bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1180EVOLUTION OF SERUM B2MICROGLOBULIN LEVELS IN INCIDENT PERITONEAL DIALYSIS PATIENTS
Authors: Barbieri Diego , DELGADO ANDRÉS FELIPE , García-Prieto Ana , Vega Almudena , Abad Esttebanez Soraya , Muñoz de Morales Alejandra , Carbayo Javier , González-Rojas Ángela , Acosta Barrios Adriana , Goicoechea Marian 
Published: June 2020

Abstract

Background and Aims
Retention of ß2microglobulin (ß2M), an uremic toxin in the middle molecular range, has been associated with cardiovascular morbidity and mortality in dialysis patients. Although ß2M levels are usually measured in hemodialysis patients, this practice is not common among peritoneal dialysis (PD) patients. The aim of this study is to evaluate the evolution of serum ß2M levels in incident PD patients.

Method
Prospective, observational study including incident PD patients in our hospital from January 2015 to October 2019. Patients with cardiorrenal syndrome or patients coming from hemodialysis were excluded. Serum ß2M levels were collected before starting PD and during follow up. Weekly KtV, residual renal function and cardiovascular events were also collected during follow up.

Results
We included 30 patients with a mean age of 57 +/- 17 years. 56.3% were male and 15.6% were diabetic. Mean follow up was 19.8 +/- 16.9 months. 18 patients were on continous ambulatory PD and 12 in automated PD. Mean serum ß2M levels before starting PD were 12.8 +/- 6.6 mg/l and they remained stable during follow up (12.9 +/- 5.2 mg/l, 15 +/- 4.2 mg/l, 14.3 +/- 6.9 mg/l, 10.2+/- 4.5 mg/l at month 6, 12, 24 and 36, respectively; p NS). No differences in serum ß2M levels were observed between continous ambulatory PD and automated PD. Serum ß2M levels were inversely and significantly correlated with weekly KtV (r= -0.943; p 0.009) and residual renal function (r= -0.829; p 0.042). One cardiovascular event was recorded during follow up.

Conclusion
Serum ß2M levels remain stable during follow up in our cohort of incident PD patients and is significantly and inversely correlated with weekly KtV and residual renal function. Serum ß2M levels monitoring could be helpful in these patients and would yield important information in this population.
P1183EFFECT OF DECREASE IN GLUCOSE GRADIENT ON CHANGE IN INTRAPERITONEAL VOLUME USING SEGMENTAL BIOIMPEDANCE DURING PET
Authors: Zhu Fansan , Abbas Samer R , Bologa Roxana , Levin Nathan W , Kotanko Peter 
Published: June 2020

Abstract

Background and Aims
The aim of this study was to investigate relationship of glucose gradient dynamics with change in intraperitoneal volume (IPV) measured by segmental bioimpedance analysis (SBIA).

Method
Ten PD patients (age 59±8.8 years, 7 females, 5 Blacks, weight 69.8±12.4 kg) were studied during standard peritoneal equilibrium test (PET). Dialysate glucose concentration (D) was measured hourly throughout the PET. IPV was monitoring continuously using SBIA (Hydra 4200; Zhu et al, Kidney Blood Press Res 2019). Hourly IPV was used to calculate (1) the difference between two conservative hours (ΔIPVt = IPVt+1 - IPVt; t=0, 1, 2 and 3) and (2) the IPVt / IPV0 ratio vs. the concurrent Dt/D0.

Results
IPVs were successfully measured in nine patients (1 high transporter, 6 high-average, 2 low-average). Ultrafiltration volume (UFV, 0.55±0.17 L) at the end of dwell was measured by SBIA. ΔIPV1(0.26±0.17 L) was positive during the first hour of dialysate dwell in 7 patients, their corresponding ΔD1 (calculated as D1 – D0) was -902±278 mg/dL. However, 2 patients (1 high and 1 high-average transporter) showed negative ΔIPV1(-0.13±0.1 L) and a ΔD1 of -861±367 mg/dL. The relationship between IPVt/ IPV0 and Dt/D0 is shown in Fig.1 (a) – (i). The figures indicate the dynamics of IPV and glucose concentration changes in all 9 patients.

