bluuebunny/crossref_metadata_2025_split huggingface dataset:
#1881 Association of circulating autoantibodies to erythropoietin receptor with anaemia in patients with type 2 diabetes and chronic kidney disease
Authors: Oshima Megumi , Toyama Tadashi , Ito Kiyoaki , Kitajima Shinji , Mizushima Ichiro , Hara Akinori , Sakai Norihiko , Shimizu Miho , Wada Takashi , Iwata Yasunori 
Published: May 2024

Abstract

Background and Aims
Anaemia is a risk factor for cardiovascular and kidney prognosis in patients with type 2 diabetes and it is important to identify patients at high risk of anemia. We have previously reported that autoantibodies to erythropoietin receptor (anti-EPOR antibodies) may functionally neutralize the activity of erythropoietin and are associated with haemoglobin (Hb) in patients with lupus nephritis, and hypo responsiveness to erythropoiesis-stimulating agents (ESAs) in patients undergoing haemodialysis. This study assessed the association between anti-EPOR antibodies and anaemia in patients with type 2 diabetes and chronic kidney disease.

Method
This cohort study included patients with type 2 diabetes and chronic kidney disease who were diagnosed between 1989 and 2014 at our hospital. The presence of anti-EPOR antibodies at baseline were assessed by ELISA in stocked serum. To investigate the association between anti-EPOR antibodies and anaemia, odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression analysis adjusted for multiple covariates. We then estimated hazard ratios (HR) and 95% CIs using Cox regression models to investigate the association between anti-EPOR antibodies and the risk of iron deficiency, defined as transferrin saturation below 20% in those with follow-up measurements of iron metabolism.

Results
The mean age was 63 years, the mean eGFR was 42 ml/min/1.73 m2 and the median urinary protein to creatinine ratio (UPCR) was 1.8 g/gCr. Anti-EPOR antibodies were detected in 26 out of 110 patients (24%). At baseline, most patients with anti-EPOR antibodies had anaemia (n=24, 92%) and severe anaemia with Hb&lt;10 g/dl (n=16, 62%) and used ESAs (n=16, 62%). The presence of anti-EPOR antibodies was independently associated with severe anaemia (OR 9.3; 1.2-70.1, p=0.03) after adjustment for baseline covariates including HbA1c, eGFR, UPCR, iron, and CRP. During a mean follow-up of 6.5 years, 6 of 10 patients (60%) developed iron deficiency in anti-EPOR antibodies positive patients, while 3 of 20 patients (15%) in negative patients. Patients with anti-EPOR antibodies were associated with an higher risk of iron deficiency compared to those without (HR 76.0; 95% CI 1.2-4721.7, p=0.04).

Conclusion
In patients with type 2 diabetes and chronic kidney disease, the presence of anti-EPOR antibodies was associated with a risk of severe anaemia and iron deficiency independently of kidney function. These results suggest that anti-EPOR antibodies may be useful in predicting the risk of anaemia and establishing therapeutic strategies of anaemia in people with type 2 diabetes.
#1831 Circulating MiRNA 195-5p may be associated with early renal impairment in patients with prediabetes
Authors: Oana Milas , Petrica Ligia , Gadalean Florica , Popescu Roxana , Vlad Daliborca , Marian Catalin , Bob Flaviu , Suteanu-Simulescu Anca , Mogos Maria , Glavan Mihaela , Ienciu Silvia , Balint Lavinia 
Published: May 2024

Abstract

Background and Aims
Type 2 diabetes mellitus (DM) is one of the leading causes of chronic kidney disease worldwide. However, there are few data concerning early kidney impairment in prediabetes patients.
The aim of the study was to demonstrate early kidney damage in patients with prediabetes by assessing proximal tubule (PT) dysfunction, podocytes injury, and miRNA expression.

Method
A cohort of 192 individuals were analysed and divided such as follows: 52-normoalbuminuria-, 48-microalbuminuria-, and 50-macroalbuminuria type 2 DM patients, respectively; 12 patients-prediabetes and 30-healthy controls.
The miRNA profile was assessed by real-time PCR, while PT dysfunction biomarker, N-acetyl-β-D-glucosaminidase (NAG), and podocyte injury biomarker, podocalyxin, were assessed by ELISA technique. The study was conducted in two distinct stages. In the first part of the study was detected a particular miRNAs profile in serum in patients with prediabetes; subsequently, the expression of the most relevant miRNA in patients with prediabetes was identified.

