bluuebunny/crossref_metadata_2025_split huggingface dataset:
EARLY RESULTS OF THE PROSPECTIVE MULTIDISCIPLINARY HAMA COHORT: DESCRIPTION OF THE FIRST 302 PATIENTS, COMPARISON WITH ALREADY PUBLISHED COHORT AND NOVEL INSIGHTS
Authors: Boulestreau Romain , Lorthioir Aurélien , Dreau Hervé , Persu Alexandre , Halimi Jean Michel , Rubin Sebastien , Tharaux Pierre Louis , Mazighi Mikael , Maier Benjamin , Michel Paques , Bonnin Sophie , Cremer Antoine , Debeugny Stephane , Gosse Philippe 
Published: May 2024

Objective:
Malignant hypertension has not disappeared and remains the most severe form of hypertension. More than 100 years after its description, many points remain unanswered. Mechanisms, definition and optimal treatment are still discussed. In 2019 we decided to launch a prospective multicenter multidisciplinary cohort in France try filling these gaps. Thjs study aims to describe the baseline characteristics of the first 302 included patients and compare these data to already published cohorts.

Design and method:
We included patient with severe hypertension and severe hypertensive retinopathy and patients filling the HYP MOD definition from a broad range of department (cardiology, nephrology, neurology intensive care unit, emergency department, internal medicine). We collected clinical data at admission, biological, imaging and target organ damage along with social and demographic data. We also recorded diagnostic and therapeutic management, adverse events during hospitalization and characteristics at discharge.

Results:
We recruited 302 patients in 32 month (105 / year) among 40 centres and different specialities. They are mostly young men (68%, mean age 48.7 +/- 14.5 years), with several interesting subgroups. Around one third of our patients were less than 40 years old, one third were from non-European origin, 13.6% were included through the multiorgan damage definition, without fundus severe injuries. Target organ damage involves the eye in 86% of patients, kidney in 54%, heart in 56%, brain in 33% and Thrombotic Microangiopathy in 13%. Our patients with severe retinopathy are very similar with those included in the most important cohorts already published. Interestingly, 22.8% of patients were treated without use of IV therapy, most patients were untreated or showed poor observance of treatments and a significant proportion had normal or low renin level.

Conclusions:
These preliminary findings already challenge long standing dogma, raise many questions and provide a strong basis to address them in ancillary studies of the cohort.
THE PRESENCE OF PROTEINURIA IS ASSOCIATED WITH IMPAIRED CEREBRAL OXYGENATION DURING EXERCISE IN CHRONIC KIDNEY DISEASE
Authors: Theodorakopoulou Marieta , Dipla Konstantina , Zafeiridis Andreas , Faitatzidou Danai , Koutlas Aggelos , Devrikis Nikolaos , Georgiou Areti , Karkamani Eleni , Doumas Michael , Papagianni Aikaterini , Sarafidis Pantelis 
Published: May 2024

Objective:
Cognitive impairment and reduced exercise tolerance are common in patients with chronic kidney disease (CKD), in part due to reduced brain function. Cerebral perfusion and oxygenation are significant determinants of brain activation and have been shown to be significantly impaired in CKD. This analysis aims to examine the impact of proteinuria on cerebral oxygenation during a mild physical stress in patients with pre-dialysis CKD.

Design and method:
66 patients with CKD stage 2-4 were included in this post-hoc analysis; 24-h urine samples were used for evaluation of proteinuria. All participants underwent a 3-min intermittent handgrip exercise (HG) at 35% of their maximal voluntary contraction. Changes in cerebral oxygenation (oxyhemoglobin-O2Hb) and deoxyhemoglobin-HHb) and regional blood volume (total hemoglobin-tHb) were continuously recorded during HG-exercise by near-infrared spectroscopy (NIRS).

Results:
No significant differences between the 2 groups were detected in age (proteinuric vs nonproteinuric: 68.4±10.6 vs 67.2±10.8; p=0.676), eGFR (41.3±18.9 vs 46.3±14.8; p=0.248) and BMI (28.4±4.9 vs 28.1±4.8; p=0.803). The MMSE score (proteinuric vs nonproteinuric: 28.0±1.6 vs 28.0±1.7; p=0.938) and MVC (22.3±7.0 vs 23.9±7.5; p=0.416) were not significantly different between groups. The average response in cerebral oxygenation during exercise was lower in patients with proteinuric CKD (O2Hb: 1.02±0.87 vs 1.61±0.95; p=0.018 and diffO2Hb 1.53±.97 vs 2.07±1.25; p=0.065). The average tHb response (index of regional-blood-volume) was also lower in patients with proteinuria (0.51±1.08 vs 1.16±0.92 p=0.013); however, no differences in HHb (-0.50±0.55 vs -0.45±0.54; p=0.717) –an index of oxygen extraction capacity- among groups were detected. In univariate linear analysis the level of proteinuria did not show significant correlations with NIRS parameters.

