bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO617EFFECTS OF 12 WEEK PHYSICAL EXERCISES ON ECHO-GEOMETRIC PARAMETERS IN PATIENTS WITH CKD
Authors: Saipova Durdona 
Published: May 2021

Abstract

Background and Aims
Structural and functional changes in the cardiovascular system in patients with chronic kidney disease (CKD) will lead to decreased exercise tolerance, decreased quality of life, and, ultimately, premature death.
The aim of this study was to study morphometric changes in the left ventricle of the heart depending on the direction of therapeutic physical training.

Method
The study involved 60 patients with CKD stage C3. The average age of the patients was 54.2 ± 3.40 years. The average level of GFR for the sample as a whole was 79.1 ± 9.4 ml / min / 1.73 m2. The control group (CG) consisted of 20 people (10 men and 10 women) comparable to the main group in terms of gender and age. The examination of patients included a general examination, assessment of complaints, collection of anamnestic data, anthropometry with calculation of BMI cardiopulmonary stress test, echocardiography.
According to the data of the cardiopulmonary stress test, 3 groups were formed on the basis of the predominant manifestation of any physical quality in the course of therapeutic training: group 1 (n = 20) - with a respiratory orientation of the training process; 2nd group (n = 20) - with a focus on cardio loads; 3rd group (n = 20) - development of predominantly endurance.

Results
Of all groups of patients with CKD, the LVMM indicator reached the highest values in men in group 2 (with a cardio-load orientation of the treatment-training process), as well as in women in group 3 (predominantly endurance development). It is this orientation of the training process that has the greatest effect on the increase in the mass of the left ventricular myocardium in patients with CKD. The 2nd group of patients with CKD stage CKD had the highest values of LVTD in diastole both among men and women. In addition, men in this group had the highest RTI per systole. In patients of the 2nd group, undergoing mainly cardio load, the change concerned a slightly more pronounced increase in the wall thickness of the left ventricle.
In the 3rd group of patients with CKD stages C3, both men and women had the maximum values of TMV in diastole, as well as LVTD in systole. Types of physiotherapy exercises with a predominance of endurance in physical exertion are distinguished by the most pronounced signs of left ventricular myocardial hypertrophy.

Conclusion
The present study has shown that patients with pre-dialysis CKD have decreased maximal and submaximal exercise tolerance. Analysis of the data obtained made it possible to reveal the peculiarities of adaptation of the cardiovascular system of patients with CKD stages CKD to a specific type of therapeutic training and to determine the quantitative values of echocardiographic parameters in patients with CKD.
MO123USE OF RIVAROXABAN VERSUS WARFARIN IN PATIENTS WITH ATRIAL FIBRILLATION AND ADVANCED CHRONIC KIDNEY DISEASE*
Authors: Abdullaev Sherzod , Igamberdieva Rano , Sharapov Olimkhon 
Published: May 2021

Abstract

Background and Aims
Patients with chronic kidney disease (CKD) develop bleeding and thromboembolic tendencies, so the indication for the use of anticoagulants for atrial fibrillation (AF) is difficult. AF is the most common chronic cardiac arrhythmia, and thromboembolism and ischemic stroke in particular are the main complications. In recent years, new oral anticoagulants (rivaroxaban) have been developed and have shown superiority over classic anti-vitamin K anticoagulants in preventing the risk of stroke, systemic embolism and bleeding.
Aim is to evaluate the safety parameters of rivaroxaban in patients with stage 4 chronic kidney disease (CKD) or a transient sustained decrease in glomerular filtration rate (GFR) to 15–29 ml/min/1,73 m2 in the presence of atrial fibrillation (AF).

Method
Multicenter prospective randomized study that included patients from cardiology departments in 2019. Of 5448 hospitalized patients, 109 (2%) patients with AF and CKD stage 4 or a sustained decrease in GFR to 15-29 ml/min/1.73 m2 were randomized in a 2:1 ratio to rivaroxaban 15 mg/day (n=73) or warfarin (n=36). Primary endpoint: development of large, small and small clinically significant bleeding according to the BARC (Bleeding Academic Research Consortium) and ISTH (International Society on Thrombosis and Hemostasis) scales. The average follow-up period is 12 months.

