bluuebunny/crossref_metadata_2025_split huggingface dataset:
#6624 EFFICACY AND SAFETY OF GLP1 ANALOGUES IN ADVANCED CKD PATIENTS: A POTENTIAL STRATEGY FOR WEIGHT LOSS AND INCLUSION IN RENAL TRANSPLANT WAITING LIST
Authors: Alonso Marta , Sánchez Luis Alberto Vigara , Fernández Florentino Villanego , Amaro Jose Manuel , Aguilera Aurora , Singh Arshdeep , Muñoz Javier Naranjo , López Juan Manuel Cazorla , Mejía Carlos Narváez , Orellana Cristhian , Masero Julia Torrado 
Published: June 2023

Abstract

Background and Aims
Diabetes mellitus (DM) is one of the main causes of chronic kidney disease (CKD) and the need for renal replacement therapy. New antidiabetic drugs such as glucagon-like peptide type 1 receptor analogues (aGLP1) improve glycemic control and cardiovascular risk and promote weight loss. Our main objective was to analyze the efficacy and safety of aGLP1 agonists in patients with advanced chronic kidney disease (ACKD).

Method
Prospective cohort study of CKD (estimated glomerular filtration rate (eGFR) ≤30 ml/min) and DM2 patients who started treatment with aGLP1 between April 2018 and November 2022. We analyzed clinical and demographic variables. We collected aGLP1 type and dose, eGFR and weight at baseline and after 6 and 12 months of treatment. We analyzed glycemic and lipid control and blood pressure (BP). We documented adverse effects. Descriptive analysis was performed and we compared eGFR before and after aGLP1 initiation.

Results
During the period 36 patients with ACKD started treatment with aGLP1 in our center, 30 with a minimum follow-up of 6 months. 66.7% were male and the mean age was 67. 88.9% were hypertensive and 91.7% dyslipidemic. 33.3% had a history of ischemic heart disease, 11.1% heart failure, 41.7% peripheral arterial disease and 8.3% stroke. The mean eGFR at drug initiation was 20.7 mL/min. The most frequent cause of CKD was diabetic nephropathy (66.7%) followed by glomerulonephritis (11.1%). Mean weight was 92.7±9.7 kg and BMI 33.15±3.2 kg/m2. The most prescribed aGLP1 was Semaglutide (83.4%) followed by Liraglutide (13.9%) and Dulaglutide (2.8%). Maximum drug dose was reached in 69.4% of patients. After initiation, eGFR remained stable at 6 months and 1 year (p = .424). We observed a 12% reduction in weight at one year after treatment (94Kg vS 83Kg; p&lt;.001). We found no differences in glycosylated hemoglobin, lipid control and BP at 6th month and first year. Two patients suffered gastrointestinal adverse effects and one discontinued the drug because of this. One patient died during follow-up of independent cause.

Conclusion
aGLP1 in patients with ACKD are safe. Adverse effects do not occur more frequently than in the non-CKD population. In addition to improving cardiovascular risk of patients, they can produce a weight loss that can independently help patients to be included in the waiting list for renal transplantation.
#6650 SGLT2-INHIBITION IMPROVES VASCULAR FUNCTION IN TYPE 2 DIABETES: A DOUBLE BLIND, RANDOMIZED, PLACEBO CONTROLLED CROSSOVER TRIAL
Authors: Kristensen Didde Kidmose , Nielsen Steffen Flindt , Buus Niels Henrik , Duus Camilla , Mårup Frederik , Bech Jesper , Mose Frank 
Published: June 2023

Abstract

Background and Aims
Sodium glucose cotransporter 2 inhibitors (SGLT2i) reduce cardiovascular events and protects kidney function in type 2 diabetes (DM2) patients. These benefits may partly be related to improvement of vascular function. In this study we examined the effects of SGLT2i treatment on vasodilatory capacity in patients with DM2.

Method
Using a double-blind, randomized, placebo-controlled cross-over study design, we included 15 patients with DM2 and preserved kidney function (eGFR &gt; 60 ml/min/1.73 m2). Each participant received four weeks of SGLT2i treatment (empagliflozin 10 mg once daily) or matching placebo. After a two-week wash-out period, each participant was crossed over to four weeks of the opposite treatment. At the end of each treatment period, vascular function was evaluated by venous occlusion plethysmography. Forearm blood flow (FBF) was measured during intra-arterial infusion of increasing concentrations of acetylcholine (ACh) and sodium nitroprusside (SNP), assessing endothelium-dependent and independent vasodilation, respectively. Repeated measures two-way ANOVA was performed to compare absolute FBF between groups.

