bluuebunny/crossref_metadata_2025_split huggingface dataset:
#2871 BRAIN NATRIURETIC PEPTIDE LEVEL IN CHRONIC EGYPTIAN HEMODIALYSIS PATIENTS: ITS RELATION TO VENTRICULAR FUNCTION AND VOLUME STATUS
Authors: Sabry Alaa , Elsaeed Rana , Ali Shaahat , Lotfy Zakarial 
Published: June 2023

Abstract

Background and Aims
Volume overload is major problem in chronic hemodialysis patient and BNP level is related to volume status of the patient .

Aims
To assess BNP level in hemodialysis patient before and after HD session and to study its role as a marker for volume overload in hemodialysis patient depending on clinical findings and echocardiography parametershemodialysis.

Method
The study was conducted on 50 patients of Nephrology and hemodialysis unit, Mansoura University Hospital. Our patients were classified according to left ventricular mass index (LVMI) into patients with left ventricular hypertrophy (LVH)(35 patients) and patients without LVH (15 patients). We classified our patients into another two groups according to predialysis BNP level to group with BNP level˃100pg/ml(33 patients) which was associated with cardiac dysfunction and group with BNP level˂100pg/ml (17 patients).

Results
In the present study, the median of pre-dialysis BNP level was 126 pg/ml and the median of post- dialysis BNP was 25 pg/ml, this demonstrate that BNP plasma level decline after the hemodialysis session.
Among The studied patients, the mean of predialysis systolic BP in patients with high BNP level ˃100 pg/ml is (155.65) higher than patients with low BNP level˂100 pg/ml .
The incidence of lower limb edema, congested neck veins and chest crepitations was high in the group with BNP level (˃100 pg/ml) when compared with BNP level (&lt;100 pg/ml). In the present study, according to ROC curve, predialysis BNP level may be a marker for lower limb edema with cutoff point (140.8) pg/ml with (85%) sensitivity and (77%) specificity and shows that the best cutoff point of predialysis BNP level in prediction of neck veins is (40.4) pg/ml with (94%) sensitivity and(28%) specificity and shows that the best cutoff point of predialysis BNP level in prediction of chest crepitation is (42.8) with (82%) sensitivity and (30%) specificity .

Conclusion
In Egyptian hempodialysis patients, there is a negative correlation between BNP predialysis and weight pre and post dialysis.There is significant correlation between BNP postdialysis and systoilc BP predialysis, RVD and COP. There is signifcant correlation between delta BNP and systoilc BP predialysis and ultrafiltration volume.
#2954 DAPAGLIFLOZIN IN IGA NEPHROPATHY: EARLY EXPERIENCE FROM A SINGLE CENTER IN CENTRAL INDIA
Authors: Balwani Manish , Godhani Umesh , Pasari Amit , Bhawane Amol , Tolani Priyanka , Dubey Shubham 
Published: June 2023

Abstract

Background and Aims
IgA nephropathy (IgAN), a common glomerulopathy, may progress to end- stage kidney disease despite use of optimum treatment with immunosuppressants and renin- angiotensin aldosterone system antagonist. Recently, dapagliflozin (DAPA) has been shown to reduce the progression of kidney function decline in IgAN. The beneficial effects in kidney function could be because of reduction in the intraglomerular pressure. To assess the kidney function in terms of change in estimated glomerular filtration rate (eGFR) and urinary protein creatinine ratio (UPCR) with use of DAPA in patients with IgAN.

Method
We retrospectively collected the data of IgAN patients from our electronic database. Demographic, renal function parameters and biopsy findings were collected and compared in patients who received immunosuppression only (group I) and those who received DAPA in addition to immunosuppression (group II).

Results
We identified a total of 150 patients with IgAN from our database. Among these, 59 (39.3%) were managed conservatively whereas 91 (60.7%) were receiving immunosuppressive (steroid+/- mycophenolate mofetil) treatments. Among these, 67 (73.6%) received immunosuppression treatment alone (group I) whereas 24 (26.4%) patients received DAPA along with immunosuppression (group II). The mean age was 34.8±10.7 years and 36.7±9.4 years in groups I and II respectively. Proportion of males was 68.7% and 70.8% in two groups. At baseline, the renal function parameters such as serum creatinine, eGFR and UPCR as well as MEST-C scores were comparable in both the groups (p&gt;0.05 for all three parameters). After a median follow-up of 4.9 months (IQR25-75: 1.6 to 13.4 months) in the group I, the improvement in eGFR (P = .065) and reduction in UPCR (P = .778) did not reach statistical significance. After a median follow-up of 3.9 months (IQR25-75: 1.1 to 12.3 months) in the groups II, there was non-significant improvement in the eGFR but the reduction in the UPCR was significant (median 2.6 [IQR25-75: 13 to 3.8] to 1.9 [IQR25-75: 0.7 to 2.6], P = .041).

