bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0638COMPARISON OF CIRCUIT PATENCY AND EXCHANGE RATES BETWEEN THE ORIGINAL PRODUCTS AND THE GENERIC VERSIONS OF NAFAMOSTAT MESILATE IN ACUTE KIDNEY INJURY RECEIVING CONTINOUS RENAL REPLACEMENT THERAPY
Authors: Shin Ho Sik , Kim Jisu , Jeon Haesu , Kim Ye Na , Jung Yeonsoon , Rim Hark 
Published: June 2020

Abstract

Background and Aims
The generic versions have the same main component as the original products. But, due to the difference in additives or the level of impurities, it is questionable the the generic versions are completely identical to the original products. Nafamostat mesilate has been widely used as an anticoagulation in continuous renal replacement therapy (CRRT) with hemorrhagic diathesis. In this study, we performed comparison of circuit patency and exchange rates between the original products and the generic versions of Nafamostat mesilate in acute kidney injury patients receiving continuous renal replacement therapy

Method
We have conducted retrospective studies to compare the original product of nafamostat mesilate (n=732) with the generic version (n=328) on the CRRT running time.

Results
CRRT fiter life time of the generic version group was shorter than that of original product group although that was not significantly.

Conclusion
When generic versions of nafamostat mesilate are adopted in a hospital formulary, it must be emphasized that the effect these versions may be not completely identical to that of the original products.
P0643PROGNOSTIC IMPACT OF THROMBOCYTOPENIA IN THE RISK OF INTRAHOSPITAL BLEEDING IN ACUTE KIDNEY INJURY (AKI) PATIENTS
Authors: Dimitrijevic Zorica , Mitic Branka , Tasic Danijela , Paunovic Goran , Paunovic Karolina , Kostic Emina , Glogovac Stevan 
Published: June 2020

Abstract

Background and Aims
Low platelet count is a marker of adverse events in acute kidney injury (AKI) patients. Thrombocytopenia has often been reported as an indicator of underlying disease severity and worse patient outcomes; however, it’s role in the prediction of the risk of bleeding is not well defined. Our study aimed to assess the prognostic impact of admission thrombocytopenia in the risk of major bleeding in non-septic, non-post surgery AKI patients.

Method
This retrospective study enrolled patients with AKI hospitalized at tertiary care hospital during the three years. Admission thrombocytopenia was defined as a platelet count &lt; 150x103/mL. The primary endpoint was major bleeding, as defined by the International Society on Thrombosis and Haemostasis.

Results
Of 178 included patients (age 61.7±11.1 years; 68.3% males), 26 (14.6%) had thrombocytopenia. These patients had more comorbidities: cancer (19.4 vs 9.6%; p=0.05); previous ulcer disease (17.6 vs. 8.8; p=0.04) and bleeding history (7.4% vs. 2.0%;p=0.04). While in a hospital, there was a trend for the use of more blood transfusions (7.4% vs. 2.7%; p=0.03) and more concomitant medications (12.7 vs. 5.1; p&lt;0.05) in patients with thrombocytopenia. During a hospital stay (IQR: 7-29 days), 19 patients (10.7%) died), 22 (12.35%) had major bleeding, and 5 (2.8%) intracranial bleeding. After adjusting for age, presence of cancer, and use of oral anticoagulant medications, patients with thrombocytopenia had a higher risk of major bleeding (HR 3.34 95%CI: 1.57-7.26; p &lt; 0.001).

Conclusion
Thrombocytopenia is a predictor of major intrahospital bleeding in the non-septic, non-post surgery AKI patients. It should be regarded in bleeding risk estimation and therapeutic strategy decisions.
P0644RELATIONSHIP BETWEEN THE PRESENCE OF INFECTION DISEASE AND CLINICAL OUTCOMES OF PATIENTS WITH CARDIORENAL SYNDROME TYPE 1
Authors: Chávez Jonathan , Valle-Rodríguez Adriana , Michell Jorge , De la Torre-Quiroga Andres , Aranda-G de Quevedo Andres , Yanowski-Ortega Ekhaterina , Cabrera Jose Said , García-García Guillermo 
Published: June 2020

Abstract

Background and Aims: Introduction
Cardiorenal Syndrome type 1 (CRS-1) can be triggered by an infection. The pathophysiological basis is vascular congestion, which is why it has been treated with different strategies of diuretics, but in the presence of infection, the inflammatory, neurohormonal and hemodynamic effects can compromise the efficacy of the diuretic therapy and potentially worsen clinical evolution. Here we compare the clinical evolution during the hospitalization of CRS-1 patients with and without infection.

