bluuebunny/crossref_metadata_2025_split huggingface dataset:
#3317 THE EFFECT OF HEMOPERFUSION ON SURVIVAL AMONG COVID-19 CRITICALLY ILL PATIENTS IN A TERTIARY HOSPITAL IN DAVAO CITY, PHILIPPINES
Authors: Lacang Joy Blossom Anne , Tom Mark Anthony 
Published: June 2023

Abstract

Background and Aims
Cytokine storm in COVID-19 is an excessive immune response through the overproduction of inflammatory cytokines which significantly increases mortality. Hemoperfusion has been granted Emergency Use Authorization (EUA) by the Food and Drug Administration (FDA) in an effort to eliminate circulating inflammatory mediators among COVID-19 critical patients to improve clinical outcomes and survival. This study aims to determine the 8 – day survival of critical COVID-19 patients who received hemoperfusion.

Method
This is a descriptive study conducted among critically ill COVID-19 patients who completed hemoperfusion treatment admitted from October 2020 to October 2021 in a tertiary hospital in Davao City, Philippines. The inclusion criteria were adult patients greater than 18 years of age with RT-PCR confirmed SARS-CoV-2 infection who underwent and completed hemoperfusion during hospitalization for COVID-19. While those patients who did not complete the hemoperfusion treatment because of hemodynamic instability or death were excluded. All of the patients classified as COVID-19 critical received the standard treatment for COVID-19 such as steroids (dexamethasone) and antiviral (Remdesevir). Among the 1,037 COVID-19 adult patients admitted from October 2020 to October 2021, 28 of them were classified as critical and received hemoperfusion, but only 19 patients completed the treatment.

Results
Majority of patients in the study were males (14/19, 73.68%) with a mean age of 59 years (SD 12.90). Hypertension (n = 15, 78.95%) and Diabetes Mellitus (n = 14, 73.68%) were the most common comorbid illnesses. Cough (n = 15, 78.95%), fever (n = 11, 57.90%), and dyspnea (n = 7, 36.84%) were the frequent symptoms. The laboratory parameters (median hemoglobin, leukocytes, thrombocytes, creatinine, and ALT were within normal range except for an elevated median AST (54 U/L). Forty-two percent (8/19) of patients survived at day 8 (Figure 1). Survivors had higher baseline oxygen saturation compared to non-survivors (89% vs 78%), but in both groups, the oxygen saturation increased after hemoperfusion (Figure 2). All inflammatory markers (CRP, ferritin, LDH, and procalcitonin) decreased among survivors
post-hemoperfusion. However, the ferritin, LDH, and procalcitonin remained elevated among non-survivors (Figure 3A, B, C D). The median time from symptoms onset to hemoperfusion initiation was longer in non-survivors compared to survivors (10 days vs 8 days) (Figure 4).

Conclusion
Close to half (42.11%) of the critical COVID-19 patients who underwent hemoperfusion survived at day 8. Therefore, hemoperfusion remains to be a beneficial adjunct treatment for critical COVID-19 patients especially if initiated early.
#3348 NATIONAL PREVALENCE OF CHRONIC KIDNEY DISEASE AMONG KOREAN ADULTS, 2007–2020, INCLUDING THE COVID-19 PANDEMIC: A KOREAN REPRESENTATIVE SERIAL STUDY
Authors: Yoon Soo-Young , Lee Hyo Jin , Kim Dae Kyu , Kim Jong Ho , Lim So Jin , Kim Jin Sug , Hwang Hyeon Seok , Jeong Kyunghwan 
Published: June 2023

Abstract

Background and Aims
Little is known about the prevalence of chronic kidney disease (CKD) during the coronavirus disease 2019 (COVID-19) pandemic, as well as the pandemics’ impact on CKD diagnosis. We aimed to investigate the long-term trends in CKD prevalence throughout the pre- and early pandemic periods in adults using a nationwide serial survey from South Korea.

Method
We used data from 108,152 Korean adults from 2007 to 2020 obtained from a representative longitudinal serial study. We defined CKD as a condition when the participant's estimated glomerular filtration rate was &lt;60 mL/min/1.73 m2, one-time spot proteinuria was ≥1+ on a urinary dipstick test according to recent guidelines, or previous diagnosis of CKD. We examined the overall trends in the prevalence of CKD during the study period and the impact of the early pandemic on the prevalence of CKD.

