bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1142DICHLOROACETATE AND L-CARNITINE REDUCED TGF-BETA-INDUCED MESOTHELIAL-TO-MESENCHYMAL TRANSITION
Authors: Masola Valentina , Arduini Arduino , Bonomini Mario , Gambaro Giovanni , Zaza Gianluigi 
Published: June 2020

Abstract

Background and Aims
Mesothelial to Mesenchymal Transition (MMT) plays a main role in the induction of peritoneal fibrosis in long term peritoneal dialysis. Mesothelial cells exposed to high glucose produce great amount of TGF-beta that plays a pivotal role in MMT. Recent findings suggest that TGF-beta controls mesothelial fibrosis via the activation of hyperglycolysis, thus we suppose that coupling glycolysis with Krebs cycle may improve mesothelial cells tolerance to TGF-beta.

Method
To test this hypothesis, we assessed the effects of Dichloroacetate (DCA), a pyruvate dehydrogenase kinase inhibitor, and L-carnitine (which sustains the production of Acetyl-CoA in multiple ways) on mesothelial cells treated with TGF-beta. Recent findings, in fact, highlight the potential anti-fibrotic effects of DCA and L-carnitine (through energy metabolic balancing) in different organs. Particularly, human peritoneal mesothelial cells (HMrSV5) were cultured in Dulbecco's Modified Eagle Medium (DMEM; Gibco) containing 10% fetal bovine serum. Then, cells, cultured to confluence, were pre-treated for one hour with or without 10mM DCA, 1 or 5 mM L-Carnitine and then with 10ng/ml TGF-beta for 4 hours. Gene expression of alpha-SMA and vimentin (markers of MMT) and IL1-beta and IL-6 (inflammatory markers) was evaluated by real-time PCR.

Results
Our results revealed that TGF-beta significantly increased the gene expression level of alpha-SMA (2.04±0.3, p&lt;0.05 versus control) and vimentin (1.61±0.23, p&lt;0.05 versus control) as well as the expression level of the pro-inflammatory cytokines IL1-beta (3.44±0.87, p&lt;0.05 versus control) and IL-6 (2.56±0.51, p&lt;0.05 versus control). Pre-treatment with DCA and L-carnitine (at 1 or 5 mM) significantly reduced these effects. In detail, pre-treatment with DCA reduced alpha-SMA expression (0.97±0.24, p&lt;0.05), vimentin (1.03±0.1, p&lt;0.05), IL1-beta (1.47±0.16, p&lt;0.05) and IL-6 (0.88±0.28, p&lt;0.05) respect to TGF-beta treated cells. Pre-treatment with 1 and 5 mM L-carnitine reduced respectively alpha-SMA expression at 0.96±0.09 (p&lt;0.05) and 0.98±0.06 (p&lt;0.05), vimentin 1.01±0.12 (p&lt;0.05) and 1.02±0.1 (p&lt;0.34), IL1-beta 1.02±0.15 (p&lt;0.05) and 1.68±0.33 (p&lt;0.05), and IL-6 0.72±0.04 (p&lt;0.05) and 0.85±0.01 (p&lt;0.05) respect to TGF-beta treated cells.

Conclusion
These preliminary results suggest, for the first time, that the use of both Dichloroacetate and L-carnitine, coupling glycolysis with Krebs cycle and oxidative phosphorylation, could restore physiological energy metabolism in mesothelial cells and control fibrosis.
P1143REDOX PROFILING IN MESOTHELIAL CELLS IN EXPERIMENTAL PERITONEAL DIALYSIS
Authors: Herzog Rebecca , Wagner Anja , Kratochwill Klaus 
Published: June 2020

Abstract

Background and Aims
PD-fluids lead to generation of reactive oxygen species (ROS) in the peritoneal cavity. The caused oxidative stress, defined as a cellular oxidant-antioxidant imbalance impairs not only peritoneal cell viability but also contributes to progression of local and systemic PD-related pathomechanisms. We aim to analyze the impact and specific targets of ROS during PD and the anti-oxidative mechanism of supplementation of PD-fluid with alanyl-glutamine (AlaGln) on a global proteome-wide level.

