bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO483CHA2DS2-VASC SCORE IN PATIENTS WITH EGFR&lt;30 ML/MIN/1.73 M2 AND ATRIAL FIBRILLATION*
Authors: Freese Ballegaard Ellen Linnea , Bjerring Olesen Jonas , Kamper Anne Lise , Feldt-Rasmussen Bo , Gislason Gunnar , Torp-Pedersen Christian , Carlson Nicholas 
Published: May 2021

Abstract

Background and Aims
CHA2DS2-VASc score (congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, stroke or transient ischemic attack, vascular disease, age 65-74 years, female sex) is a validated tool for evaluation of risk of stroke and systemic emboli in patients with atrial fibrillation without nephropathy. The validity of risk determination based on the CHA2DS2-VASc score in patients with severe nephropathy is untested. We investigate the validity of the CHA2DS2-VASc score in patients with eGFR&lt;30 ml/min/1.73m2 (including dialysis treated patients) and atrial fibrillation without anticoagulation treatment.

Method
In a retrospective cohort study, all patients with atrial fibrillation and eGFR&lt;30 ml/min/1.73 m2 were identified in nationwide Danish registers between 2008 and 2018 with subsequent exclusion of patients initiating anticoagulation treatment based on redeemed prescriptions. Cumulative incidences of stroke stratified on CHA2DS2-VASc score were computed using the Aalen-Johansen estimator, and one-year risk of stroke was calculated with comparison of CHA2DS2-VASc score based on Cox regression models adjusted for age, sex and dialysis status with G-computation of one-year risk standardized to the distribution of risk factors in the sample.

Results
From 2,452 patients with eGFR &lt;30 ml/min/1.73 m2 and de novo atrial fibrillation, a total of 1,575 patients (64.2%) without anticoagulation treatment were included. Mean age was 78.0 years (standard deviation ±12.2), 53.3% were male, and 25.5% were on dialysis. The distribution of patients into CHA2DS2-VASc score categories of 0-1, 2, 3, 4 and ≥5 was 8.7%, 14.5%, 24.6%, 24.7% and 27.5%, respectively.
Cumulative incidence of stroke in non-dialysis dependent and dialysis-dependent patients are shown in the figure.
Overall, standardized one-year risk of stroke was 3.3% (95%CI 1.3-6.4%), 2.5% (95%CI 1.0-4.1%), 5.9% (95%CI 3.9-8.2%), 5.1% (95%CI 3.6-7.0%), and 7.3% (95%CI 5.2-10.2%) for CHA2DS2-VASc score categories of 0-1, 2, 3, 4 and ≥5, respectively. Comparably, standardized one-year risk of stroke was 2.5% (95%CI 0.3-5.7%), 1.9% (95%CI 0.0-4.7%), 7.4% (95%CI 3.2-11.5%), 4.7% (95%CI 1.0-8.3%), and 16.5% (95%CI 7.9-27.2%) for CHA2DS2-VASc score categories of 0-1, 2, 3, 4 and ≥5, respectively, in dialysis-treated patients, and 4.3% (95%CI 1.0-10.3%), 2.9% (95%CI 1.1-4.9%), 5.5% (95%CI 3.5-8.1%), 5.1% (95%CI 3.4-7.1%), and 5.9% (95%CI 3.8-8.5%) for CHA2DS2-VASc score categories of 0-1, 2, 3, 4 and ≥5, respectively, in non-dialysis-dependent patients.

Conclusion
Overall, CHA2DS2-VASc score was associated with a progressive increase in one-year risk of stroke. Although the association was most obvious in non-dialysis dependent patients, discrepancy was evident with regard to risk in patients with CHA2DS2-VASc score ≤1 in both subgroups, albeit less so in adjusted analyses.
MO515CONSTIPATION IN CHRONIC KIDNEY DISEASE: PREVALENCE AND RISK FACTORS
Authors: Sharma Sourabh , Sharma Neha , Sharma Kailash 
Published: May 2021

Abstract

Background and Aims
Among various gastrointestinal disorders, constipation is one of the most common symptom in chronic kidney disease (CKD). However it is often neglected by nephrologists as self-limiting condition. Constipation impacts quality of life in multiple ways and increases socio-psychological burden. Constipation and associated risk factors have been poorly studied and most studies are retrospective.

