bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO301: The Incremental Chronic Kidney Disease Risk Among Post-Hospitalized Leptospirosis Patients With Acute Kidney Injury: Systematic Review And Meta-Analysis
Authors: Pratama Putra Boby , Nugraha Putra Felix 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Leptospirosis is a global zoonotic bacterial disease that may cause life-threatening complications, such as acute kidney injury (AKI). Patients with AKI may recover fully, but some can progress to chronic kidney disease (CKD) or even become dialysis-dependent. This study aims to evaluate the CKD and dialysis-dependent incidences and risks among post-hospitalized leptospirosis patients with AKI.

METHOD
Comprehensive searching was performed through the online databases of Pubmed, EMBASE, ScienceDirect and The Cochrane Library to include all relevant literature from 2000 to 2021. This study followed the PRISMA guidelines. The inclusion criteria are all observational studies that assess the incidence and risk for CKD development and dialysis dependence among post-hospitalized leptospirosis-associated AKI patients. The quality of included studies was accessed by using the Newcastle–Ottawa Scale. Analysis was conducted to obtain the pooled odds ratio (OR) with a 95% confidence interval (CI) with a fixed-effect heterogeneity test.

RESULTS
Five observational studies met the inclusion criteria. About 7%–14% of post-hospitalized leptospirosis patients with AKI deteriorate significantly to become CKD risk (pooled OR = 1.78, 95% confidence interval 1.41–2.23; P &lt; .0001, I2 = 0%). A population cohort study suggested that Leptospira-seropositive population is correlated with the eGFR decline, even in the non-diabetic subgroup. Multivariate analysis from a cohort study showed that the elderly patients were predictors of dialysis-dependency and mortality. The funnel plot is symmetrical suggesting no publication bias.

CONCLUSION
Post-hospitalized leptospirosis with AKI patients has an incremental CKD risk. However, further studies are warranted to confirm the association and causality.
MO302: The Correlation Between Serum and Urinary NGAL With Redox Biomarkers in Post-Ultramarathon Amateur Athletes
Authors: César Carneiro Loureiro Adriano , Fontenele Nocrato Gabriella , Luis Lima Correia André , Salviano de Matos Robson , Henrique Macedo Pinto Flavio , Cunha Oliveira Ariclécio , Marilande Ceccatto Vania , Soares Fortunato Rodrigo , Pires de Carvalho Denise , Cesar Chaves Nunes Filho Julio , Alice Peixoto Rodrigues Maria , De Francesco Daher Elizabeth 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Few studies have investigated the physiological alterations provoked by ultramarathon competition, particularly those related to redox balance, kidney function and NGAL regulation. A better understanding of the dynamics of these biomarkers during ultramarathons could be useful in the search of new biomarkers in the context of exercise physiology. Thus, the aim of this study was to evaluate the relationship between oxidative stress and NGAL levels in blood and urine of amateur athletes before and after a 100-km ultramarathon.

METHOD
The sample was composed of seven athletes between the ages of 21 and 60 years, submitted to anthropometric evaluation, ergoespirometric testing, urine and blood sampling, biochemical and hormonal measurements, body weight measurement and subjective perception of effort (SPE)—–the perception was evaluated through a scale from 6 to 19 [1], along with verification of competition duration, besides the heart rate (HR), energy expenditure and oxygen consumption (VO2) during the event. The duration, the energy expenditure and the average HR of the competition were measured by a frequency meter (Polar, m200). The data provided was analyzed by the Polar Flow app platform.

RESULTS
The sample had an average BMI of 25.75 ± 3.20, a body fat percentage of 18.54% ± 4.35% and a VO2max of 48.87 ± 4.78. In the pre-competition period, no significant correlations (P &gt; .05) were found between NGAL levels, in blood and urine and blood and urine biomarkers. In relation to the results obtained after competition, there were no significant correlations among of the NGAL levels and plasma biomarkers, except for the serum creatinine level (P &lt; .05). The average duration of the competition (the average finishing time of the competitors) was 820.60 min (±117.00), during which the mean energy consumption was 2209.72 kcal (+951.97) and energy expenditure was 7837.16 kcal (+195.71), with an average HR of 127.85 (±12.02).

