bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1589COMPARISON OF NUTRITIONAL STATUS IN HEMODIALYSIS PATIENTS WITH AND WITHOUT ANXIETY/DEPRESSION
Authors: Akagun Tulin , Türkmen Sembol , Arslan Aylin 
Published: June 2020

Abstract

Background and Aims
Approximately one-third of all dialysis patients have mild to moderate malnutrition, while 6-8% have severe malnutrition. In patienst receiving maintenance hemodialysis, a low serum prealbumin is an indicator of malnutrition. Depression and anxiety are the most common psychological disorders in patients undergoing hemodialysis. The aim of this study was to evaluate the nutrional status in our hemodialysis patients and its association with anxiety and depression.

Method
In our cross-sectional study, 61 hemodialysis patients were evaluated with mini nutrional assessment (MNA) form, Beck anxiety/depression scale, clinical and laboratory data.

Results
Of 61 hemodialysis patients; 37 were male (mean age 60,8±11.7). 11.5 % of patients were malnourished. Severe depression and anxiety rates were 14.8% and 21.3% respectively. The clinical parameters of hemodialysis patients are shown in Table-1 and clinical and laboratory findings of the hemodialysis patients according to MNA scores are shown in Table-2. Malnourished patients and patients who were at risk of malnutrition; had lower urea, creatinine and prealbumin levels.

Conclusion
Anxiety was more prevalant in malnourished hemodialysis patients with lower prealbumin levels.

Figure-1
Clinical and laboratory findings of hemodialysis patients (n=61).
Figure-2: Clinical and laboratory findings of the hemodialysis patients according to MNA scores.
P1591SERUM PARAOXONASE 1 ARYLESTERASE ACTIVITY AS AN ANTIOXIDANT MARKER IN DIALYSIS PATIENTS
Authors: Korol Lesya , Stepanova Natalia , Vasylchenko Victoria 
Published: June 2020

Abstract

Background and Aims
Patients with chronic kidney disease (CKD) have the highest risk for cardiovascular disease associated with high-density lipoprotein deficiency, chronic inflammation and the development of oxidative stress (OS).
This study aimed to investigate serum paraoxonase 1 (PON-1) arylesterase activity in patients with end-stage renal disease (ESRD) and its association with oxidative stress markers.

Method
We conducted a cross-sectional observational study involving 58 ESRD patients. Among them, there were 20 hemodialyses (HD) patients and 38 patients treated with peritoneal dialysis (PD).
Serum PON1 arylesterase activity was determined spectrophotometrically by the number of formed phenolic complexes using phenylacetate. Also, the concentrations of malondialdehyde, serum concentrations of ceruloplasmin, thiol groups and total peroxidase activity (TPA) in erythrocyte were determined spectrophotometrically. In addition, the blood lipid spectrum (including high-density lipoproteins) was determined in all patients.
The reference group consisted of 30 conditionally healthy individuals.
For the statistical analysis, we used Kruskal-Wallis’s t-test and Spearman's rank correlation test. All statistical analyses were performed using MedCalc.

Results
Serum PON1 arylesterase activity was 6.57 kU/L in reference group versus 2.25 kU/L in HD patients and 4.26 kU/L in PD patients (p &lt; 0.0001) (Fig. 1). A direct association was found between serum PON1 arylesterase activity and ceruloplasmin concentration (r = 0.38; p = 0.004) and TPA (r = 0.32; p = 0.02) in HD patients. In iddition, serum PON1 arylesterase activity was associated with high-density lipoproteins (r = 0.67; p &lt; 0.0001) in PD patients (Fig. 2).

Conclusion
We observed a decrease in serumPON1 arylesterase activityin ESRD patients compared to the control group. The lowest level of serum PON1 arylesterase activity was determined in HD patients. Moreover, the association between serum PON1 arylesterase activity and a decrease in antioxidant blood markers was found.
Our results support the hypothesis that OS is an important mediator in the progression of kidney diseases and indicates a potential antioxidant role of serum PON1 arylesterase activity in ESRD patients. We suggest using serum PON1 arylesterase activity as an antioxidant marker in dialysis patients.
P1595NUTRITION AND INFLAMMATORY STATUS IN DIALYISIS PATIENTS WITH SUICIDAL IDEATION AND DEPRESSION
Authors: Ruvalcaba Contreras Neri , Márquez Herrera Roxana Michel , Valencia Coronado Rosalinda , Calderón Fabián Alejandro , López Alvarado Sandra Estefania , Cortés Sanabria Laura , Cueto Manzano Alfonso Martín , Rojas Campos Enrique 
Published: June 2020

Abstract

Background and Aims
The main precursor of suicidal ideation is depression, which is the most common psychiatric disorder in dialysis patients. Studies have shown an association of depression with nutritional alterations and systemic inflammation; however, in patients with kidney disease there is no data about a possible relation between malnutrition, inflammation and suicidal ideation. Therefore, the aim of this study was to describe and compare the nutritional and inflammation statuses in dialysis patients with suicidal ideation and depression.

