bluuebunny/crossref_metadata_2025_split huggingface dataset:
PS-C25-12: CORRELATION OF RENAL FUNCTION AND MUSCLE MASS IN YOUNG ATHLETES
Authors: Yasuda Osamu , Yasuda Hisayo , Ohishi Mitsuru 
Published: January 2023

Objective:
Renal function is closely associated with the development of hypertension. Creatinine is often used as a serum marker of renal function. Since creatinine is a metabolite of muscle, its concentration in serum is affected by muscle mass. Therefore, serum creatinine levels are high in individuals with high muscle mass, and renal function is underestimated. On the other hand, in elderly people with low muscle mass, serum creatinine concentration tends to be low, and there is a risk that renal function is estimated better than it actually is. Since another renal function marker, cystatin C, is produced in every cell of humans, it is considered to be unaffected by skeletal muscle mass. Therefore, cystatin C is often used as a renal function marker that is less dependent on muscle mass than creatinine. In this study, we analyzed the correlation between muscle mass and renal function in young athletes with high muscle mass.

Design and Methods:
The subjects are 250 first-year male students at the National Institute of Fitness and Sports in Kanoya. The impedance method was used to measure muscle mass. Serum creatinine and cystatin C levels were measured by a clinical laboratory. Grip strength was measured with a Smedley-type hand dynamometer, and isometric measurement was performed to measure the leg extension force.

Results:
Muscle mass showed a significant correlation with left and right grip strength and right leg extension force. These results show that the muscle mass of the whole body measured in this study reveals the skeletal muscle mass, from which serum creatinine is derived. Muscle mass showed a significant correlation with serum creatinine levels. It also showed a significant correlation with the glomerular filtration rate estimated from creatinine concentration, age, and gender. Muscle mass also showed a significant correlation with serum cystatin C levels. It also showed a significant correlation with the glomerular filtration rate estimated from cystatin C, age, and gender.

Conclusion:
In general, serum creatinine concentration is a renal function marker that is affected by muscle mass, and cystatin C is a renal function marker that is less affected by muscle mass. The results in this study show that muscle mass should be taken into consideration for the evaluation of renal function based on serum cystatin C level in young athletes.
PS-C26-3: THE ASSOCIATION BETWEEN GLOMERULAR DIAMETER AND SECONDARY FOCAL SEGMENTAL GLOMERULOSCLEROSIS IN CHRONIC KIDNEY DISEASE
Authors: Zamami Ryo , Kohagura Kentaro , Ohya Yusuke 
Published: January 2023

Introduction:
When nephron loss occurs, glomerular filtration rate (GFR) is suggested to be maintained by glomerular hypertrophy, but excessive hypertrophy can rather lead to the formation of focal segmental glomerulosclerosis (FSGS), thereby cause progressive kidney damage. However, it is not clear how much glomerular hypertrophy leads to the formation of FSGS. We examined the association between glomerular diameter and FSGS lesions in chronic kidney disease (CKD) patients.

Methods:
We recruited 77 patients who underwent renal biopsy during 2016–2017; however, those identified with primary FSGS and glomerulonephritis with active glomerular lesion were excluded. We evaluated the maximal glomerular diameter (Max GD), an indicator of glomerular size, in each renal biopsy specimen and examined its association with FSGS lesion.

Results:
The median age, blood pressure, and estimated GFR of the patients were 53 years, 122/70 mmHg, and 65 ml/min/1.73 m2, respectively. The optimal cutoff threshold of Max GD for predicting the presence of FSGS lesions, assessed by receiver operating characteristic curve analysis, was determined to be at 224 μm (area under the curve, 0.81; sensitivity, 81%; specificity, 72%). Multivariate logistic regression analyses demonstrated that Max GD ≧ 224 μm was significantly associated with the presence of FSGS lesions, independent of other confounding factors (odds ratio, 11.70; 95% confidence interval, 1.93–70.84).

