bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO529PREVALENCE AND DETERMINANT FACTORS OF DEPRESSION AND ANXIETY IN PEOPLE WITH CHRONIC KIDNEY DISEASE : A MOROCCAN CROSS-SECTIONAL STUDY
Authors: Chrifi Alaoui Amina , Omari Mohammed , Qarmiche Noura , Kouiri Omar , Chouhani Basmat Amal , Sqalli Houssaini Tarik , Tachfouti Nabil , Ei Fakir Samira 
Published: May 2021

Abstract

Background and Aims
The Chronic kidney disease (CKD), like many chronic illnesses, is invariably associated with various psychiatric conditions and poorer quality of life. This study aims to assess the prevalence of depression and anxiety among CKD patient and their determinant factors.

Method
this is a cross sectional single center study in a Moroccan university hospital. Patients aged ≥ 18 years old and followed for more than one year were included. The data was collected using a questionnaire for sociodemographic and clinical information and the Hospital anxiety and depression scale (HADS) to assess depression and anxiety prevalence. After the description of the population’s characteristics, the statistical analysis aimed to assess the association between depression and anxiety disorders and the estimated glomerular filtration rate before and after adjustment on several confounding factors.

Results
88 patients were included (63.6% of them were women, the mean age was 61.8±14.0 years), 21 were on stage 3, 46 were on stage 4, and 21 were on stage 5 of the CKD. The median of depression sub-score was 5.00[2.00; 10.0], the median of anxiety sub-score was 6.00[4.00; 9.00], and the median of the global score was 11.0[7.00; 20.0], 22.0% of included patients had depression and 22.0% had anxiety. Both depression and anxiety scores were associated to eGFR before and after adjustment (p= 0.001, p&lt;0.001and p=0.04, p=0.03 respectively).

Conclusion
This study showed that depression and anxiety are strongly related to the CKD progression, which should motivate both doctors and nurses to improve their psychological care toward CKD patients.
MO531IMPACT OF INFLAMMATORY MARKERS IN COGNITIVE IMPAIRMENT IN CHRONIC KIDNEY DISEASE PATIENTS
Authors: Rroji (Molla) Merita , Shehaj Larisa , Barbullushi Myftar 
Published: May 2021

Abstract

Background and Aims
Cognitive impairment is an increasingly identified major cause of chronic disability and is commonly found in patients with chronic kidney disease (CKD). Knowledge of the link between kidney dysfunction and impaired cognition may enhance our understanding of risk factors impacting cognitive dysfunction. Our study aimed to evaluate the relation between serum inflammatory markers and the risk of cognitive decline among adults with CKD.

Method
Forty-six patients predialysis patients CKD stage 5 (mean age 55.6±11.5 years old) accepted to participate in the study. The Montreal Cognitive Assessment (MoCA) scale was administered to patients. Patients with a MoCA global score of 24/30 were considered cognitively impaired. Descriptive analysis was done for the socio-demographic and clinical variables. We measured high-sensitivity C-reactive protein (hs-CRP), ferritin level, albuminemia, and fibrinogen in baseline plasma samples.

Results
The mean total MoCA score for all the patients was 22.9 ±3.8 points. Thirty-seven patients, 57.7%, were evaluated with CI, where 74.6 % with Mild CI (MCI) and 25.4% with severe CI (SCI) under 20 points). MoCA subscale analysis revealed that the mean score for visuospatial/executive domain and attention were the lowest with 5.41±1.1 /8max and 2.93±1.75/6 max, and scores for orientation were the highest 5.92±0.57/6 max. At baseline, higher levels of each inflammatory marker were associated with poorer age-adjusted performance. In analyses adjusted for baseline cognition, demographics, comorbid conditions, and kidney function, participants in the highest tertile of hs-CRP, the highest tertile of fibrinogen, and the highest tertile of ferritin had an increased risk of impairment in attention compared to participants in the lowest tertile of each marker (p=0.043, p=0.047, p=0.029, respectively. The high level of ferritin was evaluated as a risk of impairment visuospatial/executive ability, and no relationship of inflammatory markers was observed with impairment of orientation p=0.01. hs-CRP and ferritin and low albumin level were independently associated with longitudinal global cognitive function (p=0.04, p=0.02, p=0.49 respectively).

