bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0258EVALUATION OF ACUTE - PHASE REACTANTS IN MONITORING DISEASE ACTIVITY AND RESPONSE TO IMMUNOSUPPRESSIVE THERAPY IN IDIOPATHIC RETROPERITONEAL FIBROSIS
Authors: Obrencevic Katarina , Petroviä‡ Marijana , Rancic Nemanja , Tadiä‡ Jelena , Vavic Neven , Nikolic Bojan , Radojevic Milorad , Rabrenovic Violeta , Mijuskovic Mirjana 
Published: June 2020

Abstract

Background and Aims
Idiopathic retroperitoneal fibrosis (IRF) is a rare disease characterized by fibroinflammatory periaortic tissue that affects the ureters, causing obstructive nephropathy and impairment of renal function. Findings strongly suggest an autoimmune etiology. Medical treatment includes immunosuppressive drugs, but the optimal treatment has not been established. Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) represent markers of active inflammation in the early phase of the disease, and hence could be sensitive predictors of the treatment response.

Method
This retrospective case series study includes patients with IRF treated with two different protocols: corticosteroids in combination with mycophenolate mofetil (MMF) and corticosteroids combined with azathioprine (AZA). The total number of 28 patients (13 in the first group and 15 in the second group) were treated and followed in the Clinic of nephrology in Military Medical Academy.

Results
At presentation 92.3% of patients had elevated levels of ESR and CRP, and 67.8% of them had acute renal insufficiency. Systemic symptoms resolved after four weeks in all patients. The kidney function improved significantly in both groups after first moth of treatment, although the creatinine level was higher in the MMF group because of the disease recurrence in 23% of the patients. In MMF group was observed faster reduction in the periaortic mass after six months and 53.8% of patients achieve 100% of the mass reduction at the end of the treatment while 33.3% in AZA group. The levels of ESR and CRP after one month of treatment in AZA group correlated with the fibrotic mass reduction after six months and after one year. In MMF group, only the CRP level after one month correlated with the fibrotic mass reduction achieved after one year.

Conclusion
MMF had more rapid and complete effect in hydrnephrosis withdrawal and total reduction of the fibrotic tissue, comparing with AZA whose effect was slower and without complete mass reduction. CRP strongly correlated with the remission of the disease in both therapeutic protocols.
P0264ASSESSMENT OF GFR IN MORBIDLY OBESE PATIENTS USING DIFFERENT EQUATIONS: WHICH IS THE BEST?
Authors: Sabry Alaa , Basiony Amir , Kamal Mohamed 
Published: June 2020

Abstract

Background and Aims
Obesity is a potent risk factor for the development of kidney disease. The prevalence of abdominal obesity in Egyptians based upon the European cut-off points was 30.2% for men and 70.9% for women.
To detect the best formula for estimation of glomerular filtration rates in morbidly obese individuals.
Method: In this prospective study 82 morbidly obese patients were included, Age: 15 to 65 years, Morbidly obese patient (BMI &gt; 40 Kg/m2), Creatinine clearance calculated from a 24-h urine was done, Estimated glomerular filtration rate (eGFR): It was assessed to be correlated with creatinine clearance and detect the most suitable formula for morbidly obese patients.
Cockcroft-Gault formula:  Cockcroft-Gault formula (for total body weight): ockcroft-Gault formula (for adjusted body weight): Cockcroft-Gault formula (for lean body weight), MDRD-eGFR (Modification of Diet in Renal Disease equation) (Shahbaz & Gupta, 2019), CKD-epidemiology (CKD-EPI): (Levey, et al, 2009)

Results
Demogrphic criteria of the studdied patients
Conclusion: The equations that had the nearest values to creatinine clearance were CG-TBW-GFR and CGAjBW- GFR, both of them had a moderate reliability with more agreement for the CG-TBW-GFR equation . The CG-TBW-GFR formula was the most reliable one to measure GFR, followed by the CG-AjBW-GFR formula, while the CG-IBW, CG-LBW, MDRD-GFR and CKD-EPI-GFR formulae were not reliable at all .
P0266PREDICTIVE FACTORS OF COMPLETE RENAL RESPONSE IN PROLIFERATIVE LUPUS NEPHRITIS: A COLLABORATIVE STUDY
Authors: Sanchez Alamo Beatriz , Cases Corona Clara Maria , Gatius Serena , Dominguez Torres Patricia , Valdes Elena , Shabaka Amir , Fernandez Juarez Gema Maria 
Published: June 2020

Abstract

Background and Aims
Proliferative lupus nephritis (class III and IV) is the most severe form of lupus nephritis and requires prompt diagnosis and treatment with immunosuppressive therapy. Since it represents the most serious entity and has the greatest functional consequences there is a need to determine which factors in proliferative lupus nephritis are most predictive of good long-term renal function.

