bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO521: Paricalcitol Direct Increases Hemoglobin Levels. A Repurposing Possibility for Treating Renal Anemia
Authors: Uriol Miguel , Obrador Mulet Aina , Cleofe Jimenez Mendoza Sonia , Martinez Mateu Josefa , Lado Fuentes Mario , Periañez Parraga Leonor 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The anti-inflammatory properties of the paricalcitol have been related to benefits in renal anemia; however, in chronic kidney disease (CKD) patients, the presence of secondary hyperparathyroidism (SHPT) represents a bias for determining the real effect of paricalcitol in hemoglobin levels. Whether the paricalcitol directly increases hemoglobin regardless of SHPT should be considered an opportunity for treating renal anemia, where the current treatments have safety concerns.
To determine the effect of the oral paricalcitol on hemoglobin levels administered in different types of patients. Group A: n = 10, CKD patients not on dialysis under erythropoietin stimulating agents (ESA), Group B: n = 37, CKD patients not receiving ESA. A sub-group of patients without SHPT (Group C, n = 20) and glomerulonephritis patients without CKD (Group D, n = 18). Seven patients had hyperparathyroidism without CKD (plasma creatinine &lt;1,2 mg/dL) and five CKD patients without SHPT (iPTH: 24–100 pg/mL). We also evaluated the effect of the paricalcitol according to Hb at baseline (≤10, ≤11 and ≤ 12 g/dL).

METHOD
A total of 52 consecutive patients were included and followed up by 6 months. Exclusion criteria were bleeding or recent blood transfusion history. No changes in ESA doses and iron supplements were required for inclusion. The mean paricalcitol dose was 6 mcg/week (min: 2–max: 7).

RESULTS
Age: 71(14) years, female 21(40%). As a whole, hemoglobin [mean: 95% confidence interval (CI)] increased 0.8 g/dL (0.4–1.2), partial η2: 0.24, P &lt; .001. In group A: Hb increased 0.9 (0.2–1.6) g/dL, partial η2: 0.15, P = .015; in group B: 1.0 (0.4–1.5) g/dL, partial η2: 0.32, P &lt; .001; in group C: 0.7 (0.2–1.2) g/dL, partial η2: 0.31, P = .008 and in group D: 0.4 (−0.02–0.9) g/dL, partial η2: 0.18, P = .06. In the seven patients only with hyperparathyroidism, Hb increased 1.3 (0.4–2.1) g/dL, partial η2: 0.67, P = .012 and in the five patients only with CKD the hemoglobin change 0.5 (−0.3–1.3) g/dL, partial η2: 0.40, P = .174. Interestingly, according to the baseline hemoglobin levels: ≤10, ≤11 and ≤ 12 g/dL, it significantly increased to 2.6, 2.3 and 1.2 g/dL, respectively.

CONCLUSION
The paricalcitol significantly increased the hemoglobin levels independently of ESA therapy, the renal function and the degree of hyperparathyroidism.
A greater effect was observed in patients with lower baseline hemoglobin levels.
Our results suggest that paricalcitol is a potential repurposing drug for treating renal anemia.
MO522: The Effect of Statin on Anemia in Patients With End-Stage Kidney Disease Receiving Hemodialysis: A Systematic Review and Meta-Analysis
Authors: Lin Yen-Chung 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Although treatment with erythropoietin-stimulating agents is effective in treating anemia in patients with end-stage kidney disease undergoing hemodialysis, some uremia patients, especially those with inflammation, continue to suffer from anemia. HMG-CoA reductase inhibitors (statins), which are lipid-lowering agents, may have a pleiotropic effect in reducing inflammation. Hence, we investigated the role of statin on hemoglobin (Hb) in patients receiving hemodialysis.

METHOD
We searched the PubMed, Embase, Medline, and Cochrane databases by using predefined keywords and MeSH terms for randomized controlled trials or cohort studies. Studies were included if (1) participants with CKD/ESKD were included, (2) treatment arms with statins were included, (3) study type was randomized control trial/cohort study and (4) outcomes of interest were hemoglobin (Hb), erythropoietin resistance index (ERI) and ferritin. Risk of bias tool 2.0 and the Newcastle–Ottawa Scale (NOS) were utilized to assess risk of bias in randomized controlled trials and cohort studies, respectively. Egger's test was used to test publication bias. In addition, our study was reported according to the preferred reporting items for systematic reviews and meta-analyses (PRISMA) 2020 statement.

