Report from the European Continuous Medical Education Course: diagnostic and treatment options in CKD in the new millennium.

(Full text is available at https://www.manu.edu.mk/prilozi). Nephrologists and internists who work in the field of renal replacement therapy with dialysis had an opportunity to attend the continuing medical (nephrology) education (CME) on the subject of: Diagnostic and treatment options in CKD in the new millennium. The course was held on 25 April 2009, in the premises of the Macedonian Academy of Sciences and Arts, in honour of the 70th anniversary of Academician Momir Polenakovic, one of the founders of the Macedonian nephrology. It is important to mention that this is the second CME event (the first was held in September 2006) of the nephrology area that is co-organized by the Macedonian Society of Nephrology, Dialysis, Transplantation and Artificial Organs (MSNDTAO), the European Renal Association (ERA), the International Society of Nephrology (ISN) and the Macedonian Academy of Sciences and Arts. The support by the international associations confirms the successfully built relations and authority of our national association, which is an associate member thereof. Thus, we had a rare possibility of attending 10 exceptional lectures on current topics presented by eminent European nephrologists. The participants on the course were welcomed by the President of the Macedonian Academy of Sciences and Arts, Acad. Georgi Stardelov, Acad. Horst Klinkman, member of the Macedonian Academy of Sciences and Arts, Gerard London - President of the ERA, John Feehally, Secretary of the ISN, the President of the Macedonian Medical Chamber, Vladimir Borozanov, the President of the Macedonian Medical Association, Jovan Tofoski, the Head of the Nephrology Department, Aleksandar Sikole, and the President of the ERA Continuing Medical Education Committee and local co-organizer, Goce Spasovski. In the opening lecture, Meguid El Nahas (Sheffield, UK; CKD Global Outlook: Myth and Reality) discussed the problem of the increasing number of patients with chronic kidney disease (CKD) in different stages that we are facing today, as well as the need for their prevention. Due to the fact that a significant part of the pool of new patients derives from the glomerulopathies, John Feehally (Leicester, UK; Early Detection and Treatment of Primary Glomerulopathies) delivered the message about our situation today concerning early detection, the need for research in the area of new biomarkers on CKD progression and the possibilities for successful treatment in this regard. With the ensuing end-stage kidney disease and the need for treatment with dialysis, artificial kidneys are necessary, i.e. dialysis machines, as well as membranes, filters through which the dialysis is performed. Here, Raymond Vanholder (Ghent, Belgium; Advantages of Treatment in Dialysis Patients with New Membranes and Dialysis Equipments) presented the advantages provided by the new modalities and scientific achievements implemented in clinical practice. One of the functions that cannot be replaced with an artificial kidney is of course the hormone regulation of the haematopoiesis, i.e. the existence of anaemia in CKD. Today, the possibilities for complete replacement of that kidney function are extraordinary in all groups of patients with CKD, which was elaborated by Iain MacDougall (London, UK; Anemia Treatment in CKD, ESRD and Kidney Transplant Recipients). The area in nephrology practice where there are still controversies is the problem associated with mineral and bone disorders (MBD). Ziad Massy (Amiens, France; Oxidative Stress and Cardiovascular Risks in CKD Patients) spoke on the topic of cardiovascular risks and the oxidative stress which is the Achilles' heel for vascular damage. The role of vitamin D and its involvement, not only as part of the MBD problem, but also with its impact on other target organs and systems, was discussed by Jorge Cannata (Oviedo, Spain; Effect of Treatment with Vit. D - Pros et Cons). The most important problem with CKD patients is hyperphosphatemia. Goce Spasovski (Skopje, Republic of Macedonia; Treatment of Hyperphosphatemia, Benefit and/or Hazard) discussed the current medications and doses, as well as the possibilities of determining when one medication is efficient, and when its use could be detrimental. Finally, the complexity of the human body and the need for simultaneous monitoring and treatment of more organs and systems were presented by Gerard London (Paris, France; Bone, Blood Vessels and Related Cardiovascular Consequences in Dialysis Patients), on the subject of the association between bones, blood vessels and cardiovascular disorders in dialysis patients. Not very rarely, in nephrology we meet patients where the kidney damage is secondary, especially in septic conditions. The possibilities for treating and curing this difficult nephrology entity were presented by Dieter Falkenhagen (Krems, Austria; Extracorporeal Blood Purification in Sepsis - Nonsense or New Hope). Finally, the conclusions of the meeting and the messages to the participants from the one-day CME course were brilliantly summarized by Horst Klinkman (Rostock, Germany). Advanced information technology and the possibility of live internet transfer to the centres in Greece and in Bosnia and Herzegovina, as a novelty, was for the first time implemented in the Republic of Macedonia. Thus, the basics for initiating a long-distance learning project were set, i.e. hosting presentations on the ERA web site with the possibility of access and comments by the ERA members to posted questions with a multiple choice, and the possibility of receiving credits, i.e. certificates for acquired knowledge in a certain area. The course was attended by 150 participants from the Republic of Macedonia, Serbia, Albania, Montenegro, Croatia, Bosnia and Herzegovina, Bulgaria, Greece and Turkey. There was a great interest in the lectures with plenty of constructive discussions, with an opportunity for the participants to exchange their experiences with the most prominent European nephrologists, i.e. to receive answers to many questions from everyday clinical practice. The Course evaluation was very high and a recommendation emerged for organizing such events in future. On behalf of the organizers I would like to express my appreciation to the Presidency of the Macedonian Academy of Sciences and Arts for their support in the organization of the Course, and once again I would like to congratulate Acad. Momir Polenakovic on his 70th anniversary.