bluuebunny/crossref_metadata_2025_split huggingface dataset:
#2767 Micro(nano)plastics are exposed and bioaccumulated in human fetus—the first evidence from neonatal umbilical cord blood and urine
Authors: Feng Xiaoqian , Song Xuan , Du Lixia , Tan Zhongyou , Qiu Xihong , Chen Zongwen , Mo Yunbo 
Published: May 2024

Abstract

Background and Aims
At present, the world population problem is increasingly serious, and the impact of environmental pollution on the health of pregnant women and fetuses is a global research focus. Among them, micro(nano)plastics (MNPs), as an emerging pollutant, has been confirmed by several animal experiments and in vitro human cell experiments to have biotoxic effects. Recent studies have shown that MNPs are found in human placenta, amniotic fluid, meconium, and other samples, but there is still a lack of direct evidence that MNPs can enter and bioaccumulate in the fetus.

Method
To initially explore the actual situation of neonatal exposure to MNPs, this study collected umbilical cord blood samples and postnatal urine samples from 6 healthy fetuses in Chengdu, Sichuan, China, and used pyrolysis-gas chromatography/mass spectrometry (Py-GC/MS) and laser direct infrared spectroscopy (LDIR) to detect and analyze MNPs in samples.

Results
With an average abundance of 81.15 (40.71) μg/g, MNPs were found in 6 umbilical cord blood samples by Py-GC/MS. Polyethylene (PE), polyvinyl chloride (PVC), polystyrene (PS) and polyamide 66 (PA66), 4 different types of MNPs were found, with PE content being the highest among them. By using LDIR, MNPs were found in 5 umbilical cord blood samples, with an average abundance of 17.39 (18.91) particles/g. Three different types of MNPs were found, they are acrylates (ACR), polyethylene terephthalate (PET) and polypropylene (PP). MNPs particles were detected in 6 urine samples by PY-GC/MS, and the average abundance was 8.42 (4.70) μg/g. Two kinds of MNPs, PE and PVC, were detected, and the content of PE was higher.

Conclusion
The findings demonstrated that the contents and types of MNPs in umbilical cord blood samples were higher than those in urine samples. The levels of MNPs were correlated with the living habits of pregnant mothers, such as the frequency of ordering take-out food. In this study, through the detection of MNPs in umbilical cord blood and neonatal urine samples, we found the direct evidence of MNPs in the fetus for the first time, further confirmed that MNPs can enter the urine through renal metabolism, preliminarily explored the exposure and bioaccumulation effect of MNPs in the fetus, and analyzed the possible risks and related factors of exposure of MNPs during pregnancy, which provided a theoretical basis for in-depth study of the health impact of MNPs on pregnant women and fetuses.
#676 Correlation between dietary live microbe intake and all-cause mortality based on baseline characteristics: results from NHANES 2011-2018
Authors: Nicikowski Jan , Łopińska Joanna , Habura Ireneusz 
Published: May 2024

Abstract

Background and Aims
The gut microbiome plays a beneficial role in human health, including kidney function and chronic kidney disease progression. Potential therapeutic strategies for CKD and hypertension that target the gut microbiota include dietary interventions, mainly probiotic, prebiotic, synbiotic modulation. In addition to probiotic foods, live micro-organisms are also found in other food products, such as raw vegetables and fruits. In this study, we evaluated the potential impact of dietary live microbiome intake on all-cause mortality in different baseline characteristics, including kidney function status.

Method
A total of 20 627 subjects were included in the study. We used data from the US National Health and Nutrition Examination Survey 2011-2018. Based on a 2-day 24-hour dietary recall, the dietary intake of the live microbiome was adjusted and the participants were categorized into three groups: low (&lt;104 CFU/g), medium (104–107 CFU/g), or high (&gt;107 CFU/g) dietary intake of live microbes, according to the classification system for the dietary intake of live microbes and participants’ 24-hour dietary recall data. Low intake was used as a reference. Baseline characteristics included kidney function by estimated glomerular filtration rate (GFR-EPI &lt;60 mL/min/1.73 m2) and urinary albumin-to-creatinine ratio (uACR &gt;30 mg/g). We used a multivariate Cox proportional hazards model to identify the impact of dietary live microbiome intake on all-cause mortality. In subgroups, we adjusted the Hazard Ratio (aHR) of the additional factors in the models.