Conclusion
In CKD patients, we have a relatively high risk for cognitive impairment. Our results extend the findings from prior studies by showing that inflammatory markers used in routine practice contribute and are independently associated with longitudinal changes in some domains of cognitive function in patients with CKD going in parallel with the inflammatory mechanisms that have been implicated in the pathogenesis of vascular and Alzheimer’s dementia.
MO534VITAMIN D DEFICIENCY IN PATIENTS WITH CHRONIC KIDNEY DISEASE OF UNCERTAIN ETIOLOGY IN WILGAMUWA, SRI LANKA
Authors: Godawita Rivindi , Nayanamali Ayesha , Silva Renuka , Nanayakkara Nishantha 
Published: May 2021

Abstract

Background and Aims
Vitamin D deficiency (VDD) is a common, well known association in Chronic Kidney Disease (CKD). However, there are no published studies on the prevalence of VDD among CKDu (Chronic Kidney Disease of uncertain etiology) patients. This study aims to study on Vitamin D status of CKDu patients.

Method
This was a cross sectional survey conducted in Wilgamuwa area, in Mathale located in Central province of Sri Lanka. Among the 39 GN (Grama Niladahri) divisions at Wilgamuwa, GN divisions where the CKD prevalence was high areas were taken for the study. Data were collected by using clinical examination and interviewer administered questionnaire and analyzed using SPSS statistical software

Results
A total of 150 patients living in a CKDu endemic area in Sri Lanka was studied during the study period. Majority (n=118, 78.7%) of the CKDu patients were males. Mean age (years) was 56.75±7.89 and 54.34±7.87 for females and males respectively. More than half of the patients were middle aged outdoor workers. According to the BMI (Body mass index) results, majority (n= 87, 58%) of the CKDu patients were in the healthy weight category. More than one third of the patients were in the underweight category. VDD (&lt;20ng/mL) was reported in 22.88% (n=27) of the total males and 68.75% (n=22) of the total females. Vitamin D insufficiency (20-30ng/mL) was identified among 45.76% (n=54) males and 25% (n=8) females. Rest of the males (31.35, n=37) and females (6.25%, n=2) had normal vitamin D level (&gt;30 ng/mL). As a summary the mean Vitamin D level was 24.85 ±7.93 ng/mL. There was a signiﬁcant different in the prevalence of VDD between gender groups (p = 0.004). VDD is more common (82%) during the early stages of CKDu while less common during the late stage. However, there is no any significant association between the prevalence of VDD and CKDu stage (p=0.183).

Conclusion
VDD is more commonly encountered complication in during the early stages of CKDu and it was significantly high in male CKDu patients compared to females.
MO535PREVALENCE OF CHRONIC KIDNEY DISEASE AND ASSOCIATED RISK FACTORS ON THE ISLAND OF MONTSERRAT
Authors: Chrysostom Keniel , Fisher Lori-Ann , Barton Everard , Soyibo Adedamola , West Grethlyn , Skerritt Georgette , Hoe Kyaw 
Published: May 2021

Abstract

Background and Aims
Chronic Kidney Disease (CKD) is a global health problem with disproportionate burden in low- and middle-income countries in Latin America and the Caribbean. Despite these disparities, little is known of the prevalence and risk factors of CKD in the Caribbean. We sought to determine prevalence of CKD among patients attending ambulatory centres in Montserrat, an island that to date, has no facilities for renal replacement therapy.

