bluuebunny/crossref_metadata_2025_split huggingface dataset:
#3679 ANOCTAMIN 1 INHIBITION SUPPRESSES CYSTOGENESIS BY ENHANCING CILIOGENESIS AND THE CILIARY DOSAGE OF POLYCYSTINS
Authors: Xu Tao 
Published: June 2023

Abstract

Background and Aims
Autosomal dominant polycystic kidney disease (ADPKD) is a ciliopathy which is characterized by abnormal tubular epithelial proliferation and fluid secretion. Anoctamin 1 (ANO1) is a calcium-dependent chloride channel, which has recently been shown to be involved in ADPKD progression. However, how ANO1 contributes to ADPKD is largely unexplored.

Method
1. Based on mRNA gene chips, the expression of ANO1 abnormally increased in human ADPKD kidneys. 2. Immunohistochemical staining showed ANO1 location. 3. Real-time PCR and Western blot showed mRNAs and protein of ANO1 in ADPKD patients and animal model-PKD1RC/RC mice. 4. Confocal immunofluorescence showed ANO1 and PC2 location in the cilia. 5. 3D gel culture to verify the function of ANO1 in cysts formation. 6. ANO1 inhibitors and siRNA to discover STAT3 and ERK pathway in ADPKD cell by WB.

Results
We found that ANO1 is consistently upregulated inhuman and mouse PKD kidneys. Intriguingly, ANO1 located in a vesicle-like patten at the ciliary base but not on the ciliary surface. ANO1 deficiency promotes both ciliogenesis and the ciliary dosage of polycystin-2 in human Pkd1-/- cells, and reduced cyst formation in 3D culture models. Moreover, inhibition of ANO1 abolished the activation of STAT3 and ERK pathways in PKD cells.

Conclusion
Our data indicate ANO1 may aggravate ADPKD by regulating the cilia length and PC2 expression. Moreover, ANO1 could support cyst growth by activating STAT3 and ERK pathways. Thus ANO1 is a negative regulator for both cilia formation and cilia trafficking of polycystins and provide mechanistic insights regarding the therapeutic potential of ANO1 pathway in ADPKD treatment.
#3687 KIDNEY TRANSCRIPTOME VARIES BETWEEN DONOR TYPES, WITH A DIFFERENTIAL REPONSE TO ISCHEMIC PRECONDITIONING
Authors: Coelho Tiago Pinto , Erpicum Pauline , Navez Margaux , Zhang Chenyu , Poma Laurence , Detry Olivier , Jouret François 
Published: June 2023

Abstract

Background and Aims
The prevention/attenuation of graft ischemic injury is a challenge in kidney transplantation. We developed two rat models to investigate the impact of mesenchymal stromal cells (MSCs) in the ischemic preconditioning of kidneys from Donors after Circulatory Death (DCD) and Donors after Brain Death (DBD).

Method
Under general anesthesia, rats underwent iv injection of saline (S-groups) or 1.5 106 MSCs (MSC-groups) followed by either DBD (6hr of brain death) or DCD (6hr of anesthesia and 20min warm ischemia) models, resulting in 4 groups (S-DBD, S-DCD, MSC-DBD, MSC-DCD). Kidneys were then procured after IGL1 flush. One kidney was directly fixed and the other one immersed for 14 hours in IGL1 at 4°C. Serum samples were collected before treatment (baseline) and at the time of kidney collection. Urine samples were collected by bladder puncture at the time of kidney collection. Renal function was evaluated. Kidney histology was assessed by PAS staining and KIM1 immunostaining. Total RNA was extracted from S-DCD vs S-DBD kidneys for RNAseq.