Method
We enrolled CKD stage 3 to 5 patients on regular follow-up with nephrologist from June 2018 to June 2020, at a tertiary care centre in North India. Constipation was defined using Rome IV criteria (Functional constipation) which is composed of six constipation related symptoms, and diagnosis of constipation is established by presence of two or more symptoms for at least 3 months. Patients were also asked to maintain a 7 day prospective stool diary. It consisted of seven day written prospective chart of stool form and frequency. Patients were instructed to record when each bowel movement happened and to mark stool form type for each movement as described in words and pictures on Bristol Stool Form Scale (BSFS). Opioid induced constipation was defined as per Rome IV criteria. The diagnostic criteria is similar to functional constipation, but with requisite that new or worsening symptoms occurred when initiating, changing or increasing opioid therapy.

Results
Two hundred twenty five patients were studied out of which 59 (26.2%) patients were in CKD stage3, eighty one (36%) patients were in CKD stage4 and 85 (37.8%) patients were in stage5. Out of 85 CKD stage5 patients, 23 (27%) were on dialysis. Mean age of patients was 49.1 years. Out of 225 patients, 135 (60%) were male. Constipation symptoms and diagnosis reported in each stage has been depicted in Table 1. Clinical correlates of constipation has been depicted in Table 2.

Conclusion
Constipation measured using Rome IV criteria affects around two-third of CKD stage 3-5 patients. Diabetes, hypertension and opioid use has been found to be significantly associated with constipation.
MO537INTERACTION OF PLASMA HOMOCYSTIENE, RENAL FUNCTION AND CARDIO-METABOLIC RISK FACTORS- AN OBSERVATION IN A RURAL POPULATION OF BANGLADESH
Authors: Rahman Md Hafizur , Alam Kazi Shahnoor , Alam Babrul , Banerjee Sajal Krishna , Chaudhury S R , Arslan M I , Hassan M S , Chowdhury MAA , Iqbal Md M 
Published: May 2021

Abstract

Background and Aims
Elevated plasma total homocystiene (tHcy) levels are associated with atherosclerotic diseases in coronary, cerebral and peripheral blood vessels. It is possible that hyperhomocysteinemia may lead to intrarenal arteriosclerotic lesions and decline in GFR or impaired renal function. Aim of this study was to elucidate the association of plasma homocystiene level with renal function and cardiovascular risk factors in rural population.

Method
A well defined rural area was selected. Study subjects were identified by computer generated random numbers after entering household listings and then Kish table was used to choose a participant. Adult subjects (≥18 years) were only included. The approached participant was explained the purpose, if consented, then given an appointment to be present at a research hospital on a separate date for clinical and biochemical evaluation. A face to face interview was conducted. Clinical history, physical examination anthropometrics were recorded on data sheet. Fasting blood sample and morning spot urine was collected. Then serum tHcy was measured by chemiluminescent microparticle immunoassay (CMIA) technology. Study population were investigated with Spot urine ACR, Fasting glucose, serum lipid profile, creatinine, homocysteinine , Folic acid and Vit B12.

Results
Early results of 234 random subjects are presented here. The mean age was 41 ± 13(18-92) years with male 33% and female 67%. Mean eGFR was 99± 26 ml/min, tHcy 11.6 ± 5.9 μmol/l, Vit B12 329 ± 187 pg/ml and Folic Acid 5.57 ± 2.63 ng/ml. A tHcy cut-off value in study subjects ≥15 μmol/l was seen in 17 % and &lt;15 μmol/l in 83%. Serum creatinine, Uric Acid, Cholesterol, LDL was significantly higher and Vit B12, Folic acid lower in tHcy ≥15 μmol/l group. Further grouping showed tHcy level was significantly higher in Vit B12&lt;200 pg/ml and Folic acid &lt;3ng/l group. Correlation studies showed homocystiene positively correlated with age, systolic blood pressure, creatinine, LDL and negatively with Folic acid and Vit B12.

Conclusion
Our findings suggest that elevated plasma homocystiene level might influence and are associated with altered markers of renal, cardiac and metabolic risk factors in rural population. Preventive approaches are required towards this issue as larger population segment belongs to rural areas.
MO487DYSNATRAEMIA AND ASSOCIATED MORTALITY RISK THRESHOLDS ARE MODIFIED BY KIDNEY FUNCTION IN THE IRISH HEALTH SYSTEM: THE NATIONAL KIDNEY DISEASE SURVEILLANCE SYSTEM (NKDSS)
Authors: Walsh Conor , Browne Leonard , Stack Austin 
Published: May 2021

Abstract

Background and Aims
Dysnatraemia is associated with increased mortality risk in the general population, but it is unclear to what extent kidney function influences this relationship. We investigated the impact of dysnatraemia on total and cardiovascular (CV) mortality while exploring the concurrent impact of chronic kidney disease.

