bluuebunny/crossref_metadata_2025 huggingface dataset:
MO107: Association of Renal Function with Cardio Metabolic Risk Factors in Elderly Population
Authors: Kibria Golam , Iqbal Masud , Shahnoor Alam Kazi , Chowdhury Maa , Hassan Mz , Chaudhury Sr
Published: May 2022

BACKGROUND AND AIMS

Elderly population is a vulnerable group, and cardiometabolic risk factors are highly prevalent among them. This situation complicates when the renal function becomes impaired. The aim of this study was to evaluate the association of renal function with cardiometabolic risk factors among the elderly subjects.

METHOD

This cross-sectional study was conducted among a group of elderly population (>60 years) living in three different elderly residential complexes. Written informed consent was taken from all. Study population underwent detail history taking, physical examination and relevant investigations. Renal function (eGFR) was estimated by CKD-EPIcr formula. Renal (eGFR, Ur ACR), cardiac (blood pressure, BMI, waist/hip ratio) and metabolic risk factors (lipids, albumin, uric acid, HbA1c) were evaluated. All information was recorded in separate case record form. Collected data were checked for errors and then analysed using the statistical software SPSS 16.

RESULTS

Around 145 subjects were included. About 42% were from 60–65 years of age, 37% from 66–70 years and rest > 70 years. Mean age was 68 ± 5 years with male 52%. Mean eGFR was 71 ± 2 and in male versus female it was 75 ± 22 versus 66 ± 24 mL/min/1.73 m2 (P < .032) . In 20% elderly eGFR was observed < 60 mL/min/1.73 m2. Prevalence of DM, HTN and obesity was 33%, 46% and 9%, respectively. Age (69 ± 5 and 67 ± 5 years, P < .012), waist/hip ratio (1.01 ± 0.16 and 0.97 ± 0.07,  P < .04), serum creatinine (1.6 ± 0.4 and 0.9 ± 0.2 mg/dL,  P < .001), urinary ACR (320 ± 565 and 82 ± 213 mg/g,  P < .001) were significantly altered among patients with impaired renal function (<60 versus >60 mL/min).

CONCLUSION

This study showed that various cardiometabolic risk factors among elderly patients are significantly higher in those with impaired renal function.
MO117: Predictive Factors for Renal Impairment Secondary to Familial Mediterranean Fever in an Algerian Population
Authors: Ghalia Khellaf , Benziane Ali , Benabadji Mohamed
Published: May 2022

BACKGROUND AND AIMS

The aim of this study was to assess predictors of renal involvement and other factors secondary to FMF in renal and overall survival.

METHOD

We prospectively studied 57 Algerian patients admitted to our nephrology department from January 2012 to January 2021. The diagnosis of nephropathy was suspected clinically and biologically and confirmed histologically. The search for mutations in the MEFV gene was carried out in all our patients. The patients were divided into two groups according to their evolution: G1 (patients on dialysis) and G2 (patients not on dialysis).

RESULTS

G1 presents compared to G2 a presence of patients with more men with (P = 1015 × 10−2) but the difference is not significant, consanguinity (P < 4998 × 10−3), later age of onset of FMF (P < 1116 × 10−4), triggers for renal damage (P < 3907 × 10−2), later age of onset of nephropathy (P < 4199 × 10−2), higher C-reactive protein (P < 2561 × 10−2), AA amyloidosis (P < 11.0 × 10−7), higher percentage of sclerosis glomeruli >50% (P < 2052 × 10−4), rapidly progressive glomerulonephritis (P < 1.0 × 10−7), higher proteinuria (P < 1.0 × 10−7), higher serum creatinine (P < 01.15 × 10−5), higher homozygous and/or compound heterozygous at the different gene mutations (P < 3.815 × 10−6) and a higher number of deaths (P < 3.394 × 10−5). The renal and overall survival analysis of the Kaplan–Meier survival analysis curve was significantly different in multivariate analysis (log rank, P  < .0001).

CONCLUSION

There are predictive factors specific to renal injury and FMF that predict renal and overall survival in these patients.
MO118: A Study on Renal Involvement in COVID-19 Patients with or without Preexisting Kidney Disease and Outcome: Acha Single-Centre Retrospective Study
Authors: Sharma Manjuri , Brijesh Singh K , Pegu Gayatri , Kumar Doley Prodip , Gope Manas , Kharbuli Indakiewlin , Dange Shruti
Published: May 2022

BACKGROUND AND AIMS

Chronic kidney disease (CKD) patients and renal allograft recipients (RARs) are at increased risk for severe coronavirus disease 2019 (COVID-19). Acute kidney injury (AKI) can develop in a patient with COVID-19 infection. Data regarding the outcome of COVID-19 patients affected with renal disease are scarce, especially from northeastern part of India.

METHOD

We conducted a single-centre, retrospective, observational study, involving hospitalized COVID-19 affected patients with renal disease in Gauhati Medical College, Guwahati between 1 July 2020 and 30 June 2021. Patients with various forms of kidney disease including AKI, CKD, RAR and glomerulonephritis were included. The main aim of the study was to describe the outcome (in-hospital mortality) in this group of patients.

RESULTS

The study included a total of 384 patients with most patients in the elderly age group (73.7% above 45 years). Most of the patients were male (n = 288, 75%). Those with renal disease were grouped under AKI, CKD, RAR, systemic lupus erythematosus with lupus nephritis (LN) and rapidly progressive GN (RPGN) (20.3%, 75%, 3.4%, 1% and 0.3%, respectively). The mean duration of stay at the hospital was 8.1 days with maximum duration for RAR patients with a mean of 11.2 days. A total of 199 patients (51.8%) died. Mortality data were not available for 19 patients who got transferred to various other departments after recovering from COVID-19. Mortality rates for AKI, CKD, RAR and LN were 37.2%, 55.2%, 53.8% and 75%, respectively. One patient with RPGN also died.