Method
Methods We analysed the data of 49 biopsy-proven proliferative lupus nephritis (18,4% class III and 81,6% class IV) of three different Spanish hospitals to find prognostic factors for complete renal response (CRR), defined as loss of &lt;25% of eGFR and the absence of proteinuria and microhematuria at the end of the follow up. Sociodemographic, clinical, laboratory, and treatment-related data at the time of kidney biopsy and during follow-up were obtained. We performed univariate analysis and logistic regression to identify independent risk factors.

Results
The median follow-up was 8 years (IQR: 3-12,5), during which time 18 patients (36,7 %) achieved CRR. In the univariate analysis complete renal response was related to: (1) at the diagnosis to: age [40,52 (11,29) years vs 29,92 (11,93) p=0,004]; (2) in kidney biopsy to less leukocyte infiltration (42,3% p=0,05); (3) during the follow up to: less comorbities (27,8% vs 64,3% p=0,02), less infections (27,8% vs 58,6% p=0,04) and less hospitalizations due to infections (0% vs 33,3% p=0,010), less prevalence of high BP (22,2% vs 60,7% p=0,01), (4) at the end of follow up to : serum albumin [3,97 (0,59) vs 4,31(0,19) mg/dL p=0,03].
In the logistic regression comorbidies (HR : 5,71 95%IC: 1,56-20,93 p=0,008) and age at the moment of diagnosis (HR : 1,046 95%IC:1,001-1,071 p=0,04) were related to complete renal response. We didn´t find any differences concerning treatments.

Conclusion
Proliferative lupus nephritis is one of the most severe manifestations of lupus nephritis, resulting in increased morbidity and mortality. Traditionally it has been thought that older patients have a worst prognosis, however we demonstrated that they achieved more frequently CRR. In the management of the patients traditional reno protective measures like strict control of BP must be considered since it is a predictive factor of CRR. We shouldn´t forget about the implications of an aggressive immunosuppressive treatment such as hospitalizations due to infections and comorbities.
P0275SCOPE AND CONSISTENCY OF OUTCOME MEASURES FOR PHYSICAL FITNESS IN TRIALS IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A SYSTEMATIC REVIEW
Authors: Jegatheesan Dev , Modderman Richard , Krishnasamy Rathika , Tong Allison , Coombes Jeff , Viecelli Andrea , Johnson David W , Isbel Nicole M 
Published: June 2020

Abstract

Background and Aims
Impaired physical fitness is prevalent across the spectrum of kidney disease and is associated with an increased risk of mortality, progression to end-stage kidney disease, falls and hospitalisation. Physical fitness outcomes have been extensively reported in randomised trials involving patients with kidney disease. This study aimed to assess the scope and consistency of physical fitness outcomes and outcome measures reported in kidney disease trials.

Method
A systematic review of randomised trials reporting physical fitness outcomes in adults with chronic kidney disease not requiring kidney replacement therapy, receiving maintenance haemodialysis or peritoneal dialysis, and kidney transplant recipients was conducted. The scope, frequency and characteristics of physical fitness outcome measures were categorised and analysed. Trials were identified from MEDLINE, Embase and the Cochrane Library from March 2000 to March 2019.

Results
From 115 relevant trials, 171 outcome measures for 32 outcomes were identified and categorised into five domains of physical fitness: exercise capacity (reported in 83% of trials), physiological-metabolic (57%), neuromuscular fitness (52%), body composition (45%) and cardiorespiratory fitness (19%). Exercise capacity had 53 different outcome measures and at 15 separate time points. The most common outcome measures were the 6-minute walk test (29%), peak oxygen uptake (20%), 1-repetition maximum (19%) and hand-grip strength (11%), with marked inconsistency in the reporting of outcomes between trials. Outcomes were assessed by field-based tests (65%), lab-based tests (31%) and patient-reported measures (4%).

