bluuebunny/crossref_metadata_2025_split huggingface dataset:
#2665 EFFECT OF RENAL DENERVATION ON THE PLASMA LEPTIN CONCENTRATION IN PATIENTS WITH RESISTANT HYPERTENSION
Authors: Adamczak Marcin , Czerwienska Beata , Lelek Michal , Gojowy Damian , Mizia-Stec Katarzyna , Wiecek Andrzej Jan 
Published: June 2023

Abstract

Background and Aims
Leptin is mainly produced by adipose tissue and has hypertensinogenic properties. In patients with arterial hypertension, plasma concentration of leptin is higher than in healthy subjects. Percutaneous ablation of the sympathetic nervous system fibers located in the wall of the renal arteries by radio frequency waves (renal denervation - RDN), was introduced as a method of invasive treatment of resistant arterial hypertension. The aim of this single center, interventional, clinical study was to assess the effect of RDN on the plasma leptin concentration in patients with resistant arterial hypertension.

Method
Eighteen patients (9 women, 9 men) aged 53.2±6.5 years with resistant hypertension who underwent RDN using Simplicity catheters (Medtronic, Inc., Northridge, CA) were enrolled in the study. Plasma leptin concentration was determined using the Human Leptin RIA HL-81K (Linco Research, Inc., Missouri, USA) before RDN denervation and 6 months after RDN. Additionally, patients were divided into two subgroups: responders (systolic and diastolic blood pressure - BP reduction 6 months after RDN &gt;25 mmHg and &gt;12 mmHg, respectively; n=9) and low responders (systolic and diastolic BP reduction 6 months after RDN ≤25 mmHg and ≤12 mmHg, respectively; n=9).

Results
Systolic and diastolic BP was significantly reduced after RDN (196.6±28.2 and 162.9±15.6; p&lt;0.001 and 117.9±26.4 and 90.7±8.6 mmHg; p&lt;0.001, respectively). Body mass index (BMI) before RDN and 6 months after RDN was similar (31.0±4.4 and 31.3±4.4 kg/m2; P = .8, respectively). Mean plasma leptin concentration before RDN and 6 months after RDN did not change significantly in the entire studied group (27.2±14.3 and 24.6±13.1 [ng/mL], NS), as well as both in responders (29.9±14.4 and 28.2±12.9 [ng/mL, NS) and low-responders subgroups (24.4±14.7 and 21.0±12.9 [ng/mL], NS), respectively.

Conclusion
Renal denervation is effective in the treatment of patients with resistant hypertension, however this effect is not mediated by the influence on plasma leptin concentration.
#2708 THE EFFECT OF PERCEIVED TEMPERATURE ON THE MORTALITY IN CHRONIC KIDNEY DISEASE PATIENTS
Authors: Lim Chun Soo , Lee Jeonghwan , Lee Jung Pyo 
Published: June 2023

Abstract

Background and Aims
With the global warming, the interest in health risks from the high temperature exposure is growing. The perceived temperature is an equivalent temperature based on a complete heat budget model of the human body. We aimed to analyse the effect of perceived temperature on the overall mortality among patients with chronic kidney disease.

Method
A total of 32,870 patients with chronic kidney disease living in Seoul metropolitan region were recruited in a retrospective cohort (2001-2018). The perceived temperature during summer season (from July to September, at each year) was calculated using various climate factors including air temperature nearby automated weather station, dew point temperature, wind velocity, height of anemometer above ground, and total cloud amount. We assessed the association of perceived temperature using inverse distance weighting on mortality in patients with chronic kidney disease in the Cox proportional hazard model that was adjusted for sex, age, body mass index, estimated glomerular filtration rate, hypertension, and diabetes mellitus status.

Results
During the 6.14±3.96 years, 3,863 deaths (13%) were observed. We confirmed the significant effects of perceived temperature (average perceived temperature: hazard ratio [HR] 1.21, 95% confidence interval [CI] 1.18-1.23; minimum perceived temperature: HR 1.02, 95% CI 1.00-1.05; maximum perceived temperature: 1.20, 95% CI 1.18-1.22) on mortality among patients with chronic kidney disease in univariable analysis. In multivariable analysis, average perceived temperature (HR 1.22, 95% CI 1.19-1.25) and maximum perceived temperature (HR 1.20, 95% CI 1.17-1.23) showed increased risk for overall mortality among patients with chronic kidney disease.