Results
11/15 (73%) of participants were male. Mean age was 68±9 (SD) years (range 49-82), eGFR was 81±10 ml/min/1.73 m2 and duration of diabetes was 15.8±9 years. 11/15 (73%) had hypertension and 9/15 (60%) received treatment with an ACE-inhibitor or Angiotensin-II blocker. 4/15 (27%) had cardiovascular disease. The median albumin-to-creatinine ratio was 29 mg/g (range: 4-1293). Both ACh and SNP dose-dependently increased FBF (Figure 1 and 2). FBF during SNP infusion was significantly higher during empagliflozin treatment as compared to placebo (p = 0.004), whereas there was no difference between empagliflozin and placebo in FBF during ACh infusion (P = 0.399).

Conclusion
Empagliflozin improves endothelium-independent vasodilatation in patients with DM2, whereas no changes could be observed in endothelium-dependent vasodilation. These results suggest that SGLT2i positively affects vascular function and that the effect is not related to nitric oxide from the endothelium.
#6679 ANALYSIS OF MACROPHAGE POPULATIONS IN THE KIDNEY WITH RENAL TUBULAR CELL-SPECIFIC SENESCENCE INDUCTION
Authors: Campbell Ross , Docherty Marie-Helena , Baird David , Ferenbach David , Mylonas Katie 
Published: June 2023

Abstract

Background and Aims
Ageing is a risk factor for multiple diseases, including kidney disease. To improve quality of life, pharmaceutical treatments are given to ageing patients, often with side-effects and cross-reactions. Research is needed into the effects and mechanisms of ageing in order to identify new druggable targets to improve quality of life. Cells can become senescent with age and are seen at sites of tissue injury. Senescent cells (SCs) undergo irreversible cell-cycle arrest, but remain metabolically active, producing a range of signalling molecules called the senescence associated secretory phenotype (SASP, made up of pro-inflammatory/fibrotic elements). Senescent cells within the kidney post-acute kidney injury (AKI) may be involved in ongoing damage, leading in some cases to chronic kidney disease (CKD), possibly due to interactions with macrophages. We hypothesise that the recruitment of monocytes/macrophages by senescent cells is due to the signalling components present in their SASP.

Method
Pax8 is renal tubule marker. We use Pax8-creERT2;mdm2 fl/fl mice to study kidney-specific senescence induction in absence of age/injury. Upon administration of tamoxifen, the mdm2 alleles are floxxed out by cre recombinase, allowing p53 to stabilise and activate the p21CIP1 cell-cycle inhibitor, inducing senescence in Pax8+ kidney-specific cells. The use of an endogenous tdTomato reporter allows visualisation of cells undergoing successful recombination upon the administration of tamoxifen (TAM).

Results
As expected, cell-cycle inhibitor/SC marker, Cdkn1a was upregulated by qPCR in TAM-treated young murine whole kidneys 10-fold compared to controls (p = 0.0173) (Figure 1). Ccl2 (monocyte chemoattractant) was up-regulated 20-fold in young (p = 0.0405) TAM-treated TG mice vs controls (Figure 1). In agreement with an increase of Ccl2 transcripts, there was a significant increase of renal macrophages as quantified by flow cytometry of kidney digests (p = 0.0141) in TAM treated young TG mice. Immunofluorescence staining of transgenic mice revealed an increase of Iba1 positive macrophages, correlated with staining of tdTomato tubules, suggesting that increase in macrophage numbers was in response to senescence induction (Figure 2). Iba1-p21 co-stains show a increases in p21 positive cells in TAM-treated transgenic mice, evidently a result of construct activation and appear in proximity to the macrophages (Figure 2).

Conclusion
Apparent increases in macrophages due to the presence of senescent cells may indicate one of the mechanisms by which AKI progresses to CKD, particularly if inflammatory macrophage phenotypes are present and persist. Macrophage and monocyte populations fluctuate with age and the use of this model allows analysis of macrophage recruitment/polarisation due to senescent cell burden in the absence of age/injury and possible confounding factors, in young mice.
#6691 COMPREHENSIVE TWO-DAY IN-HOSPITAL ASSESSMENT MODE IS ASSOCIATED WITH THREE-YEAR AND FIVE-YEAR MORTALITY IN PERITONEAL DIALYSIS PATIENTS
Authors: MA Dengyan , LI Xing , Zhong Hui , Pu LI , Zhou Xueli , Duan Difei , Liao Ruoxi , Fu Ping 
Published: June 2023

Abstract

Background and Aims
The study aims to explore the relationship between a "comprehensive 2-day in-hospital assessment management mode” (C2IAMM) and survival and technical survival rates of patients undergoing peritoneal dialysis (PD).

