bluuebunny/crossref_metadata_2025_split huggingface dataset:
#3423 DIAGNOSTIC SIGNIFICANCE MAGNETIC RESONANCE IMAGING IN CHRONIC HEART FAILURE OF VARIOUS GENESIS
Authors: Egamberdieva Dano , Ruzmetova Iroda , Khodjibekova Yu M , Karimova Yu A 
Published: June 2023

Abstract

Background and Aims
Based on a comparative assessment of radiological, ultrasound, clinical and laboratory studies, to determine the diagnostic significance of cardio-MRI.

Method
We analyzed echocardiographic and magnetic resonance imaging of the heart in 40 patients who were examined and treated in the cardiology departments of the Republican Medical Specialized Scientific and Practical Center for Therapy and Medical Rehabilitation. The information content of the use of instrumental research methods in patients with chronic heart failure was evaluated. Information on demographic characteristics, including age, gender, education, occupation, was collected from doctors visits using a standard questionnaire.

Results
The average age of patients was 57 years. 40% of the surveyed were made up of men. When studying risk factors for the disease, 49% of all patients had arterial hypertension, 18% had type 2 diabetes mellitus, 21% of patients were active smokers, and 11% had a family history of risk of cardiovascular disease. 36% of patients had a history of myocardial infarction, percutaneous coronary interventions. The mean LV EF was 42% and the mean right ventricular EF (RVEF) was 48%. In patients with CHF of ischemic origin, in the vast majority of cases, the results of echocardiographic and MRI examinations of the heart were comparable. The conducted MRI of the heart had an additional informative value in case of doubtful ECG and EchoCG data, as well as in differential diagnosis. The results of MRI were more accurate in determining the etiology of myocardial hypertrophy, in particular hypertrophic cardiomyopathy.

Conclusion
The diagnostic value of cardio-MRI showed great diagnostic value in the diagnosis of ischemic damage and non-coronary diseases of the myocardium.
#3428 DEPLETED HDAC3 ATTENUATES HYPERURICEMIA-INDUCED RENAL INTERSTITIAL FIBROSIS VIA MIR-19B-3P/SF3B3 AXIS
Authors: Wei Jiali , Wang Minhui 
Published: June 2023

Abstract

Background and Aims
Hyperuricemia (HN) is a threat for the occurrence of renal interstitial fibrosis (RIF). Dysfunctional histone deacetylase 3 (HDAC3) elicit renal fibrosis and damage. This study aimed to explore the role of HDAC3 in HN-induced RIF from microRNA-19b-3p/splicing factor 3b subunit 3 (miR-19b-3p/SF3B3) axis.

Method
1. The HN model was established on rats to induce RIF by oral administration of adenine and potassium oxalate; 2. HN rats were injected with related vectors (sh-HDAC3, mimic-miR-19b-3p, sh-HDAC3+miR-19b-3p inhibitor) to suppress and/or promote HDAC3 and/or miR-19b-3p; The detection indicators are listed as follows: (1) Blood samples and urine samples were collected for UA, BUN, Scr and 24 h urine protein measurement; (2) Renal pathological damages, RIF index and renal cell apoptosis were measured by HE, Masson and TUNEL staining; (3) α-SMA, TGF-β1 and FN contents in renal tissues were detected by IHC staining; (4) mRNA and protein levels of HDAC3, miR-19b-3p and SF3B3 in renal tissues were detected by RT-qPCR and/or WB. (5) Interaction of HDAC3 and miR-19b-3p was detected by ChIP and dual luciferase reporter gene assay; (6) Interaction of miR-19b-3p and SF3B3 was predicted/detected by bioinformatics website/dual luciferase reporter gene assay.

Results
1. HN induced renal dysfunction, renal pathological damages, RIF and renal cell apoptosis of rats; HN rats showed elevated HDAC3, SF3B3 and reduced miR-19b-3p in renal tissues. 2. Suppressed HDAC3 or promoted miR-19b-3p relieved HN-induced renal dysfunction, renal pathological damages, RIF and renal cell apoptosis; HDAC3 bound to the promoter of miR-19b-3p; miR-19b-3p negatively regulated SF3B3; miR-19b-3p depletion abrogated down-regulated HDAC3-induced effects on HN-induced RIF.