Conclusion
Our initial experience in patients of IgA nephropathy suggests that the addition of DAPA to existing immunosuppressive treatment is useful in reducing the UPCR in short-term.
#2968 PROGNOSIS OF CRESCENTIC GLOMERULONEPHRITIS IN ADULTS
Authors: Ciurea Otilia , Marasescu Adela , Petre Nicoleta , Mircescu Gabriel , Capusa Cristina-Stela 
Published: June 2023

Abstract

Background and Aims
Crescentic glomerulonephritis (C-GN) is characterized by severe glomerular inflammation and injury that leads to crescent formation, rapid loss of kidney function and severe prognosis in absence of prompt immunosuppressive therapy. Depending on the histological findings, there are three main types of C-GN: anti-glomerular basement membrane antibody GN (anti-GBM GN), immune complex GN, and pauci-immune GN. This study aims to assess whether the kidney and vital outcome are different among the three histologic types of crescentic GN.

Method
This unicentric, retrospective study included seventy-six subjects [50% males, 55 (95%CI 52 to 60) years; eGFR 9.6 (95%CI 7.8-13.7) mL/min and proteinuria 1.9 (95%CI 1.5 to 2.6) g/g] that had undergone a kidney biopsy between 1st January 2008 and 31st December 2017 and had a histologic diagnosis of crescentic glomerulonephritis (crescent formation in more than 50% of the glomeruli). The subjects were followed for a mean of 47.6 (95%CI 33.5 to 61.6) months. Primary endpoints were the need of renal replacement therapy initiation (RRT) and all cause death. Kaplan-Meier method was used to evaluate kidney and patients’ survival and variables related to kidney and vital outcome were evaluated by multivariate Cox proportional hazard modelling. Patients were stratified in three groups according to the type of C-GN: pauci-immune GN (n=58 pts.), anti-GBM GN (n=9 pts.) and immune-complex GN (n=9 pts.).

Results
No demographic differences were found among the three groups. Except for a higher frequency of solid neoplasia in immune-complex GN group (2.7% vs 1.3% in pauci-immune GN vs. 0% in anti-GBM GN; P = .001), no other differences regarding the clinical or laboratory data were identified. Immunosuppressive treatment was very frequent, in more than 80% of subjects, regardless of the group, corticotherapy and cyclophosphamide being the most common immunosuppressive agents. During the follow-up period, 54% of subjects needed RRT and 19.2% died. The frequency of RRT initiation or death was not different among the three groups (P = .9 and P = .4). The univariate time-dependent analysis showed similar survival times among the analysed groups (log rank =0.9) (Figure 1). In the multivariate analysis, the only independent predictor of RRT was lower baseline eGFR (OR 0.49 (95%CI 0.31 to 0.78), P = .03). Time to death did not differ among groups (log rank P = .4) (Figure 2). The only independent predictor of death was higher Charlson comorbidity score (OR 56.8 (95%CI 6.3 to 512), p&lt;0.001) in the Cox analysis.

Conclusion
In this cohort of subjects with crescentic glomerulonephritis, although limited by the low number of subjects, the kidney and vital prognosis seem to be similar indifferent of the histologic type of crescentic glomerulonephritis.
#3055 ASSOCIATION OF MORTALITY WITH INTRADIALYTIC EXERCISE IN HEMODIALYSIS PATIENTS
Authors: Abdullaev Sherzod , Igamberdieva Ranokhon 
Published: June 2023

Abstract

Background and Aims
Patients with hemodialysis (HD) have an increased risk of mortality, which can be minimized by physical activity (PA). Intradialytic exercises (IDE) are very convenient, potentially increasing adherence to PA and allowing for a sedentary lifestyle. Thus, the purpose of this study was to analyze the association of IDE with mortality in patients with HD.

Method
A single center, prospective study in adult HD patients eligible for IDE (cycling 3 times a week) was performed. After 1 year of IDE introduction, patients were followed up for up to 3 years. Three groups were created based on the impact of IDE (minutes of exercise per week): no exercise (patients who refused IDE); low load (&lt;87 min/week); high load (≥87 min/week). Kaplan-Meier models (unadjusted analysis) and Cox proportional hazard models (adjusted for age, dialysis experience, vascular access, comorbidity index, CVD, muscle tissue, overhydration, and hospitalizations) were used with a non-exercise group as a reference. In addition, a sub-analysis was conducted, limited to IDE participants, with exposure as a continuous variable.

