bluuebunny/crossref_metadata_2025_split huggingface dataset:
#4072 HEART OF STONE: THE IMPACT OF CARDIOVASCULAR RISK ON NEPHROLITHIASIS: AN OBSERVATIONAL STUDY
Authors: Damas Juliana Francisca Da Costa e Silva Barbosa , Vidal Helena , Fonseca Nuno Moreira , Jorge Cristina 
Published: June 2023

Abstract

Background and Aims
The incidence of nephrolithiasis has risen in recent years, largely due to changes in diet and lifestyle. An association between nephrolithiasis and risk of cardiovascular disease has been described, including atherosclerosis. The underlying mechanisms linking the two conditions are not well understood, making it important to study the role of exercise and nutritional habits. This study aims to examine the incidence of cardiovascular comorbidities in patients with nephrolithiasis, considering demographic information and the timeline of disease diagnosis and follow-up. Conditions such as dyslipidemia, myocardial infarction, stroke, and metabolic syndrome are of particular interest in this population.

Method
We retrospectively analysed consecutive patients that were referred to our tertiary medical center nephrolithiasis clinic between 2021 and 2023. The demographic information collected included gender, age at first nephrolithiasis diagnosis, current age, and family history. The cardiovascular conditions analysed included metabolic syndrome, hypertension, diabetes, gout, smoking, stroke, and dyslipidemia. Additionally, renal function (GFR-EPI) was also taken into account. Appropriate tests for continuous and categorical variables were applied, recurring to SPSS v21.0.

Results
A total of 84 patients were included in the study. Of these, 51.2% (n=43) were women with a median age of 52 years (IQR: 13-83) and a median age of first nephrolithiasis diagnosis of 34 years (IQR: 9-75). The analysed comorbidities showed a high incidence of hypertension (n=35, 41.7%), obesity (n=33, 40.7%), dyslipidemia (n=50, 61%), and metabolic syndrome (n=20, 23.8%). Family history was identified in 37.3% (n=31) of patients, with a significant difference for men, where 64.5% (n=20) had a positive family history (p-value 0.033). The results showed a relationship between increased body mass index and younger age of first nephrolithiasis diagnosis (p-value 0.012) and lower renal function at diagnosis (p-value 0.005).

Conclusion
The diagnosis of nephrolithiasis requires a change in the patient's diet and lifestyle, not only because of the risk of recurrence, but also because these patients are at a higher risk of developing serious cardiovascular events. This study highlights the high incidence of these comorbidities and underscores the importance of both the patient and the nephrologist being diligent in addressing these issues to achieve better kidney and overall health outcomes.
#4313 AN ANTI-FIBROTIC GENE ATTENUATES DIABETIC KIDNEY INJURY IN DB/DB MICE BY INHIBITING FIBROSIS VIA EPITHELIAL-MESENCHYMAL TRANSITION PATHWAY
Authors: Lee Seunghye , Kim Jin Hyun , Cho Hyun Seop , Jang Ha Nee , Jung Sehyun , Jung Jung Hwa , Chang Se-Ho , Kim Hyun-Jung 
Published: June 2023

Abstract

Background and Aims
Diabetic nephropathy (DN) is a major cause of mortality in patients with diabetes and chronic kidney disease, but there is a lack of effective therapeutic drugs for this disease. The development and progression of DN is influenced by fibrosis. transforming growth factor (TGF)-β1 is a key cytokine involved in fibrosis in many different organ systems. Anti-fibrotic gene (Anti-F) is a TGF-β/Smad signaling. Here we examined the therapeutic effect of Anti-F in a model of DN using db/db mice with streptozotocin (STZ) treatment.

Method
The db/db mice were divided into five groups; db/m+ (wild type), db/db+saline, db/db+STZ, db/db+STZ+CMV-Anti-F, and db/db+STZ+TGF-β-Anti-F. STZ was peritoneally injected for five consecutive days (50mg/kg) and Anti-F (40μg/head) was peritoneally administered once every two weeks. Mice were sacrificed four months after STZ injection.

