bluuebunny/crossref_metadata_2025_split huggingface dataset:
P0733PULSE MASS PRESSURE PRODUCT AND GLOMERULAR HEMODYNAMIC FUNCTION IN HEALTHY ADULTS
Authors: Oba Rina , Kanzaki Go , Haruhara Kotaro , Sasaki Takaya , Okabayashi Yusuke , Yamamoto Izumi , Tsuboi Nobuo , Yokoo Takashi 
Published: June 2020

Abstract

Background and Aims
Recent studies have conflicting findings on the association between obesity and the risk of chronic kidney disease (CKD). BMI by itself is an imperfect marker of metabolically unhealthy obesity. The Pulse Mass Index (PMI) and the Pulse Mass Pressure Product (PMPP) show strong correlation with the risk of cardiovascular disease and may reflect an individual's metabolic energy state. However, it is still unknown whether the PMI and PMPP can be helpful to evaluate glomerular hyperfiltration or hypertrophy, which may exacerbate the progression of CKD. In this study, we measured mean glomerular volume (GV) and single nephron glomerular filtration rate (SNGFR) by estimating the number of nephrons from living kidney donors and we evaluated the effects of PMI and PMPP on glomerular hemodynamic function.

Method
We identified 43 living kidney donors at the Jikei University School of Medicine Hospital from 2007 to 2017 who underwent an enhanced CT scan and a kidney biopsy at donation. The GV was determined by Weibel-Gomez methods and the SNGFR was calculated as eGFR divided by the total number of non-sclerosed glomeruli. The PMI is equal to BMI by resting heart rate (RHR) divided by 1730 and The PMPP is equal to BMI by RHR by systolic blood pressure.

Results
Of 43 subjects, 34.9% were males and with a mean age of 56.1 ± 9.9 years old. Mean Arterial Pressure (MAP) was 86.3±9.9 mmHg, eGFR was 77.4±12.4 ml/min/1.73m2, and urinalysis was normal. The estimated total nephron numbers were 743,204±242,020 /kidney, and SNGFR was 61.7±20.5 nl/min/1.73m2. The GV was strongly associated with both of PMI and PMPP (P=0.0291 and 0.0326, respectively). Interestingly, SNGFR was only associated with PMPP (P=0.0443) but whereas not associated with either age, BMI, or MAP.

Conclusion
In healthy adults, we observed a strong positive correlation between PMPP and both GV and SNGFR. This study indicates that PMPP is a more suitable physical measurement for glomerular hyperfiltration or hypertrophy, and a possible maker of the relative risk of CKD at the long term.
P0749THE ASSOCIATION OF VISCERAL ADIPOSITY INDEX WITH PROGRESSION OF CHRONIC KIDNEY DISEASE
Authors: Adibelli Zelal , Mizrak Soycan , Duran Cevdet 
Published: June 2020

Abstract

Background and Aims
Obesity is becoming an important health problem as its prevalence is increasing. Obesity is also a factor that causes an increase in chronic kidney disease (CKD) cases by facilitating the development of diabetes and hypertension, which leads to CKD, and by a direct effect on the kidney and endocrine mechanism. Obesity is generally defined by body mass index (BMI), which is not a good indicator for visceral adipose tissue (VAT), as visceral fat has been shown to be more metabolically active. A new method called the visceral adiposity index (VAI) has been developed, which is considered to be an indicator for the metabolic function of VAT. Previous studies have confirmed the association between the VAI and CKD prevalence. In this study, we attempted to investigate the association between estimated glomerular filtration rate (eGFR) decline and visceral adiposity.

Method
Data were collected from 129 patients aged 18-80 years with stage 2-5 CKD and not on dialysis; these patients were followed up in the Nephrology Department of Usak University Hospital between December 2017 and November 2018.

Results
Of 129 patients with stage 2-5 CKD enrolled in this study, 64 (40.6%) were females and 66 (59.4%) were males. The mean age was 66.8 (35-80 years). The mean VAI values of patients were 2.86±1.63, and the mean eGFR decline was -12.8±19.0 ml/min/1.73m2. No correlation was observed between the VAI values and decline in eGFR in 1 year. Patients with DM had statistically significant higher eGFR decline (p=0.04) and higher VAI values (p=0.03).

