bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO850: Casirivimab/Imdevimab in Vaccinated Chronic Haemodialyzed Patients With Acute Mild Covid-19: Safety And Efficiency
Authors: Monge Matthieu , Henriquez Soledad , Humbert Caroline , Guiard Elsa , Allouache Mahmoud , Yhuel Jean-Marc , Lavollay Marie , Richaud Clemence , Gohari Afsaneh 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Casirivimab/imdevimab (C/I) is a combination of two neutralizing human monoclonal antibodies against the SARS-CoV-2. It has been approved for primary prophylaxis or acute SARS-CoV-2 infection in patients with a poor vaccine response. Chronic haemodialyzed (CHD) patients are a high-risk population for both severe COVID-19 and impaired vaccine response. We herein report the safety and efficiency of C/I in CHD patients with acute mild COVID-19.

METHOD
In a single-centre haemodialysis facility, all 56 CHD patients received 3 injections of anti-COVID-19 mRNA BNT162b2 vaccine, with anti-S protein antibodies response assessed 7 months after the last injection. During follow-up, patients who presented an acute mild SARS-CoV-2 infection without the need for oxygen therapy and a poor vaccine response received within 5 days after diagnosis 600mg/600mg of C/I. The combination of monoclonal antibodies was infused only once after the end of the dialysis session during 20 min. Patients were kept under surveillance during 1 h before discharge. Efficiency was assessed by RT-PCR 7 days after C/I infusion and clinical evaluation.

RESULTS
Six CHD patients had an acute COVID-19 without oxygen therapy requirement and four had a vaccine response &lt; 264 BAU/mL. Among them three had the Delta variant (L452R mutation), and received C/I. Two of them had the opportunity to have a fourth vaccine injection, but got infected within 2 weeks after the boost. Clinical data are summarized in Table 1. No patient presented any adverse effect within the time in the dialysis facility. During follow-up, all patients remained asymptomatic and all control RT-PCR performed 7 days after infusion were negative.

CONCLUSION
600 mg/600 mg of C/I is a safe and efficient treatment for CHD patients with a poor vaccine humoral response presenting mild acute Delta variant COVID-19 without oxygen requirement.
MO852: Predialysis Blood-Pressure Control Based on Antihypertensive Guidelines Should Deteriorate Cardiovascular Prognosis in Patients on Maintenance Dialysis
Authors: Omae Kiyotsugu , Ogawa Tetsuya , Kyono Ai , Nishizawa Yoko , Hosoda Yumi , Hirasawa Eriko , Tosaka Mai 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Guidelines of KDOQI for dialysis patients on blood-pressure (BP) targets proposed blow 140/90 mmHg at predialysis and &lt; 130/80 mmHg at postdialysis. On the other hand, in dialysis patients, many reports have shown an association between predialysis hypotension and poor prognosis. Moreover, it has been reported that low systolic blood-pressure (SBP) is associated with poor prognosis in non-dialysis patients with heart failure. Therefore, predialysis BP controlled according to KDOQI guideline should worsen survival rate in dialysis patients, especially with any cardiac disease. This time, we investigated the difference on cardiovascular survival-rate between the group complied with KDOQI guidelines and the group complied with them for diastolic blood-pressure alone, by using Yoshikawa clinic dialysis-database (YCD).

METHOD
A total of 455 dialysis patients (264 males and 176 females) registered in YCD enrolled in this study from April 2006 on. From these patients, we extracted two groups, group G, strictly lowering on systolic and diastolic blood-pressure and group D, lowering on diastolic blood-pressure (DBP) alone, in accordance with antihypertensive guidelines. According to calculated propensity score on group G, patients were extracted by 1: 1 matching from each group. Their survival analysis was estimated by Kaplan–Meier method, and a log-rank test was used to examine the differences between the cardiovascular survival curves. The prognostic factors for cardiovascular mortality were extracted from background factors, including blood-pressure level, using Cox regression model.

RESULTS
In 455 patients, mean predialysis SBP and DBP were 143.3 mmHg and 73.1 mmHg, respectively. 141 patients were extracted as group G and 219 were as group D. According to calculated propensity-score, 116 pairs (group Gp and Dp) were extracted from group G and D. There was no significant difference in matching covariates except predialysis blood-pressure between the two groups. During mean-observational period of 5.8 years, 111 patients died, among that 59 were cardiovascular death (CVD). The survival curve on cardiovascular mortality in the group Gp showed significantly poor prognosis. In multivariate analysis of Cox proportional hazard model, SBP &lt; 140 mmHg was extracted as a prognostic factor for CVD, and the hazard ratio was 1.892. On the other hand, in group Dp, non-cardiovascular prognosis was poor, especially in those &lt; 70 years old.

