bluuebunny/crossref_metadata_2025_split huggingface dataset:
#4391 SALT SENSITIVITY AND HYPERTENSIVE NEPHROPATHY: A LINK TO BE DISCOVERED
Authors: Lanzani Chiara Livia , Simonini Marco , Citterio Lorena , Zagato Laura , Gonzalez Luz Maria , Tunesi Francesca , Contursi Marianna , Maiucchi Paola , Manunta Paolo 
Published: June 2023

Abstract

Background and Aims
Sodium sensitivity is defined as a change in blood pressure depending on sodium intake, which is present in about 30% of the adult population. According to blood pressure variation in salt load test we can classify the population in 3 categories: sodium sensitive (SS), sodium resistant (SR), inverse sodium sensitivity (ISS), based on, respectively, an increase, a non-significant variation or a decrease in the blood pressure values following the administration of sodium. It is reported that SS subjects have, independently from other risk factors, an increased risk of cardiovascular diseases. Moreover, SNPs located in genes related with Na+ metabolism, aldosterone synthesis and tubular sodium reabsorption in the kidney are related to salt sensitivity phenotype. The aim of this study is to analyze the relationship between sodium sensitivity and the development of hypertensive kidney damage in patients with primary hypertension.

Method
A cohort of 712 naïve hypertensive patients were classified for salt-sensitivity using acute saline test (NaCl 308 mEq / 2h / iv).127 patients (follow-up &gt; 5 years- median 11) were selected for the present analysis (SS, n = 40; 0 SR, n = 46; RSS, n = 41). We analyzed annual decline of the eGFR (CDK-EPI) (Delta-eGFR) and development of microalbuminuria (MicrAlb) as renal outcome. Moreover, genetic polymorphism involved in salt sensitive hypertension has been investigated.

Results
No differences in Delta-eGFR was observed among the groups. However, SR subjects develop earlier microalbuminuria (P = .002) even with an adequate pressure control. Genotypes analysis revealed: polymorphism in CYP11B2 and NEDD4L to be protective against decline in eGFR. For microalbuminuria HSD3B1 and ADD3 seem to be a risk factors, whereas KL, PKD and TRPC6 polymorphism result protective factors.

Conclusion
Unexpectedly these finding suggests that SR patients are more at risk of developing hypertensive nephropathy than other groups of patients. Moreover genotypes associated with salt sensitivity play different and complex role in kidney damage in hypertension. Improvement in salt sensitivity testing and standardization will be needed to allow all this pathophysiological knowledge to be translated in a clinical setting.
#4485 CLINICAL CASE OF MOSAICISM IN ADPKD PATIENT
Authors: Marzano Nenzi , Corradi Valentina , Caprara Carlotta , Rigato Matteo , Giuliani Anna , Gastaldon Fiorella , Ronco Claudio , Zanella Monica 
Published: June 2023

Abstract

Background and Aims
Autosomal Dominant Polycystic Kidney Disease (ADPKD) it's mainly characterized by renal involvement with progressive bilateral development of renal cysts and volumetric increase of the kidneys, responsible for the progressive loss of renal function that leads to chronic kidney disease (CKD) and the need of renal replacement therapy. There are some cases (doubtful, uncertain) in which it is necessary to perform genetic testing to achieve a definitive diagnosis. It looks like in ADPKD patients, mosaicism could modulate the clinical course of the disease. Mosaicism is characterized by few cell populations with different genomes. In these special cases the diagnosis is very difficult and the genetic analysis could be an important and helpful tool. With this report, we want to highlight the importance of the use of several diagnostic methods in those ‘atypical’ cases where otherwise the analysis would have been negative from a first molecular approach.