Methods
Cross sectional study; 36 dialysis patients &gt;18 years old, any gender, who signed informed consent were included. Suicidal ideation was measured by one psychiatrist using the Beck Scale for Suicidal Ideation, and depression with the Beck Depression Inventory. A dietitian evaluated nutritional status by means of anthropometric and biochemical variables, and the Dialysis Malnutrition Score. Additionally, C-reactive protein and fibrinogen were measured. Results were classified as dichotomous variables for suicidal ideation (yes/no) and depression (no: normal-mild/ yes: moderate-severe).

Results
Prevalence of depression, suicidal ideation and malnutrition were 97%, 63% and 31%, respectively. Main results are shown in the table.

Conclusions
Patients with suicidal ideation and depression did not show significant differences in any of the assessed nutritional variables. However, patients with suicidal ideation and depression seemed to have higher concentrations of C-reactive protein and fibrinogen. The present study opens an opportunity for future research.
P1597USE OF FEBUXOSTAT IN HYPERURICEMIC PATIENTS UNDERGOING DIALYSIS: TOLERABILITY AND EFFICACY IN INDIAN POPULATION
Authors: Sharma Sourabh , Sharma Neha 
Published: June 2020

Abstract

Background and Aims
Hyperuricemia is associated with increased vascular events in chronic kidney disease (CKD). Febuxostat is an effective alternative treatment in this subset but there is scarcity of data on its use in patients undergoing dialysis. The aim of our study was to evaluate efficacy and safety profile of febuxostat in hyperuricemic Indian patients on dialysis.

Method
Fifty four patients with CKD stage 5D and hyperuricemia were included in the study from Jul 2018 to Mar 2019. Febuxostat was started and patients followed-up over 6 months for decline in uric acid and any adverse events.

Results
Out of 54 cases, 30 were males (55.56%). Mean age was 51.28±16.9 years. Thirty two cases were diabetic (59.26) and all cases were on two or more antihypertensives. Nine cases were suffering from gout at time of inclusion and mean serum creatinine in these cases was 10.47 mg/dl. Symptomatic cases responded to treatment within 2 weeks of therapy. Mean serum uric acid level at 3 months post-treatment (4.65±0.96 mg/dL) was significantly reduced compared from pre-treatment level (8.34± 1.18 mg/dL) [p&lt;0.01]. Serum uric acid level remained significantly low for 6 months without deterioration in eGFR. Blood pressure remained well controlled during therapy period and only four cases required increment of antihypertensive medication. Out of 54 cases, five stopped medication due to adverse events. Out of them, three cases were on peritoneal dialysis. Three cases developed skin rash which subsided once drug was withheld. Most common side effect was nausea (7/54) and headache (6/54).

Conclusion
Febuxostat at a low dose of 40 mg/dl is well tolerated among dialysis population. It effectively declines serum uric acid level. Gastrointestinal side effects are most common adverse event which corresponds to non-dialysis population. There was no higher risk of skin rash or other major adverse event in this subset. It is also worth mentioning that hyperuricemia is associated with significant vascular events and all cases included in study were hypertensive.
P1598USE EXPERIENCE OF FIRAPY (FAR-INFRARED THERAPY) TREATMENT FOR WOUND OF HEMODIALYSIS PATIENTS
Authors: Maeda Kunimi , Wada Takaaki , Ikeda Shihoko 
Published: June 2020

Abstract

Background and Aims
By using far-infrared irradiation, Firapy treatment is expected to improve blood flow by expanding peripheral blood vessels and an effect of promoting wound healing due to its non-thermal effect.
The aim is to discuss the clinical effects of Firapy treatment applying to dialysis recipients with lower extremity wounds.

Method
Two dialysis patients with diabetic nephropathy who developed lower extremity wounds were included in this study. Starting from the initial stage of the wound, patients received wound rinsing at each dialysis, followed by a 30-minute Firapy treatment. The following items were observed over time from the beginning of the treatment. Evaluation and examination were then conducted.
(1) The wound healing process was evaluated over time from wound measurements, images, and records.