CONCLUSION

COVID-19 affects patients of all age and sex. CKD patients and those on immunosuppressive agents are at higher risk for mortality.
MO131: Prevalence of Pruritus in Spanish Patients with Chronic Kidney Disease and Affectation of Quality of Life
Authors: Areste-Fosalba Nuria , Emilio Sanchez-Alvarez J , Henriquez Fernando , Jesus Lloret Maria , Ulloa Catalina , Buades F Juan M , Mascarós Victoria , Isabel Martínez Puerto Ana , Dolores Arenas María , Yetman Delfina , Furaz Karina
Published: May 2022

BACKGROUND AND AIMS

The prevalence of chronic kidney disease–associated pruritus (CKD-aP) found in different studies ranges from 40% to 90% in patients undergoing haemodialysis, and from 19% to 29% in non-dialysed patients. However, despite pruritus negatively affect the quality of life (QoL) and clinical outcomes as well as increase the risk of mortality, clinicians still tend to underestimate the number of patients with CKD-aP. This study was conducted to estimate the prevalence of pruritus and its impact in different dimensions of QoL in the Spanish population with CKD.

METHOD

A short survey was designed using seven questions included in several validated tools for pruritus assessment. The questionnaire was distributed by the Spanish Society of Nephrology to all their members in the framework of the Pruritus Week. Nephrologists visiting advanced CKD patients asked them to answer the questionnaires voluntarily.

RESULTS

A total of 1605 patients (haemodialysis 92%, peritoneal dialysis 5% and non-dialysis 3%) answered the questionnaire. A prevalence of CKD-aP of 50.5% was reported, 26.7% being moderate-to-severe. As shown in figure 1, the prevalence was higher in non-dialysis advanced CDK patients suggesting a benefit of dialysis in reducing itch. CKD-aP patients reported itching throughout their body and at any part of the day, but more at night. The percentage of patients with mood changes increased as the severity of itch increased, being anguish and lack of rest the parameters that were more highly affected. An increase in depression was also observed. Sexual function and desire impairment increased as severity of CKD-aP increased. Finally, CKD-aP patients reported higher sleeping disturbances than patients with no pruritus (difficulty to sleep, restless sleep and intake of sleep medication), which enhanced with the increase of pruritus severity.

CONCLUSION

CKD-aP is highly prevalent in patients with advanced CKD (non-dialysis and dialysis), which affects patients’ quality of life by inducing mood changes, including depression, impairing sexuality and affecting sleep.
MO146: Effects of High-Intensity Exercise on Renal and Endothelial Function of Crossfit Athletes
Authors: Cesar Chaves Nunes Filho Julio , Castelo Branco Holanda Gadelha Pereira Dyego , Salviano de Matos Robson , Vieira Pinto Daniel , de Olveira Vilar Neto José , Cavalcante Meneses Gdayllon , Maria Costa Martins Alice , Silva Camurça David , Helen Barreto Melo Anne , De Francesco Daher Elizabeth
Published: May 2022

BACKGROUND AND AIMS

High-intensity exercise modalities such as Crossfit have increased the number of practitioners due to the benefits such as weight loss. However, high-intensity exercise can induce renal and endothelial damage. The objective was to verify the main acute effects of high-intensity exercise on renal and endothelial function of Crossfit athletes.

METHOD

The study was conducted by evaluating 10 high-performance Crossfit athletes, performing pre- and 24-h post-competition test collection. The athletes were evaluated using biomarkers for kidney injury, such as lipocalin associated with neutrophil gelatinase (NGAL), creatine kinase (CK), albumin, creatinine and estimated glomerular filtration rate (eGFR). Endothelial damage was evaluated using serum enzymatic markers, intercellular adhesion molecule-1 (ICAM-1), vascular adhesion molecule-1 (VCAM-1) and Syndecan-1. In addition, athletes' physical and social evaluation questionnaires measuring body composition data and socioeconomic conditions were used. Statistical analysis was performed with Shapiro-Wilk and Student t test for parametric values and Wilcoxon for non-parametric data. Pearson and Spearman tests were used for data with normality and non-normality, respectively.

RESULTS

There was a significant increase in creatinine (1.03 ± 0.24 versus 1.36 ± 0.34 mg/ dL, P = .001) and CK [median 302.40 (115.75–474.00) versus 2048.80 (542.75–3391.25) U/L, P = .005] 24 h after the activity, and reduced eGFR (91.55 ± 21.15 versus 66.45 ± 20.6  mL/min/1.73 m², P = .000). The values of ICAM-1, VCAM-1, Syndecan-1 and NGAL did not show statistically significant variations. There was a strong positive correlation between syndecan-1 and CK (P = .000, r = 0.953).

CONCLUSION

The study showed that high performance exercise performed by athletes does not cause significant acute changes in renal function, but its intensity was able to cause muscle damage and endothelial changes in the participants.
MO159: Serum Trimethylamine N-Oxide Level is Positively Associated with Aortic Stiffness Measuring by Carotid-Femoral Pulse Wave Velocity in Maintenance Haemodialysis Patients
Authors: Lai Yu-Hsien , Lin Wei-Chen , Hsu Bang-Gee
Published: May 2022

BACKGROUND AND AIMS

Trimethylamine-N-oxide (TMAO) acts as an evident predictor for the prevalence of cardiovascular disease and increased incidence of major adverse cardiovascular events. Aortic stiffness predicts cardiovascular disease and is associated with ageing-associated vascular diseases. The aim of this study was to evaluate the relationship between serum TMAO levels and carotid-femoral pulse wave velocity (cfPWV) in chronic haemodialysis (HD) patients.

