bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO1050: Covid-19 Vaccination Improved Psychological Distress (Anxiety and Depression Scores) in Chronic Kidney Disease Patients: A Prospective Study
Authors: Panizo Gonzalez Nayara , Fernanda Alvarado Maria , Garcia-Llana Helena , Gandia Lorena , Gimenez-Civera Elena , D'marco Luis , Jesãºs Puchades Montesa Maria , Sargsian Mari , Sanchis Irina , Juan-Garcia Isabel , Angel Solis Miguel , Maria Pérez-Baylach Carmen , Bonilla Begoña , Solano Rivera Camila , Moncho Francesc , Perez-Bernat Elisa , Luis Gorriz Teruel Jose 
Published: May 2022

Abstract

BACKGROUND AND AIMS
To our knowledge, the psychological impact of coronavirus disease (COVID-19) vaccination has not yet been evaluated for the general population nor for chronic kidney disease (CKD) patients.
The purpose of the study is to analyse the impact of vaccination against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) on anxiety and depression scores in patients with different modalities of CKD.

METHOD
A total of 117 renal patients (50 haemodialysis patients, 13 peritoneal dialysis patients, 32 kidney transplants and 22 advanced CKD patients at pre-dialysis care) were evaluated for depression, anxiety, health-related quality of life (HRQOL) and perceived fears and resources with standardized (The Hospital Anxiety and Depression Scale; HADS) and self-reported questionnaires. The measure points were before vaccination and 15 days after vaccination.

RESULTS
The main finding of the study is that there is a decrease in the global mean of normal scores for anxiety and depression symptoms in CKD patients, post-vaccination. We did not find statistically significant differences in depression or anxiety scores, nor HRQOL differences between the treatment groups. The three main fears reported by the participants at baseline were those of adverse effects, not getting the vaccine and lack of information.

CONCLUSION
These findings highlight the potential interest of assessing psychological variables related to the impact of vaccination against SARS-CoV-2. New studies will be required to assess the impact of comprehensive vaccine coverage and its psychological impact.
FC006: Sex Differences in the Recognition, Monitoring and Management of Chronic Kidney Disease in Health Care
Authors: Swartling Oskar , Yang Yuanhang , M. Clase Catherine , Fu Edouard , Hecking Manfred , Hödlmoser Sebastian , Trolle Lagerros Ylva , Evans Marie , Jesus Carrero Juan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Sex-specific differences exist in the population prevalence of chronic kidney disease (CKD), progression rates and health outcomes. Recognition, diagnosis and monitoring are central processes in the management of patients with CKD, but it is unknown whether these processes differ between men and women.

METHOD
This is an observational cohort study of all adult individuals (n = 227 847) with at least one eGFR (from serum creatinine) &lt;60 mL/min/1.73 m2 during outpatient routine care in Stockholm, Sweden, 2009–2017. Through logistic regression, we evaluated differences by sex in carrying an ICD-10 code for CKD and provision of recommended medications (renin–angiotensin system inhibitors [RASi] and statins) at inclusion. Through Cox regression, we evaluated potential sex differences in receiving a CKD diagnosis, referral to nephrology care and performance of laboratory monitoring (creatinine and albuminuria) in the next 18 months from inclusion. We also explored time-trends, comparing the above-mentioned nephrology care indicators among 70–80 000 unique eligible individuals per calendar year (in total 695 632 observations), thus allowing participants to contribute to different calendar year-cohorts.

RESULTS
We identified more women (55%) than men (45%) with probable CKD (eGFR &lt; 60 mL/min/1.73 m2). Women were generally older than men (median 77 versus 74 years), but eGFR was similar between sexes (51 mL/min/1.73 m2). More men than women had diabetes or myocardial infarction, but there was similar prevalence of hypertension. At inclusion and compared with men, women had lower risk of carrying an ICD-10 code for CKD (odds ratio [OR]: 0.47, 95% CI: 0.45–0.49) and were less likely to receive RASi (OR: 0.55; 0.50–0.61, among patient with albuminuria A3) or statins (OR: 0.64; 0.63–0.66, among patients ≥ 50 years), despite the presence of clear indications. In subsequent time-to-event analyses, women were less likely to receive a CKD diagnosis (hazard ratio [HR]: 0.43; 0.42–0.45) and visit a nephrologist (HR: 0.46; 0.43–0.48) regardless of CKD severity, presence of albuminuria or criteria for referral. Women were also less likely to undergo monitoring of creatinine or albuminuria, even among participants with diabetes (HR: 0.75; 0.74–0.76) or hypertension (HR: 0.76; 0.75–0.78). Multivariable adjustment including comorbidities, eGFR and indication for referral showed some attenuation of the effect, but a sex difference remained. Although in absolute terms there has been a gradual improvement in all nephrology care indicators over time, the observed sex gap persisted throughout.