Method
Eight hundred and thirty PD patients were retrospectively analyzed from January 1, 2011, to October 31, 2017. The “C2IAMM” includes admitting patients undergoing PD to the hospital for 2 days for various assessments. Based on these results, comprehensive interventions was provided. The 1-year, 3-year and 5-year survival and technical survival rates of patients following the C2IAMM were analyzed, and subgroup analysis were further performed.

Results
The 830 PD patients following C2IAMM achieved 1-year, 3-year and 5-year survival rates of 98.0%, 91.4% and 84.3%, respectively; the corresponding technical survival rates were 97.1%, 87.1% and 80.5%. The subgroup analysis showed that age ≥ 60 years, diabetes mellitus, cardiovascular and cerebrovascular diseases, and respiratory diseases (all P &lt; 0.001) were associated with survival.

Conclusion
This article implies that the C2IAMM may be associated with higher survival and technical survival.
#6713 THE INTERACTION EFFECT OF PHASE ANGLE AND AGE ON FEMORAL NECK BONE MINERAL DENSITY IN PATIENTS WITH NON-DIALYSIS CHRONIC KIDNEY DISEASE STAGE 5
Authors: Han Byoung Geun , Kim Jae Seok , Yang Jae Won 
Published: June 2023

Abstract

Background and Aims
Low bone mass is common in malnourished patients with chronic kidney disease (CKD) and can lead to higher risk of fractures. Elderly and CKD patients have the same risk factors for protein energy wasting, sarcopenia, and osteoporosis. We attempted to investigate an association between phase angle (PhA) and bone mineral density (BMD) in dialysis naïve patients with stage 5 CKD, and to identify a statistical relationship between PhA and age that affects bone density.

Method
Bio-impedance spectroscopy for evaluating body composition and PhA and dual energy X-ray absorptiometry for determining the BMD were simultaneously performed in 167 consecutive patients (age: 59.65 ± 13.98 years; women: 40.1%). Two-way analysis of variance (ANOVA) was conducted to assess the potential interaction effect of PhA and two age group (young and elderly group) on femoral neck BMD (FN-BMD).

Results
Our results showed that PhA and age were independently associated with both FN-BMD and the T-score in multiple linear regressions analyses. A significant interaction effect of PhA and age on FN-BMD was found in the two-way ANOVA (P = 0.028). Average BMD values for first and second tertiles of PhA were higher in the young group than the elderly group, whereas patients in the elderly group had higher BMD in third tertiles on average.

Conclusion
A relationship between PhA and BMD in patients with advanced-stage CKD was identified in current study. The effect of PhA level on FN-BMD was different between elderly and young patients. Higher PhA levels may have protective effects on bone health in the elderly patients with stage 5 CKD and seem to be an important determinant for BMD.
#6717 IS PERITONEAL DIALYSIS RELATED PERITONITIS A MAJOR RISK FACTOR FOR CARDIOVASCULAR EVENTS?
Authors: Almeida Catarina , de Faria Maria Victoria Vaz Da Rocha Paes , Dias Joana Pereira , Lopes Daniela , Carmo Rute , Fernandes João Carlos , Almeida Maria Clara , Gomes Ana Marta 
Published: June 2023

Abstract

Background and Aims
Cardiovascular (CV) disease remains the leading cause of death in peritoneal dialysis (PD) patients and traditional CV risk factors are unable to fully account for this high incidence. The aim of our study was to establish the incidence of CV events such as acute myocardial infarction (AMI) in the PD population and assess possible risk factors for its occurrence.

Method
We retrospectively studied patients on PD in our unit with a minimum 3-years dialysis vintage, between January 1st 2015 and April 30th 2022. Patients with previous CV disease were excluded. Demographic and clinical data were collected, such as traditional CV risk factors, AMI, peripheral artery disease, cerebrovascular events, as well as dialysis efficiency, hydration status obtained by Body Composition Monitor (Fresenius Medical Care) and PD-related infections before AMI or end of follow-up. Univariate analysis was performed and logistic regression was applied to access predictors of AMI.

Results
Of the 43 patients recruited, 53.5% were male, with a mean age of 56.4 ± 11.8 years. About 98% of patients were hypertensive, 21% were diabetic, 19% were obese, and 54% had dyslipidemia. Five (11.6%) patients had a CV event while on PD, 4 suffered AMI and 1 patient had an ischemic stroke. Patients’ characteristics are presented in Table 1. In the follow-up, peripheral arterial disease (p = 0.037), hyperphosphatemia (p = 0.035) and the cumulative number of peritonitis (p = 0.018) were associated with the occurrence of AMI. In our population we found a higher frequency of peritonitis in the year prior to the AMI (p = 0.024). In logistic regression, the cumulative number of peritonitis was a predictor of AMI (OR 4.918, CI 95%:1.093-22.132). In the mean follow-up time of 4.7 ± 1.4 years, the overall mortality was 21,7%, with CV disease accounting for 60% of the observed deaths. AMI and peritonitis were associated with higher mortality in PD patients (p = 0.016 and p = 0.009, respectively).