Results
i) in prediabetes patients, serum miRNA195-5p was 2.69 fold change as compared to the control group and correlated with NAG (p&lt;0.05) and podocalyxin (p&lt;0.03); ii) in type 2 DM patients, the expression of serum miRNA195-5p was higher and correlated with NAG (p&lt;0.05), podocalyxin (p&lt;0.04), urinary albumin: creatinine ratio (p&lt;0.001) and with eGFR (p&lt;0.001); iii) urinary NAG and urinary podocalyxin were higher in prediabetes patients and type 2 DM patients, even in the normoalbuminuria stage, as compared to controls (p&lt;0.04; p&lt;0.001).

Conclusion
A panel of molecular biomarkers, such as miRNAs, remain useful tools for the early diagnosis of renal involvement in the course of type 2 DM. MiRNA 195-5p may be associated with PT dysfunction and podocyte damage, and could predict renal dysfunction in both prediabetes and early diabetic kidney disease in type 2 DM patients.
#282 Correction of portal hypertension and renal dysfunction with losartan in patients with liver cirrhosis
Authors: Usmonov Dilshod , Daminov Botir , Abdurazakova Zarifa , Yuldashova Yulduz 
Published: May 2024

Abstract

Background and Aims
To increase the effectiveness of drug correction of portal hypertension, taking into account the functional state of patients with liver cirrhosis, using Angiotensin receptor blockers (ARBs)

Method
The work summarizes the results of an examination of 35 patients with liver cirrhosis (LC) who were treated in the hepatology department. The patients were divided into two subgroups: the first consisted of 21 patients with liver cirrhosis without ascites, Child-Pugh class A, and the second subgroup included 14 patients with liver cirrhosis with ascites, Child-Pugh class B. We evaluated the effect of the orally active angiotensin II receptor antagonist, losartan, on portal pressure in patients with cirrhosis and portal hypertension. Patients with (hepatic venous pressure gradient [HVPG] ≥ 13 mmHg) portal hypertension at baseline measurement were treated with an oral dose of 25 mg losartan once daily for 1 week.

Results
The examined patients were analyzed for the functional state of the kidneys and its relationships with the main parameters of portal hypertension and hepatic cellular failure.
Comparative characteristics of the main indicators of renal function revealed significant differences in functional parameters depending on the degree of hepatic cellular failure.
In the group of patients with cirrhosis with ascites, there was a significant decrease in renal GFR to 77.5 ± 1.4 ml/min, in contrast to the unchanged level of GFR in the group of patients with cirrhosis without ascites - 99.3 ml/min. However, no significant changes in serum creatinine levels were detected.
Therapy with Losartan in patients with Child-Pugh class A liver cirrhosis at a dose of 25 mg/day reduces PV pressure gradient by 18.1%, at a dose of 12.5 mg/day does not significantly affect the level of portal hypertension, but improves the functional state of the kidneys (increases FPR by 56%, EPP by 17.3%).

Conclusion
The present study indicates that angiotensin II blockade with orally administered losartan is safe and highly effective in the treatment of portal hypertension. In patients with liver cirrhosis with the development of impaired renal reabsorption function and a decrease in FPR from 10% to 8% in the treatment of portal hypertension, the drug of choice is an ARBs (losartan 25 mg/day) with blood pressure &gt; 115/60 mmHg.
#1411 Intrarenal hemodynamics in patients with coronary heart disease in the post-COVID-19 period
Authors: Shishkin Alexander , Kniazeva Alena , Pchelin Ivan , Vasilev Petr 
Published: May 2024

Abstract

Background and Aims
Coronary heart disease (CHD) and obesity are common pathologies in patients who have had COVID-19. Endothelial dysfunction (ED) markers determination has been important in such patients due to the high risk of cardiovascular diseases progression and complications development. THE AIM Assessment of endothelial dysfunction severity in patients with CHD and obesity in the post-COVID-19 period to improve the management of these patients.

Method
49 patients were examined, who had COVID-19 a year ago. The first group (n=24) included patients with coronary artery disease in the post-COVID period. The second group (n=25) included patients with CHD and obesity who had COVID-19. We evaluated data from an ultrasound examination of the kidneys with duplex scanning of the renal arteries (resistance index (RI), pulsation index (PI)). We also studied the medical history, performed an objective examination, the results of a biochemical blood test, albuminuria levels.