Results
The risk for all-cause mortality was significantly decreased in subjects included in the medium dietary live microbiome intake (HR: 0.82, 95% Cl: 0.73-0.93, p &lt; 0.004). In subgroup analysis (N = 3302), medium dietary intake of the live microbiome decreased mortality in subjects with eGFR &lt;60 mL/min/1.73 m2 or uACR &gt;30 mg/g and BMI &gt;25 (aHR: 0.86, 95% CI: 0.75-0.99, p&lt;0.05) as compared to low dietary intake of the live microbiome group after adjustment for hypertension, diabetes, BMI, total calorie intake, laboratory results (hemoglobin, creatinine, total cholesterol, estimated glomerular filtration rate). However, there was no significance to the risk for all-cause mortality in the subgroup with CKD between the high and low dietary live microbiome intake groups.

Conclusion
In this study, low dietary live microbial intake significantly increased all-cause mortality in the population. The medium dietary intake of live microbiome significantly decreased all-cause mortality in overweight or obese patients with CKD or microalbuminuria.
#210 Effects of serum magnesium level on kidney disease progression and major cardiovascular outcome in patients with chronic kidney disease
Authors: Kwon Seong , Park Hyejin , Cho Da Hae , Suh Sang Heon , Bae Eun Hui , Kim Soo Wan 
Published: May 2024

Abstract

Background and Aims
Magnesium is known for its anti-inflammatory, anti-apoptotic, and anti-oxidative effects, potentially inhibiting renal fibrosis. Additionally, it is believed that magnesium can inhibit vascular calcification, potentially improving cardiovascular outcomes. However, this remains a topic of controversy. This study aims to investigate the association between serum magnesium levels and CKD progression as well as cardiovascular outcomes.

Method
We analyzed 1,893 patients from The KoreaN Cohort Study for Outcomes in Patients With Chronic Kidney Disease (KNOW-CKD), which is a prospective cohort study. These patients were categorized into three groups based on their baseline magnesium levels: Mg1 (hypomagnesemia, &lt;1.8 mg/dL), Mg2 (normomagnesemia, 1.8-2.4 mg/dL), and Mg3 (hypermagnesemia, &gt;2.4 mg/dL). The primary outcome was defined as meeting one or more of the following criteria during the follow-up period: initiation of dialysis or transplantation, a two-fold increase in baseline serum creatinine levels, or a 50% decline in the estimated glomerular filtration rate. The secondary outcome was a composite of major adverse cardiovascular events (MACEs). We used Cox proportional hazard regression model.

Results
A total of 673 patients (35.6%) experienced the composite renal outcome. The Mg1 group showed significantly increased adverse renal outcomes compared to the Mg2 group (HR, 1.885; 95% CI, 1.137-3.124; p = 0.013), however, Mg3 group did not show a significant difference (HR, 0.927; 95% CI, 0.783-1.097; p = 0.379). The composite cardiovascular outcome occurred in 138 patients (7.3%). The risk of composite cardiovascular outcomes significantly increased in the Mg1 group compared to the Mg2 group (HR 3.472; 95% CI, 1.492-8.076; p = 0.003). However, we observed no statistically significant differences in the Mg3 group (HR 1.021; 95% CI, 0.689; p = 0.913). The cubic spline curves demonstrated a U-shaped association between serum magnesium levels and both renal and cardiovascular outcomes.

Conclusion
Hypomagnesemia is associated with the progression of renal disease and a significant increase in MACEs. Beyond a certain level, hypermagnesemia may also be associated with worsening renal and cardiovascular outcomes.
#691 Validation of a prognostic model for adverse events in advanced chronic kidney disease in the Chinese population
Authors: Xingchen Yao , Yang Chao , Wang Jinwei , Li Chenglong , Zhang Luxia 
Published: May 2024

Abstract

Background and Aims
Currently, the Grams model has been developed to estimate risks of adverse events among advanced chronic kidney disease (CKD) patients in western populations. Its utility is noteworthy as it predicts multiple adverse events within a single model while taking competing risks into account. While no external validation has been conducted among Asian, especially Chinese population, restricting further practical application and clinical benefits evaluation. Hence, we aimed to validate the performance of Grams model for estimating risks of major adverse events among Chinese CKD population.

Method
The Grams model was validated in the Chinese Cohort Study of Chronic Kidney Disease (C-STRIDE) study, a multicenter prospective cohort study which involved 39 renal departments of 39 hospitals from 28 cities of 22 provinces in China. Participants with estimated glomerular filtration rate (eGFR) &lt;30 ml/min/1.73 m2 during baseline and follow-up were enrolled. The same predictors as those selected in the Gram model were considered, including age, sex, race, history of cardiovascular disease(CVD), smoking status, systolic blood pressure, diabetes mellitus, eGFR, and urine albumin-to-creatinine ratio (uACR). The outcomes included kidney replacement therapy(KRT), CVD and death within 2- and 4- year follow-up periods. The discrimination and calibration of the model were evaluated using the concordance index (C index), the ratio of observed and expected outcomes (O/E ratio), and the calibration curve. The clinical utility of the model was assessed through decision curve analysis. Intercept recalibration was used to update the model.