Discussion/Conclusion:
Glomerular hypertrophy (Max GD ≧ 224 μm) has been associated with FSGS lesions in CKD patients and may reflect the limits of the compensatory process
PS-C26-5: RENAL ARTERY REMODELING AND RENAL RENIN ANGIOTENSIN SYSTEM IN CHRONIC KIDNEY DISEASE
Authors: Oshiro Nanako , Kohagura Kentaro , Kanamitsu Takafumi , Zamami Ryo , Ohya Yusuke 
Published: January 2023

Purpose:
It has long been hypothesized that renin angiotensin system (RAS) is heterogeneously activated in the kidney and is associated with the development of hypertension, but the mechanism by which RAS hyperactivity occurs is unclear. In this study, we hypothesized that narrowing of the lumen of afferent arteriole in chronic kidney disease (CKD) is associated with increased renal RAS, and investigated whether renal arteriolar remodeling is related to urinary angiotensinogen (UAGT), an index of renal RAS.

Methods:
Of 172 patients who underwent renal biopsy between 2010 and 2013 at our department, 54 patients with UAGT data and less than 10 arterioles and those on RAS inhibitors were excluded. IgA nephropathy was the most common primary disease (57.4%). Microvascular remodeling was assessed by measuring the wall to lumen ratio (WLR), which was calculated as (outer diameter of arteriole - lumen diameter of arteriole)/interstitial lumen diameter. In addition to clinical parameters, we examined the association of WLR with high-sensitivity C-reactive protein (CRP), oxidative stress markers (dROM), flow-dependent vasodilatory response (%FMD), and UAGT.

Results:
The mean age and eGFR were 38 years and 81 mL/min/1.73 m2, respectively; Log UAGT showed a positive correlation with Log WLR, LDL, and Log dROM, respectively, and a negative correlation with eGFR. Multiple regression analysis showed that Log WLR was significantly associated with Log UAGT independently of factors such as eGFR and urinary protein (β; = 0.38, p = 0.04).

Conclusions:
Our results suggest that renal arrteriolar remodeling may be associated with increased renal RAS in CKD patients.
PS-C27-5: ASSOCIATION BETWEEN ANKLE-BRACHIAL INDEX AND KIDNEY OUTCOMES IN PATIENTS WITH HYPERTENSION
Authors: Ko Ye Eun , Jhee Jong Hyun , Lee Chan Joo , Park Sungha , Yoo Tae Hyun 
Published: January 2023

Background:
Ankle-brachial index (ABI) used for diagnosis of peripheral vascular disease is related to endothelial dysfunction. Previous studies showed the relationship between endothelial dysfunction and chronic kidney disease (CKD). Therefore, we aimed to investigate the association between ankle-brachial index and CKD progression in patients with hypertension.

Methods:
A total of 2,429 patients with hypertension were enrolled from the prospective observational cohort of CMERC-HI (Cardiovascular and Metabolic Disease Etiology Research Center-High Risk). Patients were classified into quartile based on ABI (A1: ABI < 1.11, A2: ABI 1.11 to 1.17, A3: ABI 1.17 to 1.23, A4: ABI> 1.23). Primary outcome was progression of CKD, which was composite of at least 50% decrease in estimated glomerular filtration rate (eGFR) from baseline or end stage kidney disease requiring dialysis, or incident CKD which was defined as eGFR < 60 ml/min/1.73m2.

Results:
The mean age of study subjects was 60.1 ± 11.3 years and 1,346 (55.4%) were male. There were statistically significant differences in DM status (40.1%, 41.1%, 43.7%, 51.7% in A1, A2, A3, A4 group, respectively, P < 0.001) among ABI quartile groups. During a median follow-up of 42.5 months, the primary outcome met the pre-specified CKD progression in 490 (20.2%). In multivariate Cox analysis, A1 and A3 group were associated with increased risk of CKD progression (HR, 2.28; 95% CI, 1.30–4.00, P = 0.004, HR, 2.22: 95% CI, 1.27–3.90, P = 0.005) compared to A2 group. Moreover, low ABI showed increased risk of CKD progression (HR, 1.57; 95% CI, 1.04–2.38; P = 0.03) after adjusting confounding factors.

