bluuebunny/crossref_metadata_2025_split huggingface dataset:
#3961 A COMPARATIVE ANALYSIS OF EMOTIONAL RECOGNITION AND DIFFERENTIATION TWO YEARS FOLLOWING KIDNEY TRANSPLANTATION VERSUS HEMODIALYSIS.
Authors: Samaan Emad , Elrefaey Rabab , Sobh Mahmoud , Abulatta Youssef , Ibrahim Ibtihal , Sobh Mohamed , Nagy Eman 
Published: June 2023

Abstract

Background and Aims
Cognitive impairment is common in patients with End Stage Kidney Disease. There are conflicting reports regarding the degree and interval of improvement of cognitive functions with the different modalities of renal replacement therapy. Most of the published reports relied on screening tests not covering the emotional aspects of cognition. Also, the timings of assessment are different being at most during the first year of establishing the modality.

Method
Ninety age, gender, and educational level-matched participants were enrolled in the study. The participants were divided into three equal groups, thirty kidney transplant (KT) patients, thirty hemodialysis patients (HD) for more than two years, and thirty control non-diseased participants. The participants included were below 60 years of age and with no previous history of a neurological defect. All patients were subjected to three Computerized Neurocognitive Battery tests (Age differentiation test, emotional recognition, and differentiation). All the tests were judged for accuracy and the time consumed to answer.

Results
The median value of transplant duration was 59 months (24- 168), and 66 months (27- 180) of HD duration. Both groups were comparable in age, gender, educational level, socioeconomic, and marital status. KT patients were comparable to controls at all parameters of testing. KT patients' answers were significant of higher accuracy than HD patients (P = 0.04 for age differentiation and emotion recognition, and 0.005 for emotion differentiation). KT and HD had comparable response times. Total correct responses of emotional differentiation tests were negatively correlated with KT duration (rho = −0.348, P = 0.02), and (rho = −0.345, P = 0.01) for HD duration. The cumulative steroid dose was not correlated with any of the tested parameters in the KT group.

Conclusion
KT offers a much better emotional and social cognitive improvement, an effect that is expected to positively impact the quality of life and involvement in society.
#3962 BALANCING THE RISK OF ALLOIMMUNITY WHILE MINIMIZING IMMUNOSUPPRESSIVE THERAPY: A RETROSPECTIVE STUDY OF PAEDIATRIC KIDNEY TRANSPLANT RECIPIENTS
Authors: Gramkow Ann-Maria , Baatrup Johanne , Neland Mette , Koefoed-Nielsen Pernille , Thiesson Helle Charlotte 
Published: June 2023

Abstract

Background and Aims
Kidney transplantation is the best treatment for end-stage kidney disease, but life with a kidney allograft comes with significant challenges. Many paediatric kidney transplant recipients (KTRs) experience side effects from immunosuppressive medication. Reducing the medication is often necessary, but the reduction comes with a risk of inducing alloimmunity. We aimed to describe the alteration in immunosuppressive medication after kidney transplantation, the reasons for the reductions, and the possible impact on alloimmunity.

Method
49 paediatric KTRs aged 1-16 years, receiving a kidney allograft from 2009 to 2020 in a Danish single centre were retrospectively studied. The standard protocol for immunologically low risk KTRs was steroid-free immunosuppression with basiliximab as induction, tacrolimus and mycophenolate mofetil (MMF) as maintenance therapy. KTRs were screened for anti-HLA antibodies with mixed and single bead antigen kits. We defined reduced immunosuppression as a KTR receiving one; OR two immunosuppressive medications AND MMF below 600 mg/m2.

Results
49 KTRs received a kidney allograft, two were ABO incompatible transplantations and six KTRs had pretransplant donor specific antibodies. The median age of the KTRs was 11 years (IQR 8), with a median follow-up time of 5 years (IQR 5). In total, 78% KTRs received standard immunosuppressive therapy (steroid free). 5-year death censored (one KTR died) graft survival was 88%, and the cumulative incidence of rejection was 4% (95% CI: -1.5; 5.5) within the first year. None of the six graft losses were related to alloimmunity. 11.4% developed de novo donor specific antibodies (dnDSA) within a median of 3.91 years (IQR 2.28; range: 2.22-9.20) from transplantation. At transplantation, 6% received reduced immunosuppressive medication increasing to 74% at year one. Immunosuppression (primarily MMF) remained reduced in most of the KTRs during follow-up (Figure 1). Side effects predominantly to MMF led to the reduction. Leukopenia caused a reduction in 77%, gastrointestinal side effects in 34%, EBV in 19% (two KTRs developed PTLD), CMV in 15%, and BK polyomavirus in 15%. The reduction was significantly more pronounced in KTRs under 11 years (87% vs. 61%, p-0.044). Tacrolimus seemed well tolerated and was sufficiently regulated according to a target through of five microg/L two months after transplantation (Figure 2).