CONCLUSION
Blood-pressure control in maintenance dialysis-patients based on current antihypertensive guidelines (KDOQI) should worsen their cardiovascular prognosis. Therefore, it is necessary to set SBP control for each case. This study is a cohort study with a single institution, and a prospective study with multiple institutions will be needed in the future.
MO853: The Incidence of Peripheral Neuropathy Using Paindetect Questionnaire in Chronic Kidney Disease Patients on Hemodialysis in a Dialysis Center in Davao City
Authors: Rose Pasaylo Riza 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Peripheral neuropathy is considered a common complication among hemodialysis (HD) patients. However, there is no diagnostic tool designed to evaluate peripheral neuropathy among these patients. Neuropathic pain is reported to be associated with disrupted quality of life (QOL) in hemodialysis patients. Peripheral neuropathy is overlooked, unassessed and insufficiently treated in these patients. Unfamiliar to the majority is a questionnaire on peripheral neuropathy called ‘painDETECT’, a self-reported instrument that classify profile of those presenting with neuropathic components. This study is the first to utilize the painDETECT Questionnaire in determining the incidence of peripheral neuropathy in HD patients and its association with QOL.

METHOD
This is single—center prospective cross-sectional study performed in a free-standing hemodialysis center in Davao City. The participants included hemodialysis patients enrolled from June to November 2021. Assessment was done using painDETECT Questionnaire (English/Tagalog version) to assess neuropathic pain, while the Short Form 36 (SF-36) quality of life scale was used to evaluate the correlation of pain and quality of life.

RESULTS
A total of 350 patients were enrolled, only 169 participants were included, majority were females 87 (51%), with mean age of 47.42 years. Among the patients, 149 experienced pain (88.17%), and 57 (35.85%) had neuropathic pain. The most common site of pain were the lower extremities (68.42%). Neuropathic pain was associated with length of time the patient had been on hemodialysis [4.35 (±3.20)], however this did not reach statistical significance (P = 0.006). It was found to be more common among older patients (53.4, P &lt; 0.001), with diabetes (78%) with very low estimated GFR (&lt;4 mL/min) and without residual renal function (RRF) (77.19%). The quality of life of these patients was found to be lower 69.49 (±13.91) (P &lt; 0.001).

CONCLUSION
PainDETECT questionnaire could be a useful and simple bedside tool to determine the presence of peripheral neuropathy among hemodialysis patients. This study showed that presence of peripheral neuropathy was significantly associated with older age, diabetes, very low eGFR, absent residual renal function and thus, it indeed affected their quality of life. With the use of this tool, early detection and intervention can be done to aid clinicians, with the hope of improving the quality of life of these hemodialysis patients.
MO859: Factors Affecting Immune Response to Hepatitis B Vaccination Among Chronic Hemodialysis Patients in Saudi Arabia
Authors: Belarbia Anis , Ekrikpo Udeme , S. Moussa Ayman , Dridi Afef , Jubran Ibrahim , Alobaili Saad , Alahmadi Salwa , Albadr Wisam 
Published: May 2022

Abstract

BACKGROUND AND AIMS
It is well established that patients on chronic hemodialysis (HD) have an increased risk of hepatitis B virus (HBV) infection and reduced response to HBV vaccines compared with the general population.1 While advances in immunology and vaccinology have evolved several HBV vaccine modifications to enhance immunogenicity2; there is need to identify modifiable clinical factors that may help enhance response to HBV vaccines in the chronic HD population. This multi-center study aims to document the response to HBV vaccine among chronic HD patients across DaVita centers in Saudi Arabia and to identify the factors that independently affect the response of HD patients to the HBV vaccine.

METHOD
Patients eligible for HBV vaccination among our patient cohort who had received a full course of HBV vaccination (Engerix-B®, GlaxoSmithKline, United Kingdom) in all DaVita Clinics in Saudi Arabia were included in the analysis. We excluded patients who did not complete the vaccine protocol or had missing data and who were treated by immunosuppressive drugs. Levels of the antibody to the surface antigen (anti-HBs) were measured about 2 months after the last dose of the vaccine using enzyme-linked immunoassay methods. The age (in years), dialysis vintage, hepatitis C infection, diabetic status, mean albumin, parathyroid hormone (PTH), ferritin and hemoglobin levels 2 months prior to and during the 6 months of completing the vaccination protocol were recorded. Response to HBV vaccine was recorded as ‘no response’ if anti-HBs was &lt; 10 mIU/L; ‘weak response’ if the anti-HBs level is between 10–99.9 mIU/L, and ‘good response’ when ≥ 100 mIU/L. Univariate and multivariate ordinal logistic regression models were used to identify the factors independently associated with response to HBV vaccine.

