bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO895EVOLUTION AND PROGNOSIS OF HEMODYALISIS PATIENTS WITH MODERATE AND SEVERE COVID INFECTION: SINGLE HOSPITAL CENTRE EXPERIENCE
Authors: Pana Camelia , Iordache Alexandru , Bogdan Campineanu , Sburlan (Stanigut) Alina Mihaela , Tuta Liliana-Ana 
Published: May 2021

Abstract

Background and Aims
One of the major challenges of our century seems to be the SARS-COV2 virus pandemic that has resulted, at least until now, in over 2 million deaths worldwide. Multiple observational studies showed that patients with chronic kidney disease and especially those on the hemodialysis program have an increased risk of severe morbidity and mortality caused by the novel coronavirus.

Aim of study
was to determine the prognosis and mortality risk in hemodialysis patients hospitalized for symptomatic COVID-19 infection, using the ALAMA age score and the COVID-GRAM critical illness risk score.

Method
Prospective and retrospective study that included 74 patients undergoing chronic hemodialysis, hospitalized in the Constanta County Emergency Clinical Hospital between March 2020 - December 2020, confirmed with SARS-CoV 2 infection by RT-PCR testing.

Results
Out of the total number of 74 hospitalized patients (64.58% M, 35.41% F; mean age = 66.64 years), having moderate and severe forms of the disease. 56.25% needed conventional oxygen therapy, 22.9% non-invasive mechanical ventilation and 12.5% intubation and ventilation. All patients underwent specific treatment according to the national protocols, updated with the rapid changes and increasing informations regarding the disease management. The mean duration of hospitalization was 12.33 days. 94.7 % of patients had additional risk factors (diabetes mellitus-47.56%, arterial hypertension-87.3%, COPD – 7.8%, systemic aterosclerosis – 35.4%, immunosuppression – 11.6%, malignant tumors – 4.8% ). Mean ALAMA score was more than 85 years (p&lt;0.01) and mean COVID-GRAM critical illness risk score was 202 (92.1% risk for critical illness). Fatal outcome affected 37.8% of the patients, mainly due to severe respiratory failure, myocarditis, arrhythmias and stroke.

Conclusion
Hemodialysis patients with SARS-CoV 2 infection have an unfavorable evolution and a reserved prognosis with a high risk of death, depending especially on the need for ventilatory support. 6.25% of the patients followed had post-COVID syndrome (disseminated intravascular coagulation, severe bacterial infections, enterocolitis), but these long-term complications of the survivors will need further studies.
MO897ANXIETY AND DEPRESSIVE DISORDERS IN CHRONIC HEMODIALYSIS PATIENTS
Authors: Ezzaki Sanae , Failal Imane , Elafifi Rania , Elkhayat Salma , Elmedkouri Ghizlane , Ramdani Benyounes 
Published: May 2021

Abstract

Background and Aims
Hemodialysis is experienced as a vital need and is a heavy strain that is causing psychological distress expressed by anxiety and depression. The aim of our study was to estimate the prevalence of anxiety and depression in chronic hemodialysis patients.

Method
This is an observational cross-sectional study, carried out within the unit CASABLANCA CHU ibnrochd of hemodialysis in January of 2020 of 71 chronic hemodialysis patients, in collaboration with a psychiatrist, the scale of anxiety and depression (HAD) has been used to diagnose and assess the severity of anxiety and depression in this population.

Results
Our study included 71 chronic hemodialysis adult patients, the average age of our patients was 46.5 years, ranging from 16 to 93 years, with a sex ratio M / F 1.1, seniority average hemodialysis is 17.3 years; patients are single, married, widowed, divorced in 66%, 26%, 5% and 3% of cases, 72.5% of our patients are without profession.
None of the patients is followed by a psychiatrist or under antidepressant or anxiolytic during the study, 46% of our patients have anxiety and depression with a male predominance in 56% of cases, anxiety was found in 15% of patients, 1 case of major anxiety, the average score of anxiety is 10 ± 2, depression was found in 36% of cases and 1 case of major depression, the average depression score was 11 ± 2.