Method
This is a retrospective cohort study conducted in the Hospital Civil of Guadalajara “Fray Antonio Alcalde”, from January 2015 to September 2018. Conducted in CRS-1 patients, we showed the clinical evolution and diuretic strategies analyzed according to the presence or absence of infection. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) reporting guideline.

Results
We identified 63 patients classified as having CRS-1, 28 (44.4%) were classified as having an infectious disease. The mean age was 62 years (±14.6) and 58 (±12.4) in the group with infection and no infection, respectively. There were no statistically significant differences between the clinical outcomes of both groups. The median length of hospital stay was 8 days in the group with infection and 7 days in the group without infection (p=0.065). Three patients (10.7%) of the group with infection received renal replacement therapy and 1 patient (2.9%) in the group without infection (p=0.315). In the group with infection, 2 patients died (7.1%), whereas in the uninfected group there were no deaths (p=0.194). sCr values tend to diminish in a similar manner in both groups. Serum sodium tend to increase during the hospitalization but there was no significant difference between the groups. We found that all patients received furosemide at least during the first five days of hospitalization and the strategy of the diuretic chosen was similar between groups.

Conclusion
We showed that the clinical evolution of patients with CRS-1 is similar in the presence or absence of infection. We anticipate that this study may be a reason to expand knowledge in patients with CRS-1 and the presence of infection.
P0646PREDICTABLE CAPACITY OF ACUTE KIDNEY INJURY OF NEPHROCHECK TEST IN EMERGENCY ROOM PATIENTS
Authors: Gomá Elena , Gonzalez-Martin Guillermo , López-López Juan Alfredo , Perez Gomez Maria Vanessa , Ortiz Alberto , Martin Catalina 
Published: June 2020

Abstract

Background and Aims
Acute kidney injury (AKI) is increasingly prevalent and it is associated to increased hospital stay and costs, higher risk of developing a chronic kidney disease, and also major morbidity and mortality. Prediction tools may identify patients at high risk of AKI, allowing early intervention. Nephrocheck quantifies biomarkers of AKI (TIMP-2 and IGFBP-7), providing results within 20 minutes. This may allow stratification of the risk of developing an AKI in the next 12 hours in critically cardiovascular or respiratory ill patients and therefore implement preventive measures. We aimed to assess Nephrocheck performance to predict AKI development within 12 hours to 5 days in incident Emergency Room (ER) patients.

Method
Prospective observational study of 52 incident ER patients. Data were collected from April 2017 to November 2018. Inclusion criteria: sepsis of any origin, or cardiopulmonary insufficiency without AKI at baseline. Nephrochek was performed at baseline, patients were stratified into low (Nephrocheck test &lt; 0.3), moderate (Nephrocheck between 0.3-2) and high risk (Nephrocheck &gt;2) of AKI and occurrence of AKI was assessed (diagnosed as an increase of 0.3 mg/dl of serum creatinine) at 12, 24, 48 h and 5 days.

Results
Mean age as 70±13 years, 22/52 (43%) were women, risk factors included hypertension (54%), DM (29%), Cirrhosis: 2/52 (4%), heat failure (27%), prior CKD (12%), nephrotoxic use (38%). 18/52 (35%) of patients were Nephrocheck low risk, 21/52 (40%) were intermediate risk and 13/52 (25%) were high risk. AKI developed in 7/18 (39%), 3/21 (14%) and 3/13 (23%) of low, intermediate and high risk, respectively. When comparing patients who developed AKI with those who did not, those who developed AKI had been exposed more frequently to nephrotoxins and had lower urinary osmolarity and higher MAP (Table 1). However, a high risk Nephrocheck score identified patients with significantly higher urine osmolality (672±139 vs 387±172 mOsm/L, P=0.005) and lower MAP (76.7 ± 18.4 vs 101.62±22.7 mmHg; P=0.002).

