bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0750ASSOCIATION OF SERUM POTASSIUM LEVELS WITH RAPID KIDNEY FUNCTION DECLINE IN PATIENTS WITH CONGENITAL SINGLE KIDNEY
Authors: GADALEAN FLORICA , Parv Florina , Petrica Ligia , VELCIOV SILVIA , Gluhovschi Cristina Anca , Bob Flaviu , OANA MILAS , Mihaescu Adelina , GOLEA-SECARA ALINA , SIMULESCU ANCA , Grosu Iulia Dana , Chisavu Lazar , Floroiu Madalina , Schiller Adalbert 
Published: June 2020

Abstract

Background and Aims
Hypokalemia is associated with progression of chronic kidney disease (CKD), although the possible underlying mechanisms are not well established. Several observational studies showed that low or even low to normal serum potassium levels predict the decline of kidney function in the general population. However, this hypothesis has not been yet investigated in patients with reduced nephron number as are congenital single kidney (cSK) patients.
Our aim was to prospectively examine the association of plasma potassium with risk of rapid kidney function decline in a cSK patients’ cohort.

Method
A cohort of 67 consecutive patients with cSK (mean age = 44.4+/-15.7 years; males 29p (43.28%)), with a mean estimated glomerular filtration rate (eGFR) = 65.2+/-28 ml/min/1.73m2, were enrolled in this longitudinal observational study. We evaluated the associations of plasma potassium levels with longitudinal kidney function decline by estimated glomerular filtration rate (eGFR). The eGFR was assessed with CKD-EPI formula. The rapid kidney function decline was defined as a fall in eGFR of more than 5 ml/min/1.73 m2/year, according to the KDIGO guidelines.

Results
During a mean follow-up time of 20.16+/-9.3 months, 31.34% (21p) of patients presented decline of eGFR, with a fall of mean – 11.6+/-5.43 ml/min/1.73m2/year. In univariable regression analysis, the decline of eGFR was associated with baseline eGFR (R2=0.09, p=0.013), age (R2=0.31, p&lt;0.001), male gender (R2=0.14, p=0.001), arterial hypertension (R2=0.17, p=0.001), diabetes mellitus (R2=0.13, p=0.003), coronary artery disease (R2=0.12, p=0.005), uric acid (R2=0.23, p&lt;0.001), C-reactive protein (R2=0.09, p=0.011), proteinuria/24h (R2=0.14, p=0.002) and serum potassium (R2=0.29, p&lt;0.001). The serum potassium levels were significantly lower in the group with rapid decline of eGFR, with a mean of 3.62+/-0.41 mmol/L vs. 4.51+/-0.74 mmol/L, p&lt;0.001. In multivariable regression analysis, the association between lower serum potassium levels and risk of rapid eGFR decline remained significant (HR=1.65; 95%CI, 1.105-2.49; p=0.015).

Conclusion
These results suggest that lower serum potassium levels may play a role in rapid kidney function decline in the cSK population. Further research is required to assess whether the higher risk of kidney function decline in cSK individuals could be diminished when optimised serum potassium levels strictly.
P0751METFORMIN, A CLASSIC TREATMENT FOR TYPE 2 DIABETES WITH POSSIBLE RENOPROTECTIVE EFFECTS
Authors: Acosta Barrios Adriana , Goicoechea Marian , Verde Eduardo , González-Rojas Ángela , Delgado Andres , Muñoz de Morales Alejandra , Carbayo Javier , Verdalles Ursula , Ana Pérez de José , Luno Fernandez Jose 
Published: June 2020

Abstract

Background and Aims
Metformin is the antidiabetic of choice in patients with type 2 diabetes mellitus. Experimental studies and clinical observations have shown that metformin could have a beneficial effect on the progression of kidney disease through the activation of cAMP due to its anti-inflammatory, antifibrotic, and anti-oxidative action. The objective was to compare the progression of CKD in diabetic patients with or without metformin as antidiabetic in their treatment and the prevalence of cardiovascular events in both groups.

