bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO642: Comparison of Medium Cut-Off Dialyzer and Post-Dilution Hemodiafiltration on the Removal of Small and Middle Molecule Uremic Toxins
Authors: Chang Seong Kim , Hong Sang Choi , Eun Hui Bae , Seong Kwon M A , Soo Wan Kim 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The medium cut-off (MCO) dialyzer increases the removal of several middle molecules more effectively than high-flux hemodialysis (HD). However, there are no comparable data on the efficacy and safety of MCO dialyzers versus post-dilution hemodiafiltration (HDF) in Korean patients.

METHOD
A total of 9 patients with chronic HD were included in this crossover study. Patients received HD with an MCO dialyzer for 4 weeks, followed by a 2-week washout period, using a high-flux dialyzer to minimize carry-over effects and then crossed over to post-dilution HDF for 4 weeks. Reduction ratios and differences in the values before and after were calculated from the MCO dialysis, post-dilution HDF and high-flux HD. In the in vitro study, EA.hy926 cells were treated with dialyzed serum.

RESULTS
Compared with post-dilution HDF, the MCO dialyzer achieved significantly higher reduction ratios for larger middle molecules [myoglobin, kappa free light chain (κFLC) and lambda FLC (λFLC)]. Similarly, the differences between before and after the last dialysis session of myoglobin, κFLC, and λFLC were significantly greater in MCO dialysis than in post-dilution HDF. The expression of Bax and nuclear factor-κb was decreased in the serum after dialysis with the MCO dialyzer than with HDF.

CONCLUSION
Compared with high-volume post-dilution HDF, MCO dialysis showed no differences in the removal of molecules below 12 000 Da, whereas it was superior in the removal of larger uremic middle molecule toxins in patients with kidney failure. Moreover, these results might be expected to have an anti-apoptotic effect on the human endothelium.
MO643: Haemoperfusion Combined with Standard Haemodialysis May Have a Beneficial Effect on Serum Beta-2 Microglobulin Levels in Chronic Haemodialysis Patients
Authors: Sonikian Makrouhi , Chiras Theodoros , Velentza Aikaterinh , Skarakis Jacob , Biblaki Dimitra , Dagkounaki Paraskevi , Barbatsi Aggeliki , Martsoukou Maria 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Standard haemodialysis (HD) with low-flux membranes does not provide adequate middle molecular weight (MMW) clearance of uraemic toxins [1] and on-line haemodiafiltration (OL-HDF) may not be easily applicable and cost effective in some centres. We investigated whether low-flux conventional HD combined with hemoperfusion (HP) may offer any benefit regarding serum beta-2 microglobulin (β2M) levels as a surrogate of middle molecules in patients haemodialyzed for many years and we compared the method-combination with OL-HDF.

METHOD
We studied 24 stable anuric patients during 6 months, under standard medical therapy, aged 69 years (46–90), M: F = 20:4, on chronic HD for 84 (65–286) months, who formed three groups: A (GrA), B (GrB) and C (GrC). Each group included 8 age- and HD vintage-matched patients respectively. In GrA patients, a type HA130 cartridge for HP was connected in parallel to the low-flux polysulfone dialyzer and this combination of standard HD with HP (HD + HP) was used once a week for the first month, once every 2 weeks for the second month and once a month for the next 4 months. GrB patients underwent only standard HD treatment with low-flux polysulfone membranes and GrC patients were treated with OL-HDF. In all three groups serum β2M levels were determined at months 0 (M0) and 6 (M6), before (pre-dialysis, preD) and after (post-dialysis, postD) the second weekly session.

RESULTS
Serum preD β2M levels ​​were similar in GrA and GrB at M0 (44.1 ± 8.6 versus 34.6 ± 16.2 mg/L; P = NS) and at M6 (46.1 ± 7.6 versus 41.1 ± 18.9 mg/L; P = NS). In GrC, preD-β2M values were lower compared with GrA at both M0 (31.1 ± 4.2 mg/L; P = .008) and M6 (33.8 ± 6.82 mg/L; P = .02). In GrC, serum postD-β2M levels ​​decreased significantly at both M0 (7.4 ± 1.9 mg/L; P &lt; .001) and M6 (9.9 ± 3.8 mg/L; P&lt;.001). The postD reduction was maintained, with no difference between M0 and M6. An improvement/decrease in β2M values ​was observed only in GrA between M0 and M6 (−5.8 ± 7.2 versus 1.8 ± 5mg/L; P = .03) but not in GBr.

