bluuebunny/crossref_metadata_2025_split huggingface dataset:
#3131 Catheter placement by the nephrologist: a safe and effective method for improving access to peritoneal dialysis
Authors: Lafrid Maria , Bahadi Abdelaali , Labioui Narjiss 
Published: May 2024

Abstract

Background and Aims
Peritoneal dialysis (PD) is as effective as hemodialysis and provides a better quality of life. However, it remains underused, particularly in our country, for several reasons, especially the unavailability of surgeons with the necessary skills to insert catheters. The aim of our study was to evaluate the impact of catheter placement by the nephrologist on the incidence of peritoneal dialysis patients, compare the success rates and assess the short- and long-term complications between surgical and nephrologist placements. The ultimate goal was to identify and promote the most effective method with the fewest complications.

Methods
Retrospective study of 69 patients with PD from January 2008 to December 2022.

Results
28 received PD catheter placement by nephrologists (group A), while 41 underwent the procedure performed by urologists (group B).The incidence of patients placed on PD has shown a significant increase since the initiation of catheter placement by nephrologists, with a growth rate of over 100% every two years. No significant difference was observed in the incidence of short-term mechanical and infectious complications between the two groups. However, the group B experienced a higher occurrence of long-term mechanical and infectious complications compared to the group A. The waiting time before catheter placement was significantly shorter in group A (5 days vs. 20 days; p &lt; 0.001). The success rate of peritoneal dialysis catheter placement in group A was 92.85%, while it was 97.56% in group B. There was no significant difference in catheter survival at 1 year between the two groups. However, the mean catheter survival was significantly longer in group B (17 months vs. 11 months, p = 0.026).

Conclusion
The placement of the PD catheter by nephrologists has demonstrated effectiveness and safety. However, it is crucial to investigate and address the factors contributing to the shorter mean catheter survival. By identifying and correcting these factors, we can improve the longevity of catheters and enhance the overall success of PD procedures.
#1615 Working without peritoneal dialysate and urine collections during the COVID-19 pandemic: how to assure sufficient small solute removal
Authors: Zeiler Matthias , Fioravanti Gilda , Angelini Andrea , Silvestri Simona , Fioravanti Giuseppe , Santarelli Stefano 
Published: May 2024

Abstract

Background and Aims
The guidelines of the International Society of Peritoneal Dialysis suggest regular control of small solute removal. During the COVID-19 pandemic we did not perform additional controls of dialysis adequacy in our peritoneal dialysis patients. We judged patients according symptoms and serum urea levels. In this retrospective study, we aimed to evaluate whether the measurement of serum urea alone might indicate sufficient small solute removal in peritoneal dialysis patients.

Method
In 216 adult PD patients (139 males, 77 females, median age 64 years, median BMI 26.7) Kt/V urea (renal and peritoneal) was registered together with anthropometric and laboratory data during the first two years of PD therapy. Patients presenting urea values between 100 and 250 mg/dl were included in the statistical analysis, thus resulting in the evaluation of 410 measurements (265 in male, 145 in female patients). Urea distribution volume was calculated using the formula of Watson and Watson. The measurement of urea in blood and urine was performed by a standard kinetic test with urease.

Results
Serum urea correlated significantly to Kt/V urea (r = −0.28, p &lt; 0.01), whereas significance was not reached in female patients (male patients: r = −0.35, p &lt; 0.01; female patients; r = −0.14, p = 0.13). Kt/V urea of at least 1.7 is achieved in male patients presenting serum urea values lower than 160 mg/dl (95% confidence interval), whereas in female patients apparently presenting serum urea values lower than 200 mg/dl (95% confidence interval). This difference is due to the distinct sex specific urea distribution volume (median value: male patients 40.8 liters, female patients 31.8 liters) and to the absence of a significant correlation between serum urea and Kt/V urea in female patients.

