZSN RAC Chair

ANZSN Dialysis Advisory Committee (DAC) Report

The biennial ANZN Home Dialysis Conference, will be held in Auckland 28th Feb –

2nd March 2018. The theme of the conference is “Building for Home” and the invited international speakers are Prof Chris Chan from Toronto, Canada, Prof Philip Li, Hong Kong and Dr Jeff Perl, Toronto, Canada. The previous ANZSN HDC in Melbourne 2014 was very successful with over 400 delegates attending including medical, nursing and allied health professionals, consumers and industry. And I am sure that the program for the 2018 meeting that has been developed by Dr David Semple, the local organizer and his committee and the DAC should encourage at least this many delegates again. We would also like to encourage as many ANZSN basic trainees to attend this meeting as possible as it is a great opportunity for dialysis education. For more information and registration details please visit www.homedialysis2018.org

The DAC has the responsibility to oversee and regularly review key performance indicators for dialysis and we have been having extensive discussions as to how this we will be done. There are currently two ANZDATA KPIs collected – commencing haemodialysis with a functioning fistula and Peritoneal Dialysis Peritonitis rates. Unfortunately there is still a delay in reporting of this data to ANZDATA making it difficult to act on the KPIs, as once the data is complete it may well be out of date, so the DAC would like to strongly encourage units to report these KPIs to ANZDATA as quickly as possible to improve the system. Most nephrology units are collecting many other dialysis KPIs and several states have state based dialysis KPIs and we have reviewed these and are finalizing a list of recommended dialysis KPIs that could or should be collected if the resources are available.

The ability of Haemodialysis patients to travel for holiday, employment or to visit family is important. One issue we are currently trying to clarify is the reciprocal arrangements for Australian and New Zealand Haemodialysis patients as it has been brought to our attention that practice varies widely, with Australians receiving free Haemodialysis in New Zealand but in Australia some units are charging New Zealand HD patients. We would aim that there should be no fee involved but there may need to be some restriction on the number of HD treatments and we are liaising with

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health ministers to have this standardized across Australia.

The Dialysis Advisory Committee terms of reference includes providing overall strategic direction and policy advice on all aspects of HD and PD, developing protocols and pathways of care to meet the recommendations of the CARI guidelines and/or international best practice guidelines, and to provide advice on the minimum training standards in dialysis, so if there are any specific dialysis issues that members of the ANZSN would like the DAC to address please submit to anzsn@nephrology.edu.au.

Finally I am very pleased to announce that Aron Chakera will be taking over as chair of the DAC at the conclusion of the HDC in Auckland 2nd March 2018, as my 6 year term has completed. I have enjoyed being part of this important committee and am very confident Aron will do a fabulous job.

Fiona Brown, Chair ANZSN DAC

The Green Nephrology Action Team of the ANZSN

Nephrology practice (particularly dialysis) is very resource intensive and has high environmental impact. Recognising this, and the need for change, the ANZSN, in partnership with the Renal Society of Australasia (RSA) and Kidney Health Australia (KHA), convened a working group in early 2017 to promote and support a transformation to environmentally sustainable renal care in Australia and New Zealand. It was with great pleasure that I assumed the position of Chair of this working group, the Green Nephrology Action team, or GNAT. Other GNAT members include John Agar, Matt Sypek and Leila Arnold from ANZSN; Anthea White and Craig Sumpner-Johnson from RSA; and Marie Ludlow, the General Manager Clinical Directorate of KHA. The involvement of representatives from each of the three peak renal bodies in ANZ is a strength of this group because it increases the likelihood of engagement of the whole of the renal sector and because it sends a clear message to the

renal community that environmental sustainability in nephrology is important and prioritized.

Our first task involved developing a Position Statement entitled Environmental Sustainability and Renal Care. This can be found on the ANZSN website. We welcome any feedback on this this – please submit to anzsn@nephrology.edu.au.

From there, we chose to focus on raising awareness within the ANZ renal community about the environmental problems related to dialysis, because willingness to solve them can come only after there is realization that they exist. To this end, our group presented on Green Nephrology at the 2017 ANZSN Nephrology and Transplantation Update Course and is currently working with the ANZSN Scientific Program and Education Committee to develop an environmentally themed symposium for inclusion in the 2018 annual scientific meeting program. We are also working with RSA to develop an environmental workshop to be held in conjunction with the 2018 RSA meeting.

GNAT has also developed an Environmental Research Prize to encourage and support research into green practice in nephrology and dialysis services. This will be awarded for the first time at the 2018 ANZSN annual meeting. Details about the prize can be found on ANZSN website, along with a list of suggested research topics. However, any environmentally themed research will be welcomed and considered. A similar research prize has been developed for RSA.

Our future work will focus on identifying environmental champions within dialysis units and health services and establishing a network through which we can further build awareness, disseminate information and encourage and support practical change.

The GNAT welcomes any Green Ideas, enquiries or feedback from the nephrology community. We also encourage anyone interested in becoming a local environmental champion, undertaking research into the environmental impacts of nephrology or who is seeking more information to contact us via email at anzsn@nephrology.edu.au.

Katherine Barraclough GNAT Chair

KATHERINE BARRACLOUGH – CHAIR GNAT REPORT

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Clinical Research in Kidney Care

The Australasian Kidney Trials Network (AKTN) has increased its research portfolio with plans to launch two new studies in 2017. The TEACH-PD pilot trial is a nurse-led “train the trainer” study to finesse an educational module for PD nurses ahead of a larger, definitive trial in 2018. The BEST-Fluids study is a registry randomised controlled trial utilising the ANZDATA registry to assess the effect of post-transplant IV fluids on delayed graft function. Both studies have received kick-start funds from the BEAT-CKD Program grant.

PEXIVAS

PEXIVAS is a joint venture of the European Vasculitis Study Group (EUVAS) and the Vasculitis Clinical Research Consortium (VCRC). Chen Au Peh from Adelaide leads the Australian arm of this collaborative international study. The aim is to compare plasma exchange versus no plasma exchange and standard vs low dose glucocorticoids in adults and young adults with ANCA associated vasculitis. The trial successfully met its recruitment targets in August 2016 and the trial closed on 31st July 2017. Data analysis is underway, and results will be reported in late 2017.

IMPROVE-CKD

The IMPROVE-CKD hypothesizes that taking lanthanum carbonate will result in improved arterial compliance (measured by Pulse Wave Velocity) over those taking a placebo in people with CKD stage 3b/4. Recruitment closed in January 2017 with 278 enrolments. Participants will be followed up until the end of 2018.

CKD-FIX

Allopurinol, a drug commonly used for gout prevention is used as an intervention in this randomised controlled trial. The CKD-FIX trial investigates adults with CKD stage 3/4 and progression of CKD in the past 12 months whether treatment with allopurinol, will safely and effectively slow CKD progression through inhibition of Xanthine oxidase. Recruitment finished earlier this year at 369 enrolments, with participant follow-up continuing until the end of 2018.

PDOPPS

The AKTN is fully coordinating the Australian arm of the PDOPPS study in collaboration with Arbor Research. A global multicentre observational study looking at the impact of modifiable practices in the management of PD patients on the risk of all-cause PD technique failure, PDOPPS will gather data from 100 randomly selected PD units (20 in Australia) to enter data for randomly selected prevalent and incident patients. Recruitment and follow-up will cease at the end of 2017 unless further funding is obtained to continue until the end of 2020.

TEACH-PD Pilot

This pilot study aims to refine the TEACH-PD Train the Trainer modules and materials developed by The HOME Network. The study will enrol 10 PD trainers from Wollongong Renal Service and John Hunter Hospital and 10 - 20 PD patients; Enrolment will occur over 6 months starting in November 2017. The information generated from this pilot will be used improve the TEACH-PD modules and materials and to inform the large randomisation controlled trial aiming to start in 2018.

REMOVAL-HD

REMOVAL-HD is a single-armed, non-randomised trial looking at the safety of a new middle molecule cut off (MCO) haemodialysis membrane. A total of 92 participant have been enrolled (the recruitment target was 85 and occurred between January and August 2017) with participants due to complete follow-up in April 2018. The study will examine whether 6 months MCO membrane adversely affects albumin levels and/or improves clearance of middle molecules.

RESOLVE

The RESOLVE Trial will examine whether dialysate sodium levels impact on the rate of cardiovascular events and all-cause death in haemodialysis patients. The George Institute is the global sponsor with sites in Australia, New Zealand, China, India, Canada and a number of other possible countries. The AKTN is coordinating all 27 Australian sites, with the first site having commenced in June 2016. All data in Australia and New Zealand will be collected through the ANZDATA Registry with data being collected at baseline, annually and when study events occur over the 5 to 6 years of patient follow-up.

PISCES

This study will be the largest clinical study to definitively address whether supplementation with high dose long-chain omega K3 polyunsaturated essential fatty acids

CARMEL HAWLEY AKTN REPORT

11

(n3KPUFA) in adult HD ESKD patients will reduce rates of CVD events, CVD and all-cause mortality.

PISCES: Protection against Incidences of Serious Cardiovascular Events Study will involve patients from Australia, Canada and Brazil; test interventions for CVD in ESKD patients, who experience mortality more than 40 fold greater compared to the age-matched general population.

