bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO097BETA BLOCKER PREVENTS CARDIAC MOLECULAR AND MORPHOLOGICAL REMODELLING IN EXPERIMENTAL URAEMIA
Authors: Chinnappa Shanmugakumar , Maqbool Azhar , Denby Laura , Mooney Andrew , Drinkhill Mark 
Published: May 2021

Abstract

Background and Aims
Fifty years of heart failure research has shown that pathological cardiac remodelling forms a vicious cycle with myocardial dysfunction leading to progressive heart failure (HF) [Circulation, 102

IV14-23, 2000]. Fetal gene induction is associated with this process and beta blocker therapy has been shown to prevent it. Although chronic kidney disease (CKD) and HF share similar mediators of cardiac remodelling, the benefits of beta blocker therapy in CKD has not been studied. We, therefore, tested the hypothesis that beta blocker therapy prevents fetal gene induction and pathological cardiac remodelling in experimental uraemia.

Method
Wistar rats (n=32) had subtotal nephrectomy (STNx) [Frontiers in physiology, 10

1365, 2019] or sham surgery and were followed up for 10 weeks. The animals were randomly allocated to metoprolol (10mg/kg/day) or vehicle. In vivo and in vitro cardiac assessments were performed, and changes in myocardial fetal gene expression were also studied.

Results
Heart rate was significantly lower in metoprolol groups compared to untreated groups demonstrating effective beta blockade (Fig 1A). Echocardiographic LV mass was significantly higher in untreated STNx group compared to the metoprolol group (896.4 vs 632.2g, P=0.0004). Similar changes were seen with heart weight to tibia ratio (Fig 1B). There was no significant difference in blood pressure (BP) between treated and untreated STNx animals (123 vs 119 mmHg, P=0.359) (Fig 1A). STNx increased mRNA expression of fetal genes and there was a trend towards attenuation of this increase with beta blocker therapy (Fig 1C).

Conclusion
Beta blocker therapy ameliorates uraemic pathological cardiac remodelling irrespective of changes to BP. This benefit appears be associated with a reduction of induced fetal gene expression. Further translational research on the benefits of beta blockade in the treatment of uraemic cardiomyopathy is required.
MO119COMPUTER-DERIVED SOFTWARE IN CLINICAL PRACTICE: RESULTS FROM A SHORT-TERM FOLLOW-UP ACCORDING TO KIDNEY STONE COMPOSITION IN KIDNEY STONE FORMERS
Authors: Cunha Tamara , Rodriguez Adrian , Ferraro Pietro Manuel 
Published: May 2021

Abstract

Background and Aims
Urinary supersaturation (SS) contributes to stone formation, and its assessment in stone formers may be helpful in clinical practice. Several computer programs are available for SS calculation, including EQUIL2, JESS and Lithorisk1. The aim of this study was to evaluate changes in SS in 24-hour urine in patients with known stone composition before and after about three months of regular treatment.

Method
Patients who submitted their stone/s for composition analysis and had provided an adequate 24-hour urine collection (creatinine 15-20 mg/kg/24-hour) before and around 90 days under regular treatment were included. Stone composition was defined using morphoconstitutional and infrared spectroscopy. The treatment was initiated in accordance with specific guidelines, and included dietary advices and medications2. SS for calcium oxalate (CaOx), calcium phosphate (CaP) and uric acid (UA) using EQUIL2, JESS and Lithorisk were calculated at baseline and after about 90 days on treatment. Continuous variables were reported as means (SD) while categorical variables were reported as frequencies and percentages. Baseline and follow-up SS urine values were compared using the Wilcoxon signed-rank test. 3D graphs were plotted using mean SS values of CaOx, CaP and UA obtained from each program before and after treatment, dividing the stones into 4 groups1: calcium oxalate monohydrate (COM), calcium oxalate dihydrate (COD), calcium phosphate (CaP), and uric acid (UA). Ethical Committee approval was obtained.

