bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO814RISK PREDICTION OF COVID-19 INCIDENCE AND MORTALITY IN A LARGE MULTI-NATIONAL HAEMODIALYSIS COHORT: IMPLICATIONS FOR MANAGEMENT IN OUTPATIENT SETTINGS
Authors: Haarhaus Mathias , Santos Carla , Haase Michael , Mota Veiga Pedro , Lucas Carlos , Macário Fernando 
Published: May 2021

Abstract

Background and Aims
Experiences from the first wave of the 2019 coronavirus disease (COVID-19) pandemic can aide in the development of future preventive strategies. To date, risk prediction models for COVID-19-related incidence and outcomes in haemodialysis (HD) patients are missing.

Method
We developed risk prediction models for COVID-19 incidence and mortality among HD patients. We studied 38 256 HD patients from a multi-national dialysis cohort between March 3rd and July 3rd 2020. Risk prediction models were developed and validated, based on predictors readily available in outpatient haemodialysis units. We compared mortality among patients with and without COVID-19, matched for age, sex, and diabetes.

Results
During the observational period, 1 259 patients (3.3%) acquired COVID-19. Of these, 62% were hospitalised or died. Mortality was 22% among COVID-19 patients with odds ratios 219.8 (95% CI 80.6-359) to 342.7 (95% CI 60.6-13595.1), compared to matched patients without COVID-19. Since the first wave of the pandemic affected mostly European countries during the study, the risk prediction model for incidence of COVID-19 was developed and validated in European patients only (N=22 826, AUCDev 0.64, AUCVal 0.69). The model for prediction of mortality was developed in all COVID-19 patients (AUCDev 0.71, AUCVal 0.78). Angiotensin receptor blockers were independently associated with a lower incidence of COVID-19 in European patients.

Conclusion
We identified modifiable risk factors for COVID-19 incidence and outcome in HD patients. Our risk prediction tools can be readily applied in clinical practice. The current study can aid in the development of preventive strategies for future waves of COVID-19.
MO874COVID-19 IN HEMODIALYSIS PATIENTS: CLINICAL PARTICULARITIES AND OUTCOMES
Authors: Abid Hanen , Toumi Salma , Zini Olfa , Sai Amira , Agrebi Ikram , Dammak Najla , Chaker Hanen , Masmoudi Mondher , Kammoun Khaoula , Yaich Soumaya , Ben Hmida Mohamed 
Published: May 2021

Abstract

Background and Aims
Coronavirus disease 2019 (COVID-19) has affected the care and outcomes of patients treated with dialysis worldwide. Patients on hemodialysis (HD) are at extremely high risk to develop COVID-19 because of their multiple co-morbidities and immunosuppression.
We report throw this work the experience of our unit of HD with the covid-19 infection and its outcomes on our patients.

Method
We conducted a prospective study since the beginning of the pandemic. We have collected 26 HD patients reached of COVID 19 disease.

Results
The sex ratio of our population was equal to 1,36 with female predominance. The mean age of our patients was 61, 31 ±14,17 years. The co-morbidities noted among these patients were respectively hypertension, diabetes, heart diseases and obesity in 19, 17, 10 and 10 cases. The causal nephropathy was respectively diabetic, undetermined, glomerular and interstitial nephropathy in 13, 9, 2 and 2 cases. The major symptoms associated to the COVID 19 were respectively dyspnea, cough, asthenia, fever and chills, digestive manifestations, chest pain in 22, 19, 19, 15, 10, and 6 cases. 7 patients have been exposed to covid-19 infested person. Symptoms appeared within an average of 4,3 ± 2 days. Oxygen saturation was less than 92% in 65% of the cases during hospitalization. 84% of the patients are hospitalized including one among them who required the stay in a resuscitation unit and intubation. The scannographic lesions of covid were estimated to more than 50% in 8 cases and less than 50% in 4 cases. A biological inflammatory syndrome has been noted in all of the patients with a mean CRP at 117+/-127 mg/l and the mean leucocytes count at 10248±6592 elt/mm3. Lymphopenia was noted in 14 cases with lymphocytes count less than 1500 elt/mm3. The ratio of neutrophils / lymphocytes was more than 2,5 in 12 cases. The treatment was based on oxygen, corticosteroids, antibiotics, vitamins and anticoagulation for hospitalized patients (22 patients). The mean number of HD sessions realized per patient during hospitalization was 4 ± 2,3 HD sessions. The perdialytic complications noted were alteration of the state of consciousness in 3 cases and heart failure in 5 cases. The outcomes of our patients were marked by death in 38% and a recovery in 62% of the patients. Thus, the forms observed in our series are respectively moderate, severe, pauci-symptomatic and asymptomatic in 12, 10, 2 and 2 cases.