Conclusion
Despite 74% of the KTRs receiving reduced immunosuppressive medication according to our protocol, the rejection rate was low, the graft survival was comparable to European reports, and only 11% developed dnDSA during follow-up. Scheduled reduction of MMF shortly after transplantation could decrease the adverse side effects and improve the treatment of paediatric KTRs.
#4068 EVALUATION OF CHRONIC TOXIC EFFECT OF PROTON PUMP INHIBITORS (PPIS) ABUSE ON MAGNESIUM LEVEL IN HEMODIALYSIS PATIENTS
Authors: Shalaby Ezzeldin 
Published: June 2023

Abstract

Background and Aims
Proton Pump Inhibitors are widely used in haemodialysis patients for the prevention and treatment of uremic gastritis, peptic ulcer, gastritis, esophagitis and gastro oesophageal reflux. Hypomagnesaemia is reported recently in some patients who abuse intake of Proton Pump Inhibitors (PPIs) but this problem is still not well studied yet. Our study aims to evaluate the chronic toxic effect of Proton Pump Inhibitor on Magnesium level in Egyptian haemodialysis patients, especially those who suffer from abuse of intake without medical prescriptions.

Method
The study was conducted at the haemodialysis centre and clinic of Alzawya One-Day Surgery Hospital in Cairo including 60 end stage renal disease patients after their consents and approval of ethical committee in our hospital. PPIs use and duration were investigated. The patients were dialyzed using a dialysate magnesium level of 0.5 mmol/L and Calcium level 1.5 mmol/L in all groups, after at least one month of haemodialysis with the mentioned dialysate, laboratory tests were performed. The patients participating in this study after their consents were divided into 3 groups:
• Group A: - 20 patients on Proton Pump Inhibitors regularly with long term intake for more than 6 months on high dose above or equal280 mg/week [1] • Group B: -20 patients on Proton Pump Inhibitors irregularly for less than 6 months on low dose below 280 mg/week. • Group C: -20 patients not intake Proton Pump Inhibitors.
The magnesium level in haemodialysis patients was evaluated by comparison between the 3 groups, and its correlation with duration of its use, Calcium and Phosphorus level in blood. Dialysate magnesium and calcium concentration in all groups were fixed and abuse of intake of PPIs without medical prescription in the participated patients was evaluated.

Results
Show highly statistically significant higher mean value in Non-intake of PPI group, followed by PPI intake ≤6m group and the lowest value in PPI intake &gt;6m group according to magnesium “mg/dl”, with p-value (p&lt;0.001). There is no statistically significant difference between groups according to calcium “mg/dl”; with p-value (p&gt;0.05).

Conclusion
Proton Pump Inhibitors regularly with long term intake for more than 6 months on high dose above or equal 280 mg/week associated with hypomagnesaemia. So we recommend stoppage of abuse intake of PPIs in haemodialysis patients.
#4100 ACUTE KIDNEY INJURY, GLOMERULONEPHRITIS AND TUBULOINTERSTITIAL NEPHRITIS FOLLOWING VACCINATION: VIGIBASE ANALYSIS
Authors: Yoon Soo-Young , Lee Hayeon , Kim Jin Sug , Jeong Kyunghwan , Yon Dong Keon , Hwang Hyeon Seok 
Published: June 2023

Abstract

Background and Aims
Vaccination is the long-term established measure for disease prevention and worldwide outbreak of COVID-19 necessitates mass scale vaccination. However, there is a public concern on the risk of renal adverse reactions from several types of vaccination.

Method
We analyzed VigiBase (n = 120,715,116 reports), the World Health Organization pharmacovigilance database from Dec 1967 to Jul 2022 using disproportionate Bayesian reporting. Information component (IC) compares observed and expected values to find the associations of vaccines with acute kidney injury (AKI), glomerulonephritis (GN) and tubulointerstitial nephritis (TIN).