CONCLUSION
The data presented here did not support our initial hypothesis that the ultramarathon would cause oxidative stress and acute kidney injury. In addition, there was no significant correlation between oxidative stress biomarkers and NGAL in serum and urine, which suggests that NGAL is more sensitive to the inflammatory process than ROS levels.
MO309: Serum Sodium Trajectory During AKI and Mortality Risk
Authors: Chávez-Iñiguez Jonathan S , Michell Jorge , Luna-Ramos Andrea , Romero-Muñoz Alexia , Navarro Blackaller Guillermo , Ibarra-Hernandez Margarita , Renoirte Karina , Martínez-Gallardo Gonzalez Alejandro , García-García Guillermo 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Kidneys play a primary role in electrolyte homeostasis. The association between serum sodium level and mortality or the need for kidney replacement therapy during acute kidney injury has not been adequately explored.

METHOD
In this prospective cohort study, we enrolled patients admitted to the Civil Hospital of Guadalajara from August 2017 to March 2020. We divided patients into five groups based on the serum sodium level trajectories up to 10 days following hospitalization: (1) stable normonatremia (serum sodium 135 and 145 mEq/L), (2) fluctuating serum sodium levels (increased/decreased in and out of normonatremia), (3) uncorrected hyponatremia, (4) corrected hyponatremia and (5) uncorrected hypernatremia. We assessed the association of serum sodium trajectories with mortality and the need for kidney replacement therapy (secondary objective).

RESULTS
A total of 288 patients were included. The mean age was 55 ± 18 years, and 175 (60.7%) were male. Acute kidney injury stage 3 was present in 145 (50.4%). Kidney replacement therapy started in 72 (25%) patients, and 45 (15.6%) died. After adjusting for confounders, 10-day hospital mortality was significantly higher in group 5 {HR, 3.12; [95% confidence interval (95% CI) 1.05–9.24]; P = .03}, and kidney replacement therapy initiation was higher in group 3 (HR, 2.44; 95% CI 1.04– 5.70; P = .03) compared with group 1.

CONCLUSION
In our prospective cohort, most patients with acute kidney injury had alterations in serum sodium. Uncorrected hypernatremia was associated with death, and uncorrected hyponatremia was correlated with the need for kidney replacement therapy.
MO387: Dapagliflozin and Kidney Outcomes in CKD Patients with and without Type 2 Diabetes: Real Life Data (Precursor Announcement)
Authors: Griveas Ioannis 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Globally, diabetes mellitus is a leading cause of kidney disease, with a critical % of patients approaching end-stage kidney disease. At the same time, chronic kidney disease (CKD) is a major contributor to illness and is associated with impaired quality of life. Until recently, the only classes of medication that have been shown to slow a decline in kidney function were angiotensin-converting–enzyme (ACE) inhibitors and angiotensin-receptor blockers (ARBs). Sodium-glucose cotransporter 2 (SGLT2) inhibitors leading to a reduction in intraglomerular pressure may also preserve kidney function in persons with kidney diseases due to causes other than type 2 diabetes. We investigated the impact of Dapagliflozin on kidney function in CKD patients with and without type 2 diabetes.

METHOD
We monitored kidney function and proteinuria in 10 CKD patients (6 male) with and without type 2 diabetes that received Dapagliflozin. All the participants were required to be receiving a stable dose of an ACE inhibitor or ARB for the study period. All of our patients were clinically stable and there was no need for hospitalization for any reason.