METHOD

A total of 115 patients with HD were enrolled in this study. cfPWV was measured using the SphygmoCor system. Patients with cfPWV >10 m/s were defined as the aortic stiffness group. Serum TMAO level was performed with high-performance liquid chromatography and mass spectrometry.

RESULTS

Forty-two HD patients (36.5%) had aortic stiffness and higher percentages of diabetes (P < .001), hypertension (P = .026), were of older age (P = .028) and had higher systolic blood pressure (P = .025), serum glucose level (P = .029) and TMAO levels (P < .001) compared to control group. After adjusting for factors significantly associated with aortic stiffness by multivariate logistic regression analysis, serum TMAO [odds ratio (OR): 1.010, 95% confidence interval (CI): 1.003–1.017, P = .003) and age (OR: 1.046, 95% CI: 1.007–1.088, P = .021) were independently associated with aortic stiffness in patients with chronic HD. After multivariable forward stepwise linear regression analysis also noted that serum TMAO level (β = 0.355, adjusted R2 change = 0.198, P < .001) was positively associated with cfPWV values in HD patients.

CONCLUSION

Serum TMAO level is an independent marker of aortic stiffness and is positively associated with cfPWV values in patients with chronic HD.
MO168: Urinary Podocin Cell Count in Relation to Glomerular Damage Markers in Patients with Primary Nephrotic Syndrome
Authors: van den Berge Tijmen , Jansen Jitske , van de Logt Anne-Els , Smeets Bart , Wetzels Jack F M , Maas Rutger
Published: May 2022

BACKGROUND AND AIMS

Progressive renal failure in patients with glomerular disease is driven by podocyte depletion. Several methods have been proposed to monitor urinary podocyte loss. Here, we investigated the process of podocyte depletion in patients with primary nephrotic syndrome (PNS) by flow cytometric detection of podocin-positive cells in urine.

METHOD

We included nine patients with PNS. Urinary cell pellets were spun down, washed and stained for podocin and subsequently counted using FACS. Urinary protein and creatinine levels were determined from the same portion of urine. Normal values of urinary podocin-positive cells were obtained in urine samples of four healthy controls.

RESULTS

Mean urinary podocyte count (podocin-positive cells) was on average 100.0 (3.1–228.1) times higher in patients compared to healthy controls. Podocyte excretion showed significant correlations with urinary protein/creatinine ratios (R2 = 0.86, P < .01).

CONCLUSION

Urinary excretion of podocin-positive podocytes was significantly increased in patients with PNS, and correlated significantly with protein/creatinine ratios in patients with PNS. We conclude that this method can be used to monitor the process of podocyte depletion, and impact of treatment. We are planning prospective studies to evaluate the prognostic value of urinary podocin+ podocyte excretion in patients with PNS.
MO172: Correlation of Serum Adipocyte Fatty Acid Binding Protein Level and Peripheral Arterial Disease in Chronic Kidney Patients
Authors: Boey Han-Bin , Liao Tsung-Yu , Wang Chih-Hsien , Tang Chi-Chong , Hsu Bang-Gee
Published: May 2022

BACKGROUND AND AIMS

Adipocyte fatty acid-binding protein (A-FABP) is expressed in adipocytes, dendritic cells and macrophages and it was thought to be involved in insulin resistance, chronic inflammation and atherosclerotic processes. Peripheral arterial disease (PAD) is associated with all-cause mortality, cardiovascular events and a key pathological process is atherosclerosis. The present study aimed to determine the relationship between serum A-FABP level and PAD in patients with non-dialysis chronic kidney disease (CKD).

METHOD

Fasting blood samples and baseline characteristics were obtained from 260 non-dialysis CKD patients (CKD stage 1–5). Ankle-brachial index (ABI) values were measured using an automated oscillometric device. Patients with ABIs of <0.9 were categorized into the low ABI group. Serum A-FABP levels were measured using a commercial enzyme immunoassay assay.

RESULTS

In the study cohort, 32 of the 260 non-dialysis CKD patients (12.3%) had low ABIs. The rates of diabetes mellitus (P = .037), smoking (P = .030), older age (P = .002) as well as the serum levels of A-FABP (P = .003) were higher in the low ABI group compared with the normal ABI group. The multivariable logistic regression analysis revealed that serum levels of A-FABP [odds ratio (OR): 1.223, 95% confidence interval (CI): 1.068–1.401, P = .004], older age (OR: 1.064, 95% CI: 1.026–1.104, P = .001) and smoking (OR: 4.438, 95% CI: 1.493–13.198, P = .007) were the independently associated with PAD in patients with CKD. By receiver operating characteristic (ROC) curve analysis, the area under the receiver operating characteristic curve of A-FABP level was 0.662 (95% CI: 0.601–0.719, P = .0004) for predicting PAD in non-dialysis CKD patients.

CONCLUSION

In this study, serum A-FABP levels were associated with PAD in patients with non-dialysis CKD.
MO216: The Importance of Nephrotic Range Proteinuria in Renal Survival of Patients With IGA Nephropathy
Authors: Fokas Stavros , Kostopoulou Myrto , Kanellopoulou Konstantina , Drakopoulos Angelos , Tigka Eirini , Liaveri Paraskevi , Moustakas Georges
Published: May 2022

BACKGROUND AND AIMS

Persistent proteinuria (urinary protein level [UPr]>1 g/24 h) and especially nephrotic range proteinuria, is a poor prognostic factor in IgA nephropathy. Patients with proteinuria > 3.5 g/24 h have a 24-fold faster decline of renal function as compared with those with < 1g/24 h. The aim of this study was to explore the relationship between nephrotic range proteinuria and renal survival in patients with IgA nephropathy.

