bluuebunny/crossref_metadata_2025_split huggingface dataset:
#5157 ESTIMATION OF RENAL KT/V FROM 24-HOUR URINE VOLUME AND UREA DISTRIBUTION VOLUME IN PERITONEAL DIALYSIS
Authors: Zeiler Matthias , Fioravanti Gilda , Federico Antonio , Ramazzzotti Valentina , Silvestri Simona , Fioravanti Giuseppe , Santarelli Stefano 
Published: June 2023

Abstract

Background and Aims
Residual renal function is an important factor in peritoneal dialysis (PD) regarding technical survival and implementation of incremental therapy schemes. The aim of the retrospective study was to develop an estimation formula of renal Kt/Vurea in PD based on urine output and anthropometric data.

Method
In 235 adult PD patients (151 males, 84 females, median age 66 years, median BMI 26.0, diuresis &gt;100 ml/day) urine output was registered together with anthropometric and lab data during the first peritoneal equilibration test. The dose of furosemide therapy was noted. Urea distribution volume calculated using the formula of DuBois. Measurement of urea in blood and urine was performed by a standard kinetic test with urease.

Results
24-hour urine volume ranged from 100 to 3800 ml (median 1150 ml), similar in both sexes. Renal Kturea showed a significant linear correlation to daily urine volume (r=0.78, p&lt;0.01) independent from sex and diuretic dose: renal Kturea = 5.116 + 0.0221 x 24-hour urine volume (renal Kturea in liters/week, 24-hour urine volume in ml). Urea distribution volume varied between 24 and 60 liters (median 36.4 liters), and calculated renal Kt/V ranged from 0.05 to 2.57 (median 0.84). Estimated renal Kt/V, based on the before mentioned equation divided by urea distribution volume, correlated significantly to calculated renal Kt/V (r=0.75, p&lt;0.01). The goodness of fit analysis showed a mean absolute error of 0.24. The Bland-Altman Plot confirmed a tendency of over-estimation for renal Kt/V &lt; 1.0 and under-estimation for higher renal Kt/V. A restriction of the analysis to 24-hour urine volume up to 1500 ml (n=142 patients, median age 69 years, BMI 25) resulted in an improvement of renal Kt/V estimation (goodness of fit analysis: mean absolute error 0.20).

Conclusion
The estimation of renal Kt/V in PD patients seems to be feasible utilizing 24-hour urine volume and anthropometric data.
#5304 ACCURACY OF PLATELET INDICES AS PREDICTOR OF IN-HOSPITAL MORTALITY IN PATIENTS WITH ACUTE KIDNEY INJURY REQUIRING RENAL REPLACEMENT THERAPY
Authors: Balasa Melvy June 
Published: June 2023

Abstract

Background and Aims
Acute kidney injury (AKI) is a major medical complication associated with a markedly increased risk of death, particularly in patients admitted to the ICU where in-hospital mortality exceeds 50%1. This study aimed to determine the accuracy of MPV, platelet count, and PDW as predictors of adverse outcomes in patients with AKI who received initiation renal replacement therapy (RRT).

Method
A retrospective cohort single-center study was done in a local private tertiary hospital in Cebu. Four hundred ninety-one patients with AKI who underwent RRT between January 2018 and December 2021 were enrolled. A retrieval of data on demographic and clinical parameters during the initiation of RRT was done. The impact of mortality-related factors were identified using univariate and multivariate logistic regression analysis. Determination of optimal cut-off values of platelet indices for in-hospital mortality was done.

Results
This study showed that the in-hospital mortality of patients was 58.45%, with a mean age of 68.6 ± 16.28 years among non-survivors. Among the platelet indices, platelet count and PDW were good predictors of in-hospital mortality in patients who received initiation renal replacement therapy. The optimal cut-off value of platelet count was 173 x 103/uL (sensitivity 56.45%, specificity 62.25%, PPV 67.78%, NPV 50.40%, AUC 0.604). The optimal cut-off value of PDW was 16.45% (sensitivity 50.87%, specificity 71.57%, PPV 71.57%, NPV 50.87%, AUC 0.611).