BEST-Fluids

This investigator-initiated, registry-based, multi-centre, double-blind, randomised controlled trial evaluates the effect of intravenous therapy with Plasma-Lyte versus 0.9% Saline on early kidney transplant function, a ranked composite of delayed graft function and early kidney transplant graft function recovery in deceased donor kidney transplant recipients. The study plans to recruit 574 participants over 48 months. New Zealand has received ethics approval and expected recruitment start date is November 2017. Australia’s submission to the ethics committee is current and recruitment is expected to start in January 2018. Investigators met on 13th October 2017 and site initiation has been completed for Auckland City Hospital, New Zealand.

NHMRC Program Grant – BEAT-CKD (Better Evidence and Translation in Chronic Kidney Disease)

A series of three Consumer Engagement Workshops were held this year. With the aim of exchanging ideas to involve patients in all phases of renal research, researchers and clinicians met patients, their carers and community groups in the major cities of Sydney, Adelaide and Brisbane in August, November and December. The objectives of this KHA/BEAT-CKD collaboration are three-fold:

1. To enable patients/caregivers to understand the basic principles of research.

2. To provide introductory training in community involvement/engagement for patients/caregivers and researchers.

3. To develop a model and mechanism for effective patient engagement in all areas of CKD research, guideline development and dissemination in Australia including ANZDATA, AKTN, ANZSN, Cochrane, BEAT-CKD projects and KHA-CARI

In November, the strategic planning day in Sydney brought together the key personnel of the grant, early career researchers and researchers who were the beneficiaries of kick-start funding from the Program. Topics discussed included future research and funding opportunities designed to integrate the pillars of the

program, and the identification and engagement of the next generation of researchers to drive future initiatives to fulfil the objectives of the BEAT-CKD Program.

There will be a number of educational opportunities for researchers conducted over 2018, including a 2 day BEAT-CKD Research Symposium hosted by the AKTN in Brisbane in August. The AKTN will also host a Statistics Masterclass in April. Further details and dates will be posted on the BEAT-CKD website beatckd.org.au.

AKTN Working Groups

Seven Working Groups in the sub-specialities of Acute Kidney Injury, Chronic Kidney Disease, Glomerulonephritis, Haemodialysis, Methodology, Peritoneal Dialysis and Transplantation are active within AKTN under the leadership of the Scientific Committee. These special interests groups support the research agenda and priorities of the Network, with a remit to:

increase the number of trials generated by the Network

ensure all trials coordinated, facilitated or promoted are:

o Founded on good quality evidence o Are well designed o Have substantial scientific and clinical

significance to the kidney care community.

Between two to four members of the Scientific Committee serve on each working group, with additional members from the research community including nephrologists, physicians from other disciplines, GPs, nurses, renal dietitians, epidemiologists and allied health workers.

The AKTN usually calls for expressions of interest for membership to the groups via the ANZSN, or other peak body depending on the membership skills required. If you prefer to be contacted directly when a membership opportunity arises please contact Donna Reidlinger (aktn@uq.edu.au).

Staying up to date with AKTN research and events

Twitter – Follow the AKTN to receive individual trial recruitment updates, current research news and educational events @kidney_trials https://twitter.com/Kidney_Trials

Facebook – Follow us on our new Facebook page: https://www.facebook.com/AKTNUQ/

Website – A new enhanced website was launched in October, with planned future sections including as

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news and events, training webinars and individual trial portals to house study specific resources and documents www.aktn.org.au

Newsletter – sign up by emailing aktn@uq.edu.au with the subject heading “Subscribe”

Contacts

Clinical Operations Manager, Donna Reidlinger: aktn@uq.edu.au

Chair, Operations Secretariat, Carmel Hawley: carmel_hawley@health.qld.edu.au

Chair, Scientific Committee, Neil Boudville: neil.boudville@uwa.edu.au

Carmel Hawley Chair, AKTN Operations Secretariat

ANZPNA is the representative group for Paediatric Nephrologists in Australia

and New Zealand. We maintain Paediatric representation on a number of local, national and international bodies providing advocacy for children with renal disease. The group meets face to face once a year for an AGM. Through the remodeling of the ANZSN, a Chapter of Paediatrics has been established, within which ANZPNA now sits. Given the mutual philosophy behind the work and aims of our societies, this has served to further improve these collaborative links and our society has undertaken to schedule the AGM concurrent with the ANZSN ASM, which this year was held in Darwin on September 6th

2017. In addition, a Paediatric update was held in Darwin, immediately following the final session of the ASM and was incorporated into the program as an additional meeting for ASM attendees. This proved very successful with strong attendance by local general Paediatric trainees and Paediatricians as well as ASM attendees. The society is grateful for the excellent work in organizing this meeting by Dr Swasti Chaturvedi, Dr Sean Kennedy and the ANZSN ASM local organizing committee. We hope this can become a regular educational event and preliminary discussions about this are underway with SPEC.

In 2013 a subcommittee was formed to promote collaborative Paediatric research in Australia and New Zealand, chaired by Peter Trnka. The group supports such multi-center studies as the effect of CKD on

quality of life (lead investigator Anna Francis) and aDOPT trial investigating the role of mycophenolate therapeutic monitoring is successfully recruiting patients (lead investigator David Metz). The profile and impact of renal genetics in Australia continues to advance, both at a research and clinical diagnostic level thanks to a number of flagship groups, with a prominent contribution by ANZPNA members in this area, including Hugh McCarthy and Stephen Alexander in Sydney, Cathy Quinlan in Melbourne and Peter Trnka in Brisbane. There are now dedicated renal genetics clinics running at five Paediatric renal units around Australia, with combined adult and Paediatric renal genetics clinics expected in Perth and Adelaide imminently.

ANZPNA remains an active advocate in a number of areas. Debbie Lewis, with a working group of ANZPNA members, continue the work to promote the delivery of Paediatric renal care (AKI management) and education within Oceania. Significant progress has been made in delivering a local program that provides acute peritoneal dialysis to children with reversible AKI in Oceania, but due to some logistic barriers, the implementation has been delayed and we are hopeful these issues can be resolved in the short-term future. Discussions have been initiated between ANZPNA and ANZSN counterparts responsible for such projects to identify synergies and potential for collaborative activities in assisting our neighbors in the Oceania region.

The Paediatric trainee members of ANZPNA have been very active this year developing an educational program, including a series of monthly webinar lectures. Under the stewardship of Sharon Teo, there are plans to formalize a program to continue meeting the needs of our trainees. A key ingredient in this is the need to facilitate access for trainees of a small number, but scattered around the world and different time zones. The ANZPNA website, curated by Nick Larkins is evolving to service these needs and his enthusiasm for managing the website is integral to the society’s public and professional presence.

The society and I are indebted to the hard work and support of my fellow executive members, Fiona Mackie, Deirdre Hahn and Tonya Kara. Unfortunately, due to ill health, Tonya has needed to take a temporary period of leave as secretary and I am very grateful to Nick Larkins for stepping up to assume this role. All members of ANZPNA wish Tonya the very best of health, with a speedy and full recovery.

Josh Kausman ANZPNA Chair

JOSH KAUSMAN – CHAIR ANZPNA Report

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The Workforce Review Committee was established by Council in late 2016 as a time limited (12 months) advisory body with the aim to develop and promote policy to maintain and foster a sustainable nephrology workforce that best serves and meets the needs of patients with kidney disease. It was an honor to be asked to Chair the Committee. Membership covered metropolitan and rural areas, adult and paediatric nephrology, trainees, and the broad geography of the Society. Members were Randall Faull, Fiona Brown, Amanda Walker, Cathie Lane, Cherian Sajiv, Colin Hutchinson, and Jenny Heng Chen. The inaugural meeting was held by teleconference on 4th November 2016 and the final meeting on 4th August 2017.

The Committee engaged with the Royal Australasian College of Physicians (RACP), National Medical Training Advisory Network (NMTAN), and ANZSN members at the DNT meeting in February 2017.

A final report was tabled to Council for consideration at their meeting held at the Darwin ASM in September 2017.

The Committee made numerous recommendations including:

This report be published on the ANZSN

website

ANZSN publish trainee and nephrologist

numbers on its website and update annually

ANZSN and RACP acknowledge that trainee

numbers do not take into account future

workforce projections/demand. Trainees and

supervisors should be informed of this.

The RACP (with assistance of ANZSN)

conduct a broad and thorough survey of

Fellows who have completed training

supervised by the Advanced Training

Committee in Nephrology or Overseas Trained

Physician Pathway in Nephrology to include:

nephrologist numbers, practice type and

location, research, education, and future

intentions. This should be repeated

periodically (e.g. 3-5 years) to allow change to

be measured longitudinally.

The Advanced Training Committee in

Nephrology develop and publish transparent

principles of accreditation of training sites that

may include reference to the level of clinical

exposure required. This may include

reference to the renal replacement therapy

population, and inpatient and outpatient

activity at a site.

ANZSN ask the RACP to improve supervisor

education opportunities and assessment

calibration.

ANZSN and RACP consider the need and

method of assessment of minimum standards

to complete nephrology training and OTP

supervision, with a view to an exit assessment

ANZSN should develop and pursue a strategy

to engage National and State stakeholders,

regional networks and individual renal units to

match trainee numbers with future workforce

demands, and create training opportunities for

non-renal trainees (e.g. general medicine,

ICU, ED, urology)

ANZSN develop a policy on accommodation of

overseas trained physicians in workforce

estimates and determining appropriate intake

ANZSN Council endorses the proposal for

structured post-FRACP fellowships, and seeks

support from the RACP for such a program

ANZSN Council form a working party with the

specific aim of creating the business rules for

a structured fellowship program; members of

the working party to include representatives

from units with capacity to run such a program,

and also a representative from TSANZ

ANZSN Council establishes an implementation

workgroup to action this report

The NMTAN is scheduled to examine the physician workforce in the latter part of 2017 and the RACP is aware that workforce is a concern for a number of specialties. The path forward will be complex and will require engagement with government, RACP, and the ANZSN membership. Failure to act will represent a disservice to the general population, as well as junior doctors and trainees who have invested so many years in their training.