RESULTS
A total of 9/10 patients were diabetic. One patient had focal segmental glomerulosclerosis (FSGS). The mean age of our patients was 70 years (range: 50–80 years) and were monitored for an average period of 21 months (range: 3–72 months). A total of 5 of them were receiving an ACE inhibitor and the other 5 an ARB. The mean eGFR of our patients at the initiation of the study was 49.62 ± 24.35 mL/min, turned to be 41.42 ± 11.34 mL/min (P = NS) after a year and 54.2 ± 26.97 mL/min after 24 months (P = NS). Mean proteinuria of our patients at the initiation of the study was 1573.33 ± 959 mg/24-h, which turned to be 800.33 ± 575.33 mg/24-h (P = 0.122) after a year and 953.25 ± 1062.93 mg/24-h after 24 months (P = NS). No major kidney event happened in any of our patients.

CONCLUSION
Dapagliflozin preserved and slightly increased kidney function in our study population for the duration of our noticing period. Proteinuria, on the other hand, showed downward trends. Our study is in progress, but for sure long-term clinical studies in evaluating the potential benefit of SGLT2i, especially, in non-diabetic CKD patients are required before reaching a meaningful and solid conclusion.
MO406: Evolution of Kidney Damage Associated With Tobacco Consumption
Authors: Tascón Javier , G. Casanova Alfredo , Vicente-Vicente Laura , Pescador Moisés , Prieto Marta , Isabel Morales Martín Ana 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Tobacco consumption is associated with cancer, cardiovascular and respiratory diseases. Although new research relates tobacco use with the development of kidney damage, classic biomarkers, such as plasma creatinine, are not useful to detect this kidney injury [1]. In this sense, innovative diagnostic methods have been developed, such as early biomarkers capable of detecting subclinical kidney damage in the initial stages of the disease [2, 3]. In fact, studies carried out in our laboratory have shown that smoking patients suffer subclinical kidney damage evidenced by the excretion of these urinary biomarkers [4]. The aim of this work was to study the evolution of kidney damage associated with tobacco consumption using these biomarkers after monitoring smoking patients for 2 years.

METHOD
A longitudinal study was carried out that included 150 smokers and 150 non-smokers, without previous kidney damage and risk factors for kidney disease, from a Salamanca Health Centre (Spain). Urine samples were collected at the time of inclusion and after 2 years, and the biomarkers of subclinical kidney damage N-acetyl-β-D-glucosaminidase (NAG), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule 1 (KIM-1) and total proteins, were quantified using ELISA and colorimetric techniques. The data obtained were analyzed with the statistical software SPSS®.

RESULTS
The results showed a higher excretion of NAG, NGAL, KIM-1 and total proteins in smoker patients with respect to non-smoker ones, measured at baseline, which was maintained after 2 years.

CONCLUSION
Our research suggests that subclinical kidney damage associated with tobacco consumption would remain stable in the 2 years studied and could become chronic and it could constitute the basis for the development of chronic kidney failure.
MO419: Many Faces of Non-Proteinuric CKD—A Cluster-Analysis-Based Observation
Authors: Tanaka Hiroshi 
Published: May 2022

Abstract

BACKGROUND AND AIMS
With a global expansion of the elderly population, physicians encounter a growing number of chronic kidney disease (CKD) patients who have no or only a minimal amount of proteinuria. However, those patients are not clinically uniform; some quickly develop into a progressive loss of kidney function while others stay in their CKD stages for years or even over a few decades. The purpose of this study is to distinguish high-risk non-proteinuric CKD patients whose estimated glomerular filtration rate (eGFR) decline is faster than others.

METHOD
A hospital-wide study with all the laboratory data for a period of 4 years and 2 months was performed. Non-dialysis CKD patients (median eGFR &lt; 60 mL/min/1.73m2) with ≥18 years in whom the eGFR slope was obtained over 731 days or more were retrieved, then the patients with a median of dipstick proteinuria of less than 1+, i.e. (−) or (±), were included for analysis. An eGFR slope/patient was calculated by at least three eGFR measurements over time. Medians were used for each laboratory datum, including dipstick proteinuria and haematuria (both changed to numeric variables, e.g. 1 + into 1.0), blood cell count and serum chemistry. Cluster analyses, hierarchical and k-means, were performed. Statistical analysis was done with R 3.6.0 on Ubuntu. Missing values were imputed by an R package {mice}.