Results
Among the included adults (n = 80,010), the overall national prevalence of CKD was 6.2%. The trend slope gradually increased from 2007 to 2019, however, there was a sudden decrease in 2020 (2007–2010, 5.1% [95% confidence interval (CI), 4.7–5.5]; 2017–2019, 7.1% [95% CI, 6.6–7.6]; pandemic period, 6.5% [95% CI, 5.7–7.3]; and βdiff, -0.19; 95% CI, -0.24–-0.13). The prevalence of CKD among younger adults and those with poor medical utilization significantly decreased during the early pandemic.

Conclusion
This study was the first large-scale study to investigate the longitudinal prevalence of CKD from 2007 to 2020. Our results improve the understanding of outpatient health service utilization during the COVID-19 pandemic and suggest the need for governmental support to prevent the aggravation of CKD in society. Consequently, the nephrology community has a potential role in pertinent policies to reduce the public health burden of CKD by properly allocating limited medical resources.
#3357 MORPHOMETRIC AND FUNCTIONAL EVALUATION OF A NON-RENAL VASCULATURE IN FEMALE AND MALE PKD/MHM (CY/+) RATS
Authors: Liu Baoer , Mayer Tobias , Kraft Patricia , Heigwer Jana , Clanget Tilmann , Brune Maik , Sayour Alex , Schaefer Franz , Karck Matthias , Szabó Gábor , Korkmaz-Icöz Sevil 
Published: June 2023

Abstract

Background and Aims
Polycystic kidney disease (PKD) is a cystic genetic disorder of the kidneys. Vascular abnormalities are the most important non-cystic complications in PKD. In the present study, we evaluated aortic morphometry and vascular function in female and male PKD/Mhm (Cy/+) rats, an animal model of autosomal dominant PKD.

Method
Thoracic aortic rings from six month-old heterozygous PKD/Mhm (Cy/+) female (n = 10; 307±4g) and male (n = 10; 470±24g) and age-matched non-affected homozygous (+/+) Control-female (n = 9; 312±6g) and Control-male (n = 13; 460±14g) rats were used a) to evaluate both contractile/relaxation responses ex vivo using organ bath experiments and b) to study aortic morphometry assessed by hematoxylin&eosin staining. Furthermore, immunohistochemistry for cleaved poly (ADP-ribose) polymerase (PARP)-1 was performed.

Results
Although there was no significant difference in body weight, serum creatinine levels were increased in the PKD-female and PKD-male rats compared with the respective controls (PKD-female 50.0±1.7 vs. Control-female 43.9±2.1 µmol/L; PKD-male 178.7±21.0 vs. Control-male 40.4± 1.3 µmol/L, p&lt;0.05) and were found to be higher in PKD-male rats than in the PKD-females (p&lt;0.0001). Compared to Control-male, PKD-male rats showed decreased maximum relaxation to acetylcholine (55±2% vs. 77±1%, p&lt;0.05), indicating impaired endothelial function. Contractile responses to phenylephrine (3.0±0.1g vs. 3.4±0.1g, p&lt;0.05) and high potassium (3.3±0.1g vs. 3.7±0.1g, p&lt;0.05) were reduced in the PKD-male compared to Control-male. Additionally, in PKD-male aortas, the concentration-response curve to sodium nitroprusside, an endothelium-independent vasodilator, was shifted to the right compared to Control-male. Morphometrical analysis revealed that wall thickness and wall cross-sectional area normalized to body weight, and the wall:lumen area ratio were significantly higher in PKD-male aortas compared to Control-male. Additionally, PKD-male showed increased cleaved PARP-1 immunoreactivity confined to endothelial level compared to Control-male. All these parameters were unchanged in PKD-female rats compared to Control-female.

Conclusion
Six month-old PKD-male, not female, rats show endothelial dysfunction, impaired smooth muscle contraction and relaxation, pathological changes in aortic morphometry, and apoptosis in a non-renal vasculature. The rat model of autosomal dominant PKD in males can be used to identify novel targets for the treatment of this disease.
#3474 ROLE OF INTEGRIN, FIBRONECTIN, AND UPAR IN PODOCYTE-GLOMERULAR BASEMENT MEMBRANE INTERACTION UNDER FLUID SHEAR STRESS
Authors: Kim Jae Seok , Kim Ji-Hee , Kim Junyoung , Eom Minseob , Yang Jae Won , Han Byoung Geun , Choi Seong Ok , Cha Seung-Kuy 
Published: June 2023

Abstract

Background and Aims
Podocyte-glomerular basement membrane (GBM) interaction is the main component to maintain glomerular filtration barrier. Interestingly, the podocyte-GBM interaction is not static, but dynamic according to various podocyte conditions. Thus, we hypothesized that the podocyte-GBM interaction would be changed under stress conditions such as fluid shear stress (FSS). Here, we aim to explore the change of specific integrin (Itg αVβ3), fibronectin, and uPAR in the podocyte-GBM interaction under fluid shear stress (FSS).

