bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO161DIABETIC NEPHROPATHY AS AN ADDITIONAL FACTOR CAUSES DISTURBANCES IN T CELL IMMUNITY IN CHRONIC KIDNEY DISEASE PATIENTS
Authors: Sampani Erasmia , Lioulios Georgios , Dimitriadis Chrysostomos , Mitsoglou Zoi , Daikidou Dimitra Vasileia , Tsouchnikas Ioannis , Asouchidou Despoina , Fylaktou Asimina , Papagianni Aikaterini , Stangou Maria 
Published: May 2021

Abstract

Background and Aims
Chronic kidney disease (CKD) and Diabetes Mellitus (DM), are chronic inflammatory conditions, and may both affect T-cell immunity. However, our knowledge about alterations of specific T cell subpopulations, as well as the further modifications occurring after dialysis initiation, is limited. The present study aimed to investigate the changes of T lymphocyte subtypes in CKD patients due to Diabetic Nephropathy (DN-CKD) and compare to nonDN-CKD patients. Furthermore, the effect of dialysis, was also estimated in both groups.

Method
In 30 DN-CKD, 30 nonDN-CKD patients and 25 healthy individuals, cytometric analysis of T cell subpopulations was performed, including CD4+, CD8+, CD4+CD28null, CD8+CD28null, Natural Killer cells and Tregs. Measurements were performed at the day started (T0) on either hemodialysis (HD) or continuous ambulatory peritoneal dialysis (CAPD) and repeated six months later (T6).

Results
At time T0, CD4+, NK cells and Tregs were significantly reduced (p=0.001, p=0.01, p&lt;0.0001, respectively), while CD28null cells were increased (p=0.005) in CKD patients compared to controls. CD4CD28null and CD8CD28null (%) cells were increased in DN-CKD compared to nonDN-CKD (p=0.03, p=0.02, respectively). At time T6, a significant increase in total CD28null cells were noticed in DN patients (p=0.05) but not in nonDN patients. More interestingly, DN-CKD patients who started on HD showed a significant increase in CD4CD28null cells [from 30(14-100) to 52.7(15-203), p=0.02], CD8CD28null cells [from 130(47-400) to 212(25-1192), p=0.02] and NK cells [from 137(56-275) to 266(103-456), p=0.01], while those DN-CKD started on CAPD showed a significant reduction in the percentage of CD4CD28null cells [from 9.8(2.9-19.8) to 6.9(1.3-+18), p=0.05].

Conclusion
Patients with CKD due to DN are more likely to have impaired T cell immunity, mainly regarding CD28null cells, which further deteriorates after initiation of HD. Instead, CAPD method seems to ameliorate those changes.
MO162IMPACT OF THE IMMUNOSUPPRESSIVE TREATMENT, X-RAY EXPOSITION AND RENAL PATHOLOGY ON OVARIAN RESERVE IN YOUNG WOMEN
Authors: Julia Rasała , Anna Ciszewska , Król Małgorzata , Kusztal Mariusz , Katarzyna Kościelska-Kasprzak , Tukiendorf Andrzej , Kanafa Maciej , Hanna Augustyniak-Bartosik , Mazanowska Oktawia , Magdalena Krajewska 
Published: May 2021

Abstract

Background and Aims
Cyclophosphamide treatment and X-ray exposition in the area of the ovaries are proven to be the gonadotoxic factors in childbearing age women. Anti-Müllerian hormone (AMH) is regarded as a biomarker for ovarian reserve.