Results
106 patients (no exercise: 58; low exercise: 26; high exercise: 22) were followed for an average of 24.5 months. Uncorrected mortality differed between the three groups: (no exercise: 24.1%; low load: 23.0%; high load: 9.0%; p&lt;0.01). In the adjusted analysis, the high load group had a lower risk of mortality than the no exercise group (RR = 0.42, 95% CI 0.23–0.76, p&lt;0.05), while in the low load group this was not observed (RR). = 1.07, 95% CI 0.66–1.52, p = 0.568). In addition, mortality risk decreased for every 55 minutes of exercise per week in unadjusted (HR = 0.46, 95% CI 0.29–0.76, p = 0.01) and adjusted analyzes (HR = 0.54, 95% CI 0.32–0.91, p&lt;0.05).

Conclusion
Our findings show that IDE is associated with a reduced risk of mortality in HD patients, but a significant amount of exercise is required. Thus, patients who achieve low load doses may require non-clinical approaches to PA in addition to IDE. These findings complement those of earlier studies and highlight the need for a tailored approach to the exercise.
#3144 KIDNEY TRANSPLANT-RELATED KNOWLEDGE AMONG SOUTH ASIAN COMPARED TO WHITE CANADIAN PATIENTS
Authors: Jolly Simran , Balaji Shilpa , Hamid Marzan , Patel Tasneem , Lodge Denzel , Waterman Amy , Mucsi Istvan 
Published: June 2023

Abstract

Background and Aims
Kidney transplant (KT) is the best treatment for many patients with kidney failure. However, patients from racialized communities are less likely to receive KT. Gaps in transplant-related knowledge may be one of the potential reasons for the observed inequities in accessing KT. Here we compare patient characteristics and KT-related knowledge between South Asian (SA) versus white Canadians with kidney failure using the “Knowledge Assessment of Renal Transplantation” (KART) questionnaire.

Method
Secondary analysis of data from a cross-sectional convenience sample of white and SA adults with kidney failure. Sociodemographic data, self-reported information about racialized status and KART score were collected through electronic data capture. The association between racialized status and participant demographics were assessed using ANOVA, Kruskal–Wallis test or chi squared test, as appropriate. The independent association between racialized status and KART scores was assessed by multivariable adjusted linear or multinomial logistic regression, with adjustment for immigration status, age, marital status, education, gender, Ontario Marginalization Index material deprivation quintile, Charlson Comorbidity Index and ethnicity.

Results
Among 578 participants (mean [SD] age: 57 [14] years, 64% male), 43% were white and 16% were SA. 84% vs 27% of SA vs white participants were immigrants. The Charlson Comorbidity Index score was &gt;=4 for of 31[40%] SA vs 105[51%] white participants (p&lt;0.001). The median (interquartile range) KART score of white vs SA participants was 17[6] vs 14[7] (p&lt;0.001). In a univariable linear regression model the KART score was significantly associated with SA status (B: -3.27 ([95% CI]: -4.76, -1.77, p&lt;0.001). This association remained significant after adjustment for potential confounding (B: -3.36 ([95% CI]: -5.05, -1.67, p&lt;0.001) (Table 1). 26% of SA vs. 41% of white participants scored in the highest tertile for KART score (p&lt;0.001) (Fig. 1). The relative risk ratio to be in the lowest KART tertile was 3.09 [95% CI: 1.49, 6.43] for SA compared to white participants in our final, adjusted multinomial model.

Conclusion
SA participants with kidney failure are commonly immigrants who have poorer KT-related knowledge compared to white participants. Our findings indicate the need to develop culturally relevant KT related patient education for South Asian Canadian communities.
#3186 INVESTIGATING TREM2 MACROPHAGES IN CHRONIC KIDNEY DISEASE
Authors: Trivioli Giorgio , Richoz Nathan , Subramanian Ayshwarya , Vernon Katherine , Trotter Patrick , Zhou Yiming , Shaw Jillian , Greka Anna , Clatworthy Menna 
Published: June 2023

Abstract

Background and Aims
Kidney macrophages have been implicated in interstitial fibrosis and inflammation in various forms of chronic kidney disease (CKD), but subsets with different markers and putative functions have been identified through the application of single cell technologies. A recent study from the Greka Lab revealed distinct macrophage populations in the human kidney bearing lymphatic endothelium hyaluronan receptor-1 (LYVE1) and triggering receptor expressed on myeloid cells-2 (TREM2). Notably, TREM2+ macrophages, which have been implicated in limiting metabolic toxicity in chronic diseases, were enriched in diabetic mouse kidneys and human kidneys from obese individuals (Subramanian et al. BioRvix 2021). To support these findings, we aimed at characterizing LYVE1+ and TREM2+ macrophages in kidney samples taken from subjects with CKD-associated co-morbidities, including hypertension, diabetes mellitus and obesity.