METHOD

All records from patients who were followed in a renal outpatient clinic and had a biopsy-proven IgA nephropathy were retrospectively screened. Patients with nephrotic range proteinuria (UPr > 3.5 g/24 h) at the time of diagnosis were compared, regarding their clinical and epidemiological characteristics, with patients with lower levels of proteinuria. Renal survival was defined as the absence of end-stage kidney disease [estimated Glomerular Filtration Rate (eGFR)≤15 mL/min/1.73 m2] or/and a ≥ 50% reduction of eGFR from baseline values.

RESULTS

We included 53 patients with IgA nephropathy. Their mean age was 46.24 (±16.92) and the median follow-up time was 49 (17–111) months. The median UPr value at the time of diagnosis was 1.89 (0.83–3.50) g/24 h and 17 patients had UPr > 3.5 g/24 h. Patients with nephrotic range proteinuria had worse renal function (eGFR 29 versus 73 mL/min/1.73 m2 P < .001), developed more frequently hypertension (82.35% versus 50%, P = .02) and rapidly progressive glomerulonephritis (23.53% versus 5.56%, P = .05) compared with those with lower levels of proteinuria. The episodes of macroscopic hematuria were less frequent in the group of patients with nephrotic range proteinuria (11.76% versus 38.89%, P = .05). Regarding patients treated with prednisone, the mean daily dose of prednisone was 23.42 mg for the nephrotic patients versus 16.61 mg for the patients with UPr < 3.5 g/24 h (P = .03). Proteinuria > 3.5 g/24 h was an independent risk factor for poor renal survival (HR 15.48, P = .01). The 5-year renal survival of patients with nephrotic range proteinuria was reduced compared with those with lower levels of proteinuria (66.64% versus 100%).

CONCLUSION

This study showed that the presence of nephrotic range proteinuria at the time of diagnosis was an independent risk factor for reduced renal survival. This relationship persisted after sex, age and renal function adjustment at the time of diagnosis.
MO219: Are C4D, Nephrın and WT1 Expressıons İmportant ın the Dıfferentıal Dıagnosıs between Focal Segmental Glomerulosclerosıs and Mınımal Change Dısease?
Authors: Akcali Esra , Turgutalp Kenan , Yuyucu Karabulut Yasemin , Ebru Eser Zeynep , Agtas Mistik Ozge , Coskun Yılmaz Banu , Bardak Simge , Ozturk Savas , Demir Serap , Kıykım Ahmet
Published: May 2022

BACKGROUND AND AIMS

Focal Segmental Glomerulosclerosis (FSGS) and Minimal Change Disease (MCD) are most common seen glomerulonephritis. Differential diagnosis between FSGS and MCD by light microscopy (LM) cannot be made in some times. In this situation, electron microscopy (EM) is needed for differential diagnosis. Rarely, EM may not be sufficient for differential diagnosis. There are needed new markers for differential diagnose between FSGS and MCD. The aim of this study is to determine which of the glomerular C4d, nephrine staining is specific and sensitive for FSGS and MCD.

C4d, Recent experimental data show that complement activation plays a pathogenic role in the development of FSGS. Therefore, C4d staining in the sclerotic focus of the glomeruli in FSGS patients may have an important differential diagnosis.

Nephrine is the main component of the slit diaphragm that connects the foot protrusions of the podocytes. Epithelial cell and podocyte dysfunction occurs as a result of defects in the genes encoding these key proteins expressed in GBM.

Wilms’ tumour suppressor gene (WT1) is a transcription factor that plays very important role in the embryonal development of the genital organs and kidney. WT-1 is expressed in podocytes and is an important transcription factor for podocyte function.

METHOD

This is a retrospective study, comprised of patients diagnosed as FSGS, MCD and the ones who diagnosed as having FSGS or MCD couldnot be differentiated. The patients were divided into three groups. Group 1: FSGS patients, Group 2: patients with indefinite diagnosis; either FSGS or MCD and Group 3: MCD patients. All biopsy materials were stained with C4d, WT1 and nephrine. The specificity, sensitivity, positive predictive value (PPV) and negative predictive value (NPV) of C4d, WT1 and nephrine were evaluated for the diagnosis of both FSGS and MCD.

RESULTS

C4d staining in group 1 was significantly higher compared with group 2 and group 3 (P < .05). Nephrine was shown significantly more staining in group 3 patients than group 1 (P < .05). C4d was found to be associated with the presence of global or segmental sclerosis in the glomeruli, adhesion to the Bowman's capsule (P < .05). The specificity and sensitivity of C4d in FSGS patients were 85%, 73.9%, while it was 26.1% and 15.4% in MCD. Specificity and sensitivity of nephrine were 87%, 69% in MCD patients compared with 30.8% and 13% in FSGS (Fig. 1). PPV and NPV values of C4d and nephrine in FSGS and MCD were shown in Figure 2.

CONCLUSION

C4d and nephrine have predictive diagnostic value for FSGS and MCD respectively. C4d and nephrine are more specific and sensitive to FSGS and MCD, respectively. However, there is a need for randomized studies with larger study groups
MO222: Prognostic Factors for CKD Progression in Patients with IGA Nephropathy
Authors: Kostopoulou Myrto , Fokas Stavros , Drakopoulos Angelos , Louka Michaela , Gkika Vasiliki , Vasileiou Kyriaki , Moustakas Georges
Published: May 2022

BACKGROUND AND AIMS

IgA nephropathy is a progressive renal disease with up to 30% of patients reaching end stage kidney disease within 10–20 years. The aim of this study was to analyze the phenotype of patients with IgA nephropathy followed in a tertiary renal center and explore its association with renal survival.

