bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1262VASCULAR CALCIFICATION OF ABDOMINAL AORTA AND COMMON ILIAC ARTERY AFTER KIDNEY TRANSPLANTATION
Authors: Nakai Kentaro , Yamamoto Shutaro , Tomooka Haruka , Inoue Megumi , Kohara Chiaki , Shukuri Tomoya , Takae Keita , Nishiki Takehiro , Motoyama Kentaro , Mitsuiki Koji 
Published: June 2020

Abstract

Background and Aims
Vascular calcification is a risk factor for cardiovascular disease and mortality in dialysis and transplant patients. Previous studies have shown that coronary artery calcification correlates with cardiovascular mortality. However, it is not known whether vascular calcification of the abdominal aorta and common iliac artery (CIA) may impact clinical outcomes after kidney transplantation. The aim of this study was to identify the risk factors of vascular calcification after kidney transplantation.

Method
In this retrospective study, we assessed 100 patients who underwent kidney transplantation between 2008 and 2017. Of these, 62 patients received a computed tomography (CT) scan of the abdomen twice with an interval of at least 6 months. We examined the characteristics of vascular calcification of the abdominal aorta and iliac artery and divided the patients into three groups based on dialysis modality before transplantation: hemodialysis (HD group), peritoneal dialysis (PD group) and preemptive kidney transplantation (PEKT group). Then, we identified the risk factors for the progression of calcification. Abdominal aortic calcification was assessed based on the aortic calcification index (ACI), and calcification of CIA was assessed based on the maximal thickness of calcification.

Results
At baseline, abdominal aortic calcification was present in 66% of patients, and the median ACI was 10 [0-30]. Calcification of the CIA was present in 62% of patients, and maximal thickness of the CIA was 2.4 mm [0-4.6]. The mean duration of follow-up was 68 ± 29 months, and the mean interval of CT was 40 ± 29 months. After kidney transplantation, the progression rate of ACI and maximal thickness of CIA were 1.6 ± 2.5 per year and 0.17 ± 0.41 mm per year, respectively. The maximal thickness of CIA calcification was significantly higher, and ACI tended to be higher in the HD group than in the PEKT group. Age, male gender, diabetes mellitus and dialysis vintage were the independent variables related to both ACI and maximal thickness of CIA calcification. The progression rates of ACI and maximal thickness of CIA were comparable among the three groups in terms of dialysis modality. Age and rejection within the first 6 months were independent risk factors for ACI progression, and diabetes mellitus was an independent risk factor for progression of maximal thickness of CIA. No significant association was found between the progression of vascular calcification and dialysis-related parameters, including dialysis modality and vintage.

Conclusion
This study suggests that dialysis vintage was the independent variable related to calcification of the abdominal aorta and common iliac artery, whereas dialysis modality was not a significant predictor of vascular calcification and its progression in these blood vessels.
P1267EFFECT OF SODIUM AND ULTRAFILTRATION MODELING VERSUS LOW TEMPERATURE DIALYSATE IN PREVENTION OF INTRADIALYSIS HYPOTENSION: A SINGLE CENTRE STUDY FROM INDIA
Authors: Tiwari Vaibhav , Gupta Anurag , Anand Yogeshman , Bhargava Vinant , Malik Manish , Gupta Ashwani , Bhalla A K , Rana Devinder Singh 
Published: June 2020

Abstract

Background and Aims
Symptomatic intradialytic hypotension is the most frequent complication in patients receiving hemodialysis. It complicates 5 to 30 percent of all dialysis treatments. In our study, we aimed to compare the effect of sodium and ultrafiltration modeling versus low-temperature dialysate on the occurrence of intradialytic hypotensive episodes.

Method
Single center, prospective, randomized trial. Patients with chronic kidney disease (CKD) stage V on maintenance hemodialysis (HD) for at least twice weekly for a minimum of 3 months were observed for the occurrence of ≥1 intradialytic hypotensive episode per month. After full filling the inclusion and exclusion criteria, patients were randomized 1:1 ratio into two groups based on computer-generated randomization numbers allotted to them by the dialysis coordinator.
Group 1: Underwent dialysis with sodium and Ultrafiltration modeling (Linearly decreasing dialysate sodium from 141 mmol/L to 128 mmol/L and linearly decreasing ultrafiltration rate).
Group 2: Underwent dialysis with low-temperature dialysate (36 degrees Celsius).
Primary outcome was number of hypotensive episodes per month. Secondary outcomes were interdialytic weight gain and ultrafiltration volume per session.

