bluuebunny/crossref_metadata_2025_split huggingface dataset:
THE RELATIONSHIP BETWEEN ARTERIAL STIFFNESS, SUBCLINICAL HEART FAILURE, CARDIAC FIBROSIS AND RENAL FUNCTION IN CHRONIC KIDNEY DISEASE, IGA NEPHROPATHY
Authors: Kovács Tibor József , Vas Tibor , Csepregi Rita Klaudia , Horváth-Szalai Zoltán , Nagy Judit , Csiky Botond , Sági Balázs 
Published: June 2023

Objective:
IgA nephropathy (IgAN) is the most common primary glomerular disease worldwide. Arterial stiffness may predict cardiovascular (CV) mortality and morbidity in chronic kidney disease (CKD). Heart failure is very common in advanced CKD stages. Onset of myocardial fibrosis may be a pathophysiological alteration in CKD patients with heart failure.

Design and method:
In our cross-sectional study, we examined 90 patients who cared for IgAN in our clinic. Arterial stiffness was determined by measuring carotis-femoral pulse wave velocity (cfPWV) using the ShygmoCor device. N-terminal prohormone of brain natriuretic peptide (NT-proBNP) and carboxy-terminal telopeptide of collagen type I (CITP) were measured using ELISA kits. Renal function was detected by the estimated glomerular filtration rate (eGFR-CKD-EPI). Furthermore, a routine echocardiography examination was performed.

Results:
Of the 90 patients included in the study, 50 were male, with a mean age of 54.9 ± 14.4 years. Patients were divided into two groups based on eGFR (CKD 1-2 and CKD 3-5). There were significantly higher NT-proBNP (p = 0.035), cfPWV (p = 0.004), and central aortic systolic pressure (p = 0.037), but not CITP, in the CKD 3-5 group. The number of patients with combined biomarker positivity (NT-proBNP and CITP) was also significantly higher in the CKD3-5 group (p = 0.035) compared to the CKD 1-2 group. The central aortic systolic pressure was significantly higher in the diastolic dysfunction group (p = 0.034), but the systolic blood pressure was not. eGFR and hemoglobin level showed a strong negative correlation, while left ventricular mass index (LVMI), aortic pulse pressure, central aortic systolic pressure, and cfPWV showed a positive correlation with NT-proBNP. cfPWV, aortic pulse pressure, and LVMI showed a strong positive correlation with CITP by Spearman's correlation. Only eGFR was an independent predictor of NT-proBNP by linear regression analysis.

Conclusions:
A possible mechanism for the development of heart failure in CKD patients may be an elevation of central aortic systolic pressure. NT-proBNP and CITP biomarkers may help to identify IgAN patients at high risk for subclinical heart failure and further atherosclerotic disease.
HEMATOLOGICAL AND THYROID DISTURBANCE IN AN ALGERIAN POPULATION OF CHRONIC HEMODIALYSIS PATIENTS
Authors: Nawal Habak , Nadjet Rouibah , Ammar Chikouche 
Published: June 2023

Objective:
Hemodialysis patients suffer in the majority of cases from normocytic normochromic anemia, due to the decrease of erythropoietin production. Thyroid abnormalities are also observed in these patients. They are represented by hypothyroidism which is characterized by low levels of FT3, normal levels of free thyroxine, and often high levels of TSH
The objective is to estimate the prevalence of hypothyroidism and anemia in an Algerian population with end-stage chronic renal failure on hemodialysis.

