bluuebunny/crossref_metadata_2025_split huggingface dataset:
#3019 Hepcidin and erythropoietin along with iron indices to asses anemia in lupus nephritis population
Authors: Badawi Mohamed Hosney , Mohamed Nourelsabah , Refaie Ayman F , Zayed Karem N , Mortada Wael I , Nabieh Kareem A , Sobh Mohamed A 
Published: May 2024

Abstract

Background and Aims
There is a broad spectrum of hematologic manifestations in SLE including lymphopenia, anemia, thrombocytopenia, or pancytopenia. lymphadenopathy and splenomegaly are also identified especially with high disease activity. Anemia of chronic disease, representing approximately one third of the cases in patients with SLE. Santacruz et al, also reported that iron deficiency anemia is also a common cause, usually caused by blood loss. serum hepcidin levels are high in patients with CKD, and are associated with erythropoiesis stimulating agent resistant anemia due to the inability of stored iron to be accessed for erythropoiesis, they are also high in autoimmune diseases as SLE. we evaluated anaemia in lupus nephrites population by assessing the level of hepcidin, erythropoietin along with iron study

Method
in this observational study We identified 100 patients with SLE and diagnosed as lupus nephritis by means of renal biopsy ISN/RPS classification 2004 with some missed data about biopsy details, the patients assessed for anaemia by haemoglobin level, iron study (TSAT, ferritin), hepcidin (10-120 μg/L) and erythropoietin level (3-36 IU/L). Demographics, disease characteristics and comorbidities were ascertained and adjusted for.

Results
52 % of patients with SLE, LN (mean age 37.85 (9.40) years, 94 % female,) had Hgb&lt;12 g/dl. The two groups of patient were comparable in disease duration but anemia had higher disease activity than patients with normal Hgb (p. value 0.9, 0.001 ). Furthermore, incidence of DM and HTN wasn't have statical significant, laboratory investigation showed anemia is microcytic hypochromic with low TSAT, hepcidin is almost high in 72% of all patients but wasn't significantly different between the two groups but erythropoietin level was normal in 100% of patients in both groups.

Conclusion
Patients with SLE and LN have an increased prevalence of anemia due to different factors. Our data suggest that iron deficiency anaemia was prevalent in the study group which may be due to high hepcidin level in those group of patient or blood loses especially the majority were females, erythropoietin level as marker of anaemia in lupus nephritis patient had been found to be not an indicator, its receptor resistance or antibodies found in SLE patients.
#388 IONIS-FB-LRx, an antisense oligonucleotide to complement factor B for treatment of IgA nephropathy
Authors: Hladunewich Michelle , Barbour Sean , Makris Angela , Tan Sven Jean , Choo Jason , Yang Qingqing , Lin Lixuan , Barrett Terry , Schneider Eugene , Geary Richard , Mccaleb Michael , Brice Gary 
Published: May 2024

Abstract

Background and Aims
Pathogenesis of IgA nephropathy (IgAN) is known to be dependent upon multiple factors, one being the complement system. Since overactivity of the complement Alternative Pathway (AP) has been proposed to contribute to pathogenesis of IgAN, it has been hypothesized that a reduction of AP activity would improve proteinuria. IONIS-FB-LRx, (ISIS696844, RO7434656), is an investigational antisense oligonucleotide targeting complement factor B (CFB) mRNA and reduces CFB production in the liver. We have previously demonstrated that administration of IONIS-FB-LRx lowered the production of CFB, a required component of the AP, and led to reduction of AP and reduction in proteinuria in IgAN patients (2023 ASN Abstract#SA-PO926, N = 13 patients). Current abstract provides an update to our previous report extending results to 19 patients treated with IONIS-FB-LRx.

Method
An exploratory, single-arm, multi-national open-label Ph2 study (NCT04014335) recruited patients with biopsy-confirmed IgAN, proteinuria &gt;1.5 g/d, eGFR &gt;40 mL/min/1.73 m2, and hematuria despite maximum tolerated RAAS blockade and/or stable dose of SGLT-2 inhibitor for a minimum of 6 months. Study drug was administered at Weeks 1, 3, and 5, and then every 4 weeks through
Week 25 (Cohort A) and at Week 1 and then every 4 weeks through Week 25 (Cohort B). Primary outcome was change in 24-hr proteinuria at Week 29 (4 weeks after last dose) compared to baseline (BL).

