bluuebunny/crossref_metadata_2025_split huggingface dataset:
P1817DOES EPIGENETIC FACTORS LIKE HDAC2 PLAYS ROLE IN STEROID RESISTANCE VIA REGULATION OF P-GP AND MRP-1 IN CHILDHOOD IDIOPATHIC NEPHROTIC SYNDROME?
Authors: SINGH HARSHIT , Prasad Narayan , Agarwal Vikas , Jaiswal Akhilesh Kumar 
Published: June 2020

Abstract

Background and Aims
The action of glucocorticoids is to switch off activated inflammatory genes. The activated glucocorticoid receptors (GR) interact with co-repressor molecules to impair NFκB-associated co-activator activity, reducing histone acetylation, chromatin remodelling. Reduction in histone acetylation occurs via recruitment of histone deacetylase (HDAC) 2 to the activated inflammatory gene complex by activated GR, resulting in efficacious suppression of activated inflammatory genes within the nucleus.
To evaluate the effect HDAC 2 on P-gp and MRP-1 expression and function.

Method
Total of 78 subjects were considered in the study out of which 50 were steroid sensitive nephrotic syndrome (SSNS), and 28 were steroid resistant nephrotic syndrome (SRNS) patients. mRNA expression was analyzed on peripheral blood mononuclear cells (PBMCs) in SRNS patients (mean age 8.43±3.8 years), SSNS patients (mean age 7.54±3.5 years). PBMCs were treated with 1µM of Theophylline (HDAC2 stimulator) and 0.8µM of Trichostatin A (HDAC2 inhibitor) for a period of 48 hours. Quantitative PCR was performed using light cycler LC480 using SYBR green PCR technology with SYBR premix relative gene expression levels were calculated and normalized to the corresponding levels of the housekeeping gene (GAPDH).

Results
Expression of P-gp (4.79±0.970 v/s 2.13±0.72, p&lt;0.0001) and MRP-1 (3.99 ±0.8 v/s 1.99 ±0.91, p&lt;0.0001) on PBMCs was increased in SRNS as compared to that of SSNS. HDAC2 mRNA levels were significantly decreased in SRNS patients as compared to that of SSNS patients (2.97 ± 0.95 v/s 6.02 ± 1.13, p&lt;0.0001).
Theophylline(HDAC stimulator) for a period of 48 hours decreased mRNA levels of P-gp and MRP-1 in PBMCs of SRNS with maximal induction at 1µM (fold change 2.65 and 2.21, *p&lt;0.0001) However HDAC2 mRNA expression increased significantly (fold change5.67, *p&lt;0.0001). In SSNS patients P-gp and MRP-1 mRNA expression decreased at1µM (fold change 1.25, 1.24, *p&lt;0.0001) while the mRNA expression was increased (fold change 6.93, *p&lt;0.0001).
TSA(HDAC inhibitor) for a period of 48 hours increased mRNA levels of P-gp and MRP-1 in PBMCs of SRNS with maximal induction at 0.8µM (fold change 7.51, 7.31, *p&lt;0.0001) and significantly decreased the level of HDAC2 (fold change1.50, *p&lt;0.0001) similarly in SSNS patients P-gp and MRP-1 mRNA expression increased at 0.8µM (fold change 3.49, 3.35, *p&lt;0.0001) and HDAC2 decreased (fold change2.53, *p&lt;0.0001) at 0.8µM.
The functional activity of P-gp and MRP-1 was significantly higher in SRNS group as compared to SSNS group (p&lt;0.001), whereas enzymatic activity of HDAC2 was increased in SSNS group as compared to SRNS group (p&lt;0.001)

Conclusion
As we observed that HDAC2 regulates P-gp and MRP-1 efflux pumps, Inducer of HDAC2 may be a probable treatment stratergy for patients of Idiopathic Nephrotic Syndrome.
P1818CLINICAL AND MOLECULAR CHARACTERISTICS OF CHILDREN WITH WT-1-ASSOCIATED STEROID-RESISTANT NEPHROTIC SYNDROME
Authors: Prikhodina Larisa , Bashirova Zilya , Lepaeva Tatjana , Povolotskaya Inna , Sherbakova Natalia 
Published: June 2020