RESULTS
We had 509 patients with a mean age of 54.1 ± 15.1 years, 252 (49.5%) being female. Diabetes mellitus was the etiology of kidney failure in 60.5% of the patients. Most (91.1%) had concomitant hypertension and 4.3% were positive for hepatitis C virus infection. BMI was at least 30 kg/m2 in 26.1% of the study population. Immune response occurred in 374 {73.5%, [95% confidence interval (95% CI) 69.4–77.3%]}. Good response occurred in only 53.1% (95% CI 48.6%–57.4%). The factors independently associated with response to HBV vaccination were age, mean albumin, PTH, ferritin levels and BMI (Table 1). Diabetic status and Kt/v did not predict vaccine response.

CONCLUSION
A complex interaction of inflammatory markers, nutritional status, bone mineral disease parameters affects the response to HBV vaccines. Improving chronic dialysis patients’ albumin and PTH levels may increase the likelihood of achieving a good response to HBV vaccines.
MO864: Sleep Disorders in a Haemodialysis Unit
Authors: Laura Fuentes Sanchez Maria , Jimenez Salcedo Tamara , Vázquez Teresa , Ruiz-Esteban Pedro , Hernández Domingo 
Published: May 2022

Abstract

BACKGROUND AND AIMS
There is a high prevalence of sleep disorders in patients with CKD. Sleep apnea, restless legs syndrome and daytime sleepiness are much more common in haemodialysis patients than the general population.

OBJECTIVE
To know the prevalence of sleep problems in patients in our hospital haemodialysis unit through surveys carried out on patients.

METHOD
We designed a cross-sectional study on the prevalence of sleep disorders.
Exclusion criteria age under 18 years.
We gave 4 questionnaires to the patients in our unit: restless legs, Epworth daytime sleepiness, Berlin and Pittsburg Sleep quality.
We collected demographic and clinical variables, dialysis parameters and laboratory data that could be related.
Student's t-test and X-squared were applied for qualitative variables. SSps Version 15.0.

RESULTS
Of those surveyed, 12 had criteria for restless leg syndrome. The difference between ferritin and CRP among the RLS group was striking. Excessive daytime sleepiness is met in 10 patients. Only the CRP values were significantly higher in the group with the normal test. When associating the Epworth test and the Berlin questionnaire, we had a total of 3 patients with high risk of OSAS. 15 patients meet the criteria for poor quality of sleep in the Pittsburg questionnaire where we assess: quality, latency, efficacy and duration of sleep as well as use of medication and daytime impairment.

CONCLUSION
Highlight the high prevalence of sleep disorders: 24% restless leg syndrome, 20% daytime sleepiness and 30% with poor sleep quality.
We must assess sleep disorders in haemodialysis patients since they present a significant deterioration in quality of life.
MO881: Predictors of Mortality of COVID-19 in Haemodialysis Patients
Authors: Rista Elvana , Cadri Vilma , Saliaj Kristi , Akshija Ilir 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The COVID-19 pandemic has disproportionately affected patients with pre-existing comorbidities, particularly dialysis patients. These patients appear to be more susceptible to severe forms of the infection, due to underlying, coexisting pathologies and their immunocompromised status. The aim of this study was to determine predictors of mortality in this population.

METHOD
We conducted an observational, retrospective, cohort study collecting data from the electronic medical records of a single dialysis centre at Hygeia Hospital Tirana, Albania. Baseline patient characteristics, including demographic, clinical and laboratory data were recorded. The receiver operating characteristic (ROC) analysis was used to determine predictors of mortality, their respective sensitivity, specificity and cut-off values.