Conclusions:
Ankle-brachial index may be an independent predictor of renal outcome in patients with hypertension.
PS-C27-8: ELIGIBILITY OF FINERENONE INITIATION IN ASIAN CHRONIC KIDNEY DISEASE PATIENTS BY KIDNEY FUNCTION AND DIABETES STATUS
Authors: Teo Boon Wee 
Published: January 2023

Background:
Patients with chronic kidney disease, CK, due to diabetes, DM, and hypertension, HTN, are at risk of rapid progression. The addition of a non-steroidal mineralocorticoid antagonist, finerenone, reduces blood pressure and retards CKD progression. However, it causes a rise in serum potassium, K, of about 0.23 mmol per L. We examined the serum potassium of CKD patients with and without DM by kidney function.

Methods:
We analyzed data from the Asian Kidney Disease Study. There were 232 CKD patients who underwent measured glomerular filtration rate, GFR, mL per min per 1.73 m2. There were 51 percent male, mean age 58.4, 12.8; 51 percent had DM, 119 of 232, median GFR 47, IQR 29–67. There were 185 of 232 patients using renin-angiotensin system, RAS, blockers. We stratified analyses by groups of K above 4.8, threshold for initiation of finerenone and by GFR above and below 25 where the risks of hyperkalemia is highest.

Results:
Overall, mean K is 4.35, 0.54. K is negatively associated with GFR; 4.596–0.0048 x GFR; p is 0.0002. There is no difference in serum potassium by use of RAS blockers, 185 of 232. Mean K was higher in DM patients 4.45, 0.58 vs. 4.24, 0.47; P is 0.0023. In patients with GFR below 25, there were 8 of 34 or 23.5 percent with K above 4.8, and 26 of 198 or 13.1% with K above 4.8 and GFR above 25. In DM CKD patients with GFR below 25, 6 of 18 or 33.3 percent had K above 4.8; and 16 of 95 or 16.8 percent had K above 4.8 with GFR above 25.

Conclusions:
There was 16.8 percent of DM CKD patients with GFR above 25 who had K above 4.8 who would require potassium binders in order to start finerenone.
PS-P07-10: ACCESSIBILITY OF SUBSIDIZED HYPERTENSION MEDICATION IN ULAANBAATAR, MONGOLIA A RETROSPECTIVE STUDY
Authors: Myanganbayar Maral , Ganbat BolorErdene , Baatarsuren Uurtsaikh , Davaadamdin Orkhonselenge , Dashdorj Naranbaatar , Dashdorj Naranjargal 
Published: January 2023

Objective:
Mongolia has a total of 3.1 million population. Ulaanbaatar is the capital city with half of the population has migrated into the city and currently residing. For the past 3 years from 2019 to 2021, Mongolian government increased the healthcare budget for hypertension medication from 5,338,979 USD to 6,874,762 USD. The aim of the study is to examine the accessibility of subsidized hypertension medication in 7 districts of Ulaanbaatar between these years.

Design and method:
The data was collected from Health Insurance Fund database spanning from 2019 to 2021. The analysis was performed on Rstudio. The prevalence was calculated from 2019 Ulaanbaatar hypertension prevalence data.

Results:
The total population of Ulaanbaatar had increased from 1462000 in 2019 to 1534793 in 2021. Overall, the accessibility of subsidized hypertension medication increased from 31.2% to 40.7% between 2019 and 2021. The district with the most population, Bayanzurkh district, increased accessibility from 23.3% in 2019 to 31.3% in 2021. While the least populated district, Baganuur district increased accessibility to medication from 32.6% to 42.9%.

