bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO589PLASMA CONCENTRATIONS OF TRIMETHYLAMINE N-OXIDE, AND ITS DIETARY DETERMINANTS ARE ASSOCIATED WITH INCREASED RISK OF GRAFT FAILURE
Authors: Flores-Guerrero Jose L , C.J. Osté Maryse , Baraldi Paula B , Connelly Margery A , Garcia Erwin , Navis Gerjan , Bakker Stephan , Dullaart Robin P F 
Published: May 2021

Abstract

Background and Aims
Due to the critical shortage of kidneys for transplantation, the identification of modifiable factors related to graft failure is highly desirable. The role of trimethylamine-N-oxide (TMAO) in graft failure remains undetermined. Here we aimed to investigate the clinical utility of TMAO and its dietary determinants for graft failure prediction in renal transplant recipients (RTRs).

Method
We included 448 RTRs who participated in the TransplantLines Cohort Study. Cox proportional-hazards regression analyses were performed to study the association of plasma TMAO with graft failure. Net Benefit, a decision analysis method, was performed to evaluate the clinical utility of TMAO and dietary information in the prediction of graft failure.

Results
Among RTRs (age 52.7 ± 13.1 years; 53% males), baseline median TMAO was 5.6 (3.0–10.2) µmol/L. In multivariable regression analysis, the most important dietary determinants of TMAO were egg intake (Std. β = 0.10 [95%CI, 0.01;0.19]; P=0.03), fiber intake (Std. β = -0.13 [95%CI, -0.22, -0.05]; P =0.002), and fish and seafood intake (Std. β = 0.11 [95%CI, 0.02,0.20]; P=0.01). After a median follow-up of 5.3 (4.5–6.0) years, graft failure was observed in 58 subjects. TMAO was associated with increased risk of graft failure, independent of age, sex, BMI, blood pressure, lipids, albuminuria and eGFR (Hazard Ratio per 1-SD increase of TMAO, 1.62 (95% confidence interval (CI): 1.22; 2.14, P&lt;0.001). A TMAO and dietary enhanced prediction model offered approximately double Net Benefit compared to a previously reported, validated prediction model for future graft failure, allowing the detection of 21 RTRs per 100 RTRs tested with no false positives versus 10 RTRs respectively.

Conclusion
A predictive model for graft failure, enriched with TMAO and its dietary determinants yielded a higher Net Benefit compared with an already validated model. This study suggests that TMAO and its dietary determinants are associated with an increased risk of graft failure and that it is clinically meaningful.
MO607THE EFFECT OF VITAMINE E ON OXIDATIVE STRESS AND CARDIOVASCULAR COMPLICATIONS IN HEMODIALYSIS PATIENTS
Authors: Azouaou toualbi Leila , Arab Medina , Toualbi Chahine , Abderrezak Khelfi , Chader Henni , Benoui Abdelghani , Seba Atmane 
Published: May 2021

Abstract

Background and Aims
Oxidative stress represents a risk factor for cardiovascular complications . The aim of the work is to evaluate the effectiveness of vitamin E on cardiovascular complications in hemodialysis patients.

Method
a study including 420 patients on hemodialysis and 360 controls. Treatment with Vit E at a rate of 300 mg / day for 2 years. All patients benefited from a blood sample of oxidative stress markers as well as paraclinical explorations in search of cardiovascular complications.

Results
The study grouped together 780 cases. We find that there is a significant relationship between cardiovascular complications and Advanced Oxidation Protein Product (AOPP), Low Density Oxidized Lipoprotein (LDLox), Malondialdehydes (MDA) and Gluthations), we did not find any correlation with nitrogen monoxide (NO) and myeloperoxidases (MPO) .Concerning gluthations (IU / ml ) we observe that the mean values clearly increased after treatment (P-value &lt;0.05) . The mean value of MDA µmol / l significantly decreased after treatment .we note that the cardiovascular complications have decreased (11.03% versus 16.04%) with the decrease in certain markers of oxidative stress. (p &gt; 0.05)

