bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0791MATRIX GLA PROTEIN AND PREMATURE VASCULAR CALCIFICATION IN PATIENTS WITH END-STAGE RENAL DISEASE
Authors: Dai Lu , Qureshi Abdul Rashid Tony , Ripsweden Jonaz , Brismar Torkel B , Söderberg Magnus , Barany Franz Peter , Schurgers Leon , Lindholm Bengt , Stenvinkel Peter 
Published: June 2020

Abstract

Background and Aims
Vitamin K is a potential protective factor against premature vascular aging and vascular calcification (VC). Whether vitamin K supplement could halt VC progression in patients with end-stage renal disease (ESRD) is not clear, partially due to the heterogeneity of measurements of VC in different vascular sites. Here we investigated the associations between non-phosphorylated, uncarboxylated matrix-Gla protein (dp-ucMGP), a circulating marker of vitamin K insufficiency, and premature vascular aging phenotypes evaluated by coronary artery calcium (CAC) scoring, aortic valve calcium (AVC) scoring, and histology scoring of presence of media calcification in vascular biopsies in patients with ESRD.

Method
In this observational cohort study, 223 ESRD patients (median age 54 years, 68% males) comprising non-dialysis patients (n=109), prevalent peritoneal dialysis (PD, n=80, median dialysis vintage 11.6 months) and prevalent hemodialysis patients (HD, n=34, median dialysis vintage 12.0 months) underwent baseline measurements of plasma dp-ucMGP and scoring of CAC and AVC by computed tomography scan. Framingham risk score (FRS), inflammation and other relevant clinical and biochemical data were determined at baseline. In a sub-group of patients (n=94), scoring of media calcification by histology in epigastric artery biopsies was also performed.

Results
Plasma dp-ucMGP levels (median 1568 pmol/L) significantly correlated with age (rho=0.38), presence of cardiovascular disease (CVD, rho=0.16), triglycerides (rho=0.19), FRS (rho=0.33), high-sensitivity C-reactive protein (hsCRP; rho=0.35), CAC score (rho=0.30) and AVC score (rho=0.24) but did not differ with regards to treatment modality (i.e. non-dialysis, PD and HD). In multivariate regression analyses, with adjustment for presence of CVD, FRS, hsCRP and triglycerides, increased dp-ucMGP levels were independently associated with increased CAC score (coefficients 0.12, p=0.04), but not with AVC score nor presence of media calcification in epigastric arteries.

Conclusion
Our data suggest that vitamin K insufficiency as indicated by increased dp-ucMGP levels associates with premature vascular calcification evaluated by CAC but not with AVC or media calcification assessed by histology. This discrepancy warrants further studies to explore the pathophysiological background between vitamin K metabolism and susceptibility of calcification in different vascular sites as well as the pattern of VC (i.e. intima and media calcification) within sites.
P0798ASSOCIATION BETWEEN RENAL DYSFUNCTION AND GENERAL COGNITIVE FUNCTION IN COMMUNITY DWELLING OLDER ADULTS: KOREAN FRAILTY AND AGING COHORT STUDY
Authors: Kong Jiyoon , Kim Jin Sug , Kang Min Hye , Kang Shin Yeong , Ra Ri , Won Chang Won , Hwang Hyeon Seok , Jeong Kyung Hwan 
Published: June 2020

Abstract

Background and Aims
Cognitive impairment is common in older adults. Similarly, the prevalence of renal dysfunction is also increased in the elderly. We conducted this study to clarify the relationship between the renal function and cognitive impairment in community dwelling older adults in Korea.

Method
A cross-sectional analysis was performed on the data of the Korean Frailty and Aging Cohort Study (KFACS), a nationwide cohort study that began in 2016. Of the 3014 participants assessed in the first and second year, 2847 participants (1333 men, 1514 women) who completed baseline assessments were enrolled. The estimated glomerular filtration rate (eGFR, mL/min/1.73m2) was calculated using the Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) equation. Renal function of the participants was classified into four groups by eGFR quartile. General cognitive function was accessed with mini-mental state exam in the Korean version (MMSE-KC). Participants who had MMSE-KC score less than 1.5 standard deviation by age, gender, and education level were regarded as the cognitive impairment. Multivariate logistic regression model was used to examine the relationship between renal function and cognitive impairment. In addition, we investigated to find the point of eGFR interval at which the odds ratio begins to increase.