CONCLUSION
OL-HDF is obviously the most effective method for elimination of MMW uraemic toxins and in particular β2M [2–3]. Interestingly, the combination HD + HP seems to be more effective than low-flux HD alone [4] and it could be useful for specific patient cases in daily clinical practice in order to prevent or delay the onset and deterioration of symptomatic amyloidosis. Possible result improvement with a more frequent use of HD + HP needs further investigation.
MO665: 2 Icodextrin (2-ICO) Dwells in Peritoneal Dialysis (PD) Patients: One Center Experience
Authors: Viera Ramírez Elizabeth , Haridian Sosa Barrios R. , Burguera Vion Víctor , Martin Irene , Campillo Trapero Cristina , Fernandez Lucas Milagros , Maite Rivera 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Icodextrin is a soluble glucose polymer used widely as an alternative osmotic agent to glucose-only solutions in PD patients. It provides effective net peritoneal ultrafiltration (UF) and nowadays it is only licensed for once-daily dwells. However, in selected patients it has been described its use in two daily dwells (2-ICO). Our aim was to revise our center experience with icodextrin when prescribed as 2-ICO.

METHOD
We retrospectively analysed all patients with a 2-ICO dwell prescription in our PD unit from January 2018 until June 2021. Clinical data, indication for prescription and outcomes were collected.

RESULTS

CONCLUSION
In selected patients, 2-ICO dwells daily may have a clinical benefit, improving UF significantly and allowing better management of fluid overload and UF failure without relevant adverse events.
MO673: Association of Mean Corpuscular Volume with Mortality in Kidney Failure Patients: Opposite Findings in Chinese and Swedish Kidney Failure Patients
Authors: Lindholm Bengt , Zhang Xiaomeng , Chen Zhimin , Rashid Tony Qureshi Abdul , Danielson Kristin , Mukai Hideyuki , Suliman Mohamed , Heimbürger Olof , Chen Jianghua , Stenvinkel Peter , Peter Barany Franz 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Higher mean corpuscular volume (MCV), a measure of the average size of the circulating erythrocyte used for differential diagnosis of anemia or for monitoring macrocytosis, is associated with higher mortality in various clinical settings including in patients (pts) with kidney failure; however, results are not consistent and a study from Japan (Honda et al. Low rather than high mean corpuscular volume is associated with mortality in Japanese patients under hemodialysis. Sci Rep. 2020; 10(1): 15 663) found that low MCV associated with mortality in 8571 hemodialysis pts (mean age 62.5 ± 12.7 years, 37.2% female, median MCV 96.1 fL) pts. We investigated the relationship between MCV with all-cause and cardiovascular mortality in two cohorts of kidney failure pts from China and Sweden.

METHOD
In 731 incident Chinese peritoneal dialysis pts (median age 50 years, 57% males) and 404 Swedish kidney failure pts (median age 56 years, 62% males), baseline MCV and other biochemical and metabolic biomarkers were analysed in relation to mortality during follow-up period of up to 5 years. All-cause and cardiovascular disease (CVD) mortality risk were analysed with competing-risk regression models with transplantation as competing risk adjusting for age, sex, smoking, diabetes, serum albumin, hemoglobulin and calendar year.

RESULTS
Chinese pts were significantly younger (P &lt; 0.01) and had lower body mass index (P &lt; 0.01) and Framingham risk score (P &lt; 0.01) than Swedish pts while gender distribution was similar. In univariate analysis, MCV was associated with body mass index (P &lt; 0.01) and mean arterial blood pressure (P &lt; 0.01) in both cohorts. ‘Chinese pts’: During median 3.6 years of follow-up, all-cause mortality rate was 16%, and 52 (46%) of 111 deaths were caused by CVD. Low MCV (&lt;94 fL) was associated with significantly higher all-cause [Fig. 1A; sub-hazard ratio, sHR (95% CI) 2.15 (1.14–4.06)] but not CVD mortality (Fig. 2A) when adjusting for all confounders. ‘Swedish pts’: During median 2.1 years of follow-up, all-cause mortality rate was 30%, and 53 (44%) of the 120 deaths were caused by CVD. In contrast to the Chinese cohort, pts low MCV (&lt;94 fL) was associated with lower both all-cause [Fig. 1B; sHR 0.62 (0.39–0.97)] and CVD mortality [Fig. 2B; sHR 0.49 (0.26–0.94)] when adjusting for all confounders.