Results
In both cases, early initiation of Firapy treatment resulted in good healing without leaving any signs of infection or scarring. By using far-infrared irradiation, Firapy treatment has been considered to be an effective therapeutic means due to it could enhance angiogenesis and microcirculation which allows restoration of blood flow in ischemic tissue and its effect of promoting wound healing.

Conclusion
Appling Firapy treatment to the wound showed the possibility of making wound healing be faster and healed beautifully. Firapy treatment has been considered to be one of effective way to wound healing. We are looking forward to use Firapy treatment for other cases.
P1599USE OF ASCORBATE-RICH DIALYSATE IN HEMODIALYSIS PATIENTS
Authors: GRIVEAS IOANNIS 
Published: June 2020

Abstract

Background and Aims
Increments of oxidative stress have been addressed as one potential cause for the accelerated atherosclerosis of chronic kidney disease patients. Ascorbate (vitamin-C) represents one of the most prominent antioxidants both in plasma and intracellulary. Unsupplemented dialysis patients have reportedly lower plasma levels of ascorbate in comparison to healthy controls, mostly due to a loss into the dialysate. Purpose of our study was the recording of the experience of the use of Ascorbate-Rich Dialysate in patients under hemodialysis (HD).

Method
11 HD patients were recruited for the study. During a period of 8 weeks they were receiving Ascorbate-Rich Dialysate (2g/lt). Ascorbic acid levels were estimated before and at the end of the study period. We also monitored patients’ anemia profile (Hb, Hct, ferritin, TSAT, rhEPO dose), lipid and nutrition status.

Results
Ascorbic acid values were towards the lower accepted levels in our patients (3.25±1.01 mg/l) at the beginning of the study period. After 8 weeks receiving Ascorbate-Rich Dialysate, acorbic-acid levels were significantly increased (6.87±1.50 mg/l) without transcending the upper accepted limit. During the notice period, our patients were behaved normally without any sort of adverse events. Mean Hct levels remained stable (39.10±3.70% with conventional dialysate vs 39.67±1.59 % with usage of ascorbate-rich dialysate ). The same conclusion was noticed with Hb levels (12.85±1.20 vs 13.15±0.49). Mean rhEPO dose per week (epoetin- alfa) decreased (9000±5200 iu vs 6250±4300 iu, p=NS) and administration of Fe stopped to all of our patients. Ferritin (&gt;700), TSAT (&gt;35) remained stable over the whole study period. Cholesterol, triglycerides and albumin levels did not change significantly with the change of the conventional dialysate to ascorbic-rich one.

Conclusion
Although our study is limited by small numbers of subjects, short durations of follow-up, our results suggest that compared with standard care, ascorbic acid in dialysate bath is a safe choice to increase ascorbic-acid levels in traditionally vitamic C depleted HD patients within safe limits. This raise seems to favors anemia profile of HD population. Longer term studies are required to confirm these results, determine whether these changes translate into improved patient outcomes and cost-effectiveness.
P1604SIGNIFICANT DETECTION OF UNEXPLAINED HLA ANTIBODIES WITH SINGLE-ANTIGEN BEADS IN PATIENTS ON THE WAITING-LIST WITHOUT PREVIOUS SENSITIZING EVENTS
Authors: Núñez Delgado Sara , Burballa Tarrega Carla , Caro José Luis , Arias Cabrales Carlos , Mir Fontana Marisa , Pérez Sáez María José , Palou Eduard , Pascual Santos Julio , Redondo Pachón M Dolores , Crespo Barrio Marta 
Published: June 2020

Abstract

Background and Aims
The introduction of more sensitive and specific tools as solid phase immunoasssays has improved the ability to detect HLA antibodies. The techniques based on solid phase immunoassays in Luminex system can be performed either as screening assays (with pooled antigen panels that use bead populations coated in affinity-purified class I or class II HLA molecules) or to assess the specificity with single-antigen bead (SAB) assays (single cloned allelic HLA antigen).The sensitivity of each assay Is different, and their results may be discordant. Our objective was to evaluate the potential discrepancies between tests in a cohort of patients on our waiting list with no previous sensitizing events, for their potential influence in the access to transplantation.

Method
Observational study of 184 patients included in the kidney-transplant waiting list on March 31st, 2019. All possible sensitizing events (pregnancy, transfusion and previous transplants) were registered. HLA antibodies where analyzed both by screening and SAB tests.

