bluuebunny/crossref_metadata_2025_split huggingface dataset:
#2550 THE ANTI-AGING FACTOR, α-KLOTHO EXPRESSION DURING HUMAN PREGNANCY AND ITS COMPLICATIONS: PREECLAMPSIA AND SMALL-FOR-GESTATIONAL-AGE NEONATE
Authors: Nakhoul Farid , Shehada Sabren , Tadmor Hagar , Khateeb Nardeen , Farber Evgeny , Perlitz Yuri 
Published: June 2023

Abstract

Background and Aims
Pre-eclampsia (PE) is defined as arterial hypertension associated with proteinuria and may cause dysfunction of vital organs as kidney, liver, brain and other organs. PE is consider as the leading cause of maternal and perinatal morbidity worldwide [1,2]. IUGR definition is abnormal fetal growth compared with growth potential of a specific infant. α-Klotho (αKL) protein has three isoforms: a single transmembrane (mKL) form, a shed soluble form, and a secreted soluble circulating protein (sKL). mKL is expressed in the kidney and placenta. Nowadays, αKL levels correlation to pregnancy or pregnancy's complications, such as preeclampsia (PE) or intra-uterine growth restriction (IUGR) is not clear. The research goals were to monitor αKL concentrations during pregnancy and to investigate its expression alterations in correlation to pregnancy complication [3,4,5].

Method
The research included 49 participants, recruited at the Baruch Padeh Poriya medical center, Obstetric Department. The participants were divided into two groups: healthy and complicated pregnancy (PE, IUGR or both). Blood and urine samples were collected during pregnancy and post-delivery (PD). Placental samples were subjected to biochemical (WB) and Elisa), morphological (H&E) histological (IHC) staining and genetic analysis (qPCR). αKL activity was assessed using specific assigned Elisa kit.

Results
sKL during pregnancy show constant concentration that was similar in both healthy and complicated pregnancy. Significant decrease was measured in PE in sKL concentration at PD compared to its level during pregnancy. αKL activity was dramatically reduced in complicated pregnancies compared with healthy pregnancy during and PD. Placental tissue section staining presents decrease in mKL level in the placenta of complicated pregnancy group compared with healthy group. Additionally, we found significant decline in the expression of mRNA of mKL in PE/IUGR placentas compared with healthy group.

Conclusion
1. sKL level was similar in both healthy and complicated pregnancy, our results suggest low activity of sKL in complicated pregnancy compared with control. 2. Complicated pregnancy is manifested in decline in mKL, also with low activity of sKL compared with control, and gene expression between healthy and complicated pregnancy. 3. A dramatic and significant decline in NO molecules concentration in urine of complicated pregnancy compared with healthy pregnancy.
#2771 PRESCRIBING PATTERNS IN GREEK HEMODIALYSIS PATIENTS: A MULTICENTER PHARMACOEPIDEMIOLOGY STUDY
Authors: Neofytou Ioannis , Kantartzi Konstantia , Roumeliotis Stefanos , Manolopoulos Vangelis , Thodis Elias , Panagoutsos Stylianos 
Published: June 2023

Abstract

Background and Aims
The aim of the study is to investigate the prescribing patterns and polypharmacy in Greek hemodialysis patients and make comparisons between renal units. Polypharmacy and hyperpolypharmacy emerged as a concerning problem, that affects patient's adherence, causes drug-drug interactions, adverse drug events, increases morbidity and economically strains the health system. Patients in Europe, are prescribed on average 10–12 drugs despite recommendations on polypharmacy.

Method
This is a multicenter retrospective study (2018-2021), in Northeastern Greece, of 270 patients (male = 168, female = 102) with mean age of 63.8±15 years and median dialysis duration of 45(18-96) months. The medications and laboratory values were documented for a period of 12 months, provided that there were no major changes on their therapy that time. The 4 public health dialysis units participating on the survey, were classified as secondary (179 patients) and tertiary care (91 patients) depending on the bed capacity (&gt;600) and the availability of health services. Statistical analysis was conducted using SPSS ver26.

Results
The mean number of prescribed medications was 10.4 (SD 2.9, range 2–20). Of the participants, 97.4% were experiencing polypharmacy (≥5 medications per person) and 62.6% hyperpolypharmacy (≥10 medications). The average number of prescribed medications in tertiary care was substantially lower comparing with secondary care (mean: 8,7 vs 11,3, p&lt;0.001). The difference in the mean number, remained significant even when the result was adjusted for age, gender, cardiovascular disease, primary disease and dialysis duration. Notably, despite the fewer medications, there was no statistically significant difference between the two groups, in achieving the most recent Kidney Disease Improving Global Outcomes (KDIGO) guidelines for URR (Urea Ruction Ratio), renal mineral bone disease and renal anemia (chi-sqaure, p&gt;0.05 for all variables). The most frequently prescribed group of medications were EPO analogues (87%), Vitamin D supplements (83%), Proton Pump Inhibitors (68%), β-blockers (56%), Antiplatelets (45%) and Loop diuretics (37%). It is important to note the alarming number of patients receiving medication for mental illness (35.2%), mainly benzodiazepines (26%), with women to be more vulnerable (42.2% vs 30.1%, OR:1.63).