Method
We used conditionally immortalized human podocyte cells which were differentiated only under specific (non-permissive) temperature (37°C). We exposed the podocytes to 200 rpm of FSS and applied various dish coating agents. We observed cell morphology and documented the protein and mRNA expressions of Itg β3, fibronectin, and uPAR under FSS.

Results
Podocyte morphology became more elongated with actin rearrangement under FSS. Protein expression of Itg β3 did not change under FSS, while activated Itg β3 increased from early phase (30 min after exposure to FSS) (Figure 1). Fibronectin (Figure 2) and uPAR (Figure 3) gradually increased under FSS. mRNA expressions of Itg β3, fibronectin, and uPAR did not change under FSS. Cell viability increased in collagen-1 coated dish compared to non-coated under FSS.

Conclusion
This study demonstrates that Itg αVβ3 is activated, fibronectin and uPAR increase under FSS. In addition, it is shown that extracellula matrix contributes to podocyte stability. The results suggest that Itg αVβ3, fibronectin and uPAR may have specific roles to maintain podocyte's stability through the modulation of the podocyte-GBM interaction.
#3478 THE EFFECT ON NET ULTRAFILTRATION WHEN TRANSFERRING PATIENTS FROM NOCTURNAL INTERMITTENT (NIPD) TO CONTINUOUS CYCLING PERITONEAL DIALYSIS (CCPD)
Authors: Theodoridis Marios , Panagoutsos Stylianos , Margaritis Nikos , Bounta Triantafyllia , Mourvati Efthimia , Tsalikidis Christos , Charitaki Evaggelia , Thodis Elias 
Published: June 2023

Abstract

Background and Aims
Peritoneal Dialysis (P.D.) Adequacy includes a variety of targets such as the sufficient uremic toxins removal (Κt/V), patients’ euvolemia, acid-base and electrolyte balance etc.. Based on incremental PD prescription NIPD is often a reasonable modality choice when there is adequate Residual Renal Function (RRF). Eventually due to RRF decrease patients need to increase their PD adequacy by adding a solution during the day i.e Icodextrin (CCPD). The aim of this study was to evaluate the alteration of Cyclers’ ultrafiltration(UF) as well as Total Ultrafiltration (sum of Cycler ultrafiltration and the UF of the initial drainage) when transferring patients from NIPD to CCPD

Method
This is a single center retroprospective study of 16 patients (m = 9,f = 7). These patients were transferred from NIPD to CCPD due to inadequate PD adequacy. The patients’ mean age was 53.4±19 years, their mean PD duration was 74.3±25.7 months and their mean Peritoneal Solute Transfer Rate (PSTR-D/Pcr) was 0.69±0.12. We evaluated small solute clearance targets (Kt/V – t:total,p:peritoneal,r:renal), RRF (eGFR, Vurine), Cycler’ ultrafiltration, the UF of the initial drainage and the sum of them (Total UF) on three consecutive days before the initiation of CCPD and three consecutive days after the initiation. The patients’ cycler treatment program remain constant and all of them received an initial day volume of 1000 ml with Icodextrin.

Results
We compared the alterations with Paired t-Test (normal distripution)
We found a statistically significant improvement of the peritoneal fraction of Kt/V when applying CCPD (p = 0.01), on the other hand we found a statistically significant decrease from Cycler's UF (p&lt;0.05) as well as from Total UF (p&lt;0.05) without any statistically significant increase in urine's volume. Additionally, from the regression analysis there was statistically significant correlation between PSTR and ΔUF(UFNIPD-UFCCPDtotal) showing that the faster the transporter the greater the ultrafiltration loss (p = 0.035, R = 0.58).

Conclusion
Transferring patients with adequacy problems from NIPD to CCPD improves small solute clearances but in some cases the risk for total ultrafiltration decrease is important and may lead to overhydration. It is necessary to contact perspective studies with hydration status evaluation ie Bioimpedance Spectroscopy.
#3484 A NETWORK META-ANALYSIS COMPARING INTENSIVE GLYCEMIC CONTROL AND SGLT-2 INHIBITORS IN PREVENTING RENAL OUTCOMES
Authors: Ghosal Samit 
Published: June 2023

Abstract

Background and Aims
Type 2 diabetes (T2D) is one of the prominent causes for chronic kidney disease (CKD) leading to end-stage renal failure. Traditionally, prevention and retardation of CKD was attempted with effective glycemic and blood pressure control. In recent times sodium glucose co-transporter 2 inhibitors (SGLT-2is), glucagon-like peptide 1 receptor agonists (GLP1-RA), and non-steroidal mineralocorticoid receptor (MRA) inhibitors have proved to be excellent agents in preventing cardio-renal outcomes in patients with T2D, independent of baseline glucose control. SGLT-2is rank the highest in recent network meta-analysis-based scoring. We conducted this network meta-analysis to explore the ranking of intensive glucose therapy in comparison to SGLT-2is, to better understand the present position of the traditional approach and its relevance.

