bluuebunny/crossref_metadata_2025_split huggingface dataset:
#2125 Endotypes of kidney injury in patients with acute decompensation of heart failure and their impact on long-term mortality
Authors: Kontareva Natalia , Khruleva Yulia , Andriamanohery Robinson Tsimine , Efremovtseva Marina , Karapetyan Lala , Montoya Flora Elisa Cabello , Galochkin Svyatoslav , Kobalava Zhanna 
Published: May 2024

Abstract

Background and Aims
Renal dysfunction with and without albuminuria is common in patients with heart failure and associated with poorer outcomes. However, the prevalence and long-term influence of increased urine albumin creatinine ratio (uACR) and/or isolated decreased glomerular filtration rate (GFR &lt; 60 ml/min/1,73 m2) have not been well studied in patients with acute decompensation of heart failure (ADHF). The aim was to investigate the prevalence of different variants of kidney injury and their impact on the mortality in patients with ADHF within 1 year of follow-up.

Method
This prospective, observational study included 140 patients who were discharged after ADHF. We excluded patients with terminal stage of chronic kidney disease, end-stage heart failure, malignancy. Patients were divided according to the kidney function (the maximum level of GFR) and albuminuria level taken at hospitalization into four groups: normal renal function (GFR&gt;60 ml/min/1,73 m2, uACR&lt;30 mg/gCr), isolated decreased GFR (GFR&lt;60 ml/min/1,73 m2, uACR&lt;30 mg/gCr), isolated albuminuria (GFR&gt;60 ml/min/1,73 m2, uACR&gt;30 mg/gCr), combined changes (GFR&lt;60 ml/min/1,73 m2, uACR&gt;30 mg/gCr). The observation period was 365 days.

Results
During hospitalization 25% (n = 35) patients had GFR&gt;60 ml/min/1,73 m2, uACR&lt;30 mg/gCr, 19.3% (n = 27) patients had isolated decreased GFR, 22.8% (n = 32) patients had isolated uACR&gt;30 mg/gCr, and 32.9% (n = 46) patients had both. The baseline and admission characteristics are presented in the table (Fig. 1).
34 (24,3%) patients died during follow-up. Mortality was remarkably higher in groups with registered albuminuria during hospitalization regardless of GFR level (25% (n = 8) patients with isolated increased uACR, 39.1% (n = 18) patients with combined changes; with non-albuminuria: (11.4% (n = 4) patients with GFR&gt;60 ml/min/1,73 m2, uACR&lt;30 mg/gCr, 14.8% (n = 4) patients with isolated decreased GFR, p = 0.019 for trend). Kaplan-Meier plots revealed worse outcomes for these groups after adjusting for ejection fraction (EF) (Log-Rank p = 0.0057) (Fig. 2). In the multivariate Cox regression, in which age, gender, reduced EF and three categories of kidney damage were included, only combination of decreased GFR and albuminuria was an independent predictor of long-term mortality (hazard ratio: 3.71 95% confidential interval 1.59 to 8.67, p = 0.002).

Conclusion
Albuminuria is frequently observed in patients with ADHF and, especially with combination with decreased GFR, associated with higher mortality rate during 1 year of follow-up. Albuminuria with decreased GFR during hospitalization with ADHF was an independent risk factor for mortality during one year.
#2294 Muscle ultrasound as a tool for morphofunctional assessment in patients with chronic kidney disease
Authors: Barril Guillermina , Cabrera Alicia , Ochoa Patricia , Alvarez Graciela , Nogueira Ángel 
Published: May 2024

Abstract

Background and Aims
The measurement of the rectus femoris of the quadriceps by ultrasound is used as a measure correlated with muscle mass, strength and functionality, being able to determine diameters and muscle area.

Aims
To assess the usefulness of ultrasound parameters of muscle mass and correlate it with age, gender, dynamometry, exercise, biochemistry and body composition by BIVA

Method
We evaluated 78 patients with ACKD stages 3,4,5(87.2%) and peritoneal dialysis (22.8%) with ultrasound with an echography device (Echographe Sonosite) measuring: transverse(A) and longitudinal(B) axes, ratio B/A and circumference and muscle area of the rectus femoris of the quadriceps according the usual technique. Likewise, we evaluate Hand-grip strength (HOGS), calf circumference and body-composition by BIA.