CONCLUSION
We found profound sex differences in the detection, recognition, monitoring and management (including referrals) of CKD in healthcare, also across high-risk groups and indications.
FC024: Renal Proximal Tubules CB1 Receptor Modulates MTORC1 Signalling in Health and Disease
Authors: Hinden Liad , Ahmad Majdoleen , Hamad Sharleen , Nemirovski Alina , Glasmacher Sandra , Kogot-Levin Aviram , Gertsch Jürg , Leibowitz Gil , Tam Joseph 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Diabetic kidney disease (DKD), the renal manifestation of diabetes, contributes to increased morbidity and mortality of patients with diabetes. Activation of the cannabinoid-1 receptor (CB1R) and the mammalian target of rapamycin complex 1 (mTORC1) in the renal proximal tubular cells (RPTCs) contributes to the development of DKD. However, whether these two signalling molecules interact with each other to regulate kidney function during health and disease has not been described yet.

METHOD
By using a multidisciplinary approach that includes pharmacological and genetic manipulations of CB1R and mTORC1, we assessed the effect of CB1R activation/inhibition on mTORC1 activity under conditions of acute and chronic hyperglycaemia or normoglycaemia in RPTCs and mice.

RESULTS
We showed hyperglycaemia-induced endocannabinoid/CB1R stimulation. This stimulation increased mTORC1 activity and resulted in enhancing the expression of sterol regulatory element-binding protein 1c (SREBP1c) and its nuclear translocation, which in turn, induced the transcription of the facilitative glucose transporter 2 (GLUT2), thus leading to the development of DKD in mice. This effect was ameliorated by CB1R or mTORC1 nullification specifically in RPTCs. However, in non-diabetic conditions, CB1R maintained normal activation of mTORC1 by preventing the cellular excess of various amino acids via regulating their transporters, megalin, SLC6A19 and SLC7A5.

CONCLUSION
Our findings highlight two novel molecular mechanisms by which the activation of mTORC1 in RPTCs is tightly controlled by CB1R, either by enhancing the reabsorption of glucose and inducing renal dysfunction in diabetes or by preventing amino acid uptake and maintaining normal kidney function in healthy conditions. Moreover, this work highlights the therapeutic potential of targeting peripheral CB1Rs for the treatment of DKD, and on the other hand, avoiding its use in non-diabetic patients due to their possible effect on enhancing mTORC1 signalling.
FC029: A Multivariate Model Identifies Genotype, Hypertension and Kidney Length as Independent Baseline Predictors of Disease Progression in a Longitudinal Autosomal Dominant Polycystic Kidney Disease Patient Cohort
Authors: Cong Eugene Chen Wen , Ong Albert , Han Chong Jie 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Patients with autosomal dominant polycystic kidney disease (ADPKD) and evidence of rapid kidney function decline (∆eGFR &gt; 2.5 mL/min/year) are eligible for disease modifying therapy. Predictors of ∆eGFR are important to identify rapid progressors at an early stage before significant loss of kidney function. Genotype and baseline total kidney volume (TKV) are considered the most accurate individual prognostic factors though neither is widely performed in clinical practice. The major objective of this study was to assess what baseline clinical factors could most accurately predict ∆eGFR in an unselected ADPKD cohort (n = 625) followed-up through a specialist PKD clinic between 2010 and 2021.

METHOD
A cross-sectional retrospective analysis was performed in all ADPKD patients with sufficient data. The mean follow-up duration was 11 (±11.2) years. The rate of estimated glomerular filtration rate (eGFR) decline was determined by linear regression, based on a minimum of 5 years of renal function prior to the study or renal replacement therapy. Patients who were genotyped (n = 390) were classified into those with PKD1 (T, truncating or NT, non-truncating), PKD2, other genes (non-PKD1 or PKD2) or NMD (no mutation detected). Genotype combined with baseline imaging (ultrasound) was available in a subset of patients (n = 138). There was insufficient TKV information in this cohort to include it as an independent variable.