RESULTS
A total of 905 patients [Male: Female = 395:510, age 75.7 ± 10.4 (34–101, median 76 years)] were analysed whose median eGFR was 49.6 ± 9.34 (14.4–59.9, median 52.6) mL/min/1.73m2.
A hierarchical cluster analysis was initially performed so a group count of 5 was suggested to be appropriate. Then performed was a k-means cluster analysis which identified 5 clusters; Cluster 1 was a group of patients with the least progressive CKD, whereas Cluster 5 had the fastest decline in eGFR. Cluster 5 had background features such as higher blood leukocyte count, higher blood urea nitrogen, higher red cell distribution width and less serum albumin, compared with other clusters. Cluster 2 also had modestly higher blood leukocyte count, Cluster 3 had lower haemoglobin, and Cluster 4 had higher serum uric acid; Cluster 3 had a variable speed of decline in eGFR.

CONCLUSION
Non-proteinuric CKD patients are not uniform but are variable in the clinical background as well as in the speed of CKD progression. They are better be treated according to the estimated risks for each patient.
MO459: Characterization of Adrenal Gland Derived Mediators of Vascular Calcification
Authors: Bhargava Shruti , Orth-Alampour Setareh , Gayrard Nathalie , Argiles Ciscart Angel , Jankowski Joachim 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Adrenal glands participate in cardiovascular physiology and pathophysiology via the synthesis and secretion of various well-known compounds like mineralocorticoids, amine peptides and glucocorticoids. In this study, a previously unknown systemic function of adrenal glands, that is the regulation of vascular calcification processes was investigated.

METHOD
The homogenate of the bovine adrenal gland was separated using chromatographic fractionation. The fractions were analysed in aortic smooth muscle cells, aortic rings and vitamin D3 plus nicotine elastocalcinosis rat model for effects on vascular calcification processes. Potential mediators were distinguished by mass spectrometry and comparison with pertinent databases. For ease of therapeutic application, smaller fragments of the identified mediators were analysed to identify the active sites.

RESULTS
We identified a new 19aa peptide, named ‘calcification blocking factor’ (CBF), which shows a promising protective effect against vascular calcification. CBF is released from the parent protein Chromogranin A, which is released from adrenal glands via enzymatic cleavage by calpain 1 and kallikrein. CBF reduced the calcium content of cells and aortic rings in calcifying cultures. CBF downregulates vascular smooth muscle cell (VSMC) trans-differentiation into osteoblast-like cells within the vascular wall via the sodium-dependent phosphate transporter PIT-1 and by inhibiting the NF-κB activation and the subsequent BMP2/p-SMAD pathway. VDN animals treated with CBF show a significantly decreased pulse pressure as a marker of arterial stiffness. An 8aa peptide was found to have a better effect on reducing vascular calcification when compared to the original peptide.

CONCLUSION
The adrenal glands participate in cardiovascular (CV) physiology and the pathophysiology of CV diseases through their effects on sodium and water metabolism, vascular tone and cardiac function. In the present study, we identified a previously uncharacterized peptide secreted from the adrenal gland that modulates cardiovascular calcification by regulating osteoblastic differentiation in the context of vascular calcification. We show that CBF reduces calcification via PIT-1/NF-κB/BMP2/p-SMAD pathway. Further, we identified the active site of this peptide (8aa long) which can be used as a therapeutic agent. These findings suggest a novel function of adrenal glands in cardiovascular calcification.
MO470: Outcomes of Patients in Advanced Chronic Kidney Disease (ACKD) Consultation With Covid-19 Infection
Authors: Carlos Herrero Berron Juan , Suso Andrea , Mon Carmen , Ortiz Milagros , Sanchez Maria , Camacho Rosa , Lentisco Carolina , Oñate Irene , Oliet Aniana 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The coronavirus disease 2019 (COVID-19) has affected our patients not only in renal replacement therapy (RRT), but also in advanced chronic kidney disease (ACKD) consultation. Our aim is to assess the impact of COVID-19 in a group of patients of our ACKD consultation.