Method
Unicentric retrospective observational analysis. Inclusion criteria: outpatients seen in nephrology consultation during the year of 2012 with diabetes mellitus and stage 3 CKD. Renal, cardiovascular outcomes and mortality were analyzed between patients treated with / without metformin. Median follow-up of 76.5 months (41-84). Renal end-point: estimated glomerular filtration rate drop (MDRD-4) by 50% and / or start of dialysis program. Cardiovascular end-point: ischemic heart disease, stroke, arterial revascularization and / or amputation. Cardiovascular or any cause mortality.

Results
148 patients (96M, 52W) with a mean age of 75±9 years and an eGFR of 40±9 ml / min / 1.73 m2 were included. In relation to hypoglycemic therapy: 45 received metformin, 61 insulin and 31 DPP4i. 80% received treatment with RAAS blockers. After the follow-up, the progression of the renal disease was greater in patients who did not receive metformin: eGFR fall of -7.0±16 vs -0.15±16 ml / min in those treated with metformin (p = 0.019). 25 patients in the group without metformin suffered a renal event vs. 5 in the metformin group (logRank: 4.186, p = 0.045). In the Cox analysis, metformin treatment decreases the progression of kidney disease in a model adjusted for baseline renal function and treatment with RAASB (HR 0.368, p = 0.043), losing its predictive power in a proteinuria-adjusted model. During the follow-up, 45 patients died (20 metformin, 25 non-metformin) and 45 patients suffered a cardiovascular event (15 metformin, 30 non-metformin), with no differences between the two groups.

Conclusion
Metformin treatment in patients with stage 3 CKD could slow the progression of CKD, this effect should be demonstrated in randomized studies with larger sample size.
P0762THE SERUM URIC ACID HAS A INDEPENDENT ASSOCIATION WITH 1-YEAR RENAL OUTCOMES IN CHRONIC KIDNEY DISEASE PATIENT WITH HYPERTENSION
Authors: RYU JIWON , Lee Chung Sik , Kim Sejoong , Cha Ran-Hui , Lee, Hajeong , Lee Jung Pyo , Song Young Rim , Kim Yon su , Kim Sung Gyun 
Published: June 2020

Abstract

Background and Aims
Serum uric acid (UA) is associated with renal disease. Hyperuricemia can be a risk of hypertension, intrarenal vascular disease and renal injury. We investigate the serum UA has an association with renal disease progression in patients with chronic kidney disease (CKD) with hypertension.

Method
We recruited 270 CKD patients with hypertension from 4 centers in Korea through the APrODiTe study and followed for 1 year. Serum UA was evaluated as a continuous value and groups divided by quartiles. The renal outcomes were an increase in random urine protein/creatinine ratio (PCR) than baseline value or estimated glomerular filtration rate (eGFR) deterioration which means a decrease in eGFR ≥ 5 (ml/min/1.73m2).

Results
Baseline serum UA was 6.58 ± 1.73 mg/dl and 6.52 ± 3.59 mg/dl after 1 year. For proteinuria progression, a 1 mg/dl higher serum UA has independent correlation in multivariate regression (odds ratio (OR): 1.272; 95% confidence interval (CI): 1.031-1.568; P = 0.024). The higher quartile of serum UA showed a correlation with the odd ratio than lower quartile (OR: 2.243; 95% CI: 0.862-5.837; P = 0.098, OR:3.417; 95% CI: 1.275-9.152; P= 0.015, OR: 2.754; 95% CI: 1.013-7.488; P &lt; 0.047). In subgroup analysis, the patients with late CKD stage (3-5) showed serum UA has a positive correlation with proteinuria progression (OR: 1.311; 95% CI: 1.022-1.682; P= 0.033) and the top quartile group was correlated with the increased odds ratio compared to lower quartile (OR: 3.811; 95% CI: 1.153-12.59; P = 0.028). For eGFR deterioration, the higher quartile of UA was positively correlated with the odd ratio in only univariate analysis.