METHOD

All records from patients with a biopsy-proven IgA nephropathy were retrospectively assessed. Demographic and clinical characteristics were recorded for each patient at baseline and during follow-up. The transition to the next stage of chronic kidney disease (CKD) by the end of the follow-up was considered as progression of CKD.

RESULTS

We included 53 patients with IgA nephropathy, 35 (66.04%) males and 18 (33.96%) females. The mean age at the time of diagnosis was 46 (±16.92) years old and the median follow-up time was 4.75 (2–11.75) years. Median eGFR using the CKD-EPI creatinine equation was 63 (32–86) mL/min/1.73 m2 and the median proteinuria level was 1890 (830–3500) mg/24 h. At the time of diagnosis, 30.19% of patients presented with macroscopic hematuria, 24.53% with upper respiratory infection, 11.32% with rapidly progressive glomerulonephritis and 60.38% with hypertension. The majority (86.7%) of patients were treated with renin–angiotensin–aldosterone system (RAAS) blockade, while 34 patients (64.15%) received immunosuppression. Eighteen patients (33.96%) were treated with a 6-month corticosteroid regimen (Pozzi protocol), seven (13.21%) with cyclophosphamide, four (7.55%) with azathioprine and eleven (20.75%) with mycophenolate mofetil, while seven patients (13.21%) received repeated therapeutic regimens. The level of proteinuria (g/24h) and the need for repeated therapy were prognostic factors of CKD progression at the end of the follow-up (HR 1.22, P = .01 and HR 2.90, P = .04, respectively). In age-adjusted multivariable analysis only the need for repeated therapy remained statistically significant. The patients who needed repeated treatment had a 4.45-fold risk for CKD progression compared with patients of the same age, who did not need repeated therapy (HR 4.45, P = .02).

CONCLUSION

High grade proteinuria and mainly the need for repeated treatment are poor prognostic factors of CKD progression during the long-term follow up of patients with IgA nephropathy.
MO224: Antibody Responses to a 3RD Booster Dose of SARS-COV-2 Vaccines in Patients with Vasculitides and Renal Involvement
Authors: Chalkia Aglaia , Koutsianas Christos , Alexakou Zoi , Panagiotopoulos Alexandros , Aggelis George , Vasilopoulos Dimitrios , Petras Dimitrios
Published: May 2022

BACKGROUND AND AIMS

Immunosuppressed patients are in general less likely to achieve a detectable antibody response to SARS-CoV-2 after the primary doses of vaccine administration. However, there are limited data for the effect of a third booster dose in this patient population, especially for those with vasculitides and renal involvement treated with rituximab (RTX).

METHOD

We retrospectively assessed the antibody responses to SARS-CoV-2 vaccination, after completion of the primary vaccine series (two doses) and after the booster third dose, in patients with vasculitides and renal involvement. IgG antibodies to the spike protein S1 subunit of SARS-CoV-2 were measured using ELISA >1 month after completion of the primary vaccination series (two doses of Pfizer or AstraZeneca vaccines) and 15–30 days after the third booster dose (Pfizer, given 3–6 months after the second dose).

RESULTS

We included 20 patients with vasculitis [AAV, n = 16 (80%), IgAV, n = 4 (20%)] and renal involvement. All patients received immunosuppressives, including RTX (80%), MMF/AZA (15%), cyclophosphamide (5%), while half of patients were on glucocorticoids. The seroconversion rate after the primary two doses (Pfizer n = 8/16, Astra-Zeneca n = 1/1) was 53%, which increased to 67% after the third booster dose (Pfizer, n = 12/18). Similarly, the median antibody titers increased from 451 U/mL [interquartile range (IQR) 81–10.845] after the second dose to 1016 U/mL (ΙQR: 64–37.568) after the booster dose. Regarding patients treated with RTX, the respective response rates after the second and third dose were 58% and 62%. Seropositive patients after the third dose tended to have lower previous cumulative exposure to RTX compared with seronegative ones (4.55 versus 5.5 g, P = .62, respectively). No vaccine side effects or disease relapses were noted after the three vaccine doses.

CONCLUSION

In our patient cohort with systemic vasculitis and renal involvement treated mainly with RTX, a third booster vaccine dose increased the seropositivity rate from 53% to 67%. Nevertheless, one-third of patients did not achieve seroconversion. Whether a fourth booster dose could benefit these patients is still unknown.
MO270: N-3-Oxododecanoyl Homoserine Lactone Inhibits Angiogenesis by Activating the Angiopoietin-Tie System in Human Endothelial Cells
Authors: Shin Jungho , Hee Ahn Sun , Hyun Kim Su , Oh Dong-Jin
Published: May 2022

BACKGROUND AND AIMS

The dysregulation of the angiopoietin–Tie system is associated with the development of sepsis-associated endothelial dysfunction. Bacterial quorum-sensing molecules act as pathogen-associated molecular patterns; however, the effect of quorum-sensing molecules on the angiopoietin–Tie system remains uncertain.

METHOD

This study investigated the molecular mechanisms of endothelial dysfunction in human umbilical vein endothelial cells treated with N-3-oxododecanoyl homoserine lactone (3OC12-HSL) derived from Pseudomonas aeruginosa.