Conclusions:
In conclusion, the increase in healthcare budget had a positive effect on the accessibility of the subsidized hypertension medication in the city of Ulaanbaatar across all districts over the past 3 years. However, with improved accessibility of medication, more studies need to be done to assess hypertension control in Ulaanbaatar.
PS-P09-6: KNOWLEDGE, ATTITUDES AND PRACTICE OF SALT INTAKE AND BLOOD PRESSURE LEVEL IN A MULTI-ETHNIC POPULATION IN MALAYSIA
Authors: Chew Ming Tsuey , Chia Yook Chin , Oui Jethro Ee Keat , Ching Siew Mooi , Devaraj Navin Kumar , Lim Hooi Min , Chew Bee Nah , Mohamad Mohazmi , Ooi Pei Boon , Be Hooi Chin 
Published: January 2023

Knowledge, attitudes and practice of salt intake and blood pressure level in a multi-ethnic population in Malaysia

Objective:
A changing lifestyle in the transition from a developing to a more developed country has led to increases in obesity, physical inactivity and unhealthy diet, including high salt intake. Studies have shown that salt consumption is high in Asia, but little is known about the practice among different ethnic groups. This study aimed to examine the knowledge, attitudes and practice of salt intake among Malaysian adults by different ethnic groups.

Design and method:
Participants aged =  > 18 years were recruited during a blood pressure health screening campaign from various centres. All participants completed a questionnaire that capturing information on socio-demographics, knowledge, attitudes and practice about salt consumption. Weight and height were measured and seated blood pressure (BP) measurements using an oscillometric sphygmomanometer were taken twice and averaged. Hypertension is defined as a systolic BP = > 140mmHg and/or diastolic BP = > 90 mmHg.

Results:
A total of 5128 participants were included in the study. The mean age of the participants was 39.5 ± 17.4 years and 59.6% were female. The mean SBP was 121.4 ± 17.6 mmHg and mean DBP 75.5 ± 11.1 mmHg. 61.5% knew the correct amount (< = 5 g) of daily dietary salt intake and 8.4% did not think it was important to reduce salt intake. 68.6% took measures to control salt intake; 69.9% avoided/minimized canned food, only 34.2% look at the salt labels and less than a third do not add salt during cooking, used spices during cooking and avoid eating in outlets and all of these practices were statistically significant between ethnic groups (p < 0 .001). Knowledge, attitude and practice of not reducing high intake of dietary salt does contribute to raise high BP as shown in Table 1.

Conclusion:
Our study reported that good knowledge does not translate into the desired attitude or practice of lower salt intake. More needs to be done to improve attitudes and behaviours about dietary salt intake, and to tailor it to different ethnic groups. This is warranted to prevent the increasing prevalence of hypertension.
PS-P09-7: ASSESSMENT OF DIETARY DIVERSITY AMONG ADULT HYPERTENSIVES
Authors: Deshmukh Akshada T , Patil Vishal , Patil Mansi 
Published: January 2023

Introduction:
In contrast to developed countries, dietary quality is a growing challenge in developing countries. Several techniques of measuring food consumption using basic tools such as the 24-hour diet recall have been presented in recent years. This individual dietary diversity score (IDDS) proposed by FAO is a basic measure for evaluating diet quality, defined as the number of food groups represented in the diet across time.

Objective:
The goal of this study was to determine the individual dietary variety score of hypertensives who visited the hospital's out-patient department.

Materials and Techniques:
Data on the dietary intake of 200 hypertension patients was collected using an interviewer-administered questionnaire. In addition, anthropometric measurements were taken. The 14 food groups specified by the FAO were used to create IDDS classification tertiles.

Results:
Individual IDDS averaged 6 ± 1.83 food groups in the past 24hrs by hypertension patients. In our study, 8% of hypertension individuals had a high IDDS. Cereals, white tubers, other vegetables, legumes, oils and fats, and oils and fats were the most commonly consumed dietary groups by our people, at the expense of leafy vegetables, vitamin A fruits, other fruits and fish, nuts and seeds. In terms of anthropometric variables, waist circumference had a significant (p0.05) influence on food diversification in hypertensives, although BMI had no effect.

