bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO843PREVALENCE AND MANAGEMENT OF HYPERTENSION IN HEMODIALYSIS PATIENTS
Authors: AlSahow Ali , Alyousef Anas , Alhelal Bassam , AlRajab Heba , Bahbahani Yousif , Nawar Hani , Ibrahim Mostafa Mohammed Elsayed Mohammed , Elabbadi Mohamed , Kamel Vivian F , Abdallah Emad , Kumar Rajeev , AlSahu Ebrahim 
Published: May 2021

Abstract

Background and Aims
Hypertension (HTN) is common in hemodialysis (HD) patients & diagnosed by pre-dialysis BP &gt;140/90 mmHg. Causes include high salt intake, volume overload, & loss of residual kidney function. Therapy includes achieving correct dry weight with each session, restricting interdialytic sodium & fluid intake & medications. We review its prevalence, factors associated with it & its management in our patients.

Method
Demographics, HD prescription & medications data collected for patients from 5 dialysis centers.

Results
A total of 1585 files reviewed. Males were 51.8% & mean age was 59. Mean age significantly higher for females (61 vs 57). ESKD cause was DM in 51% & HTN in 35%. However, of files reviewed, adequate data on comorbidities in 1390 patients (table 1), 69% had DM, 92% had HTN, 47% had CVD & 31% had BMI &gt; 25 (which was significantly more frequent in females). HTN was more likely in older patients, diabetics & females with odds of HTN in females nearly twice the odds of HTN in males & odds of HTN with DM is 2.27 times odds of HTN without DM & one-year increase in age would increase odds of HTN by nearly 4%. Mean pre-HD BP for those with HTN was 143/76 mmHg & for those without HTN was 136/75 mmHg. HD frequency was thrice weekly in 94% & HD duration was &gt; 3.5 hours in only 77% of patients. HDF used in 81.5%. Mean interdialytic weight gain (IDWG) was 2.8 kg, with no difference according to gender or presence of DM or HTN (Table 2). Higher IDWG associated with age &lt; 65, Calcium bath of 1.75 & Sodium bath &gt; 138 with 0.638 kg higher IDWG with calcium of 1.75 compared to calcium of 1.25. Higher IDWG was associated with higher BP. Mean volume of fluid removed per session was 2.74, which was less than mean IDWG, with no difference according to gender or DM, however, it was higher in the higher dialysate sodium group, & lower in the shorter session group (with trend towards statistical significance). CCB used to treat HTN in 62% followed by βB in 52%. Number of patients with HTN on 1 drug 21%, 2 drugs 27%, 3 drugs 23%, ≥ 4 drugs 20% & 9% missing data. Number of antihypertensives did not correlate with IDWG.

Conclusion
Interdialytic weight gain in our HD patients is excessive & contributing to HTN. Patients must restrict salt & fluid intake & dialysis centers must regularly & frequently assess dry weight, ensure thrice weekly schedule & 4 hours per session are met, so excess fluid is completely removed. Also, high sodium & high calcium baths need to be avoided.
MO844COVID-19 PANDEMIC IN DIALYSIS PATIENTS IN SWITZERLAND
Authors: Winzeler Rebecca , Ambühl Patrice Max 
Published: May 2021

Abstract

Background and Aims
COVID-19 is an infectious disease that can result from infection with the novel coronavirus SARS-CoV-2. The disease, was first described in Wuhan at the end of 2019 and the first case in Switzerland was discovered in February 2020. This analysis gives an overview of dialysis patients in Switzerland that were tested COVID-19 positive.

Method
All dialysis centers reported their cases with COVID-19 to the Swiss dialysis registry srrqap. All patients reported to the registry between March 5 (1st dialysis patient with COVID-19) and June 30, 2020 were included in this analysis and comparisons were made with COVID-19-free dialysis patients (from 2019).