Results
A total of 320 patients were observed for 3 months in our centre. Intradialytic hypotension was found in 18.75 % of patients. Diabetic nephropathy (61.66%) was the leading cause of end-stage renal disease in these patients. There was no significant difference between the two groups in mean arterial blood pressure, hemoglobin, cardiac status, and serum albumin before dialysis. Both groups had a similar incidence of intradialytic hypotensive episodes (P &gt;0.05). Interdialytic weight gain and ultrafiltration volume removed per session were also similar in both groups.

Conclusion
Sodium and ultrafiltration modeling and low-temperature dialysate were both equally effective in the prevention of intradialytic hypotensive episodes.
P1271PARADOXICAL EFFECT OF ALDOSTERONE ON CARDIOVASCULAR OUTCOME IN MAINTENANCE HEMODIALYSIS PATIENTS
Authors: Lee Young-Ki , Choi Sun Ryoung , Park Hayne Cho , Kim Do Hyoung , Cho Ajin , Kim Juhee , Yoon Jong-Woo , Noh Jung-Woo , Kang Min-Kyung 
Published: June 2020

Abstract

Background and Aims
Patients with end-stage renal disease have an increased risk of cardiovascular (CV) mortality and left ventricular diastolic dysfunction (LVDD) is known to contribute to its high occurrence. Although high serum aldosterone level is involved in the development of CV complications in general population, this association is unclear in patients undergoing hemodialysis (HD). We aimed to determine the impact of serum aldosterone on LVDD and CV mortality among HD patients.

Method
We performed a prospective cohort study of maintenance HD patients without CV disease. Patients were divided into two groups according to the median level of serum aldosterone (44 ng/dL). All patients underwent echocardiography to evaluate diastolic dysfunction. Proportions of LVDD and CV mortality were compared between high and low aldosterone groups.

Results
We enrolled a total of 60 adult patients (mean age 57.9±12.1 years, male 30.0%). Low aldosterone group had an increased left ventricular diastolic dimension compared with high aldosterone group (52.2±8.4 vs. 50.3±5.2 mm, p=0.033). The E/è ratio (19.5±7.5 vs. 14.6±5.2, p=0.024) was significantly higher among patients in low aldosterone group compared to high aldosterone group. There were no significant differences either in ejection fraction, LVMI, or the proportion of LVH between two groups. Low log-aldosterone (odds ratio 0.403; 95% confidence interval 0.188-0.862) and large left atrial dimension (1.308; 1.114-1.536) were independent risk factors for LVDD. In addition, cox regression analysis demonstrated that low log-aldosterone was an independent predictor of CV mortality in HD patients (hazard ratio 0.505; 95% confidence interval 0.294-0.869, p=0.014).

Conclusion
Low serum aldosterone was not only associated with LVDD but also an independent predictor of CV mortality among HD patients.
P1273EFFECTS OF ABDOMINAL AORTIC CALCIFICATION PROGRESSION ON OUTCOMES IN MAINTENANCE HEMODIALYSIS PATIENTS
Authors: Wang Zhe 
Published: June 2020

Abstract

Background and Aims
Vascular calcification is the risk factor for cardiovascular event, cardiovascular mortality and all-cause mortality in maintenance hemodialysis (MHD) patients. We investigated the effects of abdominal aortic calcification (AAC) progression on outcomes in MHD patients.

Method
111 patients who were on MHD between Jun. 2014 and Oct. 2014 in the dialysis center and finished the AAC examination at baseline and two years later were included prospectively. We evaluated the progression of AAC by AAC score (AACs) at baseline and two years later. According to the change of AACs, the patients were divided into rapid AAC progression group (change of AACs&gt;median) and non-rapid AAC progression group (change of AACs≤median). We investigated the effects of AAC progression on outcomes in MHD patients in the follow-up period. Kaplan-Meier analysis was used to compare their survival rate. Uni- and multivariable Cox proportional hazard regression models were used to determine the risk factors of all-cause mortality, cardiovascular mortality and cardiovascular events.