Conclusion
Regarding cardiovascular complications, we have certainly noticed a drop in their frequency after treatment with vit E without the difference being significant.
MO609PREVALENCE OF MALNUTRITION AND INFLAMMATION IN NONDIALYZED PATIENTS WITH CHRONIC KIDNEY DISEASE: A CLINICAL STUDY
Authors: Parry Manzoor , Jeelani Hamad 
Published: May 2021

Abstract

Background and Aims
The prevalence of chronic kidney disease (CKD) in India varies from 0.16–0.78%. The reported incidence of malnutrition in CKD patients is 37–84%. There is a paucity of data on the quantification of malnutrition and inflammation in undialyzed patients of CKD from north east of India. This study analyzed the prevalence and causes of malnutrition and inflammation in patients with CKD before the initiation of dialysis treatment.

Method
This study was conducted from May 2017 to May 2019 in the department of nephrology Guahati medical college hospital. Assessment of nutritional and inflammatory status was carried out in patients with CKD before initiation of dialysis. Serum albumin; body mass index (BMI); triceps skin fold thickness (TST); mid-arm muscle circumference (MAMC); and subjective global assessment (SGA) scoring were used for assessment of nutritional parameters. Serum C-reactive protein; serum albumin and serum ferritin level were used to assess the inflammatory status in these patients.

Results
A total of 528 (male:female= 359:169) patients with CKD participated in this study. Diabetic Nephropathy (35%) was the most common; followed by; hypertension (23%) and chronic glomerulonephritis (20 %). The evidence of malnutrition was noted in 344 (65%). The mean age of patients with malnutrition was 52.8±12.45 years with a male predominance (68%). On the basis of SGA score; malnutrition was noted in 344 patients (mild moderate [36%]; severe; [30%]); remaining (34%) were well nourished. Thus; evidence of Malnutrition was noted in 65% of patients with CKD.). Serum total protein & albumin were higher in the non-malnourished patients in comparison to malnourished (5.83±1.0 vs 5.31±1.12 p&lt;0.05; 3.65±0.7 vs 2.62±0.74) The inflammatory markers (serum ferritin & C reactive protein) were elevated significantly in patients with malnutrition in comparison to those without malnutrition (308.15±60.18 mg/dL vs. 251.64±63.14 mg/dL; p &lt; 0.001; 77% vs. 50%; p &lt; 0.01).

Conclusion
Malnutrition and inflammation are common in patients with CKD before the commencement of dialysis. This indicates that an emphasis should be placed on the assessment and prevention or correction of malnutrition and inflammatory burden in these patients with CKD.
MO595FREQUENCY OF INTAKE OF DIETARY FIBER SOURCES NOT ASSOCIATED WITH HYPERKALEMIA IN HEMODIALYS PATIENTS IN A MULTICENTER STUDY
Authors: Dos Santos Rafaela G , Malinovski Juliana , Scatone Natália , De Oliveira Jorgiane , Sczip Andrea , Moraes Jyana , Vieira Marcos , NERBASS FABIANA 
Published: May 2021

Abstract

Background and Aims
Patients undergoing hemodialysis (HD) treatment usually have a low intake of food groups rich in dietary fiber to avoid hyperkalemia. However, dietary potassium is not associated with serum potassium or hyperkalemia in recent studies, and higher intake of fiber food groups such as fruits and vegetables is associated with lower mortality and other complications in HD populations. This multicenter cross-sectional study aimed to investigate the frequency of intake of dietary fiber sources, its determinants, and the relationship with hyperkalemia in HD patients.

Method
Prevalent HD patients from four dialysis clinics in Southern Brazil were invited to participate (at least 80% of eligible patients from each clinic). Patients were interviewed by the researchers and answered a food frequency questionnaire (FFQ) with the main dietary fiber sources (fruits, vegetables, legumes, whole grains cereals and seeds) with seven frequency possibilities (from never to more than twice a day). To estimate the weekly frequency of intake, answers were transformed into a score. Every score point corresponded to one time per week (ex.: score 7 = seven times per week). The sum of the five scores was calculated to determine the total score. Demographical and laboratory data were obtained from medical records. Univariate analysis was used to assess total score associations, and the variables with P&lt;0.20 were included in the regression analysis model.