Method
The study included 167 consecutive premenopausal women attending Nephrology Clinic who gave informed consent and met exclusion criteria (past ovarian surgical procedure, PCOS, eGFR &lt;30ml/min, irregular menstrual cycles). Clinical (renal pathology, smoking, X-rays exposition, eGFR standardized MDRD4, contraceptives) and demographic characteristics, as well as previous and current immunosuppressive therapies were recorded. Serum AMH levels were measured by Beckman Coulter’s Gen II enzyme linked immunosorbent assay (ELISA) kit; AMH levels were classified as low or normal/above age-adjusted reference levels (published norms).
Statistical analysis included both regressive and non-regressive relationships between the studied clinical features. Due to the presumption of the remaining non-regression relationships between clinical factors, an original taxonomic method by Marczewski & Steinhaus was used instead of general linear modeling. Based on patient age, eGFR, renal pathology an ‘optimal’ segregation of patients was performed following the created classification tree (dendrogram).

Results
Median age of the patients was 33 (range 18-44). Median AMH concentration was 2,66 ng/ml; AMH levels were classified in 64 females as low (median 1,015) and in 103 as normal/above age-adjusted reference (median 4,04). Sixty one patients were treated with cyclophosphamide in the past and 45 underwent kidney transplantation. 92 women suffered from glomerulonephritis, 44 from lupus nephritis, 12 from interstitial kidney disease, 5 from ADPKD and 14 from other kidney diseases.
Age, eGFR, pregnancies in the past as well as being the kidney transplant recipient were the coefficients strongly correlated with AMH level. Presence of lupus nephritis was correlated with lower levels of AMH in comparison to other renal diseases and in contrast to cyclophosphamide. X-ray exposition measured in cumulative lifetime dose was not correlated with AMH levels.

Conclusion
Although previous researchers suggested cyclophosphamide to be the strong gonadotoxic factor, our statistical analysis approach shows that lupus as the disease often treated with cyclophosphamide may be the lowering ovarian reserve factor itself. Further studies on this subject are still necessary.
MO168MANAGEMENT OF ANTICOAGULANT RELATED NEPHROPATHY: SLOVENIAN CASE SERIES AND REVIEW OF CURRENT KNOWLEDGE
Authors: Večerić-Haler Željka , Belčič Mikič Tanja , Kojc Nika , Frelih Maja , Ales Rigler Andreja 
Published: May 2021

Abstract

Background and Aims
Anticoagulant-related nephropathy is a recently recognized form of acute kidney injury associated with previously underdiagnosed kidney damage in addition to (usually) excessive anticoagulation. It occurs in patients receiving warfarin as well as those receiving direct oral anticoagulants.

Method
We collected and analyzed cases of Slovenian patients with pathohistologically documented anticoagulant-related nephropathy associated with all types of anticoagulant treatment from the first case in 2014 to 2020. We also performed an analysis of previously documented cases of anticoagulant-related nephropathy in the global literature (PubMed) in the period from their first mention until recently.

Results
In Slovenia, 13 patients with anticoagulant-related nephropathy have been histologically verified so far. All patients were diagnosed with concomitant underlying renal disease, and 80% had IgA nephropathy, which was disproportionately mild according to the degree of renal function impairment. After supportive measures and reversal of excessive anticoagulation, 8 of 13 patients were further treated with corticosteroids, resulting in significant improvement in renal function. During the follow-up period, a total of one steroid-treated patient died due to infectious complications and one patient progressed to end-stage renal failure. In the worldwide literature, we found 46 case reports or case series of patients with anticoagulant-related nephropathy. Failure of restitution of renal function with the need for maintenance dialysis was reported much more frequently compared to the results of our cohort (up to 67% vs. 8.3%)

Conclusion
To our knowledge, the Slovenian cohort of patients with histologically established anticoagulant-related nephropathy is the largest reported series to date that received corticosteroid therapy in addition to conservative measures. Our results indicate that steroids have a beneficial effect, likely exerted via suppression of hemoglobin-associated oxidative stress and inflammation. However, considering the polimorbidity of these patients, the benefit of additional steroid therapy must be weighed against the potential risks of side effects, especially life-threatening infections.
MO127CLEARED PODOCYTES AND NORMAL KIDNEY FUNCTION IN CLASSICAL FABRY MALES 15 YEARS AFTER START OF ENZYME REPLACEMENT THERAPY AT YOUNG AGE*
Authors: Tøndel Camilla , Riisnes Idunn , Leh Sabine , Larsen Kristin Kampevold , Skrunes Rannveig , Marti Hans-Peter , Svarstad Einar 
Published: May 2021

Abstract

Background and Aims
Fabry nephropathy may progress to kidney failure despite enzyme replacement therapy (ERT) when the treatment is initiated at a relatively late stage of the disease. This study evaluates long term effects of agalsidase in serial kidney biopsies and functional measurements in men with classical Fabry disease that commenced ERT at a young age.