Conclusion
We highlight throw this study the severe consequences of COVID-19 on HD patients in whom mortality reached 38%. Until the pandemic is controlled and a vaccine or a treatment are valid, we highlight the importance of the compliance with confinement and develop home dialysis among our population.
MO875SEROCONVERSION RATE AND PERSISTANCE OF IGG RESPONSE TO SARS-COV2 IN HEMODIALYSIS PATIENTS. A CASE SERIES STUDY
Authors: Tsikliras Nikolaos , Anagnostara Aggelina , Rekari Vasiliki , Nikitidis Ilias , Kyrgialanis Apostolos 
Published: May 2021

Abstract

Background and Aims
Higher incidence and worse outcome of coronavirus disease (COVID-19) are observed in dialysis patients, mainly due to weak immune response. However, little is known about seroconversion ability and duration of antibody response after COVID-19 in this group. The aim of this study was to estimate the seroconversion rate and the persistence of IgG response to SARS-CoV2 in dialysis patients.

Method
Four (4) dialysis patients previously infected with SARS-CoV2 were included in this study. Initially, all patients were tested for the presence of IgG antibodies 21-35 days after the onset of their symptoms. The cut-off value for positivity was a ratio of ≥ 1.4. Those patients with at least two consecutive positive samples were defined as seropositives. Seropositives were then having their antibodies tested monthly for a maximum period of six months or until the first negative result. Duration of antibody persistence was defined as the time between the day IgG were last detected and the day of onset of infection.

Results
All four patients were seropositives after the initial test (seroconversion rate = 100%) with a mean IgG ratio of 6.44 (±1.28). Median follow up period was 128 (range 96-193) days. Median duration of antibody persistence was 153 (range 103-193) days. By the sixth month, IgG had turned negative in two of four patients (rate = 50%).

Conclusion
In our study, dialysis patients showed a remarkable seroconversion rate after infection with SARS-CoV2. However, a rapid decline of IgG antibodies was observed in half of them.
MO670EXPANDED HEMODIALYSIS REDUCES THE CONCENTRATION OF FREE LIGHT CHAINS IN PATIENTS WITH ACUTE KIDNEY INJURY IN MYELOMA CAST NEPHROPATHY
Authors: Vishnevskii Konstantin , Domashenko Olga 
Published: May 2021

Abstract

Background and Aims
The myeloma cast nephropathy is largely associated with the production of intact immunoglobulin and free light chains (FLC) by a plasma cells monoclone. The use of high-flux hemodiafiltration (HDF) contributes to a decrease in the concentration of FLC. However, it is not always possible to achieve the required substitute volume with acute kidney injury (AKI) emergency treatment. An alternative to HDF could be the usage of membranes with a medium cut-off (expanded hemodialysis (HD), Expanded HD). The aim of this study was to compare the degree of reduction in FLC concentration using conventional HD, HDF and Expanded HD.

Method
The study includes patients with newly diagnosed multiple myeloma who presented indications for HD therapy start. Procedures were performed on a daily basis from the moment when indications for HD therapy were identified. The duration of the first three procedures was 2 hours. Consistently for each patient the first procedure was carried out using a standard low-flow filter, the second - using a high-flow dialyzer and HDF (substitute volume 9 liters for 2 hours), the third - using a Theranova 400 filter (Baxter, Germany). The concentrations of FLC (kappa and lambda) and albumin were determined every 30 minutes of each treatment. Chemotherapy was prescribed according to the local clinical recommendations in combination with the ongoing renal replacement therapy.

