bluuebunny/crossref_metadata_2025_split huggingface dataset:
#3945 ACUTE KIDNEY INJURY (AKI) AMONG COVID-19 POSITIVE PATIENTS INCREASES THE RISK OF MORTALITY: A SINGLE CENTER EXPERIENCE
Authors: Alotaibi Torki , Nagib Ayman Maher , Alserwy Nabil , Abbas Ahmad , Sobhy Islam , Nair Prasad , Khalid Mahmoud , Abdulhamed Mohamed , Fayad Zohair , Atta Ahmed , Mostafa Mohamed , Yahya Ahmed , Sami Ahmed , Abdelmonem Mohamed , Gheith Osama Ashry Ahmed 
Published: June 2023

Abstract

Background and Aims
Renal complications of COVID-19 are not yet well studied. We aimed to evaluate the prevalence of acute kidney injury (AKI) among positive COVID-19 hospitalize cases and explore its impact on patient outcomes.

Method
586 hospitalized patients with COVID-19 were retrospectively evaluated. of them, 267 (45.5%) developed AKI- classified according to the Kidney Disease Improving Global Outcomes (KDIGO) guidelines- compared with 319 (54.5%) patients without AKI.

Results
Most cases were males (72.7% vs. 69.7%), and their ages ranged (60.8± 14 vs. 51.7± 16 years). Comorbid conditions significantly predominant among the AKI group were diabetes mellitus (64 vs. 42.9%), hypertension (72.6% vs. 43.5%), and ischemic heart disease (25% vs. 14.7%). Fever, cough, shortness of breath, and dehydration were the main presentations among the AKI group, and they had significant radiological findings concordant with COVID-19 (86.8% vs. 59.8%). Sepsis, volume depletion, shock, arrhythmias, and ARDS were significantly higher in the AKI group. Anticoagulation (85% vs. 59.2%), vasopressors, plasma infusions, antimicrobials, and steroids were more frequently used in the AKI group. Acute respiratory failure requiring mechanical ventilation and the overall mortality rate were significantly higher in the AKI group (62.3% vs. 32.9% and 63.2%. vs. 31.1%, respectively).

Conclusion
AKI associated with severe COVID-19 was more frequent than reports from Chinese, European, and North American cohorts. AKI risk factors included COVID-19 comorbidities like hypertension, diabetes, mechanical ventilation, male gender, and older age. Mortality was high in this population, especially elderly patients, and in those who develop KDIGO stage 3 AKI.
#4419 THE IMPACT OF TRANSGLUTAMINASE 2 INHIBITION ON HYPERTENSION-INDUCED FIBROSIS IN HYPERTENSIVE NEPHROPATHY
Authors: Lee Jiwon , Han Sang-Woong , Yang Seung Hee , Yu MI-Yeon 
Published: June 2023

Abstract

Background and Aims
Hypertensive nephropathy is a chronic disease that requires the novel treatment. Transglutaminase 2 (TG2), linked to various diseases including cardiovascular and kidney diseases, has been suggested to play a role in the development of hypertensive nephropathy through its contribution to fibrous tissue formation, oxidative stress regulation, and inflammation. This study aimed to explore the role of TG2 in the development of hypertensive nephropathy and evaluate its potential as a therapeutic target.

Method
An in vitro hypertensive model was established using a device that mimics hypertension by applying rotational force. An in vivo hypertensive model was established in rats through subtotal 5/6 nephrectomy to induce fibrosis. The relationship between TG2 expression and the progression of hypertension-induced fibrosis was analyzed, and the impact of TG2 inhibition on fibrosis was evaluated using the TG2 inhibitor, cysteamine.

Results
In the in vitro study, rotational force was applied to induce hypertension using a hypertensive mimic device, which resulted in fibrosis in primary human glomerular endothelial cells and tubular epithelial cells and increased expression of TG2. The administration of cysteamine at concentrations of 0.5 mM, 1 mM, and 2 mM decreased fibrosis and phosphorylated P65 in a dose-dependent manner. The in vivo hypertensive model demonstrated a significant increase in blood pressure (P&lt;0.001) and kidney fibrosis (P&lt;0.001) over time at 4 and 8 weeks after surgery. A significant increase in TG2 expression was observed as hypertension and fibrosis progressed (P&lt;0.001).