Method
Six male Fabry patients with a median age of 20 years (range 7-30 years) at start of ERT were monitored over a median time of 15 years (range 14.5-17.0 years). The patients were treated with an agalsidase dose of 1.0 mg/kg/every other weak (eow) for 8.3 years (range 5-12 years) and with an agalsidase dose of 0.2-0.5 mg/kg/eow for 7.6 years (range 3-10 years). Kidney biopsies were evaluated with the scoring system of the International Study Group of Fabry Nephropathy (ISGFN) using both plastic embedded and paraffin embedded tissue with scoring of podocyte globotriaocylceramide (Gb3) in semithin toluidine blue sections (maximum score 4.0) and scoring of vacuolization in PAS-sections (maximum score 3.0). ISGFN composite score consists of both tissue scores giving a maximum score of 7.0. Renal function was evaluated with measurement of glomerular filtration rate (GFR) with iohexol clearance (mGFR) and urinary albumin creatinine ratio (uACR). Values are given in median (range).

Results
Kidney biopsies at baseline contained 24 (13-42) evaluable glomeruli and had an ISGFN composite score of 7.0 (6.9-7.0). After 15 years the ISGFN composite score had decreased to 0.56 (0-4.29), scored in 24 (9-52) evaluable glomeruli. At baseline mGFR was 106 (86-113) ml/min/1.73 m2 and after 15 years mGFR decreased to 97 (73-134) ml/min/1.73 m2. uACR was 5.6 (0.1-13.6) mg/mmol at baseline and had after 15 years increased to 10.0 (1.0-107) mg/mmol. The youngest patient had significant proteinuria with uACR 107 mg/mmol due to a chronic C3-glomerulonephritis superimposed on Fabry disease. Median uACR without this patient was at 15 years 5.8 (1.0-17.7) mg/mmol. The two youngest patients had no Gb3 visible (ISGFN composite score of 0) in their last biopsy and mGFR was normal in both. In all patients the reduction of podocyte-Gb3 was higher on an agalsidase dose of 1 mg/kg/eow; change composite score -4.66 (-7.9 to -1.8), compared to on an agalsidase dose of 0.2-0.5 mg/kg/eow; change composite score -0.15 (-5.1 to + 1.0).

Conclusion
Initiation of ERT at a relatively young age may clear the long living kidney cells of Gb3 and protect the kidneys from significant functional loss over a very long time period. The reduction of Gb3 in podocytes is higher on high dose compared to low dose of agalsidase.
MO172HYPONATREMIA IN PATIENTS WITH COVID19
Authors: Castillo-Rodríguez Esmeralda , Villa Daniel , Álvarez Nadal Marta , Regueiro Toribio Paula , Fernandez Lucas Milagros 
Published: May 2021

Abstract

Background
Among laboratory abnormalities described in the context of SARS-COV-2 infection, hyponatremia seem to be the most common. The mechanism of this sodium disbalance is not well known.

Aims
Characterize the incidence, etiology and prognostic value of sodium disbalance in patients with COVID19.

Method
Observational pilot study with 37 patients admitted to Hospital Ramon y Cajal in Madrid, Spain, between March and April 2020, with a confirmed diagnosis of COVID19. Patients were followed until discharge or death. Clinical and laboratory data were collected at admission and before the clinical outcome. Variables were analyzed comparing hyponatremic vs eunatremic patients.