RESULTS
We eventually included 10 studies (5258 participants), comprising three randomized controlled trials and seven cohort studies. Overall, Hb increased by 0.84 g/dL [95% confidence interval (95% CI) −0.02–1.70] in all groups of using statins, including single-arm cohorts, and by 0.72 g/dL (95% CI −0.02–1.46) in studies with placebo control. Hb levels were higher in the study group than in the control group, with a mean difference of 0.18 (95% CI 0.04–0.32) at baseline and 0.86 (95% CI 0.74–0.99) at the endpoint. Ferritin increased by 9.97 mg/dL (95% CI −5.36–25.29) in the study group and decreased by 34.01 mg/dL (95% CI −148.16–80.14) in the control group; ferritin fluctuation was higher in the control group.

CONCLUSION
Statin may improve renal anemia in patients with CKD and receiving regular erythropoietin-stimulating agents. Future studies with more rigorous methodology and larger sample size study should be performed to confirm this beneficial effect.
MO543: Efficacy and Influence on the Key Indicators of Mineral-Bone Disorders of the Sucroferric Oxyhydroxide and Sevelamer Carbonate in Hemodialysis Patients
Authors: Shutov Evgeny , Kotlyarova Galina , Lysenko Ksenia , Lashutin Sergey 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Currently, the effectiveness of phosphate-binding agents in patients with CKD should be determined not only by the level of reduction in hyperphosphatemia, but also by the effect on other key factors involved in the development of CKD-MBD. The results of the effect of phosphate binders on the parameters of CKD-MBD, excluding phosphate, are unclear. Our prospective randomized controlled trial evaluated the effect of 16-week treatment with sucroferric oxyhydroxide versus sevelamer carbonate (‘sevelamer’) on the parameters of CKD-MBD in patients with hyperphosphatemia on programmed hemodialysis.

METHOD
A total of 50 stable patients with hyperphosphatemia (P ˃ 5.5 mg/dL) after a 4-week washout period, were randomized at a 1:1 ratio to receive sucroferric oxyhydroxide (n = 25) or sevelamer (n = 25) for treatment up to 16 weeks. In all patients were monthly evaluated levels of FGF23, soluble Klotho, c-reactive protein (CRP), hemoglobin (Hb), ferritin, transferrin saturation, phosphorus (P), calcium (Ca), parathyroid hormone (PTH). The dose of both medications was adjusted according to serum phosphate.

RESULTS
The average intact fibroblast growth factor 23 (FGF23), PTH, transferrin saturation and ferritin levels did not significantly change in both groups. Meanwhile, Klotho levels increased by 25% in the sucroferric oxyhydroxide group (P &lt; 0.05). We observed a significant decrease in serum phosphate level from 6.8 ± 1.5 to 5.27 ± 0.99 mg/dL (P &lt; 0.01) only in the group with sucroferric oxyhydroxide. However, treatment with sevelamer did not decrease the level of P: 6.32 ± 1.5 versus 6.35 ± 1.9 mg/dL by the end of the study. The number of prescribed tablets was lower in the sucroferric oxyhydroxide group (2.0 ± 1.5 tab/day, mean ± SD) compared with sevelamer group (6.1 ± 3.2 tab/day, mean ± SD). We noted also in group sucroferric oxyhydroxide an increased Hb level from 105.6 ± 15.7 to 111.9 ± 22.3 g/L (P &lt; 0.05) and a simultaneous decrease of CRP level by 50% (P &lt; 0.01).

CONCLUSION
Treatment with sucroferric oxyhydroxide significantly increased Klotho and Hb levels and lowered CRP levels. Sucroferric oxyhydroxide was more effective in lowering phosphorus levels than sevelamer, which can be explained by an insufficient dose of sevelamer and a short treatment period.
MO556: Markers of Oxidative Stress and Coronary Calcifications in Chronic Hemodialysis Patients
Authors: Azouaou Leila , Arab Medina , Ballouti Wafa , Chader Henni , Mahrane Sadjia , Kezzal Kamel , Seba Atmane 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Cardiovascular morbidity and mortality are increased in hemodialysis patients. Oxidative stress is considered to be an important factor in these cardiovascular complications in these patients. The aim of this research is to establish the link between the levels of advanced oxidation protein products (AOPP) in the serum of hemodialysis patients and coronary calcifications.