NICHOLAS GRAY – CHAIR WORKFORCE COMMITTEE REPORT

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I would like to thank the committee members and ANZSN secretariat for their input and support over the last year.

Nicholas Gray Workforce Committee Chair

Thanks to the contributions of the Australian and New Zealand nephrology community, ANZDATA has been collating, analyzing and reporting data on the treatment of end stage kidney disease for 40 years. In 2017 we have focused on ensuring our activities reflect the registry’s core purpose and continue to develop in ways that benefit patients with kidney disease and the broader nephrology community.

Both internal and external reviews have provided an opportunity to reflect on ANZDATA’s key activities and operations. Through the development of a Mission, Vision and Values Statement (available at www.anzdata.org.au), participating in an external review commissioned by our funders, and seeking formal ethics oversight of our routine activities by the Central Adelaide Local Health Network (CALHN) Human Research Ethics Committee, we are ensuring ANZDATA remains relevant to the needs of stakeholders and operates in a transparent and responsible manner.

In an ongoing move towards digital data collection, ANZDATA launched a new web based data entry application in December 2016. In addition to paper based forms and web based data entry, contributing units can also submit their data via a Web Services application or by uploading CSV files prepared to appropriate specifications. This range of electronic data submission options aims to streamline data entry for contributors, create efficiency in data collection and improve the timeliness of ANZDATA’s reporting and feedback to renal units. In 2017, twenty-one units submitted some or all of their data electronically.

ANZDATA continues to provide data for a broad range of audit and research projects, with over 240 requests for data processed in 2017 to date. A major area of

growth has been in requests related to large data linkage projects. We have made a clear commitment to facilitate this while protecting the integrity of the data we hold. ANZDATA’s patient identifiers are now integrated into SA-NT Datalink master linkage key and efforts are underway integrate with the Tasmanian Data Linkage Unit (TDLU), NSW data linkage (CHERYL) and WA data linkage unit. Many lessons have been learnt about the challenges of multi-jurisdictional data linkage projects and ANZDATA will continue to foster researcher collaborations to help maximize the benefits of large data linkage projects.

Another exciting area of development in ANZDATA has been in building capacity for registry based trials through our collaborations with the Australian Kidney Trials Network (AKTN) under the Better Evidence and Treatment in Chronic Kidney Disease (BEAT CKD) program. Registry based trials allow existing data collection and storage resources to be integrated into trial designs in order to improve trial efficiency. ANZDATA has developed IT infrastructure to support data collection for clinical trials within the registry, with specific modules developed for the upcoming RESOLVE and BEST FLUIDS trials.

ANZDATA has also launched a number of initiatives to strengthen our engagement with people living with kidney disease. A new working group, chaired by Rachael Morton, has been launched to explore the potential role of Patient Reported Outcome Measures (PROMs) in the Registry. We have also partnered with Kidney Health Australia (KHA) and other members of the BEAT CKD consortium to run a series of consumer engagement workshops to help educate consumers about ANZDATA and current activity in nephrology research, and foster pathways for increased engagement with consumer representatives.

The ANZDATA Epidemiology Fellowship continues to be supported through the generosity of AMGEN with the position taken up in 2017 by Dr Matthew Sypek.

ANZDATA would like to acknowledge the ongoing support of our funders: the Australian Organ and Tissue Authority (AOTA), the New Zealand Ministry of Health and KHA. Critically, our activities would not be possible without the generous in-kind support of all renal units in Australia and New Zealand and the additional voluntary contributions of committee and working group members.

We would like to acknowledge the long-term contributions of Germaine Wong, who stepped down as chair of the Cancer Working Group (now in abeyance), and Kevan Polkinghorne who chaired the Haemodialysis Working Group from 2007 and has

STEPHEN MCDONALD – CHAIR ANZDATA REPORT

15

been replaced by Matthew Roberts, and Sean Kennedy who has stepped down from chairing the Paediatric Working Group, with Amelia Le Page taking up with role. We would also like to acknowledge the tireless efforts of our Steering Committee New Zealand representative, Tonya Kara, in promoting ANZDATA’s activities in New Zealand.

Stephen McDonald ANZDATA Chair

The ATC is a busy committee comprising 10 members, including paediatric, TSANZ, ANZSN and NZ representatives.

Nephrology trainee numbers continue to grow and currently the ATC oversees 112 trainees in Australia (101 adult, 11 paediatric) and 28 in NZ. There were 32 new Fellows in nephrology in 2016 and 5 so far in 2017. The nephrology trainee growth corresponds with a rapid growth in physician trainees overall. Between 2001 and 2017, there has been significant increases in numbers of adult basic physician trainees (585 to 3097) and adult advanced trainees (440 to 3815). In paediatrics, corresponding growth has been in basic training (199 to 990) and advanced training (147 to 1581).

The committee accredits training sites and in the last 12 months members have undertaken 4 Australian site visits. There has been increased interest in training overseas and a growing number of trainees are completing at least 12 months in Canada or the United Kingdom. A total of 46 sites are accredited for training and further overseas opportunities are examined as they arise. The committee has appreciated the support of supervisors in reviewing the increasing number of research projects, a task that is now not possible for the committee to undertake alone.

There have been some changes to advanced training in 2017. Implementing from 2017, the College has introduced a set of streamlined research project requirements which are mandatory across all specialties. Nephrology will continue to have a requirement of one “major” research project (as mandated across all specialties) and one other research project. The ATC has acknowledged that the

criteria for accreditation of sites need review and this process is currently being undertaken this year. Other issues such as increasing the flexibility of core training, workforce, changes to educational requirements and assessment, supervisor accreditation and a curriculum review are being considered by both the ATC and the College more widely.

None of this work would be possible without the hard work of the members of the ATC team. I would like to thank the current members, Anne Durkan (lead in paediatrics and site accreditation), Girish Talaulikar (ANZSN representative), Colin Hutchinson (chair NZ SAC), Murty Mantha (co-ordinator of advanced training), Grant Luxton (co-ordinator of advanced training), Caroline Milton (lead, projects), Emily See (trainee representative), Prof Toby Coates (TSANZ representative) and Jamie Kendrick-Jones (NZ representative). I encourage anyone with questions about nephrology advanced training to contact myself or one of the committee members.

Vincent Lee Chair, ATC in Nephrology

ANZSIN role

Our main activities over each year are planning, publicizing and holding our annual symposium in conjunction with the ANZSN ASM. 2016-17 has been no exception to this role. We continue to encourage and educate the Australia and New Zealand nephrology group on interventional related topics. This year we commenced our education program expansion in to the APCN member countries and the Pacific Islands.

ANZSIN events

Renal Week 2017 The ANZSIN annual meeting, including workshop remains our main output. This year our meeting was held on Wednesday 6th to Friday 8th September 2017. Our interventional nephrology and international guest speakers were Dr Dirk Hentschel from Brigham and Women's Hospital and Assistant Professor of Medicine Harvard Medical School, Boston, USA. Dr Hentschel is widely experienced in the vascular access intervention techniques. His points included

VINCENT LEE - CHAIR ADVANCED TRAINING COMMITTEE IN NEPHROLOGY (ATC)

DAVID VOSS - CHAIR ANZSIN

16

prolonging long term health and therefore survival of haemodialysis fistulae; and optimal care of access.

As in previous years we utilized local experts within their field – including surgeons and radiologists. Topics covered on the Thursday didactic sessions included: fistula mapping for assessment prior to creation; fistula surveillance for maximizing survival and early detection of potential problems from both medical and nursing perspectives. PD access and related issues, including further progress on our ANZ success with acute early start PD avoiding acute ‘crash start’ HD were also covered.

The Friday workshop, involved our hands-on activities, including: USS scanning of HD vascular access; percutaneous native and transplant renal biopsy techniques; PD catheter insertion by Y-Tec and Seldinger techniques; fistuloplasty; temporary (uncuffed) and long –term (tunneled/cuffed) HD catheters – in both IJ and femoral vein sites. Each registrant had the opportunity to practice each technique.

ASDIN We also continue our close relationship with ASDIN (our American equivalent) with both our ANZ members attending their annual ASM and knowledge sharing throughout the year. ASDIN often is a source for our ASM visiting speaker. This year is no exception with Dr Hentschel, ASDIN Council member our guest speaker.

Extending interventional activities in to the wider Asia-Pacific and APSN community

Following on from the Perth ANZSN meeting (September 2016) introductions, we have been successful with spreading our educational influence in to Samoa, Fiji, and Indonesia.

Dr Steve May (Australia), Dr Gerald Waters and Dr Eddie Tan (New Zealand) attended the Fiji Nephrology Symposium (29 September to 1 October 2016). As part of the meeting these three doctors held a hands-on interventional workshop, with training models and taught the local Fijian doctors to insert HD catheters (including tunneled catheters), renal biopsy and PD catheter insertion. The meeting had secured ISN sponsorship for the meeting. Fiji does have an active HD program, however not a PD program at this stage.

