bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0129DIET INDUCED ACCELERATION OF RENAL INJURY IN THE BTBROB/OB MOUSE MODEL OF DIABETIC KIDNEY DISEASE
Authors: William-Olsson Lena , Tonelius Pernilla , Tesan Tomic Tajana , Söderberg Magnus , Björnson Granqvist Anna 
Published: June 2020

Abstract

Background and Aims
There is a need of disease relevant models for efficient evaluation of new drug targets in the renal field. The obese diabetic BTBRob/ob mouse model have features resembling important aspects of human diabetic kidney disease and is extensively used in pharmacological studies. Since diet composition plays a role in diabetic- and renal disease it is important to have detailed control of nutritional intake in our pre-clinical models, especially since many studies use in-diet drug administration. In this study we compared disease progression in obese diabetic mice on non-defined chow diet (R3) with the defined control diet D12450B (Research Diets).

Method
BTBRob/ob mice were fed either regular laboratory rodent chow (R3) or the defined control diet D12450B containing 35% sucrose from 6 weeks of age. The animals were studied for 14 to 20 weeks of age and both physical parameters, urine and blood parameters, histology and gene expression was examined. (R3 group n=14, D12450B group n=8).

Results
Mice on the defined D12450B diet displayed increased calorie- and water intake, but gained less weight compared to R3 group. Blood glucose and HbA1c was higher at all timepoints, and urinary albumin-to-creatinine ratio was highly elevated compared to mice on R3 diet. Mice fed D12450B also displayed lower levels of plasma insulin and increased plasma b-hydroxybutyrate levels. Histopathological evaluation revealed that the defined D12450B diet increased induction both of mesangial injury score and gene expression of tubular injury markers NGAL and Kim-1.

Conclusion
: In summary, the choice of diet composition will have a huge impact on the disease progression in diabetic leptin-deficient overeating mouse models. These finding underline the importance of describing the diet composition in detail and take precaution on diet selection for preclinical studies.
P0138THE ROLE OF TREFOIL FACTOR 3 IN THE EVALUATION OF RENAL ALTERATION IN PATIENTS WITH ANKILOSING SPONDYLITIS
Authors: Plenkina Lidia , Simonova Olga 
Published: June 2020

Abstract

Background and Aims
Kidney damage in ankylosing spondylitis (AS) has one of the leading positions. The diagnostic value of traditional markers of renal damage is not high, which often leads to delayed diagnosis. Therefore, an active research for alternative methods is conducted. The Aim was to evaluate urinary excretion of Trefoil factor-3 (TFF-3) in patients with AS.

Method
Urine samples of 50 patients (male/female =37/13) were evaluated. The requrentments for patients providing samples were: confirmed diagnosis of AS, age 18 and over and and absence of intercurrent diseases. Median age of patients was 39 [34; 56] years, duration of articular syndrome was 10 [7;18] years, glomerular filtration rate (GFR) - 105 [83;119] ml/min/1.73 m? Patients received nonsteroidal anti-inflammatory drugs (NSAIDs) and tumor necrosis factor alpha inhibitors (TNFα inhibitors). TFF-3 level was measured by enzyme-linked immunosorbent assay. Urinary excretion was expressed as nanograms per millimol of urinary creatinine. The results were compared with the results of the control group.

Results
The level of TFF-3 in patients without chronic kidney disease (CKD) was higher than in the control group: 53.4 [20.8;105.7] and 23.3[1.9;62.9] ng/mmol respectively, (p=0.02). A correlation with disease activity was found for BASDAI (rs=0.3, p&lt;0.05) and ASDAS (rs=0.3, p&lt;0,05). Marker values in patients receiving NSAIDs were higher compared with TNFα inhibitors: 89,5 [39.8;118.9] and 32,6 [13.5; 88.2] ng/mmol respectively, (p=0.04). The level of TFF-3 did not depend on sex, age and AS duration. It did not correlate with GFR and albuminuria.

Conclusion
TFF-3 urinary excretion is higher in patients with AS compared with healthy individuals, as well as in patients receiving NSAIDs compared with TNFα inhibitors. Thus, the marker may be of interest for diagnosis in patients with pre-clinical tubulointerstitial damage, including those associated with the NSAIDs toxicity.
P0150APREECLAMPSIA ABOUT 252 PATIENTS
Authors: Akli Boubchir , Akli Boubchir , Kichou Brahim , ALI MADIOU 
Published: June 2020

Abstract

Background and Aims
The main objective was to estimate the prevalence of pre-eclampsia (PE) in pregnant women in Tizi-ouzou (Algeria). Secondary objectives were to estimate the frequency of PE risk factors, and the incidence of maternal and fetal complications.