Abstract

Background and Aims
The Wilms tumor suppressor gene 1 (WT1) (MIM 607102) has an important role in renal and gonadal development. WT1 mutations was found to be associated with a large spectrum of phenotypes with autosomal-dominant inheritance, including Wilms tumor, Denys-Drash syndrome (DDS), Frasier syndrome (FS), and isolated steroid-resistant nephrotic syndrome (SRNS). The aim of the study was to investigate clinical and molecular characteristics in children with WT1-associated SRNS.

Method
Retrospective analysis of phenotype and genotype of six children (3M/3F) with SRNS and heterozygous WT1 mutations was performed. Karyotypes were available in all patients. Data on renal histology had three subjects with FS. The median follow-up period was 35.5 (IQR: 20.0; 57.5) months. WT1 mutations identified by direct Sanger sequencing (n=3) and next generation sequencing (n=3).

Results
The median age at onset of WT1-associated SRNS was 10.0 (IQR: 5.5; 22.5) months. 4/6 (66.7%) patients presented with infantile nephrotic syndrome and 2/6 (33.3%) with SRNS. Arterial hypertension was determined in 4/6 (66.7%) of individuals. Among children with WT1-associated SRNS 3/6 (50%) patients had DDS (2M/1F) and 3/6 (50%) subjects had FS (1M/2F). Children with DDS had Wilms tumor in 2/3 (66.7%) of cases and gonadal dysgenesis with hypospadias in 1/3 (33.3%) of children. Causative mutations were identified in all three patients with DDS, including 2 earlier described c.1384C&gt;T in exon 9 and c.1098 + 1G&gt;A in intron 6 in WT1 gene, and one novel mutation с.1378Т&gt;G in exon 9. All DDS children had decreased eGFR to CKD stage 2-3 in two patients aged 7 and 11 years and ESKD in one child at the age of 2 years. All 3 patients with FS had focal segmental glomerulosclerosis on biopsy. Two phenotypic girls with FS had karyotype 46, XY and presented with pseudohermaphroditism. The same earlier described splice site mutation c.1432 + 5G&gt;A in intron 9 in WT1 gene was identified in both cases. One boy with FS had typical male chromosome pattern (46, XY) and gonadal dysgenesis. Splice site mutation c.1432 + 4C&gt;T in intron 9 in WT1 gene was found in the child. Nobody of patients with FS developed gonadoblastoma. Progression to CKD was found in all three cases with FS, including CKD stage 2-3 in two subjects aged 5 and 15 years and ESKD in one phenotypically girl with sex reversal developed at the age of 8 years.

Conclusion
We found that children with WT1-associated SRNS had a wide spectrum of renal and extrarenal phenotypes concerning the development of urogenital system and Wilms tumor with high risk of progression to CKD during childhood. Their phenotypes are clearly associated with the type and location of WT1 mutations led to DDS or FS. Genetic WT1 diagnostics is important in all children with SRNS for early detection, optimal treatment, tumor prevention and prognosis.
P1825ANALYSIS OF LATE RENAL COMPLICATIONS AND RISK FACTORS IN CHILDREN WITH HEMATOPOIETIC STEM CELL TRANSPLANTATION
Authors: Gurbanov Anar , Gülhan Bora , Kuşkonmaz Barış , Okur Fatma Visal , Uçkan Çetinkaya Duygu , Ozdemir Gulsah , Taş Nesrin , Çelegen Kübra , Ozaltin Fatih , Duzova Ali , Topaloglu Rezan 
Published: June 2020

Abstract

Background and Aims
The aim of the study is to investigate the incidence and risk factors of hypertension (HT) and chronic kidney disease (CKD) in patients who had hematopoietic stem cell transplantation (HSCT) during their childhood.