Drs Tim Spicer (Australia) and David Voss (New Zealand) attended the inaugural Indonesian Society of interventional Nephrology meeting in April 2017, held in Bali. Dr Spicer taught ultrasound theory, the technique and its application in imaging the renal tract

in general. This was subsequently applied to imaging the kidney for performing real-time renal biopsy. Dr Voss taught the theory and safety aspects of haemodialysis and peritoneal dialysis catheters insertion. Both Drs Spicer and Voss held workshops for the hands on experience in practice of these interventional techniques. The 2-day workshop was incredibly successful with interest from around Indonesia, and planned repeat workshop in 2019.

Training ANZSIN executive continue to develop minimum numbers for skill attainment, maintenance of expertise and teaching of all nephrology specialty interventional skills. These numbers are to some degree arbitrary (because of a paucity of related literature), however we feel we have to start somewhere. In our September AGM 2017 and ASM we anticipate we will ratify these minimum numbers.

CARI renal biopsy guideline Under the leadership of Dr Rob McGinley, several of our executive members are on the renal biopsy guideline writing committee - currently in the literature research phase. A draft is expected by the end of this year.

ANZSIN Website ANZSIN webpage development has made little progress – as the website manager is a busy renal physician and he develops the site in his own time.

The ANZSN office continues to provide assistance and wise administrative advice, for which we are very grateful.

Finances Our only income is from our ASM. Fortunately sponsorship from interventional nephrology related Pharma continues. Their support includes independent technical and professional advice and demonstration equipment. Pharma have been actively involved in our annual meeting organization. This year, however has been our lowest supported year, and with expensive technology required (ultrasound machines and models for procedure demonstration (for HD dialysis line access, PD catheter insertion, AV fistuloplasty and renal biopsy) we will be dipping into reserves.

We did maintain registration fees for this year’s meeting the same as the past two years, however I suspect we will need to modestly increase registration fees for the 2018 year.

David Voss ANZSIN Chair

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2017 saw a further drop in our impact factor to 1.563 – predominantly due to a rise in the denominator, ie. The number of articles published. The number of cites was marginally higher than previous years. The usually reported IF is the 2-year figure; the 5 year figure is stable at 2.002 and this is better than in the 2015 report.

We continue to have a very high submission rate – at time of preparing this (mid-Oct) we have had over 600 submissions for the calendar year; giving a projected figure of close to 800 for the year. The rejection rate remains around 75-80%, considered a healthy figure. Interestingly, since introducing mandatory plagiarism checking for every article, this is now the major reason for (prompt) rejection.

Once again, we have decided to “buy” extra pages for the second half of this year. We have done this in an attempt to catch up a little; as we have a considerable back-log of articles awaiting formal publication. All accepted articles are published on-line within 6 days of acceptance, however, there is a growing lag until print publication. This will be overcome by on-line only publication.

In this respect, a decision has been made to move to publishing on-line only. Some ANZSN members may recall I polled them in the past on this and 75% asked for cessation of paper publishing. A business model was developed and adopted by the APSN Council. On-line only publishing will commence in the course of 2018-2019. As part of that process, given the lack of need for page number restrictions, we will catch up with formal publication of our back-log (articles will still be published in volumes and editions).

The journal maintains excellent standards in terms of time to first and subsequent decisions but recognizes the constant load on Subject Editors and reviewers. There is a constant flux in the SE panel – I am always seeking active SEs and am happy to retire those who feel they have done their bit. The next editors’ meeting will be during the APCN in Beijing in March, 2018.

On-line access for all members of all APSN Societies is now available. For ANZSN members, the simplest

way is directly via the Society website (as long as you are logged in).

Peter Kerr Editor in Chief, Nephrology Journal

The ANZSN International Affairs Portfolio ANZSN is committed to showing support for, and leadership in, regional and global nephrology.

In late 2016, the ANZSN Council created an International Affairs Portfolio to ensure that international affairs were considered and prioritised on an ongoing basis.

This has led to a significant increase in ANZSN activity in this area. Over the early part of this year, ANZSN worked closely with Asia Pacific Society of Nephrology (APSN) to organize an ANZSN-APSN CME course that was held in conjunction with the 2017 ANZSN ASM Nephrology and Transplantation Update Course in Darwin in September. ANZSN and APSN jointly sponsored 16 delegates from low-middle income countries in the Asia Pacific to attend the meeting, and feedback suggested that all found it highly educational. Attendees also felt it provided them with an invaluable opportunity to network with other nephrologists from the Asia Pacific, thereby fostering future integration and collaboration across the region. Preparations are underway to hold a similar course in conjunction with our Nephrology and Transplantation Update Course in Sydney in 2018.

PETER KERR NEPHROLOGY JOURNAL REPORT

KATHERINE BARRACLOUGH ANZSN INTERNATIONAL AFFAIRS REPORT

The International Speakers and Delegates from the ANZSN APSN CME Course

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ANZSN has also recently signed a Memorandum of Understanding to develop its partnership with International Society of Nephrology (ISN) and provide co-funding for the ISN Programs. Two ISN Sister Renal Centre Pairs have been the first to benefit from this joint funding – namely, the Colonial War Memorial Hospital in Suva, Fiji, paired with the Concord Repatriation General Hospital in Sydney, Australia; and the Zainoel Abidin Hospital in Banda Aceh, Indonesia, that collaborates with the Gold Coast Hospital in Southport. More information about the ISN Sister Renal Centre Program can be found on the ISN website. A recent ISN news release about the new collaboration with ANZSN can be found via this link.

Building on this, ANZSN is also excited to be working with ISN and APSN to explore ways we may be able to support the development of nephrology in Samoa.

Lastly, we know that many ANZSN members are currently active within ISN and APSN. ANZSN would like to maintain an up to date record of the names of these individuals in order to stay abreast of their activities and recognize their efforts. If you are currently involved with these organisations but your name does not appear on the list currently on the ANZSN website, please inform ANZSN via email anzsn@nephrology.edu.au.

Katherine Barraclough International Affairs – ANZSN Portfolio Holder

President and Executive. Members of ANZSN continue to have major roles in supporting nephrology in Asia Pacific region. Philip Li (Hong Kong) is the current President of APSN. Remaining on the APSN Executive are Peter Kerr (Nephrology), Gerald Walters (website), Rob Walker (Secretary), Jonathan Craig (President ANZSN) and David Harris (Past President). ANZSN members also continue to contribute to the CME programs for this region (see below) APCN 2018. The next APCN will be held in Beijing in March 27th – 30th 2018. Rob Walker has been chosen by Philip Li and Xue-qing Yue (the President of the congress, and current President of the Chinese Society of Nephrology), as co-Chair of the Scientific Program Committee. The program is extensive with a wide range of topics with excellent speakers invited. We

strongly suggest ANZSN members consider attending to support nephrology in this region. APCN 2019. This will be held in conjunction with WCN 2019, in Melbourne. Contracts have been signed by ANZSN, APSN and ISN. Planning is well underway. Nephrology. The journal continues to grow in stature, thanks to the leadership of Peter Kerr and the many ANZSN members involved as subject editors, reviewers and authors. It is important that ANZSN members continue to strongly support the journal. We are keen to attract new members to the subject editorial board. If you are interested please contact Peter Kerr Editor in Chief. Website. Gerald Waters is now the Web master. The content of the website is increasing and improving slowly. There is now a password-protected site, to allow posting of more CME resources, access to nephrology journal for those from other Societies and official APSN documents. CME. The APSN CME program has continued to expand and provide a greater opportunity for CME around the region. This year the CME program for ANZSN was expanded to invite participants from the Asia Pacific region to attend and was very successful. The CME committee has also expanded the program to invite several trainees from the high-income countries to attend the CME so that they can engage with trainees from LMIC and LIC regions of APSN, which is a promising initiative. ANZSN continues to support this program. Katherine Barraclough is the ANZSN representative on the APSN CME committee. There is a proposed initiative to expand the CME program into Oceania over the next year or two, as there is a pressing need to support nephrology development in this part of our region. A number of members of ANZSN continue to help by being speakers to other regional meetings, especially in developing countries. Regional projects. APSN continues to support the various ISN programs (Fellowship, Sister Renal Centre, Educational Ambassador, CME, and Clinical Research) and other activities (0by25, Saving Young Lives) within our region. It is hoped that ANZSN will become more involved with a formal partnership with APSN and ISN, to support these and other regional outreach activities. Robert Walker Honorary Secretary, APSN

ROB WALKER APSN HONORARY EXECUTIVE OFFICER

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DAVID HARRIS – PRESIDENT ISN REPORT