Conclusion
This study reports that Greek prescribing practices follow the same worrisome patterns as other European countries. Rural hospitals appear to prescribe more drugs than tertiary facilities.
#2789 HIGHER MORTALITY RISK WITH CHRONIC KIDNEY DISEASE IN TYPE 2 DIABETES IN YOUNGER AGES: A DANISH NATIONWIDE COHORT STUDY 2014-2018
Authors: Nyeland Martin , Rørth Rasmus , Carstensen Bendix , Persson Frederik , Rossing Peter , Vistisen Dorte 
Published: June 2023

Abstract

Background and Aims
Chronic kidney disease (CKD) is a frequent complication to diabetes. CKD is associated with significantly increased risk of morbidity and mortality among people with diabetes. It is well known that the incidence and progression of CKD differ between men and women. Women are more likely to get CKD, while men have a more rapid progression of the disease. However, previous studies were based on small populations. We aimed to investigate the mortality with and without CKD in men and women with type 2 diabetes (T2D).

Method
Secular and age trends in mortality rates and sex differences were investigated in a dynamic, nationwide cohort of people with T2D. CKD was defined based on hospital diagnosis, procedure codes and laboratory measurements. Mortality rates were modelled as an age-period-cohort model using Poisson models with log person time, smooth effects of current age, and calendar time (date of follow-up), separate for each sex and CKD status.

Results
The study included 304,956 persons (55,9% men) and 1,2 million person-years. 87,696 persons were recorded with CKD, of which 34,967 persons had a CKD event during follow-up. The overall mortality rate was 37.8 [37.4; 38.2] versus 31.1 [30.4; 31.7] per 1000 person-years for people with T2D, without and with CKD, respectively. The mortality rate for people with T2D and CKD is larger and more pronounced in the younger ages. For elderly people the mortality rate is larger for people with T2D and without CKD. In general, mortality for men is higher than mortality for women at all ages, observed for both people with and without CKD. The overall secular trend per year was increasing for persons without CKD 2.0 [1.8; 2.2] %/year. For those with CKD, a decrease −2.4 [−2.1; −2.6] %/year was observed, decreasing until start 2017 followed by an increase. The overall M/F mortality ratios were 1.23 [1.20; 1.25] and 1.91 [1.83; 2.00], respectively.

Conclusion
The observed larger and more pronounced mortality rate for people with T2D and CKD in the younger ages, suggests a potential for early preventive intervention among young adults. Supported by an unrestricted grant from Bayer.
#2880 ASSESSMENT OF FLUID STATUS BY COMBINATION OF LUNG ULTRASOUND, BIOIMPEDANCE, AND INFERIOR VENA CAVA MEASUREMENT IN HEMODIALYSIS PATIENTS
Authors: Ekart Robert , Martin Oriol Portals , Soto Ricardo López , Galuf Tina Stropnik , Hojs Radovan 
Published: June 2023

Abstract

Background and Aims
Assessment of fluid status in hemodialysis patients (HD) remains a major challenge for nephrologists. Fluid overload is one of the most common modifiable risk factors directly associated with hypertension. The purpose of our study was to investigate whether the combination of three bedside methods-lung ultrasound comets (LUC), multifrequency bioimpedance (MBIS), and inferior vena cava diameter (IVCD) measurement-could provide complementary information to guide the management of HD patients.

Method
We assessed MBIS, LUC at 28 typical sites, and IVCD in 18 HD patients enrolled in the HD maintenance program. LUC and IVCD measurements were performed three times-before, during, and after HD, MBIS only before and after HD. For MBIS measurement, we used the Body Composition Monitor (Fresenius Medical Care, Bad Homburg, Germany), and for LUC and IVCD, we used an ultrasound machine (Esaote MyLabOmega, Genoa, Italy). Ultrafiltration during HD was not adjusted for LUC, IVCD, and MBIS. Overhydration (OH) was defined as &gt; 2L with MBIS, &gt; 15 LUC, and &lt; 40% collapsibility index (CI) on IVCD.