Conclusion
Platelet indices are feasible parameters that can be used as prognostic markers for mortality in patients with AKI requiring RRT. The in-hospital mortality of patients with AKI requiring initiation RRT is high (58.45%). Low platelet counts, high MPV values, and high PDW values are associated with poorer outcomes and higher mortality risk as compared to patients with normal indices.
#5337 PHENOTYPIC CHANGES OF LYMPHOCYTES FOLLOWING RENAL TRANSPLANTATION
Authors: Vagiotas Xaralampos , Lioulios Georgios , Moysidou Eleni , Xochelli Aliki , Kasimatis Efstratios , Tsoulfas Georgios , Papagianni Aikaterini , Fylaktou Asimina , Stangou Maria 
Published: June 2023

Abstract

Background and Aims
Phenotypic changes in lymphocytes have been described following renal transplantation (RT), including both CD4 and CD8 subpopulations. The present work aims to prospectively assess of T lymphocyte phenotypic alterations, after RT and compare differences between deceased (DR) and living (LR) donor recipients.

Method
One hundred six RTRs were included in the study, 78/106 (74%) DR, age 52.5(15)yrs and 28/106 (26%) LD, 35(21)yrs. Lymphocytes, CD4, CD8, CD4CD28null, CD8CD28null, CD16+CD56+ (NK) and CD4+CD25+FoXP3+ (Tregs) were evaluated at peripheral blood, by flow cytometry, at certain time points: RT and 3, 6, 12 months (T0, T3, T6, T12, respectively).

Results
During follow up, at T3, T6, T12, eGFR was 61(23.6), 62.2(31.1), 63.5(23.9)ml/min/1.73 m2, p=NS and 59.1(24.8), 61(25.3), 62(22.7), p=NS, in DR and LR group, respectively. eGFR showed no significant difference between DR and LR at any time point. At any time point, T0, T3, T6, 12, lymphocytes were significantly increased in DR compared to LR groups, P = .001, p&lt;0.0001, P = .002, p&lt;0.0001, similarly CD4, P = .001, p&lt;0.0001, P = .001, p&lt;0.0001, and CD8 cells, P = .002, p&lt;0.0001, P = .005, P = .006, respectively. Tregs were increased at T0, T3, T6, not at T12, p&lt;0.0001, p&lt;0.0001, P = .001, P = .1, respectively. At this point, Tregs were increased in RTRs with eGFR&gt;50ml/min/1.73 m2, 20.3(9.3) vs. 27.2(18.6), P = .03. CD4CD28null, CD8CD28null cells did not change during follow up, and there was no difference between two groups at any time point.

Conclusion
Immune profile, was improved in both groups, DR or LR, however a significantly better effect managed in LR, although elimination of CD28 molecule could not be restored. Interestingly, Tregs were associated only by renal function one year following RT.
#5436 CHARACTERIZATION OF KIDNEY FUNCTIONAL DAMAGE ASSOCIATED TO CO-TREATMENT WITH IMMUNE CHECKPOINT INHIBITORS AND CISPLATIN
Authors: Tascón Javier , Casanova Alfredo G , Vicente-Vicente Laura , Pescador Moisés , Prieto Marta , Martín Ana Isabel Morales 
Published: June 2023

Abstract

Background and Aims
Advances in the knowledge of the immune response against tumors and the evasion mechanisms of these have led to develop new cancer therapies focused on improving the immune response and thus increasing patient survival. This is the case of immunotherapeutic treatment based on immune checkpoint inhibitors (ICI). However, treatment based on these antibodies is associated with autoimmune side effects, in most of the body organs, that limit their use. Although nephrotoxicity is rare, renal effects have been shown to worsen the prognosis of cancer patients. Recently, therapies based on the combination of immuno and chemotherapy have been approved. They have improved efficacy but have increased the risk of suffering nephrotoxic adverse effects. Our hypothesis is that kidney damage associated with ICIs could be subclinical and not evidenced by the parameters used in clinical practice (mainly plasma creatinine). The aim of this work was to characterize functional kidney damage associated with ICI (anti-CTLA-4) in combination with chemotherapy (cisplatin) in a murine model.

Method
C57BL/6 mice were treated with combined therapy of cisplatin (10 mg/kg, single dose) and anti-CTLA-4 (10 or 15 mg/kg/day, for 6 days) administrated by intraperitoneal injection. In addition, groups treated with drug monotherapies and a control group were included. Urine and blood samples were collected at baseline, on day 3 and on day 6 (sacrifice). Biomarkers of subclinical kidney damage were determined by ELISA in urine samples. There were albumin, neutrophil gelatinase-associated lipocalin (NGAL) and kidney injury molecule 1 (KIM-1). Blood samples were centrifuged to obtain plasma, in which creatinine and urea were measured using colorimetric techniques. Data were analyzed with the statistical software SPSS®.

Results
Plasma creatinine and urea were elevated in the combined therapy groups with respect to the monotherapies. However, these parameters were similar to the normal range, so they do not reflect obvious kidney injury. It was evidenced a statistically significant elevation of biomarkers of subclinical kidney damage in the combined therapy groups with respect to monotherapies and control group.