Results
We found 5,484 AKI (13.8% fatal), 2,846 GN (29.4% fatal) and 289 TIN reports (23.2% fatal) as vaccine-associated adverse reactions. Almost reports indicated single drug suspected cases (&gt;99.5% reports). The cumulative number of reports on vaccine-associated AKI, GN and TIN gradually increased and Americas was most prevalent regions of reporting. Examining the different vaccines separately, reporting count of COVID-19 mRNA vaccines sharply increased and it solely was associated with significantly higher reporting of AKI (IC025 1.09) and TIN (IC025 0.48). Patients aged 12-17 years had the highest IC values for COVID-19 mRNA vaccine-associated AKI and TIN. Hepatitis B (IC025 3.22), influenza (IC025 2.64) and COVID-19 mRNA vaccine (IC025 2.89) were prominently over-reported among ten types of vaccines with significant signals of GN.

Conclusion
In conclusion, AKI, GN and TIN substantially occurred following vaccination and it was most noticeable in patients exposed to COVID-19 mRNA vaccines. Clinicians should consider the increased risk of renal adverse reactions after vaccination.
#4102 THE IMPACT OF MOBILE HEALTH ON HOME BLOOD PRESSURE AND HEALTH LITERACY IN CHRONIC KIDNEY DISEASE
Authors: Wu Pei-Yu , Tsai Yi-Chun , Chiu Yi Wen 
Published: June 2023

Abstract

Background and Aims
Mobile health (mHealth) management is an emerging therapeutic strategy for chronic diseases. mHealth has been considered to improve self-care management and assist in detecting a worsening health status early. However, the effect of mHealth management on the blood pressure (BP) of patients with chronic kidney disease (CKD) has not been well-studied. This study aimed to access the association between mHealth management and BP control in CKD. We also investigated the association between mHealth and health literacy(HL) in CKD.

Method
Kaohsiung Medical University Hospital designed and developed a new healthcare mobile application called iCKD. The application has several major features, including BP monitoring, alarms, and a warning system. We randomly assigned 122 CKD patients stages 1-5 to utilize iCKD or paper records (control group) for BP management. The primary outcome was the portion of reaching the target goal, defined as office BP less than 130/80 mmHg, during the 6-month study. Trained nurses interviewed CKD patients using structured questionnaires to evaluate HL.

Results
Baseline kidney function and BP were not significantly different between iCKD and control groups. During the study period, 11 participants had withdrawal.42.3% of the iCKD group (22/52) had the BP control reaching the target goal, while only 22.4% (11/49) in the control group(p = 0.03). Regarding HL, CKD patients with BP reaching the target goal had higher total scores than those without. The score for iCKD group, ranging from 29.29 to 32.85, were higher than the control group, ranging from 28.94 to 31.03. (p = 0.01).

Conclusion
The iCKD group had a higher proportion of reaching the BP target goal and better HL score than the control group. This study demonstrates that mHealth can improve the CKD population's health literacy and BP management.
#4117 HYPERKALIEMIA TREATMENT APPROACH BY THE NEPHROLOGIST: A REAL-WORLD ANALYSIS (K+RENAL STUDY)
Authors: Vidas Maria Marques , Molina Fernando Tornero , Rubio María Auxiliadora Bajo , Lucas Milagros Fernandez , Morales Enrique , Rodriguez-Moreno Antolina , Paraíso Vicente , Bucalo María Laura , la Flor Jose Carlos De , López Paula 
Published: June 2023

Abstract

Background and Aims
hyperkaliemia is highly prevalent among chronic kidney disease (CKD) patients and its management is determinant to allow the maintenance of therapies of demonstrated cardiovascular and renal benefit. Attitude towards hyperkaliemia is variable among different guidelines and also among different clinicians. The aim of this study was to analyze nephrologist response to K serum levels &gt; 5.5 mmol/l in the out-patient setting.

Method
multicentric cross-sectional study performed in the nephrology departments of Madrid analyzing the therapeutic approach to K serum levels &gt; 5.5 mmol/l between July 1st and December 11th, 2022. The only exclusion criteria were being on renal replacement therapy and not obtaining patient's informed consent.