Results
105 patients (61 men, 58%) were followed and provided 24h urine collection. Of these, 101 (96%) were recurrent patients. The mean (SD) follow-up was 94 (14) days. 48 (46%) of all calculi were made of CaOx, either COM or COD, 36 (34%) of UA, and 21 (20%) of CaP. A significant reduction in SS values during treatment was observed in patients with COM (p&lt;0.05) , COD (p&lt;0.001), and UA stones (p&lt;0.001) with all programs. The reduction in SS values over time in patients with CaP stones was not significant (Table 1). Figure 1 shows 3D plots with SS before and after treatment into 4 groups of stone formers.

Conclusion
EQUIL2, JESS and Lithorisk are suitable software currently used for clinical and research purposes. SS values calculated by EQUIL2, JESS and Lithorisk during follow-up showed a significant reduction among COM, COD and UA stone formers. CaP stone formers did not show significant changes in SS over time.
MO120STONE COMPOSITION AND CARDIOVASCULAR DISEASE IN PATIENTS WIITH NEPHROLITHIASIS
Authors: Valencia Ana Lucía , Coca Armando , Lorenzo Arturo , Fidalgo Veronica , Perez Vicente , Fernandez Lucila , Aller Carmen , Sanz Sandra , Mendiluce Alicia 
Published: May 2021

Abstract

Background and Aims
Kidney stone disease is widely prevalent in the general population and has been associated with multiple comorbidities including hypertension, diabetes, chronic kidney disease and cardiovascular disease. We aimed to describe the possible link between stone composition and cardiovascular disease and its differential effect among women and men.

Method
Retrospective review of patients with known stone composition seen in a nephrolithiasis unit in the last five years. Anthropometric and clinical data were gathered from the hospital records. Stone composition was defined as such if ≥50% of the stone was made from a single component. Cardiovascular disease included coronary artery disease, stroke and peripheral vascular disease. Unadjusted and adjusted logistic regression analysis were applied to describe the potential relationship between stone composition and cardiovascular disease.

Results
337 patients were included in the study sample. Median age was 57 (IQR 47-67), 61.1% males. 58.2% suffered from recurrent stone disease and 28.5% from family history of stone formation. 32.9% of patients had hypertension, 22,4% diabetes and 13,1% chronic kidney disease. The most common kidney stone component was calcium oxalate (38.6%) followed by calcium phosphate (21.3%), uric acid (14.2%), struvite (8%) and brushite (0.9%). Only uric acid as main stone component was associated with cardiovascular disease among men but not women in our sample in univariate analysis. That relationship was lost in adjusted logistic regression analysis.

Conclusion
Calcium oxalate and phosphate were the most common components of kidney stones. No relationship was found between stone composition and cardiovascular disease in the study sample.
MO1021HYPERTENSION IN CHILDHOOD MINIMAL CHANGE DISEASE: IGNORED, MISSED OR UNDER-DIAGNOSED?
Authors: Sharma Sourabh , Sharma Neha 
Published: May 2021

Abstract

Background and Aims
Minimal change disease (MCD) is most common form of primary nephrotic syndrome (76.6% as per ISKDC) in children aged 1 to 10 years. As per current literature, blood pressure (BP) is usually normal in childhood MCD while in adults, 50% MCD cases are hypertensive. We hypothesized that hypertension is prevalent in childhood MCD also and most of cases are missed or under-diagnosed due to lack of BP monitoring, inappropriate BP cuff size (larger cuff will inaccurately show lower BP; cuff should cover 75% to 80% of arm circumference between antecubital fossa and axilla) or lack of knowledge about childhood hypertension criteria (systolic or diastolic BP&gt; 95th percentile for age on ≥2 clinical visits at least 1 week apart).