Results
19 patients have completed study to date (13Nov2023), 25-62 yr, 42% Female, 11 Asian, and 8 White. Median 24-hr UPCR at BL was 1.56 g/g (IQR 1.23, 2.33 g/g). At Week 29, a 45% geometric mean ratio reduction was observed. There was little change in eGFR at Week 29 compared to BL (mean ± SD; BL 72 ± 22; Week 29 74.6 ± 20 mL/min/1.73 m2). The drug demonstrated an acceptable safety profile with no Treatment Emergent SAEs; the only clinically meaningful laboratory finding was reversible and transient ALT elevation without a change in bilirubin. All patients completed the study and one patient discontinued study drug after 4 months to initiate SGLT-2 inhibitors. That patient experienced a 38% reduction in 24-hr UPCR collected 3 weeks (Week 27) after the last dose of IONIS-FB-LRx, but prior to use of SGLT-2 inhibitors.

Conclusion
This Ph2 open-label study provides continuing clinical evidence that IONIS-FB-LRx reduces complement levels and proteinuria in patients with IgAN, supporting Ph3 development (NCT05797610) to determine the potential of IONIS-FB-LRx to reduce the progression of IgAN.
#1146 Role of renal dysfunction in the use of anticoagulants in COPD patients with atrial fibrillation
Authors: Karimdjanova Guzal , Egamberdieva Dano , Ruzmetova Iroda 
Published: May 2024

Abstract

Background and Aims
The renal dysfunction is known to be the most important predictor of outcome in patients with atrial fibrillation (AF). At the same time, assessment of the functional state of the kidneys is an integral part of the protocol when selecting the dose of oral anticoagulants. The prognostic role of the functional state of the kidneys during treatment with oral anticoagulants on a possible worsening of the cardiac prognosis during the treatment of AF in patients with concomitant comorbid background, in particular with COPD, has not been sufficiently studied.
The aim of the study was to evaluate the prognostic role of renal dysfunction in terms of possible cardiovascular events and bleeding in patients with COPD and AF treated with oral anticoagulants.

Method
56 COPD patients with CHF and AF who received oral anticoagulants were examined. Renal function (creatinine level and estimated glomerular filtration rate - eGFR) was assessed at baseline and follow-up. The functional state of the kidneys was calculated using the CKD-EPI-2011 formula. At baseline, the risk of bleeding was assessed using the HAS-BLED scale. Worsening of the functional state of the kidneys was detected when the level of creatinine increased or eGFR decreased by at least 20%.

Results
In addition to standard treatment for COPD in the presence of AF, patients received oral anticoagulants during six months of observation. Worsening of the functional state of the kidneys was observed in 18.3% of patients. In patients with renal dysfunction, the frequency of episodes of CHF decompensation and non-major bleeding (MB) was significantly higher. With a reduced glomerular filtration rate, there was no effect on the incidence of bleeding and stroke. The oral anticoagulants used did not have a significant effect on the observed renal dysfunction and did not affect the occurrence of new cardiovascular events in patients with COPD. It turned out that predictors of renal dysfunction in patients with COPD are age, female gender, and lower hemoglobin levels. In multivariate analysis, renal dysfunction was identified as an independent predictor of non-major bleeding (OR 2.04, 95%, p &lt; 0.05).

Conclusion
In patients with COPD and atrial fibrillation, the presence of renal dysfunction was an additional exacerbating factor associated with a poor mid-term cardiovascular prognosis and the risk of bleeding. However, oral anticoagulants did not affect the degree of deterioration of renal function or the incidence of cardiovascular events.
#610 Alterations in frequency and function exhausted memory B cells in lupus nephritis and systemic lupus erythematosus
Authors: Yap Desmond , Zhu Litong 
Published: May 2024

Abstract

Background and Aims
Various B cell abnormalities have been implicated in the pathogenesis of LN, and our previous studies have demonstrated that memory B cells assume pathogenic relevance in disease relapse. Memory B cell exhaustion is a B lymphocyte aberration initially reported in chronic human immunodeficiency virus (HIV) infection, and was later also observed in chronic graft versus host disease (cGVHD) and autoimmune disorders. The pathogenic roles of exhausted memory B cells in LN and disease relapse remains unclear. We will validate the significance role of exhausted B cell in the pathogenesis of LN.