Results
Patients taking warfarin were significantly more likely to develop minor bleeding according to BARC scales (n=26 (72.2%) versus n=31 (42.4%), p&lt;0.01) and ISTH (n=22 (61.1%) versus n=27 (36.9%), p&lt;0.01) and all clinically significant (minor clinically significant and major) bleeding according to the ISTH scale [n=10 (27.7%) versus n=8 (10.9%), p=0.03]. The number of readmissions was 32 (43.8% of patients) in the rivaroxaban group, 17 (47.2% of patients) in the warfarin group (p=0.57), of which 12 (37.5%) and 7 (41.1%) (in the rivaroxaban and warfarin groups, respectively) - for urgent reasons (p=0.96). A significant improvement in the dynamics of creatinine levels, GFR (according to CKD-EPI) in the rivaroxaban group was revealed.

Conclusion
The study provides evidence of a favorable safety profile for rivaroxaban compared with warfarin in patients with AF and advanced CKD.
MO222DO WE OFTEN THINK OF MULTIPLE MYELOMA AS THE CAUSE OF KIDNEY DISEASE?
Authors: Pešić Snezana , Grujic Nevena , Stopić Bojan , Janković Aleksandar , Markovic Katarina , Damjanovic Tatjana , Naumovic Radomir 
Published: May 2021

Abstract

Background and Aims
Kidney disease is a common complication in patients with multiple myeloma and other plasma cell dyscrasias. This disease can be manifested by various kidney disorders, which can evolve as either an acute or chronic disorder. Cast nephropathy is the most common cause of severe acute kidney injury (AKI) in patients with multiple myeloma. Among newly diagnosed patients, 20 to 50 % have AKI or cronic kidney disease (CKD) at the time of diagnosis. Treatment of acute renal failure consists of good supportive care and anti-myeloma therapy. Introduction of novel agents has considerably improved outcome in patients with multiple myeloma and renal failure. The aim of this study was to identify the most common risk factors (RF) for mortality in patients with MM and renal failure.

Method
The study included 22 patients ( mean years 67 ± 12 years, 12 men). Who followed two years. We analyzed routine laboratory tests, Bence Jones protein, urinary protein excretion, and creatinine clearance. Plain radiography for the evaluation of skeleton lesions were performed for all patients.

Results
Overall two years mortality of patients with MM was 38.1% with no significant difference regard to patients' age and gender. About 33% of patients required renal replacement therapy and 19% remained on a chronic dialysis treatment program. Renal biopsy was performed in 9.1% of patients (1 - FSGS, 1 - LCCD, light chain deposition disease). Bone marrow transplant (stem cell transplant) was performed in 9.1% of patients. Of the associated comorbidities, 19% had DM, 81% had hypertension, CVD 52.4%. Osteolytic changes at the time of diagnosis were present in 52.4%. In older patients, kappa chains have been identified to a much more extent. Survival is significantly lower in dialysis dependent patients with a two-year survival of 30%. Binary logistic regression revealed that platelet decrease (OR = 0.982&lt; CI 0.961–1.003&lt; p = 0.09) and increase of IgA significantly influenced mortality (OR = 103,867&lt; CI 0.459–23567.201&lt; p = 0.09) can be considered as potential predictors of mortality. Comorbidity DM, HTA, CVD were not the predictors for mortality in patients with MM

Conclusion
Multiple myeloma associated with high mortality rate and kidney disease. High percentage of patients required renal replacement therapy (33%) and 19% remained on a chronic dialysis treatment program. Among the estimated parameters, the risk factors for mortality were significant decrease of platelet (p = 0.09) and increase IgA (p = 0.09). Survival is significantly lower in in dialysis dependent patients with a two-year survival of 30%.
MO224VCAM-1 LEVELS ASSOCIATED WITH ALBUMINURIA IN MULTIBACILLARY LEPROSY
Authors: Donadello Tessarolo Louise , Cavalcante Meneses Gdayllon , Freire Bezerra Gabriela , Bezerra da Silva Junior Geraldo , De Francesco Daher Elizabeth , Costa Martins Alice Maria 
Published: May 2021

Abstract

Background and Aims
Leprosy may present important renal and endothelial abnormalities, and this can worse patients’ prognosis. However, renal and vascular involvement in these patients has been poor investigated. The aim of this study was to investigate if higher systemic endothelial biomarkers levels are associated with renal abnormalities and clinical aspects of leprosy.

Method
This is a cross-sectional study with leprosy patients before initiation of multidrug therapy enrolled in January 2017 to December 2018 in Fortaleza, northeast Brazil. Leprosy-associated clinical and epidemiological data were collected. Two groups were constructed: Paucibacillary (PB) and Multibacillary (MB) for comparisons. Serum and urine samples were obtained for laboratory analysis. In urine the following parameters were evaluated: creatinine, proteinuria and albuminuria. In serum the endothelial biomarkers were evaluated: VCAM-1 and ICAM-1, using ELISA assay.

