bluuebunny/crossref_metadata_2025_split huggingface dataset:
#6934 INFLAMMATORY STATUS PRIOR TO THE CREATION OF ARTERIOVENOUS FISTULAS FOR HEMODIALYSIS: IS IT DETERMINING?
Authors: Saponara Luis Guillermo Piccone , Heredia Nancy Giovanna Uribe , Garcia Guillermo Ferrer , Conejo Gloria García , Conforme Roger Abduvar Cox , Gutierrez Eliana Olazo , Fernández Maria Paz Castro , Fernandez Sara Anaya , Carreno Agustin , Poyatos Maria Del Carmen Vozmediano 
Published: June 2023

Abstract

Background and Aims
Clinical practice guidelines recommend an arteriovenous fistula (AVIF) as the preferred vascular access for hemodialysis and is associated with a lower incidence of morbidity and mortality. However, primary vascular access (VA) failure is not uncommon. Low-grade inflammation is present in ERCT. We identified the inflammatory parameters that influence the primary patency of the vascular access for hemodialysis.

Method
Cross-sectional study; We included all VAs made between October 2009 and April 2022. We evaluated the initial performance after the creation of the VAs. Demographic variables (age, sex), CKD etiology, and associated comorbidity were collected. Statistical analysis with SPSS 25.0. Categorical variables are expressed as percentages and compared using the Chi2 test. Quantitative variables are expressed as mean ± standard deviation and the t-student test was used to compare them. Statistical significance for a value of p&lt;0.05.

Results
712 VA performed in 546 patients were reviewed between October 2009 and April 2022. 617 autologous VA (86.7%) and 95 prosthetic VA (13.3%) were performed. The mean age of the patients was 65.4 ± 14.1 years and 67.4% were male. The most frequent etiology of CKD was diabetic nephropathy (30.5%), followed by unknown (17.3%) and glomerulonephritis (16.4%). 91.4% of the patients presented arterial hypertension (HTA), diabetes mellitus (DM) 47.5%. 72.6% of the VA presented primary permeability. In the univariate analysis using Chi2 and T student, AHT (p&lt;0.001), treatment with statins (p&lt;0.001), antiaggregation (p&lt;0.001), normal fibrinogen levels (p = 0.003), and CRP (p&lt;0.001) reached statistical significance. = 0.039). When recoding the PCR in relation to its normal values, the pathological levels were associated with primary failure after the creation of AVFs.

Conclusion
In our study, inflammatory states with elevated CRP and ferritin were associated with primary failure in initial functioning after the creation of AVFs. On the contrary, arterial hypertension and treatment with statins prior to the creation of AVFs are associated with their primary permeability.
#6962 INCIDENCE AND PROGNOSIS OF HYPONATREMIA IN HOSPITALIZED PATIENTS WITH ALCOHOLIC LIVER DISEASE
Authors: Lee Tae Won , Lee Seolje , Ryu Jun Ha , Bae Eunjin , Park Dong Jun 
Published: June 2023

Abstract

Background and Aims
Hyponatremia is a common electrolyte disorder in hospitalized patients and has a poor prognosis leading to an increased risk of poor quality of life, morbidity, and mortality. Although the prevalence and prognosis of hyponatremia in advanced liver disease such as liver cirrhosis are well known, no previous studies have been conducted on the prevalence of hyponatremia in early liver disease or alcoholic liver disease (ALD). Therefore, the purpose of this study was to investigate the prevalence and prognosis of hyponatremia in ALD group.

Method
We performed a retrospective, single centre study of patients admitted to the hepatology department from March 2016 to December 2022. Adults aged 18 years or older were included, and patients with liver cirrhosis, one of the common causes of hyponatremia, were excluded from the study. Based on the electronic medical records, the study was conducted by dividing the ALD group including alcoholic hepatitis and heavy alcoholics into a control group.