Method
We utilised data from the Irish Kidney Disease Surveillance System (NKSS) to explore the association of serum sodium (Na+) (mmol/L) and mortality in a longitudinal cohort study. We identified all adult individuals (age &gt; 18 years) who accessed health care from January 1st, 2007 and December 31st, 2013 in a regional health system with complete data on serum Na+, associated laboratory indicators and vital status up to 31st December 2013 (n = 32, 686). Patients receiving dialysis were excluded. The primary exposure was serum Na+ first recorded during the study period for each patient with a concurrent serum glucose measurement. Chronic kidney disease was defined as eGFR &lt;60ml/min/1.73m² vs greater recorded at index date. The association of serum Na+ with all-cause (ACM) and CV mortality was explored in categories and as a continuous variable using polynomial splines. Multivariable Cox regression with competing risks determined hazard ratios (HR) and 95% confidence intervals with adjustment for baseline health indicators.

Results
There were 5,118 deaths (15.7%) over a median follow up of 5.5 years. In multivariable adjusted models, the association of serum Na+ with all-cause and CV mortality followed a non-linear, u-shaped pattern. For all-cause mortality, the optimal range for greatest survival was between 139-146 mmol/L [HR 1.02 (1.00-1.03) and HR 1.19 (1.02-1.38) respectively, while for CV mortality, the optimal range was much narrower at 134-143mmol/L [HR 1.16 (1.02-1.23) and HR 1.09 (1.01-1.89) respectively] (Figure 1). The impact of serum Na+ on mortality was modified by baseline kidney function (p value &lt; 0.001 for interaction). In stratified analysis, the impact of serum Na+ on all-cause mortality was greatly attenuated among patients with GFR&lt; 60 ml/min/m², than above. This pattern was replicated in analyses of CV mortality.

Conclusion
This study supports the view that hypernatraemia and hyponatraemia are better tolerated with poorer kidney function. The risk thresholds for mortality were much narrower for CV death than all-cause death suggesting that these thresholds be taken into account to inform decision making and therapeutic interventions.

Funding source
Health Research Board (HRB-SDAP-2019-036), Midwest Research and Education Foundation (MKid)
MO430MASS-SPECTROMETRIC IDENTIFICATION OF POST-TRANSLATIONAL GUANIDINYLATED PROTEINS IN THE CONTEXT OF SYSTEMIC LUPUS ERYTHEMATOSUS
Authors: Hermann Juliane , Raffetseder Ute , Lellig Michaela , Jankowski Joachim , Jankowski Vera 
Published: May 2021

Abstract

Background and Aims
With continuous identification of post-translational modified isoforms of proteins, it is becoming increasingly clear that post-translational modifications limit or modify the biological functions of native proteins are majorly involved in development of various chronic disease. This is mostly due to technically advanced molecular identification and quantification methods, mainly based on mass spectrometry. Mass spectrometry has become one of the most powerful tools for the identification of lipids.

Method
In this study, we used sophisticated high-resolution mass-spectrometric methods to analyze the soluble ligand of receptor Notch-3, namely the Y-box protein (YB)-1, in serum from systemic lupus erythematosus (SLE) patients. In addition, kidneys of lupus-prone (MRL.lpr) mice were analyzed by mass-spectrometric imaging techniques to identify the underlying pathomechanisms. Serum YB-1 was isolated by chromatographic methods, afterwards digested by trypsin and analyzed by matrix assisted laser desorption/ionization mass spectrometry (MALDI-MS). The kidneys were fixed in paraffin, then kidney sections were deparaffinized, tryptic digested and analyzed by mass-spectrometric imaging techniques. Mass-spectrometry of extracellular YB-1 in SLE patient serum revealed post-translational guanidinylation of two lysine’s within the highly conserved cold shock domain (CSD) of the YB-1 protein (YB-1-2G). Patients with increased disease activity and those with active renal involvement (lupus nephritis, LN) had a higher degree of dual-guanidinylation within the CSD. Of note, at least one of these modifications was present in all analyzed LN patients, whereas single-guanidinylated YB-1 was present in only one and double modification in none of the control individuals. Mass-spectrometric imaging analyses specifically localized YB-1-2G and increases Notch-3 expression in kidney sections from MRL.lpr mice.