METHOD
Retrospective observational study in our centre of patients from ACKD consultation with hospitalization due to COVID-19 infection in the period from March to December 2020. We have studied demographic parameters, characteristics during hospitalization, analytics values (3 months before and 1, 3, 6 and 12 months after infection) and final status at the end of follow-up on 31 December 2021. A value comparison is made with the Wilcoxon test for paired data.

RESULTS
In an ACKD consultation with 90 patients, 12 (13%) required hospitalization due to COVID-19. 75% were male, with a mean age of 77.6 years (SD 7) (range 59–89 years) and 25% due to Diabetic Kidney Disease. Mean time in consultation 28 months (SD 14) (range 12–58). Mean Comorbidity Charlson Index 8.2 (SD 1.2) (range 7–11), all hypertensive, 42% treatment with insulin, 25% ischemic heart disease and 42% chronic obstructive pulmonary disease. In COVID-19 hospitalizations, 83% they had pneumonia, 50% steroid treatment, 75% hydroxychloroquine, 92% several antibiotics, 33% low molecular weight heparin, only two required tocilizumab, and none required admission to the intensive care unit. During hospitalization, 3 (25%) patients died, and one died during follow-up, all were males. The consequences after infection: 42% pneumology (cough, varying degrees of shortness of breath), 8% neurological (headaches, varying degrees of memory loss) and 8% loss of smell (from 1 to 6 moths). At the follow-up, only one patient needs RRT with haemodialysis (at 19 months after COVID-19).
Table 1 shows analytics comparison before and after COVID. From 6 months after COVID, the results are like 3 months after the disease.

CONCLUSION
With the important limitation of few patients and without a control group, ACKD patients with hospitalization to COVID-19 show similar patterns to those with RRT: more frequent in males, advanced age, lung comorbidity and diabetics, elevation of inflammatory parameters, anemia and increase in creatinine during hospitalization. Recovery to values prior to admission occurs from the first month after infection.
MO475: Dapa-CKD Patient Profile: Transposability Assessment in Real-Life Through the CKD-Rein French Cohort
Authors: Alencar de Pinho Natalia , Lambert Oriane , Thomas-Delecourt Florence , Bineau Sebastien , Jacquelinet Christian , Massy Ziad , Stengel Benedicte , Fouque Denis 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The objective of this observational study was to describe the `DAPA-CKD-like’ population and to assess the burden of illness (comorbidities, cardiovascular (CV) and renal events) and prognosis in patients with CKD in France, compared with those randomized in the DAPA-CKD RCT [1].

METHOD
The CKD-REIN cohort study enrolled 3033 patients with moderate or advanced CKD from 40 nationally representative nephrology clinics in France [median age of 68 (IQR: 60–76), min-max: 19–94, 65% men, CKD stage 3 (60%) or 4 (40%)]. Inclusions started in July 2013 and ended in July 2016. The analysis describes baseline characteristics of patients with DAPA-CKD inclusion criteria (75 ≥ eGFR ≥ 25 mL/min/1.73 m2 and 5000 ≥ UACR ≥ 200 mg/g) and CV and renal outcomes &gt;3-year follow-up.