Conclusions:
The presence and not the level of proteinuria is associated with impaired brain activation during a mild physical task in patients with predialysis CKD. Future studies evaluating the role of proteinuria in the decline of cerebral function and cognitive impairment are needed.
RENOPROTECTIVE EFFECTS OF DAPAGLIFLOZIN IN NON-DIABETIC CKD PATIENTS
Authors: Spanos Georgios , Vagopoulou Anastasia , Bakou Marianna , Giannakidis Ioannis , Atalla Alexandos , Serif-damadoglou Ahmed , Fragkidis Stylianos , Bantis Christos , Armentzoiou Livia -KARMEN , Bamichas Gerasimos 
Published: May 2024

Objective:
Sodium-glucose co-transporter 2 inhibitors (SGLT2i) have demonstrated significant cardiorenal protection benefits in recent years, irrespective of the presence of diabetes mellitus (DM). These agents have emerged as pivotal in reducing albuminuria and impeding chronic kidney disease (CKD) progression. This study aimed to evaluate the renal effects of dapagliflozin, an SGLT2i, in in non-diabetic proteinuric patients with CKD.

Design and method:
In this retrospective observational study we analyzed medical records of adult non-diabetic patients with CKD, in our outpatient department over the period of one year. exhibiting albuminuria, and under stable renin-angiotensin system blockade. The primary objectives were to assess dapagliflozin's impact on estimated glomerular filtration rate (eGFR) within the first month and changes in 24-hour proteinuria from baseline.

Results:
Between November 2022 and December 2023, dapagliflozin was prescribed to 37 patients (8 women) with a mean age of 59.8±11.6 years. Primary diagnoses of CKD included IgA Nephropathy (7/37), other glomerulonephritis (9/37), hypertension (6/37), unknown (9/37), and other (6/37). Baseline median creatinine was 1.60±0.6 mg/dL, eGFR was 54.1±21.6 mL/min/1.73m2, and proteinuria was 1047 mg/24h (IQR 420-2170), serum potassium 4.77±0.41mEq/L blood pressure 130±15 / 82±9 mmHg, body weight 85.1±16.8 kg. After the first month, median creatinine was 1.75±0.7 mg/dL (p=0.02 vs baseline), eGFR was 50,7±21,3 mL/min/1.73m2 (p=0.006 vs baseline). Two patients experienced >30% serum creatinine increase within 4 weeks, leading to SGLT2i discontinuation. After a median follow-up of 233 days (IQR 80-284), creatinine was 1.71±0.75 mg/dL (p=0.067 vs baseline), eGFR was 51.6±23.6 mL/min/1.73m2 (p=0.019 vs baseline), and proteinuria decreased by 33,7% from baseline (450, IQR 270-1110). One patient stopped SGLT2i due to recurrent urinary tract infection. No change was observed in serum potassium, body weight and blood pressure throughout the study period.

Conclusions:
Treatment with dapagliflozin in non-diabetic patients with CKD reduced effectively proteinuria with an initial, reversible, decline in serum creatinine.
THE PREVALENCE AND RISK FACTORS FOR ARTERIAL HYPERTENSION IN CHILDREN WITH IDIOPATHIC NEPHROTIC SYNDROME
Authors: Skrzypczyk Piotr , Wabik Anna Maria , Deja Anna , Ofiara Anna , Szyszka Michal , Panczyk-tomaszewska Malgorzata 
Published: May 2024

Objective:
Arterial hypertension (AH) is claimed to be an uncommon finding in children with idiopathic nephrotic syndrome (INS). The study aimed to analyze blood pressure, prevalence, and risk factors of AH in children with INS.

Design and method:
In 153 children with INS (9.32±3.84 years, 100 boys), we evaluated systolic and diastolic blood pressure (mm Hg, Z-scores), age at onset of the disease, anthropometric data, response to steroids, results of kidney biopsy, number of INS relapses, and medications.