Method
To establish a redox-proteomics workflow for studying oxidative stress in peritoneal mesothelial cells we used a gold-standard model of redox-stress (H2O2) and PD-fluid induced stress. Levels of oxidative stress were first validated by increased intracellular ROS and superoxide dismutase activity with PD-fluid and H2O2 treatment and a reduction of these parameters by the addition of AlaGln. To detect alterations of the redox proteome, cysteine residues were either directly or indirectly labeled with fluorescent dyes (redox-2D-DiGE) or isobaric tags (iodo-TMT).
Results: The gel-based approach allowed global visualization of the reduced and oxidized cysteines and revealed redox profiles of 540 protein spots. Compared to control, we found an increase in oxidized and decrease in reduced cysteines in all PD treatments. The development of a highly sensitive LC/MS-based redox proteomics workflow allowed identification of ∼950 proteins affected by redox-stress in mesothelial cells and confirmed the quantitative levels seen on cysteine oxidation. The addition of AlaGln reduced the overall redox status (intracellular ROS and superoxide dismutase activity) but further showed different proteins to be affected by redox modifications. Conclusion: Redox proteomics of peritoneal cells could represent a novel approach for the identification of mediators of PD-induced pathomechanisms, but also to evaluate effects of novel anti-oxidant therapeutical or pharmacological interventions.
P1148THE ASSOCIATION WITH LOWER SYSTOLIC BLOOD PRESSURE AND ALL-CAUSE MORTALITY IN PATIENTS UNDERGOING PERITONEAL DIALYSIS
Authors: Kurahashi Motoyasu , Harada Kenji , Kanai Hidetoshi 
Published: June 2020

Abstract

Background and Aims
Previous observational studies have been reported that a U-shaped association between systolic blood pressure (SBP) and mortality in patients undergoing hemodialysis. However, the optimal blood pressure in patients undergoing peritoneal dialysis (PD) remains unclear.

Method
The present study is observational and conducted in a single center. Four hundred and sixteen patients undergoing PD managed in our hospital from April 2010 to December 2017 were participated in this study. The patients were divided into four groups depended on office SBPs, as follows; group1: SBP &lt;110 mmHg (n=60), group2: SBP 110-139 mmHg (n=187), group3: SBP 140-159 mmHg (n=113) and group4: SBP ≧160 mmHg (n=56). When using the Cox proportional hazards model, group 2 was regarded as a reference. Hypertension was defined as SBP ≧140 mmHg, diastolic blood pressure ≧90 mmHg, or use of any anti-hypertensive drugs. The association between SBP with several outcomes such as the risk of all-cause deaths, cardiovascular events and these composite events were estimated using cox proportional hazards model. Adjusted factors were age, sex, comorbidities, laboratory covariates, left ventricle ejection fraction and medications such as renin-angiotensin system blockades and statins.

Results
The mean follow-up period was 29.2 months. The prevalence of hypertension was 90.4% (n=376) of all patients. The risk of all-cause deaths with multivariate cox proportional hazards regression analysis was significantly higher in the group 1 (hazard ratio 2.08, 95% CI 1.23-3.51, p=0.006). While the risk of CV events with univariate analysis tended to be higher in group 4, there was no significant association between SBP and the risk of CV events with multivariate analysis. The risk of the composite events with multivariate analysis was significantly higher in group 4 (hazard ratio 1.61, 95% CI 1.01-2.57, p=0.047).

Conclusion
This study indicated that lower SBP was independently associated with all-cause mortality in patients undergoing PD. Moreover, higher SBP might be involved with composite events.
P1155REMOVAL OF PHOSPHATE AND CREATININE DURING PD WITH DIFFERENT GLUCOSE CONCENTRATIONS
Authors: Stachowska-Pietka Joanna , Teixido-Planas Josep , Troya Maria-Isabel , Leypoldt John (Ken) 
Published: June 2020

Abstract

Background and Aims
Adequate removal of creatinine and phosphate is one of the key objectives in peritoneal dialysis (PD). Whereas the mechanism of creatinine removal is well known, there are gaps in understanding regulation of phosphate removal. Clinical studies show that although the size of both molecules is similar, their removal might behave differently (Badve et al CJASN 2008). Several, but not all, studies have suggested that peritoneal phosphate clearance is larger when using CAPD than APD prescriptions, suggesting the dwell time or duration is an important determinant of phosphate clearance. The aim of the study was to investigate specifically the effect of dwell duration at the level of single PD exchange with different glucose concentrations on peritoneal phosphate clearance.

Method
A prolonged 8-hour PET was carried out in 32 clinically stable PD patients with each of three glucose-based solutions: 1.36% (G1), 2.27% (G2), and 3.86% (G3) with temporary drainage at 1 and 4 hours of peritoneal dwell. Dialysate and blood samples were taken to measure infused and drained volume and concentration of phosphate and creatinine in dialysate and blood. Clearances were calculated for a single exchange for each solution and for 4-hour (4H) and 8-hour (8H) dwell periods. For each patient, the 4-hour creatinine D/P ratio for G3 was calculated. The clearance ratio, ClR, defined as the ratio of solute clearance for particular solution to its clearance for the G1 solution, was calculated for both solutes and each solution and dwell durations.