Conclusion
Long-term exposure to high perceived temperature during summer season increased the risk of mortality among patients with chronic kidney disease.
#2947 COMPARISON OF TRACE ELEMENT CONCENTRATIONS IN PREDIALYSIS, HEMODIALYSIS AND PERITONEAL DIALYSIS PATIENTS
Authors: Koz Suleyman , Oguz Esin , Sayın Cagla 
Published: June 2023

Abstract

Background and Aims
Regulation of many trace elements (TE) is critically dependent on kidney functions. Dialysis modality, duration of dialysis, equipment, purity of water and nutrition also impacts TE balance. There are inadequate data on comparison of TE in patients with different stages of kidney disease.
We aimed to compare TE levels in a restricted geographical area across a wide range of glomerular filtration rate (GFR) including end stage kidney disease. We assumed that this kind of design might be beneficial for understanding TE balance and impact of dialysis.

Method
Hemodialysis (HD), peritoneal dialysis (PD) and chronic kidney disease (CKD) patients with reduced GFR were included in this cross-sectional study. A sample of plasma was analyzed by inductively coupled plasma mass spectrometry (ICP-MS) (Thermo Scientific™ iCAP Q ICP-MS, USA). Sensitivity was on the order of ppb (µg/L). A control group (CG) with glomerular filtration rate ≥ 90 ml/min were used for comparison of plasma levels of TE.

Results
Results of TE are presented in the Table 1. Significant number of both patients and controls lack a valid TE measurement because of the concentrations below limit of the detection (LoD). Copper, in CKD patients, is negatively correlated with hospitalization within the last six months (r= - 0,315, p= 0.005).

Conclusion
Our data suggest that TE levels except Zn and Mn deviate from that of CG in a statistically significant manner in renal patients. Existing data on TE in renal patients are inconsistent and there is some confusion. Similarly, our results are consistent with some data and conflicting with others. In future studies, this confusion could be eliminated by evaluating each trace element separately and minimizing methodological problems.
(This study is realized with support of Cumhuriyet University CUBAP)
#3008 SERENDIPITY OF SGLT2 INHIBITION – DIABETIC AND NON DIABETIC CKD
Authors: Godanci-Kelmendi Vjollca , Piraj Mimoza Ramadani , Ymeri Fatime , Konjufca Shega 
Published: June 2023

Abstract

Background and Aims
Ever since their therapeutic introduction, SGLT2 inhibition class of medicaments did impress physicians of related fields, nephrologists, internal medicine doctors, endocrinologists etc. Their natriuretic and glucoretic effects besides lowering the plasma glucose does produce a important effect on lowering intraglomerular pressure, this became an added value and a strong point to recommend these drugs on all CKD population irregardles the main cause of the disease.

Method
Observational retrospective study on 125 patients, three groups: G1 50 pt with diabetic nephropathy treated with empagliflozine vs control group G2 50 pt with diabetic nephropathy treated with other glucose lowering agents, and G3 25 nondiabetic pt with CKD and proteinuria treated with SGLT2i. Inclusion criteria was proteinuria and T2D for G1 and G2, and patients with proteinuria and CKD for G3. Patients with T1D and eGFR &gt; 20 where excluded. Intervention - the SGLT2i drugs where started, median follow up 18 months. We followed on four periods creatinine levels, 24 hour proteinuria in g/24 h, HbA1c, cholesterol level, BMI.