Conclusion
The progression of hypertension-induced fibrosis was accompanied by an increase in TG2 expression. Inhibition of TG2 showed improvement in fibrosis, suggesting further study of its mechanism may provide new therapeutic options for hypertensive nephropathy.
#4430 PREVALENCE OF AMPUTATION IN HD PATIENTS: A DIALYSIS PROGRAM WITHOUT SOCKS
Authors: Hernández Rosa Sánzhez , González-Mariño Rocío Zamora , Jiménez Laura Rodríguez-Osorio , Gúrpide Beatríz Durá 
Published: June 2023

Abstract

Background and Aims
Peripheral arterial disease affects very commonly CKD patients on dialysis. Frequently such injuries precede severe complications that lead to hospitalizations, amputations and even death.
Objectives: Study the prevalence of ulcers and amputation on dialysis, analyze related risk factors, post-surgical results and establish a prevention program.

Method
Descriptive, observational, retrospective (7 years), single-center study in patients with CKD on dialysis.

Results
202 patients (12 PD 190 HD), 67 active and 135 off dialysis, 127 men 75 women. Average age 69 years. Average time on dialysis 47 months. Vascular access: 56%, native fistula 37% catheter 7% prosthesis. Cause CKD 30,2% ND, 22.8% NAS. 95.54% HBP, 46.53% DM 26.73% Ischemic heart disease, 31.19% chronic ischemia, 26.24% had intermittent claudication, 12.38 % had all the comorbidities indicated. Higher comorbidity in males M:F 4:1. 53.47% ex-smokers or active habit.
Ulcers 29.7% (40 men 20 women), 76.67%, diabetics. Half of the patients with DM (48.94%) presented ulcers. The most frequent was vascular ulcer (43.67%) followed by that associated with diabetic foot (26.67%) and pressure ulcer 15%.
Amputations (11 major and 13 minor) in 24 patients (16 men 8 women) with a prevalence: overall 12%, DM 22.34%, with ulcers 40% and 46% if they are diabetics. Analytics in amputees. Average: PTH 352 ng/dl, Phosphorus 4.4 mg/dl, Vitamin D 19 mg/dl, Albumin 3.3g/dl, hypercholesterolemia in 20%. 17 patients with chronic ischemia were revascularized (76.47% ended in amputation).
Mortality: 88 patients died (43.56%), of which 41 were patients with ulcers (68.33%) and 20 were amputees (83.33%, 3 early mortality and 17 late mortality).

Conclusion
The prevalence of amputations on dialysis is high. Most are male, DM with high cardiovascular comorbidity and a previous history of ulcers.
Mortality increases in patients with CKDG5D with ulcers and amputees. There is a need for 11dialysis without socks” programs for early detection of dialysis ulcers to reduce the incidence of amputees.
#4637 IS THE NEUTROPHIL/LYMPHOCYTE RATIO USEFUL IN PREDICTING THE OCCURRENCE OF DEPRESSION IN CHRONIC HEMODIALYSIS PATIENTS?
Authors: Shabi Imane , Chettati Mariam , Fadili Wafaa , Laouad Inass 
Published: June 2023

Abstract

Background and Aims
Depression is one of the most described psychiatric disorders in chronic hemodialysis patients. Previous studies have shown that the chronic inflammatory state is involved in the progression of depressive symptoms. The neutrophil/lymphocyte ratio (NLR) is an inexpensive and easily measured inflammatory marker. To date, the association between NLR and depression in this population in Morocco has never been described.

Method
In this multicenter cross-sectional study, we included a population of chronic hemodialysis patients over a period of 3 months (September- December 2023). The Patient Health Questionnaire-9 (PHQ-9) translated into Arabic (validated version) was used to assess depressive symptoms. NLR was calculated as the ratio of neutrophils to lymphocytes. An N/L ratio greater than 2.5 was considered high. We also used the patients' medical records to collect data on their biological tests and medical history.

Results
A total of 69 patients with a M/F sex ratio 1.2. The mean duration of HD was 7 ± 3.5 years, with a mean age of 53 ± 13.2 years. 28% were diabetic and 32% hypertensive. Depressive symptoms were detected in 20% of the 69 patients, and 72% of our patients had an NLR &gt;2.5. In univariate analysis, PHQ-9 scores were positively correlated with NLR and negatively correlated with albumin. There was no correlation between PHQ-9 score and sex, age, duration of dialysis, diabetes, hypertension, ferritin. NLR was a significant predictor of mild (p = 0.06) and moderate or moderately severe (p = 0.04) depressive symptoms, after adjusting for age, gender, Kt/V, duration of dialysis, history of hypertension, diabetes and Charlson Comorbidity Index score.