Conclusion
Peak IPV appears at different time points and is associated with different glucose gradients. These findings may represent specific, individual characteristics of the peritoneal membrane. Since first hour ΔIPV represents almost half of total UFV at the end of dwell, it could emerge as an important indicator of peritoneal membrane characteristics. Monitoring IPV using SBIA provides a useful tool for further investigation.
P1195ASSESSMENT OF BODY FLUID VOLUME USING THE BIOIMPEDANCE METHOD IN PERITONEAL DIALYSIS PATIENTS
Authors: Moriishi Misaki , Kawanishi Hideki , Shintaku Sadanori , Tsuchiya Shinichiro 
Published: June 2020

Abstract

Background and Aims
ppropriate maintenance of body fluid balance in peritoneal dialysis (PD) patients is important for the amelioration of cardiovascular complications and prognosis. In recent years, the usefulness of body fluid measurement with the bioimpedance method in PD patients has been reported. Meanwhile, peritoneal permeability plays an important role in maintaining body fluid balance in PD patients. In the present study, we examined the correlation between peritoneal permeability and body fluid volume in PD patients.

Method
A total of 58 patients who were undergoing PD at our hospital (42 men and 16 women; mean age, 68 ± 16.2 years; mean dialysis history, 63.5 ± 144.9 months; 25 DM and 35 non-DM patients). Overhydration (OH), total body water (TBW) volume, extracellular water (ECW) volume, and lean tissue mass (LTM) were measured using a body composition analyzer (BCM Fresenius Medical Care Japan). At the same time, peritoneal permeability was measured with fast peritoneal equilibration test to determine the dialysate-to-plasma ratio for creatinine (D/P-Cr), and its correlations with sex, age, age at the time of introduction of dialysis, dialysis history, diabetes history, brain natriuretic peptide (BNP) level, high-sensitivity troponin I (hsTnI) level, blood pressure, body weight, residual kidney function, and ultrafiltration were examined.

Results
The mean OH was 2.53 ± 2.44 L, and 8 patients (13.8%) had an OH of ≤1.1 L. The results of the multivariate analysis revealed that OH positively correlated with the presence or absence of diabetes, ultrafiltration, D/P-Cr, BNP level, hsTnI level, TBW, and ECW, but showed no correlation with sex, dialysis history, age, age at the time of introduction of dialysis, residual renal function, or LTM. Furthermore, the subjects were assigned to D/P-Cr ≥ 0.65 and ≤0.65 groups. In the former, OH correlated with diabetes and male sex by being negatively correlated with age and age at the time of introduction of dialysis and positively correlated with BNP level, hsTnI level, TBW, and ECW. However, in the D/P-Cr ≤ 0.65 group, OH positively correlated with BNP level and ECW.

Conclusion
Our results suggest that youth, complications of DM, and men are at risk for fluid overload in PD patients with increased peritoneal permeability.
P1196AN INIHIBITOR OF KRUPPEL-LIKE FACTOR 5 SUPPRESSES PERITONEAL FIBROSIS IN MICE
Authors: Muta Kumiko , Nakazawa Yuka , Obata Yoko , Inoue Hiro , Torigoe Kenta , Nishino Tomoya 
Published: June 2020

Abstract

Background and Aims
We presented previously that Am80, a synthetic retinoic acid receptor α specific agonist, inhibited the expression of Krüppel-like transcription factor 5 (KLF5) and reduced peritoneal fibrosis in mice. Now, we examined further detail about the mechanism to inhibit peritoneal fibrosis.