Method
A 47 years old woman came to our attention with typical picture of ADPKD, arterial hypertension and chronic kidney disease CKD (3b). She had no ADPKD family history, but since she had a son, genetic testing was performed. According to our workflow, first level analysis includes Next Generation Sequencing (NGS). Second level analysis, performed to investigate other genes and large rearrangement, was based on Multiplex Ligation-dependent Probe Amplification (MLPA) analysis of PKD1 and PKD2 genes, using Salsa MLPA ProbeMix P352 PKD1PKD2 kit and ProbeMix P351 PKD1 kit ©MRC Holland.

Results
NGS did not detect the presence of any genomic variants. Therefore, second-level genetic analysis (several approaches), showed a large deletion in heterozygosis of the portion comprising the 3-33 exons of PKD1 gene in mosaic in percentage close to the resolution limits of the used technique (25-30%). The same analysis was confirmed in another laboratory.

Conclusion
We concluded that the identified large deletion, without establishing the real borders due to MLPA technical restrictions, was present as mosaicism. The variant is not reported, but due to the type of mutation and the clinical picture of the patient, it is to be considered as likely pathogenic. A stepwise genetic approach might be useful in those cases where standard methods do not allow to reach a definitive diagnosis.
#4639 AN OBSERVATIONAL STUDY OF MICRO-VASCULAR COMPLICATIONS OF POST- TRANSPLANT DIABETES MELLITUS IN RENAL TRANSPLANT RECIPIENTS
Authors: Kaul Anupma , Momin Indrajeet , Prasad Narayan , Bhaduaria Dharmendra 
Published: June 2023

Abstract

Background and Aims
The worldwide incidence of PTDM ranges between 2.5% and 20%. Although there is a good knowledge of PTDM pathogenesis, there is still uncertainty about its proper long-term management. DR, DKD and DSPN are microvascular complications frequently seen in type 1 and 2 DM. Few data are available regarding these complications in patients with PTDM. It remains unclear if the progression of chronic diabetic complications in transplant recipients is similar to that of patients with other types of diabetes. The study was conducted to assess micro-vascular complications in renal transplant recipients with ≥5 years duration of PTDM

Method
This is a retrospective and prospective observational study of PTDM patients conducted between November 2018 to December 2020, at a tertiary care hospital. All renal transplant recipients on follow up at the institute with ≥ 5 years duration of PTDM were included in the study. Patient characteristics and laboratory values were noted from patient files and electronic records. Fundus evaluation was done by direct ophthalmoscopy. If graft kidney biopsy was done for clinical indications, it was included in evaluation. DSPN was assessed through MNSI and 10-g Semmes-Weinstein monofilament examination.

Results
115 patients with PTDM duration ≥ 5 years were included in the study. Mean PTDM duration was 8.7 ± 3.0 years. None presented findings of diabetic retinopathy at fundus examination by direct ophthalmoscopy. 37.4% patients had DSPN which was associated with PTDM duration (p value &lt; 0.03, 95% CI, 1.53 to 29.17). The mean eGFR was 59.2 ± 21.8 ml/min/1.73 m 2, 53.9% patients had eGFR ≥ 60 ml/min/1.73 m2. 35.7% patients had proteinuria ≤ 300 mg/day. 23 (20%) patients with PTDM duration ≥ 5 years underwent graft kidney biopsy, 4 biopsies were reported as de-novo DKD, 6 biopsies were reported as suggestive of DKD. The patients with DKD had mean PTDM duration of 143.3±52.4 months, mean eGFR 44.8 ±21.8 of and a median proteinuria of 2653 mg (IQR 2758). In secondary analysis of the 23 biopsied patients PTDM duration was associated with DKD development (p value = 0.03, 95% CI, 0.93 to 0.99).