Results
We limited the observations to males (64.7% of the cohort), as most women (95.4%) had a known sensitizing event, not being possible to discard possible pregnancies in the remaining. Of men, 46.2% had a sensitizing event and 63.8% did not. All 63 unsensitized patients showed a negative screening test, and 49 (77,78%) had at least one SAB done being positive in 73.4% (36/49). The positive SAB yielded a cPRA &gt;10% in 30 cases (between 21-85%), mostly (27/30) due to HLA class II antibodies (88.8% with at least one DQ antibody) with a median MFI of 1571 (range:752-17650).
A thorough review of specificities showed that 81% DQB1* and 89.6% DQA1* antibodies did not show consistency in all beads included for the same allele.

Conclusion
Screening and SAB assays show a significant discordancy in unsensitized men included in the waiting list for kidney transplantation. Automated detection of antibodies by SAB without a proper specialized interpretation may wrongly limit access to transplantation.
P1605THE EARLY RISE OF URINARY EXOSOMAL BK VIRUS MICRORNA AS A PREDICTIVE MARKER FOR BK VIRUS NEPHROPATHY IN A PROSPECTIVE KIDNEY TRANSPLANTATION COHORT
Authors: CHO WON HEE , Jung Su Woong , Seo Jung Woo , Moon Ju-Young , Jeong Kyung Hwan , Kim Chan Duck , Chung Byung Ha , Kim Yeong Hoon , Lee Sang ho , Park Jae Berm , KIM MI JI 
Published: June 2020

Abstract

Background and Aims
BK virus nephropathy (BKVN) is one of the significant contributors to allograft dysfunction in kidney transplantation. Because of the lack of effective anti-viral medication, early detection of BKV replication and preemptive management is vital to preserving allograft function. Herein, we investigated the predictive value of urinary exosomal BKV-microRNA for BKVN in the kidney transplantation cohort.

Method
ARTKT (assessment of immunologic risk and tolerance in kidney transplantation) is a prospective observational cohort in which a total of 420 kidney transplant recipients were enrolled from 7 teaching hospitals in South Korea since 2015. Urine samples were collected at 0.5, 3, 6, 12, and 24 months after kidney transplantation in this cohort. All enrolled patients were reviewed to identify the patients diagnosed with BKVN histologically (biopsy-proven BKVN) and those experienced BK viremia defined as plasma BKV DNA load &gt; 4 log10 copies per mL (presumptive BKVN). Urinary exosomal miR was quantified using real-time reverse transcription PCR.

Results
10 patients and 14 patients developed biopsy-proven BKVN and presumptive BKVN, respectively. Because of unavailable urine samples, urinary exosomal BKV-microRNA was investigated in 8 patients with biopsy-proven BKVN and 13 patients with presumptive BKVN. 61 patients with no evidence of BKVN were selected as a negative control. Most of BKVN was developed in a median time of 3.4 months after transplantation. In line with this pattern, urinary exosomal BKV-microRNA peaked at 3 months after transplantation and decreased thereafter in biopsy-proven BKVN and presumptive BKVN, keeping higher value in biopsy-proven BKVN compared to presumptive BKVN after 3 months. At 2 weeks after transplantation, half of the patients with biopsy-proven BKVN showed an early rise of urinary exosomal BKV-microRNA, whereas patients with presumptive BKVN and no evidence of BKVN did not. However, plasma BK virus DNA was not detected in all groups at 2 weeks after transplantation. In multivariate cox proportional hazards model, urinary exosomal BKV-microRNA was significantly associated with biopsy-proven BKVN.

Conclusion
A urinary exosomal BKV-microRNA increase as early as 2 weeks after kidney transplantation predicts future BKVN development, enabling early intervention.
P1608CXCL13 IS STRONGLY INDUCED BY RENAL ISCHEMIA REPERFUSION INJURY AND CORRELATES WITH SEVERITY OF RENAL INFLAMMATION
Authors: Jang Mi-Sun , Kreimann Kirill , Greite Robert , Rong Song , Von Vietinghoff Sibylle , Schmitt Roland , Dittrich-Breiholz Oliver , Bräsen Jan Hinrich , Vijayan Vijith , Haller Hermann , Immenschuh Stephan , Gueler Faikah 
Published: June 2020

Abstract

Background and Aims
Ischemia reperfusion injury (IRI) is a strong trigger of inflammation and is tightly linked to renal allograft damage and function. CXCL13 or B lymphocyte chemoattractant (BLC) is a chemokine that controls B cell organization in lymphoid tissues and has recently been described as a biomarker for B cell involvement in acute kidney allograft rejection.

Method
To show, that CXCL13 is already induced by IRI alone we used renal IRI models in mice with different ischemia times and a kidney transplantation model. We measured serum CXCL13 and characterized cell infiltrates by immunohistochemistry and performed single cell RNA sequencing. Allogenic and isogenic kidney transplantation (KTX) in mice was done to evaluate these findings in the transplant setting.

