bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO833PSYCHOLOGICAL REPERCUSSIONS OF THE LOCKDOWN AND THE COVID-19 EPIDEMIC IN HEMODIALYSIS PATIENTS AND CAREGIVERS IN FRANCE
Authors: Prezelin-Reydit Mathilde , Guerraoui Abdallah , Dolley-Hitze Thibault , Vendrely Benoît , Chantrel François , Kolko-Labadens Anne , Azzouz Lynda , Bouillier Marc , Pelletier Solenne , Fessi Hafedh , Vigneau Cécile , Combe Christian , Caillette-Beaudoin Agnes , Chauveau Philippe , Lasseur Catherine , Idier Laetitia 
Published: May 2021

Abstract

Background and Aims
The health crisis linked to the COVID-19 epidemic has required lockdown measures in France and changes in practices in dialysis centers. The objective was to assess the depressive and anxiety symptoms during lockdown in hemodialysis patients and their caregivers, to assess their coping strategies during this period and to assess the symptoms of depression, anxiety and post traumatic stress beyond confinement.

Method
We sent, during lockdown period, between April and May 2020, self-questionnaires to voluntary subjects (patients and caregivers), treated by hemodialysis or who worked in hemodialysis in one of the 14 participating centers in France. We analyzed their perception of dialysis sessions (beneficial or worrying), their stress level (VAS rated from 0 to 10), their anxiety and depressive symptoms (HADS). Factors associated with stress, anxiety and depression were analyzed with multiple logistic regression models. We will look for associations between coping strategies, participant characteristics and symptoms of stress, anxiety and depression using chi-square tests. A second questionnaire was sent out in October to collect symptoms of depression, anxiety and post-traumatic stress beyond confinement. Symptoms will be described and factors associated with stress, anxiety and depression will be analyzed with multiple logistic regression models.

Results
669 patients and 325 caregivers agreed to participate. 70% of participants found it beneficial to come to dialysis during confinement. The proportions of subjects with a stress level ≥ 6 linked to the epidemic, confinement, fear of contracting COVID-19 and fear of infecting a loved one were respectively 23.9%, 26.2%, 33.4% and 42%. 39.2% presented with certain (13.7%) or doubtful (19.2%) anxious symptoms. 21.2% presented a certain (7.9%) or doubtful (13.3%) depressive symptomatology. Age, gender, history of psychological disorders and perception of dialysis sessions were associated with levels of stress, anxiety and depression. 685 subjects participated in the second part of the study (68.9% of the participants of the first part). Analyzes of this data are in progress.

Conclusion
During the lockdown period, in France, the majority of hemodialysis patients and caregivers found it beneficial to come to dialysis. One in 3 subjects had anxiety symptoms and one in 5 subjects had depressive symptoms. It will be interesting to investigate if there was an association between the coping strategies implemented by the participants and their level of stress, anxiety and depression during confinement and to analyze the evolution of the anxiety-depressive symptoms over time.
MO835AFTERMATH OF FORTNIGHTLY UNIVERSAL TESTING FOR SEVERE ACUTE RESPIRATORY CORONA VIRUS-2 INFECTION IN MAINTENANCE IN HEMODIALYSIS PATIENTS
Authors: Prasad Narayan , Patel Manas Ranjan , Bhadauria Dharmendra , Kaul Anupama , Kushwaha Ravi Sankar 
Published: May 2021

Abstract

Background and Aims
Asymptomatic maintenance hemodialysis patients with SARS-COV-2are missed with pre-dialysis screening without testing. The possible ideal strategy of testing each patient before each shift with RT-PCR was not feasible. We aimed to study the effectiveness of fortnightly screening with RT -PCR for SARS-CoV-2 in curbing transmission.

Method
Between July 1, 2020, and September 30, 2020, all 273 patients receiving hemodialysis were subjected to fortnightly testing for SARS-Cov-2 in the unit to detect asymptomatic patients. The cost and effectiveness of universal testing in preventing transmission were analyzed using Susceptible-Infectious-Removed (SIR) modeling assuming R0 of 2.2.