Conclusion
The VAI, which is used to assess the metabolic function of VAT, was not associated with the eGFR decline in 1 year for patients with stage 2-5 CKD.
P0752THE EXPRESSION AND DIAGNOSTIC VALUE OF URINE ANGIOTENSINOGEN IN CHRONIC KIDNEY DISEASE
Authors: Huang Qiuyan , Chen Junzhe , Tang Ying , Xu Yanchun , Xu Anping 
Published: June 2020

Abstract

Background and Aims
This article aims to detect the expression of urine angiotensinogen (uAGT) in patients with chronic kidney disease (CKD) and its correlation with clinical and renal pathology.

Method
Patients who diagnosed with CKD and undergoing renal biopsy for the first visit to Sun Yat-sen Memorial Hospital from March 1st ,2018 to October 1st, 2019 were enrolled. First morning urine samples from CKD patients before renal biopsy and healthy volunteers as controls were collected during the same period. These samples were tested for uAGT by ELISA. Linear regression analysis was used to explore the correlation between uAGT and clinical indicators as well as renal pathology in CKD patients. The receiver operating curve (ROC curve) was used to explore the diagnostic value of uAGT for CKD stage 3 or above and glomerular sclerosis ratio&gt;50%.

Results
A total of 133 CKD patients with 59 (44.4%) in stage 1, 31 (23.3%) in CKD stage 2, 17 (12.8%) in stage 3, 17 (12.8%) in stage 4 and 9 (6.7%) in stage 5 were included in our study. At the same time, 20 healthy volunteers were included as control. uAGT levels of CKD patients were significantly higher than healthy controls(275.0 vs 774.2,P&lt;0.001). Compared with CKD stage 1-2 patients, uAGT levels in patients with stage CKD 3 or above were significantly increased, and the difference was statistically significant (P&lt;0.001) (Table 1). The result of multivariate linear regression analysis showed that uAGT levels in CKD patients were positively correlated with 24h urine protein (beta = 0.193, P = 0.012) and negatively correlated with eGFR (beta = -0.489, P&lt;0.001) (Table 2). We also demonstrated that uAGT was positively correlated with the ratio of glomerular sclerosis(P = 0.003) (Table 3). Our results showed that the area under the curve (AUC)of uAGT for the diagnosis of renal function with CKD stage 3 or above was 0.789 (Figure 1) with the cut-off value was1959.9pg/ml. The sensitivity and specificity were 51.2% and 97.3% respectively, Furthermore, the positive predictive value (PPV) was 88.0% and negative predictive value (NPV) was 82.95%.The AUC of uAGT for the diagnosis of renal pathological glomerular sclerosis ratio&gt;50% was 0.677 (Figure 2).The cut-off value of uAGT was 2131.8pg/ml.The sensitivity and specificity were 50% and 89.5% respectively. Meanwhile, the PPV was 41.67% and the NPV was 92.25%.

Conclusion
uAGT was significantly increased in CKD patients, which is closely related with the urinary protein, eGFR, and renal pathology.The specific cut-off value of uAGT can be used as a predictive indicator of advanced CKD stage and severe glomerular sclerosis.
P0754FGF23 AND URINARY PHOSPHATE EXCRETION FOR ESTIMATION OF NEPHRON NUMBER: DIFFERENCES BETWEEN CHRONIC KIDNEY FAILURE AND KIDNEY TRANSPLANTATION
Authors: Pasquali Marzia , De Martini Natalia , Tartaglione Lida , Rotondi Silverio , Catalfamo Marta , Ceravolo Maria Josè , Bagordo Domenico , Mazzaferro Sandro 
Published: June 2020

Abstract

Background and Aims
Assuming that FGF23 levels correlate with phosphate excretion per nephron, nephron number can be estimated by measuring FGF23 levels and urinary phosphate excretion (FEP). Kuro-O proposed that the ratio of FEP to serum FGF23 levels should correlate with nephron number and is defined as the Nephron Index (NI).
The aim of the study is calculating NI as nephron number estimation in patients affected by various degree of chronic kidney disease, both transplanted and not.

Method
In 147 CRF patients kidney function, mineral metabolism biomarkers and NI were evaluated. Nephron Index was calculated following Kuro-o’s equation (kuro-o 2019): NI=FEP·Ps·eGFRFGF23
Observed patients were divided into two groups: patients with CKD (noTX) and transplanted ones (TX).