Conclusion
Serum UA level has an independent correlation with proteinuria progression in especially late CKD patient with hypertension. Whereas for eGFR deterioration, serum UA did not show a significant correlation.
P0815ASSOCIATIONS BETWEEN ALCOHOL CONSUMPTION AND CHRONIC KIDNEY DISEASE: A POPULATION-BASED SURVEY
Authors: Wu Hon-Yen , Tsai Wan-Chuan , Hsu Le-Yin , Peng Yu-Sen 
Published: June 2020

Abstract

Background and Aims
Observational studies suggest an association between moderate alcohol consumption and cardioprotective effects. However, the role of alcohol consumption on chronic kidney disease (CKD) remains inconclusive, and little is known about whether age influences the effects alcohol consumtion. This study aimed to evaluate the associations between alcohol consumption and chronic kidney disease in a population-based survey.

Method
We used data from the Taiwanese Survey on Prevalences of Hypertension, Hyperglycemia, and Hyperlipidemia. This is a population-based survey which applied a multistage, stratified, and random sampling from population throughout Taiwan in 2007. The survey assessed the prevalence, awareness, and treatment of metabolic syndrome by body measurements, structured questionnaires, and examinations of blood and urine. We obtained data of adult participants, including demographic characteristics, anthropometric measurements, lifestyle habits, and results of blood and urine exams. According to the frequency of alcohol consumption, we categorized participants into frequent drinkers (at least 1 time per week), occasional drinkers (less than 1 time per week), and nondrinkers. The study outcome was CKD, which was defined as an estimated glomerular filtration rate (eGFR) &lt; 60 mL/min/1.73 m2 or a dipstick proteinuria ≥ 1+. The eGFR was calculated using the Chronic Kidney Disease Epidemiology Collaboration equation. We used univariate and multivariate logistic regression analyses to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for study outcome comparing different levels of alcohol consumption. To evaluate the influence of age, we stratified participants into younger (age &lt; 45 years) and older (age ≥ 45 years) subgroups.

Results
The mean age of the participants were 48 years, with a female prevalence of 53% and CKD prevalence of 12%. There were 2,197 older participants and 1,770 younger participants. There were 548 frequent drinkers, 915 occasional drinkers, and 2,504 nondrinkers. Compared with nondrinkers, occasional drinkers (OR 0.59, 95% CI 0.43-0.81) and frequent drinkers (OR 0.61, 95% CI 0.44-0.87) showed a lower hazard risk of CKD (Table). Among those with an age ≥ 45 years, occasional drinkers (OR 0.56, 95% CI 0.30-0.81) showed a lower risk of CKD but frequent drinkers (OR 0.70, 95% CI 0.49-1.01) showed a borderline lower risk of of CKD compared with nondrinkers (Table). Among those with an age &lt; 45 years, only frequent drinkers (OR 0.36, 95% CI 0.13-1.00) showed a lower risk of CKD compared with nondrinkers (Table).

Conclusion
Our study showed that alcohol consumption was associated with a lower risk of CKD, and this effect seemed to be more prominent among frequent drinkers and those with an age ≥ 45 years. Whether alcohol consumption provides renoprotective effects, as well as the influence of age, requires longitudinal studies.
P0830PREVALENCE OF ANXIETY IN CHRONIC KIDNEY DISEASE PATIENTS - A SYSTEMATIC REVIEW AND META-ANALYSIS OF LITERATURE
Authors: Huang Weihao Caleb , Wee Poh Hui , Low Lian Leng , Koong Ying Leng Agnes , Htay Htay , Foo Marjorie , Fan Qiao , Seng Jun Jie Benjamin 
Published: June 2020

Abstract

Background and Aims
Anxiety is a common psychopathology that affects patients with chronic kidney disease (CKD) and has been associated with poor quality of life and clinical outcomes. This review aimed to summarize the prevalence of anxiety symptoms and disorders among CKD patients.

Method
A literature search for observational studies, which reported the prevalence of anxiety in CKD patients, was performed in Medline®, Embase®, PsychINFO® and CINAHL® (through January 2019), in accordance with the PRISMA checklist. Peer reviewed, full text articles in English language were included. Studies involving kidney transplant patients were excluded. Anxiety disorders and symptoms were diagnosed and assessed using the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) or DSM-V criteria in clinical interviews, or self-administered anxiety rating scale questionnaires. To estimate the prevalence of anxiety, random effects meta-analyses were used due to the expected heterogeneity across studies.