Results
The mean age of participants was 61 (IQR, 47-74) years, and thirteen (72.2%) were male. The average dialysis vintage of our patients was 105 months (IQR, 30-155). According to the OH criteria before, during, and after HD, 13 (72%), 2 (11%) patients were overhydrated according to MBIS, 10 (56%), 7 (39%), 3 (17%) patients according to LUC, and 13 (72%), 12 (67%), and 11 (61%) patients according to CI. We found no correlation between systolic blood pressure (BP), diastolic BP, MBIS, LUC, and CI before, during, and after HD, except that systolic BP after HD correlated with MBIS (OH) after HD (r = 0.491; p = 0.039). Using the paired-samples T-test, we found a statistically significant difference between OH before and after HD (p &lt; 0.001), between LUC before and during HD (p = 0.006), between LUC during and after HD (p = 0.002), and between LUC before and after HD (p &lt; 0.001). Using the paired-samples T-test, no statistically significant difference was found between systolic, diastolic BP and CI before, during, and after HD.

Conclusion
Optimal assessment of fluid status in HD patients remains challenging and, according to our results, may require a combination of LUC and MBIS parameters.
#2935 PHARMACOLOGICAL BLOCKADE OF NMDA RECEPTOR DECREASES KIDNEY INJURY INDUCED BY LIPOTOXICITY IN VITRO AND IN VIVO
Authors: Sanjuan Auria Eritja , Enriquez Maite Caus , Bardaji Ana Martinez , García-Carrasco Alicia , Diaz-Tocados Juan Miguel , Revilla José Manuel Valdivielso , Giráldez Elvira Fernández , Bozic Milica 
Published: June 2023

Abstract

Background and Aims
Obesity and hyperlipidemia are well established risks factors for kidney injury that can lead to chronic kidney disease (CKD). N-methyl-D-aspartate receptors (NMDARs) are expressed in the kidney and they are involved in the pathology of different renal diseases. The main objective of this study was to establish the role of the NMDAR in the lipotoxicity-induced kidney injury.

Method
In vivo, we used C57BL/6J mice fed a normal diet (ND) and high fat diet (HFD), as well as mice co-treated with HFD and NMDAR antagonists (HFD+memantine and HFD+MK-801). In vitro, we used renal proximal tubular epithelial cells (HK-2) treated with free fatty acids (FFAs) and a combination of FFAs and NMDAR antagonists. Lipid accumulation was analysed using Oil-Red staining. Expression of NMDAR1 and inflammation, fibrosis and oxidative stress markers were assessed by qPCR and western blot.

Results
After 10 weeks of diet, mice fed a HFD showed elevated levels of lipids in serum and kidney, compared with the ND. HFD induced an increase of expression of renal NMDAR mRNA and protein, as well as the expression of IL6, ICAM1, MCP1, TNFα and IL1β mRNA. Furthermore, HFD induced an increase of αSMA, vimentin, TGFβ1, fibronectin, OPN and NGAL levels in the kidney. Co-treatment with NMDAR antagonists significantly decreased levels of inflammatory markers, as well as the renal expression of αSMA, OPN and NGAL, but it did not have any effect on the hyperlipidemia induced by HFD. In vitro, treatment of HK-2 with different concentrations of FFAs induced accumulation of lipids in the cell, as well as the increase of the expression of NMDAR1 and markers of inflammation and oxidative stress. Co-treatment with NMDAR antagonists reversed changes induced by FFAs in HK-2 cells. The results were confirmed at the protein level.

Conclusion
Our results indicate that the NMDAR could be a new therapeutic target in the lipotoxicity-induced kidney injury.
#2997 ASSESSMENT OF FRACTURE RISK IN KIDNEY TRANSPLANT RECIPIENTS BY FRAX SCORE WITHOUT BONE MINERAL DENSITY
Authors: Elsharkawy Magdy , Emara Ahmed , Elbraky Abdelrahman , Abdelmegied Shaimaa Zaki 
Published: June 2023

Abstract

Background and Aims
Bone disease post-transplantation is a major cause of morbidity in kidney transplant (KT) recipients, with a significantly higher risk of fractures and mortality. This study investigated the added value of calculated 10-year fracture risk for major osteoporotic fracture (MOF) and hip fracture by frax score with an assessment of risk factors in KT recipients.

Methods
A cross-sectional study included 71 live-related KT recipients. Demographic, clinical, and laboratory data were recorded. The 10-year fracture risk for MOF and hip fracture were calculated using frax score without bone mineral density in recipients who completed at least 1 year after KT.