Results
The study included 7 patients with cast nephropathy, mean age 68±8 years. Average concentration before treatment: kappa FLC 876±727 μg/ml (norm 3.25-15.81 μg/ml), lambda FLK 84±112 μg/ml (norm 3.23-28.05 μg/ml), albumin 34±1 g/l (norm 40-50 g/l). After 2 hours of treatment, there was a decrease in kappa FLC concentration with HDF (-34±33%, p=0.01) and with Expanded HD (-31±12%, p&lt;0.001), but not with conventional HD (-1±7, p=0.79, Fig 1). The lambda FLC concentration also decreased with HDF (-41±29%, p=0.01) and with Expanded HD (-28±22%, p=0.01), but not with conventional HD (-3±12, p=0.65, Fig 2). Albumin concentrations did not change significantly with any of the treatments.

Conclusion
Expanded HD, as well as high-flow HDF, helps to reduce the FLC concentration in patients with cast nephropathy without loss of albumin, which may have a positive effect on the multiple myeloma prognosis. Further studies are needed regarding possibilities of using Expanded HD in the complex therapy for patients with AKI in myeloma cast nephropathy.
MO676COMPLEMENT ACTIVATION BY DIALYSIS MEMBRANES AND ITS ASSOCIATION WITH SECONDARY MEMBRANE FORMATION AND SURFACE CHARGE
Authors: Melchior Pascal , Erlenkötter Ansgar , Zawada Adam , Delinski Dirk , Schall Christian , Stauss-Grabo Manuela , Kennedy James 
Published: May 2021

Abstract

Background and Aims
Activation of the complement system may occur during blood-membrane interactions in hemodialysis and contribute to chronic inflammation of patients with end-stage renal disease (ESRD). Hydrophilic modification with polyvinylpyrrolidone (PVP) has been suggested to increase the biocompatibility profile of dialysis membranes. In the present study we compared complement activation of synthetic and cellulose-based membranes, including the polysulfone membrane with α-tocopherol-stabilized, PVP-enriched inner surface of the novel FX CorAL dialyzer, and linked the results to their physical characteristics.

Method
Eight synthetic and cellulose-based dialyzers (FX CorAL, FX CorDiax [Fresenius Medical Care]; Polyflux, THERANOVA [Baxter]; ELISIO, SUREFLUX [Nipro]; xevonta [B. Braun]; FDX [Nikkisio Medical]) were investigated in the present study. Complement activation (C3a, C5a, sC5b-9) was evaluated in a 3h ex vivo recirculation model with human blood. Albumin sieving coefficients were determined over a 4h ex vivo recirculation model with human plasma as a surrogate of secondary membrane formation. Zeta potential was measured as an indicator for the surface charge of the membranes.

Results
The FX CorAL dialyzer induced the lowest activation of the three complement factors (C3a: -39.4%; C5a: -57.5%; sC5b-9: -58.9% compared to the reference). Highest complement activation was found for the cellulose-based SUREFLUX (C3a: +154.0%) and the FDX (C5a: +335.0%; sC5b-9: +287.9%) dialyzers. Moreover, the FX CorAL dialyzer had the nearest-to-neutral zeta potential (-2.38 mV) and the lowest albumin sieving coefficient decrease over time. Albumin sieving coefficient decrease was associated with complement activation by the investigated dialyzers.

Conclusion
Our present results indicate that the surface modification implemented in the FX CorAL dialyzer reduces secondary membrane formation and improves the biocompatibility profile. Further clinical studies are needed to investigate whether these observations will result in a lower inflammatory burden of hemodialysis patients.
MO678DISTRIBUTION OF PERIPHERAL BLOOD T CELL SUBTYPES IN HEMODIALYSIS PATIENTS TREATED WITH MEDIUM CUT-OFF MEMBRANES AND HIGH-FLUX MEMBRANES
Authors: Hasbal Nuri Baris , Sevinç Mustafa , Yilmaz Vuslat , Basturk Taner , Ahbap Dal Elbis , Sakaci Tamer , Ozcafer Perin Nazif , Lindholm Bengt , Unsal Abdulkadir 
Published: May 2021

Abstract

Background and Aims
Mortality in end stage renal disease is higher than in the general population. In addition, there is also an increase in mortality that cannot be explained by known risk factors. In this context, researchers have been determining on these additional risk factors for years. Although inflammation is a proven risk factor, further studies are still needed. In this study, we aimed to investigate the effect of membranes on the distribution of T cell subgroups in peripheral blood mononuclear cells (PBMC) that play an important role in inflammation.