Conclusion
Anxiety and depression are common in patients on periodic hemodialysisThese results emphasizes the importance of collaboration between nephrologists and psychiatrists in order to offer hemodialysis patients psychological support and guarantee a better quality of life.
MO879PROPOSAL OF A GERIATRIC ASSESSMENT TAILORED FOR OLDER CHRONIC KIDNEY DISEASE PATIENTS: RESULTS OF A PRAGMATIC CONSENSUS-BASED APPROACH
Authors: Voorend Carlijn , Joosten Hanneke , Berkhout-Byrne Noeleen , Diepenbroek Adry , Franssen Casper , Bos Willem Jan W , Van Buren Marjolijn , Mooijaart Simon 
Published: May 2021

Abstract

Background and Aims
Unidentified cognitive decline and other geriatric impairments are prevalent in older patients with advanced kidney disease. Despite guideline recommendation of geriatric evaluation, routine geriatric assessment is not common in these patients. While high burden of vascular disease and existing pre-dialysis care pathways mandate a tailored geriatric assessment, no consensus exists on which instruments are most suitable in this population to identify geriatric impairments. Therefore, the aim of this study was to propose a geriatric assessment, based on multidisciplinary consensus, for older people with advanced chronic kidney disease.

Method
A pragmatic approach was chosen to reach agreement on a suitable set of instruments to routinely identify major geriatric impairments in older patients with advanced chronic kidney disease. This approach included focus group meetings to identify criteria for the assessment, literature review to identify potential instruments, questionnaire to inventory currently used instruments, an expert consensus meeting to ensure that the selection of tests was based on input from clinical experience in nephrology and geriatrics, and pilot testing to ensure practicability. In preparation of the consensus meeting we composed a project team and an expert panel (n=33), drafted selection criteria for the selection of instruments, and assessed potential instruments for the test-set.

Results
Selection criteria related to general geriatric domains, clinical relevance, feasibility and duration of the assessment. The consensus-set contains instruments in functional, cognitive, psychological, somatic, patient preferences, nutritional status, and social domains (Figure 1). Administration of (seven) patient questionnaires and (ten) professional-administered instruments, by nurse (practitioners), takes estimated 20 and 40 minutes, respectively. Results are discussed in a multi-disciplinary meeting including at least nephrology and geriatric expertise, informing nephrology treatment decisions and follow-up interventions amongst which comprehensive geriatric assessment.

Conclusion
This first multi-disciplinary consensus on nephrology-tailored geriatric assessment intent to benefit clinical care and enhance research comparability for older patients with advanced chronic kidney disease. The proposed geriatric assessment is currently implemented in multiple hospitals and studies. Future initiatives and studies should provide insights on effectiveness, feasibility, patient’s satisfaction and, value for shared treatment decision making and outcome improvement.
MO692COULD THE RESIDUAL RENAL FUNCTION REMAIN A KEY DETERMINANT OF PLASMA OXALIC ACID CONCENTRATION IN PERITONEAL DIALYSIS PATIENTS?
Authors: Stepanova Natalia , Korol Lesya , Snisar Lyudmyla , Lebid Larysa 
Published: May 2021

Abstract

Background and Aims
Under physiological conditions, the bulk of circulating oxalate (90% to 95%) is ultimately excreted by the kidneys. Under uremic and/or anuric conditions, dialysis is considered to be the main method of oxalate removal. Nevertheless, little evidence is available on oxalate balance in peritoneal dialysis (PD) patients. The present study aimed to evaluate the separate contribution of residual renal and peritoneal oxalate clearances to oxalate balance in PD patients.

Method
We performed a cross-sectional observational study involving 62 PD patients with the average age of 50.5±13.5 years and PD vintage of 37±24 months. Plasma oxalate (POx) concentration, levels of daily urinary (UOx) and peritoneal dialysis effluent oxalate (PDEOx) excretion were evaluated. POx concentration was measured spectrophotometrically using MAK315 kit (Sigma, Spain); UOx and PDEOx concentrations were determined using an oxalate oxidase/peroxidase reagent (BioSystems, Spain). In addition, oxalate transport status (4-hour D/P oxalate ratio), renal oxalate clearance (ROxCL) and peritoneal oxalate clearance (PerOxCL) were calculated.

Results
Among the examined PD patients were 41 (66%) patients with preserved diuresis and 21 (34%) patients with anuria. The anuric PD patients had lower PerOxCL and, accordingly, peritoneal and overall oxalate removal levels compared with the patients with preserved diuresis (Table 1).

Conclusion
The results of our research demonstrated an important role of the residual renal function in oxalate balance in PD patients. However, the decline in RRF could partially (but not completely) contribute to the increase in POx in PD patients. Thus, PerOxCL but not ROxCL could significantly affect oxalate balance in PD patients.
MO698IS PERITONEAL DIALYSIS SUITABLE METHOD FOR OBESE PATIENTS?
Authors: Damjanovic Tatjana , Bjedov Jelena , Maslarevic Radovic Vesna , Stopić Bojan , Rajcic Tatjana , Manasic Mirjana , Naumovic Radomir , Dimkovic Nada 
Published: May 2021

Abstract

Background and Aims
In recent years, obesity has reached epidemic proportions, and it's a great challenge to choose an adequate treatment for obese ESRD patients. The aim of the study was to analyze the outcome in patients with peritoneal dialysis with different degrees of nutrition expressed through body mass index at the beginning of treatment.