Results
The mean eGFR in quartile 1 was 91.7 ± 3.22 ml/min/1.73m2, and 84.9 ± 1.81 in quartile 2, 76.1 ± 3.66 in quartile 3, and 57.2 ± 10.75 in quartile 4. In baseline characteristics, participants with lower eGFR had lower MMSE-KC scores. And the prevalence of cognitive impairment was 10.8% in quartile 1, 15.9% in quartile 2, 15.2% in quartile 3, 14.9% in quartile 4. After multivariate adjustment, the odds ratio (OR) of cognitive impairment in quartile 2 [adjusted OR: 1.569, 95% confidence intervals (CI): 1.141 - 2.158, p = 0.006] compared with quartile 1. And the odd ratios of cognitive impairment were 1.539 (95% CI: 1.113 - 2.127, p = 0.009) in quartile 3, 1.475 (95% CI: 1.062 - 2.049, p = 0.020) in quartile 4 compared with quartile 1, respectively. Among the participants with eGFR above 60 ml/min/1.73m2, the renal function was grouped by 5 ml/min/1.73m2 interval. The risk of cognitive impairment started to increase from eGFR between 80 and 85 ml/min/1.73m2 (adjusted OR: 1.667, 95% CI: 1.128 - 2.463, p = 0.010).

Conclusion
Renal dysfunction was associated with lower global cognitive function in older adults. And the risk of cognitive impairment increased from quartile 2, especially, eGFR between 80 and 85 ml/min/1.73m2 in this population. These results suggest that mild decline of kidney function is also a risk factor of cognitive decline in the elderly.
P0802RELATIONSHIP BETWEEN RENAL INSUFFICIENCY AND AIRFLOW LIMITATION AND THEIR IMPACT ON MORTALITY IN A COMMUNITY-BASED POPULATION: THE YAMAGATA (TAKAHATA) STUDY
Authors: Miyata Masahiro , Tanaka Tomomi , Suzuki Natsuko , Kudo Kosuke , Ichikawa Kazunobu , Inoue Sumito , Watanabe Masafumi , Kayama Takamasa , Konta Tsuneo 
Published: June 2020

Abstract

Background and Aims
Chronic kidney disease and chronic obstructive pulmonary disease (COPD) are known risk factors for mortality. In this study, we investigated the association between renal deficiency and airflow limitation that characterizes COPD, and its effect on 10-year mortality in a community-based population.

Method
The study subjects were 1,233 health check-up participants (mean age 64 years; 46.7% men). We defined renal insufficiency as GFR &lt;60 mL/min/1.73m2 estimated using serum creatinine (Cr) or cystatin C (CysC), and airflow limitation (AFL) as forced expiratory volume in 1 second to forced vital capacity ratio &lt;70% on spirometry.

Results
The prevalence of Cr-based and CysC-based renal insufficiency, and AFL in total subjects was 6.6%, 14.8%, and 11.2%, respectively. Compared with subjects without AFL, those with AFL showed a significantly higher prevalence of CysC-based renal insufficiency (24.6% vs. 13.5%, P &lt;0.01), but not of Cr-based renal insufficiency (8.0% vs. 6.4%, P =0.77). The prevalence of CysC-based renal insufficiency was increased, along with the progression of AFL severity (P for trend &lt;0.01). During the follow-up period, there were 154 (12.5%) deaths. Cox proportional hazard analysis adjusted for confounders showed that the hazard ratio (95% confidence interval) for all-cause mortality was 1.76 (1.12-2.71) in subjects with CysC-based renal insufficiency alone, 1.13 (0.62-1.94) in those with AFL alone, and 2.30 (1.20-4.18) in those with both CysC-based renal insufficiency and AFL, with subjects without both CysC-based renal insufficiency and AFL as the reference. In contrast, the adjusted hazard ratios for all-cause mortality did not reach statistical significance in subjects with both Cr-based renal insufficiency and AFL, with subjects without both Cr-based renal insufficiency and AFL as the reference.