Methods
Our study was observational, prospective and descriptive, including all pregnant women at the prenatal appointment in the 2 maternity units of Tizi-ouzou, between January 2012 and June 2013. PE was diagnosed if gestational hypertension was associated with proteinuria &gt; 300mg/24h, after 20 weeks of gestation.

Results
We had 252 cases of PE on 3225 pregnant women. The prevalence of PE was 7.8% (CI 95%: 6.9%–8.7%). The most frequent PE risk factors were nulliparity (56%), age &gt;40 years (27%), obesity (26%) and PE in any previous pregnancy (21%). The incidence of maternal adverse events was 28.7% (CI 95%: 23.1%–34.3%), including 5 deaths. The rates of prematurity, small for gestational age infant and fetal death were 58.2%, 49.7% and 6.7%, respectively.

Conclusion
The prevalence of PE in pregnant women in Tizi-ouzou is around 8%. The incidence of maternal and fetal adverse outcomes remains high. Only earlier diagnosis and closer monitoring could improve the prognosis of our patients, since the treatment of PE remains currently childbirth.
P0158RENAL DENERVATION VERSUS SPIRONOLACTONE IN THE TREATMENT OF RESISTANT HYPERTENSION: A META-ANALYSIS
Authors: Edding Sherida , Cabral Brian Michael , Cating-Cabral Monica Therese 
Published: June 2020

Abstract

Background and Aims
Resistant hypertension (RH) is defined as blood pressure that remains above guideline-directed goal despite the concurrent use of at least three antihypertensive agents of different classes, one of which is a diuretic. Treatment of RH is focused on the addition of fourth-line therapy. Several studies revealed impressive blood pressure reductions when spironolactone was added to the therapeutic regimen. In the recent years, there has been a growing perception that controlling blood pressure in resistant hypertension is beyond the reach of existing drug therapies, leading to the emergence of device-based therapies, such as renal denervation. Our aim is to do a systematic review of randomized controlled trials that compares the use of Spironolactone and Renal Denervation in patients with RH.

Method
A comprehensive literature search from the PubMed, Embase, Cochrane Library, and Ovid was performed with the following search terms: Resistant Hypertension, Spironolactone, Renal Denervation. The search was limited to randomized-controlled trials that compared Spironolactone to Renal Denervation in patients with Resistant Hypertension. Three prospective clinical trials were selected and analyzed using Cochrane Revman v5.3. Primary outcome were mean changes in 24-hour Ambulatory Systolic Blood Pressure (SBP) and Diastolic Blood Pressure (DBP). Secondary outcomes include mean changes in Office SBP and DBP. Safety was assessed by changes in eGFR and potassium levels.

Results
Two trials comprising 130 patients were selected - 63 patients treated with RDN and 67 patients with Spironolactone. Pooled analysis of the 2 trials for 24H SBP and DBP showed an adjusted standardized mean difference of 0.55 mmHg (CI -0.72, 1.82; P = 0.39) and 0.32 mmHg (CI -0.72, 1.35; P = 0.55) with significant heterogeneity. No significant differences were also noted in terms of decline in eGFR (p = 0.07) and changes in serum potassium (p = 0.29) from baseline to 6 months.

Conclusion
Based on our results, RD appears to be safe and effective treatment for RH. However, additional larger studies should be done including a cost-benefit analysis to explore that possibility of RD as treatment alternative for those intolerant of spironolactone or as a possible 5th line of treatment for those already taking spironolactone.
P0161TO EVALUATE THE TH PROFILE (TH1/TH2/TH17 ) AMONG GESTATIONAL DIABETES AND NORMAL PREGNANCY
Authors: Kaul Anupma , Pandey Amita , Aggrwal Vikas 
Published: June 2020

Abstract

Background and Aims
Gestational diabetes mellitus (GDM) is a common pregnancy complication, characterized by insulin resistance and low-grade systemic inflammation with a pro-inflammatory immune system response. Our objective was to study the peripheral Th1, Th2, Th17 and Treg response in GDM compared to normal pregnancy.

Method
Th1, Th2, Th17 and Treg subsets was determined by flow cytometry based on staining for specific intracellular cytokines levels and their CRP levels were also assessed.. The health status of all offspring was also assessed 6 months post-delivery.