Results
Systemic CXCL13 levels increased within hours after surgery in a time dependent manner, both after induction of IRI and KTX. Levels of CXCL13 increased with duration of ischemia time and were higher in allogenic than isogenic transplantation with equal duration of ischemia. CXCR5, the receptor for CXCL13, is mainly expressed on B lymphocytes but also on a subset of T lymphocytes and macrophages. CXCR5 positive infiltrates were detected in IRI kidneys seven days after injury. In kidney allografts interstitial B cell infiltrates were observed as early as seven days and increased further towards three weeks after KTX.

Conclusion
The current findings indicate that IRI is a strong trigger of CXCL13 expression in the kidney and release into the circulation, which is followed by B lymphocyte infiltration into damaged tissue in ischemic and renal allografts.
P1615IDENTIFICATION OF URINARY PROTEOMIC PROFILE OF PATIENTS WITH CHRONIC ALLOGRAFT NEPHROPATHY
Authors: Khalifa Amr , El-Wakil Hala , El-Aggan Hayam 
Published: June 2020

Abstract

Background and Aims
Chronic allograft nephropathy (CAN) is a major complication that occurs post-transplantation. At present, the diagnosis of chronic allograft nephropathy (CAN) is based on renal biopsy. Therefore, there is an ultimate need to identify more specific and sensitive noninvasive methods for the early diagnosis of CAN. Recently, proteomic-based modalities have been developed to discover biomarkers of CAN.

Method
Urine samples from 75 participants were collected. Participants were divided into 3 groups: Group I: 25 patients with chronic allograft nephropathy, group II: 25transplanted patients with stable renal functions, and group III: 25 healthy control subjects matched for age and sex. Each group was divided into training set and test set. Specimens were purified with magnetic beads-based weak cation exchange chromatography and analyzed in a MALDI-TOF MS.

Results
A Genetic Algorithm (GA) was used to set up the classification models. Five peaks represented the proteomic profile that differentiates between the CAN patients and the control group with sensitivity of 100%, specificity of 100%, recognition capability of 100 % and cross-validation91.7 % and five peaks differentiate between the transplant patients with normal renal functions and the control groups with sensitivity of96.8 %, specificity of  95.5 %, recognition capability of 98 % and cross-validation of 100 %.

Conclusion
We identified a pattern for CAN and transplant patients with normal renal functions by proteomic profiling using MALDI-TOF-MS and magnetic beads.
P1617RENAL TRANSPLANT PATIENTS HARBOR NEUTROPHILS SECRETING B-CELL ACTIVATING FACTOR (BAFF) WHICH CAN BE SUPPRESSED BY MTOR INHIBITORS
Authors: Steinberg Hannah , Dolff Sebastian , Kribben Andreas , Ma Xin , Witzke Oliver , Wilde Benjamin 
Published: June 2020

Abstract

Background and Aims
B cell activating factor (BAFF) is a cytokine which drives B cell survival and maturation. Several studies have shown that elevated BAFF levels in renal transplant patients are associated with increased risk for the development of donor specific antibodies and antibody mediated rejection. It was the aim of this study to investigate neutrophils as cellular source of BAFF in renal transplant patients.

Method
Neutrophils (NT) were freshly isolated from whole blood of healthy controls (HC) and renal transplant patients (RTX). After isolation, purity of neutrophils was usually above 98%. Neutrophils were stimulated with LPS or TNFα in presence of Granulocyte-colony stimulating factor (GCSF) or Granulocyte macrophage colony-stimulating factor (GMCSF). In selected conditions, FK506 or rapamycin was added. Supernatants were harvested after 20 hours of culture and BAFF levels were determined by ELISA.

Results
GCSF/TNFα and GCSF/LPS were the most potent stimuli leading to BAFF secretion of NT in HC (403 ±64 pg/ml and 421 ±69 pg/ml). NT derived RTX showed similar capacity to secrete BAFF as compared to HC (GCSF/TNFα: 515 ±31 pg/ml and GCSF/LPS: 539.4 ±36 pg/ml). Treatment of cultures with rapamycin reduced BAFF levels (515 ±100 pg/ml vs. 348 ±27 pg/ml, p&lt;0.001). Treatment with FK506 was less efficacious (515 ±31 pg/ml vs. 465 ±31 pg/ml, p=0.01).

Conclusion
NT may enhance of B cell maturation and survival via BAFF. BAFF-secretion by NT can be suppressed with mTOR inhibitors. In renal transplantation, NT might promote formation of allo-antibodies and drive antibody mediated rejection.