Method
The prospective clinical study included 53 incidental patients, who started peritoneal dialysis between June 2006 and August 2015. According to BMI on the beginning of treatment, patients were divided into three groups: normal weight: BMI of 18.5 - 24.9 kg/m2, n=17, overweight: BMI of 25 - 29.9 kg/m2, n=25, obese: BMI&gt; 30.0 kg/m2. n=11. Mechanical and infective complications, technique survival and patients survival were analyzed over 48 - months period.

Results
In terms of mechanical complications, there was no difference between the groups- malposition of the catheter (p = 0.769), leakage of dialysate (p = 0.462), hernia (p = 0.381). Exit sitе infection were most prevalent in group 3 - 1 episode/22 patient months vs 1 episode/30 patient months in groups 1 and 2, but without statistical significance (p = 0.272). However, the lowest incidence of peritonitis was in the group 3 - 1 episode/40 patient months vs 1 episode/30 patient months in group 2, and 1 episode/33 patient months in group 1, but even here the difference did not reach statistical significance (p = 0.624). Cardiovascular events – myocardial infarction, stroke and peripheral vascular disease were rare in all groups, with no statistical significance between groups. The incidence of hospitalizations was highest in the obese group – 1 episode/22 patient months vs 1 episode/27 patient months in group 2, and 1 episode/25 patient months in group 1 (p = 0.735). Kaplan Meier's analysis showed the worst, but not significant, survival of the technique in a group of obese patients (group 1 vs. group 2; p = 0.536; group 1 vs. group 3 - p= 0.662; group 2 vs. group 3 - p = 0.357). Also, overall patient survival was not differed between the groups (group 1 vs group 2 - p = 0.387; group 1 vs group 3 - p= 0.885; group 2 vs group 3 - p = 0.375). According to Cox's analysis, only values of total cholesterol at the end of the follow-up period (p = 0.027) and diastolic blood pressure (p = 0.013) were significantly associated with overall survival obese patients.

Conclusion
In the present study the degree of nutrition at the beginning of treatment had no significant effect on the outcome of peritoneal dialysis treatment. Therefore, patients should not be discouraged for peritoneal dialysis on the basis of BMI.
MO700EPIDEMIOLOGICAL ADMISSIONS IN PERITONEAL DIALYSIS IN A SINGLE DIALYSIS CENTER
Authors: Panuccio Vincenzo Antonio , Lucisano Silvia , Tripepi Rocco , Tripepi Giovanni Luigi , Mallamaci Francesca 
Published: May 2021

Abstract

Background and Aims
The knowledge of the impact of peritoneal dialysis (PD) program in terms of hospitalization rate can provide solid guidance for nephrologists for management purpose. In a historical cohort of adult PD patients, we examined the hospitalization rates and causes of hospital admissions.

Method
One hundred ninety-one consecutive PD patients between January 1st 2000 to December 31st 2018 were enrolled. The maximum follow up was 194 months. Their mean age was 65±15 years, 110 were males, 56 had co-morbidities and 67 were diabetics. The median PD vintage was 35 months (interquartile range 20-63 months).

Results
During the follow-up, 163 out of 191 patients (85%) underwent hospital admission for a total of 356 hospitalizations [57 hospitalizations per 100-person-years]. The most frequent cause of admission was infection (20 hospitalizations per 100-person-years) mainly due to peritonitis (12 hospitalizations per 100-person-years) followed by cardiovascular diseases (17 hospitalizations per 100-person-years). Hospitalizations due to miscellaneous causes were 21 per 100-person-years. In the whole group, high NYHA score [Incidence Rate Ratio (IRR): 1.52, 95%CI 1.21-1.89, P&lt;0.001], residual diuresis &lt;500 ml/die (IRR: 1.43, 95%CI 1.13-1.82, P=0.002), malnutrition (IRR: 1.47, 95%CI 1.08-1.99, P=0.01) and older age (&gt;65 years) (IRR 1.26, 95%CI 1.02-1.56, P=0.03) and were associated to all-cause hospitalizations. In an analysis by hospitalization type, the factors related to admission for infection diseases was malnutrition (IRR: 1.91, 95%CI 1.16-3.03, P=0.005) and high NYHA score (IRR: 1.52, 95%CI 1.03-2.22, P=0.02). As expected, hospitalizations due to cardiovascular causes were strongly related to older age (&gt;65 years) (IRR 2.02, 95%CI 1.35-3.03, P&lt;0.001), diabetes (IRR 2.13, 95%CI 1.43-3.18, P&lt;0.001), high NYHA score (IR 2.14, 95%CI 1.43-3.21, P=0.001], residual diuresis &lt;500 ml/die (IRR: 1.65, 95%CI 1.06-2.55, P=0.02) and previous cardiovascular events (IRR: 1.50, 95%CI 0.98-2.25, P=0.05).