Conclusion
These results suggest that NLR can be used as a biomarker to predict depressive symptoms in chronic hemodialysis patients.
#4667 IMMUNOSUPPRESSION FOR FAILED ALLOGRAFT: HOW PROLONGED AND MUCH IS ADEQUATE?
Authors: Song Jehun , Park Kyungsun , Yoo Kyung Don , Park Jongha , Lee Jong Soo 
Published: June 2023

Abstract

Background and Aims
The development of human leukocyte antigen (HLA) antibodies towards a failed allograft is a critical factor for the feasibility and outcomes of future transplantation. Therefore, we investigated the factors contributing to sensitization in patients with failed allografts.

Method
A single-center retrospective study of patients with failed allografts between 2010 and 2020 was performed. Samples for HLA antibodies were tested at the time of graft failure and after immunosuppression withdrawal. Sensitization was defined as more than 80% of calculated Korean panel reactive antibody (PRA) I or PRA II. In addition, variables for affecting sensitization were collected.

Results
Twenty-three patients were included in the study. The mean flow-up duration after failed allograft was 43 ±33.3 months. The sensitized patients tended to have a longer follow-up period and were exposed to less total calcineurin inhibitor (CNI) than non-sensitized patients. (non-sensitized vs sensitized patients : 27.1±12.9 vs 51.7±37.8 months, p = 0.196; 4.2±4.9 vs. 5.1±2.9 months, p = 0.231 respectively). In multivariate logistic analysis, there was no significant difference regarding the total exposure to CNI and follow-up duration (sensitization group: multivariate odds ratio [OR] 1.188, 95% confidence interval [CI] 0.55–2.52, p = 0.655, OR 1.03, 95% CI 0.97–1.10, p = 0.282, respectively). In some patients, even prolonged immunosuppression after returning dialysis therapy did not prevent sensitization toward failed allograft.

Conclusion
In this study, there was no significant difference regarding the contributing factors for sensitization in the multivariate logistic analysis. However, in sensitized patients, trends were showing longer follow-up duration and less CNI exposure. Sensitization towards a failed graft might be affected by the dose and duration of immunosuppressant. Finally, the small sample size is one of the limitations of this study, and additional prospective research analysis for patients with failed allografts is needed in the future.
#4676 RETROSPECTIVE EVALUATION OF THE PREVALENCE OF DIABETES MELLITUS IN A SINGLE CENTER RENAL TRANSPLANT COHORT
Authors: Alfieri Carlo Maria , Molinari Paolo , Cicero Elisa , Campioli Edoardo , Regalia Anna , Campise Maria Rosaria , Cresseri Donata , Verdesca Simona , Favi Evaldo , Castellano Giuseppe 
Published: June 2023

Abstract

Background and Aims
Post-transplant diabetes mellitus (PTDM) might impact significantly in renal transplant (RTx) and RTx patients (RTxps) outcome. In this study we evaluated: 1) the prevalence of diabetic patients who access the RTx 2) the incidence of PTDM and 3) the most related factors for the development of diabetes after RTx.

Method
We retrospectively studied 522 RTxps transplanted in our Unit between January 2004 and December 2014. Each patient underwent: 1) to a collection of remote and pathological anamnesis and complete physical examination and to routine and specific clinical and biochemical determinations at 1(T1), 6 (T6) and 12 (T12) months after RTx. At six months of RTx, the Oral Glucose Tolerance Test (OGTT) was performed.

Results
The age of RTxps was 48±12 years. Patients with glucose metabolism abnormalities were significantly older, without differences in gender. Inpatients with PTDM (12.6%), cyclosporine was used more than tacrolimus, and higher doses of steroids at T1 and T6 were prescribed. They had a worse general metabolic and glucose (HOMA index, glycaemia and HbA1c) status than normoglycemic. of note, no differences in 25-(OH)-D and in the other mineral metabolism parameters were found. In multivariate analysis, we found that age at transplant (OR 1.28 for 5 years older) (p = 0.006), BMI at T1 (OR 1.22 for 2 kg / m2 more) (p = 0.01) and the dose of steroid prescribed during the first post-RTx month (OR 2.7 per 100 mg additional drug) (p = 0.03) were independently correlated with PTDM.