Results
In our study the G1 showed a decrease in proteinuria average – 811 mg/24 h, serum creatinine showed increase on the first three months and it did get back to baseline afterwards, the eGFR increased + 15.44 ml/min; HbA1c decreased with -1.41%, levels, the reduction BMI – 0.9 kg/m2 and LDL cholesterol -1.11 mmol/l. G2 results decrease on 24 hour proteinuria with – 121 mg/24 hours, a drop on eGFR with - 3.3 ml/min, a drop on HbA1C – 1.45 %, - 0.3 mmol/l decrease on cholesterol level and average increase on BMI with + 0.8 kg/m2; G3 results on patients without T2D but with CKD different causes and proteinuria where: - 690 decrease proteinuria, + 14.4 increase on eGFR, HbA1C NA, we did have 2 cases that experienced hypoglycemic symptoms, both of them where improved with dose reduction, a – 0.9 decrease on cholesterol level and 0.3 kg/m2 was registered on our G3.

Conclusion
In our observation the 18 month follow up showed remarkable improve in kidney function tests, other benefits were noted such as optimal glycemic control, total body cholesterol lowering and a significant reduce of body weight expressed on BMI. Treatment with SGLT2i drugs does present a safe and efficient treatment modality for diabetic nephropathy and for all other CKD with proteinuria.
#3173 INCIDENCE AND RISK FACTORS OF SUDDEN CARDIAC DEATH IN END STAGE RENAL DISEASE PATIENTS UNDERGOING HAEMODIALYSIS: A RETROSPECTIVE STUDY
Authors: Khan Muhammad Tassaduq 
Published: June 2023

Abstract

Background & aims:
End Stage Renal Disease (ESRD) patients undergoing haemodialysis are prone to suffer from Sudden Cardiac Death (SCD). The present study was sought to evaluate the incidence and risk factors of SCD in ESRD patients on haemodialysis in Pakistani population.

Methods
The study recruited 202 eligible ESRD patients undergoing haemodialysis. Baseline characteristics of the study participants with and without Sudden Cardiac Arrest (SCA) were recorded using self-reported questionnaires. SCA and SCD events were identified by reviewing medical records and death certificates.

Results
Out of 202 patients, 37 (18.3%) suffered from the episode of SCA, 18 (48.6%) of which succumbed to death. ESRD patients who endured SCA were statistically older in comparison with their non-SCA counterparts (58.2 ± 11.4 vs. 52.3 ± 9.3 years, P&lt;0.001). The HTN (67.6% versus 64.8%, P = 0.001), DM (62.2% versus 59.4%, P = 0.004), CAD (45.9% versus 41.8%, P = 0.001) and Congestive Heart Failure (CHF) (35.1% versus 34.5%, P = 0.002) were significantly prevalent in ESRD cohort with SCA in contrast to non-SCA. We also found LVH (62.2% versus 48.5%, P&lt;0.001), ventricular tachycardia (51.4% versus 30.9%, P&lt;0.001) and ventricular fibrillation/flutter (56.8% versus 25.5%, P&lt;0.001) to be statistically higher in ESRD patients on haemodialysis with SCA event. Through multivariate logistic regression analysis, we evidenced hypokalemia (OR = 1.247, CI 1.214 – 1.278, P&lt;0.001); CAD (OR 1.886, CI 1.469 – 2.342, P&lt;0.001); LVH (OR 1.861, CI 1.392 – 1.953, P&lt;0.001); ventricular tachycardia (OR = 1.253, CI 1.012 – 1.386, P&lt;0.001); and ventricular fibrillation/flutter (OR = 0.547, CI 0.518 – 0.773, P&lt;0.001) to be significantly and independently associated with SCD in ESRD patients on haemodialysis.

Conclusion
The prevalence of SCD among ESRD patients on haemodialysis with SCA episode is very high. CAD and ventricular tachyarrhythmias were statistically significant among ESRD patients on haemodialysis with SCA in comparison with non-SCA and were independently associated with the prevalence of in-patient SCD among ESRD patients with SCA on haemodialysis.
#3276 LUPUS NEPHRITIS: THE INTERPLAY BETWEEN SENESCENT B AND NAÏVE T LYMPHOCYTES
Authors: Moysidou Eleni , Lioulios Georgios , Christodoulou Michalis , Xochelli Aliki , Nikolaidou Vasiliki , Stai Stamatia , Fylaktou Asimina , Papagianni Aikaterini , Stangou Maria 
Published: June 2023

Abstract

Background and Aims
Systemic Lupus Erythematosus (SLE) is characterized by a shift to senescent B cells, namely, switched memory (SM) (CD19+IgD-CD27+) and exhausted-double negative (DN) (CD19+IgD-CD27-) subtypes. The aim of this study was to evaluate the impact of T cell immunity in the distinct B cell - senescent pattern of SLE.