Results
Of the 4130 reports screened, 53 studies were included. Majority of studies were conducted in Asia (n=26, 49.1%) followed by Europe (n=14, 26.4%) and North America (n=7, 13.2%). The Hospital Anxiety and Depression Scale (HADS) was the most used instrument (n=28, 52.8%) followed by the Beck’s Anxiety Inventory (BAI) (n=11, 20.7%). The pooled point prevalence of anxiety across the studies involving 9,355 patients was 40.0% (95% confidence interval (CI): 33.3 – 46.7). Across continents, the prevalence of anxiety was highest in Asia (42.9%) (95% CI: 32.3 – 53.5) followed by North America (42.3%) (95% CI: 28.6 – 56.0). The prevalence of anxiety in studies that included only dialysis (n=45) or non-dialysis (n=4) patients were similar at 38.9% (95% CI: 31.8 – 46.1) and 30.5% (95% CI: 14.6 – 46.3) respectively. The prevalence of anxiety in studies that had both dialysis and non-dialysis patients (n=4) was 62.6% (95% CI: 47.1 – 78.2).

Conclusion
Given that anxiety is prevalent in 40% of CKD patients, future studies should explore developing effective anxiety screening tools and interventions as part of CKD patient management to improve clinical outcomes.
P0831HIGH SERUM ALKALINE PHOSPHATASE PREDICTS THE RISK OF CKD PROGRESSION: EFFECT NODIFICATION BY THE GFR
Authors: Mallamaci Francesca , D'arrigo Graziella , Marino F , Caridi Graziella , Parlongo Giovanna , Leonardis Daniela , Pizzini Patrizia , Cutrupi Sebastiano , Pisano Anna , Tripepi Giovanni Luigi , Kalantar-Zadeh Kamyar , Zoccali Carmine 
Published: June 2020

Abstract

Background and Aims
In the post-hoc analyses of the SUSTAIN and ASSURE trials (Kidney Blood Press Res. 2018;43:449-457), Apabetalone, an epigenetic modulator which lowers serum alkaline phosphatase (AlkPhos), stabilized the GFR in patients with cardiovascular disease and a GFR &lt;60/ml/min/1.73m2. Analyzing the relationship between AlkPhos and renal outcomes in patients with established CKD is useful to preliminarily explore the biological hypothesis that AlkPhos is implicated in CKD progression.

Method
We investigated the relationship between AlkPhos and the risk for a combined renal end-point (30% GFR loss or dialysis/renal transplantation) in a cohort of 609 stage 3-5 CKD patients with an average GFR of 34.8±12.1ml/min/1.73 m2.

Results
Median AlkPhos levels were 91 IU/L (Interquartile range 71-117 IU/L) and in the vast majority of patients had values below 147 IU/L (the upper limit of the normal range). Over a median follow up of 3 years, two-hundred patients had the combined renal end-point. In an unadjusted analysis 1 ln increase in AlkPhos entailed a 49% risk excess for the renal end-point (HR: 1.49, 95% CI 1.11-2.01, P=0.008). Adjusting for traditional (age, gender, smoking, diabetes, total cholesterol, BMI, systolic BP, CV comorbidities) and CKD specific risk factors (hemoglobin, albumin, phosphate, and hs-CRP) did not modify the strength of this association (HR:1.48, 95% CI 1.08-2.02, P=0.016). Furthermore, In a fully adjusted analysis testing the GFR as an effect modifier of the AlkPhos - combined renal end point relationship showed a strong GFR- AlkPhos interaction (Figure). Indeed the risk for the combined renal end-point was gradually more pronounced at progressively more severe degrees of renal dysfunction, the HR being 0.94 (CI95% 0.60-1.47) at a GFR of 40 ml/min/m2 and 2.71 (CI95% 1.49-4.93) at 10 ml/min/1.73m2.