Conclusion
This study suggests that the combination of anti-CTLA-4 with cisplatin could cause a potenciation effect on subclinical kidney damage compared to monotherapies. This experimental model would make possible to study the nephrotoxicity mechanisms of ICI. Moreover, it could have a potential diagnostic utility through the identification of biomarkers of subclinical kidney damage, that would avoid biopsy.
#5462 METABOLIC PROFILING IN CHILDREN WITH END STAGE RENAL DISEASE ON PERITONEAL DIALYSIS: PRELIMINARY RESULTS OF AN ONGOING PRESPECTIVE STUDY
Authors: Kondou Antonia , Dotis John , Karava Vasiliki , Begou Olga , Taparkou Anna , Panteris Eleftherios , Gika Helen , Theodoridis George , Printza Nikoleta 
Published: June 2023

Abstract

Background and Aims
Peritoneal dialysis (PD) is the main renal replacement treatment for children and adolescents with end stage kidney disease (ESRD). Peritoneal fibrosis is a major complication in long-term PD patients. Aim of the present study is to record the metabolic "fingerprint" of children on PD and to investigate its correlation with PD history and dialysis adequacy as well as the emergence of potential biomarkers that could detect early or predict peritoneal dysfunction.

Method
Serum samples from 15 patients undergoing peritoneal dialysis were analyzed. Two targeted LC-MS methodologies were used for the determination of 107 metabolites in total. The obtained results were compared based on demographic and clinical parameters, both before and after the dialysis procedure. Serum samples were further divided into subgroups, based on PD duration, creatine clearance, sex, anuria. Reragding metabolic techologies used, all samples were analyzed by a hydrophilic interaction liquid chromatography coupled to mass spectrometry (HILIC-MS / MS) method previously developed and validated in our laboratory for the simultaneous determination of amino acids and their derivatives in biological fluids. Αlso, high flow analysis was carried out (LC-qTOF analysis – HPLC /MS).

Results
8-OH-2-deoxyguanosine (8-hydroxy-2' -deoxyguanosine (8-OHdG) was the only metabolite found to differentiate between serum samples collected before and after PD (p&lt;0.05). Grouping the samples by age groups (child, teen and late teen-young adult) we found out that succinate like lactate, N-acetyl-β-d-glucosaminidase (NAG), are potential markers for the quality of PD. Grouping the patients by number of peritonitis episodes (3 groups: no episodes, 1-2 episodes and &gt;3 episodes) cytosine, riboflavin, glutamic acid, methylxantine and malate found to differentiate between the three groups (p &lt;0.05). Regrading the creatinine cleranace, xylose, dCDP, HIAA, pyroglutamic, A CoA and methylxantine seems to be significan biomarkers. Grouping the patients based on the presence or absence of diuresis,HIAA, kynurenic,glucuronic and pantothenic acid found to differentiate between the two groups (p&lt;0.05)

Conclusion
Based on the literatute the majority of the metabolites showed a statistically significant difference are involved in the inflammation process. Our results are the preliminary results of an ongoing prospective study. Limitation of the study, is the small sample of patients, which does not allow safe clinical interpretation. In any case, metabolomics seems to be a useful tool for the study and identification of biomarkers in patients with ESRD on PD.
#5471 THE URINARY BIOMARKERS IGFBP7 AND IGFBP7 X TIMP2 PRE-EMPTIVELY IDENTIFY PATIENTS AT RISK OF CONTRAST NEPHROTOXICITY
Authors: Quintero Patricia García , Casanova Alfredo G , Tascón Javier , Prieto Marta , Pescador Moisés , Lopez-Hernandez Francisco J , Martín Ana Isabel Morales , Vicente-Vicente Laura 
Published: June 2023

Abstract

Background and Aims
Drug nephrotoxicity is a serious medical and economic concern. In fact, 25% of the 100 most used drugs in intensive care units are toxic to the kidney, which limits their use and, therefore, the correct therapy for the patient. The administration of contrast media (CM) during diagnostic tests or surgical interventions carries the risk of contrast-induced nephropathy (CIN), which is a clinical condition defined as an increase in plasma creatinine of 25% or 0.5 mg/dL above baseline within 3-5 days after administration. Because once installed CIN has no treatment, identification of new biomarkers predicting patients at risk of CIN before receiving CM may be crucial to prevent future kidney complications. Clinical studies conducted in other medical areas have identified new urinary biomarkers, such as insulin like growth factor binding protein 7 (IGFBP7) and tissue inhibitor of metalloproteinases 2 (TIMP2), that anticipate the risk of developing kidney damage after the administration of different potentially nephrotoxic compounds. The objective of this work was to evaluate the usefulness of these biomarkers to predict CIN in cardiac patients.