Method
A wide range of senescent and exhaustion related lymphocyte surface molecules, including CD45RA, CCR7, CD31, CD28, CD57, on T cells and CD27 and IgD on B cells, was analyzed by flowcytometry and distinct naïve, active and senescent B and T lymphocyte subtypes were determined in 31 patients with inactive Lupus Nephritis (LP).

Results
Comparison of SM and DN B cells with T cell subpopulations revealed significant correlation of naïve and “unexperienced” CD4 and CD8 compartment with SM and DN B cells. Indeed, the correlation appeared even stronger regarding SM B cells and Recent thymic emigrants (RTE) CD4CD31+ (r=0.575), CD4+ Central Memory (CM) (CD45RA-CCR7+) (r=0.546), CD4CD45RA+CD28+(r=0.556), CD4CD28+CD57- (r=0.621), CD4CD45+CD57- (r=0.544), CD4CD45-CD57- (r=0.65), CD8CD28+CD57- (r=0.596), CD8CD45-CD57- (r=0.556) while weak yet significant was their correlation with CD4 Naïve (CD45RA+CCR7+) (r=0.432), CD8CM(CD45RA-CCR7+) (r=0.474), RTE CD8CD31+ (r=0.461), CD8CD28+CD57+ (r=0.442). Less apparent was this phenomenon between DN B cells and CD4 CM (CD45RA-CCR7+) (r=0.381), CD4CD45RA+CD28+ (r=0.504), RTE CD4CD31+ (r=0.587), CD4CD28+CD57- (r=0.487), CD4CD28+CD57+ (r=0.491), CD4CD45+CD57- (r=0.419), CD4CD45-CD57- (r=0.397), CD8 Naive(CD45RA+CCR7+) (r=0.432), RTE CD8CD31+ (r=0.366), CD8CD28+CD57- (r=0.363), CD8CD28+CD57+ (r=0.483), CD8CD45-CD57- (r=0.444), CD8CD45-CD57+ (r=0.384).

Conclusion
The predominant shift to senescent/exhausted B lymphocytes in SLE and LN may have a direct impact on naïve CD4 and CD8 T lymphocyte subpopulations.
#3429 HIGHER INPATIENT COSTS FOR HEMODIALYSIS PATIENTS HOSPITALIZED FOR CEREBROVASCULAR DISEASE
Authors: Kuroki Aki , Shimura Satoru 
Published: June 2023

Abstract

Background and Aims
Dialysis patients often have comorbidities that result in frequent hospitalizations. Several studies showed that inpatient costs contributed largely to the medical costs of dialysis patients. In this study, to assess the impact of comorbidities on inpatient costs in dialysis patients, we examined the association between reasons for admission and the inpatient costs using electronic medical records.

Method
This was a single-center, retrospective, observational study of dialysis patients admitted to Yokohama General Hospital (300 beds) between April 2020 and March 2022. Information on patient demographics, cause of end-stage kidney disease (ESKD), dialysis duration, number of complications, and reasons for admission were collected from electronic medical records. Inpatient costs were calculated from claims data and analyzed based on patient characteristics and reasons for admission. Inpatient costs for dialysis patients were compared with those for all hospitalized patients. Data were analyzed using the Kruskal-Wallis test.