Results
Α total of 32 adult pregnant women were enrolled into a GDM (n=18) and Control (n=14) group. At the third trimester of pregnancy, the GDM group had a higher proportion of Th2, Th17 and Treg cells compared to control. Contrary to the control group, the GDM group exhibited no significant change in the Th1/Th2/Th17/Treg profile postpartum. A higher circulating CRP were noted in the GDM group compared to controls. At the 6-month post-delivery assessment, 23.6% of the offspring from the GDM group were found to have developed atopic dermatitis or food allergy compared to none from the control group.

Conclusion
Compared to an uncomplicated pregnancy, GDM exhibits a significantly different peripheral T-cell profile at the third pregnancy trimester characterized by higher proportion of Th2, Th17 and Treg cells which persist six months post-delivery, while the increased high sensitivity CRP (hsCRP) levels stressed the low-grade inflammatory profile of this disease
P0166ADDITIVE INTERACTION OF HIGH SODIUM INTAKE AND INCREASED SERUM TRIGLYCERIDE ON HYPERTENSION
Authors: Yi Joo-Hark , Yu Mi-yeon , Choi Jong Wook , Han Sang-Woong , Lee Chang Hwa , Park Joon-Sung 
Published: June 2020

Abstract

Background and Aims
Both high salt diet and abnormal lipid metabolism are critical risks of vascular endothelial dysfunction. This study investigated the interactive effects of increased sodium intake and elevated serum triglyceride (TG) on elevated blood pressure (BP).

Method
We conducted nation-wide, population-based interaction analysis using Kawasaki method for estimating 24-h urinary sodium excretion (e24hUNaEKawasaki) as a candidate indicator of dietary sodium intake. Eligible as cases were all native Koreans aged 20 years or older without significant medical illness.
Results: A total of 16936 participants were divided into quintiles according to their e24hUNaEKawasaki results. Participants in the highest quintile were more obese and hypertensive and had increased white blood cell count, decreased hemoglobin, greater glycemic exposure, and poor lipid profiles as compared to lower quintiles. Linear regression showed that e24UNaEKawasaki was closely related with dietary sodium intake, systolic BP, diastolic BP, and TG. Multiple logistic regression, adjusted for dietary sodium intake and various conventional risk factors of hypertension, demonstrated that both e24UNaEKawasaki and TG were significant predictors of hypertension. Our interaction analysis revealed that high sodium intake had a bigger effect on the risk of hypertension in participants with elevated TG than those without (adjusted RERI = 0.022, 95% CI = 0.017-0.027; adjusted AP = 0.017, 95% CI = 0.006-0.028; adjusted SI = 1.010, 95% CI = 1.007-1.014).

Conclusion
Our findings indicate that the interaction of high salt diet and abnormal lipid metabolism may exert synergistic biologic effect on the increased arterial BP.
P0182SAFETY AND EFFICACY OF INTRA-RENAL ARTERIAL AUTOLOGOUS CD34+ CELL TRANSFUSION IN PATIENTS WITH CHRONIC KIDNEY DISEASE: A RANDOMIZED, OPEN-LABEL, CONTROLLED PHASE II CLINICAL TRIAL
Authors: Yang Chihchao , Li Yi-Chen , Yip Honkan 
Published: June 2020

Abstract

Background and Aims
This was a randomized, open-label, controlled phase II clinical trial to investigate the safety, efficacy and the outcomes of intra-renal artery (RA) infusion of autologous peripheral-blood-derived CD34+ cells for chronic kidney disease (CKD) (i.e., stage III or IV) patients.

Method
Between December 2016 and November 2018, 52 consecutive patients with CKD at stage III or IV were randomly allocated into treatment group (TG) (2.5 × 107 cells for each RA; n=26) and control group (CG) (standardized pharmacotherapy only; n=26). The primary endpoints included safety and change of creatinine level/creatinine clearance (Ccr). The secondary endpoints were 12-month combined unfavorable clinical outcomes (defined as dialysis or death), improvement in proteinuria, and CD34+cell-related adverse events.

Results
All patients were uneventfully discharged after CD34+ cell therapy. Flow cytometric analysis showed increases in circulating EPC (i.e., CD34+KDR+CD45dim/CD34+CD133+ CD45dim/CD31+CD133+CD45dim/CD34+CD133+KDR+/CD133+) and hematopoietic stem cell (HSC) (CD34+) populations after G-CSF treatment. Besides, Matrigel assay of angiogenesis was also significantly enhanced (all p&lt;0.001). Renal vein blood samplings (i.e., at 0/5/10/30 min after CD34+ cell infusion) demonstrated significant progressive increases in EPC level (p for trend&lt;0.001) among the TG patients. The baseline EPC populations did not differ between TG and CG (p&gt;0.5). One-year combined unfavorable clinical outcomes were significantly lower in TG than those in CG [0% (0) vs. 13.3% (4), p=0.038](Figure). By 12-month after CD34+ cell therapy, circulating creatinine level, ratio of urine protein to urine creatinine, and creatinine clearance did not differ between TG and CG (all p&gt;0.1).

