bluuebunny/crossref_metadata_2025_split huggingface dataset:
#1714 The treatment of antibody-mediated rejection in kidney transplantation with recent drugs: a network meta-analysis
Authors: Song Joon Ho , Lee Seoung Woo , Kim Kipyo , Cha Joonhyuk , Hwang Seun Deuk 
Published: May 2024

Abstract

Background and Aims
The recent treatments for antibody-mediated rejection (AMR) have been carried out in a small number of controlled clinical trials and are based on limited data. In recent research on AMR treatment, new drugs targeting B cells, plasma cells, the complement system, and IL-6 have been gaining attention.

Method
Studies on antibody mediated rejection (AMR) treatment were divided into four groups:, 1) rituximab, 2 bortezomib, 3 eculizumab, and 4) tocilizumab. We searched the CENTRAL, MEDLINE, EMBASE, and Science Citation Index Expanded databases from 1970 to February 2023.5. We performed direct and indirect network meta-analyses using Bayesian models and ranked different AMR treatment method using a generation mixed treatment comparison (GeMTC) and Stata version 13. The outcomes included patient survival, graft failure, and bacterial and viral infections

Results
This analysis included 21 clinical trials with a total of 1217 participants. We focused on graft failure events based on the use of four groups of medications when patients received induction therapy for AMR treatment. There was a lower tendency in graft failure rates in the bortezomib and tocilizumab groups (odds ratio [OR] 0.31, 95% CrI: 0.058-1.4 and OR 0.42, 95% CrI 0.012-7.4), while the eculizumab group showed a higher graft failure rate (OR 2.3, 95% CrI 0.26-31.0) compared to the rituximab using group. However, these study results were not statistically significant.

Conclusion
When looking at the study results, although not statistically significant, it was observed that bortezomib and tocilizumab, compared to rituximab, showed a tendency to reduce the incidence of graft failure after AMR occurrence. Although this study did not demonstrate statistical significance, it is believed that future research with increased enrollment and additional studies may help identify effective drugs for AMR treatment.
#2504 Histopathological findings and cardiovascular events in kidney transplantation
Authors: Espinosa Diana Rodríguez , Hermida Evelyn , Cúpich Agustín Leal , Cuadrado Elena , Escudero Victor Joaquin , Morantes Laura , García-Herrera Adriana , Diekmann Fritz , Monzo Jose Jesus Broseta , Prats José Vicente Torregrosa 
Published: May 2024

Abstract

Background and Aims
Despite offering superior outcomes for patients with end-stage kidney disease, kidney transplantation poses significant cardiovascular risks. Recently, histopathological findings in chronic kidney disease patients have been associated with all-cause mortality and cardiovascular events, but there is scant data on this subject in kidney transplant recipients. This study assesses the relationship between histopathological findings in protocol biopsies of kidney grafts and cardiovascular events, graft loss, and mortality in renal transplant recipients.

Method
A prospective observational study included 530 renal transplant recipients at the Hospital Clínic de Barcelona from March 2015 to 2019, with follow-up until March 2023. Data included demographics, comorbidities, laboratory tests, and protocol allograft biopsies at 3 and 12 months post-transplant. Associations between histopathological findings and outcomes (cardiovascular events, graft loss, mortality) were analyzed.

Results
Chronic vascular lesions (CV) were significantly correlated with cardiovascular death and major adverse cardiovascular events (MACE) (OR 10.4 (1.6–66.4); p 0.002). Arteriolar hyalinosis and interstitial fibrosis were independently associated with all-cause mortality (OR 4.9 (1.1-21.4); p 0.02, and 1.2 (1.03-1.3), p 0.005; respectively) regardless of the estimated glomerular filtration rate (eGFR). Associations were also found between pre-transplant factors (diabetes, hypertension, hyperphosphatemia), active smoking, and deceased donors. Notably, post-transplant hypophosphatemia was related to MACE, suggesting a potential association with malnutrition though, this subject requires further investigation.