Conclusion
Analyzing the causes and the rate of hospitalization in PD patients allows more accurate management of these high risk category of patients and contributes to a more efficient organization of a renal department.
MO706PATIENTS AND CENTER-RELATED FACTORS IN PERIOTONEAL CHOICE IN INCIDENT PATIENTS: A REGIONAL EXPERIENCE
Authors: Panuccio Vincenzo Antonio , Parlongo Giovanna , Tripepi Rocco , Tripepi Giovanni Luigi , Cianfrone Paola , Mollica Agata 
Published: May 2021

Abstract

Background and Aims
Effective outpatient organization is essential in the management of patients with chronic kidney disease. Although peritoneal dialysis (PD) has many advantages it is still not popular.

Method
The aim of this study was to evaluate patient and center-related factors that affect the final choice of peritoneal dialysis (PD) versus hemodialysis (HD) in the Calabrian region (Italy). We analyzed 2 annual regional surveys performed by nephrologists (2017 and 2018) in incident dialysis patients. Collected factors included: early and late referral to the dialysis program, pre-dialysis participation in outpatient visits, first dialysis access [peritoneal catheter (PC), central venous catheter (CVC), arteriovenous fistula (AVF)], final dialysis treatment (HD or PD) and the care giver.

Results
The study sample included 296 incident patients (63% males) aged 66±15 years. Time to referral influenced the type of first dialysis access. Among patients with early referral, 35% initiated dialysis by a PC, 34% by AVF and 31% by CVC, while among those with late referral, only 5% started dialysis by a PC, 15% by AVF, and the majority (80%) by CVC (P&lt;0.001). Time to referral was also associated with pre-dialysis visits (34%, 33% and 34% versus 5%, 22% and 73%, respectively, P&lt;0.001). When evaluating clinical suitability for treatment modality, 54% of early referrals and 45% of late referrals were eligible for PD. The choice of dialytic modality was again related to time to referral: 38% with early referral chose PD compared to 15% of those with late referral (P&lt;0.001). Furthermore, in patients who participated in the pre-dialysis program, 38% started PD versus 11% of patients that did not participate (P&lt;0.001). The role of the caregiver remains uncertain.

Conclusion
These data confirm that a more attentive and dedicated organization of the pre-dialysis outpatient program would contribute to a greater expansion of the peritoneal dialysis program.
MO709ASSOCIATION BETWEEN SERUM ELASTIN-DERIVED PEPTIDES AND ABDOMINAL AORTIC CALCIFICATION IN PERITONEAL DIALYSIS PATIENTS: A CROSS-SECTIONAL STUDY
Authors: Jingyuan Cao , Shizhu Zhao , Guoyuan Lu 
Published: May 2021

Abstract

Background and Aims
Peritoneal dialysis (PD) patients experience accelerated arterial aging, which is characterized by elastin degradation. Although elastin-derived peptides (EDPs) have been reported to be associated with vascular diseases, studies on the association between serum EDPs and abdominal aortic calcification (AAC) in PD patients remain limited.

Method
126 eligible PD patients were included and first grouped by the presence of AAC by an abdominal computed tomography (CT) scan. Patients with AAC were then grouped into severer and non-severer group according to the annularity of calcification. Logistic regression analysis was conducted to analyze the association between EDPs and AAC or severer AAC. Nomograms were generated to evaluate individualized risk of AAC and severer AAC.

Results
Serum EDPs were significantly elevated in PD patients compared with healthy controls (interquartile ranges: 37.65-55.02 versus 24.23-39.20 ng/mL; p&lt;0.001), and gradually increased as AAC worsens. Moreover, EDPs had the most excellent discriminatory power to differentiate AAC compared with other mineral metabolism markers. After adjustment for potential variables, higher EDPs were associated with greater risk of developing AAC (Odds ratio: 1.056, 95%CI: 1.010-1.103) and severer AAC (Odds ratio: 1.062, 95%CI: 1.004-1.123). Receiver operating curve analysis (ROC) revealed that a combination of EDPs substantially improved the accuracy of diagnostic performance for AAC and severer AAC. Nomogram demonstrated exceptional ability in recognizing PD patients with susceptibility to AAC or severer AAC.