Results
We evaluated 78 patients with CKD: age 71.54 ± 11.76 years, 59% men and 48.7% DM. Dynapenia/presarcopenia =20.8% with lower muscle-ultrasound parameters, with significant direct correlation p0.01 with A, B, C and muscle mass area transverse diameter (A) = 0.99 ± 0.43, B (longitudinal diameter) = 2.63 ± 0.77, muscle circumference (C) = 6.33 ± 1.83, muscular area = 2.23 ± 1,23.(healthy-population A = 1.31 ± 1.2 cm, B = 3.21 ± 3.4 cm), ratio B/A = 2.97 ± 0.94. Right HGS = 27.22 ± 8.26 kg. Having exercised shows better sig parameters: A1.08 ± 0.45 vs 0.84 ± 0.35 p &lt; 0.01, area 2.50 ± 1.27 vs 1.80 ± 1.02 p0.01 (B and C not sig) as well as age ≤75 vs &gt;75 sig. better in all eco-muscular parameters. We found significant differences between men and women in all parameters as well as dynamometry, perimeter-calf and muscle mass by BIA, not in albumin, Hb or CRP. Overall normal vs low hand-grip-strength (HGS) showed better not significant echo-muscle values. CKD vs PD showed higher values in CKD but not significant. Global significant direct correlations of muscle area p &lt; 0.01) with: HGS r0.324, calf-perimeter r0.30, MM r0.40, Phase-Angle r0.35, Cell mass (BCM) r0.39, and intracellular water (AIC) r0.38. Inverse sig p &lt; 0.01 with B/A ratio.

Conclusions
#2815 Single center, single arm, prospective, observational study of desidustat in chronic kidney disease-induced anemia
Authors: Datta Jayanta , Sarkar Piyali 
Published: May 2024

Abstract

Background and Aims
Anemia in chronic kidney disease (CKD) is multifactorial. Relative deficiency of erythropoietin is one of the key reasons for decreased RBC production. This anemia is associated with poor quality of life and increases morbidity in CKD patients. Injectable erythropoietin is the standard of care for CKD-anemia, which has safety concerns. Desidustat, an oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI), stimulates endogenous erythropoiesis and is approved for CKD anemia treatment. Hence, the present study identifies the real-world clinical efficacy and safety of the desidustat treatment for a short duration in CKD anemia.

Method
This is an open-label, single-center, prospective study. We analyzed the data of 130 patients who are currently in follow-up and received Desidustat as treatment for CKD-anemia. The study is for the duration of 24 weeks. We followed up on patent at 1 month, 3 months, and the end of the study (6 months). Patients were given a 100-mg Desidustat tablet orally three times in a week. The primary outcome is to assess the change in Hb from baseline, and the secondary outcome is the safety of the therapy.

Results
In this study, we enrolled 130 patients. Of these 130 patients, 58.4% (n = 76) were male and 41.5% (n = 54) were female. The mean age of the study population was 53.6 ± 12.3 years. The majority of the study population was in the pre-dialysis category; 80% (n = 104) and 20% (n = 26) were on dialysis. All the dialysis patients were on three times per week on Dialysis. Diabetes (68%) and hypertension (75%) are the most common co-morbid conditions in patients with CKD anemia. All the patients received desidustat at a 100 mg, three-weekly dose. During each follow-up visit, a significant rise in hemoglobin was observed (p&lt;0.001), as shown in the figure. With desidustat therapy, adverse drug reactions were seen in 5.3% (n = 7) cases: three cases of abdominal pain, two cases of vomiting, and two cases of diarrhea.

Conclusion
Oral HIF-PHIs and Desidustat showed significant improvement in hemoglobin in CKD anemia patients. More studies require for safety and efficacy in Dialysis dependent CKD - Anemia patients.
#1585 Ten years’ practice with calcimimetics and paricalcitol for the treatment of secondary hyperparathyroidism. Experience of one dialysis center
Authors: Shutov Evgeny , Kotlyarova Galina , Bolshakov Stepan , Keroglyan Seda , Dolodze David 
Published: May 2024

Abstract

Background and Aims
Secondary hyperparathyroidism (SHPT) remains one of the main problems in patients with chronic kidney disease (CKD), associated with deterioration in quality of life, progression of cardiovascular complications and mortality.

Method
Patients on HD (n = 2517) were treated from 2012 to 2023 years in our dialysis center with secondary SHPT were included in this study. All patients were divided into 2 groups: 1 gr. included −1536 (61%) patients whose PTH levels remained in the target range from 300 to 600 pg/ml, without therapy or with low doses of alfacalcidol (0.75-5 μg/week ); 2 gr. included - 981 (39%) patients with PTH levels &gt;600 pg/ml were treated with calcimimetics (doses of cinacalcet used from 30 mg to 90 mg/day, doses of etelcalcetide used from 5 to 15 mg/week) as monotherapy or in combination with paricalcitol (5–15 μg/week). Phosphorus levels were controlled by an adequate dose of dialysis and administration of phosphate binders (sevelamer and sucrose iron oxyhydroxide).