Conclusion
Histopathological findings in early protocol biopsies of kidney grafts, especially chronic vascular lesions, arteriolar hyalinosis, and interstitial fibrosis, have a potential predictive value for cardiovascular events, mortality, and graft outcomes in transplant recipients, irrespective of eGFR. These insights emphasize the importance of timely post-transplant histological assessments for risk stratification and personalized interventions. Prospective studies are imperative to validate these findings and improve customized care strategies in this population.
#132 Electrocauterization versus ligation of lymphatic vessels to prevent lymphocele development after kidney transplantation—a meta-analysis
Authors: Matrisch Ludwig , Nitschke Martin , Lapshyn Hryhoriy , Rau Yannick 
Published: May 2024

Abstract

Background and Aims
Lymphoceles are amongst the most common complications following kidney transplantation. They can cause pain, discomfort, and even transplant malfunction or graft loss through the application of pressure on the graft as well as its surrounding structures. Therefore, effective strategies to prevent their development are needed. The ligation of lymphatic vessels has proven to be a successful concept for that purpose. However, whether electrocauterization or suture ligation is more effective is unclear.

Method
We conducted a meta-analysis using a random effects model with the log risk ratio as primary outcome measure. Additionally, an analysis using a random effects model with the raw mean difference in lymphatic sealing time between suture ligation and electrocauterization was performed. Adequate studies were found in a literature research conducted on PubMed and Web of Science as well as from independent sources.

Results
A total of 7 studies including 511 patients were included in the analysis. 16/244 (6.5%) lymphoceles were observed in the electrocauterization group and 28/267 (10.5%) in the suture ligation group, resulting in an overall incidence of 44 (8.6%) in the total population. The estimated average log risk ratio based on the random-effects model was µ=−0.349 (95% CI: −0.934 to 0.235), not significantly different from zero (z=−1,17, p=0.241). Lymphatic sealing time was 7.28 (95% CI: 1.25-13.3, p=0.018) minutes shorter in the electrocauterization group.

Conclusion
We conclude that neither technique is superior for the purpose of lymphocele prevention post kidney transplantation and secondary criteria like time saving, cost and surgeons’ preference should be considered in the decision for optimal outcome. However, it is unclear whether these results can be generalized for all patients.
#2608 Trends over time in the causes of death with a functioning graft among kidney transplant recipients
Authors: Sab Marc , de Terwangne Christophe , Goffin Eric Jean , Darius Tom , Buémi Antoine , Mourad Michel , Devresse Arnaud , Kanaan Nada 
Published: May 2024

Abstract

Background and Aims
Cardiovascular diseases are traditionally considered as the leading cause of death in kidney transplant recipients. Significant improvements in immunosuppressive strategies but also in the prevention and management of cardiovascular diseases have been made over the last decades. Therefore, we aimed to explore the evolution over time of the causes of death with a functioning graft in kidney transplant recipients.

Method
We performed a retrospective study including all patients transplanted with a kidney between January 1995 and December 2009 at Cliniques Universitaires Saint-Luc in Brussels who died with a functioning graft. Patients younger than 18 years old and those who received bone marrow or other solid organ transplant were excluded. Clinical data were collected by electronic medical chart review. Differences in causes of death were assessed between two eras of transplantation (first era [1995-2001] vs second era [2002-2009]).

Results
A total of 256 patients (aged 56 ± 11.18 years, 164 (64.9%) man) were included. Among those patients, 65 (25.39%) died from infectious causes, 64 (25%) from neoplastic causes, 62 (24.22%) from cardiovascular causes and 24 (9.38%) from other causes. The cause of death was unknown for 42 (16.41%) patients. Patients who received a kidney graft during the first era mostly died from cardiovascular causes (33%), while those who received a graft during the second era mostly died from infectious causes (31%). Death from neoplastic causes remained similar across eras (32 (26%) versus 32 (24%), p-value &gt; 0.1). Patients grafted in the more recent era have threefold higher odds of dying from infectious than cardiovascular causes compared to those grafted in the former graft era (OR 3.1, p=0.002). Infectious causes of death were the most prevalent early cause of death in both eras i.e. 3 patients (60%) in the first era and 6 patients (50%) in the second era.