Conclusion
HDAC3 bound to the promoter of miR-19b-3p to regulate SF3B3. Depressed HDAC3 relived HN-induced RIF by restoring miR-19b-3p and knocking down SF3B3. Targeting HDAC3 and miR-19b-3p/SF3B3 axis may be a promising therapeutic strategy for preventing HN-induced RIF.
#3434 A FREE OPEN-SOURCE FRAMEWORK TO INFER PATIENT-LEVEL EGFR SLOPES FOR ASSOCIATION WITH MOLECULAR DATA
Authors: Boys Charlotte , Saez-Rodriguez Julio 
Published: June 2023

Abstract

Background and Aims
Unfolding over years or decades, patient kidney disease trajectories can be characterised using routinely collected longitudinal data. One frequently measured marker of kidney function is serum creatinine, used in clinical settings to estimate the glomerular filtration rate (eGFR). Change in eGFR over time has been put forward as a proxy endpoint for clinical trials, and most work on inferring eGFR slopes has been done in this context. However, 'omics-based studies of the molecular mechanisms of kidney disease have so far largely neglected to make use of longitudinal data linked to tissue samples. Here, we build on existing approaches [1, 2] and provide an open-source, R framework to infer eGFR slopes from routinely available clinical data linked to biobank samples.

Method
In our framework, we calculate eGFR from serum creatinine measurements using the CKD-EPI 2021 formula. To aid data adjudication, we implement criteria outlined by Hapca et al. [1] for automatic flagging of acute kidney injury (AKI) events, and extend the criteria to detect potential in-patient stays. Since the biopsy procedure may arise as a result of loss of kidney function and/or coincide with a change in treatment regime, we use a two-spline linear mixed effects model similar to that proposed by Vonesh et al. [2] to differentiate between immediate-post-biopsy (acute) and chronic eGFR slopes. Additionally, to account for non-random dropout due to the onset of dialysis or occurrence of kidney transplant, we jointly model the longitudinal and dropout processes. Our framework is made available as free, open-source software in R.

Results
From routinely collected longitudinal clinical data, we generate patient-specific values characterising the post-biopsy disease trajectory. These values can then be incorporated into the analysis of 'omics data to find molecular patterns associated with treatment response or prognosis.

Conclusion
We have developed an open-source R framework for inferring patient-level eGFR slopes from serum creatinine measurements linked to biobank samples. Leveraging this data could improve 'omics studies of the molecular mechanisms of kidney disease, allowing us to incorporate information about disease trajectory and treatment response and thus ask questions of the molecular data which have real clinical relevance.
#3437 THE ASSOCIATION OF INTERLEUKIN-6 TO ALBUMIN RATIO WITH MORTALITY IN PATIENTS WITH KIDNEY FAILURE
Authors: LI Xiejia , Qureshi Abdul Rashid Tony , Suliman Mohamed , Heimbürger Olof , Barany Franz Peter , Stenvinkel Peter , Lindholm Bengt 
Published: June 2023

Abstract

Background and Aims
Systemic inflammation - characterized by high interleukin-6 (IL-6) and low albumin circulating concentrations - associates with worse outcomes in patients with kidney failure (KF). We examined the value of IL-6 to albumin ratio (IAR) to stratify risk of death in KF patients.

Method
In 435 incident dialysis patients (median age 56 years, 61.8% male, 31% diabetes mellitus (DM), 38.4% cardiovascular (CV) disease (CVD)), plasma IL-6 and albumin were measured at baseline to calculate IAR. We performed receiver operating characteristic curve (ROC) to compare the discriminatory performance of albumin, IL-6 and IAR for predicting all-cause and CV mortality. We divided patients into IAR tertiles and analysed: 1) cumulative incidence of all-cause mortality and CV mortality censored for renal transplantation during follow up of up to 60 months; 2) the association of IAR and all-cause and CV mortality risk according to Fine-Gray analysis taking renal transplantation as competing risk; and 3) the restricted mean survival time (RMST) and differences of RMST (∆RMST) between IAR tertiles to describe quantitative differences of survival time.

Results
Among 435 patients, 146 patients (33.6%) died, and 175 (40.2%) patients underwent renal transplantation during median 24.9 months of follow-up; 83 (56.8%) of the 146 deaths were due to CVD. The area under the ROC curve (AUC) of IAR (0.696 for all-cause mortality; 0.657 for CV mortality) was higher than that of both albumin and IL-6. As shown in Fig. 1 A and B: 1) the cumulative incidence of all-cause and CV mortality of patients in middle and high IAR tertiles was significantly higher than in low IAR tertile; 2) higher IAR associated with higher risk of all-cause (sub-hazard ratio (sHR) 1.93, 95% confidence interval (CI) 1.22-3.06 for high IAR tertile) and CV mortality (sHR 1.99, 95% CI 1.03-3.87 for middle IAR tertile) risk after adjusting for age, sex, DM, CVD, and smoking; and 3) ∆RMST at 59 months showed shorter survival time in middle and high IAR tertiles compared with low IAR tertile for all-cause (∆RMST -6.21 months for middle vs low tertile; ∆RMST -11.4 months for high vs low tertile) and CV mortality (∆RMST -4.73 months for middle vs low tertile; ∆RMST -7.49 months for high vs low tertile).