Results:
The mean age at disease onset was 4.39±2.38 years; 67 patients had steroid-sensitive nephrotic syndrome (SSNS), 12 frequently relapsing nephrotic syndrome (FRNS), 58 steroid-dependent nephrotic syndrome (SDNS), and 16 steroid-resistant nephrotic syndrome (SRNS). Kidney biopsy was performed in 26: 5 – minimal change disease, 11 – mesangial proliferation, 10 – focal and segmental glomerulosclerosis. AH at disease onset was found in 10 (6.5%) patients in the following 11 (7.2%) after corticosteroid initiation. The observation period was 4.93±3.80 years, and AH was found in 31 (20.3%) – in 3 (4.5%) patients with SSNS, 2 (16.7%) with FRNS, 20 (34.5%) with SDNS, and 6 (37.5%) with SRNS. Patients with AH had lower height Z-score (-0.46±1.20 vs. 0.18±1.15, p=0.006), higher BMI Z-score (1.15±1.10 vs. 0.41±1.09, p<0.001), number of INS relapses (8.32±6.78 vs. 4.41±3.82, p<0.001), and current prednisone dose (0.49±0.67 vs. 0.18±0.29 [mg/kg/24h], p<0.001). Systolic blood pressure Z-score at the end of observation correlated with age (r=-0.192, p=0.017), BMI Z-score (r=0.368, p<0.001), and present prednisone dose [mg/kg/24h] (r=0.186, p=0.021), diastolic blood pressure Z-score with BMI Z-score (r=0.231, p=0.004), and number of INS relapses (r=0.163, p=0.044). In Cox Proportional Hazard presence of SDNS and SRNS were the only predictors of AH (SDNS: HR=4.80, 95CI(1.30-17.75), SRNS: HR=4.77, 95CI(1.06-21.53)).

Conclusions:
1. Approximately one-third of patients with SDNS and SRNS develop arterial hypertension in the course of the disease. 2. Steroid dependence and steroid resistance are the strongest predictors of AH in children with INS. Other determinants of blood pressure elevation in this group of patients are high BMI and a high number of relapses.
RISK FACTOR TO DEVELOP CKD IN GENERAL POPULATION: IMPACT OF HYPERTENSION
Authors: Redon Josep , Sauri Inma , Lidon Laura , Diaz Javier , Martinez Fernando , Fernandez Antonio , Grau Maria , Forner Maria J 
Published: May 2024

Objective:
The aim of the present study was to assess the impact of hypertension in the incidence of Chronic Kidney Disease (CKD) in a general population.

Design and method:
The study analyzed the EHR of a community of 1,450.000 adult subjects >23 years of age. eGFR was calculated using the CKD-EPI formula. Lipid and uric acid was obtained at the beginning of the observational period. HTN was considered when it was recorded in the EHR (CIE9 and 10). Cox hazard ratio of risk to develop. CKD was calculated and plotted.

Results:
The main characteristics of the study population in the absence of CKD was 53.9 year old, male 56.5%, obese 422,114 (29.1%), diabetes 198242 (13.7%) and 508,477 (35%) hypertensives. The HR of each of the factors analysed is in the Table and the Cox plot in the figure.

Conclusions:
Hypertension independent of other risk factors increases rate of progression to CKD in general population.
STUDY OF CIRCADIAN RHYTHM OF BLOOD PRESSURE IN KIDNEY TRANSPLANT RECIPIENTS DURING THEIR FIRST YEAR
Authors: Rabhia Mehdi , Arzour Hind , Benkari Atika , Taibi Fatma , Khemri Dalila , Haddoum Farid 
Published: May 2024

Objective:
There is a marked diurnal variation in blood pressure (BP), relative to these values, BP in most subjects is physiologically lower during the night and a no-drop BP profile is usually defined as a fall in blood pressure (BP). Nocturnal PAS less than 10%.
A non-dipper circadian pattern is often observed in renal transplant recipients and is linked to poor allograft function.
The primary objective of this study is to evaluate nighttime blood pressure variations in patients after kidney transplantation during their first post-operative year.

Design and method:
In this prospective study, 24-hour ambulatory BP monitoring (ABPM) was performed in 116 post-kidney transplant patients, aged > 18 years, with a serum creatinine level < 2 mg/dl after one month of transplantation. According to the nocturnal reduction in systolic BP (SBP), a profile of dipper (SBP > 10%), non-dipper (0 < SBP < 10%) and reverse dipper (SBP nocturnal increase) was defined.

Results:
We collected 116 kidney transplant patients (mean age 36 years, 66% men, all patients are treated with anti-calcineurins including 54% on Tacrolimus, with a pre-transplant dialysis duration ranging from 2 to 144 months), we note 14 preemptive transplants.
The nighttime reduction in SBP pattern among participants with respect to gender was not significant (p = 0.794). The mean age of patients with a non-dipper profile was significantly lower than that of patients with an inverse dipper profile (p = 0.009), but the mean age of patients with a dipper profile was not significantly different from patients with a non-dipper or inverted profile (p = 0.368, p = 0.605).
There was no significant correlation between dipper, non-dipper and inverse profile with immunosuppressive drugs (cyclosporin, tacrolimus), duration of dialysis before transplantation and time since transplantation (p = 0.194, p = 0.252 and p = 0.392, respectively).