Conclusion
LIMITATIONS: knowledge of Nephrocheck results may have changed patient care. CONCLUSIONS: A high risk Nephrocheck score was not associated with a higher risk of AKI in a ER setting. More nephrotoxins were used in the AKI group. Presumabily, these were discontinued in the ER, thus lowering AKI risk. By contrast, a past history of nephrotoxin use and lower urine osmolarity were associated with a higher incidence of AKI.
P0659MULTIMODAL IMAGING OF MALDI MSI DATA
Authors: Hermann Juliane , Brehmer Kai , Thiele Herbert , Jankowski Vera , Jankowski Joachim 
Published: June 2020

Abstract

Background and Aims
MALDI mass spectrometric imaging (MALDI MSI) is a powerful histologic tool for the analysis of biomolecules in tissue samples. MALDI MSI measurements results in a high sensitivity and accuracy of spatial distribution of biomolecules in tissue samples The resolution information of MALDI MSI is in the range of 5-10 µm in the spatial distribution and has the ability to identify proteins, peptides, lipids and small biomolecules directly in tissue samples in one analytical step..For a more detailed analysis of MALDI MSI data and a correlation between the molecular and microscopic level, a combination of MALDI MSI data and histological staining is essential. By combining MALDI MSI data and histological data, much more information are obtained than from a single analysis of both methods. Therefore, MALDI MSI data sets and histological staining were fused to a 3D model presenting a biomolecule distribution of the whole organ and provide more information than a single tissue section. We developed, established and validate an algorithm for an automatic registration of MALDI data with different histological image data for the cross-process evaluation of multimodal data sets for creating 3D models. This multimodal image approach simplifies and improves molecular analyses of tissue samples clinical research and diagnosis.

Method
The data sets for the fusion and creating of a 3D model consist of mass spectrometric data as well as histological and Immunohistochemical staining methods. Histological tissue sections of a whole mice kidney were prepared. For MALDI MSI data the organ sections were coated and incubated with a trypsin solution were performed by using a sprayer for MALDI imaging. As matrix, α-cyano-4-hydroxycinnamic acid was used. MALDI MSI was performed using the Rapiflex. For histological staining the hematoxylin-eosin and Gomori staining were chosen. For Immunohistochemical double staining and immunofluorescence, were used for the detection of Collagen type I, smooth muscle actin and the cell nuclei.

Results
By using a mathematical registration, a perfect superposition of the individual histological sections mass spectrometric data was achieved. It is possible to combine mass spectrometric data, histological and Immunohistochemical data sets in a high number and to reconstruct the measured mice kidney. By using different imaging methods, a variety of information about tissue structure as well as tissue changes and protein distribution can be obtained. The fusion of the data also offers a virtual incision of the organ from any angle and level. The algorithms are adapted to take the data fusion automatically offering a high-throughput approach for clinical diagnostics and the possibility to involved artificial intelligence in its interpretation in research.

Conclusion
There is a successful fusion of MALDI MSI data and different histological and Immunohistochemical staining data sets of a whole organ
P0661DIAGNOSTIC VALUE OF FULL AGE SPECTRUM EQUATION AS A PREDICTOR OF MORPHOLOGICAL LESIONS IN PATIENTS WITH GLOMERULONEPHRITIS
Authors: Elena Saganova , Galkina Olga , Sipovskii Vasiliy , Kayukov, Ivan , Smirnov Alexei 
Published: June 2020

Abstract

Background and Aims
Glomerular filtration rate (GFR) is generally accepted as a best overall index of kidney function. However, it remains controversial to choose the optimal equation to estimate GFR in patients with glomerulonephritis (GN). Recent studies have reported that newly developed full age spectrum equation based on normalized serum creatinine (FASsCr) showed improved validity and was less biased, more accurate than currently recommended sCr-based eGFR equations. Our aim was to assess FASsCr equation as a predictor of various morphological lesions in patients with GN.

Method
100 patients [48 female, age Me 39 (27; 54) years] with biopsy proven primary GN and without acute kidney injury, infectious diseases, severe heart failure, respiratory insufficiency, cancer were included in the study. Minimal change disease was diagnosed in 9% of cases based on the results of kidney biopsy, in 28% – focal segmental glomerulosclerosis, in 26% – membranous nephropathy and in 37% – IgA-nephropathy. Serum creatinine (sCr) level was measured by enzymatic method (Uni Cel DxC 800 PRO, «Beckman Coulter»,USA). eGFR was calculated using FASsCr equation. The extent of global glomerulosclerosis (GS) was assessed quantitatively as a sum of full and focal sclerotic glomeruli. Tubulo-interstitial fibrosis (TIF) and tubular atrophy (TA) were assessed semi-quantitatively (0-lesions absent; 1-mild focal tubular and interstitial lesions; 2-moderate tubular and interstitial lesions; 3 - diffuse tubular and interstitial lesions). All patients consistently were separated into 2 groups according to the degree of each morphological lesion (GS, TIF or TA): “mild” (GS&lt;25% or TIF/TA grade 0 or 1) and “severe” (GS ≥ than 25% or TIF/TA grade 2-3).