Method
Classical memory (CD19 + CD21 + CD27+) and exhausted B cells (CD19 + CD21 – CD27–) were measured in LN patients with multiple relapses (MR) (n=15) or no relapse (NR) (n=15) during disease remission. B cell-related cytokines, homing and inhibitory receptors, proliferation and calcium mobilization in classical and exhausted memory B cells were also assessed. Using single-cell RNA sequencing data from NIH and GEO, we also performed bioinformatics analysis to identify genes and pathways relevant to memory and exhausted B cells in SLE, LN and healthy controls.

Results
The MR group exhibited higher proportion of circulating exhausted memory B cells compared to NR. Blood levels of IL-6, BAFF and IL-21 in MR patients were higher than the NR group. The MR had higher blood levels of Siglec-6, CXCR3 and CD62L than the NR group. Expression of inhibitory receptors CD22, CD85j, CD183 and FCRL4 in exhausted B cells were increased in the MR group compared to the NR group. Exhausted B cells from MR patients also showed decreased proliferation compared to NR patients and impaired calcium mobilization in response to B-cell receptor triggering. STAT1, XAF1, MX1, IFI44L, EPSTI1, LCP1, OAS1, NEAT1, IFI16, IFI44 in exhausted B cells and XAF1, MX1, IFI44L in memory B cells play a pathogenic role in LN patients (Figs. 1 and 2). SLE patients also show increased proportion of exhausted B cells compared to healthy control and the expression of STAT1, XAF1, MX1, IFI44L correlate positively with the proportion of exhausted B cells.

Conclusion
Our results suggested that altered numbers and function of exhausted B cells may have pathogenic significance in SLE and LN.
#1128 Accuracy of shorter iohexol glomerular filtration rate measurement protocols in individuals with preserved kidney function
Authors: White Christine A , Gaynor-Sodeifi Kavey , Norman Patrick , Furman Michele , Sochett Etienne 
Published: May 2024

Abstract

Background and Aims
Measuring glomerular filtration rate (mGFR) using exogenous tracers is recommended in a number of settings with plasma one-compartment multi-sample protocols (MSP) being the most commonly used and iohexol being the dominant tracer. The accuracy of MSP protocols has mostly been evaluated in the setting of reduced GFR where delayed initial and final samples are recommended. Much less is known about MSPs when GFR is not decreased and the default protocol tends to include initial sampling at 120 minutes and final sampling at 240 minutes post iohexol injection. The objective of this study was to assess the performance of shorter MSPs with earlier initial (60 and 90 minutes) and final (150, 180, and 210 minutes) sampling times in individuals with preserved GFR.

Method
Participants were recruited from a 4-year prospective, observational study evaluating the cardiovascular, renal, and bone health profile of young adults with Type 1 Diabetes. The reference mGFR was calculated using a plasma iohexol clearance one compartment slope intercept method with 5 samples collected between 120-240 minutes post iohexol injection. Four different combinations of shorter sampling strategies were investigated: 60-150 min, 60-180 min, 90-180 min and 90-210 min. Performance was evaluated using measurements of bias, precision, and accuracy (P2, P5, and mean absolute error).

Results
Mean age of the 43 participants was 23.9 ± 1.9 yrs with a mean eGFRCKiD-1 of 95.5 ± 15.9 ml/min/1.73 m2 and mean reference mGFR (120-240 min) of 102.3 ± 13.7 ml/min/1.73 m2. All exploratory shorter mGFRs performed well, with median biases less than 1 ml/min/1.73 m2 and mean absolute error less than 1.6 ml/min/1.73 m2. All shorter mGFRs were within 5% of the reference mGFR and the majority were within 2%.

Conclusion
These results demonstrate that shortening the mGFR procedure in individuals with preserved GFR provided very similar results to the current standard while significantly decreasing procedure time. The cost savings and improved feasibility of these shortened protocols should reduce some of the barriers to more widespread adoption of GFR measurement.
#1921 Resveratrol improves the indoxyl sulfate-induced intestinal damage by promoting mitophagy and inhibiting apoptosis pathways
Authors: Zheng Cai-Mei , Liao Min-Tser , Lu Kuo-Cheng 
Published: May 2024

Abstract

Background and Aims
Chronic Kidney Disease (CKD) represents a systemic condition marked by progressive impairment stemming from the pathological effects of uremic toxins. There are noted interactions between these toxins and the intestinal microbiota, leading to disruption of metabolic and immune pathways central to the gut-renal axis in patients with CKD. The present study examines the protective properties of Resveratrol (RSV), which functions as an antagonist to the aryl hydrocarbon receptor (AhR), against the adverse effects of the uremic toxin, indoxyl sulfate (IS), in relation to intestinal harm within the context of CKD.