Method
This cross-sectional study was performed from March 2018 to December 2020 at a tertiary care centre in India. Newly diagnosed and relapses of primary nephrotic syndrome (presumed MCD) in children aged 1 to 10 years were included in the study. All cases were subjected to careful BP monitoring and charting using appropriate BP cuff, while child is calm and relaxed, in quiet room with comfortable temperature and empty bladder. Three measurements were taken at 1 minute interals and taking average of last 2 measurements. Percentile charts for age and height were followed.

Results
fifty four cases of childhood MCD were studied. Thirty six cases (66.67%) were male. Mean age was 5.48 years (SD ±2.31). Thirty two cases (59.26%) were found to be hypertensive. Fourteen cases (43.75%) were relapses. Seven cases (21.87%) were steroid resistant nephrotic syndrome while three cases were steroid dependent. Five cases were already on calcineurin inhibitors when diagnosed of hypertension. There was family history of hypertension in 9 cases diagnosed of hypertension (p value 0.77). There was no correlation between occurrence of hypertension and degree of proteinuria, hypoalbuminemia or body mass index. All hypertensives were managed with angiotensin receptor blockers and regularly followed-up.

Conclusion
Results of our study are contrary to traditional belief that hypertension is not common in childhood MCD. Significant number of cases are hypertensive. Correct BP measurement and interpretation is necessary in each childhood MCD case. Its occurrence is not correlated with family history or degree of proteinuria, hypoalbuminemia or body mass index.
MO1026MICROALBUMIN LEVEL IN URINE DEPENDING ON ACE GENE POLYMORPHISM IN PATIENTS WITH VUR
Authors: Zaikova Natalia , Dlin Vladimir , Sinitsina Lilia , Sacara Victoria , Korsunskiy Anatolii 
Published: May 2021

Abstract

Background and Aims
reflux nephropathy (RN) is the most serious complication of vesicoureteral reflux (VUR). The aim of the study was to assess the urinary level of MA (microalbumin) as an expression of tubulointerstitial damage depending of ACE genotype polymorphisms in children with VUR.

Method
94 patients, with VUR at the age from 3 year to 16 years (average age of 6.72 ± 0.68 years), including 65 girls (69,1%) were enrolled. As a control population to compare the distribution of genotypes and alleles of ACE gene used a sample of 100 healthy children (82girls), indigenous ethnic groups, mean age of 11.3 ± 5.4 years. To determine the gene polymorphism of ACE we used the method of polymerase chain reaction. Renal scar in DMSA scan was performed at least six months after urine tract infection (UTI). According to DMSA scan results, children were divided into 2 groups: gr. 1 - 12p. (VUR without RN), gr. 2 – 82 p. (VUR with RN). Urinary excretion of MA was measured by ELISA method.

Results
In gr. 1 is the frequency of genotype I/I amounted to 58%, I/D is 42% and D/D – is not detected. In the scar group (gr.2) frequency of genotype I/I is 12% (p1,2&lt;0,05), I/D is 63% and (p&gt;0.05), and D/D is 25% (p&lt;0.05), respectively. In the distribution of I and D allele in children with VUR (71,3% of children with RN has got D allele). In RN groups with genotype D/D, the level of MA/Cr in the urine was 1,5 times higher than in children with genotype I/D (p&lt;0.05) and 3-3,5 times higher than in patients with genotype I/I (р=0.0001). Significant difference in urinary levels of MA/Cr in the non scar group with genotype I/I and I/D is not revealed.

Conclusion
D/D-genotype of ACE may be a genetic susceptibility factor contributing to adverse renal prognosis – reflux nephropathy and presenting as risk factor for scar formation. A high urinary level of MA/Cr and positive correlation with genotype D/D is a significant and sensible marker of tubulointerstitial damage
MO1009TWENTY-FOUR-HOUR AUGMENTATION AND CARDIAC INDEX LEVELS ARE INCREASED IN CHILDREN ON HEMODIALYSIS COMPARED TO PERITONEAL DIALYSIS PATIENTS
Authors: Stabouli Stella , Askiti Varvara , Chrysaidou Katerina , Malakasioti Georgia , Karava Vasiliki , Mila Maria , Chainoglou Athanasia , Marinaki Smaragdi , Mitsioni Andromachi 
Published: May 2021