Conclusion
This study showed that CysC-based renal insufficiency and AFL are strongly associated and that their overlap is a significant risk for mortality in community-based populations.
P0819THE EFFECT OF SMOKING UPON CKD IN A JAPANESE NATIONWIDE 6-YEARS FOLLOW UP SERVEY
Authors: Nagasawa Yasuyuki , Matsumoto Ayako , Yamamoto Ryohei , Shinzawa Maki , Isaka Yoshitaka , Nanami Yoshimasa , Hasuike Yukiko , Takahiro Kuragano , Iseki Kunitoshi , Yamagata Kunihiro , Tsuruya Kazuhiko , Yoshida Hideaki , Fujimoto Shouichi , Asahi Koichi , Watanabe Tsuyoshi , Moriyama Toshiki 
Published: June 2020

Abstract

Background and Aims
Cigarette Smoking is one of important risks for cardiovascular diseases, and also smoking had been reported to have harmful effect upon Choric kidney Diseases. Our group had reported that smoking canceled the beneficial effect caused by alcohol drinking using Japanese Nationwide Survey cross-sectional data (Matsumoto-A et al Hypertension Res, 2017). In this cohort study, we aimed to reveal the effect of smoking upon incidence of proteinuria and decline of kidney function using longitudinal large cohort of general population in Japan.

Method
The present nationwide longitudial survey included members of the general Japanese population who underwent the Specific Health Check and Guidance in Japan between April 2008 and March 2014. 149,260 who were not lack of essential data without chronic kidney diseases and whose kidney function was 60≦eGFR&lt;120mL/min/1.73m2 were enrolled in this analysis. Demographic, physical, and laboratory data included age, sex, body mass index (BMI; weight [kg]/height2 [m2]), mean arterial pressure (MAP, diastolic blood pressure + [systolic blood pressure - diastolic blood pressure]/3), serum concentration of creatinine (enzymatic method), and levels of hemoglobin A1c, triglycerides, high-density lipoprotein (HDL) cholesterol, uric acid, and urinary protein as detected by a dipstick test. Proteinuria was defined as 1+ or more of urinary protein. We made statistical analysis using Kaplan-Meier analysis, Log-rank test, Cox proportional hazard method using STAT ver15. As outcomes, incidence of proteinuria (more than (1+) by dip stick, decline of eGFR more than 15 mL/min/1.73m2 from baseline kidney function were used.

Results
Smoker had significantly higher incidence rate of proteinuria than non-smoker (p&lt;0.001). Smoker also had significantly higher incidence decline of kidney function more than 15ml/min than non-smoker (p&lt;0.001). Smoking was significantly risk both for proteinuria (Hazard Rate 1.24(95％CI 1.15-1.34, p&lt;0.001)) and for decline of kidney function HR 1.24(95％CI 1.16-1.31, p&lt;0.001) in multivariate analyses. After stratification of four groups using smoking status and incidence of proteinuria during study periods. Smoker with incident proteinuria had significantly higher rate of decline of kidney function than non-smoker without incident proteinuria both in male (figure 1) and in female (Figure 2)

Conclusion
Smoking was risk for proteinuria and decline of kidney function. Moreover, smoker with incident proteinuria had worst kidney prognosis.
P0826OBESITY AND RISK FOR CHRONIC KIDNEY DISEASE IN THE HEALTHY MIDDLE-AGED KOREAN POPULATION
Authors: Cho Minhae , KIM MI JI , CHO WON HEE , Moon Ju-Young , Jeong Kyung Hwan , Lee Sang-Ho , Hwang Hyeon Seok , Kim Jin Sug , Kim Yang-Gyun 
Published: June 2020

Abstract

Background and Aims
Although obesity is a well-known risk factor for chronic kidney disease (CKD), previous epidemiologic studies have produced mixed results. This study was purposed to investigate the relationship between obesity and CKD occurrence in the healthy middle-aged Korean population.