CONCLUSION
In Chinese kidney failure pts low MCV was associated with higher all-cause mortality risk while in Swedish kidney failure pts low MCV was associated with pts lower all-cause and CVD mortality risk, independently of all confounders. Further studies are needed to explore if this difference may reflect regional differences in factors affecting MCV.
MO684: Dialysis-Network Variability in Home Dialysis use not Explained by Patient Characteristics. A National Registry-Based Cohort Study in France
Authors: Couchoud Cécile , Bechade Clémence , Kolko Anne , Caillette-Beaudoin Agnes , Bayer Florian , Rabilloud Muriel , Ecochard René , Lobbedez Thierry 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Although associated with better quality of life and potential economic advantages, home dialysis use varies greatly internationally and appears to be underused in many countries. This study aimed to estimate the dialysis-network variability in home dialysis use and identify factors associated with (i) the uptake in home dialysis, (ii) the proportion of time spent on home dialysis and (iii) home dialysis survival (patient and technique).

METHOD
All adults ≥18 years old who had dialysis treatment during 2017–9 in mainland France were included. Mixed-effects regression models were built to explore factors including patient characteristics or residence and dialysis network associated with outcomes.
RESULTS: During 2017–9, 7728/78 757 (9.8%) patients underwent dialysis at least once at home for a total of 120 594/1 508 000 (8%) months. The heterogeneity in dialysis networks regarding the uptake or total time spent on home dialysis was marginally explained by patient characteristics or residence and dialysis-network factors. Heterogeneity was less for home dialysis survival. These results were similar when the analysis was restricted to home peritoneal dialysis or home hemodialysis. Income inequity and housing were associated with reduced home dialysis uptake and reduced proportion of time on home dialysis. Home dialysis use was not affected by the number of self-care HD units in the administrative district of residence.

CONCLUSION
Our results suggest that to increase home dialysis use in France, one should focus on home dialysis uptake rather than survival. Financial incentives and a quality improvement program should be implemented at the dialysis-network level to increase home dialysis use.
MO693: Longitudinal Intraindividual Changes of Peritoneal Histology over Time in 37 Peritoneal Dialysis Patients
Authors: Aziz Alan , Kielstein Jan T , Pfister Frederick , Amann Kerstin , Eden Gabriele 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The long-term use of peritoneal dialysis is limited due to changes of the peritoneum. Those can be attributed to both, uremia and the effect of the peritoneal dialysis solution on the peritoneum. Although the effect of peritoneal dialysis on the peritoneal histology has been investigated for more than 40 years, most studies fail to report intraindividual changes of the peritoneum but report cross-sectional data from different patients at different timepoints of their dialysis career. The aim of our study was to investigate the intraindividual changes over time associated with peritoneal dialysis as part of the GRiP (German Registry in PD).

METHOD
Among patients documented by the GRiP study group 37 patients were identified in which two peritoneal samples were collected at least 2 months apart. The median [IQR] patient age was 63.6 [52.8–70.5] years with a median [IQR] BMI of 27.8 [22.4–31.8] kg/m2. The time between the two biopsies was 20.0 [7.2–27.6] months. Removal or change of the PD catheter was due to infection in 20 of the 37 patients (54%). Samples from the parietal peritoneum were collected at prespecified locations. Routine histology using hematoxylin–eosin was performed. The thickness of the submesothelial compacta was analysed with AxioVision SE64 Rel.4.9. software. GraphPad Prism 9 (San Diego, CA, USA) was used for statistical analysis. Comparison between histological parameters at implantation and explantation was done by using a paired t-test using a significance level of P &lt; 0.05.

RESULTS
Comparing the intraindividual thickness of the compacta at the time of implantation and explantation of the peritoneal dialysis catheter we saw a significant increase of the median [IQR] ‘minimum thickness’ from 50.0 [20.5–89.5] µm to 130.0 [42.5–195.5] µm, the ‘average thickness’ from 102.0 [77.75–162.5.5] µm to 181.5 [123.3–265.5] as well as the ‘maximum thickness’ from 148.0 [107.0–208.0] µm to 240 [182.0–381.0] (Fig. 1). Further, the degree of peritoneal fibrosis increased significantly (Fig. 2).

