bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0128COMPARISON OF ULTRASTRUCTURE FEATURES BETWEEN PATIENTS WITH MERCURY-ASSOCIATED MEMBRANOUS NEPHROPATHY AND IDIOPATHIC MEMBRANOUS NEPHROPATHY
Authors: Qin Aibo , Lin Zishan , Zhou Fude , Zhao Minghui , Wang Suxia , Cui Zhao 
Published: June 2020

Abstract

Background and Aims
Prolonged exposure to mercury can cause membranous nephropathy. The routine clinicopathological features of mercury-associated membranous nephropathy (M-MN) and idiopathic membranous nephropathy (I-MN) are similar. The difference in ultrastructure between them was observed clinically. The current study retrospectively compared the ultrastructure features, clinical and pathological data, treatment and prognosis of patients with M-MN and I-MN.

Method
Thirteen patients with M-MN and 13 patients with I-MN were enrolled. The clinical and pathological data were retrospectively collected. Electron micrographs of glomerular capillaries were taken and the foot process width (FPW) and the number of foot processes per 10 μm glomerular basement membrane (GBM) were measured. The presence and location of electron-dense deposits in mesangium and subendothelial region were recorded.

Results
Patients with M-MN were younger (38.7±8.5 versus 45.8±5.7 years, P=0.020), with a shorter duration of complete remission (9.0±6.1 versus 20.3±9.8 months, P=0.004) and lower relapse rate (0% versus 45.5%, P=0.014) than patients with I-MN. As to ultrastructure, patients with M-MN had lower levels of FPW [974.3nm (range 791.2∼1504.4) versus 2370.6nm (range 2219.4∼2559.1), P=0.001, Figure 1], more foot processes per 10 μm GBM [8.1 (range 5.2∼10.0) versus 3.3 (range 3.1∼3.5), P=0.001], and higher ratio of mesangial electron-dense deposits (41.7% versus 0, P=0.015, Figure 2) than those with I-MN. Multivariate analysis showed that type of disease (M-MN or I-MN) and stage of MN (stageIor stageIIand above) were the two only determinants of FPW. FPW over 1645 nm differentiated M-MN from I-MN with high sensitivity (92.3%) and specificity (83.3%).

Conclusion
The quantitative analysis of foot processes may offer a potential tool to distinguish M-MN from I-MN. Better prognosis in patients with M-MN may be related to minor podocyte damage.
P0132DIAGNOSIS OF HYPEROXALURIA FROM RENAL BIOPSY
Authors: Omrane Marwa , Aoudia Raja , Ounissi Mondher , Sellami Nada , Jerbi Mouna , Gaied Hanene , Kaaroud Hayet , Harzallah Amel , Ben Abdallah Taieb , Goucha Rim 
Published: June 2020

Abstract

Background and Aims
Crystal-induced kidney disease refers to kidney injury caused by intratubular crystal deposition. The most common forms of crystalline nephropathy encountered in renal pathology are nephrocalcinosis and oxalate nephropathy. The purpose of our study is to determine the epidemiological and clinical characteristics of hyperoxaluria diagnosed from renal biopsy.

Method
We retrospectively reviewed all kidney biopsy specimens evaluated at renal pathology laboratory, from 1976 to 2019. The biopsy specimens were received from multiple medical department and medical centers. We studied 8900 biopsy specimens and we were focused on patients whose diagnosis of hyperoxaluria was made from renal biopsy