Abstract

Background and Aims
Cardiovascular disease is highly prevalent in the chronic kidney disease population and associates with higher morbidity and mortality even in young ages. The aim of the present study was to assess data from 24h ambulatory blood pressure monitoring (ABPM) and 24h pulse wave analysis (PWA) in dialyzed children and investigate their association with left ventricular mass as a marker of increased cardiovascular risk.

Method
Children and adolescents aged 6 to 18 years, on dialysis for more than 12 months, [16 on peritoneal dialysis (PD) and 12 on hemodialysis (HD)], underwent 24h ABPM, 24h PWA, and echocardiography.

Results
Peripheral and central blood pressures (BPs), mean pulse wave velocity (PWV) and left ventricular mass index (LVMI) were similar between PD and HD patients (figure 1a,b). Among PWA hemodynamic parameters, augmentation index (AIx75), cardiac index (CI), and heart rate were higher in the HD group (p&lt;0.05) (figure 1c,d). LVMI was associated with hemoglobin (Hb) (R2=0.19, p&lt;0.05)mean arterial pressure (MAP) (R2=0.34, p&lt;0.005), central systolic BP (cSBP) (R2=0.39, p&lt;0.001), AIx75 (R2=0.26, p&lt;0.005), CI (R2=0.14 p&lt;0.05) and PWV (R2=0.26, p&lt;0.005), but not with weight, body mass index or relative overhydration. CI and AIx75 were higher in the HD group compared to PD both in patients with normal LVMI and those with left ventricular hypertrophy (LVH). CI remained higher in HD patients after adjustment for Hb, MAP, cSBP, PWV, AIx75, and LVMI (estimated marginal means 4.17, 95%CI 3.80-4.53 versus 3.40, 95%CI 3.11-369 in PD patients, p&lt;0.05). Similarly, AIx75 remained higher in HD patients after adjustment for Hb, MAP, cSBP, PWV, CI, and LVMI (estimated marginal means 28.89, 95%CI 24.49-33.30 versus 22.62, 95%CI 19.15-26.08 in PD patients, p=0.05).

Conclusion
HD pediatric patients demonstrate higher AIx75 and CI compared to PD patients even in the absence of LVH. These results suggest distinct patterns of vascular and cardiac functional changes in HD patients that may increase cardiovascular risk beyond LVH.
MO1010CLINICAL VARIABILITY OF ALPORT SYNDROME IN CHILDREN WITH MISSENSE COL4A5 VARIANTS
Authors: Aksenova Marina , Lepaeva Tatjana , Nikishina Tatjana , Piruzeeva Oxana , Obuhova Varvara , Konkova Natalia 
Published: May 2021

Abstract

Background and Aims
The phenotype-genotype relation is well established in patients (especially male) with X-linked Alport syndrome (XLAS). The aim of study was to define the spectrum of COL4A5 pathogenic variants and impact of missense mutation on disease progression.

Method
The NGS-based genetic testing of COL4A3, COL4A4, COL4A5 was performed in 186 children with suspected Alport syndrome. The comparison of clinical symptoms (frequency, age of presentation of macrohematuria, proteinuria, eGFR decrease, sensorineural deafness (SND), level of proteinuria (mg/m2/day) and eGFR (ml/min/1.73m2) at the last presentation) was carried out in male with XLAS due to different COL4A5 variants.