Method
Our research utilized 5/6 nephrectomized mice and isolated primary mouse intestinal cells to assess the influence of IS on the development of tight junction barriers within the intestinal epithelium and overall cellular health within the intestine. Serum biochemistry assessments, hematoxylin & eosin (H&E) and immunohistochemistry staining (IHC), Western blot tests, q-PCR, and si-RNA targeted against AhR were used in the study.

Results
Experiments carried out on 5/6 nephrectomized mice and IEC-6 cell lines disclosed that IS compromises the integrity of the intestinal barrier, affecting the tight junction proteins (TJPs), along with perturbing mitophagy through the upregulation of IRF1 and inhibition of DRP1. RSV mitigates intestinal barrier dysfunction by promoting the expression of TJPs including zona occludens 1 (ZO-1), occludin, claudin-1, and claudin-2 proteins in uremic conditions. It also reverses the IS-related negative impacts on mitophagy. Additionally, RSV exerts antioxidant defenses by enhancing the PI3K/Akt/Nrf2 signaling pathway and decreasing cellular apoptosis via modulation of Bcl-2/Bax/cleaved caspase 3/cytochrome C/PARP-1 pathways.

Conclusion
Our findings highlight the promise of RSV as an agent capable of mitigating intestinal barrier dysfunction in CKD. This contributes substantial findings with implications for the modulation of the gut-renal axis.
#1852 When ‘pebbles’ affect the kidney: nephrolithiasis and chronic renal failure in Crohn's disease. The experience of a 3rd level centre
Authors: Lopez Antonia , Cignesi Denise , Perivolioti Dimitra , de Sanctis Lucia Barbara , Patregnani Laura , Romani Francesca , Cannarile Daniela Cecilia , Zucchelli Annalisa , Rizzello Fernando 
Published: May 2024

Abstract

Background and Aims
Nephrolithiasis is the most common expression of kidney involvement in chronic inflammatory bowel disease (IBD), especially in Crohn's disease (CD). Stone formation favoring factors are hyperoxaluria, dehydration, acidosis, common conditions in CD patient, who present a little higher incidence of renal stones, made of calcium oxalate, than the normal population.
Only few studies focused on the relationship between CD activity (defined by CDAI score) and the development of nephrolithiasis and possible subsequent development of chronic renal failure (CRF).

Materials and Method
We conducted a retrospective study on a cohort of 1236 patients affected by CD referring to our Centre of IBD- Sant'Orsola between 2014 and 2021. We identified two cohorts from this population: 118 patients with nephrolithiasis and 118 patients without nephrolithiasis. Among these two groups, we identified variable clinical manifestations of CD and their relation with CRF and lithiasis.

Results
The prevalence of nephrolithiasis in all CD patients was 10.3%, a little higher than in the general population.
The results of the analysis of patient and disease variables in the two groups are shown in Table 1. The mean age at diagnosis of CD was higher in the group without nephrolithiasis, so the treatment was started later. The presence of perianal disease, extraintestinal manifestations (MEI), like ankylosing spondylitis (APS), biliary tract involvement, or previous surgery, and presence of ileostomy correlate with the formation of stones in univariate regression analysis (Table 2). Perianal disease and MEI also maintained significance in multivariate analysis.

Conclusion
Our data suggest that a higher degree of disease activity, defined by the presence of perianal disease (a variable on CDAI score) and the presence of MEI, correlates with higher risk of lithiasis. It is advisable to start early the study of nephrolithiasis in these patients to adopt preventive strategies against formation and progression of renal stones. Future studies are required for a better definition of this deep relationship.
#1066 Unobvious long-term effects of COVID-19 for kidneys
Authors: Fedulkina Veronika , Artamonova Aleksandra , Vatazin Andrey , Zulkarnaev Aleksei , Fomin Aleksandr 
Published: May 2024

Abstract

Background and Aims
The impact of COVID-19 on the chronic kidney disease (CKD) has already been confirmed by researchers around the world. However, there is still no description of this infection influence on kidney function without signs of CKD before it.