Conclusion
In this study, we demonstrated that the prevalence of PTDM was relatively high in our cohort reflecting data present in the literature. Interestingly, age at RTx, BMI and cumulative dose of steroids resulted the variables that significantly and strongly influence its development. On the other hand, no relationship was observed between blood values of 25 (OH) D, PTH and the onset of PTDM. Future research, possibly involving a higher number ofRTxps could also evaluate the effects of PTDM on graft and patients on long-term outcome.
#5129 CLINICAL-FUNCTIONAL KIDNEY-LUNG LINK IN A POPULATION OF HEMODIALYZED PATIENTS
Authors: Satta Ersilia , Romano Carmine , Raiola Ilaria , Scafarto Anna , Gentile Sandro , Erbaggio Gioacchino , Gembillo Guido , Polverino Mario 
Published: June 2023

Abstract

Background and Aims
We know that lung and kidney are intimately related from a functional standpoint, both in physiological conditions and in diseases. The close relationship between lung and kidney (kidney-lung link) is evidence of a homeostatic connection between all organs and systems in an attempt to maintain the body system balance. In a recent review [1] we emphasized the importance to search for the clinical signs of a disease not only in the primary affected organ but also in organ functionally related.

Method
For this purpose we examined 81 hemodialyzed patients, with a mean age of 66.6 ± 13 years (28 f and 53 M), undergoing hemodialysis treatment (mean dialysis: 96 ± 34 months), with regard to smoking habits (47 non-smokers and 34 smokers with an average of 19.8 cigarettes per day: pack / years: 33.4 ± 2.9). Pulmonary function test (PFT) and clinical signs were evaluated. we excluded 6 patients (4 males and 2 females) in the smoking group with obstructive spirometric pattern (detected by a FEV1.0/FVC ratio lower than 70 absolute value), so that the final non-smoking group consisted of 47 patients and the smoking-group by 28 smokers: both groups matched for anthropomorphic data.

Results
The mean values of PFT were globally no different between smokers with normal PFT and non smokers are summarized in Table 1: Although the never-smoking group was nearly twice as large as the smokers, and PFT were similar and normal, respiratory symptoms were predominant: daily cough (49 yes; 26 no); chronic phlegm (51 yes; 24 no).

Conclusion
in dialysis patients, cough and phlegm are common symptoms, regardless of smoking and spirometric values. Probably these results are the consequence of synergistic effects between lungs and kidneys, as recently demonstrated [2]. Hence the need to evaluate dialysis patients from the clinical-functional point of view of both, kidneys and lungs, in order to evaluate the appropriate, personalized, therapeutic strategy according to the last evidences of the literature [3].
#5199 ULTRASOUND EXAMINATION OF THE SUBCUTANEOUS PERITONEAL CATHETER TUNNEL IN CASES NOT RELATED TO INFECTION
Authors: Zeiler Matthias , Fioravanti Gilda , Fioravanti Giuseppe , Granata Antonio 
Published: June 2023

Abstract

Background and Aims
According to the guidelines of the International Society of Peritoneal Dialysis possible indications of ultrasound (US) examination of the catheter tunnel are suspected tunnel infection, initial evaluation of exit-site infection without clinical signs of tunnel involvement, follow-up of exit-site and tunnel infection after treatment and relapsing peritonitis episodes. Other authors suggest US examination of the subcutaneous tunnel in every case of peritonitis. We analyzed the associations between US findings at the catheter tunnel and their clinical impact, exclusively in cases not related to catheter infection.

Method
The subcutaneous tunnel of the peritoneal catheter was examined with a linear probe of 6.5-10 MHz having covered the exit site with a transparent adhesive film-dressing. For the retrospective investigation covering the last 10 years, we selected peritoneal dialysis patients who performed an US examination without clinical signs or suspect of exit site or tunnel infection. During the US examination, the distance of the external cuff from the exit site, the presence and extend of leakage or size of a hematoma (along the catheter and at the surgical site), the proximity of the inferior epigastric artery to the catheter, the configuration of the subcutaneous tunnel (including inclination and direction of the catheter at the entrance into the peritoneal cavity) and the position of the inner catheter cuff were documented.

Results
Several US findings were found to be associated to a specific risk or need of intervention in the follow up of the patient. The following table reassumes the US findings and the respective clinical impact.