Design and method:
This is a descriptive cross-sectional study carried out in the Biochemistry laboratory in collaboration with the Hematology laboratory of CPMC. 94 patients with end-stage chronic renal failure .
Results and discussion

Results:
The mean age of our hemodialysis patients was 59.62 years, with a sex ratio of 0.69. Most of our patients (47%) had arterial hypertension (AH) and 20% of patients had diabetes. Our results show a prevalence of normocytic normochromic anemia in 88.30% of hemodialysis patients. The TSH and FT3 hormone assays in our patients revealed a prevalence of hypothyroidism of 38%, with a female predominance. FT3 was low in 24 patients, 12 patients had high TSH levels. The hypothyroid profile was characterized by normal TSH levels associated with low FT3 levels (25% of patients), 12 patients had high TSH levels associated with normal FT3 concentrations. Thyroid abnormalities in chronic hemodialysis patients (CDH) are secondary to hormonal disorders. They are often represented by hypothyroidism. (Captein, 1996). The results of the comparison of the distribution of hypothyroid and anemic patients show an independence of the distribution of the number of cases according to the symptoms of hypothyroidism.

Conclusions:
The similarity of symptoms between anemic and hypothyroid hemodialysis patients can mislead the clinician if he does not think to measure thyroid hormones, knowing that the therapeutic conduct is different in the two situations, and the impact on the health economy is very important.
THE INFLUENCE OF GLP-1RAS (ORAL SEMAGLUTIDE) ON TENSIONAL CONTROL IN DIABETIC PATIENTS WITH CHRONIC RENAL DISEASE
Authors: Rodriguez Carlos Mañero , Gila Juan De Dios López-Gonzalez , Chumillas Vanesa García , Garrido Maria Dolores Prados 
Published: June 2023

Objective:
GLP-1 receptor agonists (GLP-1RAs) represent one of the pharmacological groups of choice for the diabetic management of patients with cardiovascular disease and chronic kidney disease (CKD). Their hypotensive effect has not been sufficiently evaluated in association with the usual antihypertensive drugs. The main objective is to study the hypotensive effect of oral semaglutide at a maintenance dose of 7mg per day in a cohort of patients with stage 3b CKD (glomerular filtration rate -GFR- 44 to 30ml/min by CKD-EPI) with poor diabetic control and without previous treatment with GLP-1 receptor agonists or iSGLT2.

Design and method:
Sixteen patients of both sexes were selected and divided into two follow-up arms of eight patients each. In one arm, the combination of oral semaglutide with an angiotensin receptor blocker (ARB) (such as losartan at a maintenance dose of 50-100mg per day) is evaluated, and in the other, dietary measures are intensified together with ARB at the same doses. After 4 months of treatment, the primary and secondary variables were assessed: body weight, glycosylated haemoglobin (HbA1c), renal function and albuminuria (albumin/creatinine ratio - ACC).

Results:
Mean age was similar in both groups (69 vs 70 years). The reduction in mean blood pressure (BP) values obtained with standardised measurements in a nephrology consultation in the semaglutide + ARB arm was -12mmHg (systolic) and -5mmHg (diastolic) compared to those in the ARB arm alone (-5mmHg systolic and -3mmHg diastolic), with statistical significance (p<0.05). The other comparative variables between the two groups were: reduction in body weight (-2.5kg vs -0.5kg, p<0.05); reduction in mean HbA1c (-1.2% vs -0.1%, p<0.05); changes in eGFR (+2ml/min/1.73m2 vs -3ml/min/1.73m2, p>0.05) and mean reduction in ACC (-257mg/g vs +12mg/g, p<0.05).

Conclusions:
Orally administered GLP-1 receptor agonists (semaglutide) are drugs with a hypotensive potential complementary to renin angiotensin system inhibitors in diabetic renal patients. This property, together with their antiproteinuric effect, makes them an ideal choice in situations of hypertension and moderate renal dysfunction. Larger, controlled studies are needed to measure the renal effect alongside the various antihypertensive groups.
NATRIURESIS INDUCED BY ACUTE INTRAVENOUS SALINE INFUSION IN MICE IS MEDIATED BY TUMOR NECROSIS FACTOR-ALPHA (TNF) - EVIDENCE FOR PHYSIOLOGICAL ROLE OF THIS CYTOKINE IN KIDNEY
Authors: Majid Dewan S. A. , Castillo Alexander 
Published: June 2023

Objective:
Chronic high salt (HS) intake in diet is associated with exacerbation of inflammation as well as hypertension. HS intake, through ‘osmoreceptor function’, induces an immune mechanism that activates the mononuclear phagocyte system (MPS) cells in the myeloid tissues which then circulated and infiltrated in many organs including the kidney. These infiltrated MPS cells release TNF that appears in the circulation in its soluble form (sTNF). We hypothesize that the intravenous saline infusion can also induce the production of sTNF from MPS cells due to an increase in salt content in immune tissues and this sTNF influences saline induced natriuretic response in the kidney.