Conclusion
Higher IAR was independently associated with significantly higher all-cause and CV mortality risk in KF patients. These results suggest that IAR may provide useful prognostic information in patients with KF.
#3447 ENVIRONMENTAL MELAMINE EXPOSURE AND ADVERSE KIDNEY OUTCOMES IN PATIENTS WITH TYPE 2 DIABETES MELLITUS
Authors: Tsai Yi-Chun , Wu Ming-Tsang 
Published: June 2023

Abstract

Background and Aims
The impact of environmental melamine exposure on kidney outcomes in type 2 diabetes (T2D) remains unclear. The aim of this study is to evaluate the relationship between melamine and adverse kidney progression in T2D population.

Method
This longitudinal study enrolled 561 T2D patients during October 2016 and June 2020 and followed until December 2021. Baseline urinary melamine levels were measured by LC-MS/MS, and average daily intake (ADI) of melamine was estimated. Primary kidney outcomes were defined as doubling of serum creatinine levels or end stage kidney disease (ESKD), and secondary kidney outcomes included rapid decline in kidney function as estimated glomerular filtration rate (eGFR) decline &gt; 5 ml/min/1.73m2/year.

Results
Baseline median urinary corrected melamine levels and estimated DI of melamine were 0.8 μg/mmol and 0.3 µg/kg/day in 561 T2D patients. During 3.7 years of follow-up, urinary corrected melamine level was positively correlated with reaching composite outcomes of either doubling of serum creation levels or ESKD and rapid decline in kidney function. Those with the highest quartile of urinary corrected melamine had 2.96-fold risk of composite outcomes of either doubling of serum creation levels or ESKD and 2.47-fold risk of eGFR decline &gt; 5 ml/min/1.73m2/year. Estimated ADI of melamine also had significant correlation with adverse kidney outcomes. Furthermore, the positive relationship between melamine exposure and rapid decline in kidney function was only found in T2D patients with male, baseline eGFR ≥ 60 ml/min/1.73m2 or glycated hemoglobin ≤ 7%.

Conclusion
Melamine exposure is significantly associated with kidney outcomes in T2D patients, especially in those with male, well sugar control or preserved baseline kidney function.
#3505 DIAGNOSING HYPERTENSION IN HEMODIALYSIS PATIENTS USING HOME VERSUS ROUTINE PERIDIALYTIC BP MEASUREMENTS
Authors: Leonidou Kalistheni , Georgianos Panagiotis , Kollias Anastasios , Kontogiorgos Ioannis , Vaios Vasilios , Karligkiotis Apostolos , Mavromatidis Konstantinos , Zebekakis Pantelis , Stergiou George , Liakopoulos Vassilios 
Published: June 2023

Abstract

Background and Aims
Although routine blood pressure (BP) measurements taken shortly before or after dialysis provide imprecise reflection of interdialytic ambulatory BP, this method continues to form the basis for the diagnosis of hypertension among patients on hemodialysis. Home BP monitoring (HBPM) is a guideline-recommended technique that may improve the diagnosis of hypertension in this population. Using 44-hour ambulatory BP monitoring (ABPM) as the reference-standard method, this study aimed to compare the diagnostic performance of home versus routine pre- and postdialysis BP recordings in hemodialysis patients.

Method
In 70 stable patients with end-stage kidney disease receiving thrice-weekly hemodialysis, BP was assessed with the following methods: (i) routine predialysis and postdialysis BP measurements averaged over 2 weeks; (ii) HBPM for 7 days (dublicate morning and evening measurements, Microlife WatchBP Home N); (iii) ABPM (20 min intervals over an entire interdialytic interval - 44 hours, Microlife WatchBPO3).

