bluuebunny/crossref_metadata_2025_split huggingface dataset:
#2871 Effect of parathyroidectomy on kidney function in adults with primary hyperparathyroidism
Authors: Bandovas João Pedro , Candeias Henrique , Mourao Mariana , Dhanani Anjum , Monteiro Nuno , Crespo Ana , Tavares Paula , Marques Hugo Pinto 
Published: May 2024

Abstract

Background and Aims
Multidisciplinary guidelines recommend parathyroidectomy to slow the progression of chronic kidney disease in patients with primary hyperparathyroidism (PHPT) and an estimated glomerular filtration rate (eGFR) less than 60 mL/min/1.73 m2. However, this is a weak recommendation, based on low-quality evidence. The objective of this study was to evaluate the estimated glomerular filtration rate change 12 months after parathyroidectomy for primary hyperparathyroidism according to preoperative kidney function.

Method
Patients who underwent parathyroidectomy for PHPT between 2017 and 2020 were retrospectively enrolled (n = 90). Patients without 1-year follow-up or with missing data were excluded (n = 42). Patients were dichotomized according to their baseline eGFR: &lt; 60 mL/min (group 1; n = 13) and ≥60 mL/min (group 2; n = 35). Variables were measured before and then at 12 months after parathyroidectomy. Statistical analyses was made using SPSS 28.

Results
The cohort included 38 female patients (79.2%) with a mean age of 68.4 ± 11.27 years. Hypertension was present in 36 patients (75%) and 16 patients (33.3%) were diabetic. Thirty-two patients were being treated with ACEI/ARAII. The mean baseline eGFR was 44.6 ± 9.5 mL/min and 88.0 ± 12.7 mL/min in groups 1 and 2, respectively. Group 1 patients had a higher median baseline serum parathyroid hormone level (p = 0.002). At 12 months, all patients were normocalcemic. The eGFR decreased significantly after parathyroidectomy in group 2 (−5.8 mL/min, p = 0.012), while in group 1 the eGFR remain stable (−0.46 mL/min, p = 0.931). We didn't find any predictive factor of eGFR variation.

Conclusion
Further studies are needed to understand the progression of renal disease after parathyroidectomy. The etiology of the disease, the use of nephroprotective measures or in the other hand nephrotoxins may have an higher impact than restore normocalcemia alone.
#2411 Inflammation in hypervolemic hemodialysis patients is linked to increased caspase-4 activity
Authors: Ulrich Christof , Canim Zeynep , Herberger Eva , Girndt Matthias , Fiedler Roman 
Published: May 2024

Abstract

Background and Aims
Hypervolemia is associated with inflammation in hemodialysis patients (HD). How hypervolemia triggers inflammation is not entirely known. We hypothesized that hypervolemia affects signaling via the NF-kB transcription factor system and thus analyzed the phosphorylated forms of RelA and RelB in immune cells of hypervolemic (H) and normovolemic (N) patients. Further on, we speculated that the higher inflammatory load in H in comparison to N patients could affect the sensor of intracellular LPS activity, namely caspase-4.

Method
Forty HD patients were categorized by bioimpedance measurement in normovolemic (N; 23) and hypervolemic (H; 17) groups. A caspase activity assay in combination with a specific Caspase-4/-5 inhibitor was used to detect Caspase-4/-5 activity in isolated PBMCs by flow-cytometry. The transcription factors RelA (pS529) and RelB (pS552) were analyzed by phopho-flow cytometry. Endotoxin as well as IL-6 and TNF-α were detected by ELISA technique.

Results
Hypervolemic patients were older and had more frequent diabetes. Although the endotoxin levels (EU/ml) in the serum of both groups were not different (N: 3.3 ± 1.6 vs. H 2.9 ± 1.4), Caspase-4/-5 activity (frequency of CD14+Caspase-4+), linked to intracellular endotoxin detection, was significantly elevated in H patients (N: 52 + 17% vs. H: 65 + 17%, p &lt; 0.01). While the frequency and expression density of Rel A expressing immune cells were not different, the monocytic frequency of cells staining positive for RelB (pS552) was significantly elevated in N patients (N: 37.7 ± 27.1 vs. H: 20.4 ± 17.1, p=0.038). Among inflammatory cytokines (pg/ml) measured in the serum of patients, only IL-6 (N: 5.8 ± 10.5 vs H: 7.2 ± 6.8, p = 0.01) but not TNF-α (N: 7.7 ± 1.1 vs. H: 7.5 ± 0.7, p = 0.580) was increased in H patients.