Design and method:
To examine this hypothesis, we measured the changes in sTNF levels in plasma and urinary excretion rate (UTNFV) during intravenous infusion of isotonic saline (0.9% NaCl), first at euvolemic conditions (3 μL/min for 60 min; Baseline period) and then at an enhanced infusion rate (12 μL/min for 90 min; saline volume infusion period) in anesthetized mice (n = 5). The concentration of sTNF in plasma and urine samples were determined using ELISA kit (Ebioscience, Woburn, MA) for measuring this cytokine.

Results:
Baseline level of plasma sTNF was undetectable, however, the level was increased to 3.7±1.3 pg/mL during saline volume infusion period. Baseline UTNFV level was 0.01±0.002 pg/min/g of kidney wt, which was increased to 0.11±0.03 pg/min/g (P<0.05) during volume infusion period. In another group of mice (n = 5) pretreated with a TNF inhibitor, etanercept (0.5 mg/kg intraperitoneally once daily for 3 days prior to the experiment day), it was observed that this increase in UTNFV during saline volume infusion period was markedly attenuated (0.003±0.002 to 0.006±0.004 pg/min/g; P = n.s.). The usual natriuretic response (0.5±0.2 to 3.8 ±1.1 μmol/min/g; P<0.05) to saline volume infusion observed in control mice was seen markedly attenuated (0.4±0.1 to 0.8±0.3 μmol/min/g; P = n.s.) in etanercept pretreated mice.

Conclusions:
These findings demonstrate for the first time that an intravenous saline volume infusion resulted an increase in sTNF level in plasma and in urine. These results strongly suggest a physiological role for sTNF in regulating renal excretory function during saline volume expansion.
SEX DIFFERENCES IN RENAL MICROCIRCULATION OF HYPERTENSIVE PATIENTS
Authors: Hendriks-Balk Mariëlle , Damianaki Aikaterini , Theiler Kenji , Polychronopoulou Erietta , Brito Wendy , Pruijm Menno , Wuerzner Gregoire 
Published: June 2023

Objective:
Arterial hypertension is associated with alterations in the morphology and function of the microvascular structure. Whether these changes are sex-specific in the kidney of hypertensive patients is unknown. Contrast-enhanced ultrasonography (CEUS) enables the quantification of renal microcirculation. The objective of this study was to compare the cortical microcirculation in hypertensive (HT) women versus HT men, and assess the response to a cold pressure test (CPT).

Design and method:
This was a prospective observational study. Hypertensive (HT) participants underwent two separate CPT of 2 minutes. Doppler ultrasound was used to measure renal resistive index (RRI) and CEUS to measure the perfusion index (PI) as a proxy of renal tissue microcirculation. Renal Doppler and CEUS were performed before and during the CPT. We compared baseline renal measures and responses to CPT of HT women and HT men using a mixed analysis model.

Results:
Twenty-two HT men and eleven HT women were included. Age and body mass index were similar for both groups. Baseline RRI was similar in both genders, but HT women had higher baseline PI (median with interquartile range): 2344 U(1553-2685) vs 1264 U(591-1741), p = 0.007. The CPT did not affect the RRI in HT women and men. Overall the PI was higher in women (p = 0.006) and the PI increased during CPT (p<0.001), but there was no significant difference in the response to CPT between the genders (no interaction).