Results
On March 5, 2020, the first dialysis patient was infected with COVID-19 in Ticino. The number of infected dialysis patients increased rapidly over the months of March and April, with the majority of patients in the cantons of Vaud (23.5%), Ticino (22.3%) and Geneva (18.8%) and together making up almost 65% of the COVID-19-infected dialysis patients in Switzerland. COVID-19 cases represented 2.4% of all prevalent patients on dialysis (as of 31.12.2019).
Twenty-seven (12 female, 15 male) out of 93 dialysis patients died, which corresponds to a mortality rate of 29%. Mortality was highest in patients from Switzerland (together with the Netherlands), and lowest in Romania with 8.5% (K. Jager and A. Kramer, submitted for publication, 2020).
Mortality was associated with advanced age in dialysis patients. In contrast to the general population, male sex, diabetes and hypertension were no major risk factors for mortality in our cohort.

Conclusion
Although dialysis patients from Switzerland in general have a better survival compared to those from other European countries, infection with COVID-19 in Switzerland results in the highest mortality compared to other European countries in this population. In addition, male sex, diabetes and hypertension seem not to be associated risk factors in our dialysis population.
MO846THE SPECTRUM OF CLINICAL AND SEROLOGICAL FEATURES OF COVID-19 IN URBAN HEMODIALYSIS PATIENTS
Authors: Gomá-Garcés Elena , Stock da Cunha Teresa , Avello Alejandro , Pereira Monica , Mas-Fontao Sebastian , Ortiz Alberto , González-Parra Emilio 
Published: May 2021

Abstract

Background and Aims
The inherent immunosuppression of uremia increases the susceptibility of hemodialysis patients to infection. There is still limited evidence on hemodialysis patients and COVID-19. The clinical and analytical spectrum and treatment responses and mortality are poorly characterized.

Method
Clinical and analytical features, chest X-ray, polymerase chain reaction (PCR) and antibodies for SARS-CoV-2, treatment and outcomes were analyzed in 48 patients diagnosed with COVID-19 during March and April 2020 in two coordinated Spanish hemodialysis units.

Results
In 200 haemodialysis patients, COVID-19 was diagnosed in 48, of whom 22 were PCR positive, eight PCR negative but seroconverted and two were diagnosed on typical clinical grounds. Despite a mean age of 72.6 years, the overall mortality rate was 5/48 (10%). Among the PCR positive patients, 21 (55%) required admission and five (13%) died. PCR positive patients were more often symptomatic and hospitalized and had higher troponin I levels than PCR negative patients, but did not differ in lymphocyte counts, D-dimer or interleukin-6 (IL-6) levels. Among PCR negative COVID-19 patients, three out of 10 (30%) required admission, and none died. The most frequent symptom among the 48 patients was fever (31%), followed by asymptomatic patients (23%). A low number of lymphocytes was the only parameter significantly different between hospitalized and ambulatory COVID-19 patients, independently of PCR status.

Conclusion
COVID-19 hemodialysis patients are frequently asymptomatic, and mortality may be lower than previously reported. Diagnosis may be retrospective, based on seroconversion, as PCR may be negative. This information should guide preventive and patient isolation strategies.
MO848PREVALENCE OF COVID -19 IN CHRONIC HEMODIALYSIS PATIENTS AT THE TARIJA DEPARTAMENTAL HEMODIALYSIS CENTER DURING THE PEACK OF THE ANDEMIC JULY - SEPTEMBER 2020
Authors: Zamora Nelson , Molina Andrea , Arduz Jaime 
Published: May 2021

Abstract

Background and Aims
Bolivia was the last country to enter in the list of Latin American countries to report cases for the worldwide pandemic of COVID-19, reporting its first two confirmed cases on March 11, 2020 in the cities of Santa Cruz and Oruro. In Tarija department, the peak of cases was registered in the months of July, August and September. The Departmental Hemodialysis Center during this period had 71 registered patients undergoing chronic hemodialysis sessions. In this article we display the prevalence of patients who were infected with COVID-19 during that period of time.

Method
This is a prospective cohort observational study in which 71 patients were observed, who underwent hemodialysis sessions during the three shifts during the day (morning, afternoon and evening, during the months of July, August and September, months which were the peak of the pandemic in Tarija. Patients suspected of being transmitted with the disease, underwent immunochromatography IgM/IgG, ELISA anti SARS-CoV-2 and RT/PCR tests before confirming the diagnosis of COVID-19. Patients who had hemodialysis sessions for a period of less than 3 months were excluded from the study, and also those who changed their treatment modality for peritoneal dialysis to hemodialysis.