Results
The obtained values of 4H creatinine D/P ratio for G3 solution were 0.67±0.11 (mean±SD). The values of solute clearances per single exchange expressed in mL/min, are presented in table below.
Creatinine and phosphate clearances were found to be solution and dwell duration dependent with p&lt;0.001. The clearances of both solutes were correlated for the same dwell duration or solution (not for creatinine G2 for 4H vs 8H) with p&lt;0.05. Moreover, solute clearances were also correlated with creatinine D/P for 4H but not for 8H. The clearances of phosphate were also correlated with that for creatinine each solution at both dwell durations with p&lt;0.001. Both calculated ClR were found to be dependent on the solution (p&lt;0.001) but not dwell duration. Similar dependence on solution and correlations are valid in one analyze solute mass removal.

Conclusion
Phosphate and creatinine clearances were found to be well correlated during a long, 8-hour PET proving similarities in their transport. Interestingly, the dependence of both clearances and ClR on solution glucose concentration suggest that the removal of phosphate as well as creatinine depends on the ultrafiltration induced by glucose concentration in dialysis solution.
P1157IMPACT OF MODE OF DIALYSIS ON COMPLICATIONS AFTER SIMULTANEOUS PANCREAS- KIDNEY TRANSPLANTATION
Authors: Martinez Adoración , Lanuza Manuel , Manzano Diana , Lopez Francisca , Carceles Eulalia , Valda de Miguel M Teresa , Navarro Julian , Domingo Julio , Cabezuelo Juan Bernardo 
Published: June 2020

Abstract

Background and Aims
Simultaneous pancreas-Kidney transplantation (SPKT) has established its position in treating patients with type 1diabetes and end-stage renal disease. Infections in the early post-transplantation period are one of the most significant causes of the high morbidity and mortality rates associated with SPKT. Pre-transplant dialysis modality may affect evolution and it has suspected that peritoneal dialysis (PD) is associated whit more surgical complications, especially intra-abdominal infections.
The aim: evaluate whether pretransplant dialysis modality affects the risk for postoperative complications in SPKT transplant recipients

Method
retrospective and descriptive study of a series of patients who underwent SPKT from 2000 to 2018 in our hospital. We studied complication occurring during the first 3 months after transplantation

Results
From 2000 to 2019 we performed 38 SPKT in 22 men and 16 women. The mean age of the patients was 35.3(28-44) years. Of the 38 SPKT patients, 44.7% on hemodialysis before transplantation, 26.3% were on peritoneal dialysis and 28.9% had not received any substitutive renal therapy. Were similar regarding baseline characteristics.
The complications of the post-transplant period are shown in graph 1. The most frequent complications were infectious in almost 2/3 of the patients and within them the intra-abdominal infections affected almost half, 18, of the patients. Were 3 thrombosis of the pancreas that caused the loss of the graft but none of the kidney.
All early postoperative complications are compared in table 1.Whit no significant difference between groups of intraabdominal infection (p. 0.5) and graft thrombosis (p 0.7). There were also no differences in relaparotomy, acute rejection and delayed graft function
During the follow-up 4 patients died, one case due to a heart attack while the other 3 in relation to intraabdominal infectious processes and need for reintervention
Conclusion: Despite improvements in the outcomes of STKP infectious complications remain a significant cause of morbidity and mortality Peritoneal dialysis is not a risk factor postoperative complication after STPK
P1161CUTANEOUS MICROCIRCULATORY DYSFUNCTION IN PERITONEAL DIALYSIS PATIENTS
Authors: Williams Jennifer , Gilchrist Mark , Fraser Donald , Strain David , Shore Angela 
Published: June 2020

Abstract

Background and Aims
Microvascular impairment is an early step in cardiovascular disease (CVD), the major cause of morbidity and mortality in patients with CKD. Changes in skin microvascular reactivity have been shown to reflect more widespread changes in the systemic and coronary microcirculation. Microvascular function is attenuated by advancing age and conditions that commonly coexist with CKD such as diabetes and hypertension. We investigated whether skin microvascular reactivity is impaired in peritoneal dialysis (PD) patients compared with healthy controls and whether this impairment is independent of comorbidity.