Results
A total of 830 patients were included, hyponatremia (under 135 mmol/L) occurred in 32.2%, and the ALD group showed a significantly higher prevalence than the control group (53.8% vs. 28.6, p&lt;0.001). In addition, the ALD group was statistically significantly higher than the control group in mortality at hospitalization (8.4% vs. 3.9%, p = 0.031) and all-cause mortality (22.7% vs. 12.1%, p = 0.002). The length of hospital stay was significantly longer (13.5±10.9 vs. 10.5±9.1, p = 0.006), and the readmission rate was also higher in the ALD group (39.5% vs. 22.5%, p &lt; 0.001). Kaplan-Meier analysis revealed significantly higher overall survival in the control group than the ALD group (87.9% vs. 77.3% p = 0.002).

Conclusion
Our study shows that ALD has a higher incidence rate of hyponatremia, which is followed by a poor prognosis, such as an increase in readmission rates, length of hospitalization, and mortality. Therefore, clinicians should realize the importance of electrolyte imbalance in ALD patients and strive to improve prognosis through early and appropriate treatment.
#2537 EPIDEMIOLOGY OF CHRONIC KIDNEY DISEASE IN THE REPUBLIC OF UZBEKISTAN
Authors: Rasulev Yorkin , Daminov Botir , Tursunbayev Aziz 
Published: June 2023

Abstract

Background and Aims
Chronic kidney disease (CKD) is an emerging global health problem, currently affecting up to 15% of the global adult population, and is independently associated with an increased risk of cardiovascular disease (CVD) similar to that of diabetes mellitus or coronary artery disease. heart [Reddy K.S., Shah B., Varghese S., Ramados A. 2005; 366: 1744-1749]. To assess the epidemiological characteristics of the development of CKD in the Republic of Uzbekistan (RUz) for 2020.

Method
The object of the study is the database of the Republican Specialized Scientific and Practical Medical Center for Nephrology and Kidney Transplantation of the Republic of Uzbekistan.

Results
According to the Institute of Health and Medical Statistics of the Ministry of Health of the Republic of Uzbekistan, the number of patients with end-stage renal disease (ESRD) decreased between 2011 and 2015. However, according to the data for 2020, the number of patients with stage 5 CKD reached 23,773 thousand and its increase is expected. The proportion of patients with chronic renal failure older than 18 years was registered 21,003 thousand in 2011 and 19,149 thousand in 2015, in those years there was a decrease. However, according to the national registry for 2020, CKD cases in the Republic of Uzbekistan, identified in all regions, amounted to 118026, there were 23773 patients with chronic renal failure receiving hemodialysis - 5149. The number of registered patients with CKD in the Autonomous Republic of Karakalpakstan was 9013, with CRF - 912, in need of hemodialysis - 115, receiving hemodialysis - 98, in need of transplantation - 21. In Andijan region, 416 persons were registered, with CRF - 201, in need of replacement therapy 137, receiving dialysis - 137, needing in transplantation - 11. In the Bukhara region, 4500 such patients were registered, CKD - 501, in need of substitution therapy - 172, receiving dialysis - 164 and in need of transplantation - 36.

Conclusion
With a general increase in the prevalence of CKD in the Republic of Uzbekistan in the dynamics of 2020, there is an improvement in the quality of diagnosing complications at earlier stages, at a later age and with a longer duration of CKD. Advances in the management of patients with CKD in recent years do not reduce the risk of end-stage chronic renal failure, but delay its development. Pronounced interregional differences in the frequency of registration of CKD in the database indicate problems in diagnosing CKD in a number of regions where the standard for examining patients with CKD with a mandatory assessment of glomerular filtration rate (GFR) and albuminuria at least once a year is not met.
#2598 KLOTHO DEFICIENCY INDUCES REGULATORY T CELLS IN MURINE LUPUS NEPHRITIS
Authors: Takenaka Tsuneo , Kurosaki Yoshifumi , Ishii Naohito , Inoue Tsutomu , Nishiyama Akira , Hayashi Matsuhiko 
Published: June 2023

Abstract

Background and Aims
Recent studies demonstrate that klotho deficiency participate in various chronic kidney disease. However, it has not been fully assessed the influence of klotho in autoimmune kidney diseases. On the one hand, klotho is known to binds transforming growth factor β (TGFβ) receptor to antagonize its pathophysiological actions including renal fibrosis. On the other hand, TGFβ is required to generate and maintain regulatory T cells with inducing FOXP3, an important cell population for immunological tolerance.