Method
We used a prospective, longitudinal data from the Korean Genome and Epidemiology Study (KoGES), a population-based, epidemiology study in South Korea (2001-2014). A total of 6,678 participants aged 40-69 who were free of diabetes, hypertension, and CKD at baseline were followed-up biennially. CKD was defined as at least two-time occurrence of estimated glomerular filtration rate &lt; 60 mL/min/1.73m2 using CKD-EPI equation during the follow-up period.

Results
A total of 433 participants (6.5%) developed CKD. We divided the participants into 5 groups by BMI: underweight (BMI &lt; 18.5), normal-weight (BMI 18.5-22.0), overweight 1 (BMI 23.0-24.9), overweight 2 (BMD 25-29.9), and obesity (BMI &gt;30). Compared to the normal-weight group, hazard ratio of CKD occurrence was elevated in overweight 2 (HR=1.43, p=0.01) and obesity (HR=1.73, p=0.03) in multivariate-adjusted regression analysis (variates: age, newly developed hypertension, newly developed diabetes, fasting glucose &gt; 126mg/dL, 2hours glucose &gt; 200mg/dL, systolic blood pressure &gt; 140mmHg, physical activity, alcohol consumption, smoking). When dividing the participants into three age groups: the 40s, 50s, and 60s, only the 60s group showed a significant correlation of BMI with CKD occurrence (overweight 2: HR=1.93, p=0.05, obesity: HR=3.94, p=0.03).

Conclusion
The risk of CKD was significantly high for those in their 60s who were overweight or obese despite free of underlying diseases in the Korean population.
P0835IDENTIFYING THE FREQUENCY OF CHRONIC KIDNEY DISEASE OF UNKNOWN ETIOLOGY (CKDU) IN A RURAL POPULATION OF BANGLADESH
Authors: Iqbal Md M , Roy S C , Chowdhury MAA , Banerjee Sajal Krishna , Islam S , Hossain R M , Hassan M S , Hassan M Z , Chaudhury S R , Arslan M I , Islam M N 
Published: June 2020

Abstract

Background and Aims
The common etiologies of CKD are diabetes, hypertension and glomerulonephritis. Prevalence of CKD of unknown (CKDu) etiology is being increasingly considered as an emerging etiology, especially in the developing countries, with environmental predisposition to hot humid climate, dehydration and toxic metal contaminations. The aim was to identify the frequency of CKDu as an etiology in a rural population with environmental exposure.

Method
In this observational study subjects were selected from a geographically defined rural population in Bangladesh. Baseline information was recorded by the translated WHO STEP wise approach surveillance- Instrument v.3.1 (Core and Expanded). Blood Pressure was measured by digital blood pressure monitor. Serum creatinine was measured by enzymatic method using assays traceable to isotope dilution mass spectrometry (IDMS). A fasting blood sample and spot urine was collected. BP ≥140/90mmHg; FBS &gt; 5.6 mmol/l and HbA1c ≥6.5%; and eGFR&lt; 60ml/min (CKD-EPI equation) or urine ACR &gt; 30mg/g was taken as diagnostic cut-offs for hypertension, diabetes and nephropathy respectively. From diagnosed CKD patients CKDu group was further identified by stepwise approach of WHO criteria as suspected and probable stages.

Results
The mean age was 41.3 ± 12.7 years with male/female ratio 37/63 in preliminary 303 study subjects. They were 12.5% diabetic, 21% hypertensive and 75% had some form of dyslipidemia. Among all 51 subjects (16.8%) were diagnosed as CKD based on single measurement of eGFR and ACR. Of these 30 study subjects (58%) met the criteria of suspected CKDu. After repeat measures of eGFR and ACR at 3 months, prevalence of CKD came down to 10.2% persisting in 31 subjects (G1:5.3%, G2:2.3% and G3: 2.6%). Of these 7 study subjects (23%) met the criteria of probable CKDu. The main etiologies of CKD among these subjects were diabetic nephropathy (48%) followed by CKDu. The frequency of CKDu in total study population as a whole was 2.3%.The pattern of environmental exposures like types of farming, use of pesticide-fertilizer, NSAIDs intakes, water sources, amount of drinking water per day, duration of work under direct sun, pattern of fish-meat intakes, etc. were not different between subjects with CKDu versus the others.