Method
Peritoneal fibrosis was induced by intraperitoneal injection of chlorhexidine gluconate (CG) into peritoneal cavity of ICR mice. Am80 was administered orally for every day from the start of CG injection. After 3 weeks of treatment, peritoneal tissues were examined using serial sections by immunohistochemistry to identify what kind of cells expressed KLF5. We also examined the effect of Am80 to inhibit peritoneal fibrosis in vitro.

Results
While KLF5 was expressed in the thickened submesothelial area of CG injected mice, Am80 treatment reduced KLF5 expression and remarkably attenuated peritoneal thickening. The numbers of transforming growth factor β positive cells, α-smooth muscle actin (αSMA) or F4/80 positive cells were significantly decreased in Am80 treated group. KLF5 was expressed in αSMA, F4/80 or CD31 positive cells.

Conclusion
These results indicate the KLF5 might not only associate phenotypical differentiation from fibroblasts to myofibroblasts but also regulate inflammatory responses and angiogenesis in peritoneal fibrosis model. Am80 can suppress peritoneal fibrosis through inhibiting these mechanisms. In vitro experiments are ongoing.
P1199THE IMPORTANCE OF DETERMINING ALPHA-2-MACROGLOBULIN CONCENTRATITON IN PATIENTS ON PERITONEAL DIALYSIS
Authors: Baralic Marko , Bontic Ana , Pavlovic Jelena , Lausevic Mirjana , Gajic Selena , Kravljaca Milica , Brkovic Voin , Milinkovic Marija , Karadzic Vidna , Kezic Aleksandra , Radovic' Milan 
Published: June 2020

Abstract

Background and Aims
To determine the concentration of Alpha-2-macroglobulin (α2M) and its activity in patients treated with peritoneal dialysis (PD) and healthy subjects (H).

Method
a cross-sectional study included 50 PD and 30 H, in which the concentration of active α2M molecules was determined. The measurement is based on covalent binding of α2M and trypsin and zymography with gelatin incorporated into the electrophoretic gel.

Results
The intensity of proteolytic bands seen with native α2M was analyzed in relation to the concentration of α2M in patients with PD with less and / or more than three peritonitis. Linear dependence was only visible in the case of the upper range, which originates from the intact α2M-trypsin complex. The highest coefficient of variation is calculated for the smallest α2M concentration (4.2%). The signal intensities originating from α2M (H) were higher compared to PD, with the PD group being lower in patients with higher peritonitis, and the difference was more pronounced as concentration increased, resulting in a lower slope of dependence. The proposed method can reliably measure the amount of α2M originating in a group H, while the quantification of α2M in PD groups that may have structurally altered α2M can be seen more for condition estimation than for accurate measurements. The zymographic test in this experiment allows us to investigate the relationship of the concentration, structure and function of α2M in different pathological conditions, as well as in the presence of modifying agents that can accompany them.

Conclusion
A simple method for the determination of α2M concentration and function by zymography has been developed, which can be used to examine residual α2M activity after partial denaturation or structural modification due to disease.
P1218OUTCOME OF RENAL REPLACEMENT THERAPY IN LEPTOSPIROSIS ASSOCIATED AKI - PERITONEAL DIALYSIS VS HEMODIALYSIS
Authors: Alex Sunu 
Published: June 2020

Abstract

Background and Aims
Leptospirosis is a common zoonotic disease and acute kidney injury(AKI) is very commonly associated with it, often seen as a marker of disease severity. Renal replacement therapy(RRT) is often required in patients with clinical indications like uremia, oliguria, pulmonary edema and hyperkalemia. The two classical modalities employed for RRT are hemodialysis and peritoneal dialysis. We designed this study to evaluate the clinical outcome among patients with leptospirosis associated AKI requiring dialysis.