Results
A total of 101 leprosy patients were included, with mean age of 48±15 years, and 71 (70%) were male. The multibacillary form occurred in 81 cases (80%), where 22 had a Virchowian form. VCAM-1 was elevated in MB group and was correlated with the bacteriological index (skin smear) (r = 0.372, p &lt;0.01), duration of disease symptoms (r = 0.234, p = 0.04), and number of skin lesions ( r = 0.331, p &lt;0.001). Moreover, in MB patients who presented albuminuria &gt;15 mg/g of creatinine, VCAM-1 showed a significant correlation (r = 0.341, p &lt;0.05) with increased albuminuria and improve the correlation with number of skin lesions (r = 0.653, p=0.003).

Conclusion
Multibacillary leprosy patients present high systemic levels of VCAM-1, associated with leprosy clinical features and increased albuminuria, an important marker of kidney disease progression. Further prospective studies are necessary to establish a cause-effect relation and evaluate the preventive role of these biomarkers, aiming to improve clinical care.
MO230A PHASE 3, RANDOMIZED, DOUBLE-BLIND, PLACEBO CONTROLLED STUDY OF ATRASENTAN IN PATIENTS WITH IGA NEPHROPATHY (THE ALIGN STUDY)
Authors: Lambers Heerspink Hiddo , Kohan Donald , Lafayette Richard , Levin Adeera , Zhang Hong , Glicklich Aland , Camargo Marianne , King Andrew , Barratt Jonathan 
Published: May 2021

Abstract

Background and Aims
IgA nephropathy (IgAN) is the most common primary glomerulonephritis globally and an important cause of chronic kidney disease (CKD). Up to 40% of IgAN patients are at risk of progressing to end-stage kidney disease (ESKD) and proteinuria is the strongest predictor of progression. There are no approved therapies for IgAN, leaving an important need for new strategies to lower proteinuria and preserve kidney function in high-risk patients.
Endothelin A (ETA) receptor activation drives proteinuria, along with kidney inflammation and fibrosis. Atrasentan, a potent and selective ETA antagonist, has been studied extensively in &gt;5,000 patients with type 2 diabetes and kidney disease (DKD), demonstrating clinically significant and sustained reductions in proteinuria when administered on top of a maximum tolerated dose of RAS inhibitor (RASi). In a global Phase 3 outcome study in DKD (SONAR), atrasentan demonstrated a 35% reduced risk of the primary composite outcome of doubling of serum creatinine or end stage kidney disease (95% CI: 0.49, 0.88; P = 0.005). The most common adverse event was fluid retention.
Selective ETA blockade represents a promising approach to reduce proteinuria and preserve kidney function in high risk IgAN patients.
This is a presentation of a global, phase 3, double-blind, placebo-controlled trial to determine the effect of atrasentan in IgAN patients at high risk of kidney function loss.

Method
Approximately 320 patients across North America, South America, Europe, and Asia-Pacific with biopsy-proven IgAN will be randomized to receive 0.75 mg atrasentan or placebo daily for 132 weeks. Patients will continue receiving a maximally tolerated and stable dose of a RAS inhibitor as standard of care. The study will also include patients that are unable to tolerate RAS inhibitor therapy. Additional eligibility criteria include urine protein creatinine ratio (UPCR) ≥1 g/g and eGFR ≥30 mL/min/1.73 m2. Participants will have study assessments over two and a half years with options for remote study visits using telemedicine and home health visits. The primary objective is to evaluate the effect of atrasentan versus placebo on proteinuria at Week 24. Secondary objectives include evaluating the change from baseline in eGFR, safety, and tolerability, and quality of life.

Results
N/A

Conclusion
N/A
MO231INFECTIVE ENDOCARDITIS IN CHRONIC KIDNEY DISEASE: CLINICAL AND OUTCOME’S FEATURES
Authors: Harzallah Amel , Chargui Soumaya , Hajji Mariem , Barbouch Samia , Ounissi Mondher , Gorsane Imen , Ben Hamida Fethi 
Published: May 2021

Abstract

Background and Aims
Infective endocarditis complicating chronic kidney disease is associated with high morbidity and mortality among this population particularly exposed to bacteremia.The aim of our study was to study the clinical and evolutionary features of infective endocarditis among patients with chronic renal failure.