Method
NZBWF1 mice were used as a model of lupus nephritis. NZBWF1 mice were housed separately in metabolic cage, and divided into two groups (n=10 for each): one group was treated with daily subcutaneous injection of klotho protein (20 µg/kg/day), and the other received vehicle alone. Systolic blood pressure was measured by tail-cuff method. Glomerular filtration rate was assessed using FITC-inulin. Four weeks later, the animals were killed to harvest the spleen and kidneys for analyses.

Results
Klotho supplementation suppressed blood pressure, 8-epi-prostaglandin F2a excretion and renal angiotensin II levels (p&lt;0.05 for all) without changes in albuminuria and glomerular filtration rate in NZBWF1 mice. Exogenous klotho protein supplementation increased serum klotho levels, urine klotho excretion, and endogenous renal expression of klotho in NZBWF1 mice (p&lt;0.05 for all). Surprisingly, anti-double strand DNA antibody was slightly elevated in klotho-treated NZBWF1 mice (p&lt;0.05). Glomerular pathology and interstitial cell infiltration were similar between 2 groups. The spleen tended to be greater in klotho-treated group, but statistical significance was not attained. In consistent, CD8+FOXP3+ T cells were unaltered between 2 groups. However, klotho supplementation reduced CD4+FOXP3+ T cells in spleen of NZBWF1 mice (p&lt;0.05).

Conclusion
The present data indicated that klotho protein supplementation suppressed renal renin-angiotensin system, ameliorating blood pressure and oxidative stress. Our results suggest that klotho supplementation worsened auto-antibody, possibly by inhibiting TGFβ with resultant deterioration in regulatory T cells. The present findings implicate that although klotho may not suite for the management of autoimmune kidney diseases, such as lupus and ANCA-related nephritis, klotho supplementation for dialysis patients could mitigate against the defect in cellular immunity and susceptibility to infections including tuberculosis and COVID-19.
#2627 IGA-DOMINANT POSTINFECTIOUS GLOMERULONEPHRITIS, “THE OTHER SIDE OF THE COIN”: A CASE REPORT
Authors: Moreno Rodolfo , Blackaller Guillermo Navarro , Chávez-Iñiguez Jonathan S , De Leon Werner 
Published: June 2023

Abstract

Background and Aims
Postinfectious glomerulonephritis (PIGN) is a disease presented as nephritic syndrome with hypocomplementemia usually secondary to a skin or throat infection by beta hemolytic Streptococcus and with histopathological findings of endocapillary proliferation, C3 deposits along the capillary wall and mesangium, subepithelial immune complex deposits and IF positive for IgG. There are other unusual presentations of PIGN with IgA dominance or C3-IgA codominance.

Method
A 58-year-old Guatemalan male, with history of one-week duration pain in the right upper quadrant associated with jaundice, diagnosed with cholangitis and intravenous antibiotics use. History of consumption of 10 beers a month for 40 years. No other medical history. During hospitalization, presented a lower-limb cellulitis, for which clindamycin was started. Blood cultures were taken and were positive for S. epidermidis and AKI (Cr 2.84 mg/dl) was observed, associated with de novo appearance of hematuria (80% acanthocytes), proteinuria (580mg/day) and hypertension. Diagnostic approach for nephritic syndrome was performed obtaining: C3 0.592 (low) ANA, ANCAs, HIV-HCV-HBV negative, total cholesterol 184 mg/dl, albumin 2.78 g/dl.