Results
The average PTH level in 2 gr. of patients at the time of treatment initiation was 916.7 ± 879.9 pg/ml (601-2500 pg/ml). During the treatment the level of PTH decreased to target values and amounted 523.4 ± 216.7 pg/ml (63-594 pg/ml) in 73% of patients. Monotherapy with calcimimetics was effective in 41%; the remaining of patients (59%) were required the addition of paricalcitol to therapy to achieve target PTH values. Therapy of SHPT was also carried out in 15 (0.6%) patients with identified parathyroid adenomas (volume more than 1 cm3) and PTH levels &gt;1000 pg/ml; the effect was achieved in 9 patients (60%), 6 patients underwent parathyroidectomy. During the previous years of observation, parathyroidectomy was required in all patients with SHPT with similar changes in the parathyroid glands.

Conclusion
In the overwhelming majority of patients with CKD5D and SHPT, the administration of calcimimetics as monotherapy or in combination with paricalcitol during the progression of SHPT allowed us to achieve target PTH values and maintain it for a long time (from 1 to 10 years), as well as reduce the number of surgical interventions for parathyroid glands, compared to the previous period.
#2085 Testosterone and markers of nutritional status correlate with leptin in chronic kidney disease
Authors: Rusu Crina Claudia , Kacso Ina , Moldovan Diana , Potra Alina Ramona , Tirinescu Dacian Călin , Maria Ticala , Orasan Remus , Budurea Cristian , Bondor Cosmina Ioana 
Published: May 2024

Abstract

Background and Aims
Leptin, the anorexic hormone, also appears to have a proatherogenic effect, contributing to the development of cardiovascular morbidity and mortality. Current data on factors related to serum leptin levels in different stages of chronic kidney disease (CKD) are inconsistent.
The aim of this study was to evaluate the determinants of leptin level in pre-dialysis stage of CKD.

Method
We performed a cross-sectional study, including 73 patients, mean age 67 (60-78) years, 38% diabetic, with GFR 31 ± 20.85 ml/min per 1.73 m(2). We followed the correlations of leptin with inflammatory, nutritional, lipid markers, testosterone and others by univariate analysis and subsequently determined the strongest predictor for leptin level by multivariate analysis.

Results
Table. Correlation between the parameters and leptin in CKD pre-dialysis group.
In the CKD pre-dialysis patients the best predictors for leptin level were body mass index, adipose tissue mass, lean tissue mass (for each p &lt; 0.001) and testosterone (p &lt; 0.001). Blood glucose (p = 0.013) was also a significant determinant of leptin level in pre-dialysis CKD patients.

Conclusion
In pre-dialysis CKD patients, testosterone levels together with nutritional markers are the best predictive markers for leptin levels. The management of these determinants can influence the level of leptin in CKD pre-dialysis patients and future research will determine if it can influence the atherosclerotic process.
#2137 Systemic inflammation as a main factor in CKD-MBD development
Authors: Martynyuk Liliya , Chaikovska Mariana , Malska Tetyana 
Published: May 2024

Abstract

Background and Aims
Chronic kidney disease (CKD) is a progressive disorder that affects more than 10% of the general population worldwide. Despite great achievements in the field of treatment of CKD, patient mortality remains at a high level. Research into the pathophysiology and correction of this condition in the early stages of development is ongoing. The aim of the study was to establish relationship between systemic inflammation and mineral disorders in any stage of CKD.

Method
We investigated 5 groups of patients with different stages (I to V) of CKD 19-22 persons in each (total amount 106 patients), aged 49,6 years and 19 healthy individuals aged 41,9 years as control group. We examined the blood level of interleukin 1 beta (IL-1β), interleukin 6 (IL-6), interleukin 8 (IL-8), C-reactive protein (CRP) and c-terminal fragment of fibroblast factor 23 (FGF-23) in all patients and control group.