Results
We identified 25 cases (15 children and 10 adults) with a sex ratio H / F of 0.9. Mean age at diagnosis was 17.2 years old [4 months-73 years old]. Most patients were offspring of consanguineous mating (14 of 25) with intermarriage of first-degree cousins being the most common pattern. A family history of chronic kidney disease was found in 13 patients: indeterminated nephropathy (n = 6) and renal stone (n = 5) and primary hyperoxaluria (n=2). Among our patients, five had a history of urolithiasis. One patient had a history of chronic diarrhea related to Crohn's disease and one patient had a history of cephalic pancreatectomy and ileal resection. Initial symptoms and signs were dominated by renal failure (n = 25) with mean creatinine of 789.5 μmol / l [306-1832μmol / l], associated with proteinuria in 10 patients and hematuria in 11 patients. Arterial hypertension was present in 4 patients. Oligo anuria was reported in 4 patients without dilation of the urinary excretory pathways. In our patients, the diagnosis of crystalin nephropathy was revealed by renal biopsy. In one case, the diagnosis was made after renal transplant. In 4 cases the diagnosis was made by postmortem kidney biopsy. In all cases, the kidney biopsy specimen showed extensive intratubular crystal deposition and tubulointerstitial mononuclear cell infiltration with features of tubular injury and interstitial fibrosis. Examination of histologic slides showed colorless refractile crystals of polygonal appearance. Multicolored birefringence under polarized light identified these crystals as calcium oxalate. After different investigations (genetic and biological analysis), the diagnosis of hyperoxaluria was confirmed. Hyperoxaluria was primary in 23 patients and secondary in 2 patients.

Conclusion
Hyperoxaluria is a rare condition, often serious, involving renal prognosis and sometimes life-threatening, especially in early-onset forms. Early diagnosis and treatment should be done as soon as possible to slow the progression to end-stage renal failure. In patients with renal insufficiency, the diagnosis of hyperoxaluria is difficult. Renal biopsy can help when clinical and radiological data are not sufficient.
P0139RETROSPECTIVE ANALYSIS OF RENAL PATHOLOGY AND CYTOGENETIC EXAMINATION IN PATIENTS WITH MULTIPLE MYELOMA WITH RENAL IMPAIRMENT
Authors: Chen Ying , Lyu Jia 
Published: June 2020

Abstract

Background and Aims
Renal impairment is one of the common implications in multiple myeloma. But the relationships between the renal pathology and cytogenetic features are not fully understood. To explore the renal pathology and cytogenetic features in patients of multiple myeloma with renal impairment.

Method
Retrospective of our hospital from January 2009 to January 2019, newly diagnosed multiple myeloma patients with renal impairment. The relationship between the results of Fluorescence in situ hybridization (FISH) and renal pathological findings was analyzed. Statistical analysis was performed using SPSS 20.0.

Results
A total of 20 patients underwent renal biopsy, included 12 males and 8 females. FISH result showed that there were 7 cases of interstitial nephritis, 3 of them were negative for FISH, and the remaining that IgH rearrangement, 1q21 amplification, RB1 deletion, D13S319 deletion, and P53 deletion detection rates were 42.86%, 28.57%, 28.57%, 28.57% and 14.29%. The incidence was lower, which was statistically significant (P&lt;0.01). There were 6 cases of cast nephropathy, IgH rearrangement, 1q21 amplification, RB1 deletion, D13S319 deletion, and P53 deletion detection rates were 66.67%, 50%, 66.67%, 50% and 0%. Compared with the total probe positive rate, there was no statistical significance (P&gt;0.05). There were 4 cases of acute tubular necrosis, IgH rearrangement, 1q21 amplification, RB1 deletion, D13S319 deletion, and P53 deletion detection rates were 100%, 50%, 50%, 25% and 25%, respectively. Compared with the total probe positive rate, there was no statistical significance (P&gt;0.05). There are 1 of amyloidosis and 1 of tubular nephropathy with amyloidosis were positive for 5 probes. One case of light chain deposition disease was positive for RB1 gene deletion + D13S319 gene deletion.

Conclusion
FISH in patients with different renal pathological changes is characterized by heterogeneity, which can be used to predict the risk of renal damage and speculate on possible renal pathological types to guide prognosis.
P0140RENAL PATHOLOGICAL CHANGES AFTER SUCCESSFUL TREATMENT OF LCDD USING CYCLOPHOSPHAMIDE, THALIDOMIDE AND DEXAMETHASONE: A CASE REPORT
Authors: Wang Yan , Wang Di , Sun Shiren 
Published: June 2020

Abstract

Background and Aims
The combined of cyclophosphamide, thalidomide and dexamethasone (CTD) haven’t reported in treatment of LCDD, and how the renal pathologic injury changes after treatment is still unknown.