WCN 2019. Planning for the Melbourne WCN is getting underway in earnest. ISN staff responsible for the organisational and financial success of its meetings are looking to the Local Organising Committee under Peter Kerr’s leadership to take on more responsibility than is usual for LOCs of WCNs. Financial success of the meeting is crucial for ISN, as it is for APSN and ANZSN. Under Masaomi Nangaku’s leadership the Scientific Program Committee has been appointed (and includes many from the Asia Pacific region and ANZ). Most of the plenary speakers have already been invited and accepted. Within a broad program, the two main scientific themes of the Congress will be glomerulonephritis and integrated ESKD care. Other ISN meetings. From 2020 WCNs will be held annually, rotating around the major regions of the world; many will be held in the Asia Pacific region. The first ISN Frontiers meeting will be held in Tokyo on February 22nd-25th 2018, on the theme of “Kidney Disease and Cardiovascular Disease”. The 2nd ISN Global Kidney Health Summit will be held in Sharjah, UAE in March 2018; several ANZ colleagues have been invited to this restricted meeting which aims to produce a longterm strategy for achieving global access to integrated ESKD care. 0by25. The pilot implementation phase of ISN’s AKI initiative will finish this year, and from 2018 it will enter a new implementation phase, rolling out from a few centres in Africa, Asia and Latin America. Some additional funding has been secured (from the Stavros Niarchos Foundation) which will allow this to occur in more units, and in the context of broader kidney care. There will be greater integration with ISN Programs, and with the very successful Saving Young Lives project. Global Kidney Health Atlas. The first edition of the Atlas, whose report can be downloaded for free from the ISN website, was highly successful. Its main publication was in JAMA in April, and a number of others will appear in KI Supplements in the near future. David Johnson and Aminu Bello will continue to lead this project. Integrated ESKD care. To ISN’s focus on AKI (0by25) and CKD (Closing the Gaps) has been added a third on access to integrated ESKD care. In addition to next

year’s Summit in Sharjah, a number of other ISN activities (outreach programs, the Atlas, ISN Academy, other meetings, a global disaster preparedness plan, an ISN Collection of advocacy, educational and clinical documents for countries wishing to develop ESKD care, etc.) will have this as a focus. ISN is keen to continue its support of the Affordable Dialysis Project, which is being led by the George Institute. ANZSN can play an important role in facilitating access to integrated ESKD care in low- and middle-income countries (LMIC), especially in the South Pacific and other parts of OSEA. Journals. From January 2018, Pierre Ronco will replace Detlef Schlondorff as editor of Kidney International. There will be two Australians in the new team of editors. Jai Radhakrishnan will remain as editor of KI Reports, which continues to exceed expectations in terms of the quality and number of submissions, and provides greater opportunity for publication of articles consistent with ISN’s global mission. Education. The ANZSN webinar series appears to have been very successful, and through its partnership with ISN Academy is reaching many colleagues around the globe. ISN Academy continues to expand as a leading on-line and mobile educational resource. ISN Programs. ANZSN’s decision to partner with ISN (outreach) Programs, specifically sister renal centre partnerships with units in Indonesia and Fiji, is particularly welcomed by ISN. Membership. ISN is introducing a new tiered system of membership. Whereas this will have minimal effect in high income countries such as ANZ and on trainees who already have free membership, it will increase the opportunity for ANZ’s neighbouring LMICs and for non-nephrologists to benefit from ISN membership. Strategic Plan. ISN’s leadership is devoting time and resources to developing a 5-10year strategic plan for ISN, which will include a focus on geographical and gender equity, substantial restructuring with more responsibility devolved to regions (including OSEA), a leaner Council with greater oversight responsibility, a strategic and advisory rather than operational focus for the Executive, an advisory role for all committees, and greater operational independence for Headquarters staff. ANZSN involvement. A number of individuals from ANZ have leadership positions within ISN. In addition to its pivotal role with the Melbourne WCN, the sponsorship of sister renal centres and the ANZSN

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webinars, there are many other opportunities for closer collaboration between ANZSN and ISN. ISN will inform ANZSN Council as such opportunities arise, and looks to ANZSN to indicate where and how it would like to be involved. David Harris President, ISN

2017 has been a year of significant change at KHA. As is the circumstance of many charities, we found ourselves battling significant financial head winds that have necessitated a review of our operations, our resource base and our program spend. Readers will be pleased to know that the corollary of adversity is opportunity and we have made the most of many opportunities in 2017.

A New Board We have positioned KHA to have a clearer focus on decision making that is informed by strong business acumen and excellent clinical guidance. To this extent, we are delighted to confirm the appointment of four new directors to the KHA board:

MAJGEN Peter Haddad AO (Rtd)

Sally Farrier

Mono Ray

Rhonda Renwick

David Morgan continues in the capacity of Chair, David Parker AM contributes the lived experience as a consumer and Professor Carol Pollock continues to provide eminent clinical leadership.

A new Clinical Director We are so thrilled to have resumed our strong relationship with the profession through the appointment of Dr Shilpa Jesudason as our Clinical Director.

We have missed the insight and guidance of Associate Professor Tim Matthew and were so pleased when Dr Jesudason accepted the role following a national search. Dr Jesudason has already had a significant

impact on the direction of our clinical focus. She has an active public practice in Adelaide and is deeply committed to research in both Australia and overseas including the establishment of renal replacement therapy in Fiji.

A new strategic direction KHA has chartered a new strategic direction with the specific imperatives being:

Community,

Research and

Advocacy. The operations of the business mirror this strategic alignment and are now comprised of three core intersecting areas of practice where all staff work collaboratively in multi-disciplinary project teams. Revenue generation is supported by a dedicated business development team whose role is to build a diversified revenue base which reduces our dependence on the lotteries business. This was formerly our primary source of income. Finally, our traditional and community fundraising teams have been better resourced enabling us to link events with community fundraising.

A new National Consumer Council (NCC) We have listened to the feedback from clinicians, policy makers and consumers telling us about the overwhelming need for articulate, informed consumers. Consumers need to provide considered input for research, participate in clinical trials and guide thinking when designing programs designed to address the needs of renal patients. To that end, we have formed a National Consumer Council. The purpose of the KHA National Consumer Council will be to:

Act as a link to the wider patient community,

identifying and prioritising any unaddressed

issues or changes impacting kidney patients

and their carers, either negative or positive.

Provide KHA and, where possible, the broader

clinical community with an open and frank

mechanism for feedback on policy, priorities,

collateral and bodies of work supporting

people living with kidney disease.

Advise and support KHA in regard to

consumer involvement in kidney research.

Support KHA, where requested, in advocating

for change to public health policy from the

kidney patient perspective.

Support KHA, as available, at public events

that raise the profile of kidney disease.

MIKAELA STAFRACE KHA CEO

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Work with KHA to educate about and raise the

profile of kidney disease and the programs

and services offered by KHA, within local

communities and networks.

Partnership in research through the Research Advisory Committee (RAC) We are delighted that the RAC has partnered with KHA for the purpose of developing a joint kidney disease research agenda which impacts positively on and improves outcomes for, patients suffering with kidney disease. The relationship has been formalized with a Memo of Understanding.

The relationship between the RAC of ANZSN and KHA Research is one of synergy, each organization leveraging off the qualities and resources of the other, to provide a strong unified Australian research voice. Working collaboratively in this manner will ensure that the pillars of research such as basic science remain, whilst at the same time broadening and enriching the research to embrace consumer priorities and voice.

Patients Voices Symposium In September 2017, KHA together with the Menzies Institute, organized a Patient Voices Symposium.

The Symposium was held during the ANZSN Annual Scientific Meeting in Darwin.

The Symposium was attended by 50 Aboriginal and Torres Strait Islander persons (representing a combination of patients, their carer or close support person). They travelled from all across the north of Australia from Cape Leveque through to the Gulf country and Thursday Island. All of the patients required dialysis which necessitated a significant logistical undertaking on the part of the Royal Darwin Hospital, particularly the Nightcliffs Renal Unit. Despite their clinical presentations, the patients were determined to attend the Symposium. Some attended for part of the time because of their dialysis schedule.

The purpose of the Symposium was to hold a facilitated solutions-focused discussion between patients, nephrologists and policy makers about their experience of living with kidney disease. A report and supporting video has been prepared outlining the key feedback from the Symposium.

Conclusion KHA is delighted to be working so closely again with the ANZSN. We have a strong common interest being the wellbeing of patients living with renal disease. We look forward to further strengthening our

relationship and thank the members of the ANZSN for their ongoing support.

Mikaela Stafrace KHA CEO

We would like to thank Steering Committee members in helping to direct and guide the work of KHA-CARI guidelines, particularly the outgoing members Dr Marie Ludlow (Kidney Health Australia) and special recognition of the tireless effort of A/Prof Martin Gallagher who has served as Chair of KHA-CARI Guidelines since 2011. We would also like to welcome, Kidney Health Australia’s new Medical Director Dr Shilpanjali Jesudason to the Steering Committee.

Current work streams

Autosomal dominant polycystic kidney disease – For the first time, consumer versions of the ADPKD guideline that were reviewed and revised by patients and caregivers have been published. These guidelines were disseminated via peak consumer bodies, Kidney Health Australia and PKD Australia.

Screening and management of infectious diseases in haemodialysis units – This guideline was presented at the DNT 2017 meeting and has been peer reviewed and is in the final stages before publication.

Management of CKD among Aboriginal and Torres Strait Islander peoples and Māori – Two working groups have been conveyed, one in Australia and one in New Zealand, these groups will work in parallel to develop a guideline that is relevant to the needs of indigenous populations. In partnership with Kidney Health Australia, an extensive community consultation process has been drafted for New Zealand and finalized for Australia to inform the development of this guideline. Further funding has been secured in New Zealand for the undertaking of this critically important community consultation process.

Renal Biopsy –a working group for a guideline on renal biopsy has been formed. Guideline development is currently underway and will include eight topics addressing pre-biopsy, biopsy and post-biopsy. Evidence synthesis has commenced, and a patient and caregiver engagement workshop was conducted on the 21st October at Royal Melbourne Hospital. This

SUETONIA PALMER KHA-CARI CHAIR

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guideline will be completed in 2018. A patient/caregiver version of the guideline will follow.