Results
The prevalence of MOF (&gt;3% risk of fracture) was 14.1%(10 patients), MOF (&lt;3% risk of fracture) was 85.9% (61 patients). A high hip fracture score (&gt;3% risk of hip fracture) was in 10% (1 patient). There was a significant difference between both groups (&gt;3%vs &lt;3% fracture risk) in age, MOF score, hip fracture score, and serum albumin p-value were &lt;0.00001, &lt;0.00001, 0.000134, and 043009 respectively. The analysis of demographic data of the patients with a score (&gt;3% fracture risk) showed that 70% were males (7 patients), 50% (5 patients) had BMI&gt;30 and the main cause of ESRD pre-transplant was lupus nephritis and glomerulonephritis in 50% (5 patients) that exposed for long periods of immune suppression pre-transplant. In 80% (8 patients) were 1st transplant, 10% (1 patient) were 2nd transplant, and 10% (1 patient) was a combined liver-kidney transplant. The rejection episode was zero%. There was a significant difference in patients' fracture risk &gt;3% in phosphorus pre-transplant versus post-transplant p-value 0.01.

Conclusion
Frax score without bone mineral density has shown a low percent of fracture risk (&lt;3%) in most kidney transplant recipients and high scores were associated with high BMI, phosphorus, and exposure pre-transplant to immune suppression.
#3015 EFFECT OF DAPAGLIFLOZIN ON ALBUMINURIA IN PATIENTS WITH TYPE 2 DIABETES AND CKD
Authors: Abdullaev Sherzod , Sharapov Olimkhon 
Published: June 2023

Abstract

Background and Aims
Albuminuria in patients with diabetes presents a higher risk for adverse renal and cardiovascular (CV) outcomes. Sodium-glucose co-transporter 2 (SGLT2) inhibitors demonstrate improved albuminuria and reduces the risk of end-stage renal disease in patients with chronic kidney disease. The study aim was the impact of the SGLT2 inhibitor dapagliflozin on urine albumin-to-creatinine ratio (UACR) and GFR decline.

Method
In the single center trial, total 132 participants with CKD and type 2 diabetes (T2D) were randomly assigned to dapagliflozin (n = 78) 10 mg once daily or placebo (n = 54). Kidney inclusion criteria were eGFR 30-60ml/min/1.73 m2 and any UACR. The primary end point was a composite of sustained decline in eGFR ≥50%, end-stage renal disease, or kidney or cardiovascular death. Percentage treatment difference was estimated by geometric mean ratio for the overall cohort and by eGFR and UACR subgroups. Progression/regression of UACR were assessed. Hazard ratios, 95% confidence intervals (CI), and p-values were estimated by Cox proportional hazards model.

Results
Median baseline eGFR was 42.3ml/min/1.73 m2, with 5% at &lt;30ml/min/1.73 m2. At baseline, median UACR was 103 mg/g, and 1/4 of patients had normoalbuminuria, 2/4 had micro, and 1/4 had macroalbuminuria. Median follow up was 18 months. The UACR difference for dapagliflozin vs placebo was -25.1% (95% CI -27.5, -23.2; p&lt;0.001). Reductions were similar across eGFRs. In UACR 30-299mg/g and ≥300mg/g, reductions were significant in dapagliflozin (p&lt;0.001). Progression risk was lower and regression risk higher in dapagliflozin vs placebo (p&lt;0.001).

Conclusion
Dapagliflozin significantly slowed long-term eGFR decline in patients with CKD with T2D compared with placebo, and significantly reduced UACR and had favorable effects on UACR progression and regression.
#3075 EFFECT OF KIDNEY TRANSPLANTATION ON CARDIORESPIRATORY FITNESS ASSESSED WITH CARDIOPULMONARY EXERCISE TESTING: A SYSTEMATIC REVIEW AND META-ANALYSIS
Authors: Pella Eva , Alexandrou Maria Eleni , Boutou Afroditi , Theodorakopoulou Marieta , Sampani Erasmia , Dipla Konstantina , Zafeiridis Andreas , Sarafidis Pantelis 
Published: June 2023

Abstract

Background and Aims
Patients with kidney failure often present with reduced functional cardiovascular reserve and exercise intolerance. Kidney transplantation is the optimal treatment for patients with end-stage kidney disease as it is associated with longer survival and improved quality of life compared to hemodialysis or peritoneal dialysis.

Method
This is a systematic review and meta-analysis of studies using cardiopulmonary-exercise-testing (CPET) to examine the cardiorespiratory fitness of patients with kidney failure before and after kidney transplantation. The primary outcome was differences in pre- and post-transplantation values of peak oxygen uptake (VO2peak). Literature search involved PubMed, Web of Science and Scopus databases, manual search of article references and grey literature. Quality assessment was undertaken with Newcastle-Ottawa-Scale.