Method:
Basic clinical and demographic parameters of our patients were studied. The dialysis modality for each patient was decided based on their predominant clinical presentation. The duration of dialysis dependency and hospitalization along with final clinical outcome in terms of renal recovery or death were recorded. Appropriate statistical methods were used for analysis of results

Results
Thirty two patients underwent renal replacement therapy for leptospirosis associated AKI. Among them 22 received hemodialysis and 10 received peritoneal dialysis. Mortality in our group was 12.5%. Multiorgan involvement, need for mechanical ventilation and oliguric AKI were observed to be predictors of mortality along with hyperbilirubinemia, hypoalbuminemia, hyperkalemia and elevated creatinine phosphokinase levels. Peritoneal dialysis was observed to be associated with a shorter duration of dialysis dependency and hospitalization, however no significant impact on mortality was noticed.

Conclusion
Leptospirosis is a disease of great epidemiological significance in our part of the county. Prompt initiation of RRT in indicated patients leads to an acceptable clinical outcome with good renal recovery. Peritoneal dialysis is slowly losing popularity, which may be revived with proper training of medical personnel and good patient selection.
P1219SLEEP AND PERITONEAL DIALYSIS
Authors: Menezes Maria Do Mar , Ferreira Ana Carina , Fernandes Vasco , Nolasco Fernando 
Published: June 2020

Abstract

Background and Aims
Sleep is considered a basic human need according to Maslow. It helps in the individual‘s physical and psychological recovery. Nowadays, sleep disturbances are an increasingly frequent reality and they interfere negatively with quality of life. Poor sleep quality has a negative impact on the individual’s health (attention, memory, Diabetes, Hypertension, immune system depression, mortality). Peritoneal dialysis (PD) may be an additional insult that is disturbing to its quality.
The aim of the study was to assess the quality and health of sleep in PD patients.

Method
We carried out a single-center study in 35 prevalent PD patients. We used the Pittsburgh Sleep Quality Scale (PSQI), which evaluates seven components (subjective quality, latency, duration, usual efficiency of sleep and sleep changes, medication use and daytime dysfunction) and which considers a good sleep quality when PSQI ≤5. We used a sleep health scale assessed by SATED PT (validated for the Portuguese population) and which considers 0 poor sleep health and 30 good sleep health.
Each patient answered both PSQI and SATED-PT questionnaires. Demographic and clinical variables were analyzed. Continuous variables are presented as means (standard deviation) or medians (interquartile range), depending on normality; categorical as frequencies. Univariate analysis was performed. STATA software was used and p &lt;0.05 was considered significant.

Results
Our cohort has 18 (51%) women, 34 (97%) Caucasians, mean age 49 ± 15 years, median dialysis time of 20.5 (8-33) months; 4 (11%) had a history of attempted construction of arteriovenous fistula and 7 underwent a short period of hemodialysis before starting PD (median 60 months). Charlson's median score was 4 (2-5). 21 patients (60%) were on automated PD, 14 on manual, 18 on Baxter system and 17 on Fresenius system.
Regarding sleep quality, the average obtained on the PSQI scale was 7 ± 3.4 and 60% had values&gt; 5. We found no correlations between these parameters and the demographic and clinical variables studied. We found that 36.4% of patients wake up earlier than expected, 43.8% get up to go to the bathroom, 30% have nightmares, 20% have pain while sleeping, 23.5% depend on sleeping medication, 34.3% have restless legs, all these parameters in a frequency greater than 3x week.
Regarding sleep health, the mean of the SATED scale was 22 ± 5.8 and only 2 patients (5.7%) had values &lt;10. We found a negative correlation between the SATED value and time on dialysis (p = 0.03) and a positive correlation with BMI (p = 0.04). Only 1 patient with normal values lived alone (p = 0.03).
None of these scales (and respective sub-scales) correlated with the PD modality.