Conclusion
PD-related peritonitis was a predictor of AMI in these population. The risk is higher in the year following a peritonitis episode. This may be due to a chronic inflammatory state that persists after successful treatment of peritonitis which may predispose to enhanced CV risk. Similar to previous studies, we found that cumulative episodes of peritonitis were associated with increased mortality in PD population.
#6728 ALCOHOL LOCK FOR PROPHYLAXIS AGAINST PERMCATH CRBSI: IS IT A BOON?
Authors: Varma Prem , Singla Mahak 
Published: June 2023

Abstract

Background and Aims
Introduction: Catheter related blood stream infection (CRBSI) is a dreaded complication in patients with tunneled dialysis catheter and often results in catheter loss. Antibiotic lock, a preventive strategy, is not followed for fear of emergence of resistant strains. We have reported usefulness of 70% alcohol lock in cases of established CRBSI. The present study was aimed to find usefulness of alcohol lock for CRBSI prophylaxis.

Method
This is a single centre observational pilot study. Dialysis patients with Permcath as vascular access were randomised into two groups. Both groups were similar in age, sex and comorbidities. Both groups received routine heparin lock after each dialysis session. Group A in addition also received 70% alcohol lock, once a fortnight. Patients with minimum follow up of 60 days were included in the study. Diagnosis of CRBSI was made by IDSA criteria.

Results
Forty five patients with permcath were divided in Group A (29 patients) and Group B (16 patients). In Group A, 21 and in Group B, 12 patients completed the study. In Group A, during a mean follow up of 2988 catheter days, 5 patients (23%,1/600 days) developed CRBSI (2 pseudomonas, two staphylococcus aureus and 1 Klebsiella) and in group B, 4 patients (33%) with mean follow up of 1611 catheter days (1 in 403 catheter days) developed CRBSI (p = 0.69) (2 klebsiella, two staphylococcus). There was no case of catheter leak, crack or block in either group. Results showed a trend towards better outcome in alcohol lock group though because of small number, statistical significance couldn't be reached.

Conclusion
This pilot study found usefulness of alcohol lock in preventing CRBSI. Alcohol lock is cheap and there was no apparent catheter damage with alcohol over 6 months period. A larger study can confirm our findings.
#6738 ALCOHOL LOCK IN CRBSI: A PANACEA
Authors: Varma Prem , Singla Mahak 
Published: June 2023

Abstract

Background and Aims
CRBSI is a dreaded complication of permcath, with a reported incidence of 1.1 – 5.5 episodes/1000 days. Many of these patients especially those infected with Staphylococcus aureus, Pseudomonas aeruginosa or fungal growth require catheter removal. 70% alcohol possibly breaks the biofilm in the catheter and exposes hidden bacteria to antibiotics. This study was done to find the usefulness of 70% alcohol lock in patients with established CRBSI.

Method
All dialysis patients in our centre with permcath as vascular access were the subjects of the study. All patients were given heparin lock after each dialysis session. CRBSI was diagnosed as per CDC/IDSA criteria. All patients with CRBSI in addition to antibiotics were also given 70% alcohol lock (2 ml in each port) for 3 consecutive days. Outcome of these patients in term of clinical response and need for catheter removal was studied. The catheter outcome of this group was compared with our patients (retrospective controls) who were given only antibiotics and not given alcohol lock.

Results
Over last two years 166 permcaths were placed in our institution. Eighty nine of them continued dialysis in our centre. Their total follow up period was 12028 days (30-720 days). There were 18 episodes of CRBSI in 14 of these patients (1.5 episodes per 1000 catheter days). Three of these patients (16.67%) required catheter removal, rest all improved with antibiotics and alcohol lock. Over a follow up of 150 days (30 -420 days), these patients have been doing well and there has been no episode of catheter leak or break or block. On comparing with our retrospective control of 22 patients with CRBSI, who were not given alcohol lock, 15 (68.18%) required catheter removal (P = 0.001).