Results
The presence of AAC was 78.4% (87/111), rapid AAC progression was seen in 54 patients, and non-rapid AAC progression was seen in 57 patients. The mean follow-up duration was 27.9(27.1, 28.0) months. Kaplan-Meier analysis showed that patients in rapid AAC progression group had a higher risk of mortality as compared to patients in non-rapid AAC progression group (P=0.017). Multivariate Cox regression analysis demonstrated that high baseline AACs (HR=1.135, 95%CI∼1.001∼1.286, P=0.048), hypoproteinemia (HR=0.789, 95%CI 0.640∼0.972, P=0.026) were independent risk factors for all-cause mortality. High baseline AACs (HR=1.187, 95%CI 1.038∼1.356, P=0.012), low spKt/V (HR=0.103, 95%CI 0.013∼0.801, P=0.030) were independent risk factors for cardiovascular mortality. Low spKt/V (HR=0.018, 95%CI 0.003∼0.115, P=0.000), hypoproteinemia (HR=0.736, 95%CI 0.608∼0.890, P=0.002) were independent risk factors for cardiovascular events.

Conclusion
Abdominal aortic calcification progression may increase the risk of cardiovascular events and death in MHD patients. Severity of abdominal aortic calcification, adequacy of dialysis, and nutritional status are predictors of outcomes in MHD patients.
P1276EXPLORING POSSIBLE PREDICTORS OF STRUCTURAL DETERIORATION AFTER TRANSCATHETER AORTIC VALVE IMPLANTATION IN HEMODIALYSIS PATIENTS
Authors: Masuyama Satoshi , Mizui Masayuki , Maeda Koichi , Kuratani Toru , Sakaguchi Yusuke , Sakata Yasushi , Sawa Yoshiki , Isaka Yoshitaka 
Published: June 2020

Abstract

Background and Aims
Transcatheter aortic valve implantation (TAVI) is an effective treatment for aortic stenosis (AS) in high-risk patients, such as those who are suffering ESRD on hemodialysis. We previously showed that long-term survival of hemodialysis patients underwent TAVI was lower than that of non-hemodialysis patients but was comparable with that of hemodialysis patients treated with surgical aortic valve replacement. It is known that hemodialysis is a high risk of the bioprosthetic structural valve deterioration (SVD) after valve replacement surgery. Consistently, higher incidence of re-TAVI operation due to restenosis was observed in hemodialysis patients than in non-hemodialysis patients (Odds ratio [OR]:29.4, p&lt;0.001).
In this study, we aimed to identify predictors of SVD in post-TAVI hemodialysis patients.

Method
From April 2012 to December 2015, 24 patients on hemodialysis were selected to receive TAVI for the treatment of AS in Osaka University Hospital. Demographic and laboratory data at pre- and post-operation were compared between patients who underwent re-TAVI (valve-in-valve) (SVD group) and those who did not (no-SVD group).

Results
During the follow-up period (maximal 7 years), 4 out of 24 patients required re-TAVI (valve-in-valve) operation because of SVD. Although serum calcium, phosphate, and PTH levels before operation were comparable between SVD group and no-SVD group, serum magnesium levels were significantly lower in SVD group. Lower serum magnesium quartiles were associated with a higher risk of SVD (OR 5.83, p=0.036). While effective orifice area index (EOAi) of aortic valve at 1 week after TAVI was similar between the 2 groups, EOAi improvement at 1 month was significantly poorer in SVD group than in no-SVD group (1.70 ± 0.15 vs 2.50 ± 0.56, p = 0.049).

Conclusion
The higher incidence of re-TAVI due to SVD in hemodialysis patients could be related with pre-operative low magnesium levels and with one-month post-operative low EOAi improvement.
This was a single center observational study, and the number of patients was very small so that our data would not be necessarily applicable for every patient. Further investigation is necessary for identifying a prognostic predictor of SVD, which will lead to the prevention of unfavorable re-operation in hemodialysis patients.
P1277EFFECT OF HEMODIALYSIS ON PERIPAPILLARY CHOROIDAL THICKNESS AND OPTIC NERVE HEAD PARAMETERS MEASURED BY SWEPT-SOURCE OPTICAL COHERENCE TOMOGRAPHY
Authors: Lee Won June , Shin Yong Un , Seong Mincheol 
Published: June 2020

Abstract

Background and Aims
To investigate the effect of hemodialysis (HD) on peripapillary choroidal thickness (PCT) and optic nerve head (ONH) parameters by swept-source optical coherence (SS-OCT) and other ophthalmologic parameters in patients with end-stage kidney disease (ESKD).

Method
A prospective observational study was performed on 29 patients who underwent HD for ESKD. Detailed ophthalmologic examinations and SS-OCT were performed immediately before and after HD. The PCT were measured using the modification tool in the built-in OCT image viewer program. The ONH parameters including rim area (RA) and vertical cup-to-disc ratio (VCDR) were obtained using built-in software. Changes in PCT, and ONH parameters before and after HD were statistically analyzed.