Conclusion
The lower frequency of pRelB-positive monocytes in hypervolemic patients may be linked to a functional impairment to resolve inflammatory circles. The elevated caspase-4/-5 activity in H patients, however, can be interpreted as a higher intracellular LPS-load in H patients. Therefore, both higher inflammatory load and lower inflammatory resolution capacities are characteristics of H patients.
#322 Are platelet-related parameters prognostic predictors of renal and cardiovascular outcomes in IgA nephropathy?
Authors: Kovács Tibor , Sági Balázs , Vas Tibor , Csiky Botond , Nagy Judit 
Published: May 2024

Abstract

Background and Aims
IgA nephropathy (IgAN) is associated with chronic inflammation. Platelet-related parameters, such as platelet (PLT) count, platelet-to-albumin ratio (PAR) and platelet-to-lymphocyte ratio (PLR), were examined as potential prognostic indicators for renal and cardiovascular (CV) outcomes in IgAN.

Method
150 IgAN patients were involved and divided into two groups based on the cut-off value of PAR. All-cause mortality, major CV events and end-stage renal disease were the primary combined endpoints. Secondary endpoints, such as CV or renal endpoints, were also analyzed separately.

Results
Seventy-four per cent of patients were male and had a mean age of 43.7 ± 13.5 years. Mean follow-up time: 124 ± 67 months. The K-M curve showed that PLT, PLR and PAR were strongly associated with primary combined and renal outcomes, but not with cardiovascular outcomes in IgAN. In the case of combining PAR with LVH, the K-M curves showed significant differences in both the primary (p &lt; 0.001) and secondary outcomes (p = 0.001 and p = 0.038). When we combined PAR with metabolic syndrome, the primary (p &lt; 0.001) and secondary (p = 0.001 and p = 0.015) outcomes were also significant in the low and high PAR groups. PAR was correlated with gender (r = -0.273, p = 0.001) and segmental glomerulosclerosis on histology (r = 0.161, p = 0.047). PLR correlated with microalbuminuria (r = -0.165, p = 0.033) and left ventricular hypertrophy (r = -0.178, p = 0.025). PLT was correlated with gender (r = -0.201, p = 0.013) and eGFR (r = 0.158, p = 0.040). PLR, gender, dyslipidemia and microalbuminuria were associated with the primary composite endpoints; left ventricular hypertrophy and microalbuminuria with the secondary renal endpoints; and gender, age and diabetes with the cardiovascular endpoints by multivariate Cox regression.

Conclusion
Elevated PAR and PLR may predict end-stage renal disease progression, but in combination with LVH and MetS, they showed CV events also in IgAN. The determination of PAR and PLR can be useful and cost-effective parameters for assessing both cardiovascular and renal risks in CKD.
#2191 Platelet function in chronic kidney disease; can flow cytometry guide in the difficult balance between risk for bleeding versus thrombotic events?
Authors: Lund Gustav , Christensson Anders , Malm Johan , Biglarnia Alireza , Norstrom Eva 
Published: May 2024

Abstract

Background and Aims
Increased risk of bleeding is a well-known complication of chronic kidney disease (CKD). However, these patients also have an increased risk of thrombotic events. Several studies have implicated both impaired and enhanced platelet function in patients with chronic kidney disease, but results vary between different studies and methods. Flow cytometry has emerged as a new method to study platelet function. Our aim was to investigate platelet function using flow cytometry in patients with chronic kidney disease.

Method
20 patients were included between February and May 2023. Pre-dialytic patients with an eGFR between 8-20 mL/min/1,73 m2 were included, mean eGFR 14.7 mL/min/1,73 m2. Patients with platelet levels &gt;100 × 109/L were included. Medication in the form of anticoagulants, NSAIDs, platelet inhibitors or SSRIs were used as exclusion criteria. Platelet activation assay was performed with flow cytometry. The expression of activation markers PAC-1 (activated GPIIb/IIIa), CD62P (P-selectin) and CD63 (dense granules) were analysed before and after activation with ADP, CRP-XL (collagen stimulating peptide, activates GPVI) or TRAP-6 (stimulates platelet activating receptor 1, PAR1). Platelets from 20 healthy control subjects were analysed for comparison.