Conclusion
Serum urea values below 160 mg/dl in male peritoneal dialysis patients are roughly indicating sufficient small solute removal, whereas a clear relation between serum urea and Kt/V urea was not present in female patients in our study population.
#1970 Mortality prediction of plasma presepsin in sepsis-associated acute kidney injury patients requiring continuous kidney replacement therapy
Authors: Hwang Won Min , Park Yohan , Yoon Se-Hee , Yun Sung-Ro , Lim Dong Mee 
Published: May 2024

Abstract

Background and Aims
Presepsin has recently introduced as a more specific biomarker for sepsis. Presepsin is greatly affected by kidney function, so its reliability may be reduced in acute kidney injury (AKI) patient, especially requiring continuous kidney replacement therapy (CKRT). For this reason, there has been no study to date analyzing presepsin in AKI patients requiring CKRT. This study analyzed the usefulness of plasma presepsin for predicting mortality in AKI patients requiring CKRT, especially in sepsis-associated AKI (SA-AKI).

Method
This single-center, retrospective study included the patients who underwent CKRT with plasma presepsin measurement from April 2022 to March 2023. A total of 57 patients were enrolled, of which 35 were SA-AKI. 28-day mortality predictive values of plasma presepsin, Acute Physiology and Chronic Health Evaluation-II (APACHE-II), and Sequential Organ Failure Assessment (SOFA) scores were analyzed using receiver operating characteristics (ROC) curve analysis. Multivariate Cox regression analysis was performed to identifying risk factors for 28-day mortality in the SA-AKI subgroup.

Results
In the overall cohort, plasma presepsin showed the lower area under the ROC (AuROC) value of 0.636 than those of APACHE-II (0.663) and SOFA (0.731) scores. However, in SA-AKI subgroup, AuROC value of plasma presepsin was much increased to 0.799, which was the higher than those of APACHE-II (0.651) and SOFA (0.697) scores. Moreover, in multivariate Cox regression analysis, high presepsin was observed as an independent risk factor for 28-day mortality in the SA-AKI subgroup (HR 6.868, P=0.005).

Conclusion
Presepsin can be used as a good prognostic marker in SA-AKI patients requiring CKRT. The usefulness of plasma presepsin in the patients undergoing CKRT needs to be further studied in the future.
#710 Rare manifestation of minimal change disease associated with prostate cancer
Authors: Kleinova Patricia , Vnučák Matej , Graňák Karol , Beliančinová Monika , Blichová Tímea , Dedinská Ivana 
Published: May 2024

Abstract

Background and Aims
Prostate cancer is the most common malignancy in men. Secondary nephrotic syndrome as part of the paraneoplastic syndrome occurs in 11% of cases and is most often associated with membranous glomerulopathy. The association of minimal change disease (MCD) and prostate cancer is extremely rare, where only one case has been described in the available literature.

Method
We present the case of a 77-year-old patient who was admitted to the Transplantation-Nephrology Department of the University Hospital Martin with 3rd degree acute kidney injury and anasarca with fully developed nephrotic syndrome.

Results
During hospitalization, there was a gradual elevation of renal parameters and oliguria with the need for hemodialysis treatment. However, as part of the oncological screening, the level of prostate specific antigen was elevated (10.69 ng/l) with subsequent biopsy confirmed adenocarcinoma of the prostate in stage IIB (pT1cN0M0). Renal biopsy was performed with the finding of MCD, in light microscopy without pathological findings, with fully vital, normocellular glomeruli, without interstitial fibrosis and tubular damage, immunofluorescence without significant findings, in the electron microscope, pedicel podocyte fusions were present. Despite the generally valid recommendations for the treatment of prostate cancer of the given stage and age of the patient (follow-up), antiandrogen therapy was started in cooperation with the urologist along with the treatment of MCD with corticosteroids at a dose of 1 mg/kg. The patient experienced a significant improvement in renal parameters with the onset of diuresis without the need for dialysis treatment.

Conclusion
In the reported case, we describe a rare form of MCD associated with prostate cancer and a rare manifestation in the form of renal failure and the need for dialysis treatment with subsequent complete restitution of renal functions after KS treatment and antiandrogen treatment of the underlying oncological disease.
#664 Childhood Takayasu arteritis: a multicentre retrospective study
Authors: Evers Katrina , Millar Lancelot , Eleftheriou Despina , Brogan Paul , Marlais Matko , Tullus Kjell 
Published: May 2024

Abstract

Background and Aims
Takayasu arteritis (TA) is a rare, large vessel vasculitis affecting mainly the aorta and its major branches. Data on paediatric TA (pTA) is very scarce. The aim of this study was to characterize clinical presentation, therapy and outcome of pTA in a global study population.