Results
eGFR using FASsCr equation positively correlated (p&lt;0,001 in all cases) with GS (r=0,44), TIF (r=0,64) and TA (r=0,61) and was significantly higher in patients with “mild” GS, TIF and TA (p&lt;0,001) in comparison with “severe” group.
Using ROC-analysis all patients were separated (p&lt;0.001) in 2 groups using FASsCr equation according to the degree of morphological lesions (“mild” or “severe”):
GS (Sn – 48.8%, Sp – 88.1%, ACC – 72.0%, AUC – 0.696, cut-off value – 47 ml/min/1.73m2), TIF (Sn - 75.4%, Sp – 76.9%, ACC – 76.0%, AUC – 0.815, cut-off value – 72 ml/min/1.73m2), TA (Sn – 65.9%, Sp – 88.8%, ACC – 70.0%, AUC – 0.798, cut-off value – 74 ml/min/1.73m2), (Figure).

Conclusion
Our results show that FASsCr equation is a significant marker of various morphological lesions in patients with GN. FASsCr equation predominantly can be used as a predictor of mild degree of interstitial sclerosis and tubular atrophy with high diagnostic value.
Figure: ROC curves with 95% CI of BM panel for A – GS; B – TIF; C – TA
P0665RENAL FUNCTION ASSESSMENT IN A SMALL COHORT OF ADULT PROFESSIONAL SOCCER PLAYERS
Authors: Kirsanova Tatiana , Talibov Oleg , Bezuglov Eduard , Mikhail Butovskiy 
Published: June 2020

Abstract

Background and Aims
Signs of acute kidney injury (AKI) are registered in 10-60% of patients with exertional rhabdomyolysis. Most professional soccer players from the time to time meet the criteria for rhabdomyolysis in high season. Link between chronic high levels of myoglobin and AKI is well known, while 25% of people who had AKI subsequently develop chronic kidney disease (CKD) and in 0,3% end-stage renal disease is diagnosed over the next 3 years. Progression of renal decline depends on incomplete recovery and the amount of AKI episodes. In all studies renal function (estimated glomerular filtration rate - eGFR) was calculated by creatinine level (SCr), while usually sportsmen have greater body muscle proportion, which makes it difficult to assess eGFR by creatinine. Cystatin C level is relatively independent of body mass index and composition therefore this parameter more accurately represents kidney function
AIM: comparison of two different GFR evaluation methods, cystatin (GFRcys) and creatinine (GFRcr) in adult professional soccer players

Method
24 adult professional soccer players (age = 28±3.8 years, BMI=23±0.98) were included. Renal function was assessed by blood tests of serum creatinine (SCr) and serum cystatin C (SCys) performed on the next day of regular matches. Blood samples were collected fasting at 8:00 in the morning after 8-hour night sleep. eGFR levels was determined by CKD-EPI formula for SCr, and (eGFR=130xcystatin C-1.069 x age -0,117-7) for CysC.

Results
Since data was distributed normally parametric tests were used. eGFRcr was significantly higher than eGFRcys : SCr 1.1±0.094 mg/dl, GFRcr 96±11 ml/min;CysC 0.94±0.093 mg/dl, eGFRcys 88±11 ml/min (p=0.0045, paired T-test). Both GFR methods and both indicators (SCr and CysC) have moderate weak statistically significant correlation. Pearson’s r=0.438 (p=0.0323) for eGFR (Pic.) and 0.4047 (p=0.0498) for SCr vs Cys.

Conclusion
In professional sportsmen cystatin C based eGFR evaluation has certain advantages in comparison to creatinine based method. Probably regular high-level physical exertions reduce kidney function.
P0670DIFFUSIONAL KURTOSIS IMAGING PREDICTS THE PROGNOSIS OF CHRONIC KIDNEY DISEASE
Authors: Liu Yan , Zhang Gu-mu-yang , Peng Xiaoyan , Li Xuemei , Sun Hao , Chen Limeng 
Published: June 2020

Abstract

Background and Aims
Renal fibrosis is the strongest prognosis predictor of ESRD in chronic kidney disease (CKD), but non-invasive and repeatable imaging markers are missing. Magnetic resonance imaging (MRI) has wide range of applications in renal parenchymal diseases, and diffusional kurtosis imaging (DKI) is a new promising noninvasive method of MRI which can provide more information about non-Gaussian diffusion using a polynomial model. We had successfully used DKI to assess renal fibrosis in IgA nephropathy in our previous work. This study aimed to evaluate the prognostic value of DKI in CKD.