RESULTS
Among the 3033 adult patients included in CKD-REIN cohort, 503 met the inclusion and exclusion criteria of the DAPA-CKD RCT. The characteristics of these 503 French `DAPA-CKD-like’ patients and those of the DAPA-CKD RCT were similar in terms of age (63.9 ± 13.6 versus 61.8 ± 12.1), gender (74% men versus 67%), eGFR (36.5 ± 9.1 mL/min/1.73 m2 versus 43.1 ± 12.4 mL/min/1.73 m2) and SBP (145 ± 21 mmHg versus 137 ± 17 mmHg). The CV and renal event rates/100 patient-year (PY) were similar between the two populations, both for the main composite outcome (eGFR decline ≥50% or end-stage kidney disease (defined as eGFR &lt;15 mL/min/1.73 m2 long-term dialysis or kidney transplantation) or CV or renal deaths), 7.9/100 PY versus 7.5/100 PY, but also for each outcome of the main endpoint and secondary endpoints.

CONCLUSION
In conclusion, the DAPA-CKD RCT patient profile appears to be similar to a real-life French CKD patient profile based on the French CKD-REIN cohort meeting the inclusion and exclusion criteria of the DAPA-CKD RCT.
MO526: Renal Function in Patients With Non-Dialysis Kidney Disease Treated With Ferric Carboxymaltose
Authors: Roldão Marisa , Duarte Rui , Escoli Rachele , Gonçalves Hernâni , Vila Lobos Ana 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Iron deficiency anemia occurs in most patients with non-dialysis chronic kidney disease (ND-CKD). Several studies have suggested the efficacy and safety of ferric carboxymaltose (FCM) in this group of patients, but none have shown a positive impact on renal function. The aim our study was to investigate the impact of FCM on renal function in ND-CKD patients.

METHOD
Prospective observational study of ND-CKD stages 3 to 5 patients, with anemia and iron deficiency [ferritin level &lt;100 µg/L or &lt;200 µg/L with transferrin saturation (TSAT) &lt;20%], treated with FCM from 01 January 2019 to 31 June 2021. FCM was administrated as a single IV infusion. Patients were categorized into two cohorts according to the dose of FCM received: 500 mg or 1000 mg. Clinical and analytical data were compared among groups at baseline and 24 weeks after infusion. Renal function was assessed using estimated glomerular filtration rate (eGFR), calculated using the CKD-EPI formula. Statistical analysis was executed using SPSS (Version 23 for Mac OSX).

RESULTS
The mean age of 140 patients was 77.31 ± 9.68 years, 62 (44.3%) were male, 86 (61.4%) were diabetic, 84 (60%) had congestive heart failure and 121 (86.4%) had hypertension. Thirty-five (25%) patients had CKD stage 3, 74 (52.9%) had stage 4 and 31 (22.1%) had stage 5. Seventy-eight (55.7%) patients were treated with 1000 mg of FCM. There were no gender, comorbidity, CKD etiology or stage differences among groups. Patients treated with 1000 mg were younger (74.36 ± 13.59 versus 78.44 ± 9.28 years, P = .046).
At baseline, mean Hb was 10.4 ± 1.35, 10.27 ± 1.47 and 10.54 ± 1.2 g/dL and mean eGFR was 26.18 ± 17.167, 23.55 ± 4.17 and 28.71 ± 19.43 mL/min/1.73 m2 for the whole group, 1000 mg and 500 mg cohorts. At 24 weeks, Hb showed an increase of 1.24 ± 1.78 (P = .001), 1.54 ± 1.99 (P = .001) and 0.86 ± 1.4 g/dL (P = .001), and eGFR an increase of 1.13 ± 6.49 (P = .041) and 1.55 ± 6.87 mL/min/1.73 m2 (P = .049) for the whole group and 1000 mg cohort, but not 500 mg cohort.
A Pearson correlation was performed and revealed a positive correlation between the variation of Hb and eGFR during the study follow-up period (r = .283, P = .001 and r = .310, P = .008) in the same groups.

CONCLUSION
In addition to the effectiveness in correcting iron deficiency anemia in patients with ND-CKD, our results suggest a positive impact on renal function of higher doses of FCM after 6 months of administration.