RESULTS

Treatment with 3OC12-HSL reduced cell viability in a dose-dependent manner. Moreover, 3OC12-HSL treatment impaired the ability of tube formation even at non-lethal concentrations. The patterns of mRNA expression regarding the angiopoietin-Tie axis were assessed and the increased mRNA expressions of angiopoietin-2, Foxo-1, Tie1, and VEGFR2 were found in the 3OC12-HSL-treated cells. Western blot revealed that treatment with 3OC12-HSL increased the relative expressions of agiopoietin-2 and Foxo-1 and decreased the expression of Tie2. The study further evaluated the expression of IQGAP1 and the expressions of IQGAP1 and Rac1 decreased in cells treated with 3OC12-HSL. In addition, coimmunoprecipitation studies showed that treatment with 3OC12-HSL decreased the association between IQGAP1 and Rac1 in endothelial cells.

CONCLUSION

3OC12-HSL can impair endothelial angiogenesis via the activation of the angiopoietin-Tie pathway. In addition, it may induce the dissociation of IQGAP1 with Rac1. Adjuvant therapy for blocking the quorum-sensing systems can help preserve endothelial cell integrity and prevent organ failure in patients with sepsis.
MO296: Seasonal Variations in AKI Incidence and Outcomes
Authors: Alsahow Ali , Alkandari Omar , Alyousef Anas , Alhelal Bassam , Alrajab Heba , Alqallaf Ahmed K E A , Bahbahani Yousif , Alsharekh Monther , Nessim Gamal , Mashal Bassem , Saad Elabbadi Mohamed , Mohamed Eltaher Eliwa Bayoumi Mazroue Ahmed , Abdelzaher Ali , Abdelrady Ahmed , Nawar Ehab
Published: May 2022

BACKGROUND AND AIMS

Kuwait enjoys a cool winter but suffers a very hot summer. We aim to evaluate the relationship between weather temperature and acute kidney injury (AKI) incidence and outcome.

METHOD

We prospectively collected demographic (age, sex and nationality), clinical (CKD status, cause of AKI and comorbidities), management (fluids, diuretics, inotropes, ventilatory support and dialysis) and 30-day patients and kidney outcome data for all adult nephrology consultations for AKI in seven major public hospitals in Kuwait during January, February and March/2021 and compared them to those of June, July and August/2021.

RESULTS

A total of 2038 patients with AKI were enrolled (mean age: 64; males: 59%, Kuwaitis: 58%; mean eGFR: 66.5; mean initial Hgb: 106). Of the cohort, 42% had baseline eGFR < 60 (with a mean eGFR of 37, a mean age of 68 and a mean Hgb of 102 versus a mean eGFR of 88, a mean age of 59 and a mean Hgb of 109 for the group with baseline eGFR > 60). Higher percentage of AKI cases took place in cooler months (63% versus 37%). Patients with AKI in cooler months were significantly older (65 versus 59), with lower baseline eGFR (63 versus 72.5) and more comorbidities (DM, HTN, CAD). There was no difference between the two groups in the use of IV fluids (saline, bicarbonate, blood products, etc.) or IV diuretics (loop, thiazide or potassium-sparing); however, IV vasopressors were used more often in cooler months in cases of AKI. Mechanical ventilation was more frequently used in the summer cases (44% of summer AKI cases versus 40% of winter AKI cases) but not statistically significant. Dialysis was needed for 44% of the entire cohort, 56% of dialysis cases were in cooler months (31% of winter AKI cases) and 44% in summer months (40% of summer AKI cases). Dialysis modality was continuous in 85% of all cases. At 30 days, 36.5% of the total cohort died; 72% of them died while on dialysis. Larger proportion of deaths in AKI cases in cooler months (58% of total deaths or 33% of the winter AKI cases versus 42% of the total death or 42% of the summer AKI cases), with more deaths while on dialysis seen in cooler months too (56% versus 44% of deaths while on dialysis). However, lower rates of complete recovery from AKI were seen in summer cases (33% versus 67%), with a mean final eGFR of 57 for the winter AKI cases versus 41 for the summer AKI cases.

CONCLUSION

AKI is more common in the cooler months of the year affecting an older group of patients with more comorbidities, and is associated with higher usage of dialysis and higher rates of death, but probably better chances of kidney recovery in those who survive.
MO301: The Incremental Chronic Kidney Disease Risk Among Post-Hospitalized Leptospirosis Patients With Acute Kidney Injury: Systematic Review And Meta-Analysis
Authors: Pratama Putra Boby , Nugraha Putra Felix
Published: May 2022

BACKGROUND AND AIMS

Leptospirosis is a global zoonotic bacterial disease that may cause life-threatening complications, such as acute kidney injury (AKI). Patients with AKI may recover fully, but some can progress to chronic kidney disease (CKD) or even become dialysis-dependent. This study aims to evaluate the CKD and dialysis-dependent incidences and risks among post-hospitalized leptospirosis patients with AKI.

METHOD

Comprehensive searching was performed through the online databases of Pubmed, EMBASE, ScienceDirect and The Cochrane Library to include all relevant literature from 2000 to 2021. This study followed the PRISMA guidelines. The inclusion criteria are all observational studies that assess the incidence and risk for CKD development and dialysis dependence among post-hospitalized leptospirosis-associated AKI patients. The quality of included studies was accessed by using the Newcastle–Ottawa Scale. Analysis was conducted to obtain the pooled odds ratio (OR) with a 95% confidence interval (CI) with a fixed-effect heterogeneity test.

RESULTS

Five observational studies met the inclusion criteria. About 7%–14% of post-hospitalized leptospirosis patients with AKI deteriorate significantly to become CKD risk (pooled OR = 1.78, 95% confidence interval 1.41–2.23; P <  .0001, I2 = 0%). A population cohort study suggested that Leptospira-seropositive population is correlated with the eGFR decline, even in the non-diabetic subgroup. Multivariate analysis from a cohort study showed that the elderly patients were predictors of dialysis-dependency and mortality. The funnel plot is symmetrical suggesting no publication bias.