Current innovations

A KHA-CARI Guidelines staff member has been seconded to Cochrane Kidney and Transplant to provide evidence synthesis support for an update of the KDIGO Blood pressure management in CKD guideline. This opportunity will be capacity building, allowing KHA-CARI Staff to develop expertise in the use of modern web programs (MAGICapp and Covidence) that could be used for the development of KHA-CARI guidelines in the future.

Suetonia Palmer CARI Chair

Kidney School has continued to grow in 2017. The monthly webcast teaching sessions are attended by trainees, nephrologists, nurse practitioners and pharmacists in Australia, New Zealand, Vietnam and Fiji. The webcasts are becoming increasingly popular, with approximately 40 sites logging into the sessions each month. Participants can join the webcasts via their smart phone or computers, allowing for greater flexibility and access to more trainees.

In addition to the usual monthly webcast, this year we have partnered with the RACP to provide an additional 8 webcast teaching sessions. These sessions have been delivered by expert speakers and have encouraged participation not only from trainees but also practicing nephrologists. The initial eight sessions were provided through a pilot-grant from the RACP and these additional lectures will continue in 2018.

We continue to strive to improve the reach of Kidney School and would appreciate departments encouraging trainees to attend. Those that participate currently provide positive feedback on Kidney School’s role in trainee education. We are also keen to hear feedback about the Kidney School format and access, so please drop us a line if you have suggestions!

If you would like to hear more about Kidney School events, please sign-up to our mailing list via this link:

http://eepurl.com/usXRn . We are only able to contact trainees that subscribe to our mailing-list, so please share and join!

Amali Mallawaarachchi Kidney School Director

AMALI MALLAWAARACHCHI KIDNEY SCHOOL DIRECTOR KIDNEY SCHOOL REPORT

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The 2017 Australian and New Zealand Society of Nephrology Awards

Front row: Emily See, Anna Francis, Andrea Viecelli, Valeria Saglimbene, Camilla Hanson, Eric Au, Keren Grynberg

Back row: Paul Lawton, Holly Hutton, Alan Cass, Jonathan Craig

ANZSN Young Investigator Award –

Basic Science

Holly Hutton

]

ANZSN Young Investigator Award - Clinical Science

Andrea Viecelli with ANZSN President Jonathan Craig

]

ANZSN Basic Science Award Supported by

Amgen, Fresenius and Roche

Joshua Ooi

ANZSN Interventional Nephrology Science

Award

Lai Wan Chan and ANZSN President Jonathan Craig

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Left: ANZSN Rural Scientist Award Winner: Dr Paul Lawton

Right: KHA Clinical Science Award Winner Prof Alan Cass

Left: ANZSN President Prof Jonathan Craig

Right: KHA Clinical Science Award Winner Prof Alan Cass

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Special Awards

Lifetime Achievement Award in Haemodialysis

At the 37th Annual Dialysis Conference Dinner held in Long Beach California on March the 10th 2017 Prof John Agar was recognized for his dedication to haemodialysis. Prof John Agar was awarded the Lifetime Achievement Award in Haemodialysis. A passionate and skilled advocate for Haemodialysis with over 40 years’ experience in Clinical Nephrology, dialysis and renal transplantation this award was well deserved. The ANZSN would like to congratulate and recognizes Prof John Agar’s hard work and commitment to Haemodialysis.

Jacquot Awards

Jacquot Award Recipient – Dr Katherine Barraclough I have been extremely privileged to receive Jacquot Research Establishment funding in both 2015 and 2016. The first year of funding allowed me to initiate a multicenter study examining immunosuppressant drug pharmacokinetics and dosing requirements in Indigenous versus non-indigenous Australian kidney transplant recipients. This is coordinated through the Menzies School of Health Research and involves the Central Northern Adelaide Renal Transplantation Services (Royal Adelaide and Queen Elizabeth Hospitals), South Australia; Fiona Stanley Hospital, South Metropolitan Health Services, Western Australia; and Northern Territory Renal Services (Royal Darwin and Alice Springs Hospitals), Northern Territory.

The additional year of funding has allowed expansion of this study to incorporate pharmacogenetics and pharmacodynamics profiling. Pharmacogenetics and pharmacodynamics (immune function monitoring) approaches hold enormous potential for personalizing immunosuppression and hold particular relevance for Indigenous kidney transplant recipients, who experience disproportionately high rates of both rejection and infection.

The study plans to enroll 40 Indigenous and 40 non-Indigenous recipients. Ethics approval and governance have been obtained at all participating sites and recruitment is underway.

I am extremely grateful to the Jacquot family for this opportunity. I am also grateful to both ANZSN and the Royal Australian College of Physicians for assessing my applications and considering both this project and me as worthy of support. I hope that the results obtained from this study contribute to better understanding, and hopefully reducing, the disparity in kidney transplant outcomes between Indigenous and non-Indigenous Australians.

Dr Katherine Barraclough Jacquot Awardee Recipient

Jacquot Award Recipient – Dr Natasha Rogers I am currently a Consultant Nephrologist at Westmead Hospital and I run a basic science laboratory at the Westmead Institute for Medical Research. I was a postdoctoral fellow at the University of Pittsburgh, commencing in 2011, and was then promoted to Faculty in the Renal-Electrolyte Division in 2015. I was recruited back to Australia mid-2016 to establish myself as an independent researcher.

The Jacquot Research Establishment Fellowship has allowed me to build a laboratory to capitalize on the work I undertook as a research fellow in the USA, as well as branch into new areas. The fellowship has provided funds for the purchase of laboratory consumables. I have been able to establish and maintain several colonies of mutant mice that are unique within Australia, and crucial to my ongoing experimental work. As a result of Jacquot

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funding, I have also been able to employ a research assistant who effectively runs the laboratory with me, and helps complete experiments when I have clinical responsibilities. I have supervised two honor students and co-supervised two PhD students in 2017 as they undertake experimental work in my laboratory.

My main research interest is in acute kidney injury and investigating the molecular mechanisms that underpin kidney damage. I am particularly interested in the thrombospondin-1-CD47 pathway that is expressed by renal tubular epithelial cells, and regulates injury and repair, as well as inflammation within the kidney. I have been able to use this grant to generate preliminary data for several additional funding applications.

In the current fiscal climate with limited funding opportunities for early stage investigators, the Jacquot foundation provides significant initial support for which I am extremely grateful. Dr Natasha Rogers Jacquot Awardee Recipient

ANZSN Travel Grant Reports

2016 American Society of Nephrology Meeting 15th of November 2016 – 20th of November 2016 Chicago, Illinois, USA

Michael Cai I was able to attend the ASN 2016 Kidney Week in Chicago last year with the support of the kind support of the ANZSN’s travel grant. This was the second ASN I have attended but the first meeting where I presented my work in poster form.

As many of previous attendees will know, the ASN meeting schedule consists of multiple concurrent knowledge and interest streams. My daily dilemma was to choose between attending my area of interest, CKD-MBD, or to extend my comfort zone to other equally exciting topics in Nephrology. I chose a lupus update session which was fascinating from a basic science perspective, especially the role of interferon alpha in the pathogenesis and potential treatment. The presenters also emphasised on variability in study endpoints in lupus trials and the important of re-biopsy in lupus patients, all very relevant to clinical practice.

The highlight of the meeting was being able to share my work with other attendees during the poster session. I was a humbling experience to discuss my findings with other scientist and clinicians interested in CKD-MBD, especially with academics whose papers I’ve read and cited extensively during my PhD. The CKD-MBD posters and oral sessions also provided an excellent overview on the current direction of

research. FGF-23 and klotho physiology remained the hot topics of discussion in the field of CKD-MBD. To put into perspective however, majority of presentation showcased pre-clinical work. Successful and positive clinical trials in CKD-MBD remains elusive.

Chicago was a wonderful city and host venue to the meeting. I would strongly encourage all who has not attended ASN before to go in the future. The scientific content was generally excellent and provides an opportunity to network with other similarly minded clinicians and scientists. I am very grateful to ANZSN for providing financial support for me to attend the meeting.

Xiaochen Chen I would like to thank the society for offering me the travel grant to Chicago for 2016 ASN Kidney Week. It was a great opportunity for me to get the latest information in the conference for the prevention and treatment of kidney diseases. I also had a chance in poster session to present my work, entitled “Sodium acetate attenuates development of diabetic nephropathy in mice”. I was so pleased to present my work to experts, who worked in different fields of the kidney diseases. They also provided me some suggestions for the current and future studies. I was also very pleased to view others’ posters, as there were nearly 1000 posters on different topics each day.

ANZSN 2016 ASN Travel Grant Reports

2016 American Transplant Congress in Boston, United States of America.

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This was my second opportunity to attend ASN Kidney Week. The meeting programs were engaging with a wide range of topics in renal disease and transplantation, both basic science and clinical aspects. There were many interesting sessions to attend, while the basic science sessions were more attractive to me. There were several sessions that I was quite interested in, including “G Proteins, Ligands, and Biased Agonists, Oh My! Unconventional Mechanisms of Signal Processing”, “You Are What You Eat: Diet and CKD”, “Oxygen Metabolism in Diabetic Kidney Disease: A Breath of Fresh Air” and “In Vivo Pathology: Functional Imaging of the Kidney”. These sessions were quite relevant to my current research field, thus it was very helpful to get ideas from these sessions. Once again, I would like to thank the ANZSN for their support to me to attend and present my work at ASN Kidney Week, which hugely improved my knowledge of diabetic nephropathy.