Results
Average PCT significantly decreased from 127.3 ± 49.2 before HD to 117.1 ± 50.9 after HD (P&lt;0.001). The RA increased and VCDR decreased significantly after HD (P=0.001 and P=0.027, respectively). Disc area did not show significant change after HD (P=0.648). Significant correlation was found between changes in PCT and changes in macular choroidal thickness (rho=0.547, P=0.002).

Conclusion
We observed significant decrease in PCT and significant changes in ONH parameters after HD. Our study suggest that HD can give influence on the ONH and its surrounding structure.
P1290RISK FACTORS FOR PROGRESSION OF CORONARY ARTERY CALCIFICATION OVER 5 YEARS IN HEMODIALYSIS PATIENTS
Authors: Alayoud Ahmed , Mounia Azizi , Marouan Jabrane , Arrayhani Mohammed 
Published: June 2020

Abstract

Background
Although progression of coronary artery calcification (CAC) has been established as an important marker for cardiovascular morbidity, very few studies have studied it in end-stage renal disease patients. Thus we examined and evaluate risk factors of calcification changes in dialysis patients.

Method
Among 28 hemodialysis (HD) patients, CAC was measured in Agatston units at baseline and after five years using the 64 multi-slice ultra-fast CT. The HD patients were classified as progressors or no progressors according to the change in the CAC score across these 2 measurements.

Results
Over an average 63 months follow-up, participants without CAC at baseline had no incident CAC .The progression of CAC was slow and was found only in 6 patients (21.4%) . It was significantly associated with several cardiovascular risk factors, namely, older age (p=0.03), diabetes (p=0.05), male sex (p=0.02), hypercholesterolemia (p = 0.05), anemia (p=0.017), inflammation (p=0.05), and hyperphosphataemia (p=0.012) . However, calcemia, parathormone levels, dialysis duration, tobacco, high blood pressure and dialysis dose did not seem to influence the progression of CAC in our series. A strong association was found between basal calcification scores and Delta increment at 5 years.

Conclusions
Our study suggests that CAC progression in dialysis is a complex phenomenon, associated with several risk factors with special regard to elevated basal scores. This progression can be avoided or slowed with appropriate management which must begin in the early stages of chronic kidney disease
P1291PULMONARY HYPERTENSION VERSUS PULMONARY CONGESTION IN HAEMODIALYSIS PATIENTS IN RELATION TO INCREASED INTER DIALYTIC WEIGHT GAIN
Authors: ElSharkawy Magdy , Khedr Lina , Abdel Rahman Ali , El Shimy Ahmed , Shebl Ahmed 
Published: June 2020

Abstract

Background and Aims
Volume overload is considered as an important clinical problem in HD patients. It is associated with morbid situations such as pulmonary hypertension and lung congestion. to assess the effect of increased (IDWG) on pulmonary hypertension, and lung congestion.

Method
This observational cross sectional study was conducted at on 60 HD patients, that were divided into Group I: 30 patients with an IDWG &lt; 3.5% and, Group II: 30 patients with an IDWG &gt; 3.5% of their dry weight. Pulmonary artery pressure was measured by echo and patients classified according to PAP into mild, moderate and severe pulmonary hypertension. Lung congestion in all patients was measured by lung ultrasound and patients classified into minimal, mild, moderate and severe lung congestion.

Results
Our study showed that pulmonary hypertension prevalence was 30% while lung congestion was 100%. Patients with increased IDWG &gt; 3.5% (group 2) had pre HD higher PAP than those with IDWG &lt; 3.5% (group 1) and patients with IDWG &gt; 3.5% had more change in their PAP post HD session than those with IDWG &lt; 3.5% but no significant difference between the change after the HD session in both groups. HD duration is an important factor in PH development over years. There is a significant relation anemia and hypercalcemia with PH. Patients with more increased IDWG &gt; 3.5 % (group 2) had higher pulmonary congestion than those with IDWG &lt; 3.5% (group 1) and patients with IDWG &lt; 3.5% had more change in their lung congestion level after the HD session than those with IDWG &gt; 3.5% but no statistical significance between the change in both groups. There was a significant relation between HD therapy duration with pulmonary congestion measured prior to the session.