Conclusion
US findings documented during the examination of the catheter tunnel in cases not related to infection have a certain clinical impact due to their association to a specific risk or need of intervention, and therefore should not be overseen during the examination.
#5219 PEROXIREDOXINS ARE RELATED TO EGFR DECLINE IN IGA NEPHROPATHY, MEMBRANOUS NEPHROPATHY AND LUPUS NEPHRITIS: A 5-YEAR FOLLOW-UP
Authors: Krata Natalia , Moszczuk Barbara , Tanska Julia , Monticolo Marta , Paczek Leszek , Foroncewicz Bartosz , Mucha Krzysztof 
Published: June 2023

Abstract

Background and Aims
Oxidative stress (OS) is known as a disturbance between pro- and antioxidant factors, that may lead to DNA or protein oxidation, resulting in cellular damage. Peroxiredoxins (PRDXs) are enzymes with an antioxidant properties. They play dominant role in regulation of cellular peroxide levels, which is crucial in maintaining organisms’ oxidative balance. PRDXs types 1-5 are involved in the pathophysiology of various diseases (e.g. cancer, inflammatory, or renal). We aim to study their role as a prognostic marker of eGFR changes in IgA nephropathy (IgAN), lupus nephritis (LN) and membranous nephropathy (MN) patients.

Method
This is a retrospective 5-year-follow-up study of 108 IgAN, MN and LN patients, in whom PRDX 1-5 serum levels were assessed with ELISA in 2017. In 2022, we were able to collect the data out of 80 patients: IgAN (n=36); MN (n=22) and LN (n=22). The remaining 28 were considered as lost-to-follow-up, namely: lack of any medical results within last 2 years (n=23); on dialysis (n=2); after renal transplantation (n=2); deceased (n=1). We classified patients depending on the changes of eGFR (decline/stable/increase; Fig. 1) between baseline and after 5 year follow-up and the PRDX levels (high/medium/low; Table 1). The Mann Whitney-U, Kruskal-Wallis and Chi-Square Test were used for statistical analysis, the p-values &lt;0.05 were considered significant.

Results
Baseline PRDX measurements indicated, that the mean concentrations of serum PRDX 1-5 differ between the glomerulonephropathies (GN). In 2022, we observed significantly different (P = .012) change of eGFR depending on the GN type. 16/80 individuals had eGFR decline and 75% of them were diagnosed with IgAN. The MN and LN groups had increase of eGFR in the last 5 years in most cases, probably as a result of the treatment. We verified if follow-up eGFR was associated with baseline PRDX levels. The 2022 eGFR differed significantly between the GNs depending on the level of serum PRDX 2, 4 and 5 at baseline (P = .002; P = .009; P = .006, respectively, Table 1).

Conclusion
Our results showed the link between serum PRDXs concentration and IgAN, MN and LN follow-up. Importantly, selected PRDXs’ might be used to predict eGFR decline, particularly in IgAN and LN.
#5364 LOW DOSE VALGANCICLOVIR AS A PRE-EMPTIVE THERAPY IS EFFECTIVE FOR CYTOMEGALOVIRUS INFECTION IN KIDNEY TRANSPLANTATION: A SINGLE-CENTER EXPERIENCE
Authors: Jeon Jin Seok , Lee Haekyung , Kim Hyoungnae , Kwon Soon Hyo , Noh Hyunjin 
Published: June 2023

Abstract

Background and Aims
Pre-emptive therapy, screen for and treat asymptomatic cytomegalovirus (CMV) viremia, is an important preventive strategy for CMV disease in kidney transplant (KT) recipients. Oral valganciclovir is the most commonly used as preventive strategy. However, the optimal dose and treatment duration of valganciclovir remains elusive.

Method
We retrospectively evaluated the efficacy and toxicity of low-dose of oral valganciclovir (450 mg twice daily) as pre-emptive therapy in KT recipients who underwent KT between January 2015 and December 2021. CMV viral load was measured by polymerase chain reaction. Pre-emptive therapy with valganciclovir was applied for 2 weeks.

Results
of 33 kidney transplant recipients who received pre-emptive CMV therapy with valganciclovir (55 therapy cases), 32 (97.0%) were CMV seropositive except 1 patient who had no related information. Thirty-two (97.0%) received T-cell depleting agent, thymoglobulin as an induction immunosuppressive treatment. Treatment failure, defined as a CMV DNA load more than or equal to 1000 copies/mL after 2 weeks of treatment, occurred in 3 (5.45 %) patients. No patient developed CMV disease during pre-emptive therapy. The median viral copies in patients treated successfully was 487.50 (311.24 – 826.25), whereas 4420.00 (2535.00 – 137450.00) in patients who undergone treatment failure.

Conclusion
These results suggest that pre-emptive therapy with low dose oral valganciclovir for 2 weeks can be successfully used for preventing CMV disease among KT recipients with low-level CMV viremia. Further research is needed to replicate these findings in larger samples and assess long-term outcomes.