Results
BUN was increased after 6h of anesthesia (DCD) or brain death (DBD) (p&lt;0.01). SCr increased in both S-DBD and MSC-DBD but was lower in MSC-treated rats (MSC-DBD 0.5±0.2mg/dL vs S-DBD 0.7±0.1mg/dL; p = 0.037). Urinary KIM1 was lower in MSC-treated DBD (S-DBD 10.9±4.5 vs MSC-DBD 7.1±1.7; p = 0.03). Acute Tubular Injury (ATI) and KIM1 expression were higher in S-DBD (ATI: S-DBD 65±24% of surface vs S-DCD 39±27% of surface (p = 0.03) and KIM1: S-DBD 0.39±0.24% of surface vs S-DCD 0.10±0.09% of surface (p = 0.0002)). In MSC groups, there was no difference in both ATI extension and KIM1 expression. RNAseq showed that proinflammatory and proapoptotic pathways were upregulated in DBD, whereas transmembrane transport and metabolic pathways were downregulated, compared to DCD.

Conclusion
The RNA profiles of the kidneys are different upon donor types, which may impact the response to MSC-based ischemic preconditioning.
#3712 INTRAVASCULAR VOLUMES AND THE INFLUENCE ON ANAEMIA IN PATIENTS UNDERGOING MAINTENANCE HAEMODIALYSIS
Authors: Vinje Vårin , Bomholt Tobias , Hornum Mads , Oturai Peter , Rix Marianne , Lundby Carsten , Lindhard Kristine 
Published: June 2023

Abstract

Background and Aims
Fluid overload is a major challenge in haemodialysis (HD) patients and might cause hypervolaemia. We speculated that HD patients reaching dry weight could have undetected hypervolaemia and low haemoglobin concentration (Hb) due to haemodilution.

Method
The study included HD patients (n = 22) and matched healthy controls (n = 22). Blood volume, plasma volume, red blood cell volume, and total haemoglobin mass (Hb mass) were determined using a carbon monoxide (CO)-rebreathing method in HD patients reaching dry weight and controls. Blood volume measurements were also obtained by a dual-isotope labelling technique in a subgroup for validation purposes.

Results
Blood volume was higher in 16 out of the 22 HD patients compared to controls. In the HD group, the median blood volume was 89.3 mL/kg (interquartile range (IQR) 76.7–95.4 mL/kg) and was higher than in the control group (79.9 mL/kg (IQR 70.4–88.0 mL/kg); P &lt; 0.037) (Table 1). The median plasma volume was 54.7 mL/kg (IQR 47.1–61.0 mL/kg) and 44.0 mL/kg (IQR 38.7–49.5 mL/kg) in the HD and control groups, respectively (P &lt; 0.001). Hb was lower in HD patients (P&lt;0.001), whereas no difference in total Hb mass was observed between groups (P = 0.11). Changes in Hb levels during and after dialysis were observed in the HD group and is shown in Fig. 1. A correlation was found between blood volume measured by the CO-rebreathing test and the dual-isotope labelling technique in the control group (r = 0.83, P = 0.015), but not the HD group (r = 0.25, P = 0.60).

Conclusion
The HD group had increased blood volume at dry weight due to high plasma volume, indicating a hypervolaemic state. The total Hb mass was similar between HD patients and controls, unlike Hb, which emphasizes that Hb is an inaccurate marker of anaemia among HD patients.
#3719 INCIDENCE, OUTCOMES AND RISK FACTORS OF ACUTE KIDNEY INJURY IN PATIENTS THAT UNDERWENT TRANSCATHETER AORTIC VALVE REPLACEMENT
Authors: Isaranuwatchai Suramath , Triwatana Wutipong , Jitpreeda Amaraluk , Srirattana Netnapis , Sukitpunyaroj Damrong 
Published: June 2023

Abstract

Background and Aims
The incidence of acute kidney injury (AKI) in transcatheter aortic valve replacement (TAVR) varied among different centers and populations. The studies about the AKI in TAVR in Asian population were relatively scarce. Here, we reported the first descriptive study of AKI in patients underwent TAVR in Thailand. We also analyzed the risk factors of AKI in patients underwent TAVR.