Results
Renal biopsy was performed and reported: PIGN with IgA dominance with extra capillary proliferation. Reason why pulses of methylprednisolone were given for 3 days and then oral prednisone (1 mg/kg/day), progressively decreasing it until it was discontinued. Resolved the soft tissue infection and was discharged. At 1-month follow-up as outpatient, was evidence of a 50% decrease in proteinuria compared to baseline, disappearance of hematuria but with persistent of high Cr (2.09 mg/dl).

Conclusion
IgA-dominant PIGN is characterized by usually presenting in patients &gt;60 years with DM, alcohol consumption and staphylococcal skin infections. It can present hypocomplementemia and histopathological findings are characterized by IgA dominance over C3 and no IgG in IF. Elevated serum IgA levels may be involved in the pathogenesis. Treatment is based on eradication of the infection with antibiotics and in some cases the use of steroids is suggested depending on the aggressiveness of the lesion and the presence of crescents in the renal biopsy. It has worse prognosis than the traditional PIGN.
#2702 ANALYSIS OF IMMUNOSUPPRESSANT ADHERENCE, TREATMENT PREFERENCES AND NEEDS, AND MENTAL HEALTH DISORDERS IN THE POST-TRANSPLANTATION PERIOD
Authors: Santacruz Juan , Garcia-Llana Helena , Santana María , Selgas Rafael , Jimenez Carlos , Gonzalez Elena 
Published: June 2023

Abstract

Background and Aims
Medical treatment after kidney transplantation is not enough to assure optimal outcomes due to emotional factors that contribute on graft survival. To incorporate patient´s treatment preferences in clinical practice improves health outcomes. Few is known about treatment preferences and needs of kidney transplant population. The aims of the study were to quantify mental health disorders prevalence, immunosuppressive adherence, treatment preferences and needs of Spanish kidney transplant patients in post-transplantation period.

Method
Transversal-observational study in stable kidney transplant patients from one center in Madrid-Spain. Demographics, social-clinical variables, validated questionaries for anxiety, depression, stress, resilience, life satisfaction and quality of life related with health, and an ad-hoc survey of treatment preferences and needs were applied.

Results
A total of 116 patients were included, 25% had mental health pathology before transplant. Mental health disorders prevalence for depression, anxiety and stress were 26%, 27% and 23.3% respectively. Life satisfaction screening revealed only 29% of patients very satisfied with life. Patients with lower scores in mental health tests were significatively related with poor immunosuppressive adherence (P = .004). Treatment preferences and needs identified were how to improve physical condition (47%), information for anxiety and/or depression management (37%), and to receive psychological therapy from Nephrology Service (95%). See Table 1 and 2 for results.

Conclusion
Mental health disorders prevalence in Spanish kidney transplanted patients were high and had a negative impact in immunosuppressive adherence. This demands a biopsychosocial, interdisciplinary, focused on patient´s treatment preferences approach, individually and in groups from Nephrology Service.
#2726 DUAL DIALYSER HAEMODIAFILTRATION: A NEW EXTRACORPOREAL DIALYSIS TREATMENT MODALITY FOR PATIENTS WITH END STAGE KIDNEY DISEASE
Authors: Glancey Gerald 
Published: June 2023

Abstract

Background and Aims
The introduction of High Flux (HF) haemodialysers and their application in single dialyser haemodiafiltration (sdHDF) for patients on extracorporeal dialysis (ECD) therapy has improved the extraction of uraemic toxins including the low molecular weight protein (LMWP) beta 2 microglobulin (β2M, 11.6kDa). Similar increases in the extraction of protein-bound uraemic toxins (PBUT) and larger LMWP (15-50kDa) remain elusive. High concomitant losses of albumin prohibit the use of Medium Cut-Off (MCO) or protein-losing haemodialysers in sdHDF to increase the convective transfer of these molecules.