Results
305 HD patients were included (male: 51%; age: 52.2 ± 14.7 years old; HD vintage: 46 (19 – 82) months; hyperkalemia: 29%). Median (interquartile) FFQ scores were: fruits: 6 (2-14); vegetables: 6 (3-10); legumes: 3 (1-7); whole-grain: 0 (0-1) and seeds: 0 (0-0). Total score was 19 (14-28) and correlated with age (r=0.15; P=0.01), HD vintage (r=-0.22; P=&lt;0.001) and body mass index (BMI) (r=0.15; P=0.007). Patients with diabetes had a higher total score (22 (15-31) versus 18 (13-27) P=0.03). Only the vegetables score correlated with serum potassium (r=0.17; P=0.03) and no difference was found between dietary fiber food groups scores and total score with hyperkalemia. The linear regression analysis model also included gender and education (years at school) (all with P&lt;0.20 in the univariate analysis). The independent predictors of dietary fiber total score were age (OR=0.1 (95%IC 0.01-0.20);P=0.04), HD vintage (month) (OR=-0.03 (95%IC -0.06 - -0.01);P=0.02) and years at school (OR=0.27 (95%IC 0.85-0.46);P=0.005).

Conclusion
The usual frequency of intake of fiber sources was low, and its independent determinants were age, HD vintage and education. The lack of association with hyperkalemia suggests that other dietary sources and clinical factors should be considered to manage hyperkalemia in this population.
MO450ANEMIC PATIENTS WITH ELEVATED RED CELL DISTRIBUTION WIDTH (RDW) ARE LIKELY TO HAVE FASTER FUTURE CKD PROGRESSION
Authors: Tanaka Hiroshi 
Published: May 2021

Abstract

Background and Aims
Elevation in red cell distribution width (RDW), a marker of size variance in red blood cells, recently has been reported to predict future cardiovascular event. RDW elevation has also been reported to be associated with faster CKD progression. It is not known whether the elevation of RDW is merely a sequela of, or truly a predictor of, the decline in kidney function.

Method
A hospital-wide study with all the laboratory data for a period of 4 years and 2 months was conducted. All the adult patients in whom an eGFR slope was obtained over 731 days or more with haemoglobin (Hb) measurements of at least twice over 731 days or more were included. Hb and RDW values were classified according to the timing of measurement: first-year measurements during the period vs last-year values. The effects of Hb and RDW on the annual decline in eGFR (mL/min/1.73m2/year) were analyzed. Statistical analysis was performed with R 3.6.0 on Ubuntu.

Results
A total of 4,611 patients (M:F = 2124:2487, age 18-105 (median 68) years) were included. The first-month Hb and RDW were 7.5 − 20.2 (median 13.6) g/dL and 10.5 − 34.6 (median 12.6). eGFR was 3.4 − 195 (median 69.3) mL/min/1.73m2. Patients with the highest tertile in the first-year RDW had significantly faster decline in eGFR than the rest (-1.74 vs -1.51, P=0.04), while patients with the highest tertile in the last-year RDW had virtually identical eGFR decline compared with the rest. Patients with higher RDW (&gt;=median) and lower Hb (&lt; median) had significantly faster decline in eGFR than the rest (-1.84±4.11 vs -1.47±2.95, P =0.002).

Conclusion
Anemic patients with elevated RDW are likely to have faster CKD progression in the future.
MO451GUANIDINYLATED APOLIPOPROTEIN C3 (APOC3) A NOVEL PLAYER IN CKD AND CKD-ASSOCIATED CARDIOVASCULAR DISEASES
Authors: Schunk Stefan , Hermann Juliane , Sarah Triem , Lellig Michaela , Hahm Eunsil , Boor Peter , Reiser Jochen , Jankowski Joachim , Fliser Danilo , Jankowski Vera , Speer Thimoteus 
Published: May 2021

Abstract

Background and Aims
Cardiovascular diseases (CVD) and chronic kidney diseases (CKD) are highly prevalent in Western populations and account for a substantial proportion of mortality. We found that apolipoprotein C-3 (ApoC3), a constituent of triglyceride-rich lipoproteins, induces alternative NLRP3 inflammasome activation in human monocytes and thus causes sterile inflammation. The aim of the present study was to screen ApoC3 for the presence of posttranslational protein modifications and to assess its relevance in vitro, in vivo, as well as in a prospective cohort of CKD patients.