Results
Distribution of patients according to their serum sodium was as follows: 16 patients with hyponatremia (44%), 19 with normal serum sodium (51%) and 2 with hypernatremia (5%). The average sodium level in hyponatremic patients was 130 ±3.2 mmol/l, median urine sodium was 36 ±3.2 mmol/l (only 6 urine sample available). Hyponatremia was associated with dyspnea at admission and with higher levels of LDH, neutrophil cells account and C reactive protein. However, no worse prognostic was associated with lower serum sodium. All patients recover sodium levels at discharge treated with salt supplementation and free water intake.

Conclusion
mild hyponatremia is a common electrolyte disorder associated with COVID19. Sing as low urine sodium and recover with water and salt ingestion, point toward hydrosaline dehydration instead of SIADH as most common origin of hyponatremia.
MO177RENAL PROXIMAL TUBULAR DISORDER AND RENAL FUNCTION LOSS IN HIV-INFECTED PATIENTS TREATED WITH TENOFOVIR DISOPROXIL FUMARATE
Authors: Zhao Bingbin , Shi Xiaoxiao , Ma Tiantian , Li Jiaying , Xia Peng , Yu Yang , Lv Wei , Chen Limeng 
Published: May 2021

Abstract

Background and Aims
Tenofovir disoproxil fumarate (TDF), as the most common antiviral drug, can cause both proximal tubular transportation dysfunctions and eGFR decline. The relationship between them is not clear due to lack of clinical data from large cohorts, especially in the Chinese population. In this study, we summarized the characteristics of proximal tubular injuries and eGFR decline in the cohort of HIV-infected patients treated with TDF, and explore the the impact of tenofovir on tubular transporters in vitro.

Method
We enrolled HIV-infected patients treated with TDF, who were regularly followed up in our hospital from Sep 1, 2001 to August 31, 2019. Their baseline and follow-up clinical data were collected. Proximal tubular dysfunction was defined as meeting two or more of the following criteria: hypophosphatemia, hypouricemia, low carbon dioxide binding capacity, positive urine glucose with normal plasma glucose level, and positive urine protein. Rapid deterioration of renal function was defined as the annual decline rate of eGFR exceeding 5ml/min/1.73m2. We also used human renal proximal tubular epithelial cell line (HK2) to further investigate the impact of tenofovir on transporters including SGLT2, NaPi-IIa, and URAT1 through immunofluorescence.

Results
A total of 375 HIV-infected patients receiving TDF were enrolled, mainly males (90.1%), with a median follow-up duration of 34(17, 58) months. The most common clinical manifestations were proteinuria (20.3%) and hypophosphatemia (12.3%). The prevalence of proximal tubular injury was 6.7%, which was significantly associated with low body weight, but was not associated with age, TDF course, baseline viral load, or baseline CD4+ T lymphocyte count. Their eGFR levels at the end of the follow-up were significantly lower than the baseline levels (104.6±15.2 vs. 110.6±14.2 ml/min/1.73m2, P&lt;0.001). The average annual decline rate of eGFR was 5.0± 22.7 ml/min/1.73m2, and 23.6% of our patients had an annual decline rate of eGFR exceeding 5 ml/min/1.73m2. Rapid deterioration of renal function (≥ 5 ml/min/1.73m2 per year) was significantly associated with female but not related to proximal tubular dysfunction in multivariate logistic regression analysis. In vitro, the survival rate of HK2 cells was more than 95% when treated with tenofovir with a concentration of 1μmol/L for 48h. The expression levels of transporters (SGLT2, URAT1, and NaPi-IIa) were declined under the condition.