Method
A clinical study was carried out with 154 patients from the University Hospital of Salamanca Cardiology Department who subsequently received a CM. Prior to contrast administration, urine samples were collected. In addition, their plasma creatinine level was registered for the following 5 days to evaluate the development of CIN. Patients were divided into Controls (who did not develop CIN) and Cases (who developed CIN). IGFBP7 and TIMP2 biomarkers were quantified in urine samples by ELISA. Subsequently, the differences between both groups were evaluated using the Mann-Whitney U test and the diagnostic capacity of each biomarker was analyzed through the generation of its receiver operating characteristic (ROC) curve.

Results
Of the total number of patients, 123 were assigned to the Controls group and 31 to the Cases group. In both groups the distribution of sex and risk factors was similar, except for the case of age and body mass index, which was slightly lower and higher, respectively, in the Controls group. IGFBP7 was significantly higher in Cases (p &lt; 0.01) compared to the Controls, and the IGFBP7 x TIMP2 product further improved this significance (p &lt; 0.001). Specifically, the area under the ROC curve for IGFBP7 was 0.67 (95% confidence interval of 0.56-0.78); while that for IGFBP7 x TIMP2 increased to 0.73 (with a 95% confidence interval of 0.63-0.84). In contrast, TIMP2 alone showed no differences between both groups of patients.

Conclusion
The biomarkers IGFBP7 and IGFBP7 x TIMP2 could therefore be used for the prophylactic identification and management of patients at risk of developing CIN.
#5527 ALDOSTERONE, CORTISOL AND URINE VOLUME CAN EXPLAIN DISCREPANCIES BETWEEN DIETARY AND URINARY NA/K RATIO
Authors: van Vliet Anne Myrthe , Zwager Charlotte , Rauh Manfred , Titze Jens , Engberink Rik Olde 
Published: June 2023

Abstract

Background and Aims
Increased urinary sodium-to-potassium (Na/K) ratio has been associated with chronic kidney disease. However, we demonstrated that urinary Na/K ratio does not accurately reflect dietary Na/K ratio. Rhythmic patterns of sodium storage and release from the skin interstitium are associated with aldosterone and cortisol levels and previous studies linked tissue sodium accumulation to water conservation. Therefore, we investigated whether the discrepancy between urinary and dietary Na/K ratio could be explained by these factors.

Method
For this post-hoc analysis, we used data from the long-term sodium balance studies Mars105 and Mars520. These studies collected 24-hour urine samples and controlled dietary salt intake for 105 (4 men) and 205 days (6 men) at levels of 6, 9 and 12 grams per day. We calculated the difference between urinary and dietary Na/K ratio. We tested whether this difference varied across salt intake levels in a linear mixed-effects model. Furthermore, we fitted two linear mixed-effect models to explain discrepancies between urinary and dietary Na/K ratio. In the first model, sodium intake, potassium intake, urinary aldosterone and urinary cortisol were fixed effects and for each factor random slopes per participant were allowed. In the second model, sodium intake, potassium intake and urine volume were fixed effects and for each factor random slopes per participant were allowed. Each salt intake level was assessed separately.

Results
The median difference between 24-hour urinary and dietary Na/K ratio was −0.21 (IQR −0.47 to 0.09). At higher salt intake levels the underestimation was significantly larger (mean difference −0.11, −0.22 and −0.36 for 6, 9 and 12 grams salt intake, respectively; P&lt;0.001). At each salt intake level, higher urinary aldosterone was associated with underestimation of the dietary Na/K ratio (Figure 1A). In contrast, higher urinary cortisol and higher urine volume were associated with relative overestimation of the dietary Na/K ratio (Figure 1B and C, respectively).

Conclusion
The discrepancy between dietary and urinary Na/K ratio can be explained by sodium intake, aldosterone, cortisol and urine volume. This suggests that tissue sodium accumulation contributes to the inaccuracy of a single 24-hour urine collection for estimation of dietary sodium and potassium intake.
#5547 SERUM PERIOSTIN IN KIDNEY TRANSPLANT RECIPIENTS AS A NOVEL BIOMARKER PREDICTING RENAL FUNCTION LOSS
Authors: Kurnik Anna , Batko Krzysztof , Krzanowska Katarzyna , Malyszko Jolanta , Żorawska Ewa Koc- , Zorawski Marcin , Banaszkiewicz Małgorzata , Woziwodzka Karolina , Małyszko Jacek , Krzanowski Marcin 
Published: June 2023

Abstract

Background and Aims
Experimental studies have shown periostin is expressed throughout organogenesis, particularly within the kidney interstitium. Periostin is enhanced in different tissues of patients with nephropathy and has been considered as a candidate biomarker of kidney injury.