Method
ApoC3 was subjected to proteomic analysis. The proinflammatory properties of ApoC3 were assessed in human monocytes and in humanized mice. Moreover, posttranslationally modified ApoC3 was quantified in prospective cohort of 543 patients with various etiologies of CKD and linked to kidney and cardiovascular outcomes.

Results
We identified posttranslational guanidinylation of lysine residues of ApoC3 (gApoC3) in patients after acute myocardial infarction and in patients with CKD. gApoC3 accumulates in kidneys and hearts after injury as determined by 2D-proteomic analyses. In human monocytes, guanidinylation enhanced the binding of ApoC3 to the cell surface and exerted substantially stronger pro-inflammatory effects as compared native ApoC3. In humanized mice, gApoC3 strongly induced kidney fibrosis and abolished the regeneration after vascular injury. In a prospective clinical trial of 543 patients, higher gApoC3 blood levels as determined by mass spectrometry were associated with increased mortality as well as cardiovascular and renal events during a long-term follow-up.

Conclusion
The present study provides evidence from preclinical models and a prospective clinical trial that gApoC3 plays an important role in the development of organ injury in patients with CKD, myocardial infarction and other clinical conditions. The clinical study represents one of the largest trials, in which the association of a specific PTM and clinically relevant outcomes was assessed. These findings highlight gApoC3 as a pathophysiologically relevant factor in development of organ dysfunction.
MO454A NEW AKI TO CKD PROGRESSION IN VIVO EXPERIMENTAL MODEL
Authors: Massaro Giampiero A , Mercado-Hernandez Joana , Fuentes-Calvo Isabel , Sancho Martinez Sandra M , Quiros Yaremi , Martinez Salgado Carlos , Lopez-Hernandez Francisco J 
Published: May 2021

Abstract

Background and Aims
Chronic kidney disease (CKD) represents an enormous problem for healthcare systems. It is estimated that in USA more than 37 million people suffer from this disease. Risk factors include hypertension, diabetes mellitus, older age, proteinuria and previous episodes of acute kidney injury (AKI). Indeed, several studies have shown that AKI increases the risk of CKD, independently of other risk factors, especially when the episode is severe or recurrent. Under these circumstances, maladaptive responses may occur leading to structural and functional abnormalities. Renal fibrosis is the hallmark for maladaptive repair and is considered the final common outcome of progressive kidney disease. We hypothesized that after multiple renal insults, the mechanisms of adaptive repair could be less effective generating a progressive accumulation of extracellular matrix and a progressive deterioration of kidney function.

Method
We used 8 weeks old male Wistar rats and we analyse their evolution during 9 months. Animals were subdivided into 4 experimental groups: Control group: SHAM operated rats, saline solution, i.p.; “CDDP5-I/R60-I/R60” group: 5 mg/kg cisplatin i.p., after renal function normalization, 60-minute ischemia-reperfusion (I/R60) on left kidney, and 2 weeks later 60-minute ischemia-reperfusion (I/R60) on right kidney; “5/6 RMR” group: 5/6 renal mass reduction; “UNX” group: nephrectomy. Blood and urine were collected at: day 0 (basal); day 4 (AKI development); day 8 (normalized renal function after AKI and induction of renal ischemia); day 9 (1 day after ischemia); day 13, day 20 and monthly thereafter. Renal function was analyzed by sCr, creatinine clearance, blood urea nitrogen and proteinuria determination using colorimetric methods. Tissue samples were stained with Masson´s trichrome and Sirius Red at days 13, 20, 56, 165 and 270 and renal fibrosis was quantified using Image J program.

