ETTORE MAIORANA FOUNDATION

ERICE (Sicily, ITALY)

INTERNATIONAL SCHOOL OF PHARMACOLOGY

Directors: P. Benigno, L. Rausa, G. P. Velo,

"10th INTERNATIONAL WORKSHOP

ON NEONATAL AND PEDIATRIC NEPHROLOGY"

and AVANCED POSTGRADUATE INTERNATIONAL COURSE

DRUGS AND THE KIDNEY:

FROM THE FETUS TO THE CHILD

October 13-17th, 2000

Directors:

Jacob V. Aranda, Luigi Cataldi,Vassilios Fanos, Umberto Simeoni

WHAT HAPPENED IN ERICE FROM OCTOBER 13th TO 17th

On the last october, from 13th to 17th, in Erice (Sicily – Italy) happened the 10th International Workshop on Neonatal Nephrology "Drugs and the kidney from the foetus to the child". It was organized by the Italian Society of Neonatology, the Neonatal Nephrology Study Group, and the International School of Pharmacology.

It took place in "the city of the science", Erice, at the Ettore Majorana International Foundation and Centre for the Scientific Culture.

The workshop was an international forum for paediatricians, neonatologists, paediatric nephrologists and pharmacologists. Conceptual and practical problems concerning drugs and nephrotoxicity were featured in a balance of formal presentation and informal discussion, so that all the people present had opportunities to be involved in a dynamic exchange of information and experiences.

Rino Agostiniani from Pistoia (Italy), Luigi Cataldi from Rome, Robert L. Chevalier from Charlottesville (Virginia - USA), Vassilios Fanos from Verona (Italy), Jean-Pierre Guignard from Lausanne (Switzerland), Mussap M. from Padova (Italy), Zoe Papadopoulou Columbis from Joannina (Greece), Christofer P. Price from London and Umberto Simeoni from Strasbourg (France) gave the lectures along the 4 days of the workshop.

First of all the "drug nephrotoxicity" was diacussed from the laboratorists’ point of view. Dr Mussap explained the role of urinary biochemical markers (NAG, b 2-microglobulin …) for the early assessment of renal tubular disfunction; then he talked about Cystatin C in amniotic fluid as an early biochemical marker for the assessment of fetal renal function and dysfunction. Dr Price explained the role of evidence based medicine in laboratory evaluation of kidney diseases.

Dr Agostiniani introduced the helpful role of imaging in drug induced nephrotoxicity, describing some particular conditions such as acute tubular or medullary necrosis, nephrocalcinosis and urolithiasis.

Professor Papadopoulou gave an interesting lecture about the drug nephrotoxicity in the foetus, explaining the toxicity mechanism of the drugs which are sometimes used during pregnancy, above all she pointed the attention on drugs which are able to damage the renin-angiotensin system. In another lecture she discussed the handling of drugs in the immature kidney.

Pofessor Cataldi talked about the normal embriological development of the kidney, then he illustrated the drugs for urinary tract infection.

Dr Fanos, after an introduction to drug-induced renal damage in the newborn, focused the attention on nephrotoxicity caused by aminoglycosides (with an interesting description of the toxicity mechanisms), amphotericin B, vancomycin and cephalosporins.

Professor Chevalier, to continue the lecture of Prof Cataldi, illustrated the impact of drug exposure on nephron numbers showing serious reduction of nephron amounts also with "innocent" drugs that are commonly used. He gave a second lecture about acute renal failure in the newborn.

Professor Simeoni explained the neonatal kidney and the systemic hemodynamics with particular attention to renin-angiotensin system and its developmental characterisitcs; then he talked about the effect of steroids on perinatal renal function.

Professor Guignard gave three lectures about dopaminergic agents, the physiology of the immature kidney and arterial hypertension in the newborn.

During the last part of the workshop there was the presentation of papers partecipating in a prize: the ex aequo winners were Dr P. Toth-Heyn from Budapest and Dr Gyula Talosi from Szeged, both Hungarian.