Conclusion
We observed a significant shift from cardiovascular deaths to infectious deaths between the former and the more recent transplantation era. Neoplastic causes of death remained stable over time.
#980 Lipid spectrum in patients with coronary artery disease with contrast-induced nephropathy during X-ray endovascular procedures
Authors: Muminova Sitora , Kadirovich Muminov Davron 
Published: May 2024

Abstract

Background and Aims
Study of the main indicators of the lipid spectrum in patients with coronary artery disease with contrast-induced nephropathy (CIN), which developed during X-ray endovascular procedures (ERP).

Method
The study included 303 patients with stable forms of coronary artery disease who underwent X-ray endovascular procedures (REP). The average age of the patients was 53.79 ± 1.27 years. Based on the results, all patients were divided into 2 groups - patients with an uncomplicated postoperative period of REP (CIN− group, 206 patients, 67.99%) and patients who developed contrast-induced nephropathy (CIN+ group, 97 patients, 32.01%). Kidney filtration function was assessed by the clearance of endogenous cystatin C with calculation of the glomerular filtration rate (eGFRcys=90.63 × cystatin C – 1.192). Three fractions of lipoproteins were selected as indicators of the lipid spectrum: cholesterol containing LDL and HDL, as an anti-atherogenic factor, and VLDL, the main triglyceride-containing fraction.

Results
It was found that in patients in the CIN+ group, the LDL level was significantly higher than that characteristic of the CIN− group (p&lt;0.001) and CG (p&lt;0.001). At the same time, in the CIN− and CG groups, the LDL concentration was comparable, despite the use of statins in the groups of patients with coronary artery disease. The concentration of the second studied atherogenic fraction, VLDL, was also increased in patients with IHD compared with the CG (p&lt;0.001 compared with both groups of patients with IHD) with a maximum increase in patients of the CIN+ group (p&lt;0.01 significance of the difference between the CIN+ and KIN−). The concentration of the antiatherogenic fraction of the lipid spectrum—HDL—was significantly and comparable reduced in both groups of patients with coronary artery disease (p&lt;0.001 when comparing both groups of patients with CG).

Conclusion
In the course of this study, it was found that one of the risk factors for the development of CIN in patients with coronary artery disease after REP is an increased concentration of atherogenic lipoproteins in the peripheral blood. A decrease in the level of anti-atherogenic HDL in the present study was not associated with the risk of developing CIN, but serves as a marker of impaired glomerular function kidney.
#347 Long-term effectiveness of a village doctor-led multifaceted strategy on blood pressure control: a cluster randomized trial
Authors: Chen Jing , He Jiang 
Published: May 2024

Abstract

Background and Aims
We tested the effectiveness of a village doctor-led multifaceted strategy on blood pressure (BP) control over 36 months among patients with hypertension in rural China. Village doctors are community health workers who provide basic primary health care in rural China.

Method
326 villages were randomly assigned to the village doctor-led intervention or usual care. Individuals aged ≥40 years with an untreated mean BP ≥140/90 mmHg (≥130/80 mmHg in individuals with clinical cardiovascular disease) or treated BP ≥130/80 mmHg were recruited. The trained village doctors initiated and titrated antihypertensive medications according to a simple stepped-care protocol with supervision from primary care physicians. They also delivered discounted and free medications to patients and conducted health coaching on lifestyle change, medication adherence, and home BP monitoring. Intention to treat analysis was conducted.

Results
At baseline, mean age (62.8 vs. 63.2 years), percentage of women (60.9% vs. 61.6%), mean systolic BP (157.0 vs. 155.5 mmHg), and diastolic BP (88.1 vs. 87.3 mmHg) were comparable between intervention and control groups. At 36 months, 72.5% patients in the intervention group and 11.7% patients in the control group had a BP of less than 130/80 mmHg, with a group difference of 60.8% (95% CI 59.4 to 62.2%; p&lt;0.0001). Mean systolic BP decreased by –30.8 mmHg (95% CI –31.7 to –29.9) from baseline to 36 months in the intervention group and by –7.6 mmHg (–8.5 to –6.8) in the control group, with a group difference of –23.1 mmHg (95% CI –24.4 to –21.9 mmHg; p&lt;0.0001). Mean diastolic BP decreased by –14.8 mmHg (–15.3 to –14.3) from baseline to 36 months in the intervention group and by –4.9 mmHg (–5.3 to –4.4) in the control group, with a group difference of –9.9 mmHg (–10.6 to –9.3 mmHg; p&lt;0.0001). No treatment-related serious adverse events were reported in either group.