Results
63 patients, 27 men and 36 women, who underwent hemodialysis sessions during the observational period met the inclusion criteria of the study. 7 patients were excluded for not meeting the inclusion criteria, 6 with a period less than 3 months undergoing hemodialysis and 1 patient who had changed the treatment modality from peritoneal dialysis to HD were excluded too. Of the 63 hemodialysis patients, 57 patients remained healthy and 6 were diagnosed with COVID-19 (Table 1). The prevalence of patients who presented COVID-19 in the hemodialysis center was 9%, with 33% of mortality and 83% who were able to recover and receive epidemiological discharge (figure 1). Of the 6 patients who developed COVID-19, 3 were women and 3 were men, 4 patients with previous hepatitis B infection who were dialyzed in the room with machines HBV + and 2 patients without liver infections who were dialyzed in negative machines. Three patients evolved asymptomatic during the SARS-CoV-2 infection, 2 presented thermal rises and mild cough, but without compromise in O2 saturation or ventilatory function, and one patient who died developed mild cough, slight fever and a hemodialysis catheter-related bloodstream infection by Staphylococcus aureus, confirmed in blood culture.
Clinical characteristics of study participants (N=63)

Conclusion
The prevalence of patients infected by SARS-CoV-2 was 9% with a mortality of 17% (1 patient), validating that strict patient control and prevention measures become a great support to avoid massive spread between patient prone to acquire this infectious disease.
MO851INCIDENCE AND MORTALITY OF CORONAVIRUS DISEASE (COVID 19) IN HEMODIALYSIS PATIENTS
Authors: Grujic Nevena , Pešić Snezana , Naumovic Radomir 
Published: May 2021

Abstract

Background and Aims
In December 2019, an outbreak of coronavirus disease 2019 (covid 19) due to SARS Cov2 began in China and spread worldwide. Hemodialysis patients represent a unique group of patients, mostly elderly, imunocompromised, with numerous comorbidities. Patients with end stage renal disease are thought to be at increased risk of disease, severe disease and death from Covid 19 infection. In addition, dialysis centers are a suitable place for an outbreak of the epidemic. All of the above represents a group of hemodialysis patients particularly susceptible to infection and the development of serious disease.

Method
We reviewed data of all maintenance hemodialysis patients in hemodialysis centar of Zvezdara Hospital, Belgrade, Serbia. We include all patients with COVID 19 infection in period between April 1 2020 and January 10 2021.

Results
Of 232 patients undergoing hemodialysis, 68 (29,31%) were infected with Sars-Cov-2. 46 (67,64%) patients were males and 22 (32,35%) females. The age range of the patients was 35 to 87 years, the mean age was 65,25. The underlyind cause of terminal renal failure in 25 patients was hipertensiv nefroangiosklerosis, 14 diabetic nephropathy, 10 opstructiv nephropathy, 9 polycystic kidney disease, and 10 other cause of kidney failure. The average of hemodialysis duration was 70,70 months. The average durations of disease was 15 days. Mortality has been estimated at 33,82% (23 patients). Among patients who died 8 (34,78%) were females, and 15 (65,21%) males.

Conclusion
The mortality among hemodialysis patients diagnosed with Covid 19 is high. Hemodialysis patients typically present with multiple comorbidities and are considered to be a high-risk group for infections. Hemodialysis patients with Covid-19 may have prolonged hospital stays and unfavorable prognoses and should be closely monitored.
MO853SEROLOGICAL RESPONSE AND FACTORS INVOLVED AFTER A VACCINATION PROTOCOL FOR HEPATITIS B VIRUS IN A HEMODIALYSIS UNIT
Authors: Castro Fernández Maria Paz , Piccone Saponara Luis Guillermo , Uribe Heredia Nancy Giovanna , Ferrer García Guillermo , Carreño Parrilla Agustín , Anaya Fernández Sara , Valle Dominguez Casimiro , García Conejo Gloria , Olazo Gutierrez Eliana , Vozmediano Poyatos Carmen 
Published: May 2021

Abstract

Background and Aims
The population with chronic kidney disease (CKD) presents an increased risk of infection by hepatitis B virus (HBV). Usually, the protective immunological response rate (considering HBV titer &gt; 10 mIU/mL) is 90–95% after the 4th dose of vaccine; In CKD the immune response is lower and correlates with the degree of CKD. In dialysis, this response is variable, less than 50% with three-dose regimens and higher with four doses. Cardiovascular risk factors have been implicated in the response rate to vaccination.
The objective of this work is to analyze the efficacy of the HBV vaccine in hemodialysis patients and to identify cardiovascular factors as predictors of response.