Method
Patients who had HSCT between January 2010-2019 with a minimum follow-up period of 6 months were included in the study. Data regarding renal complications were collected from the medical records of the patients. Guidelines of European Society of Hypertension (ESH) and American Academy of Pediatrics (APA) were used for the evaluation of hypertension. 24-hr ambulatory blood pressure monitoring (ABPM) was performed in children older than 5 years of age (68 patients). Ambulatory hypertension is diagnosed when systolic and/or diastolic blood pressure (BP) load is higher than 25%. Ambulatory prehypertension is diagnosed when mean systolic and/or diastolic BP is less than 95th percentile with systolic and/or diastolic BP load higher than 25%.

Results
A total of 72 patients (41 males and 31 females) were included in the study. The mean age of the patients at last visit was 10.8±4 years. ABPM revealed ambulatory HT in 6 patients (8.8%) and ambulatory prehypertension in 12 patients (17.6%). Office BP revealed HT in 3 patients (4.2%) and increased BP in four patients (5.6%) according to APA guideline (2017). In cohort, 12 patients with normal office BP (according to APA guideline) had ambulatory prehypertension or hypertension with ABPM. Office BP revealed HT in 1 patient (1.4%) and high-normal BP in 3 patients (4.2%) according to ESH guideline. In cohort, 15 patients with normal office BP (according to ESH guideline) had ambulatory prehypertension or hypertension with ABPM (Table 1). After a mean follow-up period of 4.4±2.5 years, CKD developed in 8 patients (11.1%). Patients with chronic graft-versus-host disease, with HLA-mismatched HSCT and/or transplantation of peripheric or cord blood hematopoietic stem cells had increased risk of CKD (p=0.041, p=0.033 and p=0.002, respectively).

Conclusion
Patients with HSCT should be regularly followed for the development of HT and ABPM should be used on regular basis. Patients with risk factors should be closely monitored for the development of CKD.
P1831ABPM DIFFERENCE BETWEEN OBESE AND NON OVERWEIGHT HYPERTENSIVE CHILDREN
Authors: Corcione Adele , Apuzzo Diletta , Pedoto Deianira , Barra Giuseppina , Annicchiarico Petruzzelli Luigi , Pecoraro Carmine , Malgieri Gabriele , Ascione Serena , Barra Pasquale , Pagano Annamaria , Lepore Lorenza 
Published: June 2020

Abstract

Background and Aims
The goal of our study was to analyze the difference in ABPM pattern in overweight and non overweight hypertensive children

Method
The ABPM were performed using Spacelab 90207 and recorded over 24h.Readings were taken every 15 minutes while awake,and every 20 minutes while asleep. In both groups were evaluated the 24h MAP,daytime MAP,nocturnal MAP, systolic and diastolic load,mean 24h SBP and DBP.
A total of 108 pts were enrolled. Pts were divided in two groups.In the first group 54 pts non overweight with primary hypertension:33 male and 21 female with mean age of 10.4 y. In the second group the obese hypertensive children, with mean age of 10.5 y, were divided into two subgroups according to BMI Z-scores:subgroup 1 BMI Z-score &gt;2&lt;3 n 40 pts (17 f;21m); subgroup 2 BMI Z-score &gt;3 n (4f;10m).

Results
Systolic load was significantly higher in obese group (p 0,0409).In obese group n.12 were dipper (22,2%).Obese with BMI zscore &gt;3 was all non dipper (n14 ;100%). In the lean group n 26 was dipper (48.1%),and 28 (51.8%) non dipper. 24 h MAP, Systolic and Diastolic load were significantly higher (p 0,0001) in the obese with BMI z score &gt;3 compared to the lean group.