Results
The level and size of platelets (MPV) were comparable in both groups. There were significantly higher levels of D-dimer in the CKD group vs healthy controls (1,17 mg/L FEU vs 0,27 mg/L FEU). Except for the decreased expression of activated GPIIb-IIIa receptor after activation with ADP and CRP-XL in one patient, the platelet activation did not significantly differ between CKD patients and healthy controls.

Conclusion
No significant differences in the activation of platelets were observed between the CKD population and the healthy controls when analysed by flow cytometry. Elevated levels of D-dimer in CKD patients have previously been described and are believed to be due to increased fibrin formation, lysis and decreased renal clearance. Further studies in a larger patient population, including thrombocytopenic patients are planned, with greater focus to be placed on dense granula quantities which may correlate with decreased levels in the CKD population.
#619 Serum aldosterone to potassium ratio and hyperkalemia risk in patients with chronic kidney disease
Authors: Kim Hyunwoo , Ko Ara 
Published: May 2024

Abstract

Background and Aims
Angiotensin converting enzyme inhibitors (ACEIs) and angiotensin II receptor blockers (ARBs) have demonstrated efficacy in improving outcomes in patients with chronic kidney disease (CKD). However, these medications have also been associated with the development of hyperkalemia. The aim of this study was to evaluate the relation of serum aldosterone to potassium ratio to the risk of the development of hyperkalemia in CKD patients receiving ACEIs or ARBs.

Method
Between January 2017 and December 2021, 186 patients with CKD 3-4 (estimated glomerular filtration rate, eGFR, of 15-59 ml/min/1.73 m2) who were receiving an ACEI or an ARB for at least 3 months and had serum aldosterone and potassium measured simultaneously were analyzed. Serum aldosterone to potassium (Aldo/K) ratio was calculated (ng/ml per mmol/l) and patients were divided into two groups according to the median value of serum Aldo/K ratio above or below 2.42. Follow-up serum potassium concentrations were measured every 2 to 3 months. The primary outcome was the occurrence of hyperkalemia (defined as serum potassium level &gt; 5.5 mEq/l). Incidence rates for hyperkalemic events were computed as the ratio of the total number of hyperkalemic events to the total patient-time at risk. In addition, the times from the index date to the first occurrence of hyperkalemia for were computed. Cox proportional hazards models were used to identify patients at the risk of the occurrence of hyperkalemia.

Results
During a median follow-up period of 3.1 years, 2505 times of serum potassium were measured (mean ± standard deviation number of annual potassium measurements per patient, 4.5 ± 1.7 measurements/year per patient). A total of 144 hyperkalemic events in 81 patients (43.5%) were identified, yielding an incidence rate of 24.6 per 100 person-years (95% confidence intervals [CIs] 20.4–28.8). The incidence of hyperkalemic events was significantly higher in patients with low serum Aldo/K ratio than in those with high serum Aldo/K ratio (35.8 events/100 patient-years, 95% CI 28.9‒42.7 events/100 patient-years vs. 12.9 events/100 patient-years, 95% CI 8.8‒17.0 events/100 patient-years, p &lt; 0.001). In multivariate Cox proportional hazards analysis, diabetes mellitus (Hazard ratio [HR], 1.842; 95% CI, 1.046-3.243; P=0.034), prior history of hyperkalemia (HR, 2.288; 95% CI, 1.372-3.815; P=0.002), low baseline eGFR (HR, 0.973; 95% CI, 0.948-0.998; P=0.037) and a low serum Aldo/K ratio (HR, 3.654; 95% CI, 2.066-6.463; P &lt; 0.001) were predictors of subsequent development of hyperkalemia.

Conclusion
This study revealed that low serum Aldo/K ratio ( &lt; 2.42) was strongly associated with the occurrence of hyperkalemia in CKD patients receiving ACEIs or ARBs, suggesting that the identification of patients at a risk for subsequent hyperkalemia could be made by measuring serum aldosterone and potassium levels simultaneously on these drugs.
#1440 Analysis of risk factors for the development of coronary events in patients with chronic kidney disease stage 5
Authors: Daminova Lola , Rasulev Yorkin , Nigmanov Bahodir , Adylova Durdona , Abdullayev Akbar 
Published: May 2024

Abstract

Background and Aims
To analyze the number and presence of certain risk factors for the development of coronary events in patients with chronic kidney disease receiving program hemodialysis.