Results
The Anti-F with CMV and TGF-β promoter administration markedly alleviated metabolic syndrome assessed by obesity and hyperglycemia, and renal dysfunction assessed by renal overweight and albuminuria in db/db+STZ mice. The administration obviously mitigated glomerular damage in diabetic mice, as reflected by the reduction of increased mesangial expansion and the expression of nephrin and podocin in db/db+STZ mice. Additionally, renal interstitial fibrosis was also significantly inhibited by Anti-F through suppressing epithelial-mesenchymal transition (EMT) signaling including α-SMA, Twist, and Snail, as well as inflammation reflected by IL-1β, MMP-2, and MMP-9 in diabetic mice.

Conclusion
Anti-F attenuated the development of DN in db/db mice with type 2 diabetes. The protective effect was associated with decreased inflammation and subsequent attenuation of EMT-mediated renal fibrosis. Thus, this study suggests that targeting the Anti-F could be considered as a novel therapeutic approach for preventing the progression of DN.
#4376 THE ASSOCIATION AMONG CAROTID IMT, PWV AND VASCULAR ACCESS FAILURE IN HEMODIALYSIS PATIENTS
Authors: Yoon Jong-Woo , Kim Hyunsuk , Kim Seokhyung , Choi Gwangho , Kim Jin-Up , Lee Younh-Ki 
Published: June 2023

Abstract

Background and Aims
Patients with chronic kidney disease (CKD) or end stage renal disease (ESRD) have an increased risk of cardiovascular mortality and morbidity. We aimed to compare the value of IMT with tests such as coronary CT and Pulse wave velocity(PWV) as predictors of cardiovascular risk in ESRD patients undergoing maintenance dialysis and examine their association with cardiovascular disease.

Method
We reviewed the participants’ medical records, including height, body weight, smoking status, alcohol intake, medication history, etiology of ESRD, HD vintage, and blood pressure which were measured during hemodialysis. Carotid dopplerwas performed by an skilledsonographer who are unaware of the aims of the study and blinded to the laboratory findings. For PWV measurement, Patients lie down, rest for at least 5 minutes, and prohibit smoking and coffee for 3 hours before the measurement. BaPWV is measured by recording pulse waves of both arm and both ankles from the pressure signal obtained by measuring 4-extremitiy blood pressure.

Results
One hundred patients were included, of whom 51 (50.5%) were men. The median age was 66years (interquartile range 58-76 years). The median vintage of hemodialysis was 47.5 months (range 31.3-89.1 months). There were no significant differences between high IMT groupand low IMT group in sex, hemodialysis vintage, end-stage renal disease etiology, and type of vascular access. However, age was significantly older in the high IMT group. IMT was significantly associated with PWV. (hazard ratio [HR] 2.109; 95% CI 1.037-4.291, P = 0.039). After adjusting for age, sex and presence of diabetes, IMT was independently associated with PWV (HR 2.110, 95% CI 1.036-4.298, P = 0.040). The risk of recurrent vascular access failure was higher in the high IMT group (HR 1.615, 95% CI 1.460-5.669, P = 0.034).

Conclusion
IMT was associated with PWV and recurrent access failure. Thus IMT may be suggested as a potential predictor of vascular access failure.
#4379 SURVIVAL RATES AND ANALYSIS OF PREDICTORS OF MORTALITY AMONG INCIDENT HEMODIALYSIS PATIENTS: A SINGLE CENTER FIVE-YEAR COHORT STUDY
Authors: Leano Danice Romagne , Chua Eric , Ninalga-Rodriguez Hazel Daphne , Danguilan Romina 
Published: June 2023

Abstract

Background and Aims
Studies on improving survival rate among maintenance hemodialysis patients have been extensive. However, only a handful of studies have focused on the factors that determine mortality risk among incident hemodialysis patients, considering that the first few months of hemodialysis initiation are the most critical. Survival rates and factors predicting mortality may vary from one geographic area to another. Local data on these factors, however, are quite lacking. Identification of factors that can be optimized during this crucial period can greatly impact survival of Filipino hemodialysis patients. This study was designed primarily to determine 1-year, 3-year and 5-year survival rates of incident hemodialysis patients enrolled at the National Kidney and Transplant Institute (NKTI). Demographic and clinical factors that may influence mortality risk were identified and analyzed.