Conclusion
The statistically significant pathological pattern among obese is the increase inmean PAS and systolic load, as well as the absence of night dipping in severe obese. The increase in systolic load is already evident in obese mild.This gives a significant predictive value of cardiovascular damage to ABPM which increases with the severity of obesity worse.
P1842THE HISTORY OF VETERINARY RENAL PHYSIOLOGY AND NOSOLOGY IN ANCIENT AND MIDDLE AGES GREEK TEXTS
Authors: Diamandopoulos Athanasios 
Published: June 2020

Abstract

ackground and Aims
Background and Aims: To present the ideas of Ancient and Byzantine Greek authors about the renal anatomy, physiology and nosology of mammals, birds, insects and fishes.

Method
Method: We searched for the appropriate passages in the works of Aristotle, Aristophanes Byzantius, Galen, Cladius Aelianus, Alexander Aphrodisiensis, Basilius Caesariensis, Gregorius Nyssensus, Nemesius Emesenus, Hippiatrica Berolinensia, Hippiatrica Parisiana, Hippiatrica Cantabergiensia, Michael Ephesius and Michael Glycas. These texts extended from the 4th cent. BC until the 12th cent. AD.

Results
Aristotle elaborates on the varied number of kidneys in several animals and on the abundance of perirenal fat. The last tissue is essential for protecting and warming the animal but, in excess, it may be lethal, as in the case of sheep. He then describes the multilubular kidneys of some animals and the supposed lack of a bladder in birds and marine animals, with the exception of the sea turtle. Aristophanes adds the issue of the deer’s ectopic kidneys and their number in canines. Basilius and Gregorius elaborate on the minute details of some animals’ organs, like the kidneys and feathers of flying ants and the moral rationale of all these. Nemesius discusses the possibility of some animals surviving without kidneys. The monumental work “Hippiatrica” deals exclusively with horse health and refers, inter alia, to kidney afflictions. It describes the clinical signs of what it calls “nephritis”, with oedema and predominating neurological symptoms. For treatment it recommends several methods of causing renal hyperaemia, like massaging, ointments, warm rooms, heated irons, but also bloodletting. Michael Ephesius returns on the absence of proper kidneys in birds and their substitution with kidney-like organs called “nephroids”. Glycas “justifies” the lack of bladder and kidneys in birds as useless because they secrete their excess water via the feathers, a long flying time and watery stools.

Conclusion
The Ancient and Byzantine Greek authors had understood well several topics of the anatomy, physiology and nosology of the veterinary renal system but they also made some very great mistakes. We will present the above conclusions in length.
P1856KIDNEY CRISES: USING IN SITU SIMULATION TEACHING TO FACILITATE MULTIDISCIPLINARY TEAM WORKING IN RENAL EMERGENCIES
Authors: Nimmo Ailish , Adams Katie 
Published: June 2020

Abstract

Background and Aims
The haemodialysis unit is a unique clinical environment. Specialist nursing staff look after patients, frequently without on-site medical cover, and need to manage medical issues until help arrives. Junior doctors often have limited experience managing renal patients and may not be aware of specialty-specific issues when dealing with medical emergencies. The different skill sets in these groups creates an opportunity for shared learning. Simulation teaching provides a safe environment for individuals to develop communication, team working and clinical skills and helps facilitate discussion and reflection on clinical scenarios. We describe a programme of renal in situ simulation sessions for nurses and junior doctors to allow them to practise their roles in an emergency and evaluate feedback on their perception of the programme.

Method
Seventeen hour-long simulation sessions were delivered between June 2017 and January 2020 within the renal ward in 2 hospitals and in a satellite outpatient dialysis unit. They utilised a high-fidelity SimMan® mannequin. Scenarios were based on common or rare-but-serious medical emergencies (hyperkalaemic cardiac arrest, arrhythmia on dialysis, air embolism, major haemorrhage post-renal biopsy, line sepsis, hypertensive seizure, pulmonary oedema and drug-induced anaphylaxis). Sessions comprised an orientation to the mannequin, a clinical scenario and a debrief discussion. Doctors and nurses completed post-tutorial feedback exploring their thoughts on the programme.