Conclusion
In rural China, the village doctor-led multifaceted strategy significantly reduced BP over 36 months in patients with hypertension. This proven-effective and sustainable implementation strategy could be scaled up throughout rural China and in other low- and middle-income countries for hypertension control.
#1059 Value of urine transcription factor 21 as a diagnostic tool for preeclampsia
Authors: Keryakos Hesham Kamal Habeeb , Mahdy Nour Mohamed , Elsayed Ayman Moheb Youssef , Abu-Ella Moustafa , El-Fattah Mohammed Emad Abd 
Published: May 2024

Abstract

Background and Aims
Prediction of pre-eclampsia early in pregnancy can reduce its incidence and subsequent maternal and fetal morbidity and mortality. The sensitivity of current biomarkers is fair despite being used in clinical settings. Podocyturia was found to be a useful biomarker of preeclampsia with high sensitivity and specificity. UTF21 is highly expressed on podocytes. We investigated the relationship between urine transcription factor 21 as a new biomarker and preeclampsia.

Method
160 pregnant women with pre-eclampsia and age and gestational age matched 64 pregnant women with normal pregnancy were recruited. Pre-eclamptic patients were subdivided into mild (92 pregnant patients) and severe (68 pregnant patients). Each group is subdivided into early-onset and late-onset preeclampsia. Urine transcription factor 21 and compared with serum PlGF and sFlts were measured. The sFlt/PlGF ratio was calculated.

Results
The mean Urine transcription factor 21 was significantly higher in pregnant patients with preeclampsia than in healthy pregnant controls (512.3 ± 281.4 vs. 300 ± 66.8; p&lt;0.001). Urine TCF21 could not differentiate between early- and late-onset preeclampsia with the mean urine TCF21 was higher in early-onset preeclampsia than late-onset preeclampsia (532.63 ± 312.33 vs. 491.41 ± 248.1, p=0.519). Urine TCF21 was statistically significantly higher in mild preeclampsia than severe preeclampsia (572.3 ± 300.9 vs. 361.9 ± 155.8, p&lt;0.001). The sensitivity and specificity of urine TCF21 was 60.62% and 90.62% when using 370 pg/mL as cutoff in the prediction of preeclampsia development.

Conclusion
Urine transcription factor 21 can be used as a possible and easy diagnostic marker for preeclampsia. It can differentiate between mild and severe preeclampsia but cannot be used to differentiate between early- and late-preeclampsia.
#337 Renal 3D photoacoustic imaging and contrast-enhanced ultrasound to assess oxygenation and perfusion and to predict fibrosis after ischemia-reperfusion
Authors: Schleef Maxime , Leon Christelle , Pillot Bruno , Chanon Stéphanie , Bidaux Gabriel , Juillard Laurent , Guebre-Egziabher Fitsum , Baetz Delphine , Lemoine Sandrine 
Published: May 2024

Abstract

Background and Aims
Renal 3D photo-acoustic imaging (3D-PAI) and contrast-enhanced ultrasound (CEUS) are promising tools in mice models to assess repeatedly and non-invasively renal ischemia-reperfusion (RIR) consequences and damages, or their improvement by nephroprotective strategies like mild therapeutic hypothermia (mTH), at the early phase of reperfusion as well as in the chronic late phase.

Method
C57Bl6 mice underwent 15 minutes of unilateral renal vascular clamping, with body temperature at 37°C (RIR-37°C, n=7) or mTH at 34°C (RIR-34°C, n=7), or a sham procedure (Sham, n=5). Renal volume and oxygen saturation (sO2-3D; corresponding to the percentage of oxyhemoglobin over the total hemoglobin content) were measured with 3D-PAI (3D reconstruction of the whole kidney through multi-plane acquisition with an automatized mobile support), and renal perfusion parameters (rBV, mTT, rBF) with CEUS (“destruction-replenishment” model of intravenous microbubbles), performed with VEVO3100 echograph (Fujifilm Visualsonic) 1 week before RIR (basal), 20 minutes after reperfusion, and 1 month after. Renal fibrosis was quantified at 1 month with Masson's trichrome coloration on histological samples. Data were compared with Mann-Whitney test or Wilcoxon test (paired data) as appropriate. Correlation was tested by Spearman test. All animal procedures were approved by the Ethics Committee.