RESULTS
Of 170 haemodialysis patients, 52 were diagnosed with COVID-19. The prevalence of COVID-19 infection in haemodialysis patients in our study was 30.5%. The mean age was 61.5 ± 12.3 years and 65.4% were men. The mortality rate in our cohort was 19.2%. Mortality rates were higher in patients with Diabetic Nephropathy (P &lt; 0.04) and Peripheral Vascular Disease (P &lt; 0.01). High BMI (P &lt; 0.024), high RDW (P &lt; 0.03), elevated C-reactive protein (P &lt; 0.018) and elevated serum ferritin (P &lt; 0.021) levels, were found to be risk factors for severe COVID-19 disease. ROC analysis identified lymphopenia and eosinopenia as the strongest predictors of mortality. AUC for lymphopenia was 0.739. It showed a sensitivity of 80% and a specificity of 85.7%, at a cut-off value of 13.15%. AUC for eosinopenia was 0.814. At a cut-off value of 0.185%, it revealed a sensitivity and specificity of 72.7% and 75%, respectively.

CONCLUSION
Our study revealed that risk factors for the development of severe COVID-19 infection were high BMI, high RDW, elevated levels of C-reactive protein (CRP) and serum ferritin. Lymphopenia and eosinopenia were determined as the most important predictors of mortality, in our cohort. Early recognition during the course of the infection, of a declining tendency of lymphocyte and eosinophil counts is paramount, in identifying high-risk patients for severe disease and poor outcomes among haemodialysis patients.
MO887: Humoral Response to the Pfizer BNT162b2 Vaccine Booster Dose in Patients Undergoing Maintenance Hemodialysis
Authors: Cohen Hagai Keren , Shashar Moshe , Nacasch Naomi , Shitrit Pnina , Grupper Ayelet , Erez Daniel , Sela Yaron , Benchetrit Sydney 
Published: May 2022

Abstract

BACKGROUND AND AIMS
COVID-19 is associated with increased morbidity and mortality in maintenance hemodialysis (MHD) patients. Recent breakthrough infection in vaccinated people has led some authorities to recommend a booster dose to patient fully vaccinated 5–8 months ago. The recent emergence of the Omicron (B.1.1.529) variant has heightened this issue.
We aimed to assess, the humoral response following a booster dose with the BNT162b2 vaccine in MHD patients.

METHOD
The study included 102 MHD patients vaccinated with 2 doses of the BNT162b2 (Pfizer-BioNTech) vaccine. A third dose (booster) was recommended to all MHD Patients in our center and was given to all patients that opt to receive it, resulting in a booster group and a control group that did not receive the booster. Previous exposure was excluded by testing for the presence of the Anti-Nucleocapsid Antibody (SARS-CoV-2) or positive PCR. We assessed the humoral response before and after the booster dose.

RESULTS
98.5% (65/66) subjects in the booster group developed a positive antibody response (472.7 ± 749.5 to 16 336.8 ± 15 397.3 AU/mL) as compared with a sustained decrease in the control group (n = 22, 695.7 ± 642.7 to 383.6 ± 298.6 AU/mL), P &lt; 0.0001 (Figure 1). No significant adverse effects were reported. Prior antibody titers were positively correlated to IgG S1 levels following the booster dose. There was a significant association between malnutrition-inflammation markers and the humoral response.

CONCLUSION
The vast majority of MHD patients developed a substantial humoral response following the booster dose administration, it was significantly higher than levels previously reported for MHD patients following administration of 2 doses alone. Further studies and observations are needed in order to determine the exact timing and dosing schedule.
MO907: Predictors of Negative Outcomes in HDF-OL Patients: A Cohort Study
Authors: Zaria Iana , Gurevich Konstantin , Plavinsky Svyatoslav , Stuard Stefano 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Haemodiafiltration on-line (HDF-ol), an effective mode of replacement therapy for stage 5 chronic kidney disease (CKD 5D), cannot be considered sufficiently studied in terms of its effect on the outcomes. Our main aim was to identify a possible association between individual anthropometric, laboratory data and parameters of the prescribed treatment regimen with the best survival rate when using the HDF-ol mode.

METHOD
A retrospective1 year analysis of the EuCliD database of 9986 patients treated with HDF-ol in 27 Fresenius Medical Care centres in Russia was carried out. All patients got post-dilution HDF-ol procedures at least 3 times a week, for at least 12 h a week with Kt/V at least 1.4. Data on alive (9616) and deceased (370) patients were compared by gender, age, treatment experience, body weight (BW), body mass index (BMI), body surface area (BSA), total body water volume (TBW), volume of urea distribution (V Urea BCM), presence of diabetes mellitus (DM), ischemic heart disease (CHD), chronic heart failure (CHF), as well as parameters of the procedure: effective weekly dialysis time, Kt/V, effective infusion volume (EIV) and effective convection volume (ECV).

RESULTS
Differences in groups were found only for a part of parameters (Table 1).