Conclusion
In conclusion, the majority of our patients have poor sleep quality but the small sample size limits further conclusions from this study.
P1222CLINICAL OUTCOMES AND MORTALITY IN PERITONEAL DIALYSIS: WHAT ABOUT ELDERLY PATIENTS?
Authors: Ayed Amel , Ben salem Meriem , Haouala Faouzi , BEN BETTAIEB Mohamed Zied , Chemli Imen , Letaief Ahmed , Hammouda Mouna , Sabra Aloui , Skhiri Habib 
Published: June 2020

Abstract

Background and Aims
The burden of elderly patients initiating dialysis regimens is increasing around the world due to rising life expectancies. However, little is known regarding the results of elderly patients treated with peritoneal dialysis (PD). Thus, the aim of this study is to determine the clinical outcomes and to evaluate the survival rates as well as the predictors of mortality among this group.

Method
This is a retrospective descriptive study performed in the PD unit in Monastir - Tunisia from 1990 till december 2017. All patients aged ≥ 65 years were included. The epidemiological and clinico-biological data as well as the complications were collected. Overall and technique survival rates were analyzed.

Results
Of the total 304 patients who began PD during the study period, 55 met our inclusion criteria. The prevalence of elderly patients was 18.1%. The mean age was 73 ± 5 years (65-86) with a male predominance (65.5%). Our patients were diabetic, hypertensive and cardiac in 45%, 64% and 33% respectively. Histories of hemodialysis necessity prior to PD use were present in 43.6 % of the patients. PD exchanges were performed by a member of the family in for 87.3% of cases and they often choose the CAPD (80%). Peritonitis rate was 17.92 patient-months. During the follow-up period, transfers to hemodialysis (15 patients) and death (39 patients) were the most common causes of withdrawal from PD. Frequent peritonitis, ultrafiltration failure warranted transfers to hemodialysis in 27% and 40% respectively. Causes of death were mostly not related to PD (87.2%) and they included cardiovascular events (28.2%), sepsis (20.5%) as well as neoplasma (15.4%). The mean patient survival time was 16.4 years versus 23.3 years in the other group. The survival rates were 96%, 93.5%, 86.9% and 76.6% at 1, 3, 5 and 10 years after peritoneal dialysis initiation, respectively. Advanced age (p 0.04) and occurrence of peritonitis (p 0.02) were predictors of mortality. The mean technique survival duration was 48.6±2.7 months. The technique survival rates were 78%, 62.6%, 53.5% and 41% at 1, 2, 3 and 4 years, respectively. Peritonitis was the primordial predictor of technique survival.

Conclusion
Mortality among elderly patients seems to be higher in our study. Infectious complications and cardiovascular events were the main causes of death. Advanced age and occurence of peritonitis represented the main predictive factors of mortality.
P1225PREVALENCE AND PROGNOSTIC SIGNIFICANCE OF DIABETES IN PERITONEAL DIALYSIS: TECHNIQUE AND PATIENT SURVIVAL
Authors: Ayed Amel , Ben salem Meriem , Haouala Faouzi , Sinda Ayed , Chemli Imen , Letaief Ahmed , Jafar Ines , Hammouda Mouna , Sabra Aloui , Skhiri Habib 
Published: June 2020

Abstract

Background and Aims
Diabetes in recent years is climbing up as the number one cause of chronic kidney disease (CKD). Clinical statistics suggest that Diabetics on peritoneal dialysis (PD) tend to have a poorer prognosis than others.
Thus, the aim of this study is to determine the clinical outcomes and to evaluate the survival rates as well as the predictors of mortality among this group.

Method
It‘s a retrospective study carried out in the nephrology Department of Fattouma Bourguiba Hospital (Monastir, Tunisia) from 1990 to 2017 including 304 PD patients. We compared two groups: diabetic and non diabetic patients in term of survival and factors in correlation.