Conclusion
Serum EDPs can predict the presence and severity of AAC in PD patients, indicating the possible roles to recognize PD patients at risk for developing AAC and severer AAC.
MO710GALECTIN-3, IS IT A NEW PLAYER IN PERITONEAL INFLAMMATION AMONG PATIENTS UNDERGOING PERITONEAL DIALYSIS?
Authors: Einbinder Yael , Cohen-Hagai Keren , Benchetrit Sydney , Zitman-Gal Tali 
Published: May 2021

Abstract

Background and Aims
Peritoneal dialysis (PD) is a common used method for renal replacement therapy. Prolonged PD treatment causes structural and functional changes in the peritoneal membrane which are attributed to local inflammatory process in the peritoneal cavity. Galectin-3 (Gal-3) is a galactoside-binding lectin with pro-inflammatory and pro-fibrotic effects. The aim of this study was to assess correlation between Gal-3 serum and dialysate effluent levels with peritoneal membrane transport characteristics.

Method
Gal-3 levels in serum and dialysate effluent were measured simultaneously in prevalent PD patients in morning visit or during peritoneal equilibration test (PET). Gal-3 levels were correlated with clinical and laboratory parameters. Interlukin (IL) -6 levels were measured in dialysate effluent. Gal-3 mRNA and protein expression were evaluated after exposure of primary endothelial cell culture to several dialysate solutions.

Results
37 PD patients were included in the study; mean age was 65.7±13.1 years, mean dialysis vintage was 17.5±13 months. Gal-3 levels in dialysate effluent correlated with peritoneal equilibration test (PET) results (0.663, p=0.005) and effluent IL-6 levels (0.674, p=0.002) but not with serum Gal-3 levels or dialysis vintage. Patients with high PET results had higher effluent Gal-3 levels as compared average low PET results. In multivariate regression analysis effluent IL-6 level was the most dominant predictor of effluent Gal-3 levels. Gal-3 mRNA and protein expression in primary endothelial cell culture were not affected by stimulation with dialysate solutions.

Conclusion
Our study demonstrated presence of Gal-3 within the dialysate effluent in PD patients. Gal-3 levels correlated with peritoneal membrane transport characteristics and effluent IL-6 levels suggesting a role in the inflammatory process within the peritoneal cavity.
MO717EFFECT ON BLOOD PRESSURE OF UNCOMPENSATED 130 MM SODIUM DIALYSATE IN CAPD PATIENT WITH RESISTANT HYPERTENSION
Authors: Borrelli Silvio , Bonomini Mario , Arduini Arduino , Palumbo Roberto , Vecchi Luigi 
Published: May 2021

Abstract

Background and Aims
In peritoneal dialysis (PD) blood pressure (BP) control is largely unsatisfied mainly due to sodium retention. Currently, sodium removal in PD patients depends substantially on ultrafiltration. Lowering sodium in PD solution might improve sodium removal by diffusion, though the real benefit of low PD solution remains still undetermined.

Method
In this case report, we used a novel uncompensated glucose-based PD solution (DextroCore LS, Iperboreal Pharma, Italy) containing 130 mM sodium to treat resistant hypertension in 78-year-old female treated by CAPD (3 dwells glucose 1.5% a day, Na 132).

Results
At baseline, Ambulatory BP monitoring (ABPM) showed 24h-BP (152/81 mmHg), diurnal BP (151/83 mmHg) and nocturnal BP (153/75 mmHg), with inversion of circadian rhythm in systolic BP (systolic night/day ratio: 1.02), despite the use of three anti-hypertensive (doxazosin 4mg, amlodipine 10 mg, telmisartan 80 mg) and diuretic (furosemide 250 mg) at adequate doses. She had no signs of hypervolemia. We switched from standard PD (132 mM/L) to low sodium PD solution using 1.5% glucose bags with sodium concentration of 130 mM. CAPD schedule was confirmed. Second ABPM after six months reported a reduction 24h BP (131/73 mmHg), diurnal (134/75 mmHg) and nocturnal BP (122/67 mmHg), with restoring of circadian BP rhythm. No change in body weight, UF and residual diuresis was found. Diet and therapy prescriptions were unmodified. No side effects were reported.

Conclusion
Six-months PD treatment with uncompensated glucose-based PD solution containing 130 mM sodium in all daily dwells has allowed to reduce systolic BP (-16 mmHg) in a CAPD patient affected by resistant hypertension, with no change in ultrafiltration and residual diuresis.