Results
Of 273 MHD patients, 55 (20.1%) got infected with SARS-CoV-2 over three months. Six (10.9%) were symptomatic, and 49 (89.1%) asymptomatic at the time of testing. Six (10.9%) asymptomatic patients develop symptoms later; and 43 (78.2%) remained asymptomatic. A total of 7(6.1%) HCWs also tested positive for the virus. With an assumption of R0 2.2 and isolation of symptomatic patients only, all 273 patients could have been affected by September 30, 2020; with the isolation of both symptomatic patients and those testing positive after pre-dialysis screen, only 52 (19%) infections could have been prevented. However, at the end of the study period, 218 (80%) patients remained uninfected of SARS-CoV-2. Fortnightly universal testing is cost-effective, and SIR modeling proved effective in preventing person-to-person transmission.

Conclusion
Repeated universal testing in maintenance hemodialysis patients detected 89% of asymptomatic SARS-CoV-2 patients over three months and appeared to be an effective strategy to prevent person-to-person transmission in the dialysis unit.
MO839URGENCY OF RENAL REPLACEMENT THERAPY INITIATION AS A PREDICTOR FOR POOR PROGNOSIS IN PATIENTS WITH KIDNEY DISEASE
Authors: Vishnevskii Konstantin , Suchkov Viktor 
Published: May 2021

Abstract

Background and Aims
It is known that mortality from COVID-19 among patients with kidney disease is significantly higher than in general population. The worst prognosis is seen for patients receiving renal replacement therapy (RRT). At the same time, many patients undergo an urgency start of hemodialysis (HD) while suffering from COVID-19. The aim of the study was to determine the significance of the RRT urgency for the prognosis in patients with COVID-19.

Method
A retrospective analysis of case histories for 253 patients who received RRT at the infectious ward of St. Petersburg State Healthcare Institution City Hospital No. 15 from May to December 2020 was performed. All patients had a diagnosis of COVID-19, confirmed by PCR and/or clinical symptoms. Urgency RRT was performed in case of detection of indications, both in acute kidney injury (AKI), and in the diagnosis of end-stage chronic kidney disease (esCKD). Kaplan-Meier curves and multivariate Cox regression were used to perform cohort analyzes of survival and relative risk of death. For the calculations, the applied statistical software package SPSS 21.0, SPSS Ink (USA) was used.

Results
Of the 253 treated patients, 197 were patients with chronic outpatient HD, in 56 HD therapy was started urgently: 45 for AKI, 11 for esCKD. Totally 83 patients died. The overall mortality rate was 33%, while in outpatient HD group it was 18% and in the urgent HD start group - 84%. After adjusting for gender and age the fact of the urgency of starting RRT was an independent risk factor that increased the probability of death by 2.5 times (95% Cl 1.6÷3.9) compared to outpatients HD (Log Rank: P&lt;0.001, Fig. 1). The patients age over 60 was also a factor significantly worsening the prognosis (Log Rank: P &lt;0.001).

Conclusion
Among patients with COVID-19 and kidney disease the urgency of RRT initiating is a factor that significantly worsens the prognosis, especially among patients of the older age group.
MO840ADAPTIVE DESIGN METHODS IN DIALYSIS CLINICAL TRIALS – A SYSTEMATIC REVIEW
Authors: Judge Conor , Murphy Robert , Reddin Catriona , Cormican Sarah , Smyth Andrew , O'Halloran Martin , O'Donnell Martin 
Published: May 2021

Abstract

Background and Aims
Adaptive design methods are intended to improve efficiency of clinical trials, and relevant to evaluating interventions in dialysis populations. We sought to quantify the use of adaptive design clinical trials in dialysis.

Method
We completed a full text systematic review and adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines. Our review utilised included a novel machine learning classifier and full text systematic review. We searched MEDLINE (Pubmed) and performed a detailed data extraction of trial characteristics and a narrative synthesis of the data.

Results
50 studies, available as 66 articles, were included after full text review. 31 studies were conducted in a dialysis population and 23 studies had renal replacement therapy as a primary or secondary outcome. Group sequential designs were the most common type of adaptive design method used in dialysis randomized clinical trials and in general adaptive designs usage is increasing over time. Acute Kidney Injury (AKI) was studied in 27 (54%) of trials, End Stage Kidney Disease (ESKD) was studied in 22 (44%) of trials and Chronic Kidney Disease (CKD) was studied in one trial (2%). The most common country of lead author was the United States of America in n=20 (40%) of studies. 26 (52%) studies were supported by public funding. 41 studies (82%) did not report their adaptive design method in the title or abstract and would not be detected by a standard systematic review involving title and abstract searches.