Method
We performed immunofluorescence microscopy of samples collected from the cortex of kidneys donated for transplantation but deemed unsuitable for implantation. Each sample was stained with anti-CD163, -LYVE1, and -TREM2 antibodies, plus Hoechst to stain nuclei. Two identically sized fields of view were imaged in each sample. Macrophages were identified based on CD163 expression and the expression of the LYVE1 and TREM2 in macrophages delineated. Macrophage subsets were compared according to age, BMI, eGFR and the presence of hypertension, obesity and diabetes.

Results
of 49 donors assessed, 19 (39%) were “healthy”, six (12%) “hypertensive” without obesity or diabetes, 16 (33%) “obese” with no evidence of diabetes, and 8 (16%) “diabetic” (all had type 2 diabetes and 6/8 were also obese) The median eGFR at donation was 95 mL/min/1.73 m2 and none of the donors had a history of CKD. Gender, median age and cause of death were not significantly different as well (Table 1). “Healthy”, “hypertensive” and “obese” donors had similar numbers of total macrophages, LYVE1+ and TREM2+ macrophages per region of interest. In contrast, “diabetic” subjects had a tendency towards a higher macrophage count (P = .10) and significantly higher numbers of LYVE1+ (P = .02) and TREM2+ macrophages (P = .002), compared to “healthy” ones (see Figure 1). The median LYVE1+/CD163+ ratio was 0.69 and did not differ substantially between the groups (P = .18), while the TREM2+/CD163+ ratio was higher among “diabetic” compared to “healthy” donors (0.43 vs 0.34, P = .06).

Conclusion
Diabetes is associated with an increase in kidney macrophages, particularly in those expressing TREM2. Further investigation is required to determine the role these cells may play in CKD progression.
#3194 THE IMPACT OF COVID-19 PANDEMIC ON PSYCHOLOGICAL AND SOCIOECONOMIC WELL-BEING OF HEMODIALYSIS PATIENTS: AN ANALYTICAL CROSS-SECTIONAL STUDY
Authors: Pasamante Jane Angele 
Published: June 2023

Abstract

Background and Aims
This study aimed to determine and assess the prevalence of depression, anxiety, and stress of the COVID-19 pandemic among outpatient hemodialysis patients and the relationship to sociodemographic and clinical factors, and to assess the economic impact of the COVID-19 pandemic.

Method
In this analytical, cross-sectional study, purposive sampling was used and a total of 69 subjects were enrolled. Sociodemographic data were collected using researcher-administered questionnaires and recent laboratory parameters were collected by reviewing medical records. Patients completed 4 sets of questionnaires including Patient Health Questionnaire 9 (PHQ-9), Generalized Anxiety Disorder 7 (GAD-7), Perceived Stress Scale 4 (PSS-4), and CoRonavIruS Health Impact Survey (CRISIS). Quantitative variables were presented using mean and standard deviation, median, and Interquartile Range (IQR). Qualitative variables were presented using frequency and percentages. Pearson's correlation was used to determine the relationship of laboratory parameters with anxiety, depression, and stress scores. The Chi-Square test was used to determine the relationship of sociodemographic profile with anxiety, depression, and stress scores. P values &lt;0.05 were considered statistically significant.

Results
Our study showed that the prevalence of anxiety, depression, and stress were 39%, 16%, and 51% respectively. There was an association between age and stress level, with older subjects reporting higher stress scores. Hemoglobin levels had a weak negative correlation with anxiety, depression and stress. The distribution of anxiety scores was significantly different between patients with normal phosphorus levels and elevated phosphorus levels. Financial worries were less of a concern since almost two-thirds of our subjects were retired and unemployed.