Results
The course of CKD is accompanied by systemic inflammation, which is characterized by an increase in IL-1β in the I stage of chronic kidney disease ((13,41 ± 3,36) pg/ml) (p &lt; 0.01), IL-6 in the III stage of chronic kidney disease (29,31 ± 5,49) pg/ml (p &lt; 0.01), IL-8 in the II stage of chronic kidney disease ((11,56 ± 2,72) pg/ml) (p &lt; 0.05) and CRP in the IV stage of chronic kidney disease ((7,22 (1,81; 10,8)) mg/ml (p &lt; 0.01), compared to the control group ((5,93 ± 3,65), (6,01 ± 1,67), (7,99 ± 1,17) pg/ml and (0,66 (0,41; 0,85)) mg/ml accordingly), and progresses with a decrease in glomerular filtration rate. Growing already at the initial stage of chronic kidney disease, the level of FGF-23 reached a statistical difference from the control group at the 2nd stage of CKD. A strong statistically significant relationship was found between FGF-23 and IL-6 (R = 0.84; p &lt; 0.01), IL-1β at GFR &gt; 15 ml/(min•1.73 m2) (R = 0.45; p &lt; 0.01) and IL-8 at GFR &gt; 15 ml/(min•1.73 m2) (R = 0.57; p &lt; 0.01).

Conclusion
Systemic inflammation appears in the initial stages of CKD, being a trigger for further kidney dysfunction and the development of mineral and bone disorders. Systemic inflammation treatment in patients with CKD is staying a magnetic but still unattainable goal that needs further efforts to invest.
#1372 Association of plasma beta-2-microglobulin with risk of cardiovascular disease in patients with chronic kidney disease
Authors: Jamba Ariunbold , Javzan Tuvshinbayar , Boldbaatar Khaliun , Amarbold Uugan-Erdene 
Published: May 2024

Abstract

Background and Aims
In patients with chronic kidney disease(CKD), beta 2 microglobulin (B2MG) can be used to assess renal function, and predialysis serum B2MG levels can predict mortality risk. In addition to the kidney, B2MG regulates the expression of interleukin 1 and tumor necrosis factor, participates in the pathogenesis of vascular damage, and is a marker that can detect the formation of amyloid, therefore it is important in the diagnosis of cardiovascular disease (CVD).
To assess the correlation of serum B2MG levels with some metabolic and cardiovascular function factors in patients with chronic kidney disease.

Method
119 people with chronic kidney disease and 52 healthy control groups were selected as a case-control study and blood samples were analyzed for creatinine, urea, cholesterol, triglycerides, LDL, calcium, phosphorus, albumin, total protein, and B2MG with Cobas 6000 fully automatic analyzer and echocardiography was performed.
Renal function was evaluated by CKD EPI crea-cys combined calculation. In the group with CKD, a person with eGFR &lt;90 ml/min/1.73 m² was not included in the study due to the study exclusion criteria.

Results
The average age of the group with CKD was 54.92, and the average age of the healthy group was 50.66. B2MG has a significantly higher (P &lt; 0.000) statistically significant correlation in the group with CKD compared to the control group.
B2MG was significantly associated with creatinine (g = 0.516, P &lt; 0.000), phosphorus (g = 0.342, P &lt; 0.000), cystatin C (g = 0.700, P &lt; 0.000), urea (g = 0.326, P &lt; 0.000), and echocardiography with directly indicators LVMI(g = 0.113, P &lt; 0.000), LVESD (r = 0.265, P &lt; 0.000), thus BMI (g = −0.274, P &lt; 0.000), tTSH (r = −0.516, P &lt; 0.000), calcium ( g = −0.137, P &lt; 0.000), albumin (g = −0.180, P &lt; 0.000), total protein (r = −0.080, P &lt; 0.000), cholesterol (g = −0.215, P &lt; 0.000), BNLP (r = −0.163, P &lt; 0.000), triglycerides (g = −0.142, P &lt; 0.000), and EV of echocardiography (g = −0.292, P &lt; 0.000) have inverse statistical significance.

Conclusion
B2MG levels have been shown to predict CVD risk and CVD-related mortality in all stages of chronic kidney disease. According to our study, B2MG is directly related to kidney function biomarkers, phosphorus, LVMI, and LVESD indicators of cardiac echocardiography, and inversely correlated with parameters of eGFR, protein, triglycerides, calcium, and cardiac echocardiogram EV indicators, which is similar to studies conducted in other countries. Therefore, B2MG can be used to detect the risk of CVD in people with severe CKD.
Figure: Will be uploaded on our poster if accepted.
#2070 Associations of fecal and plasma levels of SCFAs with gut microbiota and clinical characteristics in non-dialysis renal anemia patients
Authors: Dou Yanna , Liu Lifen 
Published: May 2024

Abstract

Background and Aims
Renal anemia is one of the most common complications of Chronic Kidney Disease (CKD). The gut-kidney axis hypothesis has led to numerous studies showing that patients with CKD have a distinct gut microbiota structure compared with controls and that changes in gut microbiota correlate with disease severity and progression. The short-chain fatty acids (SCFAs) are speculated to be pivotal in the gut-kidney crosstalk. However, the role of SCFAs in renal anemia has not been elucidated. This study aimed to explore and compare the fecal and plasma levels of SCFAs in non-dialysis renal anemia patients and healthy controls to reveal the potential interactions among SCFAs, gut microbiota, and clinical features of renal anemia, which may provide new light on further studies.