Method
Here we descript a LCDD patients who undergone repeated renal biopsy after treatment.

Results
We report a 56-year-old woman presented with nephrotic syndrome, impaired renal function, and serum M-protein of IgG lambda. First renal biopsy showed severe nodular glomerulosclerosis with single lambda light chain linear deposit along GBM. The patient treated with 14 cycles CTD regimen, and reached the complete hematologic response and renal response. At the 29 months of follow up, the repeated biopsy showed the glomerular nodular sclerosis attenuated significantly, only trace granular electron-dense deposits along inner side of GBM.(Details in figure 1: The pathological findings of the first (A-D) and second (E-H) renal biopsy.)

Conclusion
This case highlights the hematologic response not only can improve the renal function, but also alleviate the renal nodular sclerosis. And the low-cost regimen, CTD, maybe a good choice.
P0152EFFECT OF LOSARTAN ON AMBULATORY SHORT-TERM BLOOD PRESSURE VARIABILITY AND CARDIOVASCULAR REMODELING IN HYPERTENSIVE PATIENTS ON HEMODIALYSIS
Authors: Azuma Koichi 
Published: June 2020

Abstract

Background and Aims
Previous studies have shown increases in ambulatory short-term blood pressure (BP) variability to be related to cardiovascular disease. In this study, we examined whether an angiotensin II type 1 receptor blocker losartan would improve ambulatory short-term BP variability in hypertensive patients on hemodialysis.

Method
40 hypertensive patients on hemodialysis therapy were randomly assigned to the losartan treatment group (n=20) or the control treatment group (n=20). At baseline and 6 and 12 months after the treatment, 24-h ambulatory BP monitoring was performed. Echocardiography and measurements of brachial-ankle pulse wave velocity (baPWV) and biochemical parameters were also performed before and after therapy.

Results
After 6- and 12-months of treatment, nighttime short-term BP variability, assessed on the basis of the coefficient of variation of ambulatory BP, was significantly decreased in the losartan group, but remained unchanged in the control group. Compared with the control group, losartan significantly decreased left ventricular mass index (LVMI), baPWV, and the plasma levels of brain natriuretic peptide and advanced glycation end products (AGE). Furthermore, multiple regression analysis showed significant correlations between changes in LVMI and changes in nighttime short-term BP variability, as well as between changes in LVMI and changes in the plasma levels of AGE.

Conclusion
These results suggest that losartan is beneficial for the suppression of pathological cardiovascular remodeling though its inhibitory effect on ambulatory short-term BP variability during nighttime.
P0156SHORT-TERM BLOOD PRESSURE VARIABILITY IN DIABETIC AND NON-DIABETIC PATIENTS WITH CKD STAGE 2, 3A, 3B AND 4
Authors: Schoina Maria , Loutradis Charalampos , Minopoulou Ioanna , Theodorakopoulou Marieta , Dimitroulas Theodoros , Doumas Michael , Garyfallos Alexandros , Karagiannis Asterios , Papagianni Aikaterini , Sarafidis Panteleimon 
Published: June 2020

Abstract

Background and Aims
Blood pressure variability (BPV) is an important risk factor for cardiovascular events and mortality in patients with chronic kidney disease (CKD). Previous evidence suggests that BPV is gradually increasing across CKD stages. Whether type 2 diabetes mellitus (DM) is an additional risk factor for increased BPV has never been studied. The aim of this study is to examine in comparison BPV in diabetic and non-diabetic patients with CKD.