Results
Sham showed no significant changes during follow-up. RIR-37°C led to renal hypotrophy (volume on 3D-PAI) and fibrosis at 1 month, compared to RIR-34°C (median volume 76 IQR [71-119] vs 143 IQR[108-180] mm3; p=0.03), and those parameters were correlated (R=−0.49; p=0.03). In RIR-37°C, sO2-3D tended to lower at 20 minutes compared to basal values (median sO2-3D 37 IQR [37-44] vs 49 IQR [36-57]%; p=0.08), but not in RIR-34°C (p &gt; 0.99), and these early variations of sO2-3D were correlated with fibrosis at 1 month (R=−0.48; p=0.04). Renal perfusion was altered in RIR-37°C at 20 minutes compared to basal values (median rBV 73 IQR [46-105] vs 100 IQR [89-126] a.u.; p=0.047), and remained altered at 1 month (median rBV 71 IQR [57-83] a.u.; p=0.03), but not in RIR-34°C (p=0.47 at both 20 minutes and 1 month). Renal perfusion early alterations at 20 minutes were correlated with late alterations at 1 month (R=0.63; p=0.005), and tended to correlate with fibrosis (R=−0.41; p=0.08).

Conclusion
Renal 3D-PAI (on the whole 3D-reconstructed kidney) and CEUS can detect early alterations of renal perfusion and oxygen saturation after RIR, and predict chronic disturbances of perfusion and the onset of fibrosis, as well as the protection conferred by mTH. 3D-PAI can also be used to evaluate non-invasively renal volume as a surrogate of renal fibrosis after RIR.
#1706 LncRNA EGOT regulates hypoxia-induced mitophagy through the EGOT/PARKIN axis in renal tubular cells
Authors: Li Chi-Yuan 
Published: May 2024

Abstract

Background and Aims
The activation of mitophagy plays a crucial role in hypoxia signaling during acute kidney injury (AKI). The process involves coordinating the action of coding and non-coding RNA expressions to eliminate damaged mitochondria selectively. However, the specifics of how long non-coding RNAs (lncRNAs) regulate mitophagy and mitochondria biogenesis remain unclear. This study explores the impact of lncRNA called EGOT (Eosinophil granule ontogeny transcript) on mitophagy and mitochondria biogenesis in renal tubular cells under hypoxia.

Method
Overexpression and knockdown lncRNA-EGOT were evaluated. Mitophagy proteins (PINK1, p-PARKIN, BNIP3, LC3), mitochondria dynamics and biogenesis related proteins (Drp-1, MFN-1, PGC-1α, SDHA, SOD1) were determined through western blot analysis. Immunofluorescence studies of p-PARKIN mitochondrial translocation and LC3/TOMM20 localization were determined using confocal analysis.

Results
Hypoxia upregulated mitophagy proteins, mitochondria dynamics and biogenesis related proteins expressions, and mitophagosome in HK-2 cells. LncRNA EGOT expression was also significantly downregulated in renal tubular cells during hypoxia-induced mitophagy. Overexpression studies of hypoxia-regulated lncRNA- EGOT significantly downregulated p-Parkin, Parkin, LC3II expression, and LC puncta mitophagosome formation, while EGOT knockdown reversed the suppression of mitophagy. LncRNA EGOT regulates PGC-1α through parkin/paris expression.

Conclusion
Our study shows novel findings on the lncRNA-EGOT in hypoxia-induced mitophagy regulation in the renal tubular cells. Thus, downregulated lncRNA-EGOT expression with subsequent mitophagy activation is critical for hypoxia-induced mitophagy regulation through the EGOT/PARKIN axis.