Results
Among 1333 included participants (54 (IQR, 43-64) years, 699(52.4%) male), 386(29.0%) developed KRT, 118(8.9%) developed CVD, 88(6.6%) died during the follow-up period. The Grams model showed a moderate to good discrimination for three outcomes, with the C index ranging from 0.656 to 0.720. According to the O/E ratios and calibration curves, the calibration for KRT was relatively accurate, but the model overestimated the predicted probability of CVD and death. Intercept recalibration led to closer alignment of observed and predicted risks. Decision curve analyses revealed the superior net benefit of the Grams model in guiding KRT preparation.

Conclusion
In summary, the Grams model exhibited moderate discrimination for predicting outcomes, with relatively accurate calibration for KRT but an overestimation of predicted probabilities for CVD and death, intercept recalibration improved the calibration of the model. Despite its limitations, the model offered a superior net benefit in guiding KRT preparation, suggesting its potential use in clinical decision-making process. Further investigations are warranted to improve the performance of the Grams model in Chinese population.
#3012 Great impact of the results of PREMs and PROMs in all stages of chronic kidney disease. Analysis of 281 patients
Authors: Teruel Jose Luis Górriz , Giménez-Civera Elena , Francés Francesc Moncho , Herranz Athenea , Daza Carla , Gonzalez Nayara Panizo , Perez-Baylach Carmen Maria , Calabuig Maria Asuncion Sancho , Candia Boris Marcelo Gonzales , Velásquez Caterina Rodriguez , Velasquez Maria Fernanda Alvarado 
Published: May 2024

Abstract

Background and Aims
In recent years, there has been a growing interest in the use and relevance of Patient-Reported Outcomes Measures (PROMs) and Patient-Reported Experience Measures (PREMs). The main objective of the study is to analyze scores in quality of life, anxiety, depression, and functional capacity using tests that assess PREMs and PROMs in patients at different stages of chronic kidney disease (CKD).

Method
Multicenter, cross-sectional, observational, non-interventional study with 281 patients (84 on hemodialysis, 48 on peritoneal dialysis, 50 with kidney transplant, 50 with advanced CKD, and 49 patients with CKD stages 1-2). Two professionals conducted interviews for data collection from all patients. Collected data: For PROMs: PFS (Piper Fatigue Scale), HADS (Hospital Anxiety and Depression Scale), FACIT-F (Functional Assessment of Chronic Illness Therapy-Fatigue Scale), SF-36, VAS (Visual Analogue Scale). For PREMs - PACIC test (Patients' Assessment of Chronic Illness Care), in addition to other comorbidity indices and laboratory analyses. ANOVA statistical analysis was used for group comparison.

Results
Although patients showed significant differences in age and comorbidities, our analysis shows that the most PROMs do not discriminate between different stages of CKD. The PROMs that most discriminate between different stages of CKD are those related to the Piper Fatigue Scale test. PREMs, analyzed using the PACIC scale, do achieve said discrimination (Table 1).

Conclusion
The analysis of PROMs and PREMs show the significant impact that CKD has on health-related quality of life. Some PROMs can discriminate between different stages of CKD, but the most effective ones are PREMs, which are an indirect indicator of the quality of care received, contributing to patient involvement in decision-making and empowerment.
#1677 Initiation of Vericiguat and short-term cardiovascular function improvement in heart failure patients with worsened renal function
Authors: She Jianqing , Lou Bowen , Liu Hui 
Published: May 2024

Abstract

Background and Aims
Vericiguat, a novel soluble guanylate cyclase (sGC) stimulator, is approved for treating heart failure (HF) with reduced ejection fraction (HFrEF). This study aims to assess the short-term improvement in cardio-function resulting from in-hospital initiation of Vericiguat among patients with chronic kidney dysfunction (CKD), utilizing real-world data from a single-center experience in western China.

Method
Data were obtained from the Biobank of the First Affiliated Hospital of Xi'an Jiaotong University, spanning from January 2023 to December 2023. A total of 213 HF patients with Vericiguat initiation were screened for eligibility. Echocardiography was employed to evaluate cardio-function after 1- and 3-month short-term follow-up in each patient. Statistical analyses were conducted using one-way ANOVA (followed by Geisser-Greenhouse correction and Tukey's multiple comparison) to assess significance between different timepoints.