Results
The XLAS was diagnosed in 93 children (Ме 7,5[4;11], 51М) from 79 families. The following COL4A5 variants were revealed: missense (n=70, q=0.75), splice site (n=10 from 9 families, q=0.11), frame shift (n=6, q=0.06), nonsense (n=7, q=0.08). Missense variants were presented by COL4A5 c.1871G&gt;A, p.(Gly624Asp) in 26% of cases (n=18). The mean age of ESRD was lower in male family member (35[24;35] years vs 48[40;55], p=0.023) with non COL4A5 p.(Gly624Asp). There was no difference in age on last presentation (13[9;14] vs 12[8;15], p=0.091) between pts with COL4A5 p.(Gly624Asp) and other missense variants. There was significant difference between the male with p.Gly624Asp and other missense variants in frequency of proteinuria (0.61 vs 0.25, p=0.043), SND (0.5 vs 0.08, p=0.03), age at onset (5[3;7] vs 14[8;16], p=0.02) and degree of proteinuria (441[78;1158] vs 66[22;160], p=0.023) and eGFR level (83[66;109] vs 96[91;104], p=0.048) at the last examination.

Conclusion
The XLAS is caused by missense variants in ¾ of cases in our cohort. We confirmed the other European studies results: the COL4A5 p.(Gly624Asp) is the most common variant of missense mutations characterized by mild phenotype of XLAS.
MO1037WOMEN REPRESENTATION IN CLINICAL PRACTICE GUIDELINES AMONG MAJOR NEPHROLOGY GUIDELINES
Authors: Mohan Arjunmohan , Chengappa Madhuri , Herrmann Sandra , Poonacha Thejaswi 
Published: May 2021

Abstract

Background and Aims
While the percentage of women entering nephrology has increased over the years, women representation and sex disparities in the authorship of major nephrology Clinical practice guidelines (CPG) has not been examined. Our study evaluates current sex disparities and women representation, and the nationalities of women authors in nephrology CPGs developed by the Kidney Disease: Improving Global Outcomes (KDIGO), Kidney Disease Outcomes Quality Initiative (KDOQI), and the European Renal Best Practice (ERBP), the official guideline body of the ERA-EDTA.

Method
We examined the number of female versus male guideline workgroup members (panelists) for all available CPGs in each of the three organizations as of Dec. 2020, which are available on their respective websites. We discerned the sex of the panelists based on google search and their affiliated institutional websites. We obtained the nationalities of the workgroup members from the authorship information of the respective CPG.

Results
Of the total 488 panelists in all three organizations, 115 (23.6%) were females and 373 (76.4%) males. KDIGO had 184 panelists, of which 46 (25%) were females. The CPGs with the highest and the least women representation are ‘Diabetes in Chronic Kidney Disease (CKD)’ (41.2%) and ‘Anemia in CKD’ (11.8%), respectively. The countries with the highest number of women representations are the USA (20), followed by Canada (6), and China (4). In KDOQI, 39 (31%) of 127 panelists were female. While CPGs related to ‘Evaluation and management of CKD’ and ‘Nutrition in children with CKD’ each had 50% female panelists, ‘Blood pressure management in CKD’ CPG had 10% female panelists. 28 (72%) of the total 39 women were from the USA. The ERBP had 30 (17%) females of the total 177 panelists. ‘CKD in older patients’ CPG comprised 42.1% female panelists. CPGs for ‘Glycemic control in diabetes’ and ‘Glucose lowering drugs in diabetes’ had no female panelists. Belgium and UK each had six women representatives, while France and The Netherlands 4 women representatives each.

Conclusion
The guidelines developed by the most prominent organizations – KDIGO, KDOQI, and ERA-EDTA have less than 25% women representation. While it is encouraging to note that there is more women representation in some of the CPGs developed by KDIGO in 2020, evaluating the barriers contributing to the under-representation of women in major nephrology organizations is warranted. Also notable is a lack of women representation from developing countries.
MO1038JOB BURNOUT IN RARE DISEASE RESEARCH PHYSICIANS DURING COVID-19 PANDEMIC
Authors: Zou Linfeng , Zhang Yun , Wang Ying , Zhang Lei , Xia Peng , Chen Limeng 
Published: May 2021

Abstract

Background and Aims
Doctors are exposed to high levels of stress in their profession and are particularly susceptible to experiencing burnout. Rare disease researches are enlightening, with more workload to clinicians, especially during the Covid-19 pandemic. We aim to explore the mental influence of participating in rare disease researches on clinicians.