Method
The study included 359 patients from the Moscow region who applied to the nephrologist of the first level regional center in 2022, 154 men and 205 women, mean age 59±16 years. Among the patients who applied for the past year, there were 70 patients with a previously confirmed diagnosis of CKD and 289 who first applied to a nephrologist and had no nephrology complaints, clinical or laboratory signs of CKD before.

Results
A total of 95 patients from both groups had COVID-19 in 2020-2022 before a visit to a nephrologist, 45 people from the group with CKD (47.4%) and 50 people (52.6%) who were not diagnosed with CKD before COVID-19. 20.4% had COVID-19 earlier than 2 months ago, 6.4% - from 2 to 6 months ago, 45.3% - from 6 to 12 months ago, 27.9% from 12 to 24 months ago.
A mild degree of COVID-19 was in 49.4% of patients, moderate - 43, 3%, heavy - 7.3%.
It is important to note that 48 patients (96%) who first contacted a nephrologist after COVID-19 were diagnosed with CKD (CKD stages 1-2 - 14 patients (29.17%), 3A and 3B stages - 24 patients (50%), 4 and 5 stages - 10 patients (20.83%)).
Relative risk of stage 3+ CKD after COVID-19: RR= 1.036 [95% CI 0.8961 to 1.170], p=0.6742, relative risk of stage 5 CKD: RR= 0.7164 [95% CI 0.3259 to 1.534], p= 0.5403. Thus, the development of advanced (3+) stages of CKD cannot be directly related to past COVID-19. However, if we consider the risk of developing advanced stages of CKD for patients who have experienced moderate to severe COVID-19, then the relative risk of stage 3+ CKD: RR= 1.082 [95% CI 0.8936 to 1.236], p= 0.4607, and relative risk of stage 5 CKD RR = 1.013 [95% CI 0.4134 to 2.341], p&gt;0.9999.

Conclusion
Unfortunately, it is not possible to link the risk of developing CKD in patients after COVID-19 with the timing after COVID-19 at this stage of the study. In addition, the relationship between COVID-19 and CKD stage cannot be assessed without taking about the structure of CKD causes in both groups. Obviously, a larger and deeper study of this issue is needed, possibly with more patients and long-term monitoring of the dynamics of renal function in patients of both groups.
#3106 The prevalence and degree of hyperkalaemia in adult patients with chronic kidney disease, in Durban, South Africa
Authors: Bux Tasmeen , Assounga Alain 
Published: May 2024

Abstract

Background and Aims
Hyperkalaemia is a known risk factor for the development of cardiac rhythm disturbances and sudden cardiac death. The presence of chronic kidney disease (CKD) is also an independent risk factor for cardiovascular complications. The prevalence of hyperkalaemia in patients with CKD has previously varied widely between studies. The prevalence of hyperkalaemia in the patients attending the renal clinic at Inkosi Albert Luthuli Central Hospital (IALCH) has not been previously determined. This study aimed to discover the prevalence of hyperkalaemia in patients attending the renal clinic at IALCH, as well as the degree of severity amongst the patients in whom hyperkalaemia was present. Demographic and other variables were also assessed for an association with hyperkalaemia.

Method
A retrospective review of outpatients attending the renal clinic at IALCH from 1 October 2016 until 30 September 2017. Demographic and clinical characteristics were retrieved and descriptive statistical methods and logistic regression analysis were performed.

Results
The study consisted of 200 patients, of whom the majority were female (n=120, 60%). The prevalence of hyperkalaemia amongst these patients was found to be 16%. In those with stage 3 CKD, the prevalence of hyperkalaemia was 7.69%. In those with stage 4 CKD, the prevalence of hyperkalaemia was 20.5% and in those with stage 5 CKD the prevalence was 17.3%. There were no statistically significant associations between hyperkalaemia and demographic variables, nor with dietician intervention. There was a significant association with the use of sodium polystyrene sulfonate.

Conclusion
CKD is a growing burden in the developing world. With CKD comes metabolic and other derangements, including electrolyte abnormalities as well as increased cardiovascular risk. Hyperkalaemia is associated with worsening CKD. In addition, hyperkalaemia puts patients at risk of cardiac dysrhythmias and sudden cardiac death. Pharmacological measures to manage CVD risk should be weighed up against the risk of hyperkalaemia related complications. Potassium lowering agents should be considered to allow for optimal CVD management in the setting of hyperkalaemia in CKD.