Results
59 healthcare professionals (40 doctors and 19 nurses) participated and completed post-event feedback. All attendees felt that sessions improved their knowledge and increased their confidence in managing similar scenarios in the future. They all felt they would be able to apply their learning to their day job. 86% of participants strongly agreed that the programme helped them develop stronger relationships with colleagues. In white-space boxes, individuals described the sessions as being helpful in developing communication, teamwork, leadership and delegation skills in addition to specific learning points for the individual scenarios. Sessions also identified practical issues, such as where to source medications or monitoring equipment, and led to the creation of an updated protocol folder and distribution of Advanced Life Support algorithms throughout the ward.

Conclusion
Nurses and junior doctors report increased confidence in managing medical emergencies in renal patients and improved relationships with colleagues following a simulation training programme. The programme promotes a learning culture within the unit. It provides an opportunity to discuss potentially serious situations and allows reflection on similar scenarios encountered within the ward and dialysis unit. Further work is needed to determine if in situ simulation teaching has an impact on patient outcome measures.
P1857SALT CONSUMPTION, LIFESTYLE AND PROTEINURIA IN A HETEROGENEOUS YOUNG POPULATION
Authors: Zullo Claudia , Dallari Lorenzo , Bagalà Alfredo , Somma Chiara , Ferro Giuseppe , Burgio Lorenzo , Dattolo Pietro 
Published: June 2020

Abstract

Background and Aims
Obesity, hypertension, smoke, high dietary salt intake and physical inactivity are the main modifiable risk factors for chronic kidney disease, that affects about 9-10% of Italian people. About daily salt intake, the World Health Organization recommends a maximum consumption of 5 grams of salt per day. In Italy, most people consume too much salt – on average 8-10 grams per day or around twice the recommended maximum level of intake. Aim of this study was to investigate dietary habits and lifestyle of the heterogeneous students population of “Scuola Carabinieri di Firenze” (attended by people coming from all Italian regions) and their relations with urinary abnormalities.

Method
from November 2018 to March 2019 we collected anamnestic and anthropometric data, blood pressure measurements and body cellular mass (BCM) of 257 young subjects (152 males, 105 females; mean age 32 + 11 yy).
We determinated sodium, chlorine and protein excretion on a spot urine sample in addition to plasma creatinine levels. Statistical analyses were performed using SPSS.

Results
We analyzed preliminary data of urinary sodium excretion (UNa), proteinuria (Up) and hematuria (Urbc) of all the subjects. Fifty-five percent of them had a UNa higher than 100 mmol/L (approximately equivalent to a dietary salt intake of 6 grams/day). In these subjects with higher salt consumption, Up and Urbc, measured by urine dipstick, were detectable in 32% and 21% respectively. In subjects with lower salt intake (less than 6 grams/day), Up and Urbc were 0% and 5% respectively.
To determine if there was an association between our variables, we used Pearson correlation coefficient. We found that UNa was directly related to Up (r 0.26, p 0.002), age (r 0.22 p 0.011) and diastolic blood pressure (DBP, r 0.22, p 0.012). We also found that poor exercise (r -0.15, p 0.7) and low lean body mass percentage (r -0.15, p 0.7) were inversely related to UNa.

Conclusion
high dietary salt intake is associated with elevated blood pressure and proteinuria in a young and “healthy” population. Hypertension and proteinuria are both known risk factors for the development of chronic kidney disease. Wrong dietary habits and lifestyles must be detected and corrected in order to prevent nephropathy onset.
P0030MIR-182 INHIBITS KIDNEY FIBROSIS BY REGULATING TGF-Β1/SMAD3 PATHWAY IN ADPKD
Authors: Sun Liping , Zhang Xinzhou 
Published: June 2020

Abstract

Background and Aims
The aim of the present study was to investigate the molecular mechanism of miR-182 in kidney fibrosis in polycystic kidney disease (PKD).