RESULTS
Kaplan–Meier plots (probability of eGFR &gt; 60 mL/min/1.73 m2 v age, n = 368) showed a significant genotype–phenotype correlation with a median age of 54, 61, 69 and 73 years for PKD1-T, PKD1-NT, PKD2, NMD/other genes, respectively. Dividing the cohort into 3 ∆eGFR groups (&lt;2.5, 2.5–5, &gt;5 mL/min/year, n = 316) confirmed significant differences in genotype (PKD1-T), baseline hypertension, mean kidney length and proteinuria (PCR &gt; 50 mg/mmol) between patients in the low (&lt;2.5) and very rapid (&gt;5) decline groups. A multivariate linear regression model was developed with all potential baseline factors significant on univariate analysis. We found that a PKD1 truncating mutation (PKD1-T), mean kidney length and baseline hypertension were significant independent predictors for ∆eGFR. This model accounted for 27% of the variability in ∆eGFR (r2 = 0.2668; P &lt; 0.05).

CONCLUSION
Our multivariate linear regression model confirms the importance of genotype, phenotype and imaging factors as independent prognostic variables determining ∆eGFR over a minimum period of 5 years follow-up in a longitudinal ADPKD cohort. Since the current model accounts for 27% of variability, it will be important to identify other relevant clinical, genetic or epigenetic factors that determine ∆eGFR.
FC031: Validation of a Prediction System for Risk of Allograft Loss (IBOX) in Pediatric Kidney Transplant Recipients
Authors: Hogan Julien , Divard Gillian , Garro Rouba , Boyer Olivia , Seifert Michael , Smith Jodi , Tönshoff Burkhard , Twombley Katherine , Warady Bradley , Weng Patricia , Zhar Rima , Patzer Rachel , Loupy Alexandre 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Kidney allograft loss is a common cause of end-stage renal disease but accurate prediction models of kidney allograft loss are lacking in children. The iBOX system has been broadly validated among adults. We aimed to validate the iBOX system in a large international cohort of pediatric kTx recipients.

METHOD
In this observational study, we used data from pediatric (&lt;21) patients transplanted between 2005 and 2017 from 20 institutions in Europe and the USA. Patients with functional parameters (eGFR and UPCR), donor specific antibody and biopsy results (Banff scores g, ptc, cg, i, t and IFTA) were included. Individual predictions of allograft loss were obtained by applying the iBOX score on our data. The prediction performances of the model in our population were assessed via discrimination (c-statistics) and calibration.

RESULTS
A total of 573 kTx recipients were included. Median time from transplantation to evaluation was 1.0 (0.5–2.0) year with a mean age at evaluation at 12.1 (5.5) years and mean follow-up after transplantation 5.1 (2.8) years. Five-year death-censored graft survival from evaluation was 95%. At the time of evaluation, mean eGFR and uPCR were 65.5 (29.6) mL/min/1.73 m2 and 0.25 (1.2) g/g, respectively. A total of 118 (20.6%) of the patients had DSA. The iBOX system showed good discrimination with a c-statistic of 0.81 and good calibration (Figure 1).

CONCLUSION
The iBOX system demonstrated high accuracy in predicting kidney allograft loss in children with performances similar to those reported in adults.
FC048: New Tool to Predict the Clinical Course and Renal Failure in Patients with Immunoglobulin a Nephropathy
Authors: Paolo Schena Francesco , Walter Anelli Vto , Cornacchia Giandomenico , DI Noia Tommaso , Stangou Maria , Papagianni Aikaterina , Coppo Rosanna 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Idiopathic Immunoglobulin A nephropathy (IgAN) is the most common biopsy-proven glomerulonephritis in the world. Approximately 40% of IgAN patients reach renal failure (RF) 20 years after their kidney biopsy. The high prevalence of RF shows that IgAN has a significant economic impact in the countries because renal replacement therapy is costly. Moreover, the disease's onset in the second and third decades of life represents a social challenge because patients are typically very active and highly productive in the workplace. This challenge is one more reason to move on the prediction of the clinical course and RF in IgAN patients at the time of the kidney biopsy and during the follow-up. We developed an artificial neural network (ANN) tool (DialCheck 1.0) based on seven variables and the histological score of the kidney biopsy to predict RF in IgAN patients at the time of kidney biopsy [1].

METHOD
We have recently developed a new tool which consists of a set of ANN-powered models that combine temporally accurate observations for fine-grained features and leverage state-of-the-art deep neural network techniques to forecast the patient's clinical evolution.

RESULTS
A cohort of 948 IgAN patients, of whom the clinical course of the disease was known, was used to develop the new tool that predicts the dynamics of age and disease laboratory parameters (serum creatinine, daily proteinuria), blood pressure, histological score of the kidney biopsy and the RF. The system was designed to help the physicians give a broader spectrum of information regarding the patient and the potential clinical development of IgAN and outcomes.
In detail, the model computes a latent dynamic representation of the patient and predicts a prospective clinical picture of the patient and the probability of RF. The tool with an accuracy of &gt;80% will be tested in an independent retrospective cohort of 454 IgAN patients and in a prospective multicenter randomized clinical study in which 426 IgAN patients will be enrolled in two different groups based on the type of kidney lesions (active and chronic renal lesions).