Method
We prospectively enrolled forty-two CKD patients in our study in Jan. 2017. On recruitment, the basic clinical data were documented, and DKI was performed on a clinical 3T MR scanner. Region-of-interest (ROI) measurements were performed to determine apparent diffusion coefficient (ADC), kurtosis (K) and diffusivity (D) of the cortex of the kidneys. We had followed up these patients for 3 years, and collected all the clinical data and outcomes. The prognostic value of DKI metrics and clinical parameters were investigated.

Results
Forty-two patients consisted of 26 males and 16 females with mean age of 41.3±15.4 years. The most common etiology was IgA nephropathy (25/42, 59.5%). At baseline, the mean value of serum creatinine (SCr) was 224.4±156.2μmol/L. Among them, 18 patients had eGFR≥45ml/min and 24 patients had eGFR&lt;45ml/min. According to the etiology and CKD classification, all the patients had received appropriate treatment. Besides supportive treatment and management of CKD complications, 21 patients (50%) had received corticosteroid and/or immunosuppressants treatment. After 36 months follow up, 12 patients had progressed to end stage renal disease (ESRD), and the mean value of SCr of the remaining 30 patients was 153.0±78.8umol/L. The Kaplan-Meyer survival regression showed that the patients with eGFR&lt;45ml/min had worse clinical outcomes (p=0.0006). ROC analysis and Kaplan-Meyer survival regression showed that DKI metrics (K≥0.66 or ADC&lt;1.35) not only predicted severe renal fibrosis, but also had worse clinical outcomes (p=0.01 and p&lt;0.0001) (Figure 1). According to the COX regression analysis, both K (K≥0.66, HR 4.676, 95%CI 1.262-17.325) and ADC (ADC&lt;1.35, HR 13.118, 95%CI 3.499-49.178) values, but not age, gender and eGFR group (cut-off value: 45ml/min), were the independent risk factors for the progression to ESRD.

Conclusion
Renal ADC and K values obtained from DKI showed significant predictive value for the prognosis of CKD, could be a promising non-invasive technique in patients follow-up.
P0677CONTRAST-ENHANCED ULTRASOUND TO ASSESS RENAL MICROCIRCULATION IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Authors: Garessus Jonas , Brito Wendy , Loncle Nicolas , Vannelli Anna , Wuerzner Grégoire , Schneider Antoine , Pruijm Menno 
Published: June 2020

Abstract

Background and Aims
Vascular factors such as capillary rarefaction, increased vascular stiffness and reduced vasodilatation due to endothelial dysfunction probably play an important role in the pathophysiology of chronic kidney disease (CKD). However, our understanding of the underlying mechanisms is hampered by the lack of non-invasive techniques to quantify renal microvasculature in humans. The aim of this study was to assess whether contrast-enhanced ultrasonography (CEUS) can identify (1) differences in renal microcirculation and (2) the degree of nitroglycerin-induced vasodilatation (NIV) as a measure of renal flow reserve between CKD-patients and age-matched healthy volunteers.

Method
All participants underwent CEUS under standardized conditions. Sonovue© (0.015 ml/kg/min) was perfused as contrast agent until a steady state was obtained, followed by four destruction-refilling sequences. Outcome measure of CEUS was the mean (change in) perfusion index (PI) of the outer renal cortex (see figure for an example). In a subgroup of participants, CEUS was repeated before and five minutes after the sublingual administration of nitroglycerin (0.2mg). Renal resistive index (RRI) as a measure of vascular stiffness was also measured at each time point with Doppler ultrasound.

Results
A total of 38 healthy volunteers (aged 50±8 years, eGFR 95±13 ml/min/1.73 m, 69% women) and 18 CKD stage 2-3 patients (aged 55±15 years, eGFR 64±32 ml/min/1.73m, 56% women) were included. Renal PI was significantly lower in CKD patients (1304±762 vs 2989 ±2503 arbitrary units, p=0.034), whereas RRI did not differ (0.66± 0.07 vs 0.63± 0.04), p=0.10). PI was lower in CKD due to vascular nephropathy (n=3) or interstitial nephritis (n=4) than CKD due to diabetes (n=4) or other causes (7). In continuous analysis, PI correlated with eGFR (spearman’s r=0.54, p=0.005) but not with blood pressure. Renal PI did not change after nitroglycerin in both groups; RRI decreased in healthy (from 0.64±0.03 to 0.61±0.02, p=0.01) but not in CKD patients.

Conclusion
In this study, contrast-enhanced ultrasound identified important alterations in renal microperfusion in patients with moderate CKD. Whether a low perfusion index predicts renal function decline needs further study. Sublingual nitroglycerin seems to have limited potential as a new test of renal flow reserve.