Method
Doctors received electronic questionnaires regarding job-burnout in October 2020. The modified Maslach Burnout Inventory-General Survey (MBI-GS) was used to evaluate job burnout state. The MBI-GS consisting of three dimensions, emotional exhaustion (five questions), cynicism (five questions), and reduced personal accomplishment (six questions). The 7-grade Likert scale is adopted in each question, from 0 point (never) to 6 points (very frequently). Job burnout was considered if the average score of any dimension is no less than three.

Results
Questionnaires from all 203 doctors were analysed in this study, with females (70.0%, n=140). Age ranging from 25 to 39, 40 to 54, and above 55 were 41.4%, 50.7%, 7.9%, respectively. Nearly half of the subjects (50.2%, n=102) fulfil the definition of job-burnout, which was fewer than that in the residency program (50.2% vs. 62.9%, p=0.02). An inappropriate evaluation system (36.0%) and lack of private time (35.5%) were the leading cause of job-burnout. The pressure of scientific researches (79.3%) and career promotion (58.1%) was the major source of mental pressure.
Doctors who participated in rare disease researches (46.8%, n=95) did not show significant differences in burnout rate than individuals who did not (44.2% vs 55.6%, p=0.123), nor as in three dimensions (27.3% vs 36.1%, p=0.183 for emotional exhaustion, 21.1% vs 20.4%, p=0.905 for cynicism, 21.1% vs 27.8%, p=0.267 for reduced personal accomplishment). Logistic analysis revealed that high requirement from superior (22.5% vs 6.9%, p= 0.001), pressure from family (33.3% vs 17.8%, p=0.010), inappropriate job allocation (47.1% vs 29.7%, p= 0.019) as well as delayed off-work time (p=0.013) were independent risk factors of job-burnout. Physicians who participate in rare disease research had better job allocation (75.8% vs. 49.1%, p&lt;0.001), but not in the other three risk factors.

Conclusion
More workload did not increase the job-burnout of physicians participating in the rare disease research, which might be contributed by the appropriate job allocation.
MO1040KNOWLEDGE, ATTITUDES AND PERCEPTION OF ORGAN DONATION BY STUDENTS IN MEDICINE
Authors: Failal Imane , Ezzaki Sanae , Elafifi Rania , Mtioui Naoufal , Elkhayat Salma , Zamd Mohamed , Ramdani Benyounes 
Published: May 2021

Abstract

Background and Aims
Organ transplantation is a treatment option to millions of patients worldwide. In this area, Morocco lags far behind the developed countries and even compared to some countries in the Arab world.
The objective of this study is to assess the knowledge; social attitudes and perceptions of donation and organ transplantation by medical students.

Method
This is a cross-sectional study descriptive and analytical target held in the Faculty of Medicine and Pharmacy of.

Results
320 medical students were surveyed. The mean age was 21.5 ± 2.32 years, with a female representing 78%.
Almost all surveyed students knew the lethal diseases requiring the use of the graft (99.8%) and 97% of them knew the transplantable organs. 92% had heard of the possibility of organ transplants in Morocco, 90% of students felt that there are many people in need of transplants
87% of students were aware of the existence of legislation governing organ donation in Morocco. Only 7% thought that acts of donation and transplantation of organs are performed in private clinics, 89% of respondents know that there is a book in which one can register to make known its agreement to give its organs after death, 81% do not know the steps to register for this registre.97% were for organ donation and causes of refusal were: religion and the attainment of bodily integrity

Conclusion
There has to be targeted actions in order to promote donation and transplant in Morocco in order to enhance knowledge and information on medical, religious and legal order that the attitudes and perceptions of the population live.