Results
From 379 literature records initially retrieved, 6 studies (207 participants) were included in final meta-analysis. A marginal, but not significant, improvement was observed in oxygen consumption during peak exercise compared to pre-transplantation values (standardized mean difference [SMD]: 0.32, 95%CI −0.02; 0.67). Oxygen consumption at anaerobic threshold (VO2AT) was significantly improved after kidney transplantation (weighted MD [WMD]: 2.30 ml/kg/min, 95%CI 0.50; 4.09), whereas no significant changes were observed in maximum heart rate (WMD: 10.45 bpm, 95%CI −3.97; 24.86). In subgroup analysis, consistent results were shown between patients having undergone transplantation preemptively and those after dialysis initiation (p-value for subgroup differences = 0.95). Of note, a trend for improvement in VO2peak was observed when pooling data reported from follow-up assessments undertaken at least 3 months post-transplantation surgery (SMD: 0.17, 95%CI −0.03; 0.38), but not earlier (WMD: −0.03 ml/kg/min, 95%CI −4.28; 4.23).

Conclusion
Several major indices of cardiorespiratory fitness tend to improve after kidney transplantation compared to pre-transplantation values. This finding may represent another modifiable factor contributing to better survival rates of kidney transplant recipients compared to patients undergoing dialysis.
#3093 PROGNOSTIC FACTORS AND VALIDATION OF THE HISTOLOGIC CHRONICITY SCORE FOR C3 GLOMERULOPATHY: A REGISTRY ANALYSIS
Authors: Mirioglu Safak , Cebeci Egemen , Yazici Halil , Derici Ulver , Sahin Gulizar Manga , Eren Necmi , Gungor Ozkan , Dede Fatih , Dincer Mevlut Tamer , Turkmen Kultigin , Basturk Taner , Duranay Murat , Arikan Izzet Hakki , Tunca Onur , Elçioğlu Ömer Celal , Tatar Erhan , Aydin Zeki , Oygar Deren , Demir Serap , Tanrisev Mehmet , Kurultak Ilhan , Oruc Aysegul , Turkmen Aydin , Akcay Omer Faruk , Çetinkaya Hakkı , Ozturk Savas 
Published: June 2023

Abstract

Background and Aims
Data on prognostic factors of C3 glomerulopathy (C3G) are limited, and validation of the new C3G histologic index (C3G-HI) in different settings is still needed. We aimed to evaluate the chronicity score of C3G-HI and probable prognostic factors in our population.

Methods
In this prospective registry, 99 patients with C3G were identified, and 74 patients from 20 centers with adequate follow-up data were included. Total chronicity score (TCS) (0-10) was calculated according to percentages of glomerulosclerosis, interstitial fibrosis (IF), tubular atrophy (TA), and presence of arterio- and arteriolosclerosis [1]. Study outcome was defined as doubling of serum creatinine from baseline, undergoing dialysis or transplantation, development of stage 5 chronic kidney disease (eGFR &lt;15 ml/min/1.73 m2 by CKD-EPI 2009 equation), or death.

Results
Baseline features, treatment characteristics and outcomes were detailed in Table 1. Median follow-up duration was 36 (12-60) months. Overall, 19 patients (25.7%) experienced the study outcome over a median of 24 (6-51) months. Three patients died due to infections (n = 2) and unknown causes (n = 1) including a patient who died shortly after becoming dialysis-dependent. Median TCS was 3 (1-5). Univariate analyses showed that IF, hemoglobin, serum creatinine and serum albumin levels were associated with the outcome, but only grade 3 IF predicted the outcome in multivariate Cox regression (HR: 6.623, 95% CI: 1.269-34.564, p = 0.025). Since the median follow-up was 36 months, separate analyses for the outcome at 3 years were conducted. IF, TA, TCS, hemoglobin, serum creatinine and albumin were associated with the outcome in univariate analyses. In a multivariate Cox regression model encompassing IF, TA, hemoglobin, serum creatinine and albumin, only hemoglobin was identified as a predictor. A second model including TCS instead of IF and TA demonstrated that TCS (HR: 1.288, 1.021-1.626, p = 0.033) and hemoglobin (HR: 0.617, 0.407-0.935, p = 0.023) predicted the study outcome. Kaplan-Meier analysis showed that 3-year kidney survival was lower in patients with TCS ≥4 (72.4%) compared to TCS &lt;4 (91.1%) (p = 0.036) (Figure 1).

Conclusions
TCS ≥4 and lower hemoglobin levels at diagnosis predict the 3-year kidney survival in patients with C3G, which validates the chronicity score of C3G-HI.