METHOD
This is a longitudinal study involving 67 hemodialysis patients, all patients underwent a Coro-CT scan to assess coronary calcifications according to the Agatston coronary calcium score (SCCA). We divided the patients into three groups according to their low (0–100), medium (101–400) and severe calcification score &gt; 400, we measured the levels of AOPP in the three groups and we studied the correlation between the rate of AOPP at the level of the different groups.

RESULTS
The mean age of the patients is 55 ± 12.5 years, the sex ratio is 1.3, the mean us-CRP level is 12.5 mg/L, the mean NO, AOPP, MDA level, MPO and LDLox are respectively (62.188 ± 5.598, 70.82 ± 10, 6.97 ± 0.488 µmol/L, 61.466 ± 8.82 IU/mL and 31.755 ± 3.9 µmol/l), we divided the patients into three groups according to the agtston coronary calcium score (SCCA), we found 27% of the patients had a low score (0–100), 48% had a moderate sore (101–400) and 25% had a severe score &gt;400. We found that the rate of oxidative stress markers worsened with increasing calcification score, patients with a low score had levels of NO, AOPP, MDA, MPO and LDLox are respectively (67.2 ± 6.5, 64.9 ± 7, 3.24 ± 0.32, 57.8 ± 6.9 IU/mL and 10.17 ± 1.9 µmol/l), the mean score had respective levels of NO, AOPP, MDA, MPO and LDLox are respectively (62.5 ± 3.2, 72.7 ± 12, 7.2 ± 0.24 µmol/L, 60.34 ± 5.7 IU/mL and 27.6 ± 2.1 µmol/L) and patients with a severe calcification score had NO, AOPP, MDA, MPO and LDLox levels respectively (59.3 ± 2.4, 82.82 ± 12, 9.45 ± 0.34 µmol/L, 74.23 ± 9.7 IU/mL and 42.89 ± 5.19 µmol/L), there are positive correlations between the rate of coronary calcifications and the levels of markers oxidative stress NO, AOPP, MDA, MPO and LDLox) which are respectively (r = 0744, P = 0.0001; r = 0.777, P = 0.000; r = 0.318, P = 0.000; r = 0.620, P = 0.000; r = 0.526, P = 0.0001).

CONCLUSION
Markers of oxidative stress are higher in hemodialysis patients with vascular calcifications, they can be predictors of cardiovascular complications in hemodialysis patients.
MO559: The Dietary Intake of Chronic Kidney Disease According to Stages: Findings From the Korean National Health and Nutritional Examination Survey
Authors: Jung Oh Hyung , Kim Seon-MI 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Appropriate dietary adjustment in patients with chronic kidney disease (CKD) is important, and nutritional guidelines recommend different dietary management depending on the CKD stage. However, there is no study, to our knowledge, of the characteristics of dietary intake according to CKD stages.

METHOD
We tried to assess the comparison of nutritional intake according to CKD stages. A cross-sectional study was conducted to reveal the characteristics of dietary intake among CKD patients based on the Korean National Health and Nutritional Examination Survey between 2011 and 2014. Based on Kidney Disease Improving Global Outcomes guidelines, we stratified CKD into five groups (I, II, IIIa, IIIb and IV–V) and investigated the characteristics of dietary intake, such as energy, water, protein, fat, carbohydrate, sodium, potassium, calcium and phosphorus, according to stage of CKD. We also explored nutritional intake according to CKD stage among patients with early CKD (stage I and II) and advanced CKD (stage IIIa, IIIb and IV–V).

RESULTS
Of 16 878 participants, 14 952 were classed as non-CKD (88.61%) and 1926 (11.39%) as CKD. Of 16 878 participants, 14 952 were classed as non-CKD (88.61%) and 1926 (11.39%) as CKD. Intake of energy, water, protein, fat, carbohydrate, sodium, potassium, calcium, and phosphorus tended to be decreased as CKD progressed. In early CKD stage, intake of energy, water, protein, fat, carbohydrate, potassium, and phosphorus seemed to be statistically significant decreased as CKD progressed. In advanced CKD stage, intake of sodium and potassium seemed to be decreased as CKD progressed, but the intake of energy was about to be lower limit.

