bluuebunny/crossref_metadata_2025_split huggingface dataset:
#6442 HOW CAN IT BE NEPHROANGIOSCLEROSIS? HE´S BEING TREATED ONLY WITH ONE ANTIHYPERTENSIVE DRUG
Authors: Garcia Carolina González , Marquez Eva , Farrera-Núñez Júlia , Barrios-Barrera Clara , Ribas Andres , Sans Laia , Gimeno Javier , Crespo Marta , García Eva Rodríguez 
Published: June 2023

Abstract

Background and Aims
Nephroangiosclerosis is a frequent renal disease due to chronic arterial hypertension and it is one of the main causes leading to renal replacement therapy. A minority of these patients have nephroangiosclerosis although they apparently have hypertension under control with minimal treatment.

Objetives
To describe the characteristics of this group of patients when compared to the rest of patients with histological diagnosis of nephroangiosclerosis.

Method
Observational, retrospective and descriptive study. Review of 67 patients with nephroangiosclerosis as the sole diagnosis in the renal biopsy (consecutive biopsies from 2010 to 2020). We divided the population in two different groups according to the number of prescribed antihypertensive drugs: Group 1 (0-1 antihypertensive drugs) vs Group 2 (≥2 antihypertensive drugs).

Results
Both groups had similar demographics and renal function/proteinuria. Both groups had the same adequate/inadequate blood pressure control, but group 1 had significantly less time of hypertension'evolution. The histological differences (although not statistically significant) are noteworthy: Group 1 had a higher percentage of global glomerulosclerosis, interstitial fibrosis and tubular atrophy than Group 2. In addition, after 3-years of follow-up, in Group 1 there were more patients requiring renal replacement therapy. We hypothesize that a factor that could explain these results could be the lower use of RASi (33.3% vs 73.9%, P = .003*) and a higher percentage of history of dyslipidemia in Group 1 (62.,5% vs 22.,2%, p=0,017*).

Conclusion
Patients with hypertension requiring a maximum of one drug for its control, presented histological results of more marked nephroangiosclerosis, than the group of patients with more than one drug, despite similar time of evolution and degree of blood pressure control. These findings could be related to a lower rate of RASi use. Our study reinforces the indication for RASi as a first-line hypertension treatment in this population.
#6467 DETERMINANTS OF NON-DIABETIC KIDNEY DISEASES IN DIABETIC PATIENTS
Authors: Kir Yusuf , Murt Ahmet , Dincer Mevlut Tamer , Trabulus Sinan , Seyahi Nurhan , Altiparmak Mehmet Riza 
Published: June 2023

Abstract

Background and Aims
While diabetic nephropathy is the main kidney disease in patients with type 2 diabetes mellitus, a variety of non-diabetic kidney diseases (NDKD) may also occur. The decision to order a biopsy in diabetic patients is not an easy one as diabetic kidney disease is itself a proteinuric condition. The main objective of this study is to define factors that may differentiate isolated diabetic nephropathy and non-diabetic kidney disease in diabetic patients. In addition, we also aimed to analyze the effects of treatment choices on renal and overall survival.

Method
The study was conducted at a university hospital, which served as a tertiary healthcare center. One hundred and three diabetic patients who underwent kidney biopsy were involved in the study. Demographic characteristics, physical examination findings, laboratory tests and kidney biopsy findings were retrospectively evaluated.

Results
According to kidney biopsy findings 30 patients (29,1%) had isolated diabetic nephropathy. NDKDs were present in 73 (70,9%) of the patients. 78,1% of the patients with NDKDs had non-diabetic glomerular diseases. Among glomerular diseases, focal segmental glomerulosclerosis (36,9%), IgA nephropathy (17,8%) and membranous nephropathy (13,7%) were the leading three diseases. The duration of diabetes (p=0,00), HBA1C level (p=0,00) and the amount of proteinuria (p=0,02) were higher in patients who had isolated diabetic nephropathy. Presence of diabetic retinopathy (p=0,00), concomitant vascular diseases (p=0,02) and the use of insulin treatment were also more often in patients with isolated diabetic nephropathy. Multivariate analysis revealed that patients with higher HBA1C levels and longer diabetes duration had more tendencies to have isolated diabetic nephropathy. Immunosuppressive treatments for glomerular diseases were administered in around 50% of the patients. However, renal and overall survivals were not different between patients who received immunosuppressive treatments and those who didn't.