Method
We reviewed the medical records of patients underwent TAVR in Chulabhorn hospital from August 2019 to September 2022. Baseline characteristics, serum creatinine and estimated glomerular filtration rate (eGFR) at baseline, day 2, day 7 and at discharge were recorded. Patients who did not have serum creatinine measured at day 2 or day 7 were excluded from our study. Patients who already underwent hemodialysis or peritoneal dialysis before TAVR also excluded from our study. We used the definition of AKI by KDIGO guideline. Outcome of AKI including 30-day mortality, 1-year mortality and renal replacement therapy were also recorded.

Results
We included 113 patients who underwent TAVR, all of which had the diagnosis of severe symptomatic aortic stenosis. 56 patients (49.6%) were male patients. The mean age was 80.2 +/- 5.6 years. The average length of stay was 9.9 days. 54 patients (47.8%) had pre-existing chronic kidney disease (CKD) before underwent TAVR. Other co-morbidities were hypertension (81/113 = 71.7%), dyslipidemia (71/113 = 62.8%), prior myocardial infarction (53/113 = 46.9%), diabetes (36/113 = 31.9%), and prior stroke or transient ischemic attack (5/113 = 4.4%). AKI occurred in seven patients (6.2%). Four patients (4/7 = 57.1%) underwent acute dialysis after TAVR. 30-day mortality rate was 0% and 1-year mortality rate was 1.8%. The 1-year mortality rate in patient with AKI was 14.3% compared with 0.9% in patient without AKI. The univariate analysis revealed that age, prior myocardial infarction, pre-existing CKD and pre-TAVR serum creatinine were risk factors for developing AKI after TAVR.

Conclusion
This is the first study exploring incidence, outcomes and risk factors of AKI in patients underwent TAVR in Thailand. The incidence of AKI was 6.2%, relatively low compared with previous study.
#3720 ON THE DEVELOPMENT OF SOME PAIN SYNDROMES IN PATIENTS ON DIALYSIS
Authors: Khalmukhamedov Javokhir 
Published: June 2023

Abstract

Background and Aims
To study the incidence and intensity of cramps in patients with end-stage CKD during dialysis.

Method
In a cross-sectional study in 2021, 160 male and female patients on program dialysis (PD), aged 22 to 77 (53.3±7.11) receiving for 7.7 ± 1.83 (1 to 25) lasting 12 ± 0.24 hours per week (average KT / V 1.4 ± 0.03) on Fresenius and B. Braun devices. The intensity of cramps was assessed according to a numeric rating scale (NRS) from 0 to 10, as well as its impact on quality of life. To identify patients with intradialytic hypotension (IDH), we used the KDOQI guidelines, which define IDH as a 20 mm Hg decrease in systolic blood pressure (BP) from the origin, assessed over 3 consecutive sessions. All patients' blood serum was checked for phosphorus (P), calcium (Ca), parathyroid hormone (PTH).

Results
Patients were divided into 2 groups, presence 81 (51.0%) or absence 79 (49.0%) of cramps (Table 1). Among patients with diabetes, the frequency of absence of cramps is 2 times higher than among patients with diabetes (6% vs. 94%, respectively) (Table 2). Among patients with hypotension, only in 15% there were no cramps, while without hypotension 85% (Table 3). No statistically significant difference was found between the groups for any of the 3 parameters (PTH, P, Ca).