CONCLUSION
Appropriate dietary education and CKD recognition are needed to improve nutritional intake depending on the CKD stage.
MO564: The Association Between Monocyte to High-Density Lipoprotein Cholesterol Ratio and Cardiovascular Disease in Patients with Chronic Kidney Disease
Authors: Naouaoui Salma , Chettati Mariam , Fadili Wafaa , Laouad Inass 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Recently, monocyte count to HDL-C ratio (MHR) has emerged as a new cardiovascular prognostic marker. However, few studies have evaluated the impact of this marker on cardiovascular endpoints in moderate-to-severe chronic kidney disease (CKD). Therefore, we aimed to investigate whether baseline monocyte to high-density lipoprotein cholesterol ratio (MHR) is associated with cardiovascular diseases (CVD) in patients with CKD.

METHOD
In this retrospective study, carried out at nephrology department of Mohammed VI University hospital of Marrakesh, 110 patients with stage 3–5 CKD were recruited. MHR was calculated for all patients. The presence of heart failure, coronary artery disease or arrhythmia was defined as CVD.

RESULTS
Monocyte/HDL cholesterol ratio was negatively correlated with estimated glomerular filtration rate (eGFR) (P &lt; 0.001). The study cohort was divided into tertiles based on MHR. Cardiovascular diseases were more common in patients in the highest tertile of MHR with a hazard ratio of 2.41 compared with the lowest tertile. The association remained significant after adjusting for established cardiovascular risk factors including age, gender, diabetes mellitus, hypertension, eGFR and smoking status.

CONCLUSION
The present study revealed that MHR is strongly associated with CVD in patients with pre-dialysis CKD. Therefore, this easily available inflammatory marker might be useful to predict CDV in patients with CKD, especially in low-income settings.
MO567: Is Sarcopenia Associated With Clinical Outcomes in Chronic Kidney Disease Patients? A Systematic Review and Meta-Analysis
Authors: S. Ribeiro, Heitor , G. R. Neri Silvia , S. Oliveira Juliana , N. Bennett Paul , L. Viana João , M. Lima Ricardo 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Sarcopenia is a risk factor for adverse outcomes in older adults,[1], but this has yet to be confirmed in chronic kidney disease (CKD).[2] We conducted a systematic review to investigate the association between sarcopenia and its traits with mortality, hospitalization and end-stage kidney disease (ESKD) progression in CKD patients.

METHOD
Five electronic databases were searched, including MEDLINE and Embase. Observational cohort studies with CKD patients were included. The sarcopenia traits assessed were low muscle strength, low muscle mass and low physical performance, as well as confirmed sarcopenia (combined low muscle mass and low strength/performance).[3] Hazard ratios (HR), risk ratios (RR), odds ratios (OR) and 95% confidence intervals (CI) were pooled using random-effect meta-analyses.

RESULTS
From a total of 4922 screened studies, 50 (72 347 patients) were included in the review and 38 (59 070 patients) in the meta-analyses. Most of the included studies were in dialysis patients (n = 29, 58%). Table 1 shows that low muscle strength (15 studies; HR: 1.99; 95% CI: 1.65–2.41; I²:45%), low muscle mass (20 studies; HR: 1.51; 95% CI: 1.36–1.68; I²: 26%), low physical performance (five studies; HR: 2.09; 95% CI: 1.68–2.59; I²: 0%) and confirmed sarcopenia (eight studies in dialysis patients; HR: 1.87; 95% CI: 1.35–2.59; I²: 40%) were associated with an increased mortality risk. On the other hand, for dialysis patients it was uncertain whether low muscle mass was associated with hospitalization (two studies; RR: 1.81; 95% CI: 0.78–4.22; I²: 59%). Further, limited ESKD progression measures prevented meta-analysis for this outcome.

CONCLUSION
Low muscle strength, low muscle mass and low physical performance are associated with higher mortality in CKD patients. In dialysis patients, confirmed sarcopenia also represented higher mortality risk. Evidence to conclude associations with hospitalization and ESKD progression are currently lacking.
CI, confidence interval
MO568: The Relationship Between Oxidative Stress and Undernutrition in CKD Patients
Authors: Azouaou Leila , Arab Medina , Chader Henni , Seba Atmane 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Undernutrition is frequent in patients with chronic renal failure. It affects 35% of patients at the start of dialysis and represents one of the causes of morbidity and mortality. The objective of this work is to determine the relationship between oxidative stress and undernutrition in patients at different stages of chronic renal failure.

