bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO718ROLE OF CT-PERITONEOGRAPHY IN THE PATIENT WITH GENITAL EDEMA AND PERITONEAL DIALYSIS
Authors: Centellas Pérez Francisco Javier , Ortega Cerrato Agustin , Pérez Martínez Juan , Llamas Fuentes Francisco 
Published: May 2021

Abstract

Background and Aims
Genital edema is a frequent complication in those patients who are on peritoneal dialysis, generally secondary to the increase in intra-abdominal pressure that it entails. It occurs late after the implantation of the peritoneal catheter (after 30 days of implantation).
The typical clinical manifestation of this condition is basically subcutaneous edema in the genital area, accompanied by pain and UF failure.
The diagnosis must be made by using an imaging test, mainly CT-peritoneography.

Method
A series of clinical cases of PD patients who consulted for genital edema is reviewed, analyzing the role of peritoneography

Results
CASE 1
A 76-year-old male, 15 days after the start of the technique, consulted for right scrotal edema. It was decided to suspend CAPD and start hospital intermittent IPD with low volumes. A CT-peritoneography was requested, which revealed a right peritoneal-vaginal duct and a left inguino-scrotal leak. Surgical correction of the anatomical defect was performed without incident, with subsequent return of the patient to CAPD.
CASE 2
A 78-year-old man, 15 days after the start of the technique, consulted for bilateral scrotal edema. A CT-peritoneography was performed, which showed that the leak of peritoneal fluid to the scrotum was due to bilateral inguinal hernia. Subsequently, inguinal hernioplasty of the surgical defect was performed without complications.

Conclusion
Genital edema, as a complication of patients with CAPD, appears in approximately 4-10% of them. CT-peritoneography is the diagnostic technique of choice.
To do this, 150 ml of nonionic iodinated contrast, with a concentration of 300 mg/ml, are diluted in approximately 2 liters of dialysis solution, which are introduced into the peritoneal cavity of the patient 2 h before performing the CT.
Subsequently, a CT scan of the abdomen and pelvis including the perineum is performed, in the supine position and craniocaudal direction.
MO909MULTICENTER EPIDEMIOLOGICAL STUDY OF MALNUTRITION INFLAMATION IN DIALYSIS “EMID” IN SPANISH DIALYSIS CENTERS
Authors: Barril Guillermina , Nogueira Ángel , Cigarran Secundino , Latorre Juan , Sanchez Rosa , De Santos Antonio , Hadad-Arrascue Fernando , Romaniouk Igor , Anton-Perez Gloria , Thuissard Israel 
Published: May 2021

Abstract

Background and Aims
There is a high prevalence of malnutrition (PEW) in patients on dialysis (HD-PD). There is no single tool to diagnose it, varying the percentage according to the one used.

Aim
To assess prevalence of malnutrition-inflammation by MIS scale (malnutrition-inflammation-score) in HD or PD patients of Spanish dialysis units.

Method
We evaluated 2937 patients on dialysis (HD+PD) in Spain were evaluated on the MIS scale strata (Kalantar-Zadeh 1999) also analyzing:

Common data
Age, sex, dialysis time, Charlson-I., RRF, albumin,prealbumin,Kt/V transferrin, CRP, DM

, Specific-HD
HD type, AVF or Catheter

, Specific-PD
PD-type, transport type.
Statistical analysis with SPSS.23 software, using parametric and non-parametric test.

Results
We evaluate 2748 HD patients, median age 71 (RIC20), 65.90% male, median MIS 6 (RIC4), DM 36.91%, T in HD 36m (RIC54), FRR 35.44% , Charlson Index 7 (RIC4) and 186 in PD (62.96% men), median
-age 62 (RIC 24), median-MIS 4 (RIC 2), T in PD of 18.5 m (RIC 23.5),DM 30.77%, FRR 79.89%, I Charlson 5 (RIC 4), In PDA 99pac-52.38%.
Prevalence of global malnutrition (MIS&gt;2) was 89% considering HD+DP and 50% when MIS&gt;5 (table 1)
In PD the higher normonutrides greater Kt/V in manual vs automatic not the malnourished ones. FRR significantly in greater % in normonutrides. No differences in malnutrition depending on carrier type. CRP sig major in MIS&gt;2 and &gt;5
In HD, Normo versus malnourished and with MIS&gt;5 significant difference: HD type, CRP, HD Type, AVF vs catheter, age,sex.
The prescription for Oral supplement was low and higher in HD 12.4% vs DP 6.3%.