Conclusion
The prevalence of chronic kidney disease in a rural area of Bangladesh is one in ten (10.2%). Among these nearly one-fourth (23%) of the subjects belonged to probable CKDu category. This alarmingly high frequency of CKDu needs further extensive evaluation to identify the predisposing factors responsible.
P0838HYPERPROLACTINEMIA IN CKD PATIENTS AND ITS ASSOCIATION WITH STRENGHT, SEXUAL DYSFUNCTION ANS QUALITY OF LIFE
Authors: Teichman Pedro do Valle , Zanotto de Oliveira Gabrielle , Sallaberry Echeverria Silveira Samile , Angarita Jaime Carlos Alberto , Lopes De Castro Mariana , Bauer Andrea Carla 
Published: June 2020

Abstract

Background and Aims
Hyperprolactinemia is a hormonal disorder associated with many diseases, including chronic kidney disease (CKD). Some studies have shown that serum prolactin (PRL) levels increase as CKD progresses, due to decreased renal clearance and increased production. This prolactin retention leads to inhibition of gonadotropic hormone production, and testosterone deficiency in male patients with CKD. Thus, this study aimed to evaluate PRL levels in male patients with different stages of CKD and its association with clinical and laboratory characteristics, strength, sexual dysfunction, and quality of life.

Method
This is a transversal study conducted in a tertiary hospital in southern Brazil. Patients with CKD stage IV and V were included and divided into three groups: 1) stage IV; 2) non-dialysis-dependent stage V and; 3) dialysis-dependent stage V (VD). Patients with prescribed hormone therapy were excluded. PRL, creatinine, testosterone, estradiol, albumin, SHBG, LH, and FSH levels were measured. Free testosterone was estimated by the Vermeulen equation. Patients were also evaluated for strength and musculoskeletal function through the “handgrip strength” test. For evaluation of the quality of life and sexual dysfunction, validated questionnaires were applied: AMS (Aging Male's Symptoms Scale), ADAM (Androgen Deficiency in the Aging Male) and SF-36 Health.

Results
In this study, 164 patients were included (IV=75; V=41; VD=48). The mean age was 64 [55-71] years and BMI 26,9 [23,3-30,04] kg/m2. The dialysis-dependent group had higher prevalence of hyperprolactinemia (22,6% vs. 49% vs. 66%, p&lt;0,001), higher PRL (13,4 vs. 19,43 vs. 26,13, p&lt;0,001) and estradiol (25,6 vs. 24,4 vs. 30,5, p=0,041). PRL levels were positive correlated with CKD stage (rs=0,482, p&lt;0,001) and creatinine (rs=0,467, p&lt;0,001) and negative correlated with testosterone (rs=-0,286, p&lt;0,001) and free testosterone levels (rs=-0,307, p&lt;0,001). There was no difference in PRL levels between hemodialysis and peritoneal dialysis (p=1,000). Analyzes related to the association of PRL levels with strength, quality of life, and sexual dysfunction are still being analyzed.

Conclusion
Hyperprolactinemia is associated with the severity of CKD, with a higher prevalence in dialysis patients. The relation of PRL levels with strength, quality of life, and sexual dysfunction are being evaluated.
P0847HEPATIC ERYTHROPOIETIN SYNTHESIS IS ENHANCED IN HEMODIALYSIS PATIENTS WHO DO NOT REQUIRE ERYTHROPOIESIS-STIMULATING AGENTS
Authors: Hirayama Aki , Yanagawa Takamoto , Kaneko Yoko , Nagano Yumiko , Owada Shigeru , Ishizu Takashi 
Published: June 2020

Abstract

Background and Aims
Erythropoietin is synthesized in the liver during the fetal period and mainly in the kidney after birth. However, some patients with end-stage chronic kidney disease do not require the administration of erythropoiesis-stimulating agents (ESA) despite their damaged renal function. This study aimed to clarify the origin of extrarenal erythropoietin generation in these patients.