Results
We demonstrated higher RI and PI of interlobar, segmental arteries in persons of the second group. An increase in RI and PI of segmental arteries accompanied by an increase in uric acid (p=0.001). The average level of microalbuminuria in the first group was 15.71 ± 4.51 μg/l, in the second group it was 24.38 ± 5.38 μg/l (p=0.110). Increasing glucose levels accompanied by an elevation of C-reactive protein levels. Obese patients had significantly higher levels of total cholesterol, triglycerides, low density lipoproteins than patients in the first group.

Conclusion
We observed changes in lipid metabolism, a higher incidence of diabetes mellitus in females, and changes in intrarenal hemodynamic parameters associated with uric acid levels in patients with coronary heart disease and obesity in the post-COVID-19 period.
#1743 Kidney outcomes associated with SGLT2 inhibitors compared to other glucose-lowering drugs: a real-world study from China
Authors: Xiao Xiang 
Published: May 2024

Abstract

Background and Aims
Currently, there is insufficient real-world study on the kidney outcomes of SGLT2i in mainland Chinese patients with type 2 diabetes (T2D) and chronic kidney disease (CKD). This study aimed to investigate the association between the utilization of Sodium-dependent glucose cotransporters inhibitors (SGLT2i) in real-world settings and kidney outcomes in patients with T2D and CKD in mainland China.

Method
In a retrospective analysis of electronic medical records from West China Hospital of Sichuan University, patients with T2D and CKD were included. Patients were divided into two groups, those initiating treatment with SGLT2i and those receiving other glucose-lowering drugs (oGLDs). The primary focus lies in examining the impact of SGLT2i on the decline slope of eGFR and major kidney events in these patients.

Results
We enrolled 944 patients diagnosed with both T2D and CKD. Out of these, 605 patients were prescribed SGLT2i, while the remaining 339 patients received oGLDs. The median follow-up duration were 16.8 months and 20.6 months, respectively. Throughout the follow-up period, we observed a significant decrease in the rate of eGFR decline in patients using SGLT2i (4.94 ml/min/1.73 m2 per year reduction compared to oGLDs, 95% CI: 4.73–5.15). A total of 101 kidney composite endpoint events occurred, with 31 events in the SGLT2i group and 70 events in the oGLDs group. The use of SGLT2i was associated with a 65% decrease in the risk of kidney composite endpoint events (hazard ratio 0.35, 95% CI 0.19–0.63).

Conclusion
In clinical practice, SGLT2i have shown favorable effects on kidney prognosis in patients with T2D and CKD in mainland China. These effects remain consistent across patients with varying risks of CKD progression.
#1772 Comparison of interpretation of acid-base disorder in patients with critical illness: nephrologist versus ChatGPT
Authors: Lee So Young , Koh Eun Sil , Chung Sungjin 
Published: May 2024

Abstract

Background and Aims
The generative pre-trained transformer (GPT), a type of large language model (LLM), is now playing a huge role in driving innovation in fields of medical education, diagnosis and treatment and with a process of continuous improvement it will itself be able to become beacons of sustainability. Medical professionals expect that they may have help from LLMs to diagnose patients more accurately and efficiently, but it is unclear whether current LLMs are well-trained and validated on real-world clinical data. In this study, we compared the performance of ChatGPT, a representative LLM, MDCalc, an online medical calculator, and human nephrologist for their diagnostic accuracies of acid-base gas analysis in critically ill cases.

Method
This study included 130 patients admitted to intensive care unit with varying medical conditions. All variables were obtained during the first 24 hours after admission.

Results
The Fleiss’ Kappa between the interpretations of nephrologist, ChatGPT and MDCalc with the acid-base gas analysis for acid-base disorders showed that Fleiss’ Kappa value was −0.138 (95% CI −0.216 to −0.059), indicating no agreement among the judgments of human doctor, LLM and online medical calculator in critically ill patients for the interpretation of acid-base status. MDCalc showed that all patients had mixed acid-base disorders while nephrologist that 4 patients had simple acid-base disorder and 1 patient had normal acid-base balance. By contrast, ChatGPT reported that 51 patients had only simple acid-base disorder. Furthermore, according to ChatGPT, normal acid-base balance was found in 27 patients, who were all diagnosed as having acid-base disorders by MDCalc or nephrologist.