Results
13 centers entered the study including 339 patients with hyperK; 331 had enough data to be included in the final analysis. 258 (78%) patients had mild hyperK (5.5-5.9), 60 (18.1%) moderate (6.0-6.4) and 13 (3.9%) severe hyperK (≥6.5). 70.7% were males, mean age 72.0 (SD 13.4) and 87.3% and 55.6% suffered hypertension or DM, respectively. 17.3% were diagnosed from heart failure (25% NYHA type I, 63.6% TII and 11.4% TIII). Most frequent CKD diagnoses were CKD+DM 36%, nephroangioesclerosis/vascular 25.4%, glomerular 7.2% and unknown 16.6%. Median eGFG was 29.9 ml/min/1.73m2 IQR [21-41] and 40.9% had UACR &gt; 300 mg/g. Distribution according GFR stages was homogeneous (Pearson chi2 6.4 p 0.6) Percentage of use of ACEi, ARBs, MRA and NRAi was 41.5%, 37.9%, 13.7% and 1.52% and showed no association with higher K levels. 33.6% of the patients that suffer hyperK were already on any kind of low K diet, and 24.9% were on any K-binding therapy (11.2% calcium polystyrene sulfonate (CPS), 8.2% patiromer and 11.2% sodium zirconium cyclosilicate (SZC)). After hyperK episode, low-k diet was advised in 63.9% and was reinforced in 48% of patients that were already on low-k diet. Detection of hyperK was followed by initiation of k-binding therapy in 46.5% of the patients (22.8% SZC, 13.2% patiromer and 10.5% CPS). Treatment with ACEi or ARBs was stopped or decreased in 17.5% and 13% of patients respectively and in 45% of patient on MRA, with higher percentage of drug discontinuation in severe hyperK (40%, 25% and 50% respectively)

Conclusion
Most patients in nephrologist out-patient clinic suffering from hyperK are on any RAASi treatment, more than one third on low-k diets and almost 25% are on any k-binding therapy. Hyperkaliemia was followed of dietary advise in a high proportion of patients followed by initiation of k-binding drugs. There is still a high proportion of RAASi discontinuation or dose decreasing after hyperK, especially after severe episodes
#4152 CROSS-OMICS PROFILING OF PROTEOME, METABOLOME, AND TRANSCRIPTOME REVEALS MOLECULE AND CLEARANCE DYNAMICS AND ORIGIN IN PERITONEAL DIALYSIS
Authors: Herzog Rebecca , Eibensteiner Fabian , Aufricht Christoph , Kratochwill Klaus 
Published: June 2023

Abstract

Background and Aims
Peritoneal dialysis (PD) effluent is not only a rich source of markers for therapy monitoring and investigation of deregulated processes during PD it is also surprisingly underexplored and therefore poorly defined. Modern high performance mass spectrometry (MS) and sequencing methods allow monitoring of hundreds of analytes in parallel. For understanding PD transport dynamic and pathomechanisms and on a systems biology level, a multi-level omics approach is particularly attractive.

Method
Samples were obtained from stable patients chronically treated with PD at different time-points of standard 4h peritoneal equilibration tests (PETs). Effluent was collected after the pre-PET (overnight) dwell and at 0h, 1h and 4h dwells. Plasma samples were taken at the 2h PET time point. Effluent was separated into a cellular and cell-free component. Soluble proteins and metabolites in the cell-free compartment were processed using material-specific protocols and standardized LC-MS workflows. The cellular material was subjected to RNA sequencing. The Plasma-Proteome database was used for referencing plasma proteins and estimating plasma concentration. A bioinformatic workflow conjoined information from the datasets to reveal novel insights into the “PD-effluentome”, especially unravelling the origin of proteins and metabolites in PD effluent.

Results
Metabolomics enabled detecting of 207 unique metabolites in cell-free PD effluent. A mixed-effect ANOVA of all metabolites demonstrated dwell time-dependent concentration changes in 173 metabolites. Post-hoc testing revealed most metabolites to be changed between 1h and overnight time points, followed by 114 and 46 differently concentrated metabolites between 4h and overnight and 1h and 4h, respectively. We quantified 9,797 transcripts in PD-effluent cells and 2,729 proteins in PD effluent. 342 proteins were filtered from plasma, while 800 proteins were attributable to local origin or production. A quantitative analysis of the interaction proteome and cellular transcripts of ∼1700 protein-transcript pairs showed clusters of proteins explained by over-expression in peritoneal cells compared to plasma concentrations.

Conclusion
Cross-omic profiling of PD effluent can be a valuable approach for revealing small molecule related changes during PD. The exploitation of PD effluent on multiple levels could improve the understanding of pathophysiological molecular processes and transport dynamics in the peritoneal cavity and their role in development of PD complications.
#4154 CIRCULATING BETA-TRACE PROTEIN VERSUS CREATININE AS MARKERS OF EARLY KIDNEY (DYS)FUNCTION IN THE NX-INDUCED RAT MODEL OF CHRONIC KIDNEY DISEASE
Authors: Lousa Irina , Belo Luís , Viana Sofia D , Vieira Pedro , Vala Helena , Santos-Silva Alice , Reis Flávio 
Published: June 2023

Abstract

Background and Aims
Beta trace protein (BTP) is a low molecular weight protein that has been proposed as an earlier biomarker of decreased glomerular filtration rate (GFR) and renal damage, than the traditional biomarkers, particularly in the creatinine blind range. Early biomarkers of renal (dys)function are needed to allow, in due time, the detection and treatment, to prevent worsening of the disease. To the authors’ knowledge, neither urine nor serum BTP has been assessed in animals with kidney disease. In the present study, we aimed to concomitantly evaluate BTP and creatinine circulating levels, to compare their value as early biomarkers of renal dysfunction, by performing the studies in rat models of mild and moderate chronic renal failure (CRF) induced by nephrectomy.