Results
The data from this study clearly demonstrate the high potential of high-resolution mass spectrometric methods as well as mass spectrometric imaging techniques to identify pathomechanisms of diseases like SLE/LN.
MO433IDENTIFICATION AND VALIDATION OF PEPTIDIC FEATURES IN CKD PATIENTS AND UNRAVELLING OF A POTENTIAL INFLAMMATION INDUCER
Authors: Bagarolo Giulia Ilaria , Stricker Laura , Hemmers Christian , Vondenhoff Sonja , Jankowski Vera , Bruck Heike , Jankowski Joachim 
Published: May 2021

Abstract

Background and Aims
Chronic Kidney Disease (CKD) is causing serious cardiovascular diseases. Creatinine quantification and eGFR estimation are suboptimal approaches for the diagnosis of CKD, especially at early stages. Therefore, there is a strong need for identification of mediators for CKD diagnosis and prediction of disease progression. In this study we follow a cohort of renal healthy patients (controls) and CKD patients (cases) for two years, defining three time points (baseline, after 12 months and after 24 months), with the aim of identifying and characterizing mediators of disease which could be an indication for the development and progression of CKD and its outcome.

Method
By the employment of liquid chromatography-mass spectrometry (LC-MS) we analyzed the plasma samples from the patients and identified the mediators1 : lysine (K), an angio-associated migratory cell protein (AAMP) peptide and an amiloride-sensitive oxidase (AOC1) peptide, which were consistently and differentially expressed in cases and controls at all time points.
Correlation analyses between the mediators and clinical markers were performed using the software R-Studio (RStudio Team (2020). RStudio: Integrated Development for R. RStudio, PBC, Boston, MA URL http://www.rstudio.com/).
The AAMP peptide was subsequently tested in a fibroblasts cells culture to investigate whether it was an inflammation inducer, its action was investigated at four different concentrations (0.1nM, 1nM, 100nM, 1000nM). Cells were stimulated for 48h and relative expression of two inflammation markers (CCL2 and IL6) was measured through PCR.

Results
Correlation analyses revealed that the AAMP peptide showed from modest to strong relations with clinical markers such as creatinine, hemoglobin, blood urea nitrogen, homocysteine, fibrinogen and parathyroid hormone.
Results showed that the peptide after 48h of stimulation did not cause an increase in the expression of gene CCL2 at any concentration, but caused a strong increase of gene IL6 (interleukin-6), a cytokine promoting inflammation and B cells maturation.

Conclusion
In conclusion, angio-associated migratory cell peptide, might be involved in CKD by inducing inflammation and driving the development of cardiovascular consequences such as atherosclerosis.

Acknowledgments
This project has received funding from the European Union’s Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie grant agreement No 764474.
MO597ESTIMATING INDIVIDUAL-LEVEL SODIUM INTAKE WITH REPEATED SPOT URINE SAMPLING
Authors: Ginos Gina , Vogt Liffert , Frings-Meuthen Petra , Heer Martina , Olde Engberink Rik 
Published: May 2021

Abstract

Background and Aims
In daily clinical practice, individual-level sodium (Na) intake is often estimated by measuring Na excretion in a single 24h urine collection, but long-term Na balance studies indicate that 7 consecutive 24h urine collections are needed. However, this approach is not feasible in clinical settings. In this study, we investigate whether the use of repeated spot urine sampling is an appropriate alternative for repeated 24h urine collections.

Method
We performed a post-hoc analysis of a metabolic ward study in 8 healthy male adults who consumed a 7-day diet with a fixed amount of Na (200 mmol/d). Urine was collected in four daily intervals: 7-13h, 13-19h, 19-23h and 23-7h. After reaching steady state, we estimated Na intake with 1 and 3 consecutive 24h urine collections and 3-day spot urine sampling, using the Kawasaki formula with measured 24h urine creatinine excretion.

Results: On
day 5, mean 24h Na excretion matched intake, indicating that steady state was achieved (Fig A). Mean and standard deviation of absolute differences between estimated and measured Na intake (ΔNa) for each method were: 18.8 ±14.6 mmol (3 x spot urine 7-13h), 32.3 ±18.7 mmol (3 x spot urine 13-19h), 74.6 ±30.0 mmol (3 x spot urine 19-23h), 28.2 ±19.8 mmol (3 x spot urine 23-7h), 29.8 ±23.9 mmol (1 x 24h urine) and 22.9 ±11.3 mmol (3 x 24h urine) (Fig B). With the exception of the 19-23h spot urine collection period, the accuracy of 3-day spot urine sampling did not significantly differ from accuracy of 1 and 3 consecutive 24h urine collections. When combining the pre-night and morning spot urine collections (19-7h), the accuracy of the estimation did not improve (ΔNa 28.7 ±19.6 mmol).