Conclusions:
The inverse dipper profile was observed more frequently in older patients than in younger patients, and there was no significant correlation between the dipper, non-dipper, and inverse profile with immunosuppressive drugs, dialysis duration before transplantation and time since transplantation.
DEGREE OF JOINT RISK FACTOR CONTROL AND ONSET AND PROGRESSION OF CHRONIC KIDNEY DISEASE IN PATIENTS WITH HYPERTENSION
Authors: Peng Xinyi , Zhuang Miaomiao , Song Qirui , Cai Jun 
Published: May 2024

Objective:
There is a reciprocal relationship between hypertension and chronic kidney disease. We aimed to determine if controlling multiple risk factors in combination could decrease the risk of chronic kidney disease in hypertensive patients.

Design and method:
The study was performed using data from the Kailuan cohort. We investigated the association between the degree of control of multiple risk factors on development of chronic kidney disease and the risk of progression in multivariable-adjusted Cox proportional hazards regression analysis.

Results:
Development of chronic kidney disease was investigated in 73,256 participants with a mean of 11.80 ± 4.50 years. A significant inverse association was found between the degree of risk factor control and the risk of developing chronic kidney disease in the population with hypertension. Each additional risk factor controlled was correlated with a 12% decline in the risk of incident chronic kidney disease (HR 0.88, 95% CI 0.86–0.90). The risk was higher in women and older individuals with hypertension than in their matched controls. Analysis of progression of chronic kidney disease found a similar inverse association between severity of chronic kidney disease and the degree of risk factor control. Each additional risk factor controlled contributed to a 13% reduction in the risk of progression (HR 0.87, 95% CI 0.84–0.90).

Conclusions:
This study found a significant inverse relationship between the degree of risk factor control and the risk of development and progression of chronic kidney disease in patients with hypertension. Modification of multiple risk factors had an additive effect in protecting kidney function. The results suggest that stronger preventive strategies are needed in hypertensive populations to alleviate kidney dysfunction.
APOLIPOPROTEIN-L1 RISK GENOTYPES ARE ASSOCIATED WITH CHRONIC KIDNEY DISEASE REGARDLESS OF HYPERTENSION STATUS IN A TRYPANOSOMA BRUCEI GAMBIENSE ENDEMIC AREA
Authors: Mupepe Dominique , Buila Nathan , Ekulu Pépé , Wameso Marie -Noelle , Nkoy Agathe , Van Den Heuvel Lp , Levtchenko Elena , Mumba Dieudonné , M’Buyamba Jean -René 
Published: May 2024

Objective:
this study assessed the frequency of Apolipoprotein-L1 high-risk genotypes in an African rural endemic area to Trypanosoma Brucei Gambiense, and evaluated their association with arterial hypertension according to human African trypanosomiasis infection status.

Design and method:
The study enrolled 94 human African trypanosomiasis-infected and 144 non–infected participants in Masimanimba, the Democratic Republic of the Congo. Apolipoprotein-L1 high-risk genotype was the presence of two variants (G1G1, G2G2, or G1G2), and low-risk genotype the presence of 0 or 1 variant. Albuminuria was an albumin/creatinine ratio greater than or equal to 30 mg/g on freshly voided urine. We evaluated the association between Apolipoprotein-L1 risk genotypes and hypertension in human African trypanosomiasis-infected and non-infected participants.

Results:
The study population was aged 39.7 ± 17.1 years (females 62.2%). The frequency of high-risk genotypes among hypertensive participants was 14.3% in both human African trypanosomiasis - infected and uninfected individuals. Albuminuria (100% vs. 38.9%; p=0.09) was higher and estimated Glomerular Filtration Rate lower (88.5 vs. 106 ml/min/1.73 m2, p =0.066) in high-risk genotypes than low-risk carrying hypertensive participants. The respective values in non-hypertensive individuals were 100% vs. 37.5% (p=0.002) and 83 vs. 109.5 ml/min/1.73 m2 (p <0.001) for albuminuria and estimated Glomerular Filtration Rate.