Conclusion:
When analysed on an individual DDS, the majority of patients do not meet the average based on 14 food groups. As a result, the average number of food categories ingested by the participants over the reference period is deemed inadequate. In contrast to cereals, oils, and fats, fruits and vegetables were the least consumed food groups. Given the importance of dietary diversity to nutrition and health, these findings suggest that efforts should be mobilised to ensure that people have better access to nutrition information. Despite the fact that this study needs to be expanded up to a multi-centric study and comparisons with other nations are needed to harmonise the technique, our findings demonstrate that using a basic tool can be beneficial when used at a community level. IDDS can be proposed as a ready to use tools across all healthcare sectors to promote dietary diversity.
PS-P09-9: DIETARY PATTERNS AND HYPERTENSION AMONG STROKE-FREE AFRICANS IN THE SIREN STUDY
Authors: Okekunle Akinkunmi Paul , Asowata Osahon Jeffery , Akpa Onoja Matthew , Fakunle Adekunle , Sarfo Fred Stephen , Wahab Kolawole , Obiako Reginald , Akinyemi Rufus , Ovbiagele Bruce , Owolabi Mayowa 
Published: January 2023

Objective:
This study assessed the relationship of dietary patterns (derived from the frequency of food consumption) with hypertension among stroke-free controls recruited from Nigeria and Ghana in the Stroke Investigation Research and Educational Network (SIREN) study.

Design and Methods:
This study was a matched case-control study with 1500 hypertensives randomly selected and matched for the country of residence, age and sex with 1500 normotensives in the SIREN study. Factor analysis using principal component analysis was used to summarise food information and seven dietary patterns (DP); vegetables, poultry product and organ meat, whole-grain and fruit drinks, fried foods and sweetened drinks, red meat, processed foods and fruits were identified. Hypertension was defined as one of the following conditions; systolic blood pressure of 140mmHg/greater or diastolic blood pressure of 90mmHg/greater or previous diagnosis or use of antihypertensive medications. Multivariable adjusted logistic regression was used to estimate the odds ratio (OR) and 95% confidence interval (CI) for hypertension by the median of factors scores in each DP (adjusting for age, education, income, smoking, alcohol use, physical inactivity, family history of cardiovascular diseases and obesity) at a two-sided P < 0.05.

Results:
Mean age was 56.2 ± 13.5years and multivariable-adjusted OR (95%CI) for odds of hypertension by the median (with < median of factor score as reference) of DPs revealed higher consumption of whole grains and fruit drinks; 0.83 (0.73, 0.96; P = 0.01) was associated with lower odds of hypertension, but higher consumption of processed foods; 1.18 (1.00, 1.40; P = 0.04) was associated with higher odds of hypertension. Furthermore, multivariable-adjusted OR (95%CI) of hypertension for other DPs include; 0.88 (0.74, 1.04; P = 0.13) for vegetables; 0.89 (0.75, 1.05; P = 0.16) for poultry product and organ meat; 0.90 (0.76, 1.06; P = 0.21) for fruits; 0.90 (0.77, 1.07; P = 0.23) for fried foods and sweetened drinks and 1.03 (0.87, 1.21; P = 0.76) for red meat.

Conclusion:
Diet rich in whole grains was associated with lower hypertension risk, but higher consumption of processed foods was related to a deleterious hypertension risk. Also, higher consumption of plant-based diets presented a suggestive inverse relationship with hypertension, but diets dense with red meat presented a suggestive deleterious hypertension risk.
PS-R03-7: PARTIAL ADRENALECTOMY IN A PATIENT WITH ACTH-INDEPENDENT MACRONODULAR ADRENAL HYPERPLASIA: A CASE REPORT
Authors: Takebayashi Shunta , Irie Junichiro , Kurihara Isao , Kobayashi Sakiko , Miyashita Kazutoshi , Kinouchi Kenichiro , Nakamura Toshifumi , Itoh Hiroshi 
Published: January 2023

Background:
The standard treatment for ACTH-independent macronodular adrenal hyperplasia (AIMAH) with overt Cushing's syndrome is bilateral adrenalectomy. Here we show a case of AIMAH who underwent total adrenalectomy on one side and partial adrenalectomy on the other, resulting in the successful debulking of cortisol-secreting adrenal masses and improvement of Cushing's syndrome, yet not necessitating postoperative steroid replacement.