CONCLUSION
Association of risk of death in patients with CKD 5D treated with HDF-ol included male gender, older age, concomitant diseases (CHD, CHF, DM), lower BW and BMI, shorter effective weekly dialysis time, lower values of EIV and ECV, Kt/V, higher values of hypercalcemia, hypoalbuminemia, lower haemoglobin levels, higher levels of b2-microglobulin and CRP. Such indicators as TBW, VUrea BCM, BSA and the length of treatment on dialysis did not reached statistical significance when comparing alivе and deceased patients.
MO911: Prevalence of SARS-COV-2 Cellular and Humoral Immunity in Dialysis Patients After 8 Months of Vaccination Campaign in Portugal
Authors: Duarte Rui , Luz Ivan , Ferrer Francisco , Gonçalves Hernâni , Lopes Karina , Sofia Flora , Vila Lobos Ana 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Immunization of dialysis dependent patients remains the single most important protective approach in prevention of serious COVID-19 infection. This study aims to characterize the prevalence of humoral and cellular immunity in maintenance dialysis patients (MDP) in a Nephrology Centre, 8 months after vaccination onset.

METHOD
A single-center cross-sectional study enrolling patients on peritoneal (PD) and haemodialysis (HD) from a public-funded Portuguese Nephrology Centre. This study evaluated both humoral and cellular immunity to the COVID-19 vaccination. Humoral response was measured as specific IgG (S-RBD IgG), and cellular response as T-cell reactivity through IFN- γ quantification as response to antigen (IGRA). Further demographic and clinical variables were obtained to assess the risk factors of low immunity.

RESULTS
Of the 86 patients enrolled, 79.4% and 84.1% showed humoral and cellular immunity, respectively. Quantitatively, IgG S-RBD titers correlated with specific T-cell reactivity (ρ = 0.58, P &lt; 0.001). Vaccination before dialysis initiation was associated with an absent cellular response (P = .006). Subgroup analysis associated high comorbidity burden (quantified through the Charlson comorbidity index) and low serum albumin levels as predictors of immunity (P &lt; 0.05, variable). PD patients showed lower cellular response (297.1 mUI/mL versus 695.4 mUI/mL, P = 0.03) at 8 months following BNT162b2.

CONCLUSION
The prevalence of humoral and cellular immunity against SARS-CoV-2 in vaccinated Portuguese MDP is high. Vaccination in imminent pre-dialysis patients, high comorbidity burden and low serum albumin are some of the identified risk factors for absent immunity. PD-associated effector memory T-cell changes are suggested as contributing to the difference verified in cellular response.
MO912: Different Immunogenicity of Previous SARS-COV-2 Infection or Comirnaty Vaccine (BNT162B2, BioNTech/Pfizer) in Haemodialysis Patients
Authors: Gembillo Guido , Edoardo Giuffrida Alfio , Labbozzetta Vincenzo , Siligato Rossella , Spallino Eugenia , Sposito Giovanna , Ferlazzo Guido , Cuzzola Felicia , Lipari Antonella , Calabrese Vincenzo , Santoro Domenico 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The pandemic emergency deriving from the SARS-CoV-2 infection has made it necessary to find effective strategies to preserve high-risk populations with severe comorbidities like haemodialysis patients. Adequate vaccination coverage is of vital importance, representing the main weapon to counter the spread of the virus.
The purpose of our study was to evaluate the antibody response of our dialysis patients vaccinated with the Comirnaty-BioNTech/Pfizer vaccine in comparison with those with previous infection.

METHOD
We retrospectively analysed 52 patients referried to the Dialysis Unit of University Hospital G. Martino, Messina, from 2020 to 2021. Of these, 41 patients had never contracted SARS-CoV-2 (group A), while 11 patients had contracted the infection (group B). Serum samples were taken before vaccine administration, 3 months and 6 months after administration. A linear mixed model was performed on the measurements to analyse the difference in antibody response, comparing the values ​​of neutralizing IgG and anti-COVID-19 antibodies during time (Fig. 1).

RESULTS
The results showed a statistically significant higher titre of anti-spike antibodies in patients with a previous infection (P = 0.003), with a stronger association at 6 months after infection. The linear mixed model showed a significant association over time between infection and antispike (ln U/L) in the univariate model, which was confirmed in the multivariate model {adjSlope: 2.9, [95% confidence interval (95% CI) 1.3–4.6]; P =.001}. No other variables were related to antispike.

CONCLUSION
These findings can raise novel questions on the role of natural immunity and antibody titre in the haemodialysis population.