Method
To achieve this goal, we first conducted an information search in electronic databases of articles: in English - in PubMed, the search depth was from 2010 to 2020, after which we selected the most common risk factors for the development of coronary events in the conditions of Uzbekistan (Table 1). The study and recruitment of patients took place in the department of nephrology and hemodialysis of the Republican Specialized Scientific and Practical Medical Center for Nephrology and Kidney Transplantation in 2023. The study involved 73 (42.95%) men and 97 (57.05%) women; the average age of the patients was 54.00 ± 13.72 years.
The main causes of chronic renal failure in the structure of the overall morbidity of the prospective study were: diabetic nephropathy - 41% (69), chronic glomerulonephritis - 40% (68), chronic pyelonephritis - 12.9% (22).

Results
All 170 patients were assessed for risk factors for the development of coronary events according to Table 1. Based on the current literature, we selected 30 risk factors for the development of coronary events.
The most common risk factors for the development of coronary events were, that is, 2/3: albumin, body mass index, calcium, cardiovascular diseases, clinical and ambulatory blood pressure, chronic heart failure, diastolic blood pressure, hemoglobin, left ventricular hypertrophy, mean arterial pressure, systolic blood pressure, diuretic (urea), years with hypertension.
The least significant risk factors for the development of coronary events were, that is, 1/3: diabetes, diabetic nephropathy, dyslipidemia, coronary heart disease, left ventricular end-diastolic volume, metabolic syndrome, parathyroid hormone, peripheral vascular disease, phosphorus, potassium, pulse pressure, sodium (in plasma), sodium-potassium ratio, smoking, total cholesterol.

Conclusion
In 2/3 of the studied patients of the main group, the presence of 15 risk factors for the development of coronary events was noted, in 1/3 of the patients, 21 risk factors for the development of coronary events were identified. The above risk factors together increase the incidence of coronary events in patients with stage 5 CKD several times. Coronary events are the leading causes of death in all groups. The most common were: acute left ventricular failure and sudden cardiac death. And predictors of the risk factor for death for coronary events include: blood albumin levels, BMI, blood hemoglobin, LVH, SBP, DAS, CHF, blood calcium, years since hypertension.
#1534 Risk of CKD progression taken into account of metabolic changes
Authors: Egamberdieva Dano , Ruzmetova Iroda 
Published: May 2024

Abstract

Background and Aims
The purpose of this study was to study the relationship between metabolic syndrome and the risk of progression of CKD in a representative sample of patients who were hospitalized in the nephrology department of the 3rd clinic of the Tashkent Medical Academy and in the department of cardiology and interventional cardiology of the Russian National Medical Research and Medical Center.

Method
In the retrospective part of the study, 1000 case histories of patients with CKD who were inpatient treatment from 2013 to 2019 in the nephrology department of the 3rd clinic of the Tashkent Medical Academy and in the department of cardiology and interventional cardiology of the Russian National Medical Research Center for Medical Sciences were studied. In the prospective part of the study, information on demographic characteristics, including age, gender, education, and profession, was collected during medical visits using a standard questionnaire. Metabolic syndrome was defined according to international guidelines as the presence of three or more of the following risk factors: waist circumference &gt;102 cm in men or &gt;88 cm in women; serum triglyceride level ≥1.70 mmol/L; HDL cholesterol &lt; 1.04 mmol/L in men or &lt; 1.30 mmol/L in women; Blood pressure ≥ 130/85 mm Hg, including achieved; serum glucose level ≥6.11 mmol/L. Metabolic syndrome definition criteria used

Results
The demographic characteristics of the patients are presented in the table. Mean serum creatinine was similar, but GFR was estimated to be lower among those with metabolic syndrome compared with those without. The percentage of individuals with CKD and elevated serum creatinine was statistically significantly higher among individuals with metabolic syndrome. Low HDL cholesterol, elevated plasma glucose, and abdominal obesity were found to be statistically significantly associated with the risk of developing C5 CKD and elevated serum creatinine. In addition, a significant relationship was observed between the number of metabolic syndrome components and the percentage of CKD C5 or elevated serum creatinine (P &lt; 0.015 and P = 0.02, respectively). In the multivariate model, patients with 1, 2, 3 and 4 or 5 components of the metabolic syndrome had 1.51; 1.50; 2.13 and 2.72 times higher odds of CKD C5 CKD, respectively, compared with individuals without metabolic syndrome components. Overall, patients with metabolic syndrome had a 64% increased odds of CKD compared with a comparison group without metabolic syndrome.