Conclusions
1.- There is a high prevalence of malnutrition on dialysis being higher in HD. 2.- In PD, FRR major and CRP minor in well-nourished versus malnourished. 3.- In HD: Normo versus malnourished and with MIS&gt;5 significant difference: HD type, CRP,Charlson I. AVF vs catheter, age,sex. 4.- There is a percentage of malnourished patients with very low percentage of oral supplement.
MO912INMUNE STATUS ON HAEMODIALYSIS PATTIENTS AFFECTED WITH COVID19 INFECTION
Authors: Sandino Pérez Justo , Utrero-Rico Alberto , Yuste Claudia , Gutierrez-Solis Elena , Morales Enrique , Mérida Evangelina , Gonzalez-Cuadrado Cecilia , Chivite-Lacaba Marta , Mancebo Esther , Paz-Artal Estela , Caro Espada Paula Jara 
Published: May 2021

Abstract

Background and Aims
End-stage renal disease patients on haemodialysis (HD) seem more likely to develop severe COVID19 disease. Over the course of COVID disease, we observed a poor tolerance to HD sessions with a marked tendency of clinical deterioration over them.
The objective is to evaluate changes on immunological system over HD session on patients affected with COVID19 compared with patients without COVID19.

Method
Fourteen HD patients were studied including 9 confirmed COVID19 infection and 5 healthy controls. Predialysis and postdialysis blood samples were compared to study alterations on immune status. We identified cytoKines by Luminex (CCL2, CXCL10, IL1Ra, IL10, IL12p70, TNFα, IL17Ra, IL6, IL7) and adaptive lymphocyte subsets (CD4/CD8 naïve, CD4/CD8 MC, CD4/CD8 MP, CD19, CD56). Monocyte subsets (CD14+CD16-, CD14+CD16+, CD14-CD16+) were detected from peripheral blood mononuclear cells (PBMC), as well as immune activation (CD11b, HLA-DR, CD86) and migration factors (CCR2, CCR5). The supernatant of isolated CD14+ cells after 4-hour stimulation with LPS where analysed by Luminex to measure cytokines (CCL2, CXCL10, GM-CSF, IL10, IL12p70, IL17Ra, IL6, IL7, TNFα).

Results
Patients with COVID19 presented predialysis: (1) higher plasmatic levels of IL12p70, TNFα e IL7, (2) lymphopenia and neutrophilia, (3) higher percentage of intermediate monocytes and lower of non-classical, (4) lower membrane expression of CCR2, HLA-DR y CD86 over Cd14+ cells, and (5) higher production of CCL2, GM-CSF, IL10, IL12p70 y IL17Ra by LPS stimulated monocytes compared with patients without COVID19. When analysed the fold-change between pre and postdialysis values, patients with COVID19 infection present a: (a) higher plasmatic levels of IL6, IL1Ra, CCL2 e CXCL10, (b) reductions of total lymphocites, (c) higher membrane expression of CCR2, CD33 y CD86 on CD14+ cells, and (d) higher production of TNFα, GM-CSF, IL10, IL17, IL6 e IL7 by LPS stimulated monocytes compared with patients without COVID19. No differences on lymphocite subset were found.

Conclusion
The clinical deterioration on COVID19 infected patients over HD session could be related with monocyte activation and pro-inflammatory cytokines secretion.
MO914INTRADIALYTIC RESISTANCE TRAINING HAS POSITIVE EFFECT ON SURVIVAL IN HEMODIALYSIS PATIENTS INDEPENDENTLY OF THEIR NUTRITION STATUS MEASURED BY BODY COMPOSITION MONITORING
Authors: Hudacek Marek , Zelko Aurel , Rosenberger Jaroslav 
Published: May 2021

Abstract

Background and Aims
Malnutrition is considered to be an independent predictor of mortality in hemodialysis population. Physical inactivity is also connected to worse outcomes, and patients are recommended to comply with at least some physical excercise.
The aim of this study was to evaluate the survival of hemodialysed patients, taking into account the nutritional status, assessed by Body Composition Monitor. In addition, analysed the impact of three months intradialytic resistatance training.

Method
It was a prospective study of patients undergoing hemodialysis from three hemodialysis departments. Patients from two departments underwent three months intradialytic resistance training while those from the third department served as controls. Cox multivariate regression analysis was used to analyse patient survival depending on performing intradialytic resistance training and their nutritional status.