Conclusion
3-day spot urine sampling did not perform significantly different than 1 and 3 24h urine collections for estimation of individual-level Na intake. Adequately powered studies need to confirm whether repeated spot urine sampling is an accurate and low burden alternative to repeated 24h urine collections.
MO600DIFFERENCES IN BODY COMPOSITION, MUSCLE STRENGHT AND BIOCHEMICAL PARAMETERS IN CKD PATIENTS WITH AND WITHOUT PROTEIN ENERGY WASTING (PEW)
Authors: Barril Guillermina , Nogueira Ángel , Alvarez Graciela , Romasco Paula , Gil Yohana , Nuñez Almudena , Sanchez Glez Carmen , Tromborelli Natalia 
Published: May 2021

Abstract

Background and Aims
PEW sometimes produces irreversible alterations in nutritional status, and early diagnosis could mark the sindrome reversibility.
Aim.-To establish the prevalence of PEW in an advanced CKD unit in a sample of 325 patients with CKD and to establish the differences in nutritional parameters, body composition and muscle strength.

Method
The patients treated in Advanced CKD Unit (ACKD) nutritional status monitoring is performed every 3 months, will be assessed through a cross-sectional , with the frequency being able to increase if malnutrition is detected in the screening.
The ISRNM criteria are applied to diagnose PEW, and the patients are classified according to whether or not they have PEW and the differences in nutritional parameters are analyzed: albumin, transferrin, CRP, linphocytes, Hb, body composition with Akhern HD-01 monofrequency BIA and anthropometric measurements and muscular strength with dynamometer (baseline).

Results
We have evaluated 325 patients with CKD xage 70.88 ± 12.55 years, 66.8% 217pac are men with xCKD-EPI of 19.19 ± 9.28ml / min / 1.73m2 PEW prevalence 8.9% (29 patients) aged 74.06 ± 12.79 years, with no significant difference between sexes with and without PEW (18/215 men and 11/108 women). We found significant differences between the groups with PEW vs without PEW in protein intake (nPNA) 0.73 ± 0.21 vs 0.93 ± 0.26, p0.003, albumin 3.74 ± 0.66 vs 4.21 ± 0.41, CRP 1.20 ± 2.09 vs 0.68 ± 1.20, p0.05, Hb 11.33 ± 1.52 vs 11.90 ± 1.50, p0.023, transferrin 199.71 ± 48.38 vs224.95 ± 48.85, p0.013.
Data on anthropometric and body composition measures as showing in the table. The values of biochemical parameters and body composition in patients with PEW are striking, as some are close to the low limit of normality, which suggests the possible reversibility if action is taken on time.

Conclusion
The monitoring of nutritional status in a protocolized way provides low prevalences of PEW and allows its early detection, which favors its reversibility with the appropriate intervention.
MO602HIGH LEVELS OF ADVANCED OXIDATIVE PROTEIN PRODUCTS (AOPP) HELP TO PREDICT THE PROGRESSION OF ATHEROSCLEROSIS IN CHRONIC KIDNEY DISEASE WITH VITAMINE E TREATEMENT MIGHT STABILIZE AOPP LEVELS
Authors: Azouaou toualbi Leila , Adnane Mounir , Ballouti Wafa , Arab Medina , Abderrezak Khelfi , Toualbi Chahine , Chader Henni , Benoui Abdelghani , Seba Atmane 
Published: May 2021

Abstract

Background and Aims
Advanced Oxidation Protein Product (AOPP) are created during oxidative stress and are considered as markers of this phenomenon and of inflammation. Vitamin E (Vit-E) is a powerful antioxidant, whoever no consensus on its effectiveness on the level of AOPP or the process of atherosclerosis have been made. The aim of the present study was to determine AOPP levels in patients with chronic kidney disease (CKD) at different stages and their relationship with the progression of atherosclerosis in patients under Vit-E treatment.

Method
A longitudinal study has been conducted on 205 patients with CKD and 40 controls. the correlations between AOPP and glomerular filtration rate (GFR) and different biological markers were analyzed. Doppler of the supraoptic trunks was conducted to assess the correlation of AOPP with intima-media thickness. The effectiveness of Vit-E treatment on AOPP levels and atherosclerosis progression was also investigated.

Results
AOPP levels were significantly higher in CKD patients compared to the control group (P &lt; 0.05) and increased with the alteration of renal functions. The mean value of AOPP increased concomitantly with intima-media thickness (P &lt; 0.05). Furthermore, AOPP mean value was relatively higher in patients with atherosclerotic plaques (P &lt; 0.05) compared to those without plaques. Vit-E treatment stabilized the levels of AOPP but had no effect of atherosclerotic progression.

Conclusion
AOPPs were proved to be effective markers of oxidative stress and their high levels help to predict the progression of the atherosclerosis process. As a powerful antioxidant, Vit-E stabilized the AOPP levels.