Method
We measured the expression of miR-182 in kidney tissue of autosomal dominant polycystic kidney disease (ADPKD). Additionally, we investigated the relationship between miR-182 and fibrotic protein by transfecting miR-182 mimics and miR-182 inhibitor into polycystic kidney cyst-lined epithelial cells, respectively. Furthermore, we observed the interaction between TGF-β1 and miR-182 and fibrinogen factors of cyst-lined epithelial cells after TGF-β1 intervention, and measured the expression of Smad2, 3 protein.

Results
(1) MiR-182 was positively correlated with fibrosis of cyst-lined epithelial cells; (2) TGF-β1 could induce fibrosis of cyst-lined epithelial cells; (3) the expression of miR-182 had an remarkably impact on the fibrosis induced by TGF-β1, but had little effect on the expression of TGF-β1; (4) the expression of Smad3 protein in TGF-β1 induce- cyst-lined epithelial cells were increased.

Conclusion
TGF-β and miR-182 promoting the fibrosis of polycystic kidney cyst -lined epithelial cells may be mediated by the TGF-β/Smad3 signaling pathway, of which Smad3 was an important regulator.
P0767INTRAUTERINE GROWTH RESTRICTION AND RISK OF KIDNEY DISEASE DURING THE FIRST 50 YEARS OF LIFE
Authors: Gjerde Anna , Reisater Anna Varberg , Skrunes Rannveig , Marti Hans-Peter , Vikse Bjørn Egil 
Published: June 2020

Abstract

Background and Aims
Previous studies have shown that Low Birth Weight (LBW) and small for gestational age (SGA) are associated with increased risk of end-stage renal disease. Few population-based studies have however investigated risk of less severe kidney disease and in the present study, we investigate risk of chronic kidney disease and other kidney disease diagnoses.

Method
The Norwegian Patient Registry (NPR) has registered ICD diagnostic codes for all admissions and outpatient visits to Norwegian hospitals since 2008 (available for 2008-2016 in this study). The Norwegian Medical Birth Registry (MBR) has registered birth weight, gestational age and several other data on maternal and offspring health for all birth in Norway since 1967. Data from these registries were linked and risk of chronic kidney disease (CKD) and other groups of kidney disease were analyzed with logistic regression statistics. LBW (less than the 10th percentile), SGA (less than the 10th percentile) and preterm birth (less than 37 weeks) were analyzed as risk markers. Adjusted analyses were performed for the main analyses by including birth year, gender, maternal disease, maternal preeclampsia, maternal marital status and malformations in the newborn.

Results
Of the 2,663,010 included individuals, 4,495 had been diagnosed with CKD and 12,818 with acute kidney disease, glomerulonephritis, hereditary kidney disease or kidney disease due to kidney or urinary tract malformations. LBW was associated with an adjusted odds ratio (aOR) for CKD of 1.61 (1.48-1.74), SGA with an aOR of 1.51 (1.39-1.63) and preterm birth with an aOR of 1.47 (1.31-1.66). As compared to subjects with none of these risk factors (LBW, SGA or preterm birth), subjects with only one risk factor had an aOR of 1.49 (1.35-1.66), subjects with 2 risk factors had adjusted aOR of 1.72 (1.57-1.88) and subjects with 3 risk factors had aOR of 2.56(1.99-3.29). Analyses of chronic kidney disease stage 3, 4 and 5 showed similar results. There were no significant gender differences. We further analysed aOR for other groups of kidney disease and found that LBW was associated with aOR of 1.52 (1.40-1.65) for acute kidney disease, 1.26 (1.16-1.38) for glomerulonephritis, 1.55 (1.34-1.80) for hereditary kidney disease and 1.38 (1.27-1.49) for kidney disease due to kidney or urinary tract malformations; analyses for the other risk factors showed similar results.

Conclusion
LBW and SGA are strong risk factors for diagnosis of all stages of CKD during the first 50 years of life and the risks seem to be increased also for other groups of kidney disease. Our results underline the public health importance of LBW and SGA.