Conclusion
There is large heterogeneity in the reporting of physical fitness outcomes, with inconsistencies in the use of validated, relevant and patient-important outcome measures.
P0283LONG-TERM FOLLOW-UP OF CRYOGLOBULINEMIC SYNDROME WITH RENAL INVOLVEMENT AFTER DAA
Authors: Affatato Stefania , Pollastri Ester , Belotti Elena , Zani Roberta , Zaltron Serena , Spinetti Angiola , Castelli Francesco , Scolari Francesco 
Published: June 2020

Background and Aims
To date, the literature shows that HCV eradication with DAA leads to remission from HCV-related cryoglobulinemic syndrome (CS). The goal of our study is to evaluate the effect of DAA treatment on cryoglobulinemic kidney disease.

Method
Since 2015, 58 patients (pts) have been treated in our Centre; among them we have selected 12 pts with active kidney disease at the time of treatment. Clinical manifestations, renal function and immunological tests were monitored during follow-up (range 6-48 months).

Results
General characteristics of the population are shown in Table 1.
At the time of treatment 6 pts had nephritic syndrome (sdr), 1 had nephrotic sdr and 5 pts had mixed nephritic-nephrotic sdr.
It should be noted that 8/12 pts had been treated with Rituximab (RTX) in the 6 months preceding the DAA; despite that they had active disease at baseline.
Ten out of 12 pts went into complete remission after HCV-eradication, 1 went into partial remission. One pt, never treated, did not respond clinically to HCV eradication and therefore underwent RTX therapy.
Other 2 pt with a recent diagnosis of cryoglobulinemic syndrome came to our attention with a clinical picture of nephritic sdr: they’d never been treated with immunosuppressive therapy and get remission only whit HCV eradication.
One pt, although complete CS remission, started hemodialysis for ESRD secondary to ADPKD.
During follow-up 3 pts underwent CS relapse: 2 pts, one with lymphoma, were retreated with RTX after 12 and 48 months respectively; 1 pt, with type I cryoglobulinemia and clinical manifestation of vasculitis, died of acute disease reactivation in Cameroon after 9 months from the end of DAA.
By evaluating the overall population there is a rapid and prolonged clinical response to DAA therapy, in particular a complete resolution of skin ulcers (Tab 2).
Cryocrit decreases and C3 and C4 increase early and persistently after treatment; vice versa the rheumatoid factor does not undergo significant variations.
Proteinuria is reduced at the end of the treatment (EOT) and shows a decreasing trend also afterwards; urinary sediment is drastically reduced at EOT and further decreases during follow-up up to the presence of only isolated urinary anomalies in almost all patients (Tab 3).

Conclusion
The eradication of HCV, and therefore the removal of the immunological stimulus underlying the cryogloblinemic syndrome, appears to be crucial in the control of cryoglobulinemic glomerulonephritis, also after failure of RTX treatment.
However, relapses at variable interval from DAA therapy do not allow us to lose these patients to follow-up even after several years from disease remission.
P0292CONSTIPATION IN CHINESE ELDERLY: A HIDDEN CAUSE OF CHRONIC KIDNEY DISEASE AND THE RISK OF RAPID RENAL FUNCTION DECLINE
Authors: Jian Guihua , Cheng Dongsheng , Wang Zhi , Li Junhui , Yang Qi , Chen Huan , Wang Niansong 
Published: June 2020

Abstract

Background and Aims
Both constipation and chronic kidney disease (CKD) are common among seniors. However, the association between constipation and CKD remain unclear. This study investigates the correlation between the two to provide a new basis for clinical treatment.

Method
Data from Shanghai community elderly physical examination database (2010-2018) were used to conduct a cross-sectional study and a retrospective cohort to evaluate the relationship between constipation and the prevalence of CKD and rapid renal function decline in the elderly community.

Results
The cross-sectional study covered 16,177 participants, with an average age of 71.3. Comparing to no constipation group, seniors with constipation have a higher proportion of suffering from CKD stage 3. Constipation is an independent risk factor contributing to the high prevalence of CKD stage 3 (OR:1.238,95% CI,1.045-1.466). This finding was further tested through a retrospective cohort study that included 4,203 participants with a medium following time of 6.1 years. As a result, 9.5% (n=401) reported to have rapid progression of renal function. After adjustment of confounding factors, the logistic regression analysis indicates that, constipation is an independent predictive variable of rapid renal function decline among aged population.