Results
Among the 213 patients randomized in this study, baseline characteristics were compared based on estimated glomerular filtration rate (eGFR) ≤ 30 (worsened renal function group, WRF, n = 20) and &gt;30 mL/min/1.73 m2 (n = 193). No significant differences were observed in age, gender, and other biochemical parameters expect hemoglobin and creatine between the two groups (Table 1). Analysis of cardiac function after 1- and 3-month follow-up revealed a promising increase in left ventricular ejection fraction (EF) (37.2% vs. 43.9%, Mean diff −6.7, 95% CI −12.78 to −0.62, p = 0.03), fractional shortening (FS) (20.9% vs. 25.3%, Mean diff −4.42, 95% CI −8.57 to −0.27, p = 0.04), and a significant decrease in left ventricular end-diastolic dimension (LVEDD) (65.0 mm vs. 60.6 mm, Mean diff 4.35, 95% CI 0.33 to 8.38, p = 0.03) after 3-month follow-up compared to Vericiguat initiation in WRF patients. However, no significant changes were observed between the beginning and 1-month follow-up in echocardiographic measurements (Fig. 1).

Conclusion
In this real-world single-center study, Vericiguat demonstrated effectiveness in short-term improvement of cardiac function among HF patients with worsened renal function. The long-term efficacy in reducing major cardiovascular events in this subgroup, based on real-world experience, warrants further exploration.
#373 Risk factors for progressive cardiorenal syndrome in patients with chronic kidney disease: the CRIC study
Authors: Chen Jing , He Jiang 
Published: May 2024

Abstract

Background and Aims
Cardiorenal syndrome (CRS) is associated with poor outcomes. However, risk factors for progressive CRS are not well studied in patients with chronic kidney disease (CKD). We studied the incidence and risk factors for progressive CRS in a cohort of CKD patients.

Method
3 557 participants with CKD in the Chronic Renal Insufficiency Cohort (CRIC) Study were included in this analysis after excluding those with heart failure (HF) at baseline visits. The mean follow-up time was 10.5 years. Progressive CRS was defined as development of both HF and renal failure (RF) (dialysis or transplant) within 12 months of each other. Cox proportional hazards models were used to examine the association of risk factors with progressive CRS. In a sensitivity analysis, risk factors for CRS type 2 (HF preceded RF during entire follow up) and CRS type 4 (RF preceded HF) were analyzed.

Results
The average baseline age was 59 years for those with progressive CRS and 57 years for those without. The age-adjusted incidence of progressive CRS was 4.5/1000 person-years and was 5.0/1000 person-years in Men and 5.9 in Black. The multivariable-adjusted hazard ratios (HRs) with corresponding 95% confidence intervals (CIs) for traditional risk factors are as follow: less than high school education (1.82, 1.2-2.73), history of cardiovascular disease (CVD) (1.48, 1.03-2.12), lower educational attainment (per 1 standard deviation [SD]) in eGFR (1.83, 1.40-2.39), and higher (per 1 SD) albumin-to-creatinine ratio (ACR) (2.26, 1.78-2.86). The multivariable-adjusted HRs with corresponding 95% CIs for a one-standard deviation increase in novel risk factors are as follows: hemoglobin (0.82, 0.68-0.99), hemoglobin A1C (1.31, 1.14-1.52), log alkaline phosphatase (1.18, 1.00-1.38), and log brain natriuretic peptide (1.32, 1.10-1.57), adjusting for age, sex, race, clinic sites, and all significant traditional risk factors (education, CVD, eGFR, and ACR). In sensitivity analysis, the risk factor associated with both CRS type 2 and 4 were kidney dysfunction, albuminuria, and mineral bone disorder (higher alkaline phosphatase and FGF23), inflammation (TNF-α), and fibrotic factor (GDF-15), while diabetes, CVD, systolic blood pressure, waist circumference, anemia, HbA1c, and volume overload were more strongly associated with CRS type 2 compared to CRS type 4.