Results
The group of 90 patients included 35 women, 55 men (61%) with a mean age of 62.6 years, and a mean dialysis program duration of 49.1 months. 31 patients completed whole three months interdialytic training. In total, 80% of participants survived the follow-up period of two years. Cox regression analysis showed a statistically significant effect of the intervention: the patients who had been training had a benefit in survival (HR 4.4; 95%CI 1.003;19.267; p=0,05). The stratification by nutritional status did not change this model, it was always crucial whether patients exercised or not. Malnourished patients had also a better survival when they were training.

Conclusion
Malnourished hemodialysed patients have higher mortality compared to well-nourished patients. Intradialytic resistance training brings survival benefit and might reduce the adverse effects of malnutrition. Therefore we recommend this intervention even in malnourished hemodialysed patients.
MO916THE EFFECT OF EXTENDED HAEMODIALYSIS ON NUTRITIONAL PARAMETERS: A SYSTEMATIC REVIEW
Authors: Majlessi Alireza , March Daniel , Burton James 
Published: May 2021

Abstract

Background and Aims
Individuals who receive haemodialysis have a high mortality rate, up to 20% within one year of starting dialysis and just under 50% at 5 years. One of the risk factors that contributes to this high mortality rate is the nutritional status of haemodialysis patients; improving this will be a key element of risk mitigation. Extended haemodialysis may improve nutritional outcomes through better clearance and reduced dietary restrictions and medications. The aim of this systematic review is to provide an up to date assessment of trials of extended haemodialysis reporting the following nutritional outcomes: Lean body mass, body mass index, protein intake and energy intake, nutritional status assessed by the subjective global assessment and PEW scores, and circulating markers of appetite.

Method
No limits on language were set, and databases were searched from inception to December 2020 using a predefined search strategy. Inclusion criteria were; randomised and non-randomised trials of extended haemodialysis (defined by &gt;15 hours per week of total haemodialysis time), with a comparator group which received conventional in-centre haemodialysis (usually &lt;=12 hours per week of hemodialysis time). The following databases were searched: Medline, EMBASE, CINAHL, Cochrane Controlled Register of Trials (CENTRAL), the Web of Science Core Collection,PROSPERO, Clinicaltrials.gov, the ISCRTN Registry and Conference Proceeding Citation Index, National Health Service Centre for Reviews and Dissemination: Health Technology Assessment (HTA), and Database of Abstracts of Reviews of Effects (DARE). Additional internet searches (i.e Google Scholar) were also conducted. Search results were compiled in Endnote and studies were screened for title and abstract.

Results
Searches identified 9251 records. After removing duplicates 6190 records were screened for title and abstract against inclusion criteria, leaving 22 papers for full text screening. A further 17 records were removed following full text screening. Of the remaining 5 papers, one was a randomised controlled trial and four were prospective, non-randomised trials. All studies investigated nocturnal haemodialysis (one with the additional of short daily), three were in-centre and two were at home. Range of duration for the included studies was 2-18 months. Outcomes of interest measured included lean body mass, protein and carbohydrate intake, body mass index, dry lean mass and water soluble vitamin levels. Of these trials, only one reported a statistically significant increase in an outcome of interest (lean body mass). One study also reported cross-sectional data highlighting Vitamin-C deficiency in half of their nocturnal haemodialysis population.

Conclusion
There is insufficient high-quality evidence assessing the effect of extended haemodialysis on nutritional parameters. Further research is required to understand the impact of novel dialysis prescriptions on these clinical parameters.
MO917INFLAMMATORY PARAMETERS IMPROVEMENT WITH CITRATE COMPARED TO ACETATE DIALYSATE
Authors: Broseta Monzo Jose Jesus , López Romero Luis Carlos , Rodríguez Diana , Guillen Olmos Elena , Sánchez-Pérez Pilar , Hernandez Jaras Julio 
Published: May 2021

Abstract

Background and Aims
The relation between inflammation and cardiovascular disease is well established. Dialysis patients are at a higher risk of cardiovascular death, mostly attributed to cardiovascular disease. This study evaluated the potential benefits of citrate (CD) vs. acetate dialysate (AD) regarding the patients’ inflammatory status.

Method
Single-center, cross-over, prospective study, with a follow-up of a total of 24 dialysis sessions, 12 with each dialysate. Blood samples were taken on the twelfth dialysis session with each type of dialysate. Every patient acted as its own control. The pre-dialysis parameters analyzed were procalcitonin (PCT), high-sensitivity C-reactive protein (hsCRP) and interleukin-6 (IL-6).