Method
Male Wistar rats, 12 weeks old, were randomly divided in three groups: Sham (n = 8, subjected to surgical process without kidney mass reduction), Mild CRF (n = 8, subjected to 1/2 nephrectomy), and Moderate CRF (n = 7, subjected to 5/6 nephrectomy). After five weeks, rats were sacrificed, blood and kidneys were collected. We analysed the circulating levels of BTP and creatinine and studied the association of BTP concentration with the glomerular and tubulointerstitial lesions, and with the traditional biomarkers of renal (dys)function, eGFR and creatinine.

Results
The serum levels of BTP were correlated with serum levels of creatinine (r = 0.575, p = 0.004) and also with eGFR (r = -0.453, p = 0.030); additionally, we found positive correlations with the total score of mild and advanced tubular lesions (r = 0.610, p = 0.02 and r = 0.517, p = 0.011, respectively), observed in kidney sections. The circulating levels of BTP increased with disease severity; Mild CRF showed a higher value of BTP than Sham group, although without statistical significance that was reached in Moderate CRF group, as observed for serum creatinine. The combined use of BTP and creatinine did not improve the discriminatory power in early disease detection. Though, the combination showed stronger correlations with the total score of tubular lesions (r = 0.849, p &lt; 0.001 for mild tubular lesions and r = 0.774, p &lt; 0.01 for advanced tubular lesions).

Conclusion
In rat models of mild and moderate CRF induced by nephrectomy, serum BTP levels increased with kidney function worsening, and correlated with disease severity, assessed by GFR and the degree of histopathological alterations. However, the earlier diagnostic value of BTP does not outperform serum creatinine in this model.
#4160 PHASE ANGLE (PA), AGE AND MIS AS MORTALITY PREDICTORS IN PATIENTS WITH ADVANCED CKD
Authors: Barril Guillermina , Alvarez Graciela , Núñez Almudena , Glez Carmen Sanchez , Nogueira Ángel 
Published: June 2023

Abstract

Background and Aims
Survival study in Advanced CKD patients according to age, MIS and phase angle

Method
We studied 225 patients with ACKD, 153 men (68.3%), xage 70.09±12.72 years. We analyze survival at 120 months and how the Phase angle (PA) and MIS scale influence mortality. We chose these parameters, one of body composition (BIA-vector) and the MIS malnutrition-inflammation scale, since they are described as independent predictive factors.

Results
We defined the cut-off point for PA with the ROC curve, appearing as 3.75 (sensitivity 67% and specificity 55%). With 83 (37.1%) ≤3.75 and 141 (62.9%) greater than 3.75 PA, with significance between men and women p0.001. Analyzing the % of deaths with PA with PC- 3.75 there is a significant difference between groups p0.001 with difference between men and women With a cut-off point of 5 for MIS, we established 162 (72.3%) with ≤5 and 82 (22.7%) with MIS&gt;5. Analyzing the % of deaths according to MIS strata, there is a significant difference p 0.001, Sig difference between men and women p0.021 We define with COR cut-off point age = 70.5 years sens 85% spec 63% 79 patients (64.6%) died in 120 months, 53/152 (65.1%) men and 45/71 (63.4%) women pns. xage deceased 76.39±9.16 vs 66.63±13.14 years p0.001. The survival curves for the 3 variables by Kaplan Meier are significant with the established cut-off points (Fig. 1). In the univariate analysis we found that age (CP-70.5 years) p0.001, and PA (CP-3.75) p0.04 are significant, but not MIS(CP-5). In the Cox analysis we evaluated age, PA and MIS, with age appearing as a priority, followed by PA and finally the statistical MIS Wald 18.73, 3.77 and 2.26 respectively.

Conclusion
1-Age, phase angle and MIS are independent mortality risk factors for ACKD patients. 2-In the multivariate model Age and phase angle are predictors of mortality. 3-Independent of age, the phase angle is the best predictor of mortality.