Case presentation:
A 74-year-old female patient with hypertension, type 2 diabetes and dyslipidemia developed edema of the legs. She visited her primary physician and was found to have lumbar vertebral compression fractures. The blood test and 24-hr urine collection revealed the plasma cortisol levels of 26.1 μg per dL, adrenocorticotropic hormone of 1.1 pg per mL, and urine free cortisol of 340 μg per day. Computed tomographic scan and adrenal scintigraphy confirmed bilateral adrenal nodules with notable tracer uptake. Diagnosis of AIMAH with Cushing's syndrome was made. Laparoscopic partial adrenalectomy, i.e., total removal of the left adrenal gland and partial removal of the right counterpart, was conducted aiming to avert from steroid replacement therapy. After the surgery, blood pressure and glycemic control were markedly improved and maintained for 4 years whilst adrenocortical functions were preserved.

Conclusion:
Partial adrenalectomy could be an effective therapy in selected cases of AIMAH.
PS-R04-9: REVERSIBLE ACUTE RENAL INJURY IN MALIGNANT HYPERTENSION DURING LONG-TERM FOLLOW-UP
Authors: Hishida Erika , Imai Toshimi , Nagata Daisuke 
Published: January 2023

Background:
Malignant hypertension is a disease characterized by severe hypertension and multi-organ damage. Although mortality and renal prognosis have improved with antihypertensive therapy, progression to end-stage renal disease remains a leading cause of morbidity and mortality.

Case presentation:
A 37-year-old man with a history of untreated hypertension and proteinuria was referred to our hospital with complaints of right paralysis. He was diagnosed with left putaminal hemorrhage and treated with conservative blood pressure reduction management. He was also complicated with severe hypertension (blood pressure 231/146 mmHg), acute renal failure (BUN 39 mg/dl, serum creatinine 4.01 mg/dl, urinary protein 2.848 g/gCre), and heart failure with preserved ejection fraction (BNP 373 pg/ml). Initial evaluation demonstrated hyperreninemia (32.6 ng/ml/hr) with hyperaldosteronism (125 pg/ml), consistent with malignant hypertension. Secondary hypertension, such as primary aldosteronism, Cushing's syndrome, pheochromocytoma, and renal artery stenosis was excluded by further examination. His renal size was mildly atrophic assessed by CT scan, suggesting a history of chronic kidney disease. At first, we gradually decreased blood pressure with antihypertensive agents except for angiotensin-converting enzyme (ACE) inhibitor and angiotensin receptor blockade (ARB) so as not to induce exacerbation of renal function via glomerular ischemia. In the long-term, he was treated to achieve a tight blood pressure control to systolic blood pressure of 100–110 mmHg with the combination of ACE inhibitor, calcium channel blocker, and alpha/beta blocker. Although his clinical course showed gradual recovery of renal function, our conservative approach successfully induced renal function recovery over six months of follow-up (BUN 27 mg/dl, serum creatinine 2.26 mg/dl, urinary protein 0.154 g/gCre).

Discussion:
Previous reports suggest that malignant nephrosclerosis may recover slowly if the blood pressure is tightly controlled during the follow-up. From a long-term perspective, tight blood pressure control with inhibition of the renin-angiotensin-aldosterone system, which is a critical factor of the pathogenesis in malignant hypertension, may provide beneficial effects on the renal prognosis of malignant hypertension.