Conclusion
The initiation of microvascular complications does not seem to be as accelerated as previously supposed. DR may not be as strongly associated with de-novo DKD in PTDM patients as seen in type 1 and type 2 diabetes mellitus. PTDM seems to be a unique type of diabetes, and its consequences may be milder than expected in type 1 and type 2 diabetes.
#4641 RISK FACTORS FOR RRT RESTART AFTER CESSATION OF CRRT: A MULTICENTER STUDY
Authors: Shin Chungjoh , Min Ji Won 
Published: June 2023

Abstract

Background and Aims
Acute Kidney Injury occurs frequently in patients admitted to the Intensive Care Unit (ICU) and continuous renal replacement therapy (CRRT) is a commonly used treatment modality in these patients. Restart of renal replacement therapy (RRT) after initial discontinuation of CRRT is also frequently needed. The purpose of this study is to identify clinical characteristics and biomarkers influencing the restart of RRT after the cessation of CRRT, and to build a predictive model using these parameters.

Method
This multicenter retrospective study includes 891 patients who were treated using CRRT from July 2012 to December 2020 in the ICU of 3 academic hospitals. The primary end point observed was the restart of RRT during hospitalization. Baseline characteristics were compared between the no restart and restart RRT groups. Using univariate analysis and logistic regression, a prospective index was developed, and receiver operator characteristic (ROC) curve analysis was performed to confirm the predictivity of the prognostic index.

Results
Restart of RRT was needed in 632 (71.2%) patients. Compared to patients that did not restarting, patients in the restart RRT group demonstrated higher age, higher BMI, higher baseline serum creatinine (Cr), lower urine output, longer ICU admission, and more comorbid conditions (HTN, DM, HF, ischemic heart disease). In the multivariate analysis, five parameters demonstrated independent influence on restart of RRT: HTN, Cr, ICU admission duration, BMI, and mean blood pressure. The prognostic index, which was calculated from these variables, showed a satisfactory potential to predict the restart of RRT after discontinuation of CRRT. ROC analysis revealed an area under the curve of 0.738 (95% CI, 0.703-0.773, p&lt;0.001).

Conclusion
We found that 5 of the 40 parameters observed in our study were independent risk factors for the restart of RRT during admission and we successfully developed a prognostic index based on these variables to predict the restart of RRT after discontinuation of CRRT.
#4691 LAPAROSCOPIC NEPHRECTOMY IN PATIENTS WITH AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE
Authors: Sharapov Olimkhon , Abdullaev Sherzod 
Published: June 2023

Abstract

Background and Aims
At the present, discussions continue on the indications and timing of performing kidney nephrectomy in patients with autosomal dominant polycystic kidney (ADPK) disease who are on the waiting list for kidney transplantation. Large sizes of kidneys, traumatic access, accompanying these operations cause a high incidence of postoperative complications, mortality and aggravate the severity of patients. The aim of the presented study was to find the preferred algorithm for preparing patients for kidney transplantation.

Method
The results of the nephrectomy of polycystic kidneys were analyzed in 28 patients (mean age 49±1.5 years, 16 men, 12 women), which were conditionally divided into two groups. The first group included 13 patients (46.4%) with open surgery using median laparotomy and lumbotomy, in the second group - 15 (53.6%) - laparoscopic nephrectomy. Surgical interventions for patients in both groups receiving renal replacement therapy dialysis, performed according to emergency and planned indications.

Results
The average duration of laparoscopic and open surgical interventions was 149±14 and 132±15 min, respectively. The maximum size of deleted polycystic-altered kidneys in the first group was 21.3±4.21 cm, in the second group it was 20.5±3.3 cm. The incidence of postoperative complications in the 1st and 2nd groups was 6 cases (46.1%) and 2 cases (13.3%), respectively. There was one fatal outcome (7.69%) in the 1st group as a result of septic complications. the average postoperative bed-day in the first group was 12-13 (12.7 ± 1.1), in the second - 8-9 (8.6±0.5). Patients after laparoscopic interventions are activated on the 2nd-3rd day (2.8±0.14), after open operations - on the 4th-5th (4.43±0.32).