Conclusion
Constipation is an independent risk factor for the prevalence of CKD and an independent predictor of rapid renal function decline among seniors in the community. Prevention and treatment for constipation should be taken at an early stage, which may reduce the incidence of CKD and delay the progression of CKD.
P0295IMPROVED LEFT VENTRICULAR FUNCTION EVALUATION AFTER KIDNEY TRANSPLANT
Authors: Flores Fonseca Milagros Melissa , Rodriguez Ugarte Viridiana , Villalvazo Osoria Priscila Berenice , Ruiz Cruz Norma Cecilia , Velasco Ramirez Sandra Fabiola , Ramirez Anguiano Ana Cristina , Gomez Navarro Benjamin 
Published: June 2020

Abstract

Background and Aims
Chronic kidney disease (CKD) represents a major risk factor for cardiovascular (CV) disease. CKD pro inflammatory state evokes structural and functional cardiac and vascular changes, such as chronic dysregulation of nitric oxide in vascular muscle, results in left ventricular hypertrophy (LVH), LV dilatation, LV systolic and diastolic dysfunction, endothelial dysfunction and atherosclerosis. Recent advances in echocardiographic methods allows to evaluate changes in cardiac structure and function after KT. The aim of this study was to assess changes in LV structure and function after renal transplantation in patients with end-stage renal disease (ESRD).

Method
All subjects were prospectively recruited prior to kidney transplantation in our center at Centro Medico Nacional de Occidente, Jalisco, Mexico. Demographics, echocardiographic evaluation, clinical and biochemical studies were performed before and after KT. Patients with transplant failure after KT were excluded. Thirty patients were included in the final analysis. Statistical analysis: Results are expressed as means and standard deviation (SD). Accordingly, paired T test or Wilcoxon test were used for comparison of paired observations. Categorical variables were compared using chi-square test or Fisher’s exact probability test, as appropriate. Multivariate logistic regression models including the variables changes in LVEF, LV systolic and diastolic function and LV mass index. Statistical analyses were performed using SPSS v26.0 (IBM Corporation, NY, USA); p &lt; 0.05 was considered statistically significant.

Results
Mean age was 31.99 ± 11.28 years, and 65% were women. Before transplant, LVEF was 58% and pulmonary arterial pressure was 32 mmHg. Ventricular dysfunction was associated with unclamping donor renal vessels at 107.8 ± 7.96mmHg, and lower perioperative hemodynamics values. The LVEF group increased from 25% to 72.5%, and serum creatinine decrease from 2.25 ± 3.76 mg/dl to 1.98± 2.65 mg/dl (p&lt;0.001) by 6 months after kidney transplant. The best set of predictors in multiple regression analysis of renal function were the onset of diuresis and the use of diuretics (R2 = 0.4; p &lt; 0.001).

Conclusion
We observed a significant reversal of LV dysfunction. This was accompanied by a significant improvement on kidney graft function. These findings highlight the dynamics between cardiac and renal function, and support the application of adequate echocardiographic evaluation on CKD patients with low LVEF undergoing KT.
P0297CHANGES OF CD4CD28NULL AND CD8CD28NULL T CELLS IN CHRONIC KIDNEY DISEASE AND THE IMPACT OF DIFFERENT DIALYSIS MODALITIES
Authors: Sampani Erasmia , STANGOU MARIA , Daikidou Dimitra Vasileia , Nikolaidou Vasiliki , Asouchidou Despoina , Dimitriadis Chrysostomos , Faitatzidou Danai , Fylaktou Asimina , Papagianni Aikaterini 
Published: June 2020

Abstract

Background and Aims
Chronic Kidney Disease (CKD) affects both the innate and adaptive immunity, although clinical consequences, and the effect of different renal replacement methods on those alterations remain unclear. The purpose of this prospective observational study was to investigate the alterations of T cell immunity in CKD patients, as well as the effect of different dialysis methods on T lymphocyte subtypes.