Results
noTX group was made up of 67 patients (40 males and 27 females) affected by CKD stages from G1 to G5. TX group was composed by 80 patient (49 males and 31 females) with various degree of CKD (G1T-G4T) showing mean graft age of 83,2 ± 54,8 months (range: 10,3-268,0). The two groups differed for age (mean age 59 ± 15,6 years in CKD, 55± 10,3years in TX). Mean eGFR did not differ between TX and noTX but NI was higher in TX since FEP was higher despite lower FGF23 levels in TX. The difference in FGF23 levels does not appear to depend on Klotho and PTH whose serum levels were no different between Tx and noTx. (Table1). As far as correlations are concerned, NI correlated with eGFR, FGF23, PTH and 1,25D in both group, while NI correlated with FEP only in the TX group. It's interesting that no correlation existed between FGF23 and sP, FEP, eGFR and sKlotho in TX differently from noTX (Table2).
Discussion. NI could not be properly defined as nephron number estimation in TX pts. However it may represent higher function of residual nephrons, since higher FEP did not correlate to FGF23 and could be determined by compensatory hyperfiltration (increased single nephron GFR) in transplanted patients.

Conclusion
After kidney transplantation, high NI value could have a functional meaning rather than represent residual number of nephrons.
P0755CALCIUM/MAGNESIUM RATIO: NEW PREDICTOR OF INCREASED PULSE PRESSURE IN CHRONIC KIDNEY DISEASE PATIENTS
Authors: Carias Eduarda , Mendes Filipa , Fragoso André , Leão Neves Pedro , Silva Ana 
Published: June 2020

Abstract

Background and Aims
Cardiovascular disease (CVD) is the main cause of death in chronic kidney patient. Increase pulse pressure (PP) is associated with adverse cardiovascular outcomes and is an independent risk factor of progression of chronic kidney disease.
In this study we aim to identify the risk factors associated with increased PP in a population with severely decreased glomerular filtration rate.

Method
This was a prospective analysis conducted in an outpatient nephropathy clinic between 2005-2018, enrolling 692 patients with stage 4 CKD.
Patients were divided into two groups according to their pulse pressure. Group 1 mean PP&lt; 50 mmHg, Group2 mean PP &gt;50 mmHg.
Based on the calcium/magnesium ratio (rCaMg), the subjects were also divided into 4 risk groups according to the following criteria: &lt;25th percentile (rCaMg &lt; 3.8mg/dl; n=168) – G1; 25-50th percentile (rCaMg: 3.8-4.7; n=171) – G2; 50-75th percentile (rCaMg: 4.7-8.6; n=188) – G3; and &gt;75th percentile (rCaMg: &gt; 8.6; n=165) - G4.
We used descriptive analysis, Student's t test, Univariate logistics regression analysis and CHAID analysis to determine the relationship between variables and PP.

Results
Total of 682 patients, with mean age 70 (SD 12.5), female 54%.
An independent t-test was conducted to compare groups. There was a significant difference in mean hemoglobin level (p=0.005), calcium (p=0.029), phosphorus (p=0.017), magnesium (p&lt;0.001), Ca/Mg ratio (p&lt;0.001) and eGFR (p=0.034).
Phosphorus OR 1.906 (CI 1.338-2.715) p&lt;0.001, eGFR OR 1.440 (CI 1.023-2.027) p=0.037 were all associated with increased PP. We also compared PP with the subjects of the 4 groups based on calcium/magnesium ratio. Results: G2= OR 7.003 (CI 4.162-11.783) p&lt;0.001; G3= OR 5.136 (CI 3.205-8.230) p&lt;0.001; G4= OR 6.695 (CI 3.999-11.208) p&lt;0.001.
After adjusting for confounding variables only sex OR 0.613 (CI 0.420-0.896) p=0.012 and rCa/Mg groups: G1 OR 7.392 (CI 4.362-12.527) p&lt;0.001, G2 OR 6.436 (CI 3.361-12.323) p&lt;0.001 and G3 OR 8.485 (CI 4.009-17.957) p&lt;0.001, showed significant differences.
CHAID analysis identified rCa/Mg G2, G3, G4 (82.4%) as the more likely significant predictor to PP&gt; 50 mmHg (p&lt;0.001) in association with male gener (86.2%) (p=0.037). The model correctly classified 76.2% of patients and the estimate of the risk misclassification of events was 0.238±0.016.