Conclusion
Adaptive design methods are infrequently used in dialysis randomized control trials.
MO845EUROQOL EQ-5D-3L IN DIALYSIS POPULATION IN COLOMBIA
Authors: Sanabria Mauricio , Vesga Jasmin , Rivera Angela , Ariza Juan Guillermo 
Published: May 2021

Abstract

Background and Aims
The EuroQol-5D (EQ-5D-3L) is a generic questionnaire to evaluate the quality of life related to health, and simultaneously facilitates the obtaining of preference values (utilities) In the economic evaluation of health interventions. Quality-adjusted life year (QALY) is a commonly used metric. Our objective is to evaluate the quality of life (QoL) and obtaining of utilities according the dialytic treatment.

Method
This was an observational, multicentre cross-sectional study. Prevalent patients on dialysis for at least 90 days, older than 18, at the Baxter Renal Care Services Colombia were included between August 2, 2019, to December 11, 2020. Socio-demographic and clinical characteristics of all patients were summarized descriptively, additionally, all categorical variables were compared with Pearson’s χ2 test or Fisher’s exact test and continuous variables were analysed with Student’s t-test or Mann Whitney U test. The difference in the QoL by domains will be evaluated using Pearson's χ2 test or Fisher’s exact test. The EQ VAS provides a quantitative measure of the patient’s perception of their overall health.

Results
A total 254 patients were evaluated, the median age was 55 years, 55% were men. At enrolment the median dialysis vintage 3.2 years, and 63% were in peritoneal dialysis treatment (Table 1). We did not find differences in the proportions by dialysis treatment when exploring each of the 5 dimensions of the QoL (Table 2). We observed that the patient´s perception of their overall health was similar median EQ VAS score 80 in HD and EQ VAS score 80 in PD (Figure 1). We did not find statistically significant differences in health status 11111, which represents not having problems in any dimension 46.8% versus 45.6%, HD and PD respectively, p-value= 0.855.

Conclusion
The quality of life reported by the patients and health status in haemodialysis was similar to peritoneal dialysis.
MO847PREVALENCE OF FATIGUE REPORTED BY PATIENTS ON HEMODIALYSIS THERAPY
Authors: Sanabria Mauricio , Doria Cesar Mauricio , Martinez Edward , Simon Carlos , Vesga Jasmin , Marin Magda 
Published: May 2021

Abstract

Background and Aims
Fatigue is a symptom with a high prevalence in patients on hemodialysis therapy due to uremic toxins, anemia, associated comorbidity, and hemodialysis treatment per se. Our objective is to evaluate the prevalence of fatigue reported by patients and their association with the nutritional status.

Method
This was a prospective observational, multicenter cohort study. Prevalent patients on HD therapy for at least 90 days, older than 18, at the Baxter Renal Care Services were included between September 1, 2017, to November 30, 2017 with one-year follow-up. Socio-demographic and clinical characteristics of all patients were summarized descriptively, the nutritional status was evaluated by protein Energy waste (PEW). Patient reported fatigue was measured with high flux membrane and medium cut-off membrane (Theranova). A generalized linear binomial multivariable model was conducted to assess the effect of PEW on fatigue symptom controlling for some confounding variables.

Results
We found that the fatigue reported by the patients has a prevalence of 55% [95% CI: 52.2 to 57.7] in our population, there are no statistical differences due to the use of different types of membranes p= 0.911, and neither did we find that the nutritional status is an independent factor that explains this symptom. If we find that women and diabetics have a higher risk of fatigue; RR=1.17 [95% CI: 1.06 to 1.29] and RR= 1.19 [95% CI: 1.00 to 1.42] respectively.

Conclusion
The fatigue is a prevalent symptom in the chronic hemodialysis population; being a woman and the diagnosis of diabetes are risk factors associated with this outcome. PEW and the type of dialysis membrane used were not associated with this symptom. Studies evaluating the recovery time from post-dialysis symptoms and its relationship with the type of membrane are necessary.
MO850OUTCOMES OF COVID-19 INFECTION IN DIALYSIS PATIENTS IN QATAR: A NATIONWIDE COHORT STUDY
Authors: Abdellatif Tarek , Hamad Abdullah , Alkadi Mohamad , Abuhelaiqa Essa , Othman Muftah , Ibrahim Rania , Akl Tabaseem , Yasin Fadumo , Aly Sahar , Eljaali Musab , Almalki Hassan 
Published: May 2021

Abstract

Background and Aims
Patients on maintenance dialysis are more susceptible to COVID-19 and its severe complications. We studied outcomes of COVID-19 infection in dialysis patients in the state of Qatar. Our primary outcome was to determine the mortality rate of dialysis patients with COVID-19 infection and associated risk factors. Our secondary outcomes were to assess the severity of COVID-19 in dialysis patients and its related complications such as the incidence of hypoxia, critical care unit admission, need for mechanical ventilation or inotropes, incidence of acute respiratory distress syndrome (ARDS), and length of hospital stay.