Method
We included 48 diabetic and 48 non-diabetic adult patients (&gt;18 years) with CKD (eGFR: &lt;90 και ≥15mL/min/1.73m2), matched in a 1:1 ratio for age, sex and eGFR within each CKD stage (2, 3a, 3b and 4). All patients underwent 24-hour ambulatory blood pressure (BP) measurement with the Mobil-O-Graph device. Brachial BP variability was calculated with validated formulas. We calculated standard deviation (SD), weighted SD (wSD), coefficient of variation (CV), and average real variability (ARV) of BP during the 24-hour, day- and night-time periods with validated formulas.

Results
In total population, ambulatory systolic BP (SBP) levels were significantly higher in diabetics compared to non-diabetic counterparts in all studied periods. No significant differences were evidence for ambulatory diastolic BP (DBP) in total or across CKD stages. In total, 24-hour SBP SD (15.43±4.34 vs 13.38±3.35, p=0.011), wSD (14.41±4.11 vs 12.53±3.19, p=0.014) and ARV (10.94±2.75 vs 9.46±2.10, p=0.004) were higher in patients with DM compared to those without DM. In addition, 24hour DBP SD (11.04±2.39 vs 9.80±2.28, p=0.010), wSD (10.30±2.52vs 9.05±1.99, p=0.008), CV (14.77±3.05 vs 13.14±2.96, p=0.009) and ARV (8.23±2.10 vs 7.10±1.33, p=0.002) were again different between groups. Across CKD stages 2 and 3a, BPV indices were insignificantly higher in patients with DM. In CKD Stage 3b, 24-hour SBP-SD (16.30±4.52 vs 11.35±2.62, p=0.003), wSD (15.42±4.54 vs 10.77±2.30, p=0.004), ARV (12.46±3.19 vs 8.34±2.07, p=0.001) and 24-hour DBP-CV (14.84±3.63 vs 12.18±1.91, p=0.035) were higher in diabetic compared to non-diabetic patients. In contrast, no difference between groups existed in CKD Stage 4.

Conclusion
Patients with DM present increased BPV in CKD Stages 2, 3a and 3b (moderately impaired renal function). This difference is not apparent in patients with advanced CKD at Stage 4.
P0160HOW TO MANAGE INTRADIALYTIC HYPERTENSION?
Authors: BENHAMOU Ramia , ELASSAS Hajar , Chettati Meriem , Fadili Wafaa , Laouad Inass 
Published: June 2020

Abstract

Background and Aims
Hypertension in subjects on long term dialysis is frequent. Intradialytic hypertension affects up to 20% of hemodialysis patients and occurs more frequently in patients who are older, have lower dry weights, are prescribed more antihypertensive medications. Elevated BP detected by home or ambulatory BP monitoring is clearly associated with shorter survival.

Method
We realized a cross sectional study in two hemodialysis center patients during october 2019. We compared two groups of patients: group 1 with HTA (HTA+) and the second without (HTA-). Prevalence of hypertension intra dialysis (increase in systolic BP &gt; 15mmHg during dialysis) was determined by blood pressure recordings every thirty minutes during hemodialysis. We collect information about prescription patients (bolus dose of IV nicardipine or administration of captopril orally) after HTA inicident. We collected and analyzed datas of 1476 hemodialysis sessions for 123 patients.

Results
The mean age of your patients was 46 ± 26,3 years with a female predominance.
The mean duration of hemodialysis was 9,8 years. The initial nephropathy was hypertensive in 14,6%. 44,7% (n=55) patients used at least one antihypertensive treatment (HTA+ group), in 72,7% calcic inhibitor. Hypertension crisis in HTA+ group was higher than HTA- group, respectively 37,9% and 4,7% (p=0,0002).
Concerning HTA+ group, in 9,35% of cases patients receveid IV bolus of nicardipine, 7,9% captopril and 17,9% of cases have not receveid any antihypertensive medication. In HTA- group they receveid IV nicardipine on only 2,5% cases and no drugs in half of all cases.
Patients who were older and receive erythropoietin-stimulating agents were more likely to exhibit an increase in SPB despite similar amounts of ultrafiltration in each groups.
It appears HTA- group had better control of hypertension crisis in 77,5% versus 65,5% in HTA+ group, at 20minutes of crisis (p= 0,004). Administration of captopril in the both group allowed better control of hypertension 90% (HTA+ group) and 84,2%(HTA- group). Hypertension crisis was more controlled in group with high ultrafiltration rate with administration of captopril .