Conclusion
A renal biopsy in diabetic patients might be preserved for those with shorter diabetes duration and lower HBA1C levels. As poor glycemic control and susceptibility to infections pose additional risks, immunosuppressive treatments might not always be beneficial.
#6579 ANALYSIS OF RISK FACTORS FOR CUTANEOUS CALCIPHYLAXIS IN HEMODIALYSIS PATIENTS
Authors: Ren Zhimin , Zhou LI , Xiang Ting 
Published: June 2023

Abstract

Background and Aims
Risk factors with cutaneous calciphylaxis were analyzed in hemodialysis patients.

Method
Clinical data of hemodialysis patients who were diagnosed with cutaneous calciphylaxis and admitted to Sichuan University West China Hospital and hospitals in West China Nephrology Union were retrospectively collected. Noncalciphylaxis patients in hemodialysis center of West China Hospital Sichuan University were randomly selected as the controls. Group 1: The 1:1 matched cases and controls by age (year, within ±3) and duration of hemodialysis (month, within ±20%) as matching factors. Group 2: The controls were matched to cases in a 1:1 ratio by gender and duration of hemodialysis (month, within ±20%) as matching factors. Univariate and multivariate binary Logistic were used regression analysis model, screening for statistically significant variable factors.

Results
Most of cutaneous calciphylaxis patients were male and elderly. Group 1: The univariate regression analysis showed that gender, diabetes mellitus, coronary heart disease are significantly associated with calciphylaxis. Laboratory examination results showed that parathyriod hormone (PTH), serum albumin, serum phosphate, C reactive protein (CRP) were significantly with calciphylaxis. Diabetes mellitus, lower albumin, higher serum phosphate and higher CRP were independent risk factors after multivariate analysis. Group 2: The univariate logistic regression analysis showed that age, BMI, coronary heart disease, diabetes were significantly associated with calciphylaxis. Laboratory examination showed that alkaline phosphatase (ALP), PTH, serum albumin and CRP were all significantly associated with calciphylaxis. Diabetes mellitus, lower albumin, higher PTH, and higher CRP were independent risk factors after binary Logistic analysis.

Conclusion
Diabetes mellitus and higher CRP, higher PTH, higher serum phosphate, lower albumin, are important high risk factors.
#6754 THE EFFECT OF REDUCED RENAL FUNCTION ON SEXUAL DYSFUNCTION IN PATIENTS WITH HEART FAILURE
Authors: Loutradis Charalampos , Koutsampasopoulos Konstantinos , Intzevidou Eleni , Stavropoulos Konstantinos , Sdogkos Evangelos , Imprialos Konstantinos , Vogiatzis Ioannis , Papadopoulos Christodoulos , Doumas Michael 
Published: June 2023

Abstract

Background and Aims
Sexual Dysfunction is a common and often undiagnosed complication in patients with Heart Failure (HF) or Chronic Kidney Disease (CKD). Sexual dysfunction presents a strong association with cardiovascular disease and death. This study aims to evaluate the possible effect of reduced renal function on sexual dysfunction in patients with heart failure.

Method
This is a prospective case-control study in patients with Hearth Failure (clinical diagnosis based on relevant symptoms and/or signs) with preserved or reduced renal function, defined as estimated glomerular filtration rate (eGFR) ≥60 and &lt;60 ml/min/1.73 m2, matched for age (± 5 years). The eGFR was calculated with the CKD-EPI equation. Sexual dysfunction was evaluated with the validated Female Sexual Function Index Scoring (FSFI) and the International Index of Erectile Function (IIEF) questionnaires in the native language.

Results
A total of 214 (107 per group) patients were included in this study. Patients’ age 74.10±8.97 vs 75.81±8.66; P = .157), gender (males: 65.4% vs 57.9%; P = .261) and BMI (28.10±4.90 vs 28.99±4.43; P = .164) were not different between the two study groups. In total population, sexual dysfunction was lower in patients with eGFR≥60 compared to &lt;60 ml/min/1.73 m2 (75.7% vs 88.8%; P = .012). In females, no significant differences were evidenced in sexual dysfunction based on FSFI score &lt;26.0 (91.9% vs 95.6%; P = .490). In contrast, males with preserved renal function had lower prevalence of sexual dysfunction (IIEF&lt;22) compared to those with reduced renal function (67.1% vs 83.9%; P = .027). In regression analysis eGFR was an independent factor associated with sexual dysfunction.