Results
A total of 110 diabetic versus 194 non diabetic patients were reported. The mean age of diabetic group was 55.14 ± 15 years with a sex ratio 2.33 (men/women). In addition to diabetes, comorbid diseases included hypertension (47.3%) and cardiopathy (32.7%). The mean Charlson score of diabetic group was 5.22±1.5 versus 2.72±1.23 in the other group. A total of 62.7% (n=69) of the patients performed PD with the help of another person mostly a member of the family. The PD modality often used was CAPD (71%). Only six patients made a compulsory choice to begin PD due to vascular access while sixty diabetics chose PD to maintain autonomy (54.5%). During the follow-up period, transfers to hemodialysis (40.9%) and death (53.6%) were the most common cause of withdrawal from PD. In total, 45 patients were transferred to hemodialysis because of infectious complications (31%), Ultrafiltration failure (31%), catheter dysfunction (27%), and psychological intolerance (11%). The death was unrelated to PD in 83% of cases mostly due to considerable burden of cardiovascular events (23 patients). The median survival of the diabetic patients was 15.8 years versus 20.8 years in non diabetic ones with significant difference between the 2 groups (p=0.0001). Diabetes was associated with worse prognosis (OR:147, p=0.0001). The median survival adjusted to the diabetes group was 180 months. Kaplan–Meier analysis showed that diabetes was associated with a significant increase in mortality (p=0.006). Global median survival of the technique was estimated to 68 months (95%, IC [47 ,90]), and it was correlated to the presence or the absence of diabetes. In fact, the technique survival among diabetic patients was estimated to 80% after 12 years and 25% after 20 years whereas, in the other group it approaches 90% and 35% respectively.

Conclusion
This study confirms the pejorative impact of diabetes in the technique and patient survival in DP. So, it stresses the importance of organizing appropriate care upstream to prevent the development of cardiovascular morbidities and infectious complications in DP.
P1226MITOCHONIC ACID 5 (MA-5) AMELIORATES CG-INDUCED PERITONEAL FIBROSIS IN MICE
Authors: Inoue Hiro , Obata Yoko , Suzuki Takehiro , Torigoe Miki , Torigoe Kenta , Suzuki Chitose , Abe Takaaki , Koji Takehiko , Nishino Tomoya 
Published: June 2020

Abstract

Background and Aims
Peritoneal fibrosis is one of important complications induced by long-term peritoneal dialysis. Mitochondrial dysfunction causes an increase of oxidative stress and depletion of ATP. Thus, it may be associated with a variety of disease including fibrosis in several organs. Recently, mitochonic acid 5 (MA-5) was synthesized and its therapeutic potential for mitochondrial dysfunction in kidney disease models has been reported. In this study, we investigated the effect of MA-5 for peritoneal fibrosis model in mice.

Method
Peritoneal fibrosis was induced by intraperitoneal injection of chlorhexidine gluconate (CG) every other day for 3 weeks in C57/BL6 mice. MA-5 was administered at 2 mg/kg by gavage every day from the initiation of CG injection. Control mice received only a vehicle (distilled water). After 3 weeks of treatment, the animals were sacrificed and the peritoneal tissues were collected. The peritoneal sections were stained with Masson’s trichrome for light microscopic examination and the fibrotic thickening of parietal peritoneum was measured on the randomly selected different regions on each section. The expressions of F4/80, which is a marker of macrophages, monocyte chemotactic protein 1 (MCP1), α-smooth muscle actin (α-SMA), and transforming growth factor-β (TGF-β) were evaluated by immunohistochemistry.

Results
The fibrotic thickening of parietal peritoneum was significantly attenuated in MA-5 treated mice compared with control mice (the thickness of submesothelial area: 100.24 +/- 13.67 vs 54.78 +/- 7.43 μm (p&lt;0.05)). The numbers of TGF-β positive cells, α-SMA positive cells, MCP1 positive cells and infiltrating macrophages were significantly decreased in MA-5 treated mice than those in control mice.

Conclusion
These results suggest that MA-5 may have a therapeutic potential in the progression of peritoneal fibrosis as well as kidney disease models.