Results
During the observation period, 172160 patients were admitted to the hospital, of which 169 were maintenance dialysis patients. One hundred and twenty-three of them were male, with a mean age of 73.0 years. Diabetic kidney disease was the most common cause of ESKD (n=128), followed by chronic glomerulonephritis (n=21), nephrosclerosis (n=19), and autosomal polycystic kidney disease (n=1). The median time on dialysis was 5 years. Seventy-three patients were admitted for peripheral vascular disease, 24 for cardiovascular disease, 24 for fractures, 16 for gastrointestinal disease, 13 for cerebrovascular disease, and remainder for other conditions. Inpatient costs ranged from €764 to €79743, with a mean of €14884, and a median of €9002. Inpatient costs did not differ significantly by age, sex, time on dialysis, number of complications, or cause of ESKD. There were significant differences in inpatient costs according to the reason for admission. Patients hospitalized for cerebrovascular disease had significantly higher inpatient costs with a mean of €17733 and a median of €14623 (P = .049). During the study period, dialysis patients accounted for 0.098% of all inpatient admissions, and their medical costs were 3% of the hospital's total inpatient medical costs.

Conclusion
Considering the number of dialysis patients as a percentage of all inpatients during the study period, it was clear that dialysis patients had a high cost burden. Among dialysis patients, hospitalization for cerebrovascular disease was associated with significantly higher costs.
#3493 INCIDENCE, PREVALENCE, DEMOGRAPHIC PROFILE, AND CLINICAL OUTCOMES OF PERITONEAL DIALYSIS IN A TERTIARY MEDICAL CENTER IN THE PHILIPPINES
Authors: Cruz Keth Ivory Dela , Arsolon Clarissa 
Published: June 2023

Abstract

Background and Aims
Chronic Kidney Disease (CKD) has emerged as a global public health burden. As one of the treatment options for CKD-5, peritoneal dialysis is underutilized, accounting for only 11% of the global distribution of renal replacement therapy (RRT). In the Philippines, PD accounts for only 4.2% [1] of all dialysis. This is perplexing because PD has several advantages over hemodialysis including better survival in the first few years of RRT, better survival of PD to HD than HD to PD [2], more cost-effective [3], can be done at home without sophisticated equipment, and feasible in remote areas. This study aims to characterize the incidence, prevalence, demographic profile, and clinical outcomes of the PD patients in our center to uncover strengths, weaknesses, and roadblocks for a stronger “PD First” program in the Philippines.

Method
Descriptive retrospective chart review of 146 PD patients of the Southern Philippines Medical Center from January 2018 to September 2022.

Results
There were a total of 146 adult patients enrolled to the PhilHealth PD Z-package from January 2018 to September 2022. Majority of the patients were aged 50-59 years old (20%), followed by 40-49 years old (19%), and 60-69 years old (19%), mostly male (57%). Predominant etiology of CKD-5 was Chronic Glomerulonephritis (41%), followed by Diabetic Nephropathy (30%), and Hypertensive Nephrosclerosis (19%). Incidence rate of PD was 44%, 22%, and 41% for 2019, 2020, and 2021 respectively. The prevalence rate of PD was 64%, 56%, and 59% for 2019, 2020, and 2021 respectively. The PD peritonitis rate was 1.25, 0.4, 0.24, and 0.3 episodes per patient year in 2018, 2019, 2020, and 2021 respectively. Out of the 146 PD patients, 41 (28%) are still on active PD, 1 (0.07%) underwent Kidney Transplantation, 38 (26%) had PD Technique Failure from peritonitis and catheter malfunction, and 66 (46%) expired due to death at home, sepsis, and acute coronary syndrome. Among those who expired, 22 (33%) were PD First and 44 (67%) were shifted from HD. There was a significant difference in the primary outcomes between those who were PD First and shifted from HD, with a p-value of 0.048.