METHOD
A descriptive longitudinal study of 162 patients with chronic renal failure at different stages (2, 3, 4, 5 and 5D). We have studied the biological and anthropometric nutritional parameters in CKD patients at different stages as well as markers of oxidative stress, and we have studied their correlations with undernutrition in these patients.

RESULTS
The mean age of the patients is 56.5 ± 17 years with a sex ratio of 1.43. Regarding markers of oxidative stress, MDA, MPO and AOPP were studied. The means of which are respectively (6.1 ± 0.12 μmol/L, 59 0.89 ± 1.98 IU and 61.89 ± 1.4 μmol/L). The average body mass index, albumin and pre-albumin levels are respectively: (21.98 ± 0.28), (37.84 g/L ± 0.47) and (302.93 mg/L ± 5.4). All three parameters decrease significantly (P &lt;0.05) with degradation of renal function (from stage 2 to stage 5D) and increase in markers of oxidative stress with a negative correlation (P &lt; 0.05). The most undernourished patients are found in stage 5 and 5D with high levels of oxidative stress markers. Undernutrition is greater in patients with severe CKD and in hemodialysis patients with high levels of oxidative stress markers.

CONCLUSION
Chronic renal failure represents a real public health problem. Undernutrition is one of the causes of morbidity and mortality in these patients, especially after extra renal treatment, hemodialysis, oxidative stress worsens undernutrition and cardiovascular morbidity.
MO569: Assessment of Inflammation Using Neutrophil-Lymphocyte Ratio Among Non-Dialyzed Chronic Kidney Disease Patients—A Prospective Observational Study
Authors: Rashid Ishfaq , Tiwari Pramil , Cruz Sanjay D , Jaswal Shivani 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Persistent low-grade inflammation is intimately linked to the pathophysiology of chronic kidney disease and contributes grossly to poor nutritional status and mortality. There is insufficient evidence on inflammation in relation to diabetic status, stages of CKD among chronic kidney disease patients before the commencement of dialysis. This study has characterized the prevalence and factors of inflammation among pre-dialysis chronic kidney disease patients at a tertiary care public teaching hospital.

METHOD
This longitudinal observational study adopted neutrophil–lymphocyte ratio (&gt;3.53) to evaluate the inflammatory status among pre-dialysis chronic kidney disease patients. Glomerular filtration rate (eGFR) calculated by CKD-EPI equation from National Kidney Foundation was used as a measure of renal function. Multiple/multinomial regression analysis was also performed to determine the predictors of inflammatory status.

RESULTS
A total of 450 non-dialysis chronic kidney disease patients with or with diabetes were recruited during the period of study, consisting of 265 males and 185 females. Patients were aged 53.9 ± 14.2 years. According to neutrophil–lymphocyte ratio, the prevalence of inflammation among chronic kidney disease patients was found to be 91 (20.2%). The chronic kidney disease patients with diabetes 51(11.3%) were found to have higher rates of inflammation than non-diabetic chronic kidney disease patients 40 (8.9%). The adult age group 57 (12.7%) suffered more with inflammation than the elderly 34 (7.6%). Patients with severe malnutrition 42 (9.3%) were noted to have higher prevalence of inflammation followed by well-nourished 27 (6.0%) and mild/moderately malnourished population 22 (4.9%). The extent of inflammation was found to increase {CKD stage 1–2 (0.6%), CKD stage 3a-3b 34 (7.6%), CKD stage 4–5 54 (12.0%)} with decrease in renal residual function. Serum albumin, nutritional status and serum phosphorous have shown a significant association with the inflammatory status among chronic kidney disease patients.

CONCLUSION
The current findings demonstrate that the inflammation should be regarded as a familiar comorbid condition in chronic kidney disease. The intensity of inflammation is greater in patients with poorer renal function, comorbid diabetes and higher age. Future work needs to be aligned with respect to comprehensive understanding of inflammation mechanisms among patients with chronic kidney disease.