Method
A cohort of 30 non-dialysis renal anemia patients and 20 healthy controls were recruited from the First Affiliated Hospital of Zhengzhou University. Gut microbiota was analyzed using 16S rRNA gene amplification sequencing. Fecal and plasma concentrations of SCFAs were measured using GC-MS/MS platform. The clinical characteristics of patients with renal anemia and controls were evaluated.

Results
Renal anemia patients displayed altered microbiota composition compared to healthy subjects. The relative abundance of Enterobacterales, Enterobacteriaceae, Escherichia-Shigella, and Escherichia-coli were higher in patients with renal anemia, and the Lachnospiraceae family decreased in renal anemia patients. In contrast, the relative abundance of Lachnospirales, Lachnospiraceae, and Bacteroides vulgatus was higher in the control group. Patients with renal anemia had higher fecal and plasma concentrations of SCFAs compared to controls. The fecal and plasma concentrations of SCFAs were significantly different not only between the patients with renal anemia and controls but also in the different severity of renal anemia. Moreover, different types of SCFAs are intimately associated with clinical characteristics. The applications of medications may exert effects on the fecal and plasma SCFAs. A positive correlation was obtained between Lachnospirales and the plasma SCFAs. The levels of acetic acid and caproic acid in fecal and the levels of acetic acid, propionic acid, and butyric acid in plasma were all positively correlated with the abundance of Cyanobacteria.

Conclusion
The gut metabolites SCFAs are tightly linked to the alterations of gut microbiota and clinical characteristics of renal anemia. Further studies are warranted to elucidate the relationships more in-depth.
#108 Mineral and bone disorders during chronic kidney disease
Authors: Abdelkerim Charfadine Senoussi , Ibrahim Hamat , Guillaume Mahamat Abderrramane , Youssouf Djibril , Mahamat Aboubabakar Abdelkerim , Seid Haoua Youssouf , Hissein Nassima , Djibrine Dibrine Mahamat , Mahamat Hapsita 
Published: May 2024

Abstract

Background and Aims
The objectives of our work were to describe mineral and bone disorders in patients with chronic kidney disease (CKD) not yet at the dialysis stage and to assess the compliance of phosphocalcic balance indicators with international KDIGO recommendations

Method
It was a retrospective study conducted over a 10-month period (01 November 2018 to 31 August 2019) in the nephrology and haemodialysis department of the Renaissance University Hospital in Ndjamena. We have included all patients followed up in the unit for non-dialysis CKD, aged over 18 years and consenting to participate to this study.

Results
A total of 387 patients files were collected, 82 of which have been taken on. The average age of the patients was 52.7 (± 15.8) years, with a male predominance (67.1%). The comorbidities were arterial hypertension (71.9%) and diabetes (24.4%). CKD has predominated in stage V (55%), followed by stage III (23%). Clinical signs were mainly diffuse bone pain (37.8%), pruritus (8.5%), muscle pain (7.3%) and insomnia (8.5%). Disorders in phosphocalcic metabolism have been noticed in stage IV (11.9% and 10.7%) and stage V (40.5% and 34.5%) for hypocalcaemia and hyperphosphataemia. Secondary hyperparathyroidism and 25 OH vitamin D deficiency were respectively 28.8% and 40.5% in stage V CKD. Compliance with international KDIGO recommendations was 59.7%, 53.7% and 37% respectively for serum calcium, serum phosphorus and parathyroid hormone. Radiological fractures were observed in 4.9% of patients. The management of these disorders has focused on calcium carbonate (52.4%), native vitamin D (64.6%) and Cinacalcet (6.1%) administration. Hypocalcaemia (p = 0.005) and hyperphosphataemia (p = 0.0001) were higher in stage V patients, with a significant difference.

Conclusion
The treatment of mineral and bone disorders has way to go for the majority of patients, due to lack of resources and the exorbitant cost of treatment. Prevention of mineral and bone disorders is a fundamental pillar of CKD treatment for our patients.