Method
Twenty-five patients were enrolled in the study, and patients received hemodialysis treatment first with MCO membrane (MCO) for 3 months and then with high-flux membrane (HF) for another 3 months. Peripheral blood samples were taken from the patients just before the hemodialysis procedure at 0 (starting with MCO), 3rd (switching to HF) and 6th (end of study) months. PBMC’s were separated by ficoll density gradient centrifugation and stored in liquid nitrogen. Frozen cells were stained with fluorescently labeled monoclonal antibodies and were utilized with flow cytometry device. Data were analyzed using FlowJo7.6.5 programs.

Results
Proportions of helper T (CD3+CD4+), cytotoxic T (CD3+CD8+), and follicular helper T (CD3+CD4+ CXCR3-CXCR5+) cells were similar in both membranes. The use of MCO decreased the ratios of peripheral CD3+T (p=0.07) and Th1 (CD3+CD4+CXCR3+CCR6+) (p&lt;0.0001) cells while increasing the ratio of NK cells (p=0.03). In addition, the shift of the immune balance towards an increase in Th17 (CD3+CD4+CXCR3-CCR6+) (p=0.005) and Th2 (CD3+CD4+CXCR3-CCR6-) (p &lt;0.0001) cell ratios with HF.

Conclusion
: The results can be interpreted as the prevention of a Th1 dominant inflammation seen with HF. Therefore, it suggests that the use of MCO may reduce T cell based inflammation in peripheral blood.
MO659INITIAL EXPERIENCE OF PERCUTANEOUS ARTERIOVENOUS FISTULA CREATION
Authors: Balta Lamprini , Kitrou Panos , Georgopoulou Georgia Andriana , Papasotiriou Marios , Papachristou Evangelos , Karnabatidis Dimitrios 
Published: May 2021

Abstract

Background
Arteriovenous fistulas (AVFs) for hemodialysis are inconstantly used primarily due to problems with maturation and early thrombosis. An endovascular approach -without open surgery- for fistula creation offers another option for establishing a reliable vascular access. By this procedure, a arteriovenous fistula is created in the area of the cubital fossa in the deep vascular system, either between the ulnar artery and the accompanying vein or the radial artery and radial vein and uses the perforating vein at the level of the elbow to transfer blood to the superficial network of the arm.

Aim
To evaluate the safety, success and maturation rates of percutaneous arteriovenous fistula creation.

Materials and Methods
From February 2018 to June 2020 (28 months), 30 percutaneous arteriovenous fistulas (pAVF) using the WavelinQ device were created in 30 patients (male: 100%) with end stage kidney disease. Outcome measures were safety, defined as adverse events occurring within the first month of creation, success, defined as the ability to create an anastomosis between the vessels of interest and maturation rates, defined as the ability to perform at least one successful dialysis with the AVF. Secondary outcome measures included procedural complications, secondary procedures, time to cannulation, and AVF survival.

Results
All cases were performed as day procedures. 23 out of 30 patients (70%) were already on hemodialysis carrying a permanent central venous catheter. Main comorbidities were hypertension (21/30; 70%), diabetes (15/30; 50%) while 11/30 (30.5%) were smokers. Success was 100% (30/30). Mean follow-up was 547 days (range: 14-1071 days). In one case a pseudoaneurysm of the brachial artery was created immediately after sheath removal and in another case, an aneurysm of the AVF anastomosis was observed 17 days post-procedure and AVF was legated with a covered stent placed in the arterial part. In all, 26/30 AVFs (86.6%) were successfully cannulated. Mean time to cannulation was 61.3 days. Another one failed after maturation during the follow-up period. In total, 15 interventions were needed to achieve maturation (15/26; 0.58 procedures per AVF). 5 maintenance endovascular interventions were performed during the follow-up period (5/26; 19.2%). Mean time from cannulation to the end of follow up was 566.2 days (range: 135-1041 days).