Conclusion
The incidence of postoperative complications after laparoscopic nephrectomy in patients with ADPK does not exceed 13.3%. The use of laparoscopic technologies makes it possible to expand the possibilities of using nephrectomy for the treatment and preparation of patients with polycystic kidney transplantation.
#4946 PREVALENCE OF CHRONIC KIDNEY DISEASE IN WOMEN OF REPRODUCTIVE AGE AND OBSERVED BIRTH RATES
Authors: Vrijlandt Willemijn , De Jong Margriet , Prins Jelmer , Bramham Kate , Vrijlandt Patrick , Janse Roemer J , Mazhar Faizan , Carrero Juan Jesus 
Published: June 2023

Abstract

Background and Aims
Women of reproductive age with chronic kidney disease (CKD) are recognised to have decreased fertility and a higher risk of adverse pregnancy outcomes, such as hypertensive diseases, preterm birth and longer hospital stays. How often CKD afflicts women of reproductive age and how many pregnancies are affected is not well known. This study aimed to evaluate the burden of CKD and associated birth rates in an entire region.

Method
This was a retrospective cohort study including women of childbearing age in Stockholm during 2006–2015. We estimated the prevalence of CKD by the presence of an ICD-10 diagnosis of CKD, a single estimated glomerular filtration rate (eGFR) &lt; 60 mL/min/1.73 m2 or history of maintenance dialysis. By linkage with the Swedish Medical Birth Register we identified births during the subsequent three years from study inclusion and evaluated birth rates. For CKD prevalence, we reported overall counts and the age-averaged prevalence to adjust for the uneven age distribution in the cohort. A linear regression model was fitted to identify the increase in prevalence and 95% confidence interval (CI) per additional year in age. Birth rate was calculated per 1000 person years. All analyses were performed using R version 4.2.1.

Results
We identified 817,730 women in our region, of whom 55% had at least one creatinine measurement. A total of 3938 women were identified as having CKD, providing an age-averaged CKD prevalence of 0.50%. Women with probable CKD showed a lower birth rate 3 years after the index date (35.7 children per 1000 person years) than the remaining women free from CKD (46.5 children per 1000 person years).

Conclusion
As many as 0.50% of individuals in this cohort had CKD, defined on the basis of at least one eGFR&lt;60 ml/min1.73 m2 test result, dialysis treatment (i.e. CKD stages 3–5) or an ICD-10 diagnosis of CKD. This prevalence is lower than previous estimates. Women with CKD had a lower birth rate than those without CKD, illustrating the challenges of this population to successfully conceive. Future research should be done to identify impeding factors.
#5189 THE ASSOCIATION BETWEEN CD86 +1057G&gt;A POLYMORPHISM AND ACUTE KIDNEY ALLOGRAFT REJECTION AMONG EGYPTIAN PATIENTS
Authors: Elsayed Moatasem , Shokeir Ahmed , Wafa Ehab , Sobh Mohamed 
Published: June 2023

Abstract

Background and Aims
T-cell mediated immune response is crucial in kidney transplantation and plays an important role in allograft rejection. . CD86 is a costimulatory molecule that participates in the regulation of T-cell lymphocytes activation. Single nucleotide polymorphisms (SNPs) located in this gene have been studied with inconsistent results. The aim of the study was to examine the association between (rs1129055:G/A) polymorphism in the CD86 gene and the development of acute renal allograft rejection among Egyptian patients.

Method
In this non- concurrent cohort study, we included a group of 50 kidney transplant recipients diagnosed by acute allograft rejection (AR) (which was defined by clinical diagnosis, elevated serum creatinine &gt;30% of basal line in the absence of other pathology including infection, urinary tract obstruction, allograft artery stenosis or calcineurin toxicity and responded to treatment by immunosuppression and was confirmed by positive biopsy that was graded according to BANFF classification) and another matched group of 50 kidney transplant recipients without AR and all of the 100 patients were genotyped by direct sequencing for CD 86 polymorphism (rs1129055:G/A) by TaqMan genotyping assay.