Results
Pre-dialysis hsRCP [AD: 4,32 (1,27 – 12,16) vs. CD: 4,08 (0,98 – 8,65) mg/L, p = 0,031], PCT [AD: 0,44 (0,28 – 0,74) vs. CD: 0,38 (0,29 – 0,44) ng/mL, p = 0,037], and IL-6 [AD: 13,7 (7,85 – 29,03) vs. CD: 11,8 (5 – 27,13) pg/mL, p = 0,029] are significativly higher after twelve dialysis sessions with AD vs. CD.

Conclusion
Even in the medium term, the use of citrate instead of acetate as the dialysate acidifier, reduces the measured inflammatory parameters and could therefore be considered a more biocompatible dialysate option.
MO918INFECTIOUS COMPLICATIONS IN HEMODIALYSIS: INTERSET OF NEUTROPHIL TO LYMPHOCYTE AND PLATELETS TO LYMPHOCYTE RATIOS
Authors: Lahouimel Rania , Salma Toumi , Abid Hanen , Kharrat Emna , Saai Amira , Agerbi Ikram , Dammak Najla , Chaker Hanen , Kammoun Khaoula , Yaich Soumaya , Benhmida Mohammed 
Published: May 2021

Abstract

Background and Aims
Infectious complications represent the leading cause of death among the dialysis population, prompting early diagnosis and increased vigilance. Neutrophil-to-lymphocyte and platelets-to-lymphocyte ratios are newly emerging as more accessible and simple markers for the detection of the onset of infections. The objective of our study is to prove the value of these markers in the diagnosis of infections in hemodialysis patients.

Method
This is a cross-sectional study spread over one year including 85 chronic hemodialysis patients with duration of at least 6 months. patients with hemopathies, tumors, or with a history of hospitalization during the 3 months before the study were excluded. CRP was used as a biomarker of infections and N / L; P / L ratios were calculated to study the correlation between the two biomarkers. Based on the literature reviews, the threshold of the N / L ratio and the P / L ratio admitted for our stydy were respectively : &gt; = 2.5 and &gt; = 150.

Results
The mean age of our patients was 49 ± 19 years with a predominance of women (55%) .The average duration in hemodialysis was 67.2 months. An infectious complication was noted in 22% of our patients whose distribution was as follow: 4% as a pulmonary infection with 3 coronavirus cases, 6% a sepsis, one case of abscess of the nephrectomy compartment.The median value of the CRP was 37±10mg/l We found a positive correlation between the 2 ratios associated (RNL and RPL) and infection with (p = 0.03) . We noted throw this study that patients with both high ratios RPL&gt; 150 and RNL&gt; 2.5 have significantly elevated values of CRP.

Conclusion
N/L and P/L ratios are easy-to-calculate markers that are of great benefit to the hemodialysis population. We have shown through this study the existence of a positive correlation between the N/L and P/L ratios and the occurrence of infections in hemodialysis patients. We therefore encourage the use of this ratios to be included as markers to detect infections occurence.
MO903THE ASSOCIATION BETWEEN VITAMIN K, CALCIUM, PHOSPHORUS LEVELS AND NUTRITIONAL STATUS IN HEMODIALYSIS PATIENTS
Authors: Małgorzewicz Sylwia , Puchalska-Reglińska Ewelina , Konieczna Lucyna , Krzanowska Katarzyna , Debska-Slizien Alicja 
Published: May 2021

Abstract

Background and Aims
Vascular calcification is highly prevalent in dialysis patients. The most common postulated cause, apart from calcium and phosphorus disorders, is sub-clinical vitamin K deficiency. It results in the failure of the GLA-matrix protein (MGP) to undergo carboxylation. The lack of functional carboxylated MGP may contribute to increased vascular calcification. Aim: We assessed the relationships between vitamin K, MGP, calcium, phosphorus levels and nutritional status in hemodialysis patients.

Method
The study included 58 hemodialysis patients in stable clinical condition (mean age 64.1 ± 15.6 yr) . We determined plasma levels of: vitamin K1 and K2 (LC-MS method), GLA -matrix protein (ucMGP and cMGP), osteocalcin (ELISA methods), parathyroid hormone (iPTH), calcium (Ca), phosphorus (P), CRP and routine biochemistry. Echocardiography was performed and BMI was calculated. Nutritional status was assessed by SGA and s-albumin – malnutrition was diagnosed based SGA ≤5 and s-albumin ≤ 38g/l. FFQ-6 was used to dietary assessment. Patients with HPT (n=17; 32%) were treated by active vitamin D/paricalcitrol and calcium carbconicum.