Conclusion
Current analysis suggests that percutaneous AVF creation is safe, successfully performed with high maturation rates. Large scale prospective studies are needed to validate results.
MO662EFFECT OF ARTERIOVENOUS VASCULAR ACCESS ON BIOIMPEDANCE MEASUREMENTS IN HEMODIALYSIS PATIENTS
Authors: Wang Lin-Chun , Zhu Fansan , Thwin Ohnmar , Preciado Rojas Priscila , Rosales Merlo Laura , Tao Xia , Thijssen Stephan , Kotanko Peter 
Published: May 2021

Abstract

Background and Aims
Fluid management remains a major problem in hemodialysis (HD) patients, partly because of the lack of objective assessment methods. Many methods have been proposed to estimate the fluid status in HD patients and bioimpedance has established as one of the most popular clinical tools. Resistance to alternate current was found to be lower in the arteriovenous (AV) access-bearing side compared with the non-access side in post-HD bioimpedance measurements. We hypothesized this difference between access and non-access sides can be seen in both pre- and post-HD measurements of arms and whole body. The aim of the study was to investigate whether this variation between access and non-access sides could affect single-side whole body measurements.

Method
Pre- and post-HD bioimpedance measurements with two 8-point devices (InBody 770 and Seca mBCA 514) were performed in 11 HD patients with functioning AV access in the arm (8 male, pre-HD 75.4 ± 13.6 kg, post-HD 72.8 ± 13.5 kg). Values of resistance at 5 kHz (R5) in the arm and whole body (R5 of arm + trunk + leg on the same side) were extracted. Whole-body extracellular water (ECW) was calculated using whole-body R5 by the Xitron equation* to evaluate how measuring only one side of the body can affect the fluid volume calculation.

Results
The R5 of the arm on the access side was lower compared with the non-access side both pre- and post-HD (P &lt; 0.01), measured by InBody. The same was seen with the Seca but did not reach statistical significance (Table 1). The estimated whole-body ECW was higher on the access side for InBody (P &lt; 0.01). With Seca, the same trend was seen but remained non-significant. While the difference in ECW between both arms reported by InBody was small, the impact on calculated whole-body ECW was much larger with a difference between sides of 0.50 ± 0.82 L pre HD and 0.55 ± 0.81 L post HD.

Conclusion
InBody appears to pick up the difference in fluid status between the access and non-access side with greater precision than Seca. The large contribution of the arm to whole-body resistance amplifies the impact of the presence of an AV access on whole-body ECW estimations based on single-side wrist-to-ankle bioimpedance measurements. Eight-point bioimpedance devices (like the tested InBody and Seca) measure both sides of the body, so, choice of measurement side does not enter the picture.
MO894EVALUATIONS OF TOXIC HEAVY METALS LEAD AND MERCURY IN REGULAR HEMODIALYSIS SMOKER AND NONSMOKER PATIENTS BY COMPARISON WITH OTHER HEALTHY CONTROL SUBJECTS IN EGYPTIAN POPULATION
Authors: Shalaby Ezzeldin , Abdelmawgoud Hisham 
Published: May 2021

Abstract

Background and Aims
Around worldwide population, 10% are affected by chronic kidney diseases (CKD); hemodialysis is the common choice of renal replacement therapy. Cigarette smokers have higher Lead level than non-smoker population. As Tobacco leaves are grown on polluted soil, it is proven that Mercury poisoning depends on dose and duration of exposure. Aim of the study was to determine two important toxic heavy metals elements Lead and Mercury concentrations in regular hemodialysis patients smoker and non-smoker by comparison with normal subjects and its correlation to anemia.

Method
Blood samples were collected from CKD patients on maintenance hemodialysis for more than 6 months divided into non-smoker and smoker to be compared with samples from a control group of non-CKD, non-smoker persons. This study was conducted in September 2019 in Al Mokattam Insurance Hospital – Cairo and involved 60 persons of both sex. They were divided into 3 groups: CKD stage 5 patients on hemodialysis 40 patients and sub-divided into 2 groups; (smoker) 20 patients and (non-smoker) 20 patients and the history of eating fish and seafood was taken. The third group was a control group included 20 healthy non-smoker participants. Lead and Mercury were analyzed by electro thermal atomic absorption spectrophotometer in Al Borg central Laboratory. The complete blood count (CBC), kidney function tests and Iron parameters were also detected.

Results
duration on hemodialysis did not raise Lead or Mercury level in blood, while smoking raises Lead level in blood, and eating fish and sea food more than once per week increased Mercury level in blood. There was a relation between raised Lead level and anaemia in hemodialysis patients.

Conclusion
Lead Prolonged and Mercury measurement is important in hemodialysis patients with possible symptoms of heavy metal toxicity. Lead level monitoring is recommended in resistant anemia in hemodialysis patients.