Conclusion
Hemodialysis patients belong to high-risk populations with a high prevalence of psychological distress hence they are subjected to more severe psychological stress, depression, and anxiety. Our findings suggest that psychological intervention may be necessary for some patients during this pandemic.
#3314 DIURETIC AND RENOPROTECTIVE EFFECTS OF GOREISAN IN A RAT MODEL OF NEPHROTIC SYNDROME
Authors: Yamatani Satoshi , Fujii Hideki , Kono Keiji , Shimizu Mao , Hirabayashi Ken , Sakamoto Kazuo , Watanabe Kentaro , Goto Shunsuke , Nishi Shinichi 
Published: June 2023

Abstract

Background and Aims
Goreisan, a traditional Chinese medicine composed of five herbs, is commonly used for the purpose of control of edema and gastrointestinal symptoms. However, the detailed mechanisms have not been fully elucidated. In clinical settings, nephrotic syndrome often causes edema, mainly due to hypoalbuminemia and sodium retention. Thus, we investigated the effects of Goreisan on the kidney using a rat model of nephrotic syndrome.

Method
A model of nephrotic syndrome was created by a right nephrectomy and subsequent administration of adriamycin using Sprague Dawley rats. Nephrotic rats were randomly divided into three groups at 10 weeks of age as follows; vehicle (control), Goreisan 0.5 g/kg (GL), and Goreisan 1.0 g/kg (GH) groups. Goreisan was administered once a day for 4 weeks. At 14 weeks of age, the rats were sacrificed for the evaluation of blood, urine, mRNA expressions, and kidney histopathology.

Results
Urine volume was significantly increased in the GL and GH groups than in the control group (Δurine volume: control; −1.25±2.48 mL, GL group; 9.83±4.16 mL, GH group; 10.00±2.62 mL). The GH group showed significantly lower urine osmotic pressure compared to the control group. There were no significant differences in urinary sodium excretion and serum arginine-vasopressin levels among the three groups. Subsequently, we assessed the expression of aquaporin (AQP) in kidney tissue using real-time PCR and immunohistochemical staining. The mRNA expression of AQP1, AQP2, AQP3, and AQP4 did not differ among the three groups. However, immunohistochemical staining showed that the localization of AQP2 at the apical plasma membrane of the collecting ducts was decreased by treatment with Goreisan. Furthermore, deterioration of kidney function was prevented by treatment with Goreisan. Histological analysis revealed that glomerular and tubulointerstitial damages were ameliorated in the GL and GH groups compared to the control group (glomerular damage score: control; 2.19±0.05, GL group; 1.71±0.05, GH group; 1.10±0.05, tubulointerstitial damage score: control; 2.55±0.09, GL group; 2.28±0.10, GH group; 2.12±0.10). In addition, urinary 8-OHdG, which is an oxidative stress marker, was significantly lower in the GL and GH groups than in the control group.

Conclusion
Our results suggested that Goreisan may have diuretic and renoprotective effects by suppressing the trafficking of AQP2 to the apical plasma membrane of the collecting ducts and possibly reducing systemic oxidative stress.
#3419 LINARIN PROTECTS THE KIDNEY FROM ISCHEMIA-REPERFUSION INJURY AND SUPPRESSES ETS2 INDUCED ACUTE KIDNEY INJURY
Authors: Yang Chengyu 
Published: June 2023

Abstract

Background and Aims
Ischemia/reperfusion injury (IRI), a participant in acute kidney injury (AKI), can occur as a series of pathological processes such as inflammation. Linarin (LIN) has been widely used for different diseases. To confirm the anti-inflammatory value and relevant mechanism of LIN during IRI, in vivo and vitro model were established.

Method
LIN or isovolumetric DMSO was given, and histologic analysis, quantitative real-time reverse transcription polymerase chain reaction (qRT-PCR), serum creatinine (SCr) testing and blood urea nitrogen (BUN) were used to evaluate kidney injury. Microarray analysis, protein-protein interaction (PPI) analysis and molecular docking were used to identify target protein of LIN.

Results
At first, we find that LIN could inhabit the kidney injury in vivo IRI model and decrease the expression of IL-12 p40 in vitro IRI model. To explore the mechanism of LIN, we collected raw data from public microarray database and identified E26 oncogene homolog 2 (ETS2) as a target protein of LIN according to microarray analysis, PPI and molecular docking. The contact area is highly conserved and located on a protein-protein interaction domain of ETS2 which indicated that LIN may alter the interaction with synergistical protein in the regulation of IL-12 p40 expression.

Conclusion
Our study demonstrated the anti-inflammatory effect of LIN during IRI-triggered AKI, broadening the medicinal value of LIN and the therapeutic options for IRI-triggered AKI.