Conclusion
Renal dysfunction may be an important factor predisposing heart failure patients to more frequent sexual dysfunction.
PROTECTIVE POTENTIAL OF 17-β-ESTRADIOL ON OXIDATIVE STRESS AND RENAL METABOLISM IN AGED FEMALE RATS
Authors: Kumar Pardeep 
Published: June 2023

Abstract

Background and Aims
The objective of this study was to observe the changes in activity of antioxidant enzymes, hepatic glucose homeostasis, lipogenic enzymes and lipid metabolism, serum lipid profile and liver function occurring in livers of female rats of 3, 12 and 24 months age groups, and to see whether these changes are restored to 3 months control levels rats after exogenous administration of steroid hormone estrogens (17-β-estradiol, E2).

Methods
The aged rats (12 and 24 months old) (n= 8 for each group) were given subcutaneous injection of 17beta estradiol (0.1 ug/g body weight) daily for one month. After 30 days of hormone treatment, experimental animals of all the groups were sacrificed and livers were isolated for further study. A detailed study was carried on non-enzymatic glutathione (GSH) and enzymatic antioxidants [superoxide dismutase (SOD), glutathione peroxidase (GPX) and catalase (CAT)], hepatic glucose homeostasis, lipogenic enzymes, lipid metabolism, serum aspartate aminotransferase (GOT), alanine aminotransferase (GPT),alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), phosphatase alkalin (PAL) as well as bilirubin level.

Results
The results obtained in the present work revealed that normal aging was associated with significant decrease in the activities of antioxidant enzymes, serum expression and an increase in hepatic glucose homeostasis, lipogenic enzymes and lipid profile and GGT, PAL, GOT, GPT, ALP as well as bilirubin level increased significantly in livers of aging female rats. Our data showed that exogenous administration of E2 brought these changes to near normalcy in aging female rats.

Conclusions
The present study showed that E2 treatment reversed the changes to normal levels. E2 treatment may be beneficial in preventing some of the age related changes in the liver by increasing antioxidant defences and decrease oxidative stress. E2 plays important role in the progression of chronic hepatic diseases.
#6789 HYPERTENSION AND CHRONIC KIDNEY DISEASE: A CLOSE AND PROPORTIONAL RELATIONSHIP
Authors: Rebhi Feyza , Khadhar Meriam , Sarra Hadded , Jerbi Mouna , Aoudia Raja , Gaied Hanene , Goucha Rim 
Published: June 2023

Abstract

Background and Aims
Hypertension is a common clinical finding in patients with Chronic Kidney Disease (CKD). In fact, hypertension accelerates the progression of the renal disease and damages other target organs leading to worsening renal failure and increased incidence of cardiovascular morbidity and mortality.

Method
We conducted a retrospective, cross-sectional study at the Department of Nephrology at Mongi Slim Hospital, and we studied the relation between blood pressure levels and CKD stages. The stage of chronic kidney disease (CKD) was defined according to the KDIGO 2012 classification.

Results
A total of 89 patients were recruited in this study. The mean age was 69,19 years (rang 30-96) with a gender ratio M/F of 1,225. The patients who had hypertension were 41 (46,06%). We noted the presence of chronic kidney disease stage 3 or more in 64 patients (71.91%) among whom 32 patients had hypertension . Thirty-seven patients had a stage 3 CKD, 14 had a stage 4, and 13 had a stage 5. As for blood pressure levels, the mean systolic blood pressure was 137,94 mmHg, and the diastolic 79,52 mmHg. Twenty-three patients had stage 1 hypertension and 13 presented a stage 2 hypertension. Stage 3 hypertension was noted in 5 patients, who all had a stage 3 or 4 chronic kidney disease. Higher blood pressure levels were noted in patients with CKD stage 3 or more: Among the 13 patients who had a stage 5 chronic kidney disease, 7 had hypertension.

Conclusion
Hypertension is ubiquitous in the chronic kidney disease, and it can be a cause or consequence of CKD. Both hypertension and CKD contribute to each other and it has been noted that patients with CKD are at higher risk for hypertension-related adverse outcomes, including cardiovascular disease, and therefore, the management of hypertension is particularly important in patients with CKD.
#6834 PREVALENCE, ETIOLOGY AND CLINICAL CHARACTERISTICS OF BIOPSY PROVEN NON-DIABETIC RENAL DISEASE: 10 YEARS OF BIOPSES IN DIABETIC PATIENTS
Authors: Ramos Ana Rita , Trigo Ana , Alves Ana Rita Valerio , Santos Paulo 
Published: June 2023

Abstract

Background and Aims
Diabetic nephropathy (DN) is the major cause of kidney disease in diabetic patients. However, a significant proportion of diabetic patients may actually have nondiabetic renal disease (NDRD). Therefore, it is important to identify patients who can benefit from a renal biopsy in order to establish the correct diagnosis. Our study aims to determine the prevalence and etiology of biopsy proven NDRD and to explore the clinical differences encountered in the diabetic patient with NDRD.