Method
Forearm skin vasculature was examined in 27 healthy controls, 27 patients on PD and 27 controls matched to the PD patients for age, gender, diabetes and previous CV events. Microvascular function was assessed using laser Doppler flowmetry in combination with post-occlusive reactive hyperaemia (a test of generalised microvascular function) and iontophoretic application of acetylcholine (ACh) and sodium nitroprusside (SNP) to investigate endothelium dependant and non-endothelium dependant vasodilation respectively.

Results
Peak post-occlusive flow was lower in the PD patients than in both the healthy controls and the co-morbidity matched group; 90.45 AU (60.9-128.35) in healthy controls, 73AU (58.8-134.4) in matched controls and 56.95AU (45.1-89.8) in PD patients (p=0.0239 healthy controls versus patients, p=0.0373 matched controls versus patients). SNP-mediated vasodilatation was statistically lower in the PD group compared with healthy controls (p= 0.016), ACh response was lower but did not reach statistical significance (p= 0.076). ACh and SNP-mediated vasodilatation trended towards being lower in PD patients than matched controls but did not reach statistical significance.

Conclusion
The PD patients were characterised by a generalised dysfunction of the skin microcirculation compared with healthy controls and controls matched for factors known to affect the microcirculation. This appears to be the result of impaired endothelium dependant and independent vasodilatory mechanisms.
P1172IS PERITONEAL PROTEIN LOSS A CONSEQUENCE OF OVERHIDRATATION?
Authors: Malho Guedes Anabela , Domingos Ana , Calças Roberto , Silva Ana , Bernardo Idalécio , Neves Pedro , Rodrigues Anabela 
Published: June 2020

Abstract

Background and Aims
Peritoneal protein loss (PPL) in peritoneal effluent is a well-recognised detrimental result of peritoneal dialysis treatment since its inception. Hydrostatic convection is a major drive for peritoneal protein transport; therefore venous congestion may have a role in peritoneal protein loss (Krediet RT et al Perit Dial Int. 2019 ). The aim of this study was to explore the importance of overhydration on the magnitude of peritoneal protein clearance in incident PD patients.

Method
A total of 97 adult incident PD patients were included. A standard peritoneal equilibration test, 24-hour urine and dialysate collection, and multifrequency bioimpedance analysis were performed. Independent-samples t test and Pearson correlation coefficient were performed to evaluate relevant clinical associations and linear multivariable regression was done.

Results
Statistically significant univariable relationships for 24h PPL were found for continuous ambulatory PD technique (CAPD) and, with a correlation coefficient &gt;0.20, for age, pulse pressure, 4-hour dialysate/plasma creatinine and extracellular water/total body water. On multivariable analysis, type of PD technique (β=0.327, p=0.011), 4-hour dialysate/plasma creatinine (β=0.247, p=0.037), and extracellular water/total body water (β=0.304, p=0.016) were significant independent predictors of peritoneal protein loss.

Conclusion
Overhydration revealed the most important connection with peritoneal protein loss. Mortality has been associated with PPL in some studies, but not others. This could be a result of this relationship, as volume overload has been strongly related with lower survival.
P1175INTESTINAL MICROBIOME, METABOLOME AND BACTERIALLY-DERIVED UREMIC TOXINS IN PD-PATIENTS - DISPARITIES IN CHRONIC KIDNEY DISEASE AND ACUTE KIDNEY INJURY
Authors: Daniel-Fischer Lisa , Herzog Rebecca , Aufricht Christoph , Kratochwill Klaus 
Published: June 2020

Abstract

Background and Aims
Recent evidence suggests a bidirectional relationship between the intestinal microbiome and CKD. CKD and concomitant uremia lead to loss of integrity of the intestinal barrier, causing increased intestinal permeability and potentially contributing to systemic inflammation. Uremia itself has been speculated to cause a selection of certain microorganisms, known as dysbiosis. The alteration of the intestinal microbiome may favor the formation of specific uremic toxins. We hypothesized that the composition of the microbiome is altered between patients with CKD and AKI. The aim was to investigate the effect of CKD (with already established uremic dysbiosis) and AKI (without established uremic dysbiosis) and the exposure to PD-fluids on the intestinal microbiome and on a local (peritoneal) and systemic metabolome level of patients treated with PD.

Method
Patients on PD therapy with CKD and AKI were included. Stool samples were analyzed by 16S rRNA sequencing, 188 systemic (serum) and local (PD-effluent) metabolites as well as 10 uremic toxins (including p-cresyl sulfate and indoxyl sulfate) were analyzed using a mass spectrometric approach. Clinical standard parameters in serum and PD-effluent were measured by routine laboratory techniques.