Conclusion
In patients with stage 3-5 CKD alkaline phosphatase within the normal range is associated with the risk for progression to ESRD and the GFR is an effect modifier of this relationship. Findings in this study are compatible with the hypothesis that within the normal range of this biomarker, the risk for CKD progression by alkaline phosphatase is amplified by the severity of CKD. These data are in keeping with post-hoc analyses of the SUSTAIN and ASSURE trials and provide circumstantial support to the hypothesis that interventions lowering serum alkaline phosphatase may mitigate CKD progression.
P0833SYMPTOM BURDEN IN CHRONIC KIDNEY DISEASE : A CASE FOR STARTING KIDNEY SUPPORTIVE CARE CLINIC
Authors: Prabhu Ravindra Attur , Singhai Pankaj , Salins Naveen , Nagaraju Shankar Prasad , Rao Indu R , Rangaswamy Dharshan , Shenoy Srinivas Vinayak , Rao Seema 
Published: June 2020

Abstract

Background and Aims
Chronic Kidney Disease(CKD) is associated with a huge symptom burden which increases with progression and leads to depreciation in Quality of life both directly and indirectly through effects on functional status, health perception, and feelings of subjective well-being. Dialysis therapy does not completely improve symptoms. We studied supportive care needs of patients with CKD through assessment of symptoms using translated version of Integrated Palliative Care Outcome Scale (IPOS- Renal) in a single tertiary health setting.

Method
Patients with chronic Kidney disease having creatinine clearance less than 60 ml/min/m2 were surveyed using IPOS Renal modified translated to vernacular language by forward- backward method. Translated version was approved by independent translator. Symptoms were classified into domains and analyzed using descriptive statistics. Scores were compared for those on maintenance hemodialysis with predialysis CKD patients.

Results
Of 184 patients, 128(69.6%) were receiving twice weekly hemodialysis, mean age was 52 years (range 20-82 year), 140(76%) were male. Average duration of dialysis was 4 years, 87 (46.9%) reported pain of which 39/87(45%) had moderate to severe pain. Other symptoms over past one week were dyspnea in 59(33.6%), Fatigue in 117(69.4%), Nausea in 53(33.6%), Vomiting in 36(20.9%), Anorexia in 90(42.4%), Constipation in 50(35.3%), Dry mouth/soreness in 62(36.4%), increased drowsiness in 63(46.6%), poor mobility in 87(55.8%), Itching in 69(39.3%), Disturbed sleep in 83(48.6%), Restless leg in75(43.6%), Skin related problems in 47(28.6%). Five patients reported presence of other severe symptoms. In Psychosocial domain 138(79.8%) patients and 126(72.8 %) family members expressed anxiety related to their disease or treatment of which one third had persistent anxiety, 140(81.6%) felt depressed and among them 58(42%) felt it most of the time or always and 145(88.6%) felt that they were not at peace, 59(35%) felt they did not have enough information about their disease and treatment and 79(47%) reported that they had unaddressed financial or personal problems, 124(77.2 %) felt they had to spend significant amount of time in healthcare facility. Patients on dialysis had significantly higher symptoms burden and Psychosocial needs.

Conclusion
CKD patients face high physical and psychosocial burden which is unaddressed in present clinical care and increases with stage. Tools such as iPOS renal are required to assess need of supportive care in CKD. Kidney supportive care clinic may be required to address this unmet need.
P0840RENAL FUNCTION AND RISK FACTORS IN LIVER TRANSPLANT PATIENTS
Authors: Kang Gun Woo , Kim Seoung Gyu , Lee In Hee , Ahn Ki Sung 
Published: June 2020

Abstract

Background and Aims
Advanced surgical techniques and medical managements play major roles in improving patient survival after liver transplantation (LT). At the same time, identifying the causes and risk factors for long-term survival after LT are also important. Renal dysfunction following malignancy and infection is known as an important cause of mortality after LT. Various causes such as pre/post transplantation factors are known to affect renal function. The purpose of this study is to investigate the changes of renal function in patients undergoing LT and to identify factors that can predict long-term renal dysfunction.