Method
Retrospective study of the medical records of all diabetic patients who underwent a renal biopsy due to suspicion of NDRD from January 2012 to December 2022 at Nephrology department Collected data comprised demographic information, indication and result of renal biopsy, lab results (serum creatinine, Hb1Ac, proteinuria, albuminemia, hematuria, presence of active urinary sediment and presence of auto antibodies) and disease's characteristics (duration of diabetes, presence of diabetic retinopathy). Categorical variables are presented as frequencies and percentages, continuous variables as means and standard deviations, or medians and interquartile ranges (IQR) for variables with skewed distributions. A p-value&lt;0.05 was considered statistically significant. Statistical analysis was performed using SPSS version 28.1 for Mac OS X.

Results
57 patients, 33.3% (n=19) were females, the medium age was 64.9 $\langle {{\rm{italic}}} \rangle \pm \langle {/{\rm{italic}}} \rangle $ 12.1. The most frequent indication for renal biopsy was acute kidney injury (26.3%), followed by rapidly progressive renal failure and nephrotic syndrome (22.8%). In our population, 22.9% had DN and 77.4% had NDRD. Pauciimune Glomerulonephritis (14%) and Membranous Nephropathy (10.5%) were the most common causes of NDRD. A chi-square test was performed to examine the relation between the two groups (ND vs NDRD) and the presence of diabetic retinopathy. There was a statistically significant association between the two variables ($\langle {{\rm{italic}}} \rangle {{\rm{X}}}^2\langle {/{\rm{italic}}} \rangle $= 11.778, p&lt;0.01). Mann-Whitney test was performed to compare the median of duration the diabetes and Hb1Ac in two groups. That showed a statistically significant difference (U = 357, P = .018 and U=335.5 P = .013 respectively).

Conclusion
Since renal biopsy is critical to establish the correct diagnosis and provide an appropriate treatment, it should be performed in patients with high suspicion of NRDN, especially in patients with a recent diagnosis of diabetes, good metabolic control and the absence of diabetic retinopathy.
#6843 CITATION CLASSICS IN LUPUS NEPHRITIS: A BIBLIOMETRIC ANALYSIS
Authors: Subbiah Arunkumar , K Sudarshan 
Published: June 2023

Abstract

Background and Aims
Lupus nephritis is an important risk factor for morbidity and mortality in systemic lupus erythematosus. During the past three decades, extensive research has been done to address this important complication and devise better management strategies. In this article we aimed to perform a thorough assessment of the research productivity in lupus nephritis by identifying the 100 most-cited articles in lupus nephritis.

Methods
The top 100 most-cited English language articles on lupus nephritis from 1990 were examined by bibliometric analysis from the Google Scholar database of ‘Harzing's Publish or Perish’ software. These articles were subsequently analysed in detail and the chief characteristics are presented here.

Results
From 1990-2022, there were 111358 citations with 3480 cites/year and an average of 111 cites/paper. Thirty articles had greater than 400 citations, with 9 having more than1000 citations. Majority of the publications were from the United States of America (46%) with maximum publications from the National Institute of Health (NIH), Bethesda. Among these 100 most-cited articles, there were a median of 7 (5-12) authors per article with a mean of 9.6 authors. Twenty-six percent of the top-100 most-cited articles were randomized controlled trials while cohort and in-vivo studies addressing pathophysiology and biopsy related data accounted for one-fourth each. Among rheumatology journals, ‘Arthritis Rheum’, ‘Ann Rheum Dis’ and ‘Lupus’ were the most preferred journals for researchers working on lupus nephritis.

Conclusion
This article gives an overview of the research productivity, landmark publications and emerging trends in lupus nephritis. Increased emphasis on high-quality data from randomized controlled trials is revolutionising the management of lupus nephritis.
#6869 CARDIAC ALTERATIONS FOUND IN PATIENTS WHO START DIALYSIS
Authors: Legarra María Iraola , Monzo Jose Jesus Broseta , Caravaca Pedro , Rodríguez Diana , Cuadrado Elena , Farrero Marta , Maduell Francisco 
Published: June 2023

Abstract

Background and Aims
The presence of cardiac structural alterations in patients with chronic kidney disease who start renal replacement therapy is frequent. In fact, the real prevalence of heart failure is not well known due to the masking of symptoms by frequent ultrafiltration. Despite this, most deaths in these patients occur due to cardiovascular events, especially non-atheroembolic events, which are closely related to heart failure and ventricular remodeling. This study aimed to describe the echocardiographic alterations present in patients who start renal replacement therapy.