CONCLUSION
The longitudinal, intraindividual assessment of peritoneal biopsies in a sizeable cohort of patients confirms previous cross-sectional data showing an increase in the thickness of the sumesothelial compacta over time.
MO698: Evaluation of Outcomes of Peritoneal Dialysis Patients in the Post-Covid-19 Period: a National Multicenter Case–Control Study from Turkey
Authors: Ozturk Savas , Gursu Meltem , Arici Mustafa , Sahin İdris , Eren Necmi , Yılmaz Mürvet , Ozberk Sumeyra , Karahisar Sirali Semahat , Ural Zeynep , Dursun Belda , Yuksel Enver , Uzun Sami , Sipahi Savas , Ahbap Dal Elbis , Yazici Halil , Altunoren Orcun , Tunca Onur , Ayar Yavuz , Gok Oguz Ebru , Yilmaz Zulfikar , Kahvecioglu Serdar , Asicioglu Ebru , Oruc Aysegul , Ataman Rezzan , Aydin Zeki , Huddam Bulent , Esra Dolarslan Murside , Azak Alper , Bakirdogen Serkan , Ugur Yalcin Ahmet , Karadag Serhat , Sena Ulu Memnune , Gungor Ozkan , Ari Bakir Elif , Riza Odabas Ali , Seyahi Nurhan , Yildiz Alaattin , Ateş Kenan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
There is not enough data on the post-COVID-19 (coronavirus disease 2019) period for peritoneal dialysis (PD) patients affected from COVID-19. We aimed to compare the clinical and laboratory data retrospectively obtained in the follow-up of PD patients after COVID-19 with a control PD group.

METHOD
This study, supported by the Turkish Society of Nephrology, is a national multicenter retrospectively case–control study involving adult PD patients with confirmed COVID-19, using data collected from 21 April 2021 to 11 June 2021. A control PD group was also formed from each PD unit, from patients with similar characteristics but who did not have COVID-19. Patients in the active period of COVID-19 were not included. Data at the end of the first month and within the first 90 days, as well as other outcomes, including mortality, were investigated.

RESULTS
A total of 223 patients (COVID-19 group: 113, control group: 110) from 28 centers were included. The duration of PD in both groups was similar [median (IQR):3.0 (1.88–6.0) years and 3.0 (2.0–5.6)], but the patient age of the COVID-19 group was lower than the control group [50 (IQR:40–57) years and 56 (IQR:46–64) years, P &lt; 0.001]. PD characteristics and baseline laboratory data were similar in both groups, except serum albumin and hemoglobin levels on Day 28, which were significantly lower in the COVID-19 group. In the COVID-19 group, respiratory symptoms, rehospitalization, lower respiratory tract infection, change in PD modality, UF failure and hypervolemia were significantly higher on the 28th day. There was no significant difference in laboratory parameters at Day 90. Only one (0.9%) patient in the COVID-19 group died within 90 days. There was no death in the control group. Respiratory symptoms, malnutrition and hypervolemia were significantly higher at Day 90 in the COVID-19 group.

CONCLUSION
Mortality in the first 90 days after COVID-19 in PD patients with COVID-19 is not different from the control PD group. However, some of these patients continue to experience significant problems, especially respiratory system symptoms, malnutrition, and hypervolemia.
MO712: Involvement of Mitochondrial Dysfunction in the Inflammatory Response in Human Mesothelial Cells from Peritoneal Dialysis Effluent
Authors: Ramil Gómez Olalla , Lopez-Pardo Mirian , Rodriguez-Carmona Ana , Fernandez-Rodriguez Jennifer , Vaamonde-García Carlos , Perez Fontan Miguel , José López-Armada María 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Recent studies have related mitochondrial impairment with peritoneal membrane damage in peritoneal dialysis (PD) therapy. Here we assessed the involvement of mitochondrial dysfunction in the inflammatory response in human mesothelial cells, a hallmark in the pathogenesis of PD-related peritoneal membrane damage.

METHOD
Ex vivo studies of effluent-derived human mesothelial cells were carried out. Mitochondria function was evaluated by analysing the mitochondrial membrane potential with flow cytometry using the fluorescent dye tetramethylrhodamine. Mitochondrial dysfunction was induced with the inhibitors oligomycin and paraquat. The effects of mitochondrial dysfunction on inflammatory mediators were studied. Mitochondrial ROS scavenger (MitoTEMPO) and a NF-κB inhibitor (BAY-117 085) were used to investigate the pathways involved. The natural anti-inflammatory antioxidant resveratrol was also tested.

RESULTS
Our ex vivo studies showed that IL-1β causes a drop in the mitochondrial membrane potential in cells from peritoneal effluent. Besides, when mitochondrial damage was induced by inhibitors of mitochondrial function a low-grade inflammatory response was generated. Interestingly, mitochondrial damage sensitizes mesothelial cells causing a significant increase in the inflammatory response induced by cytokines, in which ROS generation and NF-κB activation are involved since inflammation was counteracted by both MitoTEMPO and BAY-117 085. Furthermore, pretreatment with resveratrol significantly reduced the inflammatory response by reversing the decline in mitochondrial membrane potential and decreasing the expression of IL-8, COX-2 and PGE2 caused by IL-1β.