Method
This was an observational, analytical, retrospective, nationwide study. We included all adult patients on dialysis who tested positive for COVID-19 (PCR assay of nasopharyngeal swab) during the period from February 1, 2020 to July 19, 2020. Patient demographics and clinical features were collected from a national electronic medical record. Laboratory tests were evaluated upon diagnosis and on day 7.

Results
There were 76 out of 1068 dialysis patients who were diagnosed with COVID-19 (age 56±13.6, 56 hemodialysis and 20 peritoneal dialysis, 56 males). Eleven patients (15%) died during study period. Mortality due to COVID-19 among our dialysis cohort was 100 times higher than that in the general population for the same period (15% vs. 0.15%; OR 114.2 [95% CI: 1.53 to 2.44]; p&lt;0.001). Univariate analysis for risk factors associated with COVID-19-related death in dialysis patients showed minor but statistically significant increases in risks with age (OR 1.07), peak WBC peak level (OR 1.189), AST level at day 7 (OR 1.04), fibrinogen level at day 7 (OR 1.4), D-dimer level on day 7 (OR 1.94), and peak CRP level (OR 1.01). A major increase in the risk of death was noted with atrial fibrillation (OR, 8.7; p=0.008) and hypoxia (OR: 28; p=0.001). High severity of COVID-19 illness in dialysis manifested as 25% of patients required admission to the intensive care unit, 18.4% had ARDS, 17.1% required mechanical ventilation, and 14.5% required inotropes for intractable hypotension or shock. The mean length of hospital stay was 19.2±10.4 days. Laboratory tests were remarkable for severely elevated ferritin, fibrinogen, CRP, and peak IL-6 levels and decreased albumin levels on day 7.

Conclusion
This is the first study to be conducted at a national level in Qatar exploring COVID-19 in a dialysis population. Dialysis patients had a high mortality rate of COVID-19 infection compared to the general population. Dialysis patients had severe COVID-19 course complicated by prolonged hospitalization and high need for critical care, mechanical ventilation and inotropes. Special care should be done to prevent COVID-19 in dialysis patients to avoid severe complications and mortality.
MO859TRANSITIONS BETWEEN THE DIFFERENT DIALYSIS MODALITIES AND THEIR EFFECT ON SURVIVALS: A SINGLE-CENTER STUDY
Authors: Kurylovich Krystsina , Komissarov Kirill 
Published: May 2021

Abstract

Background and Aims
An integrated care approach available today, which implies that most patients will use different modalities at different time points of their disease, creates a need to accumulate data on patient outcomes and survival when switching from one treatment modality to another. The aim was to compare survival after the transition from hemodialysis (HD) to continuous ambulatory peritoneal dialysis (CAPD) and after the transfer from CAPD to HD.

Method
A single-center retrospective trial included 20 (18.9%) from 106 initiating CAPD between January 2016 and December 2020 patients, who were transferred from CAPD to HD or from HD to CAPD through a follow-up period until December 2020. 2 groups of patients were identified: the 1st group included CAPD-to-HD transition patients, the 2d group - HD-to-CAPD transition patients. At the end of a follow-up, the transfer's causes, outcomes, and cohort life expectancy (CLE) on the new treatment modality were evaluated.