Conclusion
Use of ACE inhibitors during dialysis to manage hypertension crisis appears a great solution and confirm hypothesis of activation of the renin–angiotensin–aldosterone system. Treatment of intradialytic hypertension may include careful attention to dry weight, avoidance of dialyzable antihypertensive medications, limiting the use of high calcium dialysate, achieving adequate sodium solute removal during hemodialysis, and using medications which inhibit the rennin-angiotensin-aldosterone system or which lower endothelin 1.
P0164AMBULATORY BLOOD PRESSURE MONITORING AND CLINICAL SIGNIFICANCE IN PATIENTS WITH GASTROESOPHAGIAL REFLUX DISEASE
Authors: Ozdemir Arabaci Sule , Kurultak Ilhan , Tezel Ahmet , Üstündağ Sedat 
Published: June 2020

Abstract

Background and Aims
The patients with gastro-esophageal reflux disease (GERD) have distortion of sympathetic and parasympathetic components of the autonomic nervous system. The increase in sympathetic activity results in hyperkinetic circulation with peripheral vasoconstrictor and tachycardia and also regulates blood pressure with increase of renin in kidneys. We aimed to elucidate the patterns of pulse pressure in GERD patients, and also to investigate possible relationship between patterns of pulse pressure and laboratory/urinary parameters in adults

Method
The ambulatory blood pressure measuring was performed in all cases. Fifty patients in the reflux group and fifty individuals in the control group were included. Blood and urine specimens were examined. The individuals with cardiovascular disease, hypertension, malignancy, asthma disease, gastric peptic ulcer, hepatitis disease, tuberculosis, gastrointestinal disease excluding reflux, cerebrovascular disease, vasculitic disease, chronic alcohol usage, drugs with affect on autonomic system usage were excluded from study.

Results
We found lower diastolic blood pressure and increased pulse pressure values in reflux group and these were significant statistically. When patients were evaluated separately as men and women, this situation was found to be more pronounced in women. The decrease in serum potassium, chloride levels and the increase in serum LDL cholesterol, triglyceride levels in reflux group considered as statistically significant. Urinary parameters were similar in both groups. Non-dipper pattern found more common in reflux group, but considered as insignificant. The results were summarized in Table 1 and Table 2.

Conclusion
This study supports the hypothesis that increased vascular risk may be present in patients with GERD. Thus, perhaps a new population at risk for cardiovascular disease will be identified and mortality rates will able to decrease with early clinical evaluation.
P0167HYPERTENSION IN PATIENTS WITH LUPUS NEPHRITIS
Authors: Omrane Marwa , Aoudia Raja , Ounissi Mondher , Najar Mariem , Jerbi Mouna , Gaied Hanene , Barbouche Samia , Gorsane Imen , Ben Abdallah Taieb , Goucha Rim 
Published: June 2020

Abstract

Background and Aims
Hypertension is a common manifestation during systemic lupus erythematosus (SLE). Its mechanism is multifactorial and microthromboses of renal arterioles seem to be the most important mechanism. The objective of our study is to identify the histological and evolutionary characteristics of patients with lupus nephritis (LN) presenting with hypertension.

Method
A retrospective study of 85 patients followed for LES with lupus nephritis documented by a renal biopsy collected in 17 years and presenting with hypertension.