Method
The origin of erythropoietin was investigated by analyzing the erythropoietin glycation patterns based on the percentages of migrated isoforms (PMI). Sera of stable hemodialysis (HD) patients with (ESA group) or without (non-ESA group) ESA treatment and umbilical cord blood of newborns (UCB group), which contained erythropoietin of liver origin, were analyzed. The non-ESA group was determined as HD patients without ESA treatment for &gt; 6 months. Informed consent was obtained from all included HD patients and from the parents or guardians of the newborns. This study was performed with permission from the institutional ethical committee and was registered as a clinical trial (no. R000033462 UMIN000029335).

Results
The mean duration of no ESA treatment in the non-ESA group was 29.2 months. There were no differences in major clinical parameters, including age and HD duration. The hemoglobin concentration in the ESA group was 107 ± 5 g/L (mean ± standard error), which was significantly lower than that in the non-ESA group (123 ± 4 g/L) (P = 0.025, unpaired Student’s t-test). The PMI values of the ESA, non-ESA, and UCB groups were 12.6 ± 11.4％, 61.2 ± 13.1%, and 65.0 ± 13.5％, respectively, and the PMI value of the ESA group was significantly lower than that of non-ESA or UCB group (one-way analysis of variance with Tukey-Kramer test), suggesting that the glycation pattern of erythropoietin in the non-ESA group was similar to that in the UCB group but different from that in the ESA group. No significant differences were found in the reticulocyte ratio, serum iron concentration, total iron binding capacity, and ferritin and transferrin saturation between the ESA and non-ESA groups.

Conclusion
These results suggest that patients in the non-ESA group had enhanced extrarenal erythropoietin synthesis and that their erythropoietin originated from the liver. Further analysis of the underlying mechanism may contribute to the development of internal extrarenal erythropoietin-stimulating therapy.
P0850SERUM OSTEOPROTEGERIN LEVELS ARE ASSOCIATED WITH AN INCREASED RISK OF DEVELOPING ANEMIA IN PATIENTS WITH NON DIALYSIS CHRONIC KIDNEY DISEASE
Authors: Nam Yooju , Lee Seonyeong , Kim Hyung Woo , Chang Jae Hyun , Yoo Tae-Hyun 
Published: June 2020

Abstract

Background and Aims
Osteoprotegerin (OPG), which is an osteoclastic inhibitory factor, have been shown associated with adverse renal outcomes and progression of vascular calcification in chronic kidney disease (CKD) patients. Anemia and CKD-bone mineral disorders (CKD-MBD) are also frequently observed in these patients. Since CKD-MBD and anemia might be closely linked, therefore, we further examined whether OPG level as a marker for bone turnover can predict the future development of anemia in a large-scale prospective cohort.

Method
Among 2,238 patients with non-dialysis CKD enrolled in the KoreaN cohort study for Outcome in patients With Chronic Kidney Disease (KNOW-CKD), 2,086 patients who measured hemoglobin, hepcidin, iron profiles and OPG level were included in the analysis. Anemia was defined as a hemoglobin level of &lt; 13.0 g/dL and 12.0 g/dL for male and female, respectively.

Results
The mean age was 53.6 ± 12.2 years and 1,270 (60.9%) patients were males. At baseline, anemia was found in 941 (45.1%) patients. Log transformed OPG levels significantly correlated with FGF23 levels, but inversely with iron profiles and hemoglobin levels at baseline. A multivariate logistic regression model showed that log OPG level was independently associated with the prevalence of anemia (odds ratio [OR], 2.22; 95% confidence interval [CI], 1.41-3.48, P=0.001). Among 1110 patients without baseline anemia, 258 (25.3%) patients developed anemia during a median follow-up duration of 34.6 (interquartile range, 23-48) months. In the fully adjusted multivariable Cox models, risk of developing anemia was significantly higher in the fourth (hazard ratio [HR], 1.99; 95% CI, 1.08-3.67; P =0.028) than in the first OPG quartile. Similar association was observed in a model when OPG was treated as a continuous variable.

Conclusion
We showed that high serum OPG levels are associated with an increased risk of developing anemia in patients with non-dialysis CKD.