Method
T cell subpopulations namely CD3+CD4+, CD3+CD8+, CD4+CD28- and CD8CD28- cells, were isolated from whole blood samples using flow cytometry in 40 CKD patients at predialysis state (ESRD-T0). The immunological profile was repeated six months later after initiation of renal replacement therapy (hemodialysis (HD) or peritoneal dialysis (CAPD)). Fifteen age and gender matched healthy individuals served as controls.

Results
Both CD4+ and CD8+ T cells were significantly reduced in ERSD-T0 patients compared to controls, 604(105-3551) vs. 943(584-1867) μ/L, p=0.001, and 352(103-1561) vs. 422.4(263-1453) μ/L, p=0.05. The percentage of both CD4+CD28null and CD8+CD28null cells, 6.4(0.3-30) % vs. 2.7(0.1-7.8) %, p=0.04 and 58.2(12.8-85.4) % vs. 39(7.8-57.1) %, p=0.01 was increased in ERSD-T0 patients comparing to controls. Furthermore the percentage of CD4+CD28null cells correlated with CRP (r=0.4, p=0.04) and serum albumin levels (r=-0.5, p=0.007), while, significant differences were noticed between patients with and without cardiovascular disease, regarding both, CD4+CD28null and CD8+CD28null cells, 8.6(1-30) % vs. 2.1(0.1-19.8) %, p=0.04 and 62.5(12.8-85.4) vs. 45.5(5.7-73.7), p=0.02, respectively.
Changes in the population of CD4+CD28null after 6 months on dialysis showed significant differences between HD and CAPD methods, 110.11(-27.1 to 311.4)% vs. -28.1(-100 to 30)%, respectively, p=0.003, as were in CD8+CD28null cells, 55.23(-29.06 to 197.93)% vs. -8.34(-54.99 to 66.72)%, respectively, p=0.05.

Conclusion
CKD seem to affect specific T cell subtypes, at a pre-dialysis stage, and levels correlate with chronic inflammatory markers and the presence of CVD. These disturbances are further enhanced in HD, while they are alleviated in CAPD.
P0299EVALUATION OF THE CORRELATION BETWEEN VITAMIN D LEVELS AND THROMBOCYTE MARKERS IN PATIENTS WITH DİALYSİS, CHRONIC RENAL DISEASE AND RENAL TRANSPLANTATION PATIENTS
Authors: AHMEDOVA KÖNÜL , SAHIN Garip , Bal Cengiz , Mutluay Rüya 
Published: June 2020

Abstract

Background and Aims
25(OH)D3 levels are known to be lower in patients with chronic renal disease (CRD). Vitamin D supplementation has been shown to have beneficial effects on mortality in these patients. In our study, we have evaluated the pleiotropic effect of vitamin D on thrombocyte markers, which is known very little by most.

Method
The main thrombocyte function markers (MPV, PDW and PCT) were obtained in patients which underwent dialysis, renal transplantation and patients with grade 3-4 CRD before and after vitamin D supplementation. 40 healthy individuals were chosen as control group and 24 patients underwent renal transplantation, 25 patients underwent dialysis for at least 3 months, 32 patients were diagnosed as Grade 3-4 CRD. All of the patients above had 25(OH)D3 levels &lt;20ng/mL (&lt;50nmol/L). Thrombocyte markers were evaluated before and after vitamin D supplementation (which was given 50.000 IU orally once a week for 8 weeks).

Results
Statistically no significant difference were found between MPV values in- and across- group comparison before and after vitamin D supplementation. After the correlation analyses were reviewed, statistically significant negative correlation was found (r=-0,422 p&lt;0.05) between ΔMPV and ΔVitamin D in renal transplantation group. Also statistically significant positive correlation was found between ΔPDW and ΔVitamin D. In the control group with healty participants, a statistically significant negative correlation was found (r=-0,493 p&lt;0.05) between ΔVitamin D and ΔThrombocyte count. In the dialysis group a statistically significant negative correlation was found (r=-0,422 p&lt;0.05) between ΔVitamin D and ΔMPV.

Conclusion
A significant correlation was found particularly between Vitamin D and MPV in dialysis and renal transplantation patients. In order to prevent cardiovascular events due to thrombosis caused by Vitamin D deficiency which increases MPV, it has been thought that Vitamin D supplementation and antiaggregant therapy might be beneficial.