Results
Among 174 patients with LN, eighty-five (48.58%) are hypertensive. A sex ratio F / H of 6.08. The mean age of LN diagnosis was 36.4 years old [13 -75 years old]. The average time to onset of hypertension was 25.8 months [0-204 months]. Malignant hypertension was present in 12% of patients. Antiphospholipid Antibody Syndrome (APLS) was found in 35.3% of cases. Renal biopsy showed LN class II in 2 cases, class III in 8 cases, class IV in 43 cases, class V isolated in 8 cases and class VI in 3 cases. Vascular lesions were arteriolosclerosis in 40% of cases and thrombotic microangiopathy (TMA) lesions in 17.6% of cases. The treatment was essentially based on blockers of the renin angiotensin system, either as monotherapy or in combination with calcium channel blockers, beta blockers or central antihypertensives. The evolution was marked by the occurrence of cerebrovascular accidents associated in 7 cases with APLS and coronary artery disease in 2 cases. Renal evolution was marked by total and durable remission in 27.5%, chronic renal disease in 31.7%, and end-stage renal failure in 40.8% of cases. Blood pressure was balanced in 40,5 % of cases and unbalanced in 59,5% of cases.

Conclusion
In our lupus patients, hypertension was common, associated with severe glomerular and vascular lesions and a rather severe renal prognosis.
P0169DYSFUNCTION OF ABCG2, URATE TRANSPORTER, IS RELATED WITH UROLITHIASIS
Authors: Ohashi Yuki , Yamaguchi Satoshi , Matsuo Hirotaka , Hosoyamada Makoto , Ichida Kimiyoshi 
Published: June 2020

Abstract

Background and Aims
Urolithiasis is one of the rapidly increasing diseases in developed countries. It has been reported that urolithiasis is related with lifestyles, diet, obesity, climate and chronic diseases including hyperuricemia, diabetes mellitus, metabolic syndrome, chronic kidney disease et cetera. Among them, hyperuricemia is the leading cause of urolithiasis. ATP–binding cassette subfamily G member 2 (ABCG2), urate transporter, excretes uric acid in the kidney and the intestinal tract and ABCG2 dysfunction increases a risk of hyperuricemia. In this study, we investigated the estimated ABCG2 function by common two dysfunctional variants, Q126X (rs72552713) and Q141K (rs2231142), in patients with urolithiasis, and we evaluated the relation between urolithiasis and ABCG2 dysfunction.

Method
One hundred and ninety-seven urolithiasis patients without gout (150 males and 47 females) were enrolled. Q126X totally abolishes ABCG2 function, while Q141K reduces its function by about 50%. Since these two SNPs do not link each other and two SNPs do not exist on same chromosome, these two are regarded as independent risks. Namely, based on the genotype of Q126X and Q141K, it can be divided into three categories: a full functional group, a 75% functional group and a ≦50% functional group. Serum uric acid levels and amount of urinary uric acid were measured. Renal uric acid handling of the patients was classified into renal uric acid underexcretion type or renal uric acid overload type based on uric acid clearance and amount of urinary uric acid. Stone composition was analysed, if it had been possible.

Results
ABCG2 function of the patients was evaluated as follows: 82 patients, ABCG2 full function (41.6%); 78 patients, 75% function (39.6%); 37 patients, ≦50% function (18.8%). 155 patients were classified into renal uric acid underexcretion type, 13 patients were classified into renal uric acid overload type and 2 patients were classified into normal type (27 patients have not had 24-hour urine biochemical test). Stone composition analysis was performed for 136 patients; calcium oxalate stone was identified in 107 patients and uric acid stone in 29 patients. In this study, 58.4 % of the patients with urolithiasis had some ABCG2 dysfunction as against 49.8 % of the healthy individuals previously reported (p=0.0246). In addition, the ratio of subjects with urolithiasis having 50% or less of ABCG2 function was higher than healthy individuals significantly (OR=1.773, p=0.007). The high ratio of ABCG2 dysfunctional patients with urolithiasis suggested that ABCG2 dysfunction is a risk factor for urolithiasis. In the patients with urolithiasis, renal uric acid underexcretion type accounted for about 90% of the patients. This means that this type accelerated urolithiasis as well as hyperuricosuria.

Conclusion
ABCG2 dysfunction and renal uric acid underexcretion type were suggested to be a risk factor for urolithiasis.