Mardiana Lee I would like to sincerely thank the Australian and New Zealand Society of Nephrology for awarding me a travel grant to attend ASN Kidney Week 2016 in Chicago. I started the meeting with one of the early program ‘Fundamental of Renal Pathology’. It was very educational to be taken through the basic concepts and approaches in renal pathology. It was very useful to go through the classic renal biopsy features of many common renal diseases.

I particularly enjoyed the laboratory sessions where we got to test our knowledge looking at various images of renal biopsies. The sessions were interactive, with plenty of opportunities to ask questions and learn from leading pathologists in renal biopsies. The course has greatly improved my understanding and interpretations of renal biopsies.

Although I have attended ASN before, the size and scale of the ASN meeting still took my breath away. There were so many interesting clinical sessions running concurrently and it was near impossible to decide which one was best to attend. Most were very informative. The ones I enjoyed most were ‘Lupus Nephritis: Back by Popular Demand’ and ‘Membranous Nephropathy: From the Discovery of an Antigen to a Novel Treatment’. The session about ‘IgA Nephropathy: Are We There Yet’ was a highlight for me where I learnt about the advances made in IgA pathophysiology, abnormal glycosylation and the upcoming therapeutic strategies.

I had the opportunity to present some of my preliminary results from my PhD research, which is looking at the role of energy metabolism in renal fibrosis, in a poster session. It was an excellent opportunity to meet other renal scientists or clinicians who had similar interests in renal fibrosis. We exchanged ideas and contact details and discussed some of the challenges in our research. I learnt about other fibrotic markers commonly investigated in renal fibrosis from other groups and have been able to incorporate this into my research.

I found the session titled ‘Golden Nuggets: Role of Exosomes and Microvesicles in Kidney Diseases’ was particularly informative. This is a relatively new area in nephrology where urinary exosomes are being investigated as potential biomarkers in renal diseases. My host laboratory has a strong interest in this area and I have been involved in some of the exosome research projects aside from my PhD research. Attending this session has improved my understanding in urinary exosomes, its roles in healthy individuals and how they change in renal injuries.

I am extremely grateful for the financial support provided by the Australian and New Zealand Society of Nephrology which allowed me to attend the meeting. Attending Kidney Week has provided me with the exposure to the scope of international research as well most recent clinical updates in nephrology. The experience has undoubtedly contributed to my career development both as a researcher and as a clinician nephrologist.

Usman Mahmood I would like to thank ANZSN for allowing me to travel to the ASN meeting held in Chicago in 2016. I attended the early program ‘diagnosis and management of disorders of acid-base, fluid and electrolyte balance’. I particularly enjoyed sessions on ‘Diuretic resistance’ and ‘Vaptans in treatment of hyponatremia’ and found it very relevant to the clinical practice. It was a pleasure to interact with world experts in the field. Plenary sessions were simply excellent. I was fascinated by the number of participating delegates and sessions felt like a huge rally. There were many interesting sessions, ones I particularly enjoyed were: “Lupus Nephritis RITUXILUP protocol”, “Sparsentan use in Focal segmental glomerulosclerosis” and “KDIGO CKD-MBD update 2016”. I presented a poster on my current research on spectrum of patients with chronic kidney disease with increasing age. I

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made contact with number of people from around the world which will hopefully build collaboration in the future projects. Discussion around strengths and weaknesses of current KDIGO guidelines was also very interesting and informative. It was my first experience to attend American Society of Nephrology, Kidney week and I was amazed by the quality of speakers and the research presented. It was a very well organized meeting given there were thousands of delegates. As there were so many simultaneous sessions, I was able to attend only limited number of talks but watched quite a number of sessions online afterwards. I am very grateful to the society for giving me the opportunity to attend this great meeting. It was extremely useful for my professional development. I’ll plan to go again in the near future for sure.

Kim Maree O’Sullivan The annual American Society of Nephrology meeting celebrated its 50th year of meetings in Chicago in November 2016. The convention centre in McCormick Place is one of the largest convention centers in the USA. This allowed multiple plenary sessions and scientific sessions to occur simultaneously, it also catered for many opportunities for exercise and occasions to get lost.

The conference ran over 6 days. The first 2 days contained courses to extend your clinical knowledge in the treatment of renal diseases, or to learn the latest innovations in kidney research. I chose to do a Renal Pathology course taught by some of the worlds most renowned renal pathologists (such as Prof. Charles Jennette, and Dr. Agnes Fogo). Completion of this course, enhanced my skill base on identifying lesions within kidney biopsies, essential for my PhD, which is based on the histopathology of ANCA-GN patient biopsies. In addition, I now have an added wealth of knowledge on the pathology of many other kidney diseases.

Sessions of note were the plenary on the advances in the treatment of ANCA vasculitis, and the basic science session on “Barbarians at the Gate: Inflammatory Cells in AKI” which featured two great talks on Neutrophil and Macrophages extracellular traps (NETs and METs respectively). I was fortunate to have 2 abstracts accepted for presentation, which I presented over 2 days of poster presentations. The first of the 2 posters I presented was “Toll- Like Receptor 4 is dominantly expressed compared to Toll-Like Receptor 2 and 9 in Kidneys of Patients with Anti Neutrophil Cytoplasmic Antibody Associated

Vasculitis”. The second of the posters was “Deoxyribonuclease I Treatment attenuates NET formation, leukocyte infiltration and inflammation in experimental anti MPO glomerulonephritis”. Both of the posters attracted attention from leaders in research on ANCA-Vasculitis. This gave me a great opportunity to present my work, and engage with key players in my area of research.

Attendance at the ASN also gave me the rare opportunity to spend time with past lab members, and visiting Research Fellows, who now live in Japan and Germany. I would like to thank ANZSN for awarding me a travel grant and giving me this great opportunity.

Pek Ghe Tan I am grateful to the ANZSN for supporting my travel to the ASN 2016 conference in Chicago. The trip was not only educational but also inspirational with all the latest research studies in nephrology field being presented.

I started my conference with the glomerulonephritis update course. It was a comprehensive course that cover all topics in glomerulonephritis (GN) in two days. Hearing the updates and latest highlight in investigations and management for various glomerulonephritis was fascinating and helpful with day to day clinical practice.

I delivered a poster presentation on maturation of arteriovenous fistula and factors that impact on early maturation. It was great to see many research that have been done on this topic. I had the opportunity to speak to the other presenters about their research, clinical practices and findings in their center.

The other highlight of ASN was the successful translational research findings on the role of complement in relation to ANCA associated vasculitis that resulted in the new found complement targeted therapy – C5a inhibitor therapy for patient with AAV. The Phase II trial (Clear Trial) of the newly developed C5a Receptor inhibitor for ANCA associated vasculitis reports positive result. This orally administered selective C5a receptor inhibitor has been shown to be effective and non-inferior to standard treatment for patients with AAV in terms of BVAS response and proteinuria. From the trial, it successfully replaced the need of high dose glucocorticoid treatment, resulting in lower incidence of steroid inducing side effects.

In summary, my trip to the ASN 2016 conference has been very rewarding and an eye opening experience. I would strongly recommend all trainees to seize the opportunity to attend this yearly international

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conference. Once again, thank you to the society in providing the travel grant for this great event.

Emily See I would like to sincerely thank the ANZSN for supporting my travel to attend the 2016 American Society of Nephrology Kidney Week in Chicago. This travel grant enabled me to present two research projects, discuss my work with leaders in the field, and attend a broad range of sessions offered as part of the comprehensive scientific program.

The high impact clinical trial session was a definite highlight of the meeting. The investigators of the LEADER study presented the long-term effects of liraglutide on renal outcomes in patients with type 2 diabetes. In this study, a total of 9340 patients were randomised to liraglutide or placebo, and at a median of 3.84 years, the risk of chronic kidney disease development or progression was 22% lower in the liraglutide group. This effect appeared to be driven by changes in persistent microalbuminuria. Other notable presentations included the SoLID trial, a randomised controlled trial comparing left ventricular mass between patients receiving low and standard dialysate sodium; the REPAIR study, which found that in patients undergoing live donor kidney transplantation, remote ischaemic preconditioning led to a sustained improvement in allograft; and the AURA-LV study which highlighted that voclosporin may be another therapeutic option for the treatment of active lupus nephritis.

There were several other thought-provoking presentations and posters at the meeting. A series of studies performed in Canada investigated the haemodynamic and circulatory effects of haemodialysis on myocardial, renal and hepatic vascular beds. Using real-time imaging, they demonstrated that the haemodialysis procedure itself resulted in organ hypo perfusion, which may contribute to progressive organ dysfunction this population. The European DOPPS group presented the results of an observational study comparing patient survival between haemodialysis and haemodiafiltration, the findings of which did not support the notion that HDF is associated with superior patient survival. Within the field of acute kidney injury, several studies reported the medium and long-term patient outcomes following acute kidney injury, which is a key area of interest for me. These studies found that survivors of acute kidney injury are at increased long-term risk of hypertension, chronic kidney disease, and death.

In addition to attending these sessions, I was also able to present my own work on the use of everolimus in patients with tuberous sclerosis complex complicated by intravascular invasion. Although aggressive disease of this type is usually managed surgically due to the risk of tumour embolism, we reported that everolimus could induce regression of invasive tumour thrombus. I also presented a single-centre matched case-control study comparing early and late outcomes between patients managed with urgent-start and conventional-start peritoneal dialysis. Overall, the meeting was a highly enjoyable and invaluable educational experience that provided an excellent opportunity to network with colleagues, to discuss and plan future collaborative work.