Method
This is a retrospective cohort study which evaluated the data of all incident adult patients enrolled at NKTI Outpatient Dialysis Unit, over a period of 5 years (January 2016 to December 2020). Patients were followed, retrospectively, from initiation until censorship (end of study, loss to follow up, transfer, conversion to peritoneal dialysis or kidney transplant) and the following factors were compared between those who remained alive and those who expired: etiology of kidney disease, age, sex, mode and frequency of dialysis, access, socioeconomic class and biochemical parameters. Descriptive statistics was used to describe and summarize the baseline data. Frequency and proportion were used for categorical variables, and median and inter-quartile range (IQR) for non-normally distributed interval/ratio variables. Survival probabilities were estimated using the Kaplan-Meier method. Cox regression was done to determine factors of overall survival. All valid data were included in the analysis. Null hypothesis was rejected at 0.05α-level of significance. Stata 15.0 was used for data analysis.

Results
A total of 562 incident hemodialysis patients were enrolled, 94 of whom expired. Among those who expired, there were more patients who were aged above 60 years (56.38% vs 29.91%, p &lt;.001) and with low serum phosphorus level (29.21% vs 16.78%, p=.029) in comparison to those who were alive. Computed 1-year, 3-year, and 5-year survival rate among patients were 89.51% (95% CI 86.10% - 92.12%), 73.03 (95% CI 66.46 – 78.52%) and 42.06% (95% CI 29.52% - 54.99%), respectively. Patients who are older than 60 years (HR 2.75, p= 0.013), hepatitis C positive (HR 3.92, p= 0.021) and those with low phosphorus (HR 1.86, p= 0.015) were noted to have increased risk of mortality.

Conclusion
Survival rate of incident hemodialysis patients at NKTI is at par with survival estimates abroad. Risk factor identification and optimization of modifiable ones are key in improving patient survival.
#4431 PREPARATION OF IMIDAZOLE QUATERNARY AMMONIUM SALT MICROSPHERES WITH HIGH BILIRUBIN ADSORPTION PERFORMANCE AND SELF-ANTICOAGULATION ABILITY
Authors: Deng Ningyue , Jin Lunqiang , Su Baihai 
Published: June 2023

Abstract

Background and Aims
Bilirubin is a crucial toxin in liver metabolism. Increase of bilirubin is one of common manifestations in patients with abnormal liver function, and large accumulation of bilirubin in the blood can lead to more severe hepatic dysfunction and even death. Due to the poor therapy effect and the shortage of available donor organs, the artificial liver support system has been introduced to maintain the liver function and bridge patients to transplantation. Previous studies have found that imidazole quaternary ammonium salts have great potential to adsorb bilirubin. This work is to develop a novel bilirubin adsorption column by simple and general method, and evaluate the removal efficiency, anticoagulant property and biocompatibility of the bilirubin adsorption column.

Method
Multifunctional microspheres were fabricated by in situ co-polymerization of 1-vinylimidazole and divinylbenzene. Nuclear magnetic resonance (NMR), thermo-gravimetric analysis and X-ray photoelectron spectroscopy (XPS) etc. were performed to characterize the chemical compositions of the microspheres. Meanwhile, hemolysis test, blood routine test and clotting time test etc. were leveraged to evaluate the biocompatibility of the microspheres. Both static adsorption test and dynamic adsorption test were performed in vitro to evaluate adsorption performance.

Results
A variety of methods had proved successful synthesis of the adsorption performance. The hemolysis ratios of microspheres were less than 5%. Compared with BS330 microspheres and PES microspheres, the activated partial thromboplastin time (APTT) and thrombin time (TT) were longer in this work. Moreover, the microspheres showed a high adsorption clearance. In PBS solution of bilirubin, the adsorbent could decrease bilirubin from 200 mg/L to 45-55 mg/L.