Results
The mean age of the patients was 65.3±13.3 years; 45 patients (64%) were males, and 62 (88.7%) had a known history of hypertension. The mean [95% confidence interval (CI)] of the difference between ambulatory systolic BP (SBP) and (i) predialysis SBP was 11.43 (8.24, 14.62) mmHg, (ii) postdialysis SBP was 3.9 (0.37, 7.56) mmHg, and (iii) home SBP was 8.61 (6.05, 11.17). The area under the receiver operating characteristic curve for the detection of an ambulatory daytime SBP ≥135 mmHg was significantly higher for home SBP measurements 0.934 (95% CI: 0.871-0.996) as compared to predialysis 0.778 (95% CI: 0.643-0.913) and postdialysis 0.766 (95% CI: 0.623-0.909) BP recordings (P = 0.02 for both comparisons). 1-week averaged home SBP at the cut-off point of 141.0 mmHg provided the best combination of high sensitivity (85.7%) and high specificity (92.9%) in diagnosing systolic ambulatory hypertension.

Conclusion
The present study shows that among patients on hemodialysis, HBPM for 1 week provides greater accuracy than 2-week averaged routine pre- and postdialysis BP recordings in the diagnosis of hypertension confirmed by the reference-standard method of interdialytic ABPM.
#3507 IV CYCLOPHOSPHAMIDE VERSUS MYCOPHENOLATE MOFETIL AS INDUCTION REGIMEN IN PROLIFERATIVE LUPUS NEPHRITIS: A STUDY FROM NORTH-EAST INDIA
Authors: Sharma Manjuri , Bora Farha , Pegu Gayatri , Doley Prodip Kumar 
Published: June 2023

Abstract

Background and Aims
SLE is a chronic autoimmune disorder that can affect all organ systems. Clinically evident renal disease known as Lupus Nephritis (LN) occurs in upto 50% patients of SLE and upto 10% of LN patients develop ESRD. LN carries a significant morbidity and mortality and requires an early aggressive management. Our Aim is to study the effect of IV Cyclophosphamide (CYC) vs Mycophenolate Mofetil (MMF) as Induction regimen in proliferative Lupus Nephritis patients of North- East India.

Method
This is a prospective observational study conducted in the department of Nephrology, Gauhati Medical College, over a period of 1 year. Haematological and biochemical assay including serum creatinine, blood urea, serum albumin, ANA, Anti ds DNA, C3 and C4,24h urinary protein, estimated glomerular filtration rate (eGFR) of all patients were taken into account. Renal biopsy was performed under ultrasonographic guidance. SLEDAI Score and Activity and Chronicity Indexes were calculated for all patients. Statistical analysis was done by SPSS Version 22 for windows. Two tailed p&lt;0.05 was considered to be statistically significant. A total of 64 biopsy proven LN patients of Class III, Class IV and Class V (Plus Class III/ Class IV) were enrolled in the study. We randomly assigned 34 patients with Class III through V lupus nephritis to IV CYC (NIH protocol/monthly) and 30 patients to MMF (2 gm/day) for 24 weeks as Induction Regimen. Both the groups received prednisone, tapered from a maximum starting dosage of 60 mg/day. All the patients were followed up for 6 months. Complete Response (CR) was considered when proteinuria&lt;0.5g/g and Partial Response (PR) when proteinuria&lt; 3g/g or there is reduction in proteinuria by at least 50%. Baseline characteristics and CR and PR were compared between the two groups.

Results
Of the total 64 patients, 57 patients (89%) were female, and 7 patients were male (11%) with the mean age of 31± 9.45 years. 24% patients had Class III LN and 76% had class IV LN. Complete Response was achieved in 13 patients (43%) in the MMF group and in 15 patients (44%) in CYC group. Partial Response was achieved in 11 patients (36.67%) in the MMF group and in 12 patients (35%) in the CYC group. There was a non-significant statistical difference between the two groups (p value ≥0.05 for both CR and PR).

Conclusion
The Northeastern population of India consists of various ethnic groups and there are records of variation in response to the Regimens in different geographical areas. In our study from North-east India, IV Cyclophosphamide and Mycophenolate Mofetil showed similar efficacy as Induction Regimen in proliferative Lupus Nephritis. However, there were higher rates of infection in the Cyclophosphamide group.
#3520 THE RELATIONSHIPS OF BONE TURNOVER MARKERS AND CEREBRAL WHITE MATTER ALTERATIONS IN PATIENTS UNDERGOING HEMODIALYSIS
Authors: Kuo Mei-Chuan , Lin Yi-Ting , Lin Hsiu-Fen , Chen Kung-Chao , Wu Ping-Hsun 
Published: June 2023

Abstract

Background and Aims
Patients with end-stage kidney disease (ESKD) have a higher prevalence rate of cognitive impairment than the general population. ESKD patients also present a worsening brain white matter damage than healthy subjects. Some studies showed a lower bone marrow density was associated with cognitive impairment, but limited studies investigated the relationship between bone turnover biomarkers and brain white matter damage in ESKD patients.