Results
The addition of several AKI episodes induces a progressive accumulation of extracellular matrix. In addition, the “CDDP5-I/R60-I/R60” group presented an initial reduction in renal function that remained stable in the last 6 months of the study. On the contrary, we observed a spontaneous and progressive decline of kidney function in the “5/6 RMR” group, which nevertheless presented a significant lower degree of interstitial fibrosis than the “CDDP5-I/R60-I/R60” group.

Conclusion
We have generated a new in vivo experimental model of AKI to CKD transition combining nephrotoxic and ischemic AKI. We demonstrate that after recurrent episodes of AKI, kidneys show progressive interstitial fibrosis which however does not correlate with a progressive decline of renal function.
MO460ASSOCIATION BETWEEN CARBAMYLATED ALBUMIN, GUT MICROBIOTA AND THEIR DERIVED METABOLITES IN CHRONIC KIDNEY DISEASE
Authors: Steenbeke Mieke , Valkenburg Sophie , Van Biesen Wim , Delanghe Joris , Speeckaert Marijn , Glorieux Griet 
Published: May 2021

Abstract

Background and Aims
Chronic kidney disease (CKD) is characterized by gut dysbiosis. We recently demonstrated a decrease of short-chain fatty acid (SCFA) producing bacterial species with the progression of CKD. Besides, levels of protein-bound uremic toxins (PBUTs) and post-translational modifications of protein are increased in CKD, both are risk factors for accelerated cardiovascular morbidity and mortality. The link between the gut-kidney axis and protein carbamylation is unclear. The aim of the study was to explore the relation between carbamylated albumin, estimated by the albumin symmetry factor, and plasma levels of PBUTs, fecal levels of SCFAs (ongoing), and the abundance of related gut microbiota in different stages of CKD (1-5).

Method
The study cohort includes 103 non-dialyzed CKD patients (stages 1-5). Serum proteins were detected by capillary electrophoresis and UV absorbance at 214 nm with the symmetry factor as a marker of albumin carbamylation [the lower the symmetry factor, the more carbamylated albumin].
The quantification of PBUTs and SCFAs in plasma and fecal samples, respectively, using validated UPLC methods.

Results
The Pearson correlation coefficient (r) shows a positive correlation between the albumin symmetry factor and the estimated glomerular filtration rate (eGFR) (r=0.3025; p=0.0019).
The albumin symmetry factor correlates positively with the abundance of Butyricicoccus spp. (r= 0.3211; p=0.0009), Faecalibacterium prausnitzii (r=0.2765; p=0.0047) and Roseburia spp. (r=0.2527; p=0.0100) and negatively with the PBUTs, p-cresyl sulfate (pCS) (r=-0.2819; p=0.0039), p-cresyl glucuronide (pCG) (r=-0.2819; p=0.0039) and indoxyl sulfate (IxS) (r=-0.2650; p=0.0068).

Conclusion
The decreased abundance of SCFA producing gut bacteria with the progression of CKD can evoke unfavorable conditions in the gut. This can contribute to increased plasma levels of PBUTs potentially (indirectly) playing a role in albumin carbamylation. It will be further explored whether fecal levels of SCFAs are affected in parallel and could be potential targets to restore gut dysbiosis and uremia.
MO462TIME-TRAJECTORIES OF RENAL FUNCTION AND OUTCOMES IN ELDERLY INDIVIDUALS WITH CKD OF VARIOUS ETIOLOGY
Authors: Zicarelli Mariateresa , Comi Alessandro , Patella Gemma , Cianfrone Paola , Coppolino Giuseppe , Comi Nicolino , Fuiano Giorgio , Bolignano Davide , Andreucci Michele 
Published: May 2021

Abstract

Background and Aims
Despite hypertension ranks among the leading causes of chronic kidney disease (CKD), the impact of chronic hypertensive nephropathy, the so-called “nephrosclerosis” (NS), on CKD progression towards end-stage kidney disease (ESKD) is often unpredictable, particularly in older populations. We run a prospective, observational study to define renal function patterns and outcomes in elderly individuals with or without NS-related CKD.