Conclusion
on the short term increased IDWG affect lung congestion more than pulmonary hypertension.
P1294AMBULATORY BLOOD PRESSURE PROFILE IN PERITONEAL DIALYSIS COMPARED TO HEMODIALYSIS AND CHRONIC KIDNEY DISEASE PATIENTS
Authors: Alexandrou Maria Eleni , Loutradis Charalampos , Kouris Nikolaos , Sarris Dimitrios , Schoina Maria , Tzanis Georgios , Dimitriadis Chrysostomos , Sachpekidis Vasileios , Papadopoulou Dorothea , Gkaliagkousi Eugenia , Papagianni Aikaterini , Parati Gianfranco , Sarafidis Panteleimon 
Published: June 2020

Abstract

Background and Aims
Hypertension is highly prevalent in dialysis patients and is often poorly controlled. Data on the ambulatory blood pressure (BP) profile of patients undergoing peritoneal dialysis (PD) are scarce. The aim of this study is to compare the ambulatory BP profile of PD patients with that of hemodialysis (HD) and to pre-dialysis CKD patients.

Method
38 patients undergoing PD were matched in a 1:2 ratio for age, gender and dialysis vintage with 76 HD patients and in a 1:1 ratio for age and gender with 38 CKD stages 2-4 patients. Patients under PD and HD underwent 48-hour and CKD patients 24-hour ambulatory BP monitoring. BP levels were compared for the 48hour, 1st and 2nd 24hour, daytime and nighttime periods. Two-way mixed ANOVA analysis for repeated measurements was used to evaluate the effect of dialysis modality and time on ambulatory BP in PD and HD.

Results
During all periods studied, SBP and DBP were numerically higher but not statistically different in PD than in HD patients. SBP was significantly higher in PD or HD compared with predialysis CKD (PD:138.38±20.97; HD:133.75±15.5; CKD:125.52±13.4 mmHg, p=0.003; PD vs CKD: p=0.003; HD vs CKD: p=0.041 accordingly); significant differences were also evident during the daytime and nighttime periods. DBP displayed a similar trend in the total period studied (PD:82.34±15.22; HD:80.47±11.13; CKD:76.81±7.82 mmHg, p=0.108), but the difference significant only during the second nighttime period. Repeated-measurements analysis showed no effect of dialysis modality and no interaction between modality and time on ambulatory BP during all periods studied.

Conclusion
Average BP levels are similar between PD and HD patients, but higher for both groups compared to CKD counterparts. The dialysis modality had no significant effect on ambulatory BP profile.
P1297PULMONARY HYPERTENSION VERSUS PULMONARY CONGESTION IN HAEMODIALYSIS PATIENTS IN RELATION TO INCREASED INTERDIALYTIC WEIGHT GAIN
Authors: ElSharkawy Magdy , Khedr Lina , El Shimy Ahmed , Abdel Rahman Ali , Shebl Ahmed 
Published: June 2020

Abstract

Background and Aims
Volume overload is considered as an important clinical problem in HD patients. It is associated with morbid situations such as pulmonary hypertension and lung congestion. to assess the effect of increased (IDWG) on pulmonary hypertension, and lung congestion.

Method
This observational cross sectional study was conducted at on 60 HD patients, that were divided into Group I: 30 patients with an IDWG &lt; 3.5% and, Group II: 30 patients with an IDWG &gt; 3.5% of their dry weight. Pulmonary artery pressure was measured by echo and patients classified according to PAP into mild, moderate and severe pulmonary hypertension. Lung congestion in all patients was measured by lung ultrasound and patients classified into minimal, mild, moderate and severe lung congestion.

Results
Our study showed that pulmonary hypertension prevalence was 30% while lung congestion was 100%. Patients with increased IDWG &gt; 3.5% (group 2) had pre HD higher PAP than those with IDWG &lt; 3.5% (group 1) and patients with IDWG &gt; 3.5% had more change in their PAP post HD session than those with IDWG &lt; 3.5% but no significant difference between the change after the HD session in both groups. HD duration is an important factor in PH development over years. There is a significant relation anemia and hypercalcemia with PH. Patients with more increased IDWG &gt; 3.5 % (group 2) had higher pulmonary congestion than those with IDWG &lt; 3.5% (group 1) and patients with IDWG &lt; 3.5% had more change in their lung congestion level after the HD session than those with IDWG &gt; 3.5% but no statistical significance between the change in both groups. There was a significant relation between HD therapy duration with pulmonary congestion measured prior to the session.

Conclusion
on the short term increased IDWG affect lung congestion more than pulmonary hypertension.