Conclusion
This study indicates that education level, history of CVD, kidney dysfunction, albuminuria, mineral bone disorder, diabetes control, anemia, volume overload, inflammation, and fibrotic factors are associated with progressive CRS. Many of these risk factors are modifiable. Further studies are warranted to assess the benefits of specific interventions to improve CRS outcomes.
#1313 Dicumarinics and the direct thrombin or factor Xa inhibitors (NOAs) their usefulness in advanced chronic renal disease
Authors: Gutiérrez Paulo García , Garrote Pablo Luis Sánchez , Morales Byron Chiliquinga , Varas Carmen Martin , Gomez Astrid Rodriguez , Garcia Leonardo Calle , Alonso Carlos Santos , Losada Maria Nieves , Luis Maria Jose Fernandez-Reyes 
Published: May 2024

Abstract

Background and Aims
Our population with advanced chronic kidney disease (ACKD), is more prone to thrombotic and hemorrhagic processes so the indication of anticoagulation before the appearance of atrial fibrillation (AF) is complex. Since AF is the most common cardiac arrhythmia, its main complications are thromboembolism and stroke. New treatments are being developed, such as the new oral anticoagulants (NOAs), but their safety in ACKD is still uncertain.
To see anticoagulation needs, safety and major adverse effects (major or minor bleeding) in population with ACKD and taking dicumarinics or NOAs.

Method
Retrospective study of 234 patients followed in our ACKD practice, at least two revisions, with a mean follow-up 25.5 months, in which we recorded cause of anticoagulation, type and major adverse effects.

Results
26% of patients have indication for anticoagulation (66 patients), of which 55 remain anticoagulated during follow-up (45% Dicumarinics, 44% NOAs). The indication for anticoagulation was 23% AF (56 patients) and 3% mechanical prostheses (7 patients). Table 1 shows the characteristics of the overall population and the comparison between anticoagulated patients with different types of anticoagulation and non-anticoagulated patients. Non-anticoagulated patients are younger and have less ischemic heart disease, with no differences in the non-anticoagulated population. Throughout follow-up, we found a higher incidence of bleeding with NOAs (compared to the rest) and higher mortality in patients with dicumarinics (compared to the rest). There were no differences in age, sex and ischemic heart disease between the two anticoagulant treatments.

Conclusion
Our CKD population has a high need for anticoagulation but also a high risk of bleeding. NOAs can be used in ACKD although they are associated with a higher incidence of bleeding than dicumarinics but lower mortality. More studies are needed to conclude which is the best approach for these patients.
#1533 The relationship between the severity of anemia, the level of inflammation markers and the dose of epoetin in patients in pre-dialysis stages of CKD
Authors: Egamberdieva Dano , Ruzmetova Iroda 
Published: May 2024

Abstract

Background and Aims
Inflammation is known to be an important factor associated with hemoglobin variability in patients with anemia of chronic disease. However, the question remains whether high levels of C-reactive protein, a widely used marker of inflammatory activity, and other inflammatory markers predict less stable anemia control in patients with CKD.
The purpose of this study was to establish the relationship between the severity of anemia with the levels of inflammatory markers (C-reactive protein, IL-6) and the dose of epoetin in patients with pre-dialysis stages of CKD.
The purpose of our study was to study the age-related characteristics of the nutritional status in patients with CKD of the dialysis stages who are on parenteral nutrition.

Method
180 patients (96 men and 84 women) with CKD as a result of nephropathies of diabetic and non-diabetic etiology were examined. Chronic pyelonephritis was diagnosed in 96 patients, chronic glomerulonephritis - in 73, polycystic kidney disease - in 11 patients. Glomerular filtration rate was calculated based on serum creatinine concentration using the CKD-EPI formula (2011). The patients were divided into 2 groups, depending on the achievement of the target hemoglobin value. Thus, group 1 included patients with CKD C3, C4, whose hemoglobin concentration was above 110 g/l (n = 101). Group 2 included patients whose hemoglobin concentration was less than 110 g/l in at least one analysis (n = 79).

Results
In the examined patients, a significant correlation was found between the range of hemoglobin concentration and the range of CRP concentration (p &lt; 0.05), as well as between the range of hemoglobin concentration and the variation in the percentage of hypochromic erythrocytes (p &lt; 0.05), between the range of hemoglobin concentration and the variation of ferritin ( p &lt; 0.05). The change in the percentage of hypochromic erythrocytes also correlated with the change in IL-6 (p &lt; 0.05) and the change in CRP ( p &lt; 0.05). We found an association between the average weekly dose of epoetin and the levels of CRP, IL-6 and TNF-α. Patients with TNF-α levels ≥2 ng/mL and IL-6 ≥40 ng/mL required a significantly higher dose of epoetin than patients with lower levels of these markers (128 U/kg per week versus 57 U/kg at week).

Conclusion
The establishment of a relationship between inflammatory markers and hemogram and iron parameters suggests that inflammation had an indirect effect on the increase in hemoglobin through its effect on iron metabolism. The results of the study indicate the presence of diabetic and non-diabetic etiology of systemic inflammation in CKD, more so in the group of patients with type 2 diabetes mellitus.