Conclusion
CD34+ cell therapy was safe and improved one-year outcome.
P0230IMMUNOSUPPRESSIVE TREATMENT DOES NOT IMPROVE KIDNEY SURVIVAL IN PATIENTS WITH HCV CRYOGLOBULINAEMIA TREATED WITH DIRECT-ACTING ANTIVIRALS
Authors: Ana Pérez de José , Carbayo Javier , Pocurull Anna , Huerta Ana , Cases Corona Clara Maria , Bada Bosch Teresa , Shabaka Amir , Ramos Terrada Natalia , Martinez Valenzuela Laura , Goicoechea Marian 
Published: June 2020

Abstract

Background and Aims
Since the introduction of direct-acting antivirals (DAAs), few data have been published about kidney outcome in hepatitis C virus related mixed cryoglobulinaemia (HCV-MC) patients treated with combined DAAs and rituximab.
We aimed to asses if combined treatment with DAAs and rituximab in patients with HCV-MC improves kidney survival and immunological response.

Method
Observational, multicentre, cohort study of 100 patients with HCV-MC from 14 Spanish centres treated with DAAs. Patients were followed up for a median duration of 138 months (11.5 years).
Long-term kidney survival and immunological response were evaluated based on immunosuppressive treatment received. Kidney event was defined as duplication of creatinine level or 50% decrease in glomerular filtration rate, dependence on renal replacement therapy or non-reduction of proteinuria by 50% compared to baseline. Immunological response was defined as the decrease in cryocrit ≤1%.

Results
Sustained virological response was attained in 98 (98%) patients. 49 patients were treated with immunosuppressive treatment associated with DAAs, 26 with rituximab and the rest (23) with steroids and/or cyclophosphamide. Patients receiving immunosuppressive treatment had higher basal cryocrit (6.3±4.5 vs 3.8±3.9%, p=0.011), lower glomerular filtration rate (55±27 vs 68±25 ml/min/1.73 m2) and more haematuria (p=0.001). The 26 patients treated with rituximab had more severe disease: higher viral load (p=0.001), cryocrit (p=0.011), proteinuria (p=0.004), microhaematuria (p=0.012) and hypertension (p=0.012) and lower glomerular filtration rate (p=0.001). 15 patients had a kidney event at the end of follow-up. Predictive variables of kidney events were lower age (HR 0.94, 95%CI 0.89-0.99; P= 0.038) and lower glomerular filtrate rate (HR 0.97, 95%CI 0.94-0.99; p=0.026), in a model adjusted to proteinuria and microhaematuria. Immunosuppressive treatment with or without rituximab did not change kidney survival.
Regarding the immunological response, only 19 patients had a cryocrit &gt;1% at the end of follow-up. There were no differences in age, viral load, proteinuria and basal glomerular filtration rate between these patients with no immunological response and those who had a sustained immunological response over time. The only differences between these two groups were a higher basal cryocrit and a minor C4 levels. Immunosuppressive treatment with or without rituximab did not changed the immunological response.

Conclusion
Patients with more severe HCV-MC are those receiving immunosuppressive treatment. However, immunosuppressive treatment does not change kidney survival nor immunological response of these patients in the long term.
P0238LONG-TERM OUTCOME OF CHILDHOOD IDIOPATHIC NEPHROTIC SYNDROME
Authors: Dao Myriam , Hummel Aurélie , Boyer Olivia , Charbit Marina , Joly Dominique , Dessaix Kathleen , Salomon Rémi , Knebelmann Bertrand , Servais Aude 
Published: June 2020

Abstract

Background and Aims
Little is known about the long-term outcome of childhood idiopathic nephrotic syndrome (INS), in particular long-term complications, rate of relapses, frequency of prolonged steroid (S) and immunosuppressive treatment (IS). The choice of immunosuppressive drug remains discussed. Our aim was to study the long-term outcome in adulthood of patients with INS diagnosed during childhood.