Method
Retrospective observational study. We evaluated the response to a 4-dose vaccination protocol (0-1-2-6 months), determining the levels of HBVA 3 months after the last dose. Demographic variables (age, sex), associated comorbidity, etiology of CKD, among others, were collected. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and have been compared using the Chi2 test. The quantitative variables are expressed as mean +/- standard deviation and the T-student was used to compare them. Statistical significance for a value of p &lt;0.05.

Results
89 patients were included; 68.5% are male, with an average age of 65 years. 85.4% had arterial hypertension, and 39.3 were diabetic, the most frequent cause of CKD being renal vascular disease (20.8%), diabetic nephropathy (26.4%) and interstitial (9%). The immune response to HBV vaccination was 79.2%. When making statistical comparisons between the qualitative variables, we have not observed differences between serological response and DM or sex; We did find a trend towards significance when comparing the serological response with the variable HT and etiology of CKD (polycystic kidney disease), pNS. The comparison of means between quantitative variables when performing the Student's T-test did not show differences for any of the study variables.

Conclusion
In our center, HBV vaccination on dialysis achieves a response rate of 79.2%. HT may condition the immune response to vaccination in HD patients, although significance was not reached. Hereditary pathology has been the one that has shown the best serological response with respect to the rest of etiologies, perhaps associated with greater residual renal function.
MO854PHYSICAL ACTIVITY IN CHRONIC HEMODIALYSIS PATIENTS: ABOUT 71 CASES
Authors: Chemli Imen , Ayed Amel , Sinda Ayed , Ben salem Meriem , Ben salah Manel , Handous Insaf , Letaief Ahmed , Hamouda Mouna , Aloui Sabra , Skhiri Habib 
Published: May 2021

Abstract

Background and Aims
physical activity is generally impaired in the chronic hemodialysis patient. Studies confirm the benefit of maintaining or improving physical activity in these patients. For this reason, our study aims to assess physical inactivity in chronic hemodialysis patients using a physical activity score: DIJON score and to identify the factors linked to a decrease in physical activity .

Method
this is a descriptive and analytical cross-sectional study carried out at the hemodialysis center of Fattouma Bourguiba hospital in Monastir. We used the DIJON questionnaire to measure physical activity: daily activities, sports or leisure. The reference values for the level of physical activity are 0-10 (low), 10-20 (medium); and 20-30 (high).

Results
our study included 71 patients. The middle age was 46.62 + - 15.34 years. 69% of patients were male. The overall physical activity level was high at 22.75 + -1.99 in 28.2% of patients, medium at 13.75 + -3.65 in 33.8% of patients and low at 5.56 + -2.91 in 38% of hemodialysis patients. Analysis in multiple linear regression showed that the variables that explained the DIJON score in our population are in order of contribution: pre-dialytic uremia (β = 0.433; t = 2.99; p = 0.005), cardiac diseases(β = 0.305; t = 2.074; p = 0.044), the KT/V ratio (β = -. 858; p = -1.915; p = 0.063), the PRU (β = 1.21; t = 1.885; p = 0.066) , anemia (β = 0.211; t = 1.704; p = 0.096), comorbidity evaluated by Charlson score (β = -. 461; t = -1.414; p = 0.165).

Conclusion
our results showed that the level of physical activity is linked to many factors, some of which are modified. So, prescribing an adapted and personalized program will improve the prognosis and the quality of life of our patients.
MO855PREVALENCE OF SELF-REPORTED KIDNEY DISEASE AMONG THE FIRST DEGREE RELATIVES OF SAUDI PATIENTS ON DIALYSIS AND ITS RELATIONSHIP TO SPECULATIVE VERSUS DEFINITIVE CAUSES OF CKD IN THE INDEX CASE
Authors: Al-Sayyari Abdulla 
Published: May 2021

Abstract

Background and Aims
CKD is common in Saudi Arabia. This study evaluates and compares the prevalence and clinical characteristics of Saudi dialysis patients with a positive family history of kidney disease to those without such a history and to assess certainty of the CKD diagnosis by their physicians.