CONCLUSION
We have a new tool (DialCheck 2.0), based on ANN, that may predict the outcome and the RF in IgAN patients. Moreover, it may help the physician to analyze the long-term response to therapy.
FC051: Atacicept Reduces Serum ANTI-GD-IGA1 Levels in IgAN Patients
Authors: Barratt Jonathan , Lin Celia , Nawaz Nadia , Molyneux Karen , A. Tumlin James , Suzuki Yusuke 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Gd-IgA1 plays a central role in IgAN pathogenesis. In IgAN patients, antibodies develop against Gd-IgA1, which then form immune complexes that deposit in the kidney. Increased circulatory levels of autoantigen (Gd-IgA1) or autoantibody (anti-Gd-IgA1) levels correlate with increased risk of progression and worse clinical outcomes. The Ph2a JANUS trial was the first to show substantial serum Gd-IgA1 reduction with atacicept in a randomized clinical trial with IgAN patients. This analysis investigates whether atacicept can also reduce serum anti-Gd-IgA1.

METHOD
JANUS patients were evaluated for serum anti-Gd-IgA1 at baseline, weeks 4, 12, 24, 48, and 72. An ELISA was developed using as the capture antigen an intact IgA1 paraprotein, which displayed high HPA lectin binding measured Gd-IgA1-specific IgG. Serum samples were normalized using three standard serum samples included on all plates.

RESULTS
Decrease in serum anti-Gd-IgA1 levels was observed in both atacicept 25- and 75-mg groups over time. At 24 weeks, mean % change from baseline was 24% decrease for atacicept 25 mg and 29% decrease for atacicept 75 mg. At 72 weeks, 28% decrease for atacicept 25 mg and 39% decrease for atacicept 75 mg was observed. Plot of mean % change in serum anti-Gd-IgA1 levels over time is presented in the Figure 1.

CONCLUSION
Atacicept is the first therapeutic to show a reduction in anti-Gd-IgA1 in IgAN patients. Atacicept’s ability to decrease both circulatory Gd-IgA1 and IgG autoantibodies to this protein, which are central to the pathogenesis and progression of IgAN, supports its potential as a disease modifying therapy for IgAN patients.
FC062: Baseline Soluble Immune Checkpoints Predict Relapse Risk in PR3-Anca Vasculitis Following Rituximab Induction Therapy
Authors: Kronbichler Andreas , Gamerith Gabriele , Mildner Finn 
Published: May 2022

Abstract

BACKGROUND AND AIMS
We investigated whether soluble immune checkpoints (sICPs) predict treatment-resistance, relapse risk and risk of infections in patients with antineutrophil cytoplasm antibody (ANCA)-associated vasculitis (AAV).

METHOD
Plasma levels of sICPs were measured by enzyme-linked immunosorbent assay from samples obtained at baseline and during follow-up from patients with AAV in the RAVE trial and were correlated with selected clinical outcomes. Log-rank test was used to evaluate survival benefits, and optimal cut-off values of the marker molecules were calculated using Yeldons J.

RESULTS
Among 95 patients receiving rituximab as induction therapy, lower soluble (s)Lag-3 (&lt;90 pg/mL) and higher sCD27 (&gt;3000 pg/mL) were predictive of not achieving remission. Among patients with remission, 32.9% relapsed with a median relapse free survival of 5.64 months. Low baseline values of sTim-3 (&lt;1200 pg/mL), sCD27 (&lt;1250 pg/mL) and sBTLA (&lt;1000 pg/mL) were associated with disease relapse. In addition, patients with high levels of at least one of these markers were prone to infectious complications. These findings were restricted to patients with proteinase 3 (PR3)-ANCA vasculitis and not observed in patients with myeloperoxidase (MPO)-ANCA vasculitis. Moreover, these relationships do not hold for the group of patients randomized to receive cyclophosphamide/azathioprine.

CONCLUSION
Rituximab-treated patients achieved remission less frequently when sLag-3 was low and sCD27 was high. Higher expression of sTim-3, sCD27 and sBTLA at baseline was associated with a lower risk of relapse in PR3-ANCA vasculitis following rituximab. These results will require confirmation in future studies, but may contribute to personalized medicine in AAV.
FC081: Cholinesterase Inhibitors and Kidney Function Decline in Patients with Alzheimer's Dementia
Authors: Xu Hong , Garcia-Ptacek Sara , Bruchfeld Annette , Fu Edouard , Darreh Shori Taher , Lindholm Bengt , Eriksdotter Maria , Jesus Carrero Juan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Preclinical evidence shows that activation of the cholinergic anti-inflammatory pathway (CAP) may have direct and indirect beneficial effects on the kidney. Cholinesterase inhibitors (ChEIs) are specific Alzheimer's dementia (AD) therapies that block the action of cholinesterases and activate CAP. This study explores a plausible effect of ChEIs on slowing kidney function decline.