Conclusion
Among the HIV-infected Chinese patients treated with TDF, 6.7% had proximal tubular dysfunction and 23.6% showed accelerated annual decline rate of eGFR (≥ 5 ml/min/1.73m2 per year).
MO181ULTRASOUND ASSESSMENT OF KIDNEY SIZE AND ITS CORRELATION WITH BODY MASS INDEX IN HEALTHY VOLUNTEERS WITHOUT RENAL DISEASE
Authors: Mohammed Nazma , Latief Muzamil , Parry Manzoor , Yadla Manjusha 
Published: May 2021

Abstract

Background and Aims
Renal length as well as renal cortical thickness has been closely related to creatinine clearance in patients with chronic kidney disease. Our primary aim was to establish a normal range of values for kidney length in our adult population with normal renal function.

Method
This was a prospective observational study. Ultrasonographic assessment of renal parameters in 499 healthy volunteers between 18 to 80 years of age was done. Volunteers with any known renal condition or any co-morbidity were excluded from the study population. Correlation between body mass index (BMI) and renal parameters was assessed.

Results
Out of 499 volunteers 327 (65%) were males and 172(35%) were females. 17.8% volunteers were less than 30 years of age, 51.5% volunteers were in the age group of 30-60 years and 30.7 % were above 60 years of age. Mean BMI in males was 25.20 ± 3.96 kg/m2 whereas mean BMI in females was 24.08 ± 3.28 kg/m2. In males the mean cortical thickness in right kidney was 13.68+/- 2.47 mm and in left kidney cortical thickness was 13.94 ± 2.6 mm. In females right kidney cortical thickness was 12.63 ± 1.91 mm and left kidney cortical thickness was 13.40 ± 2.37 mm. In the present study the right mean renal length was 9.9 ± 40cm and left renal length was 10.19 ± 0.97cm. In our study, there was positive correlation BMI with renal length.

Conclusion
Size of kidney has significant ethnic and geographic basis and there is a positive correlation between BMI and kidney size in our study population.
MO128RETINOL BINDING PROTEIN (RBP) - NEW BIOMARKER OF KIDNEY INJURY IN MULTIPLE MYELOMA PATIENTS*
Authors: Woziwodzka Karolina , Malyszko Jolanta , Banaszkiewicz Małgorzata , Koc- Żorawska Ewa , Dumnicka Paulina , Jurczyszyn Artur , Batko Krzysztof , Tisończyk Joanna , Gołasa Paulina , Krzanowski Marcin , Zorawski Marcin , Małyszko Jacek , Drozdz Ryszard , Krzanowska Katarzyna 
Published: May 2021

Abstract

Background and Aims
The aim of the study was to analyse the utility of retinol binding protein (RBP) in case of renal impairment in MM patients and investigate its relationship with acclaimed parameters of renal failure and markers of MM stages.

Method
We recruited 73 patients (35 women, 38 men, in age range of 29-90 years, mean 70 ± 10 years) with multiple myeloma (MM), including 6 (8%) with smoldering MM, 40 (55%) with International Staging System (ISS) stage I, 15 (21%) with ISS II and 12 (16%) with ISS III. The majority of patients (65, 89%) received at least one treatment scheme. Thirty patients (41%) received maintenance treatment at recruitment. Median eGFR based on serum creatinine (CKD-EPICr) equaled 67 (range 9 – 117) ml/min/1.73 m2.

Results
Significant correlation was observed between RBP and the ordered variable describing MM stage from smoldering myeloma to ISS III (R=0.36; p=0.002). There were no differences between patients in CR, PR, SD and PD at the time of samples’ collection. Patients who were on maintenance treatment at recruitment tended to have higher serum RBP (median 42.6 versus 37.7 mg/l), however, the difference was not statistically significant (p=0.068). The patients who received steroid treatment had significantly higher RBP concentrations. There were no such association with other medications. There was no association between RBP and the number of previous treatment lines (p=0.8). Serum RBP did not differ between men and women (p=0.7) and did not correlate with age (p=0.6).
Significant correlations were found between RBP and serum creatinine, cystatin C and eGFR values calculated based on creatinine and/or cystatin C (Table 1). In multiple regression, serum creatinine or cystatin C and the treatment with steroids were associated with RBP independently of ISS stage (Table 2).
Moreover, RBP correlated with β2-microglobulin, LDH, leukocyte count, α-klotho, FGF-23, GDF-15, uNGAL and uIGFBP-7, however, only the associations with β2-microglobulin and sTfR were independent of serum creatinine in multiple regression (Table 1).
Baseline serum RBP concentration was significantly correlated with eGFR after a median of 19 months follow-up (range 1-24 months) (R=-0.35; p=0.003), however, the correlation was not independent of baseline serum creatinine ((beta ± SE: 0.06 ± 0.10; p=0.5). To the contrary, baseline serum cystatin C (beta ± SE: -0.36 ± 0.13; p=0.009) predicted final eGFR independently of baseline serum creatinine.