Method
A retrospective study was performed on 113 patients aged 15 years or older who had undergone LT at Daegu Catholic University Hospital form January 2012 to December 2013. 97 patients survived and were followed up. Changes of renal function after LT were identified using serum creatinine every year up to 4 years. And all patients were divided into groups with increased creatinine (70 patients) and non-increased creatinine (27 patients) at 4 years after LT. pre-transplantation factors were blood urea nitrogen (BUN), creatinine, protein, albumin, hemoglobin, total bilirubin, international normalized ratio. Subsequent BUN and creatinine were compared by independent t test. Statistical analysis was performed with IBM SPSS Statistics for Window, Version 19.0.

Results
58 were male (59.7%) and the mean age was 49.5 years old. 83 patients (85.6%) received liver transplantations from living donors. There were no significant differences in the donor types and recipient’s sex between the two groups with the increased and non-increased creatinine at 4 years after LT. However, the age of recipients was a significant difference between the two groups (51.3 and 45.4 years old) (p=0.018). Annual mean creatinine levels from pre-transplantation to 4 years after LT were 0.88 ± 0.39 (before transplant), 1.19 ± 0.54 (1 year after LT), 1.07 ± 0.44 (2 years), 1.12 ± 0.68 (3 years), and 1.19 ± 0.99 (4 years). Renal function decreased in 1 year after LT and improved in 2 years, then decreased again. In univariate analysis, the increased creatinine group was older than the non-increased group, and BUN and creatinine at 1 year after LT were significant differences in the two groups (p = 0.018, p = 0.031, p = 0.013). Multivariate analysis identified the creatinine at 1 year was an independent risk factor for long-term renal function after LT (OR 14.31, 95% CI: 1.5-133.3, p = 0.019).

Conclusion
This study explored that renal function was continuously decreased after LT and renal function at 1 year after LT had a significant effect on long-term renal function. Therefore, management of renal function during one year after LT is important for long-term renal function and may reduce mortality.
P0860INTRAVENOUS IRON ADMINISTRATION SUPPRESSES ENDOGENOUS ERYTHROPOIETIN SECRETION IN PATIENTS WITH CHRONIC KIDNEY DISEASE
Authors: Muras-Szwedziak Katarzyna , Pawlowicz Ewa , Nowicki Michal 
Published: June 2020

Abstract

Background and Aims
Iron therapy may induce inflammatory response that may indirectly affect endogenous erythropoietin (EPO) production. We postulated that increased secretion of FGF-23 may provide a link between intravenous iron administration and suppression of endogenous EPO secretion.
Evaluation of a short-term effect of intravenous iron sucrose administration on the secretion of endogenous EPO in patients with chronic kidney disease (CKD).

Method
35 non-dialysed patients with G3b-5 CKD were included. All patients received 100 mg of intravenous iron infusion (iron (III)-hydroxide sucrose complex) daily for 5 days. Plasma concentration of EPO, iFGF-23, cFGF-23, PTH, bone alkaline phosphatase (BAP), phosphorus (PO4) and calcium (Ca) were measured before and two hours after the first and third iron infusion and at the end of iron therapy.

Results
EPO concentration at the end of iron treatment was significantly lower compared to 2 h after the first iron infusion (p&lt;0.001) and before the third dose (p&lt;0.001) (12.6 [31.2] mIU/mL, 30.9 [38.3] mIU/mL, 33.4 [41.3] mIU/mL and, respectively). Conversely, serum iFGF-23 increased significantly after the third dose (61.1 [401.5] pg/mL; p&lt;0.05) and after the treatment (92.1 [849.7] pg/mL; p&lt;0.01) compared to pre-treatment value (48.4 [403.8] pg/mL). cFGF-23 concentration decreased significantly after the first dose of iron (491.8 [828.6] vs. 339.2 [875.8] RU/mL; p&lt;0.01) and after the completion of the therapy (398.7 [931.9]) vs. baseline (p&lt;0.05). There was no linear correlation between EPO and FGF-23.

Conclusion
Intravenous iron therapy increases the secretion of FGF-23 and supresses endogenous EPO production but these two effects do not seem to be related.