Method
A cross-sectional observational study of Participants were individuals aged ≥18 years was performed. Random cluster sampling of at least 500 participants who attended clinic from January 1 to July 1, 2020 across all primary health care facilities on island was performed. Patients without lab values for creatinine were excluded. The main outcome measures was estimated CKD prevalence (as defined based on KDIGO 2012 guidelines of eGFR &lt; 60mL/min/1.73m2 using creatinine based CKD-EPI for blacks; and estimated prevalence of CKD risk factors (Self-reported diabetes or hypertension and obesity, BMI&gt; 30kg/m2). Multivariate Logistic regression was used to determine independent predictors of CKD.

Results
Three hundred and fifty-five participants (n = 355) were selected for participation. Participants’ mean age was 63 ± 17 years, with 60% (n=213) being female. 38% (n=135) had self-reported diabetes and 58% (n=201) had hypertension; and 44% were obese. Mean± SD estimated GFR was 81 ± 30 ml/min/1.73 m2 . One quarter of the participants (25%) had an eGFR &lt;60 ml/min/1.73 m2, indicating CKD. Age [95% CI, OR 1.03 (1.01–1.07)], Self-reported hypertension [95% CI, OR 2.09, (1.13–3.90)] and female gender [95% CI ,OR 0.20 (0.10, 0.39)] were independent predictors of reduced eGFR.

Conclusion
CKD and its risk factors were prevalent among adults in Montserrat. Consideration must be made for infrastructural and/or policy changes to be mandated, to slow the progression of CKD. Primary prevention initiatives can be implemented to reduce the associated morbidity, mortality and cost associated with CKD. There is room for further longitudinal studies to identify etiology, as well as factors affecting CKD progression. This study will also propel creation of the Montserrat arm of the Caribbean Renal Registry, to allow for future follow up of long-term effects, as well as ascertain risk factors for CKD progression.
MO536CHINESE CHRONIC RENAL INSUFFICIENCY STUDY: BASED ON SMARTPHONE PLATFORM (C- CRISS): DESIGN AND METHOD
Authors: Fan Xiaohong , Xia Peng , Zhang Xuehan , Li Jiaying , You Ruilian , Zhu Yuanyuan , Liu He , Qiu Ling , Qin Yan , Li Xuemei , Chen Limeng 
Published: May 2021

Abstract

Background and Aims
Abnormal mineral bone metabolism of chronic kidney disease (CKD-MBD) is the most common CKD complication. However, fewer data concerning the relationship between bone metabolic indexes, such as high serum phosphorus and cardiovascular diseases, bone mass reduction, and fracture, is available in Chinese adult patients. The Chinese Chronic Renal Insufficiency Study: Based on Smartphone Platform (C-CRISS) is established to explore the relationship between bone metabolic markers and other non-traditional risk factors with renal function progression, cardiovascular (CVD), and cerebrovascular diseases (BVD), and bone loss in CKD patients.

Method/design
The C-CRISS study is a multi-center prospective cohort study in China. It will recruit 3360 pre-dialysis patients aged 18 to 74 years and follow up for at least two years. The individuals with CKD G3b-5ND will account for over 70 percent of the study population. Active glomerulonephritis, rapidly progressing and advanced heart, liver, and tumor diseases will be excluded. The primary composite endpoints include the events of progression to ESRD, cardiovascular events, and death. The participants will undergo the clinical evaluation at baseline and clinic visits at six-monthly intervals in traditional consultation ways. The CVD, BVD, retinopathy, DXR, and other complications will be measured annually. Data on the questionnaire, diet, quality of life, and patients’ status during follow-up will be collected by the smartphone platform developed for this study. The sample size will enable us to have 80% power to detect a 2.0 risk ratio of CVD events in CKD G4 patients compared with CKD G3a patients.

Conclusion
The C-CRISS study would provide evidence of the potential risk of bone metabolic markers for progressive CKD and CVD/BVD. The study will also provide a new management and complication monitoring model through smartphone communication in chronic kidney disease patients.