Conclusion
The results suggested that the multifunctional microspheres can significantly reduce bilirubin concentration without obvious adverse interactions and could exhibit anticoagulation activity.
#4437 ASSESSMENT OF THE PSYCHOLOGICAL EXPERIENCE OF KIDNEY TRANSPLANT PATIENTS DURING THE COVID-19 PANDEMIC
Authors: Mazighi Sara , Naouaoui Salma , Chettati Mariam , Fadili Wafaa , Laouad Inass 
Published: June 2023

Abstract

Background and Aims
The coronavirus (COVID 19) pandemic has caused a major health crisis, and quarantined half of the world's population, therefore it contributed to the appearance or aggravation of mental distress such as anxiety, depressive disorders and deterioration of the quality of sleep especially in the immunocompromised population and especially in the kidney transplant patients. Among the causes of these disorders are the risk of infection and the relatively high mortality rate associated with this virus. The aim of our study is to investigate anxiety and depression scores in renal transplant patients during the COVID 19 pandemic and compare them to those of the general population to highlight the impact that the pandemic has had on this vulnerable population.

Method
This is a descriptive and analytical case-control study of a group of 113 patients divided into 2 groups: group of kidney transplant patients and that of the general population. A questionnaire collecting sociodemographic data was used. Anxiety symptoms were assessed by the GAD anxiety scale. Depressive symptoms were assessed using the Beck's scale abbreviated.

Results
In our study, the rates of anxiety and depression in the general population group were around 33.3% and 18.3% respectively. This rate was significantly higher in subjects with previous psychiatric history. These rates were higher in women with an anxiety rate of 18.3% versus 15% in men and a depression rate of 11% in women versus 7% in men and were significantly higher in subjects with previous psychiatric history. In the group of kidney transplant patients the rates of anxiety and depression were high compared to the general population, with a rate of anxiety at 66% and depression at 26.4% (p&lt;0.001).

Conclusion
This study raised the major negative impact of the covid 19 pandemic on the increase of psychiatric disorders in this at-risk population compared to the general population. This requires a multidisciplinary and adapted management of these vulnerable patients, associating a joint nephrological and psychiatric follow-up in order to preserve their quality of life and their mental health.
#4568 C-REACTIVE PROTEIN / SERUM ALBUMIN RATIO IN PATIENTS WITH COVID-19 AND ADVANCED CHRONIC KIDNEY DISEASE DUE TO TYPE 2 DIABETES MELLITUS
Authors: Klochkova Nataliya , Lysenko Mariana , Zeltyn-Abramove Eugene , Belavina Natalya 
Published: June 2023

Abstract

Background and Aims
The patients with advanced kidney disease (DKD) due to type 2 diabetes mellitus (T2DM) are at a high risk of adverse outcomes of COVID-19. The causes of high mortality among these patients are the subject of debate. C-reactive protein (CRP)/serum albumin (SA) ratio is one of the probable prognostic laboratory indicator of adverse outcome.

Aims
The evaluation of diagnostic value of CPR/SA in patients with COVID-19 and advanced DKD.

Method
The patients with laboratory confirmed COVID-19 and advanced DKD were included in the retrospective observation study. The observation period 04.01-10.31.2020. The study endpoints were the outcomes of hospitalization−discharge or lethal outcome. Data were collected from electronic medical database. The observation group was divided in two subgroups: (1) patients with advanced DKD 4-5stage (according to eGFR) not requiring maintenance hemodialysis (MHD), (2) patients on MHD. CPR, SA, CPR/SA were analyzed at hospital admission.