2017 American Society of Nephrology Meeting 31st of October 2017 – 5th of November 2017 New Orleans, Los Angeles, USA

Titi Chen I would like to express my profound gratitude to the ANZSN for awarding me the travel scholarship, hence allowing me to present my work in this conference.

The ASN Kidney Week 2017 was held in the Ernest N. Morial Convention Center in New Orleans, LA, USA between the 31st October and 5th November 2017. The conference was attended by more than 15,000 nephrology professionals across the globe, and provided an excellent opportunity to exchange knowledge, learn the latest scientific and medical advances, and to listen to engaging and provocative discussions with leading experts within the field.

The conference commenced with a two day “early bird program” that addressed a specific topic in nephrology, with the program I attended being the “Diagnosis and Management of Disorders of Acid-Base, Fluid, and Electrolyte Balance” course. In this course, international experts in the field provided an up-to-date review of the diagnosis and management of important disorders of acid base, fluid, and electrolyte balance. It highlighted the challenges that we often face, as well as emerging new concepts and areas of controversy. The sessions consisted of lectures, interactive case-based discussions, and self-assessment questions. I have benefited greatly from the sessions, and they have provided me with a wealth of information, hence enabling me to apply them to the diagnosis and management of these disorders.

Subsequently, the annual meeting ran from the 2nd to 5th November. The conference consisted of scientific

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exposition, plenary sessions, educational sessions, poster and oral abstract sessions, as well as industry-sponsored educational symposia. My two posters entitled “Renal CD141 dendritic cell infiltration in human and experimental kidney disease” and “Flt3 inhibitor attenuates renal injury in Adriamycin nephropathy” was presented on Thursday the 2nd of November and Friday the 3rd of November. Throughout the conference, I gained important insight into other research being conducted around the world in this area, and I met several leading experts in the field who took an interest in my work and gave valuable suggestions that I have followed through. We have also found some collaboration opportunities with other researchers in the field.

In addition to the many informative and inspirational sessions during the conference the other highlight of the conference is the opportunity to interact with nephrologists around the globe. For example, I caught up the nephrologists from Hong Kong that I met during the HK Society of Nephrology ASM a few month ago, and we discussed further regarding research and education. I have also talked to a few nephrologists from developing countries such as Nepal and Vietnam, which have given me a very good global perspective of nephrology practice in other countries.

The conference was a huge success and the knowledge I acquired during the conference was invaluable.

The next meeting will be held in San Diego in November 2018. I highly recommend that Nephrology professionals attend the world premier Nephrology conference. Once again, I would like to express my thanks to the ANZSN for supporting me to be able to attend this meeting.

Amy Kang Thank you for supporting me to attend the American Society of Nephrology Kidney Week in New Orleans.

I presented a small case series on patients with biopsy proven IgA nephropathy and positive serum ANCA in the Saturday poster session. We identified 7 patients with biopsy proven IgA nephropathy and a positive serum ANCA. This was 3% of IgA patients tested for ANCA. In our series, patients with positive serum ANCA appeared to have rapidly deteriorating renal function, despite benign appearing biopsies and a high rate of response to immunosuppression, with four out of five patients who were selected to receive immunosuppressive therapy having improved or stable renal function at the end of follow up. This generated some interest. I spoke to another

researcher who conducted a similar small case series and found similar results.

The opening plenary was about new technologies to regenerate blood vessels and the opportunity to use this for fistula restoration. Other highlights were the KDIGO update, which was a great summary of the current state of evidence.

There were a number of interesting posters including the renal outcomes from the CANVAS study, canagliflozin (Sodium-glucose cotransporter 2 inhibitor), finding a positive effect on the progression of albuminuria and the composite outcome of progression of CKD (defined as a sustained 40% reduction in eGFR), need for renal replacement therapy or death from renal causes. Another clinical practice changing study was the PRESERVE study demonstrating no added benefit of sodium bicarbonate or acetylcystine over sodium chloride alone for the prevention of contrast induced nephropathy.

The meeting was a great opportunity to present my own research, be the first to learn the cutting edge of current renal research and to meet colleagues.

Brendan Smyth Thank you to the ANZSN for providing me with the opportunity to attend the ASN conference in New Orleans 2017. I very much enjoyed the conference and was interested to see the size and scope of the US meeting. The plenary sessions were interesting, including what amounted to a call to arms by the President of the ASN for more clinically relevant research. Her discussion of the workforce challenges facing nephrology in the US was also interesting to see – quite different to those faced in Australia. Subsequent talks were also interesting and of course covered a wide range from biological grafts to Mesoamerican nephropathy. The late breaking clinical trials session was a highlight as the tolvaptan study, due to be published in NEJM, is likely to change our practice.

I am grateful for the opportunity to present my two posters on the quality of life (QOL) outcomes in the ACTIVE dialysis trial. These were well received and I was able to discuss the findings with other researchers, including one from the Frequent Hemodialysis Network group. The field of patient reported outcomes is expanding dramatically in the US as routine QOL measurements are now mandated by the regulatory body. The work that we are doing will have broader implications than I had previously realized. Moreover, outside of the conference I attended a meeting of the ISN Advancing Clinical

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Trials working group, of which I am a member. It was a great opportunity to meet the other members of the group and some of the ISN staff with whom I have previously only ‘met’ via email. Further steps forward for the ISN-ACT project are now planned and I look forward to continuing to play a part in this fascinating work.

Finally, I enjoyed visiting New Orleans. It is a fascinating city with a lively history and culture. I had a free day prior to the start of the conference and was able to take a walking tour of the old quarter. Dinners with colleagues each night were always fun and typically followed by a walk to a bar or two and some live music. Overall it was a great trip.

Catherine Leader Title of Poster presentation: Effect of spironolactone on induced hypertension and myocardial infarction in a rat model.

The ASN conference is the world’s premier nephrology conference of the calendar year, with almost 14 thousand people from all over the world attending this year (2017). Being able to attend the ASN conference was a wonderful opportunity to listen to leading researchers in the nephrology field, hear about new and exciting research in the field, and converse with people from across the globe about my research.

My presented work (from my PhD) by poster, was well received, with many people stopping by and asking questions, including people very well respected in the field. This initiated good discussion and further ideas for future research, as well as several contacts to further potential collaborations in both America and Europe.

I believe this conference was of tremendous value. With so many in attending, it was a fantastic opportunity to meet and converse with well-respected nephrology clinicians and researchers from around the world. My research sparked some serious interest, and I am hopeful that this will lead to exciting new collaborations. This was a real highlight for me, and allowed me to see the value of my research on a global scale.

I would like to thank the organization for supporting me and allowing this wonderful opportunity that would otherwise have been out of reach.

International Travel Grant Report The 53rd Annual Meeting of the European Association for the Study of Diabetes.

Matthew Snelling With the assistance of an international travel grant from ANZSN I was able to attend the 53rd Annual Meeting of the European Association for the Study of Diabetes, which was held on the 12-15th of September in Lisbon, Portugal. This meeting is the largest scientific meeting for diabetes in Europe, with 15,436 participants in attendance. I was one of 128 attendees from Australia, and this was my first time presenting my original research findings at an international conference outside of Australia. This meeting represented a great opportunity for me to disseminate my research findings, looking at the effects of a processed diet on gut homeostasis and the progression of kidney disease in a diabetic mouse model, because of the increased interest in the role of the gut microbiota in the pathogenesis of diabetic complications. I presented research findings in two session titled “Understanding and treating nephropathy” and “Insights into diabetic nephropathy”, which enabled me establish on the world stage the role of Australian researchers in gut dysbiosis and diabetic kidney disease. Sharing research findings is an integral part of progressing the field and I feel honoured that I was able to contribute to the collective knowledge that will help patients with chronic kidney disease. At the meeting I was able to attend many talks and poster presentations, which greatly increased my knowledge of emerging techniques for the assessment of kidney function as well as cutting edge therapies that may serve as potential treatments in diabetic nephropathy. I was also able to meet with some potential collaborators from the Netherlands who are able to analyse samples from our studies, using techniques that we are currently unable to undertake in Australia, enabling us to further identify mechanisms by which changes in the gut microbiota lead to kidney damage, which may represent dietary therapeutic targets. I was very lucky to be selected to be part of the EASD Young Academy Meet the Expert sessions, a masterclass of about 20 early career researchers and motivated PhD students, taken by Professor Bernard Zinman covering the major landmark clinical trials that have been conducted looking at diabetes and its complications. Attending this meeting has increased the scope and breadth of my knowledge, fostered collaborations and has enabled me to continue undertaking world-class research here in Australia. I wish to sincerely thank the ANZSN for their support for me to attend this meeting,

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ANZSN Contact Details

Australian and New Zealand Society of Nephrology

Mailing address: 145 Macquarie Street, SYDNEY NSW 2000

Phone: (02) 9256 5461/ 9256 9637 Fax: (02) 9241 4083

Contact: Anna Golebiowski – Executive Officer Email: anzsn@nephrology.edu.au Contact: Jourdan Pinnell - Administrative Officer Email: admin@nephrology.edu.au

Website: www.nephrology.edu.au

Please note, during the 2017 summer holidays the ANZSN Office will be closed

after COB Friday the 22nd December 2017 and reopening Tuesday the 2nd of

January 2018.