Trial registration
ClinicalTrials.gov Identifier: NCT04229485
MO488HOSPITALISATION EVENTS IN PEOPLE WITH CHRONIC KIDNEY DISEASE AND MULTIPLE LONG-TERM CONDITIONS
Authors: Sullivan Michael , Jani Bhautesh , McConnachie Alex , Mair Frances , Mark Patrick 
Published: May 2021

Abstract

Background and Aims:
Chronic Kidney Disease (CKD) typically co-exists with multiple long-term conditions (LTCs). The impact of CKD combined with multiple LTCs on hospitalisation rates is not known. We hypothesised that hospitalisation rates would be high in people with multiple LTCs, particularly in those with CKD. We also hypothesised that the association between multiple LTCs and hospitalisation would be greatest in subgroups and with certain patterns of LTCs.

Method:
Two cohorts were studied in parallel: UK Biobank (2006-2019) and Secure Anonymised Information Linkage Databank (SAIL: 2011-2018, Wales, UK). UK Biobank is a prospective research cohort. SAIL is a routine care database. Participants were included if their kidney function was measured at baseline. LTCs were obtained from self-report (UK Biobank) and primary care read codes (SAIL). Participants were categorised into zero, one, two, three and four or more LTCs with and without CKD. CKD was defined as estimated glomerular filtration rate less than 60 ml/min/1.73m2 (single blood test for UK Biobank, two blood tests three months apart for SAIL). Hospitalisation events were obtained from linked hospital records.

Results:
Among 469,344 of 502,503 UK Biobank participants, those without CKD had a median age of 58 and a median of 1 LTC. Those with CKD had a median age of 64 and a median of 2 LTCs. Among 1,620,490 of 2,768,862 SAIL participants, those without CKD had a median age of 50 and a median of 1 LTC. Those with CKD had a median age of 79 and a median of 4 LTCs. Participants with four or more LTCs had high event rates (Rate Ratios (RRs) 5.35 (95% CI 5.20-5.51)/3.77 (95% CI 3.71-3.82)) with higher rates in CKD (RRs 8.99 (95% CI 8.47-9.54)/9.92 (95% CI 9.75-10.09)).
Amongst those with CKD, the association between each increase in LTC count and hospitalisation was greatest in those under the age of 50 (RRs 1.93 (95% CI 1.73-2.16)/1.35(95% CI 1.29-1.41)). Event rates were highest in those with eGFR&lt;30ml/min/1.73m2, but the impact of multiple LTCs was weaker in these participants compared to those with higher eGFRs.
Event rates were high in certain patterns of LTCs: cardiometabolic LTCs (RRs 4.45 (95% CI 4.02-4.92)/2.81 (95% CI 2.71-2.91)), complex patterns (RRs 3.60 (95% CI 3.26-3.96)/2.91 (95% CI 2.81-3.01)) and physical/mental LTCs (RRs 3.30 (95% CI 2.86-3.80)/3.18 (95% CI 3.06-3.30)).

Conclusion:
People with multiple LTCs have high rates of hospitalisation and the rates are augmented in those with CKD. The impact of multiple LTCs is greatest in younger patients and in those with certain patterns of LTCs. Strategies should be developed to prevent hospitalisations in these high-risk groups.
Hospitalisation Events by Chronic Kidney Disease (CKD) status and number of Long-term conditions (LTCs) in UK Biobank
Hospitalisation Events by Chronic Kidney Disease (CKD) status and number of Long-term conditions (LTCs) in SAIL
MO489GESTATIONAL DIABETES AND THE LONG-TERM RISK OF MATERNAL KIDNEY DISEASE: A SWEDISH NATIONAL COHORT STUDY
Authors: Barrett Peter , McCarthy Fergus , Evans Marie , Kublickas Marius , Perry Ivan , Stenvinkel Peter , Kublickiene Karolina , Khashan Ali 
Published: May 2021

Abstract

Background and Aims
Gestational diabetes (GDM) is increasingly common worldwide. GDM is associated with increased risk of type 2 diabetes (T2DM) and cardiovascular disease in women. It is uncertain whether GDM is independently associated with long-term risk of maternal kidney disease. We aimed to examine the association between GDM and maternal chronic kidney disease (CKD) and end-stage kidney disease (ESKD) and to determine whether this depends on progression to overt T2DM.