Method
We conducted an international multicentre retrospective observational study of children diagnosed with pTA. Inclusion criteria were an age of less than 18 years at initial presentation in the year 2000 or more recently. Clinical data were collected from patients’ charts by the treating paediatric rheumatologist or nephrologist; data were fully anonymised for analysis purposes. Follow-up data was collected up to 2 years after diagnosis.

Results
198 patients from 20 countries were included (76% female). The median age at disease onset was 12 years. Arterial hypertension (67%), a difference in pulses between limbs (65%) and fatigue (66%) were the most common symptoms at presentation. The gastrointestinal system was the second most affected organ system. The median eGFR (estimated glomerular filtration rate) at baseline was 105 ml/min/1.73 m2. Renal artery stenosis was documented in 58% of all patients and in 37% there was need for an invasive renovascular procedure. In 25 of 32 (78%) patients who had either a positron emission tomography–magnetic resonance imaging (PET-MRI) or PET-computed tomography (CT) there was evidence of active inflammation mainly of the aorta. 67% of all patients showed thickened wall abnormalities and 31% had arterial dilatations in a major vessel on any one or more anatomical imaging modality such as ultrasound, CT or MRI. Immunosuppressive treatment was primarily steroids, cyclophosphamide and methotrexate, 37% of all patients were treated with monoclonal antibodies of which 65% received an anti-tumor necrosis factor (TNF) antibody, 31% an anti-Interleukin 6 (IL-6) antibody and 4% an anti-B-cell antibody. Dialysis was necessary in 7% and one patient underwent kidney transplantation. Seven patient deaths (4%) were documented at the most recent follow-up.
The renal function after two years was median eGFR 102 ml/min/1.73 m2, with 67% showing normal function, 31% presenting with chronic kidney disease (CKD) stage 1, 1% with stage 2, 1% with stage 3 and no patients showed stages 4 and 5. A quarter of the patients (27%) were still symptomatic at the 2-year follow-up. The median systolic blood pressure was 117 (interquartile range 107–125) mmHg. 64% of all patients still had antihypertensive treatment, and 87% were still on immunosuppressive therapy.

Conclusion
Our study represents the largest paediatric cohort of children diagnosed with Takayasu arteritis. Several organ systems were involved at onset and the clinical spectrum was highly variable. We will in our further analyses in more detail describe the outcome in relation to presenting symptoms and treatment.
#2493 Podocyturia: a novel biomarker of ageing
Authors: Puzantian Houry , Nasrallah Nadim , Malik Eva , Al Mardini Michel , Njeim Rachel , Eid Assaad , Badr Kamal 
Published: May 2024

Abstract

Background and Aims
Urinary podocyte shedding (podocyturia) is a biomarker of glomerular injury in young and old individuals. Podocyturia is associated with diabetes and hypertension, and it is an early indicator of systemic cardiovascular disease. Importantly, podocyturia has also been noted in healthy adults and may indicate physiologic podocyte turnover. Whether age is a predictor of podocyte loss, independently of diabetes and hypertension, is still unclear. The aim of this study was to examine the association between age and urinary podocin levels.

Method
This was a secondary analysis of data from 5 studies, including 868 individuals, 18-90 years of age. Data on urinary podocin mRNA levels was present on all subjects, as measured by CFX96 Touch™ RT-PCR detection system (Biorad, USA). Descriptive statistics, Chi-square test, ANOVA, and post hoc analysis were performed. Linear regression was conducted with gender, diabetes status, and hypertension status as covariates. Significance was set at p &lt; 0.05.

Results
The mean age of the total sample was 55.10 ± 14.84 years; 46% were female, 26.4% had diabetes, and 37.9% had hypertension. There were significant differences in mean podocin levels by age group (F = 25.27, p ≤ 0.001) as follows. Podocin levels were significantly lower in Group 1 (age 18-35 years; 0.79 ± 0.67 million copies), compared to Group 2 (36-55 years; 2.21 ± 2.15 million copies) and Group 3 (over 56 years; 2.86 ± 3.18 million copies). Moreover, mean podocin levels differed significantly between Group 2 and Group 3 (p = 0.003). Age was a predictor of podocyturia, independently of diabetes and hypertension (p &lt; 0.001).