Conclusion
RBP may be useful marker in renal damage in patients with chronic kidney injury among patients with MM. This can lead to noninvasive biomarker-targeted diagnostic interventions and contribute to early beginning of treatment that may improve life expectancy quality of life in MM.
MO182CRYSTALLINE LIGHT CHAIN CAST NEPHROPATHY IS ASSOCIATED WITH EARLY MORTALITY IN PATIENTS WITH MULTIPLE MYELOMA
Authors: Lin Zishan , Zhang Xu , Yu Xiaojuan , Wang Suxia , Cen Xinan , Zhou Fude , Zhao Minghui 
Published: May 2021

Abstract

Background and Aims
Light chain cast nephropathy is the most common paraprotein-associated kidney lesion in patients with multiple myeloma (MM). Rarely, light chain cast nephropathy could show crystalline appearance in patients with multiple myeloma, also known as crystalline light chain cast nephropathy. We here report the first retrospective study of crystalline light chain cast from a single centre.

Method
All native kidney biopsies were retrospectively studied in the Peking University First Hospital from 2000 to 2020. Newly diagnosed MM patients with were enrolled. Patients with light chain cast nephropathy at least one cast with crystalline appearance were identified as crystalline light chain cast nephropathy (Figure 1, n = 8), others were identified as ordinary light chain cast nephropathy (n = 18).

Results
The cohort of crystalline light chain cast nephropathy consisted of 6 men and 2 women with a median age of 59.5 (range, 41-73) years. All patients suffered from advanced multiple myeloma (1 with ISS staging II, 7 with ISS staging III) and acute kidney injury with a median eGFR of 5.59 (range, 2.27-26.04) mL/min/1.73m2. All patients except 1 required emergency dialysis at admission. Microhematuria was presented in 3 patients. Median proteinuria was 2.13 (rang, 0.83-3.59) g/24h and median serum albumin was 38.2 (30.7-46.7) g/L. No one presented with nephrotic syndrome. Monoclonal immunoglobulin, detected in all patients on serum protein immunofixation electrophoresis, was λ alone in 5 patients, κ alone in 1 patient, IgG λ in 1 patient, IgA λ in 1 patient.
The 8 patients were followed up with a median time of 8 (range, 2-24) months. Three patients received VAD chemotherapy and 5 patients received bortezomib based regimens. At the time of last follow-up, 2 of 7 patients who needed emergency dialysis got rid of dialysis and the rest remained dialysis-dependent. Five patients died with a median time of 5 (range, 2-19) months, 2 patients achieved partial remission and 1 patient achieved complete remission.
There was no significant difference in clinical features, treatments and main outcomes between crystalline light chain cast nephropathy patients and ordinary light chain cast nephropathy patients (Table 1). However, crystalline light chain cast nephropathy patients had higher early mortality than ordinary light chain cast nephropathy patients (50.0% vs 11.1%, p = 0.03).

Conclusion
Crystalline light chain cast nephropathy patients usually presented with acute kidney injury requiring emergency dialysis. Although various types of monoclonal immunoglobulin were detected, there was a dominance of the λ isotype. Compared to ordinary light chain cast nephropathy patients, crystalline light chain cast nephropathy patients had higher early mortality.