Method
A database search was conducted using the Cochrane library to identify relevant citations. Analysis was conducted using RStudio (2022.07.1, Build 554). Using progression of macroalbuminuria and end-stage kidney disease (ESKD) as the outcomes of interest, scoring was performed comparing intensive glycemic control (IGC) and SGLT-2is. Using a frequentist approach P-score was conducted and corroborated using the Surface Under the Cumulative Ranking (SUCRA) using Bayesian network meta-analysis.

Results
A pooled population of 62,742 patients from twelve citations were included for analysis. The Cochrane risk of bias was used to assess quality of the studies. IGC scored higher than SGLT-2is as far as retardation of progression of macroalbuminuria was concerned while using both the P-score (0.99 Vs 0.50) as well as the SUCRA (0.97 Vs 0.52). A similar trend was also observed with ESRD as the end point with both the P-score (0.84 Vs 0.65) and the SUCRA (0.81 Vs 0.68) rankings favoring IGC (Fig. 1).

Conclusion
The importance of achieving glycemic targets should be emphasized in recommendations in the same footing as the choice of individual reno-protective agents.
#3485 IMPROVING THE DIAGNOSIS OF MYOCARDIAL INFARCTION IN CHRONIC KIDNEY DISEASE
Authors: Mcdonald-Coley Marrica , Wright Marilyn Lawrence- 
Published: June 2023

Abstract

Background and Aims
Chronic Kidney Disease has significant morbidity and mortality owing to the increased prevalence in cardiovascular disease. This increase in morbidity and mortality is seen more so as glomerular filtration rate (GFR) declines, that is, advanced kidney failure with GFR equal to or less than 30ml/min/1.73m2. Hence, it is important to control risk factors and accurately diagnose myocardial infarction in this cohort of patients.
Secondary objectives showed that social isolation was significantly associated with confirmed myocardial infarction. Additionally, ST changes, and T- QRS discordance on electrocardiogram were found more commonly in the myocardial infarction group. Other diagnostic tools such as angiography proved to be an underutilized investigation with a prevalence of 13% in the kidney disease cohort at the University of the West Indies during the years 2018 to 2020.

Method
In this retrospective cross-sectional study, data was collected from the online records system at the University of the West Indies. Patients with an admission diagnosis of acute coronary syndrome, unstable angina, non-ST elevation myocardial infarction, ST elevation myocardial infarction and chronic kidney disease were included in the study population. Cases were assigned based on whether or not myocardial infarction was confirmed on echocardiogram.

Results
Of the total number of 102 cases, 58 were chosen based on fulfillment of our inclusion criteria. 13 (22.4%) had echocardiographic evidence of a new myocardial infarction while 44 (75.9%) had no echocardiographic evidence of new myocardial infarction. Receiver Operator Characteristic Curves (ROC) used to evaluate the diagnostic performance of high sensitivity cardiac troponin T and interval/ delta changes showed an ideal value 141.50ng/L on first troponin T and 100.75ng/L on serial troponin T with delta change of 20.5%, (sensitivities of 61.5%, 72.7% and 72.7% respectively). Area under the Receiver-Operating Characteristic Curve (AUC) used to determine the diagnostic accuracy of the highly sensitivity cardiac troponin T and interval delta change demonstrated high accuracy of 0.708 for the first troponin T, 0.750 for the second troponin T and 0.767 for the interval or delta change.