CONCLUSION
These findings suggest that IL-1β regulates mitochondrial function in mesothelial cells and that mitochondrial dysfunction could induce an inflammatory scenario and sensitize these cells, causing a significant amplification of the inflammatory response induced by cytokines. Resveratrol may represent a promising strategy in controlling the mesothelial inflammatory response.
MO738: Simplified Portable Lung Ultrasound Assessment of Fluid Status among Dialysis Patients
Authors: Ling Grace Tan Feng , Lun Allen Liu Yan , Muang Nyein Chan , Du Tiehua 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Fluid assessment is challenging, and fluid overload poses a significant problem among dialysis patients [1], with pulmonary oedema being the most serious consequence. Detection of B lines on lung ultrasound (LUS) is a reliable method of estimating lung water with higher sensitivity compared with clinical examination [2]. A simplified 8-point LUS has also shown a good correlation with the standard 28-point LUS in assessing lung water [3]. Using a simplified 8-point LUS by a portable hand-held ultrasound can help increase the uptake of LUS fluid assessment in dialysis units.
Our study aims to determine the performance of simplified 8-point LUS using a portable hand-held LUS unit in assessing the fluid status of dialysis patients compared with bioimpedance alone or a combination of bioimpedance and clinical examination.

METHOD
Two independent nephrologists performed a simplified 8-point LUS unit using a portable hand-held US unit. Clinical assessment of fluid status and bioimpedance were used as comparators. Fluid overload was defined as a B-line count of &gt; 5.
Our primary outcomes were the performance of simplified 8-point LUS compared with overhydration (OH) presented as absolute value and by percentage (OH%), with or without the combination of clinical examination of fluid status.

RESULTS
LUS was performed on 50 hemodialysis and 11 peritoneal dialysis patients. A total of 10% of patients were euvolemic, 46% had mild, 42% moderate and 2% severe fluid overload on clinical examination.
The OH and OH% of the area under the curve (AUC) for the receiver operating characteristic curve (ROC) curve were 0.697 and 0.713, respectively, for the performance of LUS compared with bioimpedance alone (Fig. 1). The same assessments were 0.782 and 0.781, respectively for a combination or bioimpedance together with clinical examination (Fig. 1).

CONCLUSION
Simplified 8-point LUS using a portable hand-held LUS unit showed a good performance with the assessment of fluid status using a combination of clinical examination and bioimpedance. This simplified and portable method will help increase the use of LUS in dialysis units.
MO740: Decrease Serum IgG anti-oxLDL Antibodies Levels are Associated with Peripheral Arterial Disease IN PATIENTS WITH PERITONEAL DIALYSIS
Authors: Teng Yi-Yen , Mitra Sari Santi , Wang Chih-Hsien , Kuo Ch , Hsu Bang-Gee 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Antibodies to oxidized LDL (anti-oxLDL antibodies) were found to indicate protection from coronary artery disease and possibly major adverse cardiovascular and cerebral events. Peripheral arterial disease (PAD), defined by a low ankle-brachial index (ABI), is associated with increased mortality in patients on peritoneal dialysis (PD). The present study aimed to determine the relationship between serum IgG anti-oxLDL antibodies level and PAD in PD patients.

METHOD
The present cross-sectional, a single-center study included 90 PD patients. Serum IgG anti-oxLDL antibody levels were determined by available enzyme-linked immunosorbent assays. ABI values were measured using an automated oscillometric device. Patients with ABIs of &lt; 0.9 were categorized into the low ABI group.

RESULTS
In the study cohort, 23 of the 90 patients (25.6%) had low ABIs. The rates of diabetes mellitus (P = 0.010), older age (P = 0.006) as well as the serum levels of fasting glucose (P &lt; 0.001), triglyceride (P = 0.008) and C-reactive protein (P &lt; 0.001) were higher, while IgG anti-oxLDL antibodies (p &lt; 0.001) were lower in the low ABI group compared with the normal ABI group. The multivariable logistic regression analysis revealed that serum levels of IgG anti-oxLDL antibodies [odds ratio (OR) 0.978, 95% confidence interval (95% CI) 0.958–1.000; P = .046) and C-reactive protein (each 0.1 mg/dL increase, OR 1.662, 95% CI 1.151–2.398; P = 0.007) were independently associated with PAD in PD patients. The area under the curve plotted to estimate the optimal level of IgG anti-oxLDL antibodies predicting PAD in PD patients by the receiver-operating characteristic curve analysis was 0.687 (95% CI 0.580–0.780; P = 0.0022).

CONCLUSION
Lower serum IgG anti-oxLDL antibodies together with higher C-reactive protein were associated with PAD in PD patients.