Conclusions:
Hypertensive women had a higher PI than hypertensive men, suggesting that microcirculation is better preserved in HT women compared to HT men. The increase in PI during the CPT is similar in both genders suggesting the absence of sex-specific reactivity of the microvasculature during CPT.
MEDICAL VERSUS SURGICAL TREATMENT IN PATIENTS WITH NON-FUNCTIONING KIDNEY
Authors: Gebara Nicole , Machado Filipe , Lazkani Aida , Ahmar Marc Al , Lorthioir Aurélien , Riancho Julien , Baron Stéphanie , Azizi Michel , Amar Laurence 
Published: June 2023

Objective:
Non-functioning kidney (NFK) can be responsible in whole or in part for hypertension. Patients with a lateralized renin secretion can be treated either medically or surgically.

Objective:
assess the benefice of nephrectomy over medical treatment in the management of lateralized NFK in hypertensive patients diagnosed after renal vein sampling (RVS). The profit is based on the blood pressure (BP) control, the number of BP lowering drugs or the daily-defined dose (ddd).

Design and method:
We conducted an observational retrospective study at the Hypertension Unit at Georges-Pompidou European Hospital in France, between January 2004 and January 2021, that analyzes RVS in hypertensive patients. We studied the data (N = 68) at the time of diagnosis and at two follow up visits: the first after RVS or nephrectomy (V1) and the last visit (V2).

Results:
At V1, in patients with a lateralized NFK:
- 18 underwent nephrectomy: 11 vascular disease, 4 urologic disease, 2 trauma and 1 another cause.- 5 were treated medically: all had a vascular disease

In patients who underwent nephrectomy, between the diagnosis, V1 and V2 (N = 12) respectively:
In patients with medical treatment, between the diagnosis, V1 and V2 (N = 4) respectively:
a) systolic BP dropped from 189 to 170,33 to 133,33 mmHgb) number of molecules increased from 3 to 4,8 at V1 and V2c) ddd increased from 63,35 to 118,3 to 267d) at V1 and V2: 1 had a controlled HTN

Conclusions:
In patients with lateralized NFK, nephrectomy helps in the control of the BP and reduces systolic BP, number of drugs and ddd. The effect on the BP control seems not to be maintained on the long term. Further studies, with a bigger sample, are needed to define subgroups that can benefit the most from nephrectomy.
RELATION BETWEEN WAIST CIRCUMFERENCE AND THE RENAL HEMODYNAMIC IN PATIENTS WITH UNCOMPLICATED HYPERTENSION GRADE 1-2
Authors: Bosch Agnes , Kannenkeril Dennis , Ott Christian , Guenes-Altan Merve , Striepe Kristina , Schiffer Mario , Schmieder Roland E. 
Published: June 2023

Objective:
Abdominal adiposity, measured by waist circumference (WC), is associated with increased mortality in patients with hypertension. Little is known about the impact of abdominal obesity on the renal perfusion and function in patients with hypertension. We analyzed whether abdominal adiposity changes renal hemodynamics in 36 patients with uncomplicated hypertension grade 1-2 without other cardiovascular (CV) disease.

Design and method:
We analysed the renal hemodynamic using steady state input clearance with infusion of para-aminohippuric acid and inulin, respectively. Intraglomerular pressure and resistances of the afferent (RA) and efferent (RE) arterioles were calculated according to the Gomez equation. The study population was divided in into two groups based on median of WC of the total study population.

Results:
The study cohort consisted of 36 male, non-smoking individuals, aged 36 ± 10 years with mean WC of 96.1 ± 10.4 cm and mean BMI of 27 ± 3.8 kg/m2. True hypertension was confirmed using 24-hour ambulatory blood pressure (BP) measurement. Patients in the high WC group (19 patients) showed mean office BP of 145/ 90 mmHg and mean 24-hour ambulatory BP of 139/ 86 mmHg, whereas patients in the low WC group (17 patients) showed mean office BP of 144/ 88 mmHg and mean 24-hour-ambulatory BP of 140/ 86 mmHg (office BP: p = 0.895/ p = 0.662, 24-hour-ambulatory BP: p = 0.645/ p = 0.918). Renal vascular resistance and RA were higher in the high WC compared to the low WC group, whereas glomerular filtration rate and renal plasma flow were lower in the high WC compared to the low WC group (table 1).