Method
It is a retrospective and descriptive study including patients with chronic kidney disease hospitalized in our department, whom presented an infective endocarditis confirmed by modified DUKE criteria

Results
13 patients were included aged meanly of 42.69 years [27-63 years] with a sex-ratio of 0.85. Twelve were in end stage renal disease with an average duration of dialysis of 52 months [1-180 months] and in stage 5 in one case. At the time of diagnosis, vascular access was fistula in one case and a central venous catheter in 11 cases. The catheter was simple in 3 cases and tunnelled in eight cases. The circumstances of discovery were fever in 12 cases associated with an alteration of the general state with asthenia in 10 cases. Low blood pressure was present in seven cases. At biology, the mean hemoglobin level was 8.28 g/dl [6.1-10.8 g/dl]. Leukocytosis was noted in 8 cases. Mean albuminemia was 30.61g/l [24-41g/l]. Albuminemia below 35 g/l was objectified in 6 cases. Major causative organisms were Staphylococcus species in 10 cases. Trans-thoracic echography shows vegetation in 11 cases with an average size of 17.4 mm [6-37 mm] and aortic annular abscess in 2 cases. Antibiotherapy was conducted in all cases. Complications were frequent, including congestive heart failure in 2 cases, secondary septic localisations in 3 cases, hemoptysis in one case and valve perforation in 2 cases. Five patients underwent surgery after a mean delay of 32.75 days [6-47 days]. Death occurred in 8 cases.

Conclusion
Infective endocarditis is severe during chronic kidney failure and more frequent among patients on dialysis by catheter. It is associated with high morbidity and mortality. Management of central venous catheter must be enhanced. Treatment must be early to improve the prognosis of this complication.
MO232BORTEZOMIB INDUCED PERIPHERAL AND CENTRAL NEUROPATHY : ABOUT 3 CASE REPORTS
Authors: Houli Rawnak , Barbouche Samia , Mariem Hajji , Sakay Amira , Badrouchi Samarra , Nadia Cherni , Ben Hmida Fethi 
Published: May 2021

Abstract

Background and Aims
Bortezomib is a proteasome inhibitor, whose efficacy in the treatment of multiple myeloma has been proven over the last years. However, its side effects may cause concern for patients as well as physicians. We focused in this study on Bortezomib-induced neuropathy, one of the most frequent complications. We present 2 cases of peripheral sensory neuropathy and one intriguing case of central neurological manifestation, all caused by Bortezomib administration.

Case 1
A 62-year-old man, with a history of diabetes and hypertension, was diagnosed with multiple myeloma in 2019. He received 2 cycles of Bortezamib (2,5 mg), Dexamethasone , and Cyclophosphamide. Each cycle included 4 doses of Bortezomib, and the cycles were 21 days apart. At the end of the second cycle the patient developed posterior cord syndrome with balance disorder and lower extremities paresthesia. Axonal sensitivo-motor polyneuropathy was confirmed by electromyography. A pharmacology investigation was conducted, and the symptoms were attributed to Bortezomib toxicity. Evolution was favourable after change in protocol to Revlimide. No recurrence was noted.

Case 2
A 64-year-old man with no prior history was diagnosed with multiple myeloma in 2020. She received a protocol of 4 cycles, 21 days apart, of Bortezomib (2.1 mg) ,Dexamethasone and Thalidomide . Three weeks after the first cycle, the patient presented with confusion, gait disturbance and four-limb pyramidal deficiency syndrome. Electromyography showed axonal sensitivo-motor polyneuropathy .In the absence of other causes, Bortezomib toxicity was suspected and the patient underwent an emergency epurative hemodialysis session, after which symptoms completely disappeared. Bortezomib doses were then reduced. The evolution was favourable.

Case 3
A 50-year-old woman was diagnosed with multiple myeloma in 2018 with Randall's disease and quadri-pyramidal syndrome. She was put on 4 courses of Bortezomib 2.4mg Cyclophosphamide and Dexamethasone, 21 days apart. After 2 coursess, she presented a generalized tonic-clonic seizure preceded by headache, dizziness and followed by speech disturbances. Biological screening for metabolic disorders and toxins was unremarkable. Cerebral MRI showed no abnormalities. Doses of Bortezomib were reduced during the following course. We then witnessed an improvement in speech and no recurrence of seizures.