Method
Hemodialysis participants were enrolled in two hemodialysis units from August 2016 to January 2017. Participants' baseline characteristics, bone-turnover proteins, and Fazekas scale of brain magnetic resonance imaging (MRI) white matter lesions were recorded. Fazekas scale of periventricular lesions was defined as cerebral white matter hyperintensities in MRI from grade 0 to grade 3. Multivariable ordinal regression and logistic regression models were analyzed to identify the independent association between bone turnover proteins and the Fazekas scale of periventricular lesions.

Results
In 59 hemodialysis patients, a higher Fazeaks scale of periventricular lesions was found in elderly patients and correlated to a lower Mini-Mental State Examination (MMSE). Among 8 bone turnover proteins, the serum level of sclerostin (SOST) showed a dose-response effect (P value for trend = 0.004), corresponding to a higher level of SOST correlated with a lower grade on the Fazekas scale. After full adjustment with potential confounders, a negative association between SOST and Fazekas scale of periventricular lesions remained in the ordinal regression model (Odds ratio [OR] 0.886; 95% confidence interval [CI] 0.828-0.947, P value &lt;0.001) and in the logistic regression model (OR 0.828; 95% 0.712-0.963, P value = 0.014).

Conclusion
The circulating SOST level was negatively associated with brain white matter damage. Our study result provided a potential link between bone turnover markers and brain damage.
#3521 ASSOCIATION BETWEEN NEPROLITHIASIS AND KIDNEY DISEASE PROGRESSION IN AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE PATIENTS: A PROSPECTIVE COHORT STUDY
Authors: Moon Hongran , Ryu Hyunjin , Kim Yong Chul , Park Hayne Cho , Oh Kook-Hwan , Oh Yun Kyu 
Published: June 2023

Abstract

Background and Aims
Nephrolithiasis is a common complication in Autosomal dominant polycystic kidney disease (ADPKD) patients and is known to occur in up to 8% to 36% of the patients. A few in vitro and in vivo studies showed that kidney and ureter stone formation could accelerate renal disease progression in ADPKD. However, its association between nephrolithiasis and renal function deterioration remains unknown in ADPKD patients.

Methods
This is a study from single center prospective cohort called HOPE-PKD. A total of 410 study subjects with abdominal computed tomography (CT) scan within 1 year before the enrollment were analyzed. Study subjects were divided into two groups according to the CT results as follows: Patients with papillary calcification, calyceal stone, ureter stone, or renal stone were classified as a stone group (n = 80, 19.5%), and patients only with renal cyst calcification or without any stones in the kidney and ureter were classified as a no-stone group (n = 330, 80.5%). The primary outcome was defined as the initiation of renal replacement therapy due to end-stage renal disease. The secondary outcome was a composite outcome of a 50% decline in estimated glomerular filtration rate (eGFR), doubling serum creatinine from baseline, or the initiation of renal replacement therapy. The hazard ratios (HRs) and 95% confidence interval (95% CI) for the outcome were analyzed using multivariate Cox regression analysis.

Results
There was no difference in the baseline characteristics between the stone group and the no-stone group. During a median 5.18 [interquartile range 3.41 - 8.03] year of follow-up, the primary and secondary outcomes occurred in 51 (12.4%) and 96 (23.4%) patients, respectively. In the unadjusted Cox regression analysis, there was no significant difference in the survival analysis between the two groups. However, after adjusting possible confounding factors (age, sex, body mass index, eGFR, comorbidity of hypertension and diabetes, serum uric acid, phosphorous and calcium level, results of PKD1 and PKD2 gene analysis, and Mayo classification), the stone group showed an increased risk of the primary and secondary outcome of HR 2.84 (95% CI 1.26 - 6.38; p-value 0.012) and HR 1.83 (95% CI 1.03 - 3.27; p-value 0.041), respectively compared to the no-stone group (Figure 1).

Conclusion
This is the first prospective cohort study showing that nephrolithiasis is associated with poor renal outcomes in patients with APDKD. Further clinical studies of nephrolithiasis in ADPKD patients are warranted to improve renal outcomes.