Conclusion
The present study though on small numbers, shows that alcohol lock works as a boon in the setting of established CRBSI. It avoids catheter removal in majority of patients.
#6747 ACTIVATION OF GPR120 IMPROVES THE SENESCENCE OF TUBULAR EPITHELIAL CELLS IN SEPTIC ACUTE KIDNEY INJURY
Authors: Yang Letian , Wang Bo , MA Liang , Fu Ping 
Published: June 2023

Abstract

Background and Aims
Acute kidney injury (AKI) is a serious clinical complication that has high morbidity and mortality. Although there have been substantial advances in understanding AKI mechanisms, at present, there are no effective therapies to treat or prevent it.

Method
We had formerly found that TUG891, a GPR120 (a member of the G protein-coupled receptor (GPCR) family) agonist, alleviated tubular damage as well as renal dysfunction in mice with AKI. Nevertheless, the multifunctional effects of FFAR4 in the kidney have not been well described.

Results
In the current research, the GPR120 expression was abnormally reduced in tubular epithelial cells (TECs) of cecal ligation/perforation induced AKI mice, respectively. Systemic and conditional TEC-specific knockout of GPR120 aggravated renal function and pathological damage, whereas GPR120 activation by TUG-891 alleviated the severity of disease in AKI mice induced with cisplatin. Notably, GPR120, as a key determinant, was firstly explored to regulate the cellular senescence in TECs and AKI mice injured kidneys, as represented through the activity of senescence associated β-galactosidase (SA-β-gal), marker protein p21, p53, Lamin B1, phospho-histone H2A.X, phospho-Rb expression, and secretory phenotype IL-6 level. Mechanistically, pharmacological activation and overexpression of FFAR4 reversed the decrease of aging-related SirT3 protein, where GPR120 regulated SirT3 expression to exhibit anti-senescent effect via Gq subunit-mediated CaMKKβ/AMPK signaling in cisplatin-induced mice and tubular epithelial cells.

Conclusion
These results underline the primordial role of renal tubular GPR120 in the cellular senescence through AMPK/SirT3 signaling and define GPR120 as a target for underlying drugs against septic AKI.
#6809 PULSE VERSUS DAILY ORAL CYCLOPHOSPHAMIDE IN ANCA-ASSOCIATED VASCULITIS WITH RENAL INVOLVEMENT: A SINGLE CENTER EXPERIENCE
Authors: Dias Joana Pereira , de Faria Maria Victoria Vaz Da Rocha Paes , Almeida Catarina , Alferes Daniela , Carmo Rute , Santos Maria Clara , Almeida Clara 
Published: June 2023

Abstract

Background and Aims
We aimed to compare the risk of death, relapse and infections requiring hospital admission of ANCA-associated vasculitis (AAV) patients according to the induction of remission scheme used: daily oral (PO) cyclophosphamide or pulse intravenous (IV) cyclophosphamide.

Method
We identified all newly diagnosed AAV patients treated with PO or IV cyclophosphamide between January 1998 and December 2022 admitted to the CHVNGE Nephrology Department. Data were analyzed with SPSS v28® using parametric and non-parametric tests and Kaplan Meyer survival analysis.

Results
We identified 74 cases of de novo vasculitis, 50 of them received PO cyclophosphamide and 24 received IV cyclophosphamide. Median age at presentation was 68,50 ± 16,06 years PO and 68,00 ± 10,41 years IV. Median duration of follow-up was 3,8 years ± 2,98 for both groups, 6,21 years PO and 3,88 years IV. One-year survival was 84% in PO and 91,3% in IV patients; 15 (30%) PO and 5 (20,8%) pulse patients had at least one relapse. Neoplasms occurred in 3 (6%) patients in the PO group and 1 (4,2%) patient in the IV group. The number of patients admitted with one or more infections was 22 (44%) in the PO group and 9 (37,5%) in the IV group. Renal survival was 26 (52%) PO and 15 (62,5%) IV. There was no difference in survival (p = 0,176), renal survival (p = 0,113), risk of relapse (p = 0,283) and infection (p = 0,196) between the two groups.

Conclusion
There was no difference in renal or overall survival, confirming the previous published data. Contrasting with CYCLOPS, our analysis does not confirm an increased risk of relapse in the IV group. One particularly interesting data is that the number of infections in IV route was lower than PO, corroborating the data on lower cumulative doses and therefore lower risk of infection in previous studies. Potential bias of this study is the small sample of patients enrolled in the two groups and the duration of follow up. Despite the reduction in the cumulative dose of cyclophosphamide, we continue to have significant adverse effects, which can also be explained by the dose of corticosteroid previously used, therefore strategies to reduce the toxicity associated with treatment without compromising efficacy are important goals for future research. Treatments need to be optimized and customized according to the severity of the patient's disease and the risk of recurrence.