Method
A new extracorporeal dialysis treatment modality, dual dialyser haemodiafiltration (ddHDF), has been designed together with an accompanying mathematical model to compare its predicted performance to that of sdHDF in the extraction of solute. The extra process that distinguishes ddHDF from sdHDF is the secondary ultrafiltration and partial re-infusion of the effluent haemodiafiltrate from the initial or primary haemodialyser. This allows MCO and protein-losing haemodialysers to be used to increase the extraction of both LMWP and PBUT without excessive concomitant loss of albumin.
Glancey GR. Modeling the transfer of low molecular weight proteins during haemodialysis and online haemodiafiltration. Artificial Organs 2021;45(4):419-426.

Results
Data from the mathematical model show that ddHDF could increase the extraction of smaller and larger LMWP by an extra 102% and 220% respectively compared to standard HF sdHDF whilst restricting the loss of albumin to 0.83 grams per hour of treatment. In using albumin as a recyclable carrier molecule for the extraction of PBUT from plasma ddHDF has the potential to increase PBUT reduction ratios (RR's) to 49% by convection alone. Even higher RR's are possible if the dialysate volume flow rate can be increased beyond 600 ml/min.

Conclusion:
ddHDF provides an opportunity for a step change increase in the level of extraction of both larger LMWP and PBUT in patients with end stage kidney disease.
#2736 THE PHASE ANGLE AS A PREDICTOR OF SARCOPENIA IN NORMOHYDRATED PATIENTS ON HEMODIALYSIS: A MULTICENTER STUDY
Authors: López Yanet Parodis , Ortega Sebastian Hillebrand , Alman Francisco Alonso , Vega Nicanor , Anton-Perez Gloria 
Published: June 2023

Abstract

Background and Aims
The skeletal muscle index (SMI) is an impedance parameter that assesses muscle mass, and the phase angle (PA) is inversely related to strength and muscle mass in hemodialysis patients. Both parameters may represent useful and inexpensive tools to identify sarcopenic patients.

Method
The presence of sarcopenia was analyzed in 348 normohydrated patients in 5 hemodialysis centers by means of vector bioimpedance using the BIA101 BIVA PRO equipment. To do this, the skeletal muscle index (SMI) and the phase angle (PA) are evaluated as markers of muscle mass and strength, respectively.

Results
Mean SMI and PA were 8.64 ± 1.5 and 5.2 ± 0.9.
The mean PA was 5.6 ± 0.9 in those with SMI within normality (9.2 ± 1.9) (p&lt;0.001).
In moderate and severe sarcopenics patients, the means of SMI (8.9 ± 1.2 vs 7.5 ± 0.9) and PA (5.3 ± 0.86 vs 4.7 ± 0.67) were significantly lower (p &lt; 0.001) (Table 1).
In patients on standard hemodialysis, the PA (P = .02) and the SMI (P = .004) were significantly lower.
The PA (P = .014) and the SMI (p &lt; 0.01) were significantly lower in the female gender but the number of sarcopenic patients was higher among the men (p&lt; 0.001).
The cut-off value of PA, which predicted a higher risk of sarcopenia, was 3.5 in all patients (95% CI, 0.60-0.71; P = .0001; 100% sensitivity, 96% specificity ); 3.55 for men (95% CI, 0.57-0.78; P = .003; 100% sensitivity, 94% specificity) and 3.65 for women (95% CI, 0.60-0.73 ; P = .0001; 100% sensitivity, 96% specificity) (Fig. 1).
In the logistic regression analysis, male gender, standard hemodialysis technique, and PA were associated with a higher risk of sarcopenia (Table 2).