Results
A summary of patients' characteristics are shown in the table below. The patient's number in the 1st group was 13, in the 2d - 7. Transfer causes in the 1st group were peritonitis (76.9%), leakage (15.4%), in the 2d group - vascular access problems (57.1%), poor hemodialysis tolerance (28.6%). In both groups in 1 case transfer cause was the patient's preference (7.7% and 14.3% respectively). In the 1st group CAPD duration was 29 [13;50] months, transfer outcomes included death in 7 cases (53.8%), renal transplantation (RT) in 2 cases (15.4%), in 2 cases (15.4%) patients were alive and were on HD, in 2 cases (15.4%) patients later were transferred back to CAPD. In the 2d group HD duration was 23 [3;30] months, transfer outcomes included death in 2 cases (28.6%), RT in 2 cases (28.6%), in 3 cases (42.8%) patients were alive and on CAPD. In the 1st group in 6 from 7 cases (85.7%) patients died in the intensive care unit (ICU), the main causes of death included cardiovascular accidents - 42.8% (cardiac arrest, acute heart failure, stroke), sepsis - 28.6% (due to gallbladder empyema and diabetic foot sepsis), bleeding - 28.6% (due to essential thrombocythemia, undiagnosed peptic ulcer). In the 2d group all patients died at home, causes of death involved congestive heart failure - 50% and uremia - 50.0%. In the 1st group CLE was 3.4 months, in the 2d - 20.5 months.

Conclusion
Post-transfer mortality is higher in the CAPD-HD transition group. In most cases, such patients die faster and in more severe condition and almost always in the ICU. Almost half of the CAPD-to-HD transfer patients died due to cardiovascular complications. Therefore, when transferring a patient to HD, it is necessary to take into account the load exerted on the heart and blood vessels, as well as the risks of bleeding and sepsis.
MO861THE PROGNOSIS OF PATIENTS RECEIVING CONTINUOUS RENAL REPLACEMENT THERAPY (CRRT) AFTER CARDIOVASCULAR SURGERY DEPENDS ON THE INDICATION FOR ITS INITIATION
Authors: Schizas Nikolaos , Smyrli Maria , Dedeilia Aikaterini , Patris Vasilios , Samiotis Ilias , Dedeilias Panagiotis , Argiriou Michail 
Published: May 2021

Abstract

Background and Aims
Continuous Renal Replacement Therapy is required in 2.6% to 5% of patients who have undergone cardiovascular surgery. Although its implementation is frequent, several aspects of this therapeutic measure still remain uncertain.

Method
The data of all patients who were surgically treated during a 3-year period (2017-2019) at a single cardiovascular department were collected and the cases in which continuous renal replacement therapy was used were identified. From this group, the data of those that received dialysis for the first time were analyzed.

Results
In about 5% of patients renal replacement was inevitable, and the mortality rate among them reached 57.6%. The mean duration of renal therapy was 8.4 days. The investigation of laboratory parameters in different stages revealed certain aspects about the expected outcomes. The survival rate varied significantly in relation to the indication for CRRT. Fluid overload and electrolytic disorders were associated with high survival rate, while oliguria or anuria, acidosis or intoxications were linked to increased mortality rate.

Conclusion
Despite CRRT being associated with high mortality rates, it is the only option for life-threatening conditions in clinical practice. The indication for CRRT is a key factor for the prognosis, decision-making and the overall management of a patient.
MO867THE SIGNIFICANCE OF THE MEAN PLATELET VOLUME AS A BIOMARKER IN HEMODIALYSIS PATIENTS
Authors: Al-Sayyari Abdulla 
Published: May 2021

Abstract

Background and Aims
The mean platelet volume was found to be an important biomarker in certain medical conditions. We evaluate its significance in patients on chronic hemodialysis

Method
Adult stable patients on chronic hemodialysis for at least six months were included. MPV together with certain demographic ( age, sex, BMI, dialysis vintage, cause of CKD, medication taken, mode of dialysis, type of vascular access) and laboratory parameters (Hb, albumin, Kt/V, PTH, CRP serum lipids) were measured and recorded
The correlation between these parameters and MPV was evaluated using Pearson correlation coefficient and the MPV in the absence or presence of the demographic parameters was calculated independent t test

Results
One hundred and twenty- three patients were studied. The mean age was 60.0± 18.4 and 48.7% were male and diabetes was the cause of CKD in 56.3% ; 72.6% were on hemodialysis and 27.4% on hemodiafiltration , 52.1% used AV fistula and 47.9% used permcath as vascular access; 50.9% were on aspirin Comparing the mean MPV above and below the 50th percentiles in different parameters revealed no significant differences. No significant correlation was found between MPV and duration on dialysis, age, weight, BM, erythropoietin dose per week, PTH, hemoglobin, albumin, CRP, number of admissions in the preceding year yea, LDL or HDL. However , there was a mild positive correlation with triglyceride level (Pearson coefficient = 0.2 (P=0.02).

Conclusion
No significant correlation or association was found between the MPV and any of the clinical demographic or laboratory parameter measured except that there was a mild positive correlation with triglyceride level.