Method
This is a cross-sectional survey-based study on adult Saudi hemodialysis patients in six dialysis centers in four Saudi cities. The first part of the survey recorded the demographic variables and the degree of diagnostic certainty (completed by the physicians) and the second part (completed by the patients) recorded first degree family history of kidney disease.

Results
A total of 1080 patients were included. The prevalence of positive family history (FH) was 21.5%. The number of relatives affected was 285, (41%) were parents and (57%) were siblings. More relatives of female patients had ESRD than in relatives of male patients (80.2% and 68.9% respectively) (p=0.0001). There were significantly more patients with “unknown” or “hypertensive” diagnostic labels among the patients with FH of kidney disease than in the group without a family history (p=007 and 0.005 respectively). Dialysis vintage was significantly shorter and CKD vintage was significantly longer in positive FH patients (4.9 ±6.4 yrs.) than in patients without FH (5.9 ±5.8yrs) (p=0.03). The duration since the diagnosis of CKD was made was significantly longer in patients with FH of kidney disease (7.5±7.7 yrs.) than in patients without (2.0±4.5) (p=0.0001). Of all the diagnoses given to the patients, more than half (57.8%) were either “unknown” (33%) or only speculative in nature (25.3%). In those with a diagnostic label, the diagnosis was thought to be definitive in only 62.2% of the cases.

Conclusion
The prevalence of FH of kidney disease was 21.5%, and it was more prevalent with patients with “unknown” or “hypertension” (13%) diagnostic labels.
MO856IMPACT OF HEMODIALYSIS TIME PROLONGATION ON BLOOD PRESSURE CONTROL IN PREVALENT HEMODIALYSIS PATIENTS
Authors: Teama Nahla , Elsharabasy Reem , Soliman Heba , ElSharkawy Magdy 
Published: May 2021

Abstract

Background and Aims
Hypertension prevalence among ESRD patients range from 76% to 90%. Sodium & volume overload is among the main mechanisms. Increasing theduration of dialysis time, either by longer session hours or increased sessions, aiming at reducing the dry weight to achieve euvolemia, may be beneficial for individuals who failed to achieve target BP or ideal volume status during standard HD prescription hours.We aim to study the effect of increasing hemodialysis session time on blood pressure control.

Method
This observational study was conducted on 50 adult clinically stable hypertensive prevalent HD patients on thrice weekly maintenance HD. Patients with secondary causes of hypertension and Patients with decompensated medical conditions were excluded from our study.Patients were divided into 2 groups:(A) 25 patients who received longer session hemodialysis session (4.5hour) and (B) 25 patients HD who received the usual 4 hours session.
Revision of antihypertensive medications&dosages,dry weight was reassessed regularly, andthey were instructed to restrict their salt intake as much as possible aiming at BP &lt;140/90mmHg.they werefollowed up for a period of 6 months assess changes of pre-dialysis blood pressure to monitor response.

Results
Patients in both groups were age matched, with male sex predominance (64%in groupA&56% in groupB). Patients in both groups underwent their HD sessions mostly through AVF (68% and 92% for group A and B respectively). Ultrafiltration volume declined significantly with longer HD sessions compared to conventional sessions (p-value &lt;0.001 vs 0.523).
Longer HD session time session was associated with highly significant decline in mean SBP, (p-value &lt;0.001). Longer HD session time session was associated with highly statistically significant decline in mean DBP, (p-value &lt;0.001). The decline in mean perdialysis SBP & DBP was -17.27 &-9 mmHg, respectively and the rate of decline of postdialysis SBP & DBP was -6.45 & -12.38 mmHg, respectively at 6th month compared to values in 1st month of follow up period.

Conclusion
Longer HD session duration is associated with better improvement in UF volume, mean SBP&DBP, pre-dialysis SBP&DBP and post-dialysis SBP&DBP as well.