Method
In this monocentric retrospective study, we included all adult patients (&gt;18 years) admitted in our nephrology department between 2013 and 2019 with INS diagnosed during childhood. Patients who reached ESRD during childhood were excluded. Data regarding the outcome in adulthood were obtained through clinical database and medical charts.

Results
Eighty-two patients (M/F = 2/1) were included. Sixty-height patients had steroid-sensitive nephrotic syndrome (SSNS), including 52 with steroid-dependant nephrotic syndrome (SDNS). The other 14 patients had steroid-resistant nephrotic syndrome (SRNS). The median age at diagnosis was 3.9 years (1.2-16.5). The median number of relapses during childhood was 12 (0-52), 0.9/patient/year. 89% of patients received IS therapy in addition to S during childhood: median number of successive therapeutic lines was 3 (0-10) per child.
Median follow-up during adulthood was 4.6 (0.1-25) years. 67% of patients experienced at least one relapse during adulthood, with a median number of relapses of 0.53 (0-3.7)/patient/year. Risk of relapse during adulthood was significantly associated with the total number of relapses during childhood (p=0.015) and with the number of relapses per year during childhood (p=0.007). 45% of patients received IS in addition to S during adulthood, mainly mycophenolate mofetil (23/82), calcineurin inhibitors (21/82) and rituximab (12/82). High blood pressure was observed in 22% of patients.
At last follow-up, median eGFR was 90 (64-117) mL/min/1.73m in SSNS patients, 86 (57-126) mL/min/1.73m in SDNS patients and 70 (23-113) mL/min/1.73m in SRNS patients. Only 4/82 patients presented with eGFR lower than 60 mL/min/1.73m. Among them, 3 had SRNS. Only 1 thrombo-embolic event and 3 severe infections were reported.
Bone densitometry was performed in 26 adult patients and osteopenia was found in 19 of them (73%).

Conclusion
The incidence of relapses in adulthood was relatively high in our study. However bias related to inclusion criteria could play a role. Whereas renal function remained normal in most patients, high blood pressure and osteopenia were frequent but major complications were rarely reported.
P0255THE SHORT TERM MATERNAL OUTCOME OF PREGNANT CHRONIC KIDNEY DISEASE PATIENTS
Authors: Lim Christopher thiam seong , Ong Yun Jin , Yong Shao Wei , Weeven94@hotmail.com Wee Ven Hing , Bidin Mohammad Zulkarnain , Goh Bak leong 
Published: June 2020

Abstract

Background and Aims
Pregnancy in chronic kidney disease (CKD) is associated with increased risk of adverse maternal outcomes and fetal outcomes. The risks are noticeable even in early stages of CKD. Despite the rising concern, there are few follow-up studies in this high-risk group.

Method
We followed up and analysed 538 pregnancies in 173 women with pre-existing of primary renal disease who were seen at a tertiary nephrology centre from January 2007 until December 2015. We sought to investigate the changes in laboratory and clinical parameters, maternal and fetal outcomes.

Results
Figure 1 showed the changes of parameters intra and post-partum period. Increase in weight (p=0.034, OR 1.135, 95% CI 1.01-1.276), antibiotics consumption (p=0.022, OR 0.088, 95% CI 0.011-0.0703), pregnancy-related hypertension (p=0.056, OR 0.161, 95% CI 0.025-1.05) and gromerulonephritis (p=0.049, OR 14.22, 95% CI 1.009- 200.52) were associated with worsening of proteinuria intra-pregnancy and post-pregnancy period. Age more than 30-year-old (p=0.024, OR 0.644, 95% CI 0.439-0.945), multiple pregnancies (p = 0.032, OR 14.4, 95% CI 1.25-165 , antibiotics usage (p=0.033, OR 27.59, 95% CI 1.302-585.169), diuretic usage (p=0.034, OR 0.003, 95% CI 1.26-0.646), pregnancy-related hypertension (p=0.06, OR 21.838, 95% CI 0.878-543.376) and proteinuria (&gt; 1.5g/d) (p=0.025, OR 0.235 95% CI 0.067-0.717) and fetal complications such as fetal death (p=0.013, OR 3.608 95% CI 1.311-9.930) was associated with rapid renal function decline of 25-50% . Elevation of serum uric acid is associated with a higher risk of adverse fetal outcome (r=0.845 p=0.004).

Conclusion
Multiple pregnancies, antibiotic usage, pregnancy-related hypertension are strong predictors of rapid maternal rapid function decline. Pre-conception counselling, minimization of antibiotic usage and aggressive blood pressure monitoring and treatment should be part of the standard treatment for this high-risk population.