Results
The genotypic frequencies of CD 86 rs1129055 SNP in the acute rejection group were 72% GG, 28% AG and 0% AA while in the no rejection group it were 66% GG, 30% AG and 4% AA. The AA genotype and A allele at position +1057 in the CD86 gene were more frequent in patients without AR (4% and 23.4%, respectively) compared with those showing an AR (0% and 16.2%, respectively). The odds of acute rejection weren`t statistically significant either in dominant or recessive model (P = 0.665 and 0.475 respectively).

Conclusion
These results suggest that AA genotype and A allele of CD86 +1057G&gt;A polymorphism may provide a nonsignificant protection against acute kidney allograft rejection among Egyptian patients.
#5384 IMPROVEMENTS IN QUALITY OF LIFE (QOL) OF HEMODIALYSIS PATIENTS AFTER THE PANDEMIA; IT IS NOT WHAT IT SEEMS TO BE
Authors: Berdud-Godoy Isabel , Hernández María Teresa , Ortego Sofia , Pérez Alicia Sobrino , Bello Abraham Rincon , Andrada Clarencio Cebrián , Shkolenko Kateryna , Samaniego Diana , Such Ramón Devesa , Salvador Maria Eva Baró 
Published: June 2023

Abstract

Background and Aims
Patients on hemodialysis (HD), are a clinically vulnerable population. We analyzed changes in the results of the KDQOL™-36 questionnaire carried out in 2019 vs 2021, during Covid-19 pandemic. We have related the results to demographic and analytical parameters, BCM, modality and dose of dialysis, in addition to having suffered a COVID-19 infection.

Method
This is a retrospective, observational analysis performed in 47 clinics from Fresenius Medical Care (FMC) Spain. As part of our Healthcare Quality Improvement Program, HRQoL measurements were assessed using the KDQOL™-36 questionnaire. This questionnaire evaluates Physical and Mental Composite Scores (PCS and MCS, respectively) and three disease-specific scales: Effects, Burden and Symptoms dimensions (EKD, BKD, SKD). We focused our analysis in 1000 patients who completed both surveys in 2019 and 2021 in order to analyze differences.
We compared results of both surveys by Wilcoxon test. Improvement between 2019 and 2021 was calculated for each QoL Score. We categorized patients based on QoL evolution (improvement vs worsening) and analyzed the relationship between QoL improvement and different variables by univariate and multivariate logistic regression. Non-normal variables were categorized.

Results
The results are presented in detail in the figures section.

Conclusion
Except for the PCS, there were an improvement in QoL results in 2021 vs 2019. Women presented a worse evolution in EKD, MCS and SKD scores. In our study, having COVID-19 infection did not seem to be a factor associated with changes in quality-of-life in 2021. Patients on OL-HDF presented an improvement on the SKD scale compared to those treated with conventional therapy. Higher lean tissue index was related with improvement in PCS scale. Age was related with better EKD scale evolution as CCI above 5 was related with MSC Improvement. BKD scale evolution was related with HD vintage.
#5526 COMPLEMENT C3 EXERTS DIRECT PRO-FIBROTIC EFFECTS ON KIDNEY TUBULES
Authors: Manzéger Anna , Bencs Rita , Fazekas Krisztina , Stepanova Ganna , Kokeny Gabor 
Published: June 2023

Abstract

Background and Aims
Renal complement expression has been observed in both experimental and human kidney diseases. We have previously reported massive tubular C3 expression in fibrotic TGF-beta1 transgenic mice (Nephrol Dial Transpl 2015, 30; S3:FP301). Still, little is known whether this intra-renal complement is only an inflammatory marker of renal fibrosis or also exerts direct pro-fibrotic effects in the pathogenesis. In the present study we aimed to investigate the effect of C3a receptor activation in murine primary tubular epithelial cells.

Method
Primary tubular epithelial cells (TEC) were isolated from kidneys of four weeks-old male C57Bl6 mouse. The cells were grown in DMEM/12 medium supplemented with 2% FBS and recombinant 5 ng/ml EGF, and characterized for epithelial and mesenchymal markers. Verified TEC between P4 and P10 passages were used for the experiments. TEC cells were seeded on 6-well plates and treated for 24 hours with PBS (CTL, n=3), 100 nM C3a receptor agonist peptide (C3aR, n=3) or 10 ng/ml recombinant TGF-beta1 (TGFb, n=3). Then, mRNA and protein expressions were assessed and evaluated using Kruskal-Wallis test (p&lt;0.05).