CONCLUSION

Post-hospitalized leptospirosis with AKI patients has an incremental CKD risk. However, further studies are warranted to confirm the association and causality.
MO302: The Correlation Between Serum and Urinary NGAL With Redox Biomarkers in Post-Ultramarathon Amateur Athletes
Authors: César Carneiro Loureiro Adriano , Fontenele Nocrato Gabriella , Luis Lima Correia André , Salviano de Matos Robson , Henrique Macedo Pinto Flavio , Cunha Oliveira Ariclécio , Marilande Ceccatto Vania , Soares Fortunato Rodrigo , Pires de Carvalho Denise , Cesar Chaves Nunes Filho Julio , Alice Peixoto Rodrigues Maria , De Francesco Daher Elizabeth
Published: May 2022

BACKGROUND AND AIMS

Few studies have investigated the physiological alterations provoked by ultramarathon competition, particularly those related to redox balance, kidney function and NGAL regulation. A better understanding of the dynamics of these biomarkers during ultramarathons could be useful in the search of new biomarkers in the context of exercise physiology. Thus, the aim of this study was to evaluate the relationship between oxidative stress and NGAL levels in blood and urine of amateur athletes before and after a 100-km ultramarathon.

METHOD

The sample was composed of seven athletes between the ages of 21 and 60 years, submitted to anthropometric evaluation, ergoespirometric testing, urine and blood sampling, biochemical and hormonal measurements, body weight measurement and subjective perception of effort (SPE)—–the perception was evaluated through a scale from 6 to 19 [1], along with verification of competition duration, besides the heart rate (HR), energy expenditure and oxygen consumption (VO2) during the event. The duration, the energy expenditure and the average HR of the competition were measured by a frequency meter (Polar, m200). The data provided was analyzed by the Polar Flow app platform.

RESULTS

The sample had an average BMI of 25.75 ± 3.20, a body fat percentage of 18.54% ± 4.35% and a VO2max of 48.87 ± 4.78. In the pre-competition period, no significant correlations (P > .05) were found between NGAL levels, in blood and urine and blood and urine biomarkers. In relation to the results obtained after competition, there were no significant correlations among of the NGAL levels and plasma biomarkers, except for the serum creatinine level (P <  .05). The average duration of the competition (the average finishing time of the competitors) was 820.60 min (±117.00), during which the mean energy consumption was 2209.72 kcal (+951.97) and energy expenditure was 7837.16 kcal (+195.71), with an average HR of 127.85 (±12.02).

CONCLUSION

The data presented here did not support our initial hypothesis that the ultramarathon would cause oxidative stress and acute kidney injury. In addition, there was no significant correlation between oxidative stress biomarkers and NGAL in serum and urine, which suggests that NGAL is more sensitive to the inflammatory process than ROS levels.
MO309: Serum Sodium Trajectory During AKI and Mortality Risk
Authors: Chávez-Iñiguez Jonathan S , Michell Jorge , Luna-Ramos Andrea , Romero-Muñoz Alexia , Navarro Blackaller Guillermo , Ibarra-Hernandez Margarita , Renoirte Karina , Martínez-Gallardo Gonzalez Alejandro , García-García Guillermo
Published: May 2022

BACKGROUND AND AIMS

Kidneys play a primary role in electrolyte homeostasis. The association between serum sodium level and mortality or the need for kidney replacement therapy during acute kidney injury has not been adequately explored.

METHOD

In this prospective cohort study, we enrolled patients admitted to the Civil Hospital of Guadalajara from August 2017 to March 2020. We divided patients into five groups based on the serum sodium level trajectories up to 10 days following hospitalization: (1) stable normonatremia (serum sodium 135 and 145 mEq/L), (2) fluctuating serum sodium levels (increased/decreased in and out of normonatremia), (3) uncorrected hyponatremia, (4) corrected hyponatremia and (5) uncorrected hypernatremia. We assessed the association of serum sodium trajectories with mortality and the need for kidney replacement therapy (secondary objective).

RESULTS

A total of 288 patients were included. The mean age was 55 ± 18 years,  and 175 (60.7%) were male. Acute kidney injury stage 3 was present in 145 (50.4%). Kidney replacement therapy started in 72 (25%) patients, and 45 (15.6%) died. After adjusting for confounders, 10-day hospital mortality was significantly higher in group 5 {HR, 3.12; [95% confidence interval (95% CI) 1.05–9.24]; P = .03}, and kidney replacement therapy initiation was higher in group 3 (HR, 2.44; 95% CI 1.04– 5.70; P = .03) compared with group 1.

CONCLUSION

In our prospective cohort, most patients with acute kidney injury had alterations in serum sodium. Uncorrected hypernatremia was associated with death, and uncorrected hyponatremia was correlated with the need for kidney replacement therapy.
MO387: Dapagliflozin and Kidney Outcomes in CKD Patients with and without Type 2 Diabetes: Real Life Data (Precursor Announcement)
Authors: Griveas Ioannis
Published: May 2022

BACKGROUND AND AIMS

Globally, diabetes mellitus is a leading cause of kidney disease, with a critical % of patients approaching end-stage kidney disease. At the same time, chronic kidney disease (CKD) is a major contributor to illness and is associated with impaired quality of life. Until recently, the only classes of medication that have been shown to slow a decline in kidney function were angiotensin-converting–enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs). Sodium-glucose cotransporter 2 (SGLT2) inhibitors leading to a reduction in intraglomerular pressure may also preserve kidney function in persons with kidney diseases due to causes other than type 2 diabetes. We investigated the impact of Dapagliflozin on kidney function in CKD patients with and without type 2 diabetes.