Conclusion
PD First is infrequently practiced in our center. There is a significant difference in the number of those who were PD First, and those who were shifted from HD. There is a higher rate of mortality among those who were shifted from HD to PD compared to those who were PD First. PD-peritonitis is the number one cause of PD Technique Failure followed by issues with the PD Catheter. To improve the mortality rate of our CKD-5 patients, it is recommended to do PD First, rather than HD to PD, while awaiting transplant.
#3642 SERUM APELIN AND RENAL PROGNOSIS IN PATIENTS WITH NON-DIALYSIS DEPENDENT CHRONIC KIDNEY DISEASE
Authors: Kani Nao , Hirata Michinori , Makino Shuzo , Naka Tomoya , Okamoto Kazuhiro , Miyakawa Hiromitsu , Uwatoko Ryuta , Bessho Saki , Hashimoto Nobuhiro , Iio Rei , Ueda Yoshiyasu , Hayashi Terumasa 
Published: June 2023

Abstract

Background and Aims
The apelin/APJ system is a novel pleiotropic system with an essential role in renal and cardiovascular physiology and disease. A role for the apelin/APJ system in diverse pathological states, including disorders of sodium and water balance, hypertension, heart failure, pre-eclampsia, acute kidney injury, sepsis and diabetic nephropathy, has recently been reported. Especially, the impact of apelin/APJ system on cardiovascular system has been attracting attention, but scarce data is available in chronic kidney disease (CKD).

Method
We measured serum apelin-36 by ELISA in 411 outpatients with non-dialysis dependent (NDD) CKD and analyzed factors associated with serum apelin. Furthermore, we examined the association of serum apelin with renal outcome (renal replacement therapy, RRT) using multivariate Cox proportional hazards model.

Results
Median age and eGFR were 71 years and 21.7 ml/min/1.73 m2, respectively and the prevalence of male gender and diabetes was 26.8% and 50.8%, respectively. Median serum apelin was 0.81pg/ml. There was no significant difference in serum apelin level between male and female patients, or those with and without diabetes. Moreover, serum apelin level had no significant association with age and eGFR; however, there was a significant relationship between serum apelin and brain natriutetic peptide. During the follow-up period of 38 months, 126 patients started RRT. eGFR and age were associated with the time to RRT induction. Serum apelin was not associated with renal outcome (HR, 1.05; 95%CI, 0.64-1.71; P,0.86); however, this association was interacted by diabetes and gender (P for interaction, 0.073 and 0.070, respectively).

Conclusion
Serum apelin could be a predictive marker of renal prognosis in male and non-diabetic CKD patients.
#3736 SACUBITRIL/VALSARTAN IMPROVES THE VASCULAR ACCESS FLOW OF HEMODIALYSIS PATIENTS WITH HEART FAILURE AND REDUCED EJECTION FRACTION
Authors: Lin Chih-Ching 
Published: June 2023

Abstract

Background and Aims
Sacubitril/valsartan improved left ventricular systolic and diastolic function in patients with heart failure with reduced ejection fraction&lt;40% (HFrEF) and end-stage kidney disease. However, there was no report concerning the effect of sacubitril/valsartan on access flow (Qa) of vascular access in maintenance hemodialysis (HD) patients with HFrEF. We aimed to investigate the effect of sacubitril/valsartan on Qa of vascular access in HD patients with HFrEF.

Method
We retrospectively screened the HD patients who received echocardiogram and Qa measurement in Taipei Veterans General Hospital and Cheng Hsin General Hospital from Jan. 2019 to Dec. 2021. Patients with HFrEF received twice of both echocardiography and Qa at 1 year apart were enrolled and divided into two groups, including those with or without the treatment of sacubitril/valsartan. The difference of Qa at baseline and 1 year later was compared by Wilcoxon signed-rank test, with a statistical significance of P&lt;0.05.

Results
A total of 33 HD patients with HFrEF were analyzed with a mean HD vintage of 4.7 years. Sixteen patients received sacubitril/valsartan and the other 17 patients received conventional treatment. The mean Qa increased significantly from 633.8 to 948.8 mL/min (P&lt;0.001) and the Qa change correlated with LVEF change [Fig. 1. correlation coefficient (r) =0.70, P=0.006] after 1-year treatment of sacubitril/valsartan; however, there was neither significant change of Qa (from 637.7 to 621.8 mL/min, P=0.44) nor correlation with LVEF change (Fig. 2, r=0.41, P=0.13) for controls after one year.

Conclusion
Sacubitril/Valsartan improves Qa in HD patients with HFrEF possibly related to the increase of LVEF.