Results
A total of 120 patients were included. 55 patients with advanced chronic kidney disease not requiring MHD (1) and 65 patients on MHD (2). Mediana age 69 y (IQR 63.5; 79.5), females 53%. The study subgroups did not significantly differ on gender, age, comorbidity, duration of DKD and onset of COVID-19. The mortality in both subgroups was rather high (38.2% vs 38.5% resp). The median of CRP in (1) was 96 (IQR 27; 144) mg/l (survivors) vs 158 (IQR 43; 193) mg/l (nonsurvivors), P = .025. The median of SA in (1) was 37.0 (IQR 32.0; 38.5) g/l (survivors) vs 30.0 (IQR 29.6; 33.0) g/l (nonsurvivors), p&lt;0.001. The median of CPR (2) was 69 (IQR 39; 133) mg/l (survivors) vs 90 (IQR 33; 156) mg/l (nonsurvivors), P = .246. The median of SA in (1) was 34.8 (IQR 32.0; 37.0) g/l (survivors) vs 33.0 (IQR 28.0; 35.0) g/l (nonsurvivors), P = .084. CPR/SA in (1) subgroup was 2.7 (IQR 0.8; 4.0) (survivors) and 4.9 (IQR 2.6; 5.9) (nonsurvivors), P = .012. CPR/SA in (2) subgroup was 2.4 (IQR 1.3; 4.3) (survivors) and 2.6 (IQR 1.0; 5.9) (nonsurvivors), P = .457. Determination of the cut-off point for CPR/SA ratio was based on the receiver operating characteristic (ROC) analysis. Cut off point CPR/SA ratio for (1) subgroup is 3.6 and cut off point for CPR/SA ratio for subgroup (2) is 2.4. 55-days cumulative proportion surviving (Kaplan-Meier method) are presented on the Fig. 1 and Fig. 2 In subgroup (1), a threshold value of the CRP/SA ratio was revealed, which significantly affects the survival of patients. In subgroup (2), it was not possible to identify the threshold value of the CPR/SA ratio, which significantly affects the cumulative survival rate of patients.

Conclusion
CRP/SA ratio ≥3.6 in patients with advanced DKD not requiring MHD is a laboratory indicator of adverse outcome of COVID-19. The studied parameter did not differ in patients on MHD regardless of the COVID-19 outcomes.
#4654 THROMBOEMBOLIC EVENTS AND THEIR RELATIONSHIP WITH COVID-19 IN HEMODIALYSIS PATIENTS: MYTH OR TRUE ?
Authors: Cidraque Ignacio , Román Vicente García , Pérez Alicia Sobrino , Bello Abraham Rincon , Shkolenko Kateryna , Ortego Sofia , Blanco Ana , Samaniego Diana , Salvador Maria Eva Baró 
Published: June 2023

Abstract

Background and Aims
Since the beginning of COVID-19 pandemic, there has been more than 668 million of diagnosis and more than 6 million deaths worldwide. This pandemic also has had a dramatic impact on chronic patients, such as those with end stage renal disease (ESRD) on hemodialysis (HD).
Many studies have hypothesized that COVID-19 could induce a hypercoagulability state, activating coagulation cascade. Post-mortem studies revealed vascular injuries in more than 60% of lung tissues and many patients diagnosed with COVID-19 have suffered neurological pathologies, as ischemic stroke. Patients with ESRD are also at higher risk of thromboembolic events than healthy subjects.
In this study, we analyze thromboembolic events in HD patients with or without COVID-19 diagnosis.

Method
We performed a retrospective observational study between March 2020 and December 2022 with 4679 HD patients (2635 COVID-19 positive patients (Group 1) and 2044 COVID-19 negative (Group 2)) from 50 Spanish clinics. The baseline dates of the non COVID-19 patients were randomly chosen. Follow-up time was 1 year since COVID-19 diagnosis (Group 1) or since selection (Group 2).
We identified patients who has suffered any thromboembolic event during follow-up time. We compared usual clinical parameters between groups using Chi2 and Mann-Whitney U tests. Survival analysis was performed by Kaplan-Meier and Cox regression. Continuous variables were categorized to perform the Cox analysis.