Conclusions:
Higher WC in young, male patients with hypertension grade 1-2 without other cardiovascular disease was associated with increased renal vascular resistance predominantly at the afferent site leading to reduced glomerular filtration rate.
REVEAL-CKD: PREVALENCE OF UNDIAGNOSED STAGE 3 CHRONIC KIDNEY DISEASE IN PATIENTS WITH DIAGNOSED HYPERTENSION IN CANADA
Authors: Peach Emily , Wittbrodt Eric , Barone Salvatore , Chen Hungta , Järbrink Krister , Tangri Navdeep 
Published: June 2023

Objective:
Hypertension is a risk factor for and complication of chronic kidney disease (CKD), a progressive condition affecting 11.1% of the global population. Early recognition and diagnosis of CKD is crucial for effective management to slow disease progression and improve patient outcomes. This REVEAL-CKD study assessed the prevalence of, and factors associated with, undiagnosed stage 3 CKD in patients with hypertension.

Design and method:
REVEAL-CKD is an observational study using secondary data from electronic medical records (EMR) and claims data. Data were extracted from the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) database, that consists of primary care EMR data from approximately 1,500 general practice clinicians across eight provinces and one territory of Canada. The study cohort included patients aged at least 18 years with two consecutive estimated glomerular filtration rate (eGFR) values 30-59 mL/min/1.73m2 recorded 91-730 days apart between 2015-2021. The date of the second qualifying eGFR was the index date. Included patients were required to have hypertension diagnosis code before index. Patients with no CKD diagnosis code before and up to 6 months after index were considered undiagnosed. This study was granted approval by the CPCSSN data access committee (project number: 2022SRE147).

Results:
Of the 45,914 patients meeting the study inclusion criteria for stage 3 CKD, median age at index date was 77 years (interquartile range [IQR]: 69-84 years) and 19,597 (42.7%) were male. Of these patients, 32,192 (70.1%) also had an existing diagnosis of hypertension. Among patients meeting the criteria for stage 3 CKD and having a diagnosis of hypertension there were 30,523 patients, (94.8%) who did not have a recorded diagnosis of CKD up to 6 months after index. Of these patients, only one fifth was diagnosed with CKD after 4 years.

Conclusions:
A large proportion of patients in Canada with hypertension and stage 3 CKD do not have a recorded CKD diagnosis, and there is substantial diagnostic delay despite clinical evidence. This likely results in patients not receiving guideline-directed management to reduce the risk of disease progression and adverse clinical outcomes that could have been avoided by early detection of CKD.
WATER LOAD EFFECT ON URINARY HYALURONIDASE ACTIVITY IN NORMOTENSIVE OFFSPRING OF NORMOTENSIVE AND HYPERTENSIVE SUBJECTS: A POSSIBLE LINK TO HYPERTENSION DEVELOPMENT
Authors: Bongrani Alice , Verzicco Ignazio , Tedeschi Stefano , Maestrini Fabio , Graiani Gallia , Cavazzini Stefania , Figus Giuliano , Vicini Vanni , Coghi Pietro , Calvi Anna , Montanari Alberto , Perlini Stefano , Cabassi Aderville 
Published: June 2023

Objective:
Alterations in sodium and water intake-excretion balance are currently admitted as a relevant factor in arterial hypertension development. Hyaluronic acid metabolism in renal medullary has been proved to play a relevant role in the regulation of water resorption by the collecting duct, and hyaluronidase excretion in urine has been found to be inversely related to hydration status. Thus, the aim of our study was to assess urinary hyaluronidase activity in response to water loading in hypertensive and normotensive subjects with and without familial predisposition to hypertension.