Method
A nationwide retrospective cohort study was designed using data from the Swedish national registers. Women were included if their first delivery occurred between 1 January 1987 and 31 December 2012. Previous GDM was the main exposure variable, and this was stratified according to whether women developed T2DM after pregnancy. We estimated the risk of CKD, ESKD and different CKD subtypes (tubulointerstitial, glomerular, hypertensive, diabetic, other/non-specific). Cox-proportional hazard regression models were used with time-dependent covariates. We adjusted for a wide range of confounders including maternal age, country of origin, maternal education, parity, antenatal BMI, gestational weight gain, smoking during pregnancy and preeclampsia.

Results
There were 1,121,633 women included, of whom 15,595 (1.4%) had a diagnosis of GDM. Overall, GDM-diagnosed women were at increased risk of CKD (aHR 1.81, 95% CI 1.54-2.14) and ESKD (aHR 4.52, 95% CI 2.75-7.44). Associations were strongest for diabetic CKD (aHR 8.81, 95% CI 6.36-12.19), hypertensive CKD (aHR 2.46, 95% CI 1.06-5.69), and glomerular CKD (aHR 1.86, 95% CI 1.37-2.51). However, these associations were largely explained by progression to post-pregnancy T2DM. Among women who had GDM + subsequent T2DM, strong associations were observed with CKD (aHR 21.70, 95% CI 17.17-27.42) and ESKD (aHR 112.37, 95% CI 61.22-206.38). By contrast, women who only experienced GDM (and no future T2DM) were not at significantly higher risk of CKD (aHR 1.11, 95% CI 0.89-1.38) or ESKD (aHR 1.58, 95% CI 0.70-3.60).

Conclusion
Women who experience GDM are at increased risk of CKD and ESKD if they develop T2DM. However, GDM-diagnosed women who do not develop overt T2DM in later life have a similar risk of CKD/ESKD to those with uncomplicated pregnancies.
MO42825-HYDROXYVITAMIN D AND TUBULAR DYSTROPHY IN PATIENTS WITH CKD STAGES 1-3*
Authors: Galkina Olga , Bogdanova Evdokia , Zubina Irina , Levykina Elena , Anpilova Anastasiia , Sipovski Vassili , Panina Iraida , Kovalchuk Yurii , Smirnov Alexei 
Published: May 2021

Abstract

Background and Aims
According to a recent data the 25-hydroxyvitamin D (25OHD) level is known to be reduced in advanced stages of CKD presumably due to i) catabolic activity of CYP24 in damaged tubules and ii) increase in renal excretion of 25OHD/Vitamin D binding protein complex. The association of the 25OHD level with different types of tubular damage in early stages (1-3) of CKD is not well investigated.

Method
The cross-sectional study included 100 patients (37 male; age 38 (30-50) yrs.) with biopsy proven primary glomerulopathy (membranoproliferative glomerulonephritis (n=9); minimal change disease (n=10); membranous nephropathy (n=11); focal segmental glomerulosclerosis (n=20); IgA nephropathy (n=50)) and CKD stages 1-3 (median eGFR was 64 (33-90) ml/min/1.73 m2). Patients with AKI, infectious diseases, heart failure, respiratory failure and cancer pathology were excluded. The levels of proteinuria, intact parathyroid hormone (PTH) (Beckman Coulter), 25OHD (Abbott) were estimated in all patients. In all cases the following types of tubular damage were analyzed by light microscopy of kidney tissue (hematoxylin and eosin, periodic acid Schiff, Masson's trichrome, Congo red, and Jones' silver) and calculated semi-quantitatively (0 – &lt;10%; 1 – 10-25%; 2 – 26-50% and 3 – &gt;50% of tissue sample): granular dystrophy, hyaline-drop dystrophy, hydropic dystrophy, foamy degeneration and atrophy. The association between clinical and morphological variables was estimated by Spearman’s coefficient and multiple linear regression analysis.