Method
Retrospective analysis of electronic medical record of one hundred and five kidney transplant recipients (KTRs) was performed. Only patients under sequential ambulatory care, with a history of at least 2 years post-transplant were included. Median (IQR) follow-up and time post-transplant was 4.42 (2.65, 4.58) and 4.29 (3.04, 8.07) years, respectively. Additionally, thirty-two health volunteers (HV) were enrolled. Biochemical testing was performed using commercially-available immunoassays.

Results
Median [IQR] serum periostin was significantly lower in KTRs as compared with HV (959 [732, 1204] vs. 1176 [997, 1408]; P&lt;0.01). Higher serum periostin was observed in male patients (7.01 [6.84, 7.22] vs. 6.79 [6.64, 7.07], P&lt;0.05) and a significant relationship was noted for interleukin 6 (IL6; r=0.24, P=0.01) and baseline estimated glomerular filtration (eGFR) (r=0.20, P=0.04). Patient age (P=0.60), body-mass index P=0.08), cardiovascular disease (P=0.31), diabetes (P=0.45), current smoker status (P=0.27), nor anemia (P=0.23) were not associated with serum periostin. In a generalized additive model adjusted for baseline renal function and IL-6, serum periostin showed a signficant nonlinear association (P=0.04) with eGFR change over follow-up.

Conclusion
Previous studies reported an association between periostin expression and the severity of histological injury within the kidney in both inflammatory and non-inflammatory conditions. Serum periostin may be a potential marker aiding in prediction of renal function in KTRs.
#5555 TAKAYASU ARTERITIS IN THE TIME OF SARS-COV-2
Authors: Finocchiaro Pietro , Caridi Graziella , Catalano Francesco , Postorino Adele , Tripepi Rocco , Mallamaci Francesca , Panuccio Vincenzo Antonio 
Published: June 2023

Abstract

Background and Aims
SARS CoV 2 infection is characterized by pulmonary, cardiovascular, neurological and other complications. New onset hypertension after SARS Cov 2 infection was observed in various studies with an unclear mechanism. Vessel inflammation is a common finding in these patients.

Case
A young woman (24 years old) referred to our Unit for high blood pressure levels appeared few days after SARS COVID 2 infection. She had a positive familiar history of hypertension. A 24 hours blood pressure monitoring confirmed hypertension and the patient was treated with a beta-blocker and referred to the nephrologist. Physical examination was negative and peripheral pulses were palpable. Blood pressure was 150/90 mmHg without significative discrepancy (&lt;10 mmHg) between right and left arm and between upper and lower limbs. Carotid-femoral and carotid-radial pulse wave velocity was in the upper limit of the normal range (9.8 and 8.0 m/sec respectively), renal function was preserved (serum creatinine 0.6 mg/dl, eGFR 154 ml/min) and proteinuria was 450 mg/die. C-reactive protein was 13 mg/L. Complement components C3 and C4 as well as IgG and anti-neutrophil cytoplasmic antibody (ANCA) levels were in the normal range. IgA and IgM were slightly elevated and anti-nuclear antibody (ANA) levels were 1:160. TSH was in the normal range. Patient was switched to calcium channel blockers and a screening to exclude secondary hypertension was performed. Hormonal profile showed hypersecretion of cortex and medullary adrenal gland (high renin and aldosterone, plasma and urinary cortisol, and epinephrine levels). Patient was treated with ACE inhibitor and showed an optimal blood pressure profile. Abdominal-Chest CT angiography detected no increase in adrenal gland dimension. Conversely, a left renal artery stenosis and a mild enlargement of the para-aortic tissue, suggestive of a retroperitoneal fibrosis, was described (Figure 1). A Doppler ultrasound examination confirmed a high systolic peak velocity in left renal artery and a low resistive index in the left kidney. According to the diagnosis of renal fibrosis, patient was treated with oral prednisone at a dosage of 1 mg/Kg/BW. Three months later, Doppler ultrasound and CT were materially unchanged. After a case revision and a negative evidence of inflammation at PET-FDG examination, the Takayasu Arteritis diagnosis was formulated and the patient underwent left renal artery angioplasty. Oral prednisone was tapered and methotrexate was started. One month later blood pressure and Doppler ultrasound velocimetric parameters were normalized.

Conclusion
This case report suggests that Takayasu arteritis may occur after SARS COVID 2 infection.