Method
304 elderly patients with already established CKD (mean age 69±4 y; mean eGFR 44.2±19.6 mL/min/1.73 m2; male= 64.1%), followed in our outpatients’ clinic were categorized according to the etiology of CKD. NS was defined as the presence of CKD associated with long-term essential hypertension, hypertensive retinopathy, left ventricular hypertrophy and minimal proteinuria. Time-trajectories in eGFR (CKD-Epi) were computed over a 4-year follow-up. In addition, we analysed the occurrence of a composite outcome of doubling of serum creatinine, eGFR reduction≥ 25% and/or ESKD needing dialysis or kidney transplantation.

Results
CKD was secondary to nephrosclerosis (CKD-NS) in 220 (72.3%) patients. Among the remaining 84 (27.7%), glomerular/diabetic diseases were the most frequent cause of CKD (47.6%). In the whole cohort, the average estimated annual GFR slope was of 1.8 mL/min/1.73 m2. eGFR decline was slower in CKD-NS as compared with the one of others (1.4 vs. 3.4 mL/min/1.73 m2; p&lt;0.001. Figure 1). The composite renal outcome during follow-up (median 36 mo.; range 6-48) occurred less frequently among elderly with CKD-NS (16/204 vs 14/70; p=0.01 Crude HR 0.43, 95%CI 0.22-0.85) and was associated at logistic analyses with etiology of CKD, serum total cholesterol, serum LDL cholesterol levels and glycemia (p ranging from 0.01 to 0.04).

Conclusion
Despite being highly prevalent in the elderly, NS is associated with a more favorable renal disease course as compared with other conditions. Therapeutic efforts to delay CKD progression in older populations should go beyond just optimizing blood pressure control and focus more on concomitant diseases.
MO463EVIDENCE OF MICROALBUMINURIA AND ESTIMATED GLOMERULAR FILTRATION RATE DECLINE AS CHRONIC KIDNEY DISEASE RISKS IN NON-ALCOHOLIC FATTY LIVER DISEASE PATIENTS: META-ANALYSIS OF COHORT STUDIES
Authors: Putra Boby Pratama , Putra Felix Nugraha 
Published: May 2021

Abstract

Background and Aims
Recent evidences showed an association between NAFLD and extrahepatic manifestations such as chronic kidney disease (CKD) although the result is still inconclusive. This study aims to measure the association of microalbuminuria and estimated glomerular filtration rate (eGFR) decline as CKD risks in NAFLD patients.

Method
Comprehensive searching using predefined queries was done through online databases Pubmed, EMBASE, ScienceDirect, and The Cochrane Library to include all relevant literature until November 2020. We included all cohort studies of NAFLD patients diagnosed by ultrasonography (USG), commutated tomography (CT), or scoring system fatty liver index (FLI) that reports microalbuminuria and eGFR decline below 60 ml/min/1.73m2. Bias risk was assessed by The Newcastle-Ottawa Scale for cohort studies. Analysis of this study was performed to provide pooled hazard ratio (HR) with 95% confidence interval (CI) using random-effect heterogeneity test.

Results
We included 10 cohort studies met our criteria. Analysis of 6 NAFLD cohort studies diagnosed by USG is significantly associated with eGFR decline (pooled HR = 1.54, 95% CI 1.13 to 2.11, p=0.006, I2=88%), while NAFLD patients diagnosed by FLI also showed significant association with eGFR decline (pooled HR = 1.58, 95% CI 1.52 to 1.64, p&lt;0.0001, I2=0%), thus overall analysis combined with CT diagnostic modalities showed significant association between NAFLD and eGFR decline (pooled HR=1.53 95%CI 1.29-1.80 p&lt;0.00001 I2=82%). Microalbuminuria risk is significantly increased in NAFLD patients (pooled HR = 1.93, 95% CI 1.39 to 2.67, p&lt;0.0001, I2=0%). Surprisingly, NAFLD patients whose increased gamma-glutamyltransferase (GGT) has higher eGFR decline risk (pooled HR = 1.73, 95% CI 1.02 to 2.92, p=0.04, I2=78%).

Conclusion
Microalbuminuria and eGFR decline are associated as CKD risks in NAFLD patients. However, further studies are still needed to establish the causality.