Conclusion
Podocyturia was present in younger adults. There was a significant rise in podocyturia in middle-aged adults (36-55 years), denoting a transitional phase. There were higher podocyturia levels in older adults compared to the youngest and middle-aged adults. These differences in podocin by age were observed while accounting for diabetes and hypertension.
#2584 Mapping Progression of DKD in ReninAAV UNx db/db mice utilizing time-series RNA sequencing
Authors: Marstrand-Jørgensen Adam Bøgh , Østergaard Mette Viberg , Kaasbøll Ole , Dalbøge Louise S , Christensen Michael 
Published: May 2024

Abstract

Background and Aims
The Renin adeno-associated virus (AAV) uninephrectomized (UNx) db/db mouse model of diabetic kidney disease (DKD) recapitulates hallmarks of DKD with hypertension, including albuminuria and glomerulosclerosis. Despite previous characterization of the model, gaps persist in our understanding regarding temporal patterns of gene expression and pathophysiology in the glomeruli. This longitudinal study characterizes isolated glomeruli from ReninAAV UNx db/db mice during progression of DKD with hypertension.

Method
Female db/db (BKS.Cg-Dock7m +/+ Leprdb/J) received a single i.v. dose of LacZAAV (control) or ReninAAV. Untreated db/m mice (BKS.Cg-Dock7m +/+ Leprdb/J) served as healthy controls. One week after AAV injection, ReninAAV mice underwent UNx, recovered for three weeks, and were subsequently randomized and stratified into 4 groups according to fed blood glucose and body weight. ReninAAV UNx mice were terminated at 4, 8, 12 and 16 weeks (w4-w16) after UNx. Control groups were terminated at 16 weeks. Endpoints included urine and plasma biochemistry, kidney histology (i.e. Collagen 1a1 and Glomerulosclerosis) and RNA sequencing of glomeruli isolated by laser capture microdissection.

Results
ReninAAV UNx db/db mice showed progressive kidney fibrosis (Col1a1%-area) and albuminuria (uACR) compared to LacZAAV db/db and db/m mice across all timepoints investigated. Furthermore, a significant increase in glomerulosclerosis was observed from w12 and onwards compared to LacZAAV and db/m mice. When compared to LacZAAV mice, more than 1,700 glomerular differentially regulated genes and more than 250 uniquely regulated genes were found at each timepoint, including markers of fibrosis, inflammation and glomerular injury. Several glomerular drug targets exhibited time-specific regulated in ReninAAV UNx db/db mice (e.g. Slc5a2, Egfr, Agtr1a). Regulated genes were segmented into nine clusters with distinct temporal patterns. Among these, a continuous increase in expression of genes associated with extracellular matrix (ECM), small molecule transport and temporal stimulation of metabolic pathways. Finally, a correlation analysis revealed strong associations between ECM and ECM-related pathways vs. glomerulosclerosis and albuminuria.

Conclusion
The ReninAAV UNx db/db mouse model of hypertensive DKD demonstrates a progressive increase in fibrosis and albuminuria paralleled by dynamic changes in glomerular gene expression signatures. Notably, the identification of temporal patterns of gene expression and pathway regulation provides novel insights into DKD pathophysiology and progression. This underscores the ReninAAV UNx db/db mouse as an applicable model of human DKD in preclinical target and drug discovery.
#1054 Dietary manganese intake and risk of chronic kidney disease: insights from the UK Biobank Study
Authors: Park Jung Tak , Choi Da Sol , Park Cheol Ho , Heo Ga Young , Kim Hyung Woo , Han Seung Hyeok , Yoo Tae-Hyun , Kang Shin-Wook 
Published: May 2024

Abstract

Background and Aims
Manganese, an essential trace element crucial for various physiological processes, has been linked to metabolic syndrome and cardiovascular health. Despite these associations, the relationship between dietary manganese intake and incident chronic kidney disease (CKD) remains unclear. In this study, the connection between dietary manganese consumption and the development of CKD in individuals with normal kidney function was investigated.