Results
Malnourished patients (n=11; 20%) presented statistically significantly higher CRP, age and lower phosphorus, iPTH, BUN, creatinine, cholesterol and potassium. Also, malnourished patients presented significantly higher ucMGP and lower cMGP and lower both vitamin K forms in comparison to well-nourished (ucMGP 18.9 vs 13.2 ng/dl; p=0.0005; cMGP 150.1 vs 332.4 ng/dl; p=0.0002). Diet in both groups malnourished and well-nourished not differ significantly, though malnourished patients ate less amount of nutrients. Additionally, phosphorus level positively correlated with Kt/V, SGA and vitamin K2 (R Spearman =- 0.3;p=0.01,R Spearman = 0.4;p=0.05;R Spearman = 0.3; p=0.001, respectively).

Conclusion
Vitamin K deficiency, as expressed by high ucMGP levels is associated with nutritional status. Low albumin and chronic inflammation might increase risk of calcification in spite relatively low iPTH and phosphorus levels.
MO904DIETARY PATTERNS IN HEMODIALYSIS PATIENTS: RELATIONSHIP WITH CLINICAL AND NUTRITIONAL PARAMETERS
Authors: Garagarza Cristina , Valente Ana , Caetano Cristina , Ramos Inês , Sebastião Joana , Pinto Mariana , Oliveira Telma , Ferreira Anibal , Sousa Guerreiro Catarina 
Published: May 2021

Abstract

Background and Aims
Nutritional recommendations for hemodialysis (HD) patients focus on the achievement of a sufficient energy and protein intake without exceeding phosphorus, potassium, sodium and/or fluids intake limits. This study aimed to identify different dietary patterns of HD patients and analyze their relationship with clinical and nutritional parameters.

Method
This was a longitudinal prospective multicenter study with 582 HD patients from 37 dialysis centers. Dry weight, Kt/V, serum potassium, phosphorus, calcium, sodium, creatinine and C-reactive protein were measured. Dietary intake was obtained using the Food Frequency Questionnaire. Dietary patterns were derived from principal component analysis based on 20 food groups which were adjusted for total energy intake. Linear regression was used to analyze patterns and the variables of interest. All statistical tests were performed using SPSS 26.0 software. A p-value lower than 0.05, was considered statistically significant.

Results
Patients’ mean age was 67.8±17.7 years and median HD vintage was 65 (43-104) months. Three different dietary patterns were identified: “Western” (31.3% of the patients) with high intake of soft drinks, home-made fried potatoes, caffeinated drinks, red and processed meat, and low intake of fruit and vegetables soup; “Mediterranean” (33.5% of the patients) with high intake of vegetables, beans, fish, olive oil, eggs, and low intake of milk and milk products. Finally, “Low animal protein” (35.2% of the patients) with high intake of whole grain bread, cookies and sweets, vegetables soup and low intake of white bread, rice, pasta and potatoes. Regarding clinical parameters, the Mediterranean pattern was predictor of a higher dry weight (p=0.001), higher creatinine (p=0.032) and lower serum calcium (p=0.024), whereas Western pattern predicted higher phosphorus (p=0.006), sodium (p=0.014) and creatinine (p=0.001). Low animal protein pattern predicted lower creatinine levels (p=0.011). After adjusting for age, gender, presence of diabetes, HD vintage and Kt/V, serum calcium was the only parameter which remained statistical significant within the Mediterranean pattern. Comparing the nutritional parameters studied, the Mediterranean pattern was the strongest predictor of a higher intake of protein (%) (p&lt;0.001), folate (p&lt;0.001), vitamin B12 (p&lt;0.001), vitamin B6 (p&lt;0.001), vitamin C (p&lt;0.001), vitamin D (p&lt;0.001), potassium (p=0.015) and omega 3 fatty acids (p&lt;0.001) and a lower intake of carbohydrates (%) (p&lt;0.001), calcium (p&lt;0.001) and sodium (p=0.006).

Conclusion
Three different dietary patterns were identified in these HD population. The pattern which was closer to the well-known Mediterranean diet was associated with a better nutritional intake profile, which, at least theoretically, are associated with better clinical outcomes.