Conclusion
The present study revealed a positive and significant association between metabolic syndrome and the risk of CKD C5 in those examined. The risk of CKD increased progressively with increasing number of metabolic syndrome components.
#2550 Micro(nano)plastics in human urine: a surprising contrast between Chongqing's urban and rural regions
Authors: Song Xuan , Feng Xiaoqian , Chen Tian , Tan Zhongyou , Du Lixia , Chen Zongwen , Qiu Xihong , Mo Yunbo , Li Yan , Zhang Yuxin , Zhu Yu 
Published: May 2024

Abstract

Background and Aims
Microplastics (100 nm-5 mm) and nanoplastics (&lt;100 nm) collectively referred to as micro(nano)plastics (MNPs), which are emerging pollutants all over the world. Environmental differences affect its distribution. The content of MNPs differs between urban and rural environments, according to previous studies.

Method
To understand the actual situation of human exposure to MNPs in various environments, this study collected 12 urine samples from volunteers in urban and rural regions of Chongqing and used pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) and laser direct infrared spectroscopy (LDIR) to detect and analyze MNPs in urine.

Results
With an average abundance of 1.50 (2.31) mg/kg, MNPs were found in 9 samples by Py-GC/MS. Polyethylene (PE), polyvinyl chloride (PVC) and polyamide 66 (PA66), three different types of MNPs were found, with PE content being the highest among them. By using LDIR, MNPs were found in 7 samples, with an average abundance of 15.17 (23.13) particles/kg. Five different types of MNPs were found, with acrylates (ACR) being the main type, followed by polymethylmethacrylate (PMMA), polyurethane (PU), polypropylene (PP), polyethylene terephthalate (PET).

Conclusion
The findings demonstrated that urban region had much greater levels and more types of MNPs in human urine than rural. Additionally, regular contact with plastic toys and the use of personal care products are linked to the presence of MNPs. The influence of environmental factors on the actual exposure of the human body to MNPs was preliminary explored in this study, and two different methods were used for the first time to simultaneously detect and analyze MNPs in human urine. This allowed for the feasibility of comprehensively and effectively quantitatively analyzing the actual exposure of the human body to MNPs, and also provided the theoretical foundation for further research on the harm of MNPs to human health in different environments.
#1081 Associations of MRI-derived kidney volume, kidney function, body composition, and physical performance in &gt;38 000 UK Biobank participants
Authors: Kim Jung-Hyun , Park Sehoon , Joo Kwon Wook 
Published: May 2024

Abstract

Background and Aims
Kidney volume is used as predictive and therapeutic marker for several clinical conditions. However, there is a lack of large-scale studies examining the relationship between kidney volume and various clinicodemographic factors, including kidney function, body composition, and physical performance.

Method
In this observational study, MRI-derived kidney volume measurements from 38,526 UK Biobank participants were analyzed. Major kidney volume-related measures included body surface area (BSA)-adjusted total kidney volume (TKV) and the difference of bilateral kidneys. Multivariable-adjusted linear regression and cubic spline analyses were used to explore the association between kidney volume-related measures and clinicodemographic factors. Cox regression was used to identify the risks of death, non-kidney cancer, myocardial infarction (MI), and ischemic stroke.

Results
The median of BSA-adjusted TKV and difference in kidney volume were 141.9 (128.1–156.9) mL/m2 and 1.08 (1.04–1.15) fold, respectively. Higher BSA-adjusted TKV was significantly associated with higher eGFR (beta [95% CIs], 0.43 [0.42–0.44]; P &lt; 0.001), higher composition of muscle volume (beta [95% CIs], 0.50 [0.48–0.51]; P &lt; 0.001), and higher mean handgrip strength (beta [95% CIs], 0.15 [0.13–0.16]; P &lt; 0.001), while associated with lower visceral adipose tissue volume (VAT, beta [95% CIs], −0.09 [−0.11 – −0.07]; P &lt; 0.001) in adjusted models. Higher difference in bilateral kidney volumes was associated with lower eGFR, muscle volume, and physical performance, while associated with higher proteinuria and VAT.

Conclusion
Higher BSA-adjusted TKV and lower discrepancies in bilateral kidney volumes are associated with higher renal function, muscle volume, and physical performance.