Results
The patients had a lack or deficiency of 25OHD [Me (Q1-Q3): 13.1 (7.6-19.3) ng/ml]. There was no correlation between serum 25OHD and PTH (r = -0.03, p = 0.86). Proteinuria was negatively associated with level of 25OHD (r = -0.56, p = 0.012). The level of 25OHD was associated with granular (r = -0.39, p &lt;0.05) and hyaline-drop (r = -0.39, p &lt;0.05) tubular dystrophy. In multiple regression analysis the 25OHD level was the independent predictor of the severe hyaline-drop tubular dystrophy (β = -0.33 ± 0.11, p = 0.046) when adjusted for proteinuria (β=0.22±0.11, p=0.062).

Conclusion
In patients with CKD stages 1-3 decline in serum 25OHD is associated with the severity of tubular dystrophy. 25OHD level may be useful in laboratory diagnosis as a risk factor of tubular damage in early stages of CKD.
MO437RENAL RESISTIVE INDEX IS INDEPENDENTLY ASSOCIATED WITH THE RENAL BLOOD FLOW IN HYPERTENSIVE PATIENTS
Authors: Lubas Arkadiusz , Zegadło Arkadiusz , Grzywacz Anna , Niemczyk Stanisław 
Published: May 2021

Abstract

Background and Aims
The Renal Resistive Index (RRI) measured in intrarenal arteries is considered a marker of cardiovascular damage, and its value can express the amount of renal perfusion. However, some experimental investigations don’t confirm this association. Moreover, in recent works, End Diastolic Velocity (EDV) was used as a better than RRI marker of kidney damage. The study aimed to investigate relations between different ultrasound Renal Doppler parameters (RRI, acceleration (ACC), acceleration time (ACT), and EDV) with the Renal Blood Flow (RBF) estimated in contrast-enhanced computed tomography (CE-MDCT).

Method
In 25 patients (14F, 11M; age 58.9 ±19.0; eGFR 56,9 ±27.4 mL/min/1.73m2) with hypertension and suspected renal artery stenosis, ultrasound Color Doppler examination of intrarenal segmental arteries (GE Logiq P6) was performed. Then CE-MDCT (GE Discovery 750 HD) of renal arteries with RBF assessment was completed. Renal Doppler parameters (RRI, ACC, ACT, and EDV) and RBF were evaluated for each kidney separately. Finally, 31 kidneys without a narrowing of supplying arteries were considered for statistics.

Results
Mean values of intrarenal Doppler parameters were calculated: RRI = 0.699 ±0.113; ACC = 7.41 ±2.75 [m/s2]; ACT = 35.8 ±8.4 [ms]; EDV = 13.68 ±8.41 [cm/s]. CE-MDCT RBF = 218.04 ±71.92 [ml/s/100g]. Only RRI and EDV correlated significantly with RBF (r = -0.544; p=0.002 and r=0.428; p=0.018, respectively). The retrograde multivariable regression analysis included all investigated ultrasound renal Doppler parameters showed an independent association only between RRI and RBF (b = -0.544; R2 = 0.27, p &lt; 0.002).

Conclusion
Only Renal Resistive Index measured in intrarenal segmental arteries is independently related to the Renal Blood Flow from investigated ultrasound renal Doppler parameters. Although End Diastolic Velocity is positively correlated with RBF, this association is not superior to Renal Resistive Index.