Conclusion
Painful muscle spasms have been insufficiently studied, although their impact on the quality life of dialysis patients is clinically significant. The first steps should be on correcting for potentially modifying risk factors, development of hypotension during a procedure and correction of phosphorus levels.
#3738 KIDNEY TRANSPLANT RECIPIENTS BECOME LESS ADHERENT TO PREVENTIVE MEASURES AFTER SARS‑COV‑2 VACCINATION AND AFTER AWARENESS OF ANTIBODY RESPONSE
Authors: Frölke Sophie , Bouwmans Pim , Messchendorp Lianne , Vervoort Hanneke , Nieuwkerk Pythia , Abrahams Alferso C , De Vries Aiko , Hemmelder Marc , Gansevoort Ronald , Hilbrands Luuk , Reinders Marlies , Sanders Jan-Stephan , Bemelman Frederike , Geerlings Suzanne 
Published: June 2023

Abstract

Background and Aims
Kidney transplant recipients (KTRs) were advised to tightly adhere to government recommendations to curb the spread of SARS-CoV-2 because of a high risk of morbidity and mortality and decreased immunogenicity after vaccination. The aim of this study was to analyze the change in adherence to preventive measures after vaccination and awareness of antibody response, and to evaluate the effectiveness of these measures.

Method
Questionnaires were sent to 3531 KTRs enrolled in the Dutch RECOVAC studies, retrospectively asking for adherence to nine preventive measures on a 5-point Likert scale before and after SARS-CoV-2 vaccination and after awareness of antibody response. Blood samples were collected 28 days after the second vaccination. Antibody response was categorized as non-responder (≤50 BAU/mL), low-responder (&gt;50 ≤300 BAU/mL) or high-responder (&gt;300 BAU/mL), and shared with participants as a correlate of protection. Adherence before and after vaccination were compared by the Wilcoxon signed rank sum test. Logistic regression analysis was performed to estimate the association between antibody response and adherence, and adherence on acquiring SARS-CoV-2 infection.

Results
In 2939 KTRs (83%) who completed the first questionnaire on adherence to preventive measures, adherence was higher before than after SARS-CoV-2 vaccination (4.56, IQR 4.11-4.78 and 4.22, IQR 3.67-4.67, p &lt; .001) (Figure 1). Adherence after awareness of antibody response was analyzed in 2399 KTRs (82%) of whom also blood samples were available, containing 949 non-responders, 500 low-responders and 950 high-responders. Compared to non-responders, low- and high-responders reported lower adherence (Figure 2). Higher adherence was associated with lower infection rates before and after vaccination (OR 0.67 [0.51-0.91], p = 0.008 and OR 0.48 [0.28–0.86], p = 0.010).

Conclusion
To the best of our knowledge, we are the first to show that KTRs became less adherent to social isolation and other preventive measures after vaccination against COVID-19. Adherence decreased in KTRs who were aware of a subsequent antibody response compared to those without. Moreover, preventive measures in this vulnerable group are effective, regardless of vaccination status.
#3763 RELATIONSHIP BETWEEN INITIAL EGFR DIP AND CHANGES IN LABORATORY PARAMETERS WITH DAPAGLIFLOZIN TREATMENT IN NON-DIABETIC CKD PATIENTS
Authors: Kokubu Maiko , Okanishi Go , Tansho Kosuke , Matsui Masaru 
Published: June 2023

Abstract

Background and Aims
Treatment with sodium-glucose co-transporter-2 inhibitors (SGLT2i) induces an initial decline in estimated glomerular filtration rate, also termed the ‘eGFR dip’ and remains beneficial effects for cardiovascular and kidney outcomes, even after modified by eGFR dip in diabetic CKD. However, the difference of eGFR dip after SGLT2i between diabetic and non-diabetic CKD patients and the effects of eGFR dip on changes of laboratory parameters is not fully understood. In this study, we aimed to investigate the eGFR dip after Dapagliflozin and its relationship with clinical and laboratory data in non-diabetic CKD patients.

Method
We conducted a cohort study on 127 non-diabetic CKD patients receiving Dapagliflozin in whom at least two measurements of eGFR levels at three months were confirmed. eGFR dip was defined by percent eGFR change from baseline. eGFR was calculated using Japanese equation. Correlation analyses between initial eGFR dip and clinical value were conducted using the Pearson correlation coefficient.