Results
Small differences between Group 1 and 2 were found in age (70.45 (62-81) vs 68.94 (61-80); p&lt;0.001), proportion of men (63% vs 67.2%; p&lt;0.05), HD vintage (34 (14-71) vs 30 (11-65); p&lt;0.05), preHD systolic blood pressure (SBP) (140.73 (126-155) vs 142.65 (128-157); p&lt;0.05), plasma hemoglobin (Hb) (11.19 (10.40-11.90) vs 11.31 (10.5-12); p&lt;0.05) and proportion of patients with antithrombic medication (604 (22.9%) vs 401 (19.6%); p&lt;0.05).
No statistically significant differences were found in time to first thromboembolic event between the two groups (Figure 1). In univariate Cox regression (Table 1) thromboembolic events showed significant relation with gender, Charlson Index above 8, preHD relative overhydration (relOH) above 13.4% and preHD SBP above 155 mmHg. In multivariate analysis (Table 1), Charlson Index and preHD SBP showed hazard ratio above 1.5 for thromboembolic event (p&lt;0.05). COVID-19 diagnosis did not show relationship with thromboembolic events.

Conclusion
Publications on thromboembolic events in HD patients who have suffered from COVID-19 are scarce and with small size samples. In our large HD sample, thromboembolic events were not related to COVID-19. Only Charlson Index and preHD SBP showed a significant relationship in the multivariate analysis.
#4695 LOSS OF NLRP6 INCREASES THE SEVERITY OF KIDNEY FIBROSIS
Authors: Valiño Lara , Favero Chiara , Pintor-Chocano Aranzazu , Carriazo Sol , Ortiz Alberto , Sanchez-Nino Maria Dolores 
Published: June 2023

Abstract

Background and Aims
The burden of chronic kidney disease (CKD) is growing worldwide, illustrating the need for better prevention and therapeutic approaches. Kidney fibrosis is a hallmark of CKD that is not specifically addressed by current therapeutic options. The nucleotide-binding oligomerization domain-like receptor (NLR) family has 22 members. The NLRP3 inflammasome has been most extensively studied in the context of kidney disease where it plays a pathogenic role. However, the role of NRLP6 during CKD and kidney fibrosis remains unexplored. The aim of the study was to explore the role for endogenous Nlrp6 in protecting from kidney fibrosis.

Method
A hypothesis-driven analysis of non-biased human kidney disease transcriptomics databases was performed to identify NLRs other than NLRP3 of potential therapeutic interest, based on differential gene expression during CKD and the relationship of gene expression to severity of CKD. We explored Nlrp6 expression in preclinical accelerated CKD and kidney fibrosis (UUO) and characterized the function of endogenous Nlrp6 by inducing UUO in Nlrp6-deficient mice and validated the results in a second model of kidney fibrosis. Once tubular cells were identified as the key cells expressing NLRP6 and regulating NLRP6 expression during UUO, we explored the drivers of Nlrp6 downregulation in tubular cells, as well as the consequences of Nlrp6 downregulation in these same cells.

Results
The role of Nlrp6 in experimental CKD was explored in wild-type and Nlrp6-deficient mice with unilateral ureteral obstruction (UUO). Whole kidney Nlrp6 mRNA and tubular cell Nlrp6 protein decreased following UUO. Low kidney Nlrp6 immunostaining was also observed in human CKD. Genetic Nlrp6 deficiency resulted in increased kidney p38 MAP kinase activation and more severe kidney inflammation and fibrosis, as assessed by kidney inflammatory gene expression, interstitial macrophage infiltration, expression of profibrotic cytokines and extracellular matrix encoding genes, Smad3 phosphorylation, Sirius red staining, collagen, and fibronectin deposition and myofibroblast numbers. Similar results were obtained in adenine-induced kidney fibrosis. Cytokines involved in the pathogenesis of kidney fibrosis, such as the profibrotic cytokine TGF-β1 and the proinflammatory cytokine TWEAK, decreased Nlrp6 expression in cultured tubular cells, while siRNA targeting Nlrp6 resulted in increased TGF-β1 and CTGF expression, which was limited by inhibiting p38 MAPK.

Conclusion
In conclusion, endogenous constitutive Nlrp6 dampens sterile kidney inflammation and fibrosis likely by dampening tubular cell responses. Loss of Nlrp6 expression may contribute to CKD progression.