Conclusion
These results suggest increased calcium/magnesium rate and male gender were associated with increased pulse pressure in a population with stage 4 CKD.
Further studies are needed to understand this relationship.
P0760THE INFLUENCE OF MICROBIOME COMPOSITION ON THE DEVELOPMENT OF IGA NEPHROPATHY
Authors: Nakhoul Farid , Nakhoul Nakhoul , Nakhoul Rula , Farber Evgeny 
Published: June 2020

Abstract

Background and Aims
Overall, human microbiota contains 1014 bacterial cells. The human intestine is particularly dense of microbes, 1012 bacteria per g (dry weight), especially at colon level. Under healthy conditions, the human microbiota provides trophic and protective functions. Bacteroidaceae, and Prevotellaceae differed among IgA and Healthy Control subjects (HC). Enterobacteriaceae species were almost the highest in the fecal samples of patients.
Bifidobacterium species decreased in the fecal samples of Patients compared to HC subjects. Increasing evidence indicates that changes in the microbiota composition known as Dysbiosis, can affect human health and disease. Altering the balance of the gut microbiota can also affect kidney physiology and pathology, such as IgAN. we hypothesize that the aberrantly IgA1 that produced in IgAN in response to a mucosal infection may be influenced by the composition of the patient microbiome by inducing excessive abnormal mucosal IgA responses.
Study aim is to explore if IgAN patients have different microbiome composition compared with the healthy control individuals.

Method
Stool sample from 26 IgAN patients & from 26 healthy control individuals subjected to microbiome array and to taxonomic analysis, to characterize their microbiome compositions. Serum Creatinine\ albumin and urine proteinuria levels are used for evaluate the renal function of each IgAN patient. The clinical and laboratory evaluations will be crossed with the taxonomic data using statistical analysis methods.

Results
Based on our preliminary result with 11 IgAN patients and 11 healthy control individuals, there are significant differences in the microbiome composition between the two groups.
IgAN patients have a significant increase in the Bacteroides phylum accompanied with a significant decrease in the amount of both the Actinobacteria and Verrucomicrobia phyla, compared with the healthy individuals.
At the genus level, there is a significant increase in the Prevotella bacteria in the IgAN subjects compared with the healthy individuals.

Conclusion
1. A strong association between specific bacteria population and IgAN disease, we isolate specific population of bacteria that leads to IgAN or even aggravate its manifestation.
2. It may help to predict the tendency of each individual to develop IgAN and even predict the prognosis of each IgAN patient according to their microbiome.
3. it is rational to alter the intestinal barrier, the content of gut microbiota and its metabolites in the realm of CKD using different strategies such Prebiotics and symbiosis.
4. To develop disease-specific therapies based on microbiome modulations and manipulations such as modifying the gut microbiota through diet, antibiotic therapies, probiotic, bariatric surgery, fecal transplants.
P0770IMPAIRED FASTING GLUCOSE AND CHRONIC KIDNEY DISEASE: A MENDELIAN RANDOMIZATION STUDY
Authors: Noh Hyunjin , Kim Hyoungnae , Park Su Yeon , Hwang Dohui , Choi Kyoungin 
Published: June 2020

Abstract

Background and Aims
Diabetes mellitus is a risk factor of chronic kidney disease (CKD); however, the relationship between fasting glucose and CKD remains controversial in non-diabetic population.

Method
This study included 6,354 participants without diabetes and CKD from the KoreanGenome Epidemiology Study. The genetic risk score (GRS9) was calculated using nine genetic variants associated with fasting glucose in previous genome wide association studies. Incident CKD was defined as estimated glomerular filtration rate (eGFR) &lt;60 mL/min/1.73 m2 or proteinuria (≥1+). The causal relationship between fasting glucose and CKD was evaluated using Mendelian randomization (MR) approach.

Results
The GRS9 was strongly associated with fasting glucose (β, 1.01; P &lt; 0.001). During a median follow-up of 11.6 years, 531 (8.4%) CKD events occurred. After adjusting for confounding factors, fasting glucose was not associated with incident CKD (odds ratio [OR], 0.991; 95% confidence interval [CI], 0.980–1.003; P =0.139). In the MR analysis, GRS9 was not associated with CKD development (OR per 1 standard deviation increase, 1.179; 95% CI, 0.819–1.696; P = 0.376). Further evaluation with various other MR methods using inverse-variance weighted, MR-Egger, and weighted median methods for multiple genetic variants and strict CKD criteria (decrease in the eGFR of ≥ 30% to a value of &lt; 60 mL/min/1.73m2) found no significant relationship between GRS9 and incident CKD.

Conclusion
Impaired fasting glucose was not causally associated with CKD development in nondiabetic population.
P0777REPRODUCTIVE HISTORY AND INCIDENT CKD IN MIDDLE-AGED WOMEN
Authors: Kim Kipyo , Ko Gang-Jee , Moon Ju-Young 
Published: June 2020

Abstract

Background and Aims
Previous epidemiologic data showed female has slower renal function decline compared to male and experimental studies showed the renoprotective effects of estrogen. Nevertheless, clinical studies that supports the beneficial effects of female sex hormone on chronic kidney disease (CKD) progression are limited. Middle age in women is the period of experiencing hormonal alteration. Therefore, we investigated that the associations of reproductive history with incident CKD in middle-aged women.