Conclusion
PA is a good predictor of sarcopenia in hemodialysis patients.
#2905 CLINICAL OUTCOMES OF ORAL ANTICOAGULATION AND NO ANTICOAGULATION AMONG HEMODIALYSIS PATIENTS WITH ATRIAL FIBRILLATION
Authors: Polito Eratosthenes , Darunday Grecia 
Published: June 2023

Abstract

Background and Aims
The delicate balance of risk versus benefit of oral anticoagulation in the general population is well established but the decision to use these agents in end-stage renal disease (ESRD) remains complex and difficult owing to the paucity of clinical trials and lack of substantial evidence in literature for its safe and effective use in the haemodialysis population. This study aims to determine the difference in clinical outcomes between oral anticoagulation and no anticoagulation therapy among ESRD patients on maintenance haemodialysis with atrial fibrillation.

Method
This is a prospective, single-center, observational study conducted in Perpetual Succour Hospital that included all ESRD patients on maintenance haemodialysis for at least 3 months with atrial fibrillation. Out of the 188 identified patients, only 69 patients were included in the study and were grouped according to how the cardiac dysrhythmia was approached either with oral anticoagulation or no use of oral anticoagulation. Basic demographic information were obtained as well as the aetiology of ESRD, CHA2DS2-VASc Score and the HAS-BLED Score. Lastly, patients were prospectively followed for a period of 12 months and were then assessed for new onset of thromboembolic events, hemorrhagic events, calciphylaxis and all-cause mortality.

Results
At enrolment, 59 (85.5%) patients were identified to have no oral anticoagulation therapy and 10 (14.5%) were already receiving oral anticoagulation. Ischemic strokes was more prevalent among patients who were on oral anticoagulant (80%, p &lt;0.0001). Patient outcomes differ significantly in terms of intracranial hemorrhage (30%, p= 0.0004) and gastrointestinal bleeding (50%, p &lt;0.00001) which were noted among patients on oral anticoagulation. In relation to over-all mortality, acute myocardial infarction, peripheral arterial occlusive disease and calciphylaxis, there was no significant difference between the two groups.

Conclusion
This study suggests that the use of oral anticoagulation did not prevent ischemic strokes in ESRD patients on maintenance haemodialysis with atrial fibrillation and its use was associated with increased risk for intracranial haemorrhage and gastrointestinal bleeding. There was no significant difference in relation to all-cause mortality, acute myocardial infarction, peripheral arterial occlusive disease and calciphylaxis between the two study groups.
#2970 CYTOMEGALOVIRUS INFECTION AND RISK OF NEW-ONSET DIABETES AFTER TRANSPLANTATION: A RETROSPECTIVE STUDY
Authors: Khan Muhammad Tassaduq 
Published: June 2023

Abstract

Background and Aims
New-onset diabetes after transplantation (NODAT) is one of the common complications reported in patients with kidney transplant and is associated with risk of infection, poor allograft and patient survival. There is conflicting research literature regarding the role of cytomegalovirus (CMV) infection in increasing the risk of NODAT development.

Aim
To assess the risk of development of NODAT in kidney transplant patients with CMV infection

Method
A total of 59 kidney transplant patients were studied from March 2017 to February 2019. NODAT was defined as two readings of fasting plasma glucose of ≥126 mg/dL at three months post-transplant. CMV viral load was also documented. The 12 months post-transplant allograft and patient survival outcomes were also measured.

Results
Mean age was 43.4 ± 6.2 years. Nearly one-fourth, 14 (23.7%), of the patients had NODAT. CMV viral load and viremia were high in NODAT group; however, the result did not reach statistical significance. CMV DNA replication was statistically high during 1-6 months post-transplant for NODAT group (P&lt;0.001). Only 7 (11.9%) recipients advanced to symptomatic CMV infection. Also, we found that high CMV viremia load was associated with poor kidney allograft function at 12 months.

Conclusion
In summary, this study showed that infection with CMV may not be a risk factor to develop NODAT in patients transplanted with kidney. An elevated CMV viral load may decrease the post-transplant allograft function at 12 months. The prompt diagnosis and timely 2 management of CMV infection could substantially lessen the risk to develop NODAT subsequent worsening of allograft and patient survival.