Method
A total of 135,577 participants enrolled in the UK Biobank were assessed. Dietary manganese intake was determined through a 24-hour dietary recall questionnaire and categorized into quartiles. Individuals with prevalent CKD or an estimated glomerular filtration rate (eGFR) &lt;60 mL/min/1.73 m2 at baseline were excluded. The primary outcome was incident CKD diagnosed using ICD-10 and OPCS-4 codes. Incident CKD, defined as eGFR &lt;60 mL/min/1.73 m2 or a urine albumin-to-creatinine ratio (UACR) ≥30 mg/g, was also evaluated in a sub-cohort that included eGFR and UACR follow-up data.

Results
During a follow-up period of 1,492,228 person-years (median, 11.2 years), incident CKD occurred in 4,900 (3.6%) participants. The incidence of CKD exhibited a progressive increase among individuals with low manganese intake (2.3, 3.0, 3.6, and 4.2 events per 1000 person-years in Q4–Q1, respectively). In a multivariate Cox proportional hazard model, the adjusted hazard ratios (95% confidence intervals) for the lowest, second, and third quartiles were 1.39 (1.26–1.54), 1.22 (1.11–1.34), and 1.12 (1.02–1.23), respectively, compared to the highest quartile. Similar findings were observed in relation to eGFR or UACR-defined CKD outcomes.

Conclusion
Lower dietary manganese consumption was found to be associated with an elevated risk of incident CKD in adults with normal kidney function. This implies that a deficiency in dietary manganese intake may contribute to an increased risk of CKD development.
#2577 Sodium-mediated blood pressure rise is associated with a lower vasodilation response to nitroglycerin in healthy controls, but not in CKD
Authors: van Duin Robert , Oppelaar Marjet , van den Born Bert-Jan , Engberink Rik Olde , Vogt Liffert 
Published: May 2024

Abstract

Background and Aims
Chronic kidney disease (CKD) is characterized by endothelial dysfunction, that is partly caused by reduced bioavailability of NO. In addition to volume overload, endothelial dysfunction may contribute to hypertension in CKD. High sodium consumption affects NO levels, potentially leading to impaired vasorelaxation and a salt-sensitive blood pressure (BP) response. Whether salt-sensitivity in CKD is related to impaired NO bioavailability remains unknown. In this randomized-crossover-study, the vasoresponse to the NO donor nitroglycerin (NTG) during a high sodium diet in both CKD and healthy controls (HC) was assessed.

Method
CKD-patients (KDIGO stage G2-3A, proteinuria &gt;0.5 g/d) and HC followed a 7-day low sodium control diet (&lt;50 mmol/d) and high sodium diet (&gt;200 mmol/d) in random order. After each diet, the hemodynamic profile was assessed by daytime BP and cardiac output (CO) measurements, by which systemic vascular resistance (SVR) was calculated. Nitroglycerin was administered to assess SVR changes.

Results
We included 15 CKD-patients (mean age, 49 yrs; median (IQR) proteinuria 0.7 (0.6-1.4) g/d; and plasma creatinine 129 (105-160) µmol/l) and 16 HC (41 yrs). Dietary salt intervention was comparable in the CKD and HC groups. After HSD, mean (SD) systolic BP increased in CKD by 9.7 mmHg (9.8; p &lt; 0.01) as compared to 3.1 mmHg ((6.0), p = 0.07)) in HC (between-group difference p = 0.04). After HSD, changes in body weight and CO did not differ between groups. Median (IQR) SVR change after HSD was 163.0 (−34.9-275.7) in CKD and −13.8 ((−299.4–61.4),p = 0.03) dyn⋅sec⋅cm-5 in HC. In HC, salt-mediated blood pressure change was positively associated with a NTG-induced SVR change during HSD (r = 0.70, p = 0.01). This association was not present in CKD (r = −0.24, p = 0.34) and significantly different from that in HC (p &lt; 0.01).

Conclusion
CKD-patients have a higher sodium-mediated BP response with comparable change of fluid status but a different SVR change as compared to HC. In HC, impaired sensitivity to the NO donor nitro-glycerin associates with higher BP response to sodium. No such association was found in CKD-patients, suggesting that persistent endothelial dysfunction is pivotal for salt sensitivity in CKD.