Results
The mean age of study participants was 60±13 years and 69 (54%) were male. The underlying kidney diseases included glomerulonephritis in 59 (46%) patients and hypertensive nephrosclerosis in 57 (45%). The mean levels of baseline eGFR were 43±13 mL/min/1.73 m2 and the mean proteinuria was 0.58±0.83 g/gCre. The mean eGFR change from baseline was −0.33±4.3 mL/min/1.73 m2 with eGFR dip of 0.8±9.4%. Factors including age, sex, body mass index, baseline eGFR and urinary protein were not significantly associated with the eGFR dip. Dapagliflozin increased hemoglobin levels by 0.5g/dL and decreased uric acid levels by 0.9 mg/dL. We found indirect and direct correlation of the eGFR dip with changes in proteinuria (r = 0.30, p = 0.001) and uric acid levels (r = 0.21, p = .015) after Dapagliflozin, respectively.

Conclusion
Our results suggest that the eGFR dip following SGLT2i initiation may be associated with the changes of proteinuria and uric acid levels in non-diabetic CKD patients.
#3770 EBV-NEGATIVE KIDNEY TRANSPLANT RECIPIENTS AND PTLD: THE IMPACT OF INDUCTION THERAPY
Authors: Attieh Rose Mary , Mao Shennen , Mao Michael , Pungpapong Surakit , Cheungpasitporn Wisit , Jarmi Tambi , Wadei Hani , Taner Burcin , Leeaphorn Napat 
Published: June 2023

Abstract

Background and Aims
Individuals who are most susceptible to developing PTLD are those who are EBV-negative and receive organs from EBV-positive donors (EBV R-/D+). The evidence regarding the connection between ATG induction therapy and PTLD is inconsistent. No studies have specifically examined the relationship between ATG use and PTLD in subgroups of EBV-negative transplant recipients (EBV R-). Using the UNOS database, we studied the association between the use of induction agents and PTLD in EBV R- patients.

Method
We analyzed data from 2007 to 2022 of EBV R- patients who underwent their first kidney-only transplant and excluded those who received induction agents other than ATG, basiliximab, or alemtuzumab. We used logistic regression to evaluate the association between induction agents and PTLD.

Results
Of 20,531 recipients, 50.7% received ATG, 19.13% received basiliximab, 13.42% received alemtuzumab, and 16.75% received no induction. The overall PTLD incidence was 2.14%. ATG recipients had higher rates of deceased donor transplants, higher degree of HLA mismatch, longer dialysis vintage, and were less likely to be white, compared to non-ATG recipients. Multivariate analysis showed ATG recipients had a higher risk of PTLD compared to non-ATG (odds ratio = 1.47, p&lt;0.001). After excluding recipients who did not receive induction, ATG remained a significant independent risk factor for PTLD when compared to recipients who received either basiliximab or alemtuzumab (odds ratio = 1.35, p = 0.007). There was no statistically significant difference in PTLD risk among patients treated with basiliximab, alemtuzumab, or no induction (refer to Table 1).

Conclusion
The use of ATG induction in EBV-negative kidney transplant recipients is associated with a higher risk of PTLD compared to basiliximab, alemtuzumab, and no induction. The risk of PTLD should be considered when choosing induction therapy for this patient population.
#3781 INSULIN RESISTANCE IS ASSOCIATED WITH INCIDENT CHRONIC KIDNEY DISEASE IN POPULATION WITH NORMAL RENAL FUNCTION
Authors: Bae Eun Hui , Song Su Hyun , Kim Su In , Cho Da Hae , Lim Sang Yoeb , Kim Soo Wan , MA Seong Kwon 
Published: June 2023

Abstract

Background and Aims
Insulin resistance is prevalent in chronic kidney disease (CKD) and may accelerate its progression. This study aimed to investigate whether insulin resistance was associated with the development of incident CKD in a population with normal renal function.

Method
A total of 3,331 individuals with normal renal function from a community-based cohort formed the study population. We determined the relationship between insulin resistance indices and incident CKD using Cox proportional hazard model and Kaplan-Meier survival analysis.