Results
TGF-beta induced a 2-fold Col1a1 and 1,6-fold Tgfb1 mRNA expression, accompanied by 4-fold Egr2 but did not affect Ccl2 or C3 mRNA expression. In contrast, C3aR group depicted 1,6-fold C3 and 1,8-fold Ccl2 mRNA expression, an only 1,6-fold Egr2 but a 2-fold Col1a1 and 1,5-fold Tgfb1 mRNA expression. Despite the similar Tgfb1 mRNA overexpression in TGFb and C3aR groups, marked TGFB1 protein overexpression (15-fold) was only observed in TGF-beta treated cells but not in the C3aR group.

Conclusion
Our study data indicate that renal complement C3 production can exert autocrine / paracrine direct pro-fibrotic effects on tubular epithelial cells unrelated to TGF-beta protein levels. Therefore, local C3 overexpression might play a significant pathogenetic role in kidney fibrosis.
#5536 CIRCULATING LEVELS OF COPEPTIN, GROWTH DIFFERENTIATION FACTOR 15 (GDF15) AND INTERLEUKIN 6 (ILA-6) IN PATIENTS WITH ADVANCED KIDNEY DISEASE
Authors: Gutiérrez Paulo García , Garrote Pablo Sánchez , Varas Carmen Martin , Iglesias Pedro , Gomez Juan Jose Diez , Silvestre Mardomingo Monchi , Garcia Leonardo Calle , Gomez Astrid Rodriguez , Santos-Alonso Carlos , Luis Maria Jose Fernandez-Reyes 
Published: June 2023

Abstract

Background and Aims
The search for new serum biomarkers of cardiovascular risk and mortality in patients with CKD is relevant to improve the monitoring of these patients. Copeptin is a glycopeptide that is released equimolarly with arginine-vasopressin. GDF-15 is a cytokine involved in macrophage activation processes and is a marker of response to oxidative stress, and IL-6 as a marker of systemic inflammation. Objective: To study the serum levels of copeptin, GDF-15 and IL-6 in patients with advanced CKD.

Method
Cross-sectional study in 32 patients with advanced CKD. In all patients, the estimated glomerular filtration rate (eGFR) was determined by CKD-EPI, the albumin/creatinine ratio (CrAI) and the serum concentrations of copeptin (immunofluorescence, Thermo Fisher), GDF-15 (chemiluminescence, Roche Diagnostics International) and IL-6 (Siemens Healthineers). Results were compared to laboratory reference values (RVs) for copeptin (VN&lt;4.2 pmol/L) and IL-6 (VN&lt;4.4 pg/mL). The VR of GDF-15 (708±227 pg/ml) corresponds to own data from 10 Blood Bank donors. Results for copeptin and GDF-15 (normal distribution) are shown as mean ± SD. IL-6 results (without normal distribution) as median and interquartile range.

Results
In CKD we observed an increase in copeptin (26.9±22 pmol/l, 90% &gt;4.2 VR) and GDF-15 (4703±2683 pg/ml p&lt;0.0001 vs. control population). Median IL6 3.2 pg/ml (IQR: 2.7-5.1, 35% &gt;4.4 VR). We did not find differences in the levels of copeptin, GDF-15 or IL-6 based on age, sex and presence or absence of diabetes. A significant correlation was found between GDF15 levels and eGFR (r=-0.54 p&lt;0.002).

Conclusion
Serum levels of copeptin and GDF-15, but not IL6, are increased in CKD patients. Our data suggest a significant inverse relationship between GDF15 and eGFR. More studies are needed to know the possible role of GDF-15 on the progression of kidney damage and cardiovascular complications in patients with CKD.