Design and method:
Eighty-six adult Caucasian men underwent a water loading test consisting of oral administration of 15-20 ml of water/kg body weight over 40-45 min. Urinary hyaluronidase activity was assessed by turbidimetric assay at baseline and every 60 min for 4 hours. The study cohort included 21 hypertensive patients (HT) and 65 normotensive offsprings of normotensive (NT neg, n = 29) and hypertensive subjects (NT pos, n = 36).

Results:
Urinary hyaluronidase activity decreased in response to water loading in all groups, attaining the lowest levels at 60 and 120 min. However, while at baseline and after 240 min hyaluronidase activity was similar for all subjects, between 60 and 180 min NT pos subjects maintained significantly highest levels than both NT neg and HT patients (p<0.0001 and p<0.001 at 120 min, respectively).

Conclusions:
Consistent with previous findings, our results show that hyaluronidase activity in urine is inversely correlated with hydration status as we observed in all studied groups in response to water loading. However, while baseline levels did not differ between groups, the decrease in hyaluronidase activity was significantly lower in the subgroup of subjects having a family history of hypertension. Since hyaluronidase activity in the renal medullary has been postulated to be associated with ADH metabolism, individuals genetically predisposed to hypertension might exhibit increased renal sensitivity to ADH action resulting in alterations in the management of water loading by the vasopressinergic system that could precede and contribute to hypertension development.
INCREASED ARTERIAL STIFFNESS ASSOCIATED WITH BLOOD PRESSURE IS THE PREVALENT HYPERTENSION MEDIATED ORGAN DAMAGE IN YOUNG PATIENTS WITH FIRST DIAGNOSED SYSTOLIC HYPERTENSION
Authors: Triantafyllidi Helen , Benas Dimitrios , Birmpa Dionyssia , Fambri Anastasia , Schoinas Antonis , Thymis Ioannis , Kostelli Gavriela , Ikonomidis Ignatios 
Published: June 2023

Objective:
Early onset arterial hypertension (AH) is associated with a considerably increased risk for cardiovascular (CV) disease if left untreated. Hypertension mediated organ damage (HMOD) evaluation is necessary in order to estimate cardiovascular risk in each hypertensive patient. We investigated the incidence of HMOD in young first diagnosed and never-treated patients with systolic arterial hypertension (SH) trying to identify those young patients in high CV risk based on the presence of HMOD.

Design and method:
In 220 patients, <50 years [median (IQR) age = 43(38-47) years], with SH diagnosed by ambulatory blood pressure monitoring (24-h ABPM), CV risk factors [smoking, obesity (BMI), hyperlipidemia] and 5 HMOD [arterial stiffness (PWV), left ventricular diastolic dysfunction [(DD (EEa)], cardiac hypertrophy (LVMI), coronary arteries microcirculation (CFR), and carotid intima-media thickness (cIMT)] were evaluated before treatment initiation.

Results:
Smoking (40%) and obesity [median (IQR) BMI = 30(26-32) kg/m2] were found in young hypertensives. HMOD were found in 50% of hypertensives (>1 HMOD while 10% had > 2 HMOD. The most prevalent HMOD were the increased cIMT (32%), PWV (19%), LVH (9%), impaired CFR (6%) and DD (1%). Only PWV (beta = 0.27, p<0.001) and LVMI (beta = 0.41, p<0.001) were associated to systolic BP burden (Figure). In a subgroup analysis, the population with >2 any studied HMOD was older with increased office BP and 24-h ABPM, impaired lipid profile and increased levels of LVMI, PWV, CFR and cIMT compared to the rest of the hypertensives.

Conclusions:
The presence of >2 any studied HMOD (PWV, LVMI, cIMT, E/Ea, CFR) in young hypertensives characterizes a truly “high-risk population”. Arterial stiffness represents the predominant HMOD in the whole population as well as in the “high-risk hypertensive population”.