METHOD
Observational study with a landmark design of patients with incident AD from the Swedish Dementia Registry (SveDem) 2007–2018 with complete extraction of routine serum creatinine tests from the Stockholm CREAtinine Measurements (SCREAM) registry to evaluate estimated glomerular filtration rate (eGFR) over time. Patients starting on ChEI within 90 days of an AD diagnosis were compared to patients with AD not receiving ChEI. The primary study outcome was CKD progression, defined as the composite of a sustained eGFR decline of &gt;30% from baseline, initiation of kidney replacement therapy or death attributed to kidney disease. Secondary outcome was death. Inverse probability of treatment weighting Cox models were used to estimate hazard ratios, balancing 45 confounders.

RESULTS
We included 11 898 incident patients, of whom 6803 started on ChEI and 5095 did not. Mean age was 80 years, 64% were women and mean baseline eGFR was 68 mL/min/1.73 m2. After weighting, and during median follow-up time of 3.0 (IQR 1.3–4.5) years, 1231 events of CKD progression occurred, along with 5691 deaths. Compared to noninitiators, ChEI use was associated with a 18% lower risk of CKD progression [adjusted hazards ratio (aHR) 0.82; 95% confidence interval (95% CI) 0.70–0.96] and a 21% lower risk of death (aHR 0.79; 0.72–0.86). Results were consistent across subgroups of age, sex, and across ChEI subclasses and after accounting for competing risks.

CONCLUSION
In routinely cared patients with incident AD diagnosis, use of ChEI (versus no-use) was associated with lower risk of CKD progression and death, lending support to the role of CAP activation on preservation of kidney function.
FC085: Cerebral Oxygenation During Exercise Across Different Stages of Chronic Kidney Disease
Authors: Theodorakopoulou Marieta , Zafeiridis Andreas , Dipla Konstantina , Faitatzidou Danai , Koutlas Aggelos , Eleni Alexandrou Maria , Polychronidou Georgia , Chalkidis Georgios , Papagianni Aikaterini , Sarafidis Pantelis 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Cognitive impairment and reduced exercise tolerance are common in patients with chronic kidney disease (CKD), in part due to reduced brain function. Proper brain function relies on sufficient blood flow and oxygen supply by the cerebral vasculature. A reduction in cerebral oxygenation of more than 10% may deteriorate brain function and influence the decision to continue exercise. This study aims to examine the cerebral oxygenation and blood volume during a mild physical stress as an index of brain activation in patients at different stages of CKD and controls without CKD.

METHOD
This is a preliminary analysis of an observational study enrolling patients with CKD stage 2–4 (matched for age and sex within the different stages) and controls without CKD. All participants underwent a 3-min intermittent handgrip exercise (HG) at 35% of their maximal voluntary contraction. Changes in prefrontal oxygenation (oxyhaemoglobin—O2Hb) and deoxyhaemoglobin—HHb) and total blood volume (total hemoglobin—tHb) were continuously recorded during HG-exercise by near-infrared spectroscopy (NIRS).

RESULTS
A total of 59 participants are included in this preliminary analyses (n = 11 controls, n = 15 stage 2 CKD, n = 18 stage 3 CKD and n = 15 stage 4 CKD patients). During HG-exercise, O2Hb significantly increased (P &lt; 0.001) and HHb remained relatively unchanged in all groups compared to pre-exercise values. However, this O2Hb increase was progressively lower with advancing CKD Stages (controls: 2.58 ± 1.43; stage 2: 1.51 ± 1.31; stage 3: 1.29 ± 0.97; stage 4: 0.95 ± 0.92; P = 0.006) (Figure). During HG, tHb (an index of microvascular blood volume) increased significantly in controls, stage 2 and stage 3 CKD patients (P &lt; 0.05) but not in stage 4 CKD patients (P = 0.100). As before this tHb increase was progressively lower with advancing CKD stages (P = 0.030). Controlling for age differences between groups did not alter the above observations.

CONCLUSION
Brain activation/response during a mild physical task appears to decrease with advancing CKD as suggested by the smaller rise in cerebral oxygenation and blood volume. This may contribute both impaired cognitive function and reduced exercise tolerance with advancing CKD.