Results
Changes in relative abundances of intestinal bacteria and differences in gut microbiome composition at the phylum level were associated with chronic disease. Patients with CKD and AKI had significantly increased levels of uremic toxins and revealed a distinct metabolomic pattern. Cross-omics correlation between bacterial phyla and metabolites was performed to obtain functional information on differentially abundant species and molecules.

Conclusion
Patients with CKD on PD are characterized by an altered intestinal microbiome, local and systemic metabolome changes in contrast to patients with AKI. PD-patients with CKD and AKI have increased serum levels of bacterially-derived uremic toxins. Further investigations are required to obtain deeper understanding of reciprocal influences of the uremic status and intestinal microbiome.
P1178FEASIBILITY OF UNPLANNED START IN PERITONEAL DIALYSIS (PD)
Authors: López Melero Eva , Sosa Barrios R Haridian , Burguera Vion Víctor , Ortego Pérez Sofía , Fernandez Lucas Milagros , Rivera Maite 
Published: June 2020

Abstract

Background and Aims
Chronic kidney disease (CKD) is increasing worldwide and there is a rising need for renal replacement therapies (RRT). PD has multiple advantages over hemodialysis (HD), but in most patients requiring an unplanned start HD is the selected RRT.

Method
We retrospectively analyzed all patients started on unplanned PD in our unit from January 2006 until April 2019. Demographics, blood test parameters and complications were collected. Unplanned start on PD was defined as initiating PD less than 4 weeks after PD catheter implantation.

Results
Of 14 patients, 8 were referred from ACKD clinic, 3 were failing renal transplants and 3 previous PD patients that required catheter replacement due to severe peritonitis. Fluid overload with rapid decline in kidney function was the acute trigger for RRT in 4 patients and 1 had a nephrectomy. Late referral with uremic symptoms was the reason for unplanned start in 5 patients. Two patients (14.2%) had mechanical complications that did not require surgical intervention. None had infections related to technique. PD was performed by our PD unit nursing staff in all cases and technique was well tolerated. Results are summarized in table 1.

Conclusion
PD is a safe and valid option even when an unplanned start on RRT is required. It did not show higher morbidity nor mortality in our series, allowing avoidance of central lines in our patients and preserving vascular capital. Furthermore, PD is a less expensive technique than HD. Nursing staff support is key to develop it.
P1179PREDICTIVE FACTORS OF PERITONITIS IN PERITONEAL DIALYSIS PATIENTS AFTER TENCKHOFF CATHETER IMPLANTATION : A META-ANALYSIS
Authors: Makrufardi Firdian , Safika Erri Larene , Galayudha Aulia Sigra , Wijayanto Rachmat Aldhi 
Published: June 2020

Abstract

Background and Aims
Chronic kidney disease is one of the leading cause of years living with disability. Peritoneal dialysis has been an effective treatment for end-stage renal disease (ESRD). Unfortunately, there are infectious and non-infectious complication after tenckhoff catheter implantation in patients. Peritonitis has been the most common major clinical problem and is often the cause for failure of peritoneal dialysis. Many researchers have studied the predictive factors of peritonitis in peritoneal dialysis patients after tenckhoff catheter implantation, but their conclusion were not always consistent. Therefore we performed a meta-analysis to make a more integrated and precise estimation.

Method
Multiple databases were searched for comparative studies without language or date restrictions. Gray literature was sought. The meta-analysis study was conducted using Revman 5.3, with p &lt;0.05 considered significant. Aspects investigated included age at implantation, diabetes mellitus, and gender. Two reviewers independently assessed study eligibility and the quality of included studies.

Results
A total of 7 studies were identified and analyzed, and 3 were multi-institutional. Reporting standards were highly variable. Overall, 7730 patients with ESRD were incorporated in this study. Meta-analysis demonstrated there was signiﬁcant difference in the incidence of peritonitis with age at implantation, (OR= 1.98 [1.81, 2.17], p=0.00001). Significant difference was not seen in the incidence of peritonitis with diabetes mellitus, (OR= 1.03 [0.23, 4.55], p=0.97). Meta-analysis showed that there was no association between gender with incidence of peritonitis (OR= 1.57 [0.62, 3.97], p=0.35), while male had a higher peritonitis incidence (See figure). No publication bias was noted in this study

Conclusion
Peritonitis is still a major problem in patients with peritoneal dialysis. Age at implantation is the predictive factors that affect peritonitis incidence in peritoneal dialysis patients after tenckhoff catheter implantation, while gender and diabetes mellitus do not appear to be correlated with peritonitis incidence.