Results
During a mean follow-up of 11.03 ± 4.22 years, incident CKD occurred in 414 (12.4%) participants. The high homeostasis model assessment-insulin resistance (HOMA-IR) level group had an increased risk of incident CKD (HR, 1.40; 95% CI, 1.13-1.74; p = 0.002) compared to the normal group after adjusting for confounding factors The risk of incident CKD also increased with lower quantitative insulin sensitivity check index (QUICKI) levels (HR, 0.62; 95% CI, 0.41-0.92; p = 0.018) and higher leptin-adiponectin ratio (LAR) levels (HR, 1.23; 95% CI, 1.06-1.42; p = 0.006).

Conclusion
Higher insulin resistance indices were associated with the incidence of CKD. Our data suggests that increased insulin resistance may be involved in the development of incident CKD in individuals with normal renal function.
#3783 INCIDENCE AND PREDICTORS OF MAJOR ADVERSE KIDNEY EVENTS IN ICU PATIENTS WITH SEPSIS: A PROSPECTIVE COHORT STUDY FROM A DEVELOPING COUNTRY
Authors: Rao Indu Ramachandra , Thanekar Saurabh , Nagaraju Shankar Prasad , Prabhu Ravindra Attur 
Published: June 2023

Abstract

Background and Aims
Acute kidney injury (AKI) occurs in 15-60% of intensive care unit (ICU) admissions and is associated with higher mortality, morbidity and increased healthcare costs. Major adverse kidney events (MAKE) is a clinically meaningful patient-centred outcome for AKI which includes mortality, need for renal replacement (RRT) and persistent kidney dysfunction. There is a paucity of data on the incidence and risk factors of MAKE, particularly from developing countries. We sought to examine the incidence of MAKE at day 30 (MAKE30) and its predictors in a cohort of critically ill patients with sepsis.

Method
This was a prospective cohort study conducted in the medical ICUs of a tertiary-care hospital in India. Ethical clearance was obtained from the Institutional Ethics Committee. Adult patients (≥ 18 years) admitted in the medical ICUs between 1st September, 2022 and 31st December, 2022 with sepsis (as defined by Sepsis-3 criteria) were included. Those with chronic kidney disease stage 5/5D, those requiring dialysis within 72 hours of admission and with an ICU stay of &lt;72 hours were excluded. Baseline clinical and demographic data were recorded on the day of admission. AKI was defined as per KDIGO 2012 guidelines. Patients were followed up till hospital discharge or day 30 (whichever was earlier) and clinical outcomes were noted. The primary outcome measure was MAKE30 (defined as a composite of death, provision of RRT, or sustained loss of kidney function i.e., a final inpatient creatinine ≥200% of the baseline value, at hospital discharge or at 30 days, whichever comes first).

Results
A total of 250 patients admitted in the medical ICUs during the study period were included for analysis. The baseline characteristics are tabulated below (Table 1). Over the 30-day follow-up period, AKI was noted in 185 (74%) patients, with stage 1 AKI in 38 (15.2%), stage 2 AKI in 29 (11.6%) and stage 3 AKI in 118 (47.2%). Renal replacement therapy was initiated in 86 (34.4%) patients. Mortality occurred in 58 (23.2%). Overall, MAKE30 was seen in 102 (40.8%) patients. Serum lactate (OR 1.04, 95% CI:1.01-1.06; P = 0.010) and SOFA score (OR 1.38, 95% CI:1.27-1.56; P &lt;0.001) at admission were independently associated with MAKE30 (Table 2). There was no association with age, gender, diabetes, type of resuscitation fluid or cumulative fluid balance (at 72 hours) with MAKE30.

Conclusion
In this cohort of critically ill patients with sepsis, MAKE30 was observed in 40.8%. Serum lactate and SOFA score at admission were independent predictors of MAKE30.