Method
Cross-sectional study to evaluate the prevalence of structural abnormalities in transthoracic echocardiography performed in patients at the time of initiating renal replacement therapy in the prevalent group of patients in kidney replacement therapy program at Hospital Clínic de Barcelona. Demographic variables and baseline drugs for heart failure were also collected.

Results
We included 170 patients of 67.84 ± 15.92 years. 115 (67.6%) were men, and 55 were women (32.4%). Of these, 124 (72.9%) were on hemodialysis, 11 (6.5%) on home hemodialysis, and 35 (20.6%) on peritoneal dialysis.
Transthoracic echocardiogram findings at the beginning of dialysis showed a left ventricular ejection fraction of 47.5 ± 10.6%. It was reduced in 21 (12.4%), slightly reduced in 9 (5.3%) and preserved in 125 (73.5%) of the patients. The estimated pulmonary artery systolic pressure was 28.5 ± 3.53 mmHg. The telediastolic diameter of the left ventricle was 5.5 ± 0.71 cm, that of the interventricular septum was 1.15 ± 0.27 cm, the diameter of the left atrium was 4.5 ± 1.27 cm, its volume was 95.05 ± 56.5 mL in the biplane section and 54.3 ± 28.28 mL in the four-chamber section. There were no significant differences between groups when analyzed by type of renal replacement therapy.
Regarding valvulopathies, 47 (21.8%) had some degree of aortic stenosis, 68 (40%) had some degree of aortic insufficiency, 104 (62.2%) had some degree of tricuspid insufficiency, 118 (69.4%) some degree of mitral insufficiency.
Regarding treatment, 50 (29.4%) of the patients had some RAASi, 60 (35.3%) had beta-blockers, and 2 (1.2%) had MRA.

Conclusion
The presence of structural alterations in the heart of patients initiating renal replacement therapy is practically universal and independent of the type of technique initiated. Nephrologists should become aware of these findings and seek ways to prevent and reverse these alterations as far as possible to achieve better clinical results in dialysis.
#6896 A SCREENING AND CLINICAL MANIFESTATIONS OF FABRY DISEASE IN PATIENTS ATTENDING DIALYSIS AND NEPHROLOGY CLINICS IN DURBAN, SOUTH AFRICA
Authors: Singh Jillian , Benjamin Sherilene , Assounga Alain 
Published: June 2023

Abstract

Background and Aims
Fabry disease is inherited in an X-linked manner in which the mutated gene inhibits the functioning of the alpha-Galactosidase-A enzyme causing a deficiency or absence of the enzyme, characterizing it as a progressive, lysosomal storage disorder. Subsequently, the accumulation of globotriaosylceramide (Gb3) in the lysosomes causes damage to tissues and major organs. Fabry nephropathy is one of the major organ complications caused by Fabry disease resulting in end-stage kidney disease. The aim of our study is to determine the prevalence of Fabry disease in our patients.

Method
This study was a prospective, quantitative study. A cohort of 200 male patients with chronic kidney disease (CKD stage 2-5D) was enrolled. A control group of 14 healthy males was also enrolled for this study. The ELISA technique was employed to determine the alpha Gal-A enzyme concentration levels in plasma. A questionnaire using the MSSI scoring system was presented to the participants to identify clinical manifestations. The SPSS Version 27 (IBM, New York, USA) was used to analyse the data.

Results
A cut-off value for the alpha Gal-A enzyme concentration levels of &lt;500 pg/ml was calculated. A total of 17 participants from the patient group (n=11) and the control group (n=6) displayed alpha-Gal-A enzyme levels &lt;500 pg/ml. Using the univariate regression analysis, statistically significant results were revealed between alpha-Gal levels &lt;500 pg/ml and age (P = .007), heat or cold intolerance (P = .049), hypertension (p &lt; 0.001) and eGFR (p &lt; 0.001). MSSI scores displayed a negative association (P = .001). The multivariate regression analysis showed that age and MSSI scores retained their significance when eGFR was excluded as a variable, however, with the inclusion of eGFR as a variable, none of the variables retained their significance.

Conclusion
Fabry disease is suspected in 17 participants with alpha-Gal levels of &lt;500 pg/ml. The cause of CKD nephropathy raises interest as conditions such as FSGS have been associated with FD. The low levels of the alpha-Gal enzyme and presentation of the clinical manifestations can be utilized as preliminary findings. Confirmatory tests such as DNA analysis or Gb3 and GL3 analysis are warranted.