METHOD

We monitored kidney function and proteinuria in 10 CKD patients (6 male) with and without type 2 diabetes that received Dapagliflozin. All the participants were required to be receiving a stable dose of an ACE inhibitor or ARB for the study period. All of our patients were clinically stable and there was no need for hospitalization for any reason.

RESULTS

A total of 9/10 patients were diabetic. One patient had focal segmental glomerulosclerosis (FSGS). The mean age of our patients was 70 years (range: 50–80 years) and were monitored for an average period of 21 months (range: 3–72 months). A total of 5 of them were receiving an ACE inhibitor and the other 5 an ARB. The mean eGFR of our patients at the initiation of the study was 49.62 ± 24.35 mL/min, turned to be 41.42 ± 11.34 mL/min (P = NS) after a year and 54.2 ± 26.97 mL/min after 24 months (P = NS). Mean proteinuria of our patients at the initiation of the study was 1573.33 ± 959 mg/24-h, which turned to be 800.33 ± 575.33 mg/24-h (P = 0.122) after a year and 953.25 ± 1062.93 mg/24-h after 24 months (P = NS). No major kidney event happened in any of our patients.

CONCLUSION

Dapagliflozin preserved and slightly increased kidney function in our study population for the duration of our noticing period. Proteinuria, on the other hand, showed downward trends. Our study is in progress, but for sure long-term clinical studies in evaluating the potential benefit of SGLT2i, especially, in non-diabetic CKD patients are required before reaching a meaningful and solid conclusion.
MO406: Evolution of Kidney Damage Associated With Tobacco Consumption
Authors: Tascón Javier , G. Casanova Alfredo , Vicente-Vicente Laura , Pescador Moisés , Prieto Marta , Isabel Morales Martín Ana
Published: May 2022

BACKGROUND AND AIMS

Tobacco consumption is associated with cancer, cardiovascular and respiratory diseases. Although new research relates tobacco use with the development of kidney damage, classic biomarkers, such as plasma creatinine, are not useful to detect this kidney injury [1]. In this sense, innovative diagnostic methods have been developed, such as early biomarkers capable of detecting subclinical kidney damage in the initial stages of the disease [2, 3]. In fact, studies carried out in our laboratory have shown that smoking patients suffer subclinical kidney damage evidenced by the excretion of these urinary biomarkers [4]. The aim of this work was to study the evolution of kidney damage associated with tobacco consumption using these biomarkers after monitoring smoking patients for 2 years.

METHOD

A longitudinal study was carried out that included 150 smokers and 150 non-smokers, without previous kidney damage and risk factors for kidney disease, from a Salamanca Health Centre (Spain). Urine samples were collected at the time of inclusion and after 2 years, and the biomarkers of subclinical kidney damage N-acetyl-β-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1) and total proteins, were quantified using ELISA and colorimetric techniques. The data obtained were analyzed with the statistical software SPSS®.

RESULTS

The results showed a higher excretion of NAG, NGAL, KIM-1 and total proteins in smoker patients with respect to non-smoker ones, measured at baseline, which was maintained after 2 years.

CONCLUSION

Our research suggests that subclinical kidney damage associated with tobacco consumption would remain stable in the 2 years studied and could become chronic and it could constitute the basis for the development of chronic kidney failure.
MO419: Many Faces of Non-Proteinuric CKD—A Cluster-Analysis-Based Observation
Authors: Tanaka Hiroshi
Published: May 2022

BACKGROUND AND AIMS

With a global expansion of the elderly population, physicians encounter a growing number of chronic kidney disease (CKD) patients who have no or only a minimal amount of proteinuria. However, those patients are not clinically uniform; some quickly develop into a progressive loss of kidney function while others stay in their CKD stages for years or even over a few decades. The purpose of this study is to distinguish high-risk non-proteinuric CKD patients whose estimated glomerular filtration rate (eGFR) decline is faster than others.

METHOD

A hospital-wide study with all the laboratory data for a period of 4 years and 2 months was performed. Non-dialysis CKD patients (median eGFR < 60 mL/min/1.73m2) with ≥18 years in whom the eGFR slope was obtained over 731 days or more were retrieved, then the patients with a median of dipstick proteinuria of less than 1+, i.e. (−) or (±), were included for analysis. An eGFR slope/patient was calculated by at least three eGFR measurements over time. Medians were used for each laboratory datum, including dipstick proteinuria and haematuria (both changed to numeric variables, e.g. 1 + into 1.0), blood cell count and serum chemistry. Cluster analyses, hierarchical and k-means, were performed. Statistical analysis was done with R 3.6.0 on Ubuntu. Missing values were imputed by an R package {mice}.

RESULTS

A total of 905 patients [Male: Female = 395:510, age 75.7 ± 10.4 (34–101, median 76 years)] were analysed whose median eGFR was 49.6 ± 9.34 (14.4–59.9, median 52.6) mL/min/1.73m2.

A hierarchical cluster analysis was initially performed so a group count of 5 was suggested to be appropriate. Then performed was a k-means cluster analysis which identified 5 clusters; Cluster 1 was a group of patients with the least progressive CKD, whereas Cluster 5 had the fastest decline in eGFR. Cluster 5 had background features such as higher blood leukocyte count, higher blood urea nitrogen, higher red cell distribution width and less serum albumin, compared with other clusters. Cluster 2 also had modestly higher blood leukocyte count, Cluster 3 had lower haemoglobin, and Cluster 4 had higher serum uric acid; Cluster 3 had a variable speed of decline in eGFR.

CONCLUSION

Non-proteinuric CKD patients are not uniform but are variable in the clinical background as well as in the speed of CKD progression. They are better be treated according to the estimated risks for each patient.