Conclusion
We found that current ChatGPT does not yet provide better diagnostic performance for interpreting acid-base balance in critically ill patients who with usually have mixed acid-base disorders compared with an existing online medical calculator or nephrologist.
#207 Early single session of hyperbaric oxygen therapy mitigates renal apoptosis in lipopolysaccharides-induced endotoxemia in rats
Authors: Kim Jin , Lee Hyoung Youn , Kim Injin , Choi Hong Sang , MA Seong Kwon , Kim Soo Wan , Bae Eun Hui 
Published: May 2024

Abstract

Background and Aims
Sepsis-associated acute kidney injury (SA-AKI) is a prominent sepsis complication, often having adverse clinical outcomes. Hyperbaric oxygen therapy (HBOT), known for its anti-inflammatory characteristics, antioxidant effects, and ability to deliver high oxygen tension to hypo-perfused tissues, may offer potential benefits for SA-AKI. This study investigated whether HBOT improved renal injury in sepsis and elucidated its underlying mechanisms.

Method
An lipopolysaccharides (LPS)-induced endotoxemia model was established using eight-week-old C57BL/6 mice. Thirty minutes post-LPS administration, a subset of mice underwent HBOT at a 2.5 atmospheric pressure absolute with 100% oxygen for 60 minutes. After 24 hours, all mice were euthanized for measurements.

Results
Our results demonstrated that HBOT effectively mitigated renal tubular cell apoptosis, as evidenced by decreased apoptosis-associated proteins, including Bax/Bcl-2 and cleaved caspase 3/caspase 3 ratios. HBOT significantly reduced phosphorylated p53 proteins and cytochrome C levels, suggesting that HBOT may attenuate renal apoptosis through decreased p53 activation and cytochrome C release. Notably, HBOT preserved manganese-dependent levels of superoxide dismutase, an antioxidant enzyme, compared to the LPS group. Furthermore, transforming growth factor-β (TGF- β)/Smad4 and alpha-smooth muscle actin expressions were significantly reduced in the LPS+HBOT group.

Conclusion
An early single session of HBOT exhibited renoprotective effects in LPS-induced endotoxemia mice models by mitigating apoptosis by suppressing p53 activation and cytochrome C levels. The observed TGF-β decrease, downstream Smad expression reduction, and antioxidant capacity preservation following HBOT may contribute to these effects.
#2385 Inhibition of histone lysine demethylases 5 attenuates acute kidney injury but not acute kidney disease or chronic kidney disease
Authors: Lee So Young , Koh Eun Sil , Chung Sungjin 
Published: May 2024

Abstract

Background and Aims
The histone lysine demethylases 5 (KDM5) are members of the family of Jumonji C domain-containing histone demethylases and catalyze the removal of di- and tri-methyl moieties from the fourth lysine of histone 3 (H3K4me2/3). It has been reported that the KDM5 family mediates a range of physiological and pathological events including cell differentiation, motility, senescence and epithelial-mesenchymal transition (EMT) via activating or repressing transcription in demethylase-dependent or independent manners in both homeostasis and disease. This study investigated the potential role of KDM5 in the development and progression of renal fibrosis in acute kidney injury (AKI), chronic kidney disease (CKD) or AKI to CKD transition (acute kidney disease, AKD).

Method
We evaluated therapeutic effects of KDM5 inhibition in AKI model of unilateral nephrectomy plus contralateral ischemia-reperfusion (IR) injury, AKI to CKD transition model of unilateral IR injury plus removal of contralateral uninjured kidney after 8 days of IR injury, and CKD model of unilateral ureteral obstruction (UUO) in mice.

Results
KDM5 C70 inhibitor prevented the increase of blood urea nitrogen and positive areas of trichrome, Sirius red, F4/80 and α-smooth muscle actin in injured kidneys 7 days after IR injury. Significant reductions in renal mRNA levels of pro-inflammatory cytokine/chemokine, EMT and pro-fibrotic markers (IL-1β, IL-6, TNF-α, CCL2, CCL3, GM-CSF, MMP9, fibronectin, vimentin, TGF-β1, COL4A1) were also observed with attenuated mRNA levels of KDM5a-c. In addition, renal protein levels of antioxidants such as catalase, SOD1 and SOD2 were increased in injured kidneys of KDM5 inhibitor-treated mice. However, parameters of renal fibrosis and inflammation were similar between mice without and with KDM5 inhibitor in both AKD and CKD models.