Conclusions:
Apolipoprotein-L1 high-risk genotypes are associated with Chronic Kidney Disease regardless of the hypertension status in Human African Trypanosomiasis endemic area
ACUTE VASCULAR RESPONSE TO HEMODIALYSIS AS MEASURED BY SERUM SYNDECAN-1 AND ENDOTHELIN-1 LEVELS, AS WELL AS VASCULAR STIFFNESS
Authors: Csiky Botond , Sagi Balazs , Kun Szilard , Jakabfi-csepregi Rita Klaudia , Sulyok Endre 
Published: May 2024

Objective:
End-stage kidney disease (ESKD) patients on chronic hemodialysis (HD) have very high cardiovascular risk. Acute vascular changes during dialysis mediated partially by factors of the endothelium may have a crucial role in the cardiovascular (CV) disease of HD patients.
Aim: To study acute vascular changes during HD measured by applanation tonometry and to assess the role of syndecan-1 (SDC-1), endothelin-1 (ET-1), and traditional and non-traditional CV risk factors in these changes.

Design and method:
Patients and methods. 29 consecutive chronic HD patients (median age: 65.6±10.4 years; 52% men) were included in the study. Pre-, mid-, and post-HD plasma SDC-1 and ET-1 levels and routine biochemical parameters were measured. Applanation tonometry (SphygmoCor, AtCor Medical) was performed before HD.

Results:
As assessed by trend analysis SDC-1 levels increased significantly during HD (p=0.004). ET-1 levels were decreasing during HD. Male patients had significantly higher ET-1 levels than women. Patients were divided into 2 groups based on their pulse wave velocity (PWV), PWV>=12 m/s and PWV<12 m/s). Pre-HD and mid-HD SDC-1 levels were significantly higher in the group with PWV>=12 m/s (10.174±2.568 vs. 7.928±1.794 ng/ml, p = 0.013, and 10.319±3.482 vs. 8.248±1.793 ng/ml, p = 0.044, respectively). Post-HD ET-1 levels were significantly higher in the patient group having PWV>=12 m/s (10.88±3.00 vs. 8.05±3.48 pg/l, p = 0.027). Patients having PWV>=12 m/s had significantly higher pre-HD peripheral and aortic systolic blood pressure than the patients having lower PWV (147.4±73.3 vs. 134.1±72.2 mmHg, p = 0.038, and 130.7±16.6 vs. 122.5±14.9 mmHg, p = 0.016, respectively). Mid-HD and post-HD blood pressures were not different. We found a positive correlation between total cholesterol and the decrease in SDC-1 levels during HD (r = 0.539; p = 0.008). Pre-, mid-, and post-HD SDC-1 correlated significantly with the ultrafiltration volume during HD (r = 0.432, p = 0.019; r = 0.377, p = 0.044; and r = 0.401, p = 0.012, respectively).

Conclusions:
SDC-1 and ET-1 may contribute to the vascular changes observed during HD, and they have correlations with some traditional and non-traditional CV risk factors.
TEMPORAL TRENDS IN LIFESTYLE MODIFICATION OF PATIENTS WITH HYPERTENSION IN KOREA, 2007-2021
Authors: Won Hoyoun , Cho Jun Hwan , Park Kyung -TAEK , Kim Hyue Mee , Lee Sang Yeub , Jeong Young -HOON , Kim Sang -WOOK 
Published: May 2024

Objective:
Lifestyle modification is crucial in managing hypertension, independent of medical treatment. This study aimed to evaluate the implementation of lifestyle modifications and analyze the trends in lifestyle modification among patients with hypertension in Korea from 2007 to 2021.

Design and method:
Data from the Korea National Health and Nutrition Examination Survey conducted between 2007 and 2021 was analyzed. The study included patients with hypertension and aged >19 years. Factors such as regular physical activity, smoking and alcohol abstinence, weight and stress management, and adherence to a healthy diet were analyzed.

Results:
In 2021, a double-fold increase was observed in the proportion of patients with hypertension who adhered to sodium restriction compared to 2007. However, 70% of patients with hypertension consume more sodium than recommended. Moreover, potassium intake has steadily decreased since 2014, with only 23.8% of patients with hypertension meeting the recommended intake. (Figure) The body mass index and waist circumference of patients with hypertension have gradually increased, with fewer patients maintaining an appropriate weight. The neglect of diet and weight control among young patients with hypertension who experience high stress levels poses challenges in modifying their lifestyles.

Conclusions:
Patients with hypertension in Korea still consume high amounts of sodium, whereas potassium intake is gradually decreasing. Additionally, obesity rates have been increasing, especially among young patients with hypertension. Considering the increasing number of young patients with hypertension and the low control rate, the importance of lifestyle modifications should be further emphasized.