Method
A total of 4481 women aged ≥ 40 years with normal renal function were included in the study from the Korean Genome and Epidemiology Study database. The cohort consisted of community-based general population and were followed up from 2001 to 2016. Primary outcome was the incident occurrence of CKD (eGFR&lt; 60 ml/min/1.73m2 and 25% decline from baseline creatinine). We additionally defined the endogenous estrogen exposure (menopausal age - age at baseline - 0.75 x each childbirth) to examine the effect of estrogen exposure on renal function. Multivariable Cox proportional hazards analysis was performed with time-varying covariates including childbirth, menopausal status, and hormone replacement therapy.

Results
The mean age of participants was 52.3 ± 8.9 years, and 51.5% (n=2306) of patients have reached menopause at baseline. The mean eGFR was 94.1 ± 12.7 mL/min/1.73 m2 and 7.0% (n=315) participants experienced childbirth during follow-up period. Age-adjusted Cox model showed that childbirth (HR 1.58, CI 1.24-2.02) and menopause (HR 1.31, CI 1.04-1.63) were significantly associated with high risk of incidental CKD, but not in hormonal therapy. These associations remained after multivariate adjustment (childbirth, HR 1.55, CI 1.21-1.98; menopause, HR 1.26, CI 1.01-1.57). Endogenous estrogen exposure ranged 0 to 14 years, and was categorized into no exposure (51.5%), moderated exposure (1-6 years), and high exposure (&gt;6 years). High exposure group was associated with the lower risk of CKD compared to no exposure group (HR 0.74, CI 0.58-0.94). Restricted cubic spline analysis also showed the inverse relationship between estrogen exposure and the risk of incident CKD.

Conclusion
In middle-aged women, menopause and childbirth were significantly associated with higher risk of incident CKD. These associations could be attributable to the reduction of endogenous estrogen exposure.
P0785POSITIVE CORRELATION OF SERUM RESISTIN LEVEL WITH PERIPHERAL ARTERY OCCLUSIVE DISEASE IN PATIENTS WITH CHRONIC KIDNEY DISEASE STAGE 3 TO 5
Authors: Tang Chi-Chong , Hou Jia-Sian , Hsu Bang-Gee 
Published: June 2020

Abstract

Background and Aims
Resistin named for its ability to resist insulin action has an important link between obesity, insulin resistance and diabetes. Moreover, additional reports suggest that resistin has a pathogenic role in the development and progression of atherosclerosis and coronary artery disease. Chronic kidney disease (CKD) accelerates atherosclerosis via augmentation of inflammation and perturbation of lipid metabolism. Peripheral arterial occlusive disease (PAOD) is associated with an increased risk of death in CKD patients. The aim of this study was to evaluate the relationship between serum resistin level and PAOD by ankle-brachial index (ABI) in CKD patients.

Method
Fasting blood samples and baseline characteristics were obtained from 240 patients with CKD (stage 3-5). ABI values were measured using the automated oscillometric method (VaSera VS-1000). ABI values that were &lt; 0.9 were included in the low ABI group. Concentrations of human serum resistin were determined using a commercially available enzyme immunoassay kit.

Results
Among the 240 CKD patients, 30 of them (12.5%) were in the low ABI group. Compared with patients in the control group, the patients in the low ABI group had higher prevalence of diabetes (p = 0.033), hypertension (p = 0.023), current smoking (p = 0.013), older age (p &lt; 0.001), higher systolic blood pressure (p = 0.013), glucose (p = 0.022) level and resistin (p &lt; 0.001) levels. In addition, the multivariable logistic regression analysis showed that serum resistin levels (Odds ratio [OR]: 1.140, 95% confidence interval [CI]: 1.054-1.234, p = 0.001) and age (OR: 1.102, 95% CI: 1.051-1.156, p &lt; 0.001) were the independently associated with PAOD in CKD patients. The area under the receiver-operating characteristic (ROC) curve predicting PAOD by serum resistin level in CKD patients was 0.699 (95% CI: 0.636-0.756, p = 0.0001).

Conclusion
In this study, serum resistin level was found to be associated with PAOD in non-dialysis CKD stage 3-5 patients.