Conclusion
These data demonstrate that inhibition of KDM5 could prevent renal inflammation and fibrosis after acute and severe IR injury. The activation of KDM5 might be an early step in the development of renal fibrosis after AKI insult.
#1256 Comparison of clinical characteristics of acute kidney injury between glufosinate and glyphosate poisoning
Authors: Cho A Young , Sun In O 
Published: May 2024

Abstract

Background and Aims
There are few studies comparing the clinical characteristics of acute kidney injury (AKI) between glufosinate and glyphosate poisoning. In this study, we investigated the clinical characteristics of AKI in patients with glufosinate and glyphosate poisoning, and compared the clinical features of AKI between two groups.

Method
This study performed between 2008 and 2021 included 76 patients with glufosinate poisoning and 184 patients with glyphosate poisoning. This study included 76 patients with glufosinate poisoning and 184 patients with glyphosate poisoning in the period from 2008 to 2021. Based on Risk, Injury, Failure, Loss of kidney function, and End-stage kidney disease classification, we investigated the incidence, clinical characteristics, and severity of AKI between two groups [(glufosinate-induced AKI (Glu-AKI, n=54) and glyphosate-induced AKI (Gly-AKI, n=82)].

Results
The incidence of AKI in patients with glufosinate poisoning is higher than that of glyphosate poisoning (57.5% vs 44.5%, P&lt;0.05). However, there is no difference of AKI severity between two groups (Glu-AKI; Risk 56.2%, Injury 36.9%, Failure 6.9% vs Gly-AKI; Risk 56.2%, Injury 14.6%, Failure 29.2%, P=NS). Comparing two groups, there is also no difference in age (62.6 ± 14.2 years vs. 63.3 ± 16.2 years, P=NS) and renal function on admission (63.9 ± 25.2 mL/min/1.73 m2 vs. 62.2 ± 22.9 mL/min/1.73 m2, P=NS). The length of hospitalization was longer (17.2 ± 17.2 days vs. 10.7 ± 12.1 days, P&lt;0.05) in Glu-AKI group than that of Gly-AKI group. The mortality rate was higher in the Gly-AKI group than Glu-AKI (11.1% vs. 18.3%, P=NS). Multivariate logistic regression analysis showed that serum bicarbonate concentration on admission was a significant predictors of AKI in patients with AKI after glyphosate and glufosinate intoxication.

Conclusion
Although there is a higher incidence of AKI in glufosinate poisoning, there is no difference in clinical characteristics between the two types of intoxication.
#1304 Clinical characteristics of acute kidney injury caused by Phytolaccaceae ingestion
Authors: Sun In O , Cho A Young 
Published: May 2024

Abstract

Background and Aims
Phytolaccaceae is a poisonous plant that is associated with cardiac and gastrointestinal toxicity. However, there are limited data about acute kidney injury (AKI) in patients with Phytolaccaceae ingestion. We conducted this study to investigate the clinical characteristics of AKI by Phytolaccaceae overdose.

Method
From 2010 to 2022, 15 patients with Phytolaccaceae ingestion were enrolled in this study. The incidence, clinical characteristics, and severity of AKI were compared between AKI (N=8) and non-AKI (N=7) groups according to the RIFLE classification.

Results
Of the 15 patients, 8 patients experienced AKI during hospitalization period. There is no difference in age (54.3 ± 7.2 years vs. 67.1 ± 13.5 years, P=0.057) and comorbidities such as hypertension and diabetes (37.5% vs 28.5%, P=0.563) between two groups. In addition, there is also no difference in total leukocyte count (10.8 × 103/mL vs. 11.4 × 103/mL, P=0.84) and serum albumin level (4.5 ± 2.6 vs 4.3 ± 0.5, P=0.498). Compared to patients without AKI, the estimated glomerular filtration rate was lower in the AKI group (57 ± 12 ml/min/1.73 m2 vs. 77 ± 24 ml/min/1.73 m2, p&lt;0.05) on admission. The AKI group had a significantly longer hospital stay (9.7 ± 6.2 vs 6.1 ± 3.1 days, p&lt;0.001). The overall AKI incidence was 61.5%, of which 46.1% and 15.4% cases were classified as risk and injury, respectively. All patients recovered baseline renal function without renal replacement therapy following antibiotics therapy and supportive care.

Conclusion
The incidence of AKI in patient with Phytolaccaceae ingestion is 61.5%. Most patients with AKI had a mild type of AKI during admission period. In cases of AKI patients with Phytolaccaceae ingestion, aggressive supportive care including hydration is very important.