Conclusion
Overall, we showed that serial troponin measurements in kidney disease patients increase sensitivity for predicting myocardial infarction and that the values are nearly 10 times that used for the general population. An interval change of 20.5% was also predictive of myocardial infarction.
#3486 CELL-FREE CIRCULATING DNA IN ANCA-ASSOCIATED VASCULITIS – A COMPARISON OF PATIENTS DURING ACTIVE DISEASE AND REMISSION
Authors: Karlsson Julia , Weiner Maria , Appelgren Daniel , Bruchfeld Annette 
Published: June 2023

Abstract

Background and Aims
Patients with ANCA-associated vasculitis (AAV) undergo immunosuppressive treatment to thwart organ failure and avoid relapse. However, the treatment is associated with risk of infections and malignancy. There are currently no reliable biomarkers which can be used in the clinic to assess disease activity. Neutrophil extracellular traps containing nuclear (n) and/or mitochondrial (mt) DNA have been implied in the pathogenesis of AAV. The aim of this study was to explore whether there is a difference in levels of circulating cell-free DNA (cfDNA) amongst AAV patients during active disease and in remission.

Method
Paired samples from 7 male and 9 female patients with AAV, of which 10 were diagnosed with GPA, were obtained during both active disease and clinical remission as part of an ongoing observational prospective study. Participants’ ages ranged from 21.8 to 80.0 years (median = 64.9), and 11 participants had a history of kidney engagement. After DNA-extraction digital droplet PCR was performed to obtain levels of mtDNA and nDNA. Clinical diagnosis (GPA or MPA), ANCA-positivity, kidney involvement, and Birmingham vasculitis activity score (BVAS) were also assessed.

Results
There were no significant differences in levels of mtDNA or nDNA in patients with active disease compared to remission; mtDNA (median = 14 520 and 11 985 copies/µL respectively, p = .379) and nDNA (median = 4.45 and 4.70 copies/µL, p = .569). The ratio between mtDNA and nDNA did not differ either (median 2100 and 2400, p = .679). A strong correlation between mtDNA- and nDNA levels (r = .920, p &lt; .001) was found, whereas no correlations were found between cfDNA and age, sex, clinical phenotype, ANCA positivity, kidney engagement or BVAS (Tables 1 and 2).

Conclusion
This study provides additional information regarding levels of mtDNA and nDNA comparing AAV patients during active disease and in clinical remission. The lack of association with disease activity and the correlation between nDNA and mtDNA may indicate cell damage as a source of cfDNA. To further delineate the contribution of NETs to the levels of cfDNA, and the mechanisms behind cellular injury and inflammation, studies with larger samples with longitudinal follow-up and healthy controls are needed.
#3496 HOURGLASS APPEARANCE ON FACE IN SAGLIKER SYNDROME IN CKD WITH SH.FACE MAP'S IMAGE PROCESSING LIKE FROM SATELLITES IN SKY AND FROM DRONES IN FUTURE
Authors: Sagliker Yahya , Sagliker Hasan Sabİt , Ozkaynak Piril Sagliker , Paylar Nuray , Sagliker Cemal 
Published: June 2023

Abstract

Background and Aims
Image processing is critical component in science and technology (Doughert, 2009). Soil surveyors use image process methods to classify differentiation of soils by using satellite images. Marine scientists use image process methods for monitoring marine pollution. Astronomers and space scientists use image processing techniques to classify objects in galaxy (Sararu, 2009). Image processing is process of modifying or interpreting existing pictures, such as photographs. (Hearn & Baker, 1997). SS patients have uglifying human face appearances, extremely severe maxillary and mandibulary changes, soft tissue in mouth, teeth/dental abnormalities, skull deformities, (Sagliker, 2004–12).

Method
SS patients have two kinds of photographs in literatures, before SS nondeformed and after SS deformed. We studied to create face map in SS by using technic in soil survey.10 face images (5 before SS and 5 after SS) were used. Unsupervised Classification (UC) system of Erdas 8.4 software was used to classify images. Methodology had 3 phases in this research In first phase, we got the images at same scale by cutting them around faces images. In final phase, we applied coloring on 10 classes of images. We used same color for same class number both CIbSS and ClaSS images. If color classes are in same structure of face (on cheek, forehead, etc), they may be combined.

Results
We have very important results on deformed faces photos in SS (CIaSS). First finding is all CIaSS have specific “hourglass”shapes [figure4]. “Hourglass” is enclosing red area for sample A and B Figure 3, Column 1: photos of patients before SS (raw images), column 2: classified photos of column 1, column 3: classified photos of patients after SS, Figure 5. “Hourglass” is Comformity of “Hourglass” form for all CIaSS curved face.

Conclusion
Image processing plays very important role in clinical practices and biomedical researches. SS is a kidney disease and derived from inside of the body but its effects are appearance outside of human body, such as head, face, skull deformations. These symptoms can be put forward by using Image Classification for SS. Moreover, shape of “hourglass” can be an index for SS and this is very specific for SS.“Hourglass” can be an indicator for grading SS. Finally, “hourglass” should be carefully evaluated in SS.