Conclusion
Bortezomib induced neuropathy is a serious and debilitating complication to which physicians must pay special attention. This side effect can be managed by dose reduction or change of molecules. Outcomes are often favourable.
MO235EFFECT OF OMEGA-3 POLYUNSATURATED FATTY ACID SUPPLEMENTATION ON GLYSEMIC CONTROL AND RENAL FUNCTION IN TYPE 2 DIABETIC PATIENTS WITH CHRONIC KIDNEY DISEASE
Authors: Usta Mehmet , Ersoy Alpaslan , Ersoy Canan , Ayar Yavuz , Goksel Gultekin , Saka Karagoz İsminur 
Published: May 2021

Abstract

Background and Aims
The aim of this study was to evaluate the short-term effects of omega-3 polyunsaturated fatty acids (n-3 PUFA) supplementation on glycemic control and renal function in type 2 diabetic patients with chronic kidney disease.

Method
Twenty-five diabetic patients received medication containing 2 g/day n-3 PUFA orally in addition to standard treatments. Their estimated glomerular filtration rates (eGFR) were &lt;80 mL/min/1.73 m2. Biochemical values were evaluated before and 3 months after treatment.

Results
After three months of supplementation, the changes in serum creatinine, uric acid, eGFR and urinary albumin excretion levels did not reach statistical significance. There was no difference between serum glucose, HbA1C and lipid profile values before and after the n-3 PUFA supplementation in patients. Only serum albumin significantly increased from 4.10±0.26 to 4.28±0.31 g/dL (p=0.016), and systolic blood pressure decreased from 121.4±14.5 to 116.6±14.9 mmHg (p=0.001).

Conclusion
Short-term n-3 PUFA supplementation did not affect renal function and glycemic control in patients with type 2 diabetes with chronic kidney disease.
MO237A SERUM COMPLEMENT ABNORMALITY REVEALED BY THROMBOTIC MICROANGIOPATHY DURING INTERFERON TREATMENT OF MULTIPLE SCLEROSIS
Authors: Rihem Dahmane , Sanda Mrabet , Raja Boukadida , Yosra Guedri , Asma Fradu , Wissal Sahtout , Awatef Azzabi , Narjess Ben aicha , Dorsaf Zellama , Abdellatif Achour 
Published: May 2021

Abstract

Background and Aims
Multiple sclerosis (MS) is a chronic and potentially disabling disease of the central nervous system and is the leading cause of non-traumatic neurological disability in young adults. Beta interferons (IFN-β) are the most-widely prescribed medications for this disease. Despite good overall long-term safety data with prolonged use of this group of drugs, they can rarely cause serious and sometimes life threatening adverse effects. We report a case of thrombotic microangiopathy (TMA) in a patient treated with IFN-β-1a for 03 years. The serum complement study revealed a decrease in Factor I.

Method
Case report

Results
A 28-year-old man was diagnosed with relapsing remitting multiple sclerosis in 2007. Subcutaneous IFNβ-1a 44 μg was commenced three times a week in 2017. He had not had a relapse since 2012. In July 2020, he was admitted to intensive care unit for a status epilepticus associated with severe arterial hypertension and then transferred to our department for management of malignant arterial hypertension with acute renal failure.On examination, he did not present any neurological disorder but had very unbalanced blood pressure under triple therapy. Biology had shown an hemoglobin at 9, 7 g / dl; no thrombocytopenia with a collapsed haptoglobin, very high LDH with absence of schizocytes, positive non-specific ANCA and proteinuria at 7g/24hour.
The renal puncture biopsy showed chronic vascular and glomerular TMA with IgG and fibrinogen deposits. The course was marked by the rapid deterioration of renal function. The patient received flash corticosteroid therapy 10 mg / kg IV for 3 consecutive days switched to oral corticosteroid therapy 0.5 mg / kg / day and received supportive treatment including plasma exchange and hemodialysis. He was discharged after a prolonged admission.
At follow-up 6 months later, he had not regained kidney function and remained on hemodialysis and was still taking 3 antihypertensive treatments. A follow-up immunological workup showed a decrease in Factor I: 26,83 mg/l (32,3-87,5).
The patient was diagnosed with drug-induced TMA favored by complement abnormality. Treatment with Eculizimab is under discussion.

Conclusion
IFN-β are main therapies for relapsing remitting multiple sclerosis. Serious complications are relatively rare and IFN-βs are generally considered to be safe. Nevertheless, rare serious and/or life-threatening side effects have been reported such as TMA. This can, as in our patient, be favored by an abnormality of the serum complement. Thus, a study on serum complement would be recommended before IFN-β prescription.