bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO837: Antibody Response to Mrna Covid-19 Vaccination in Haemodialysis Patients—A 7-Month Follow-Up
Authors: Chiras Theodoros , Velentza Aikaterinh , Kalamaris Athanasios , Skarakis Jacob , Biblaki Dimitra , Dagkounaki Paraskevi , Barbatsi Aggeliki , Martsoukou Maria , Sonikian Makrouhi 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Haemodialysis (HD) patients have a great risk of severe infection from coronovirus 2(SARS-CoV-2). However, chronic kidney disease is often associated with immunodeficiency and other existing vaccines have reduced efficacy in HD patients [1]. Humoral immune response to SARS-CoV-2 vaccination in chronic HD patients was investigated during a period of 7 months.

METHOD
A total of 39 patients, M/F = 34/5, aged 71 (47–90) years, dialyzed for 55(18–286) months, vaccinated with mRNA Comirnaty vaccine (BNT 162b2; BioNTech & Pfizer) were studied. Patients received two initial vaccine doses in March and April 2021, respectively, and 24 out of 39 patients received a third dose in October 2021. We analyzed the antibody response to the spike (S) antigen of SARS-CoV-2 at 0, 1, 4 and 7 months (November) after second vaccine dose in all patients. We also compared serum antibody titers at time-point 7 between the 24/39 patients and 20 healthy age-matched individuals, also vaccinated with three doses at the same months.

RESULTS
At time-point 0, titers of S protein-targeting antibodies(S-Abs) were 5 ± 1 AU/mL. At 1 month S-Abs were &lt; 50 AU/mL in 2 patients (5.15%), between 51 and 100 AU/mL in 2/39 patients (5.15%), between 101 and 1000(528 ± 292) AU/mL in 19/39 patients (48.7%) and between 1001 and 10 000 (4486 ± 2547) AU/mL in 13/39 patients(33.3%). S-Abs were higher than 10 000(14 516 ± 3062) AU/mL in 3/39 patients (7.7%) after previous infection. In the 36/39 patients not infected, at 4 months there was a significant titer decrease compared with values at 1 month: from 3108 ± 4361 to 1442 ± 4357 AU/mL; P &lt; 0.001. At 7 months, the 24/39 patients vaccinated with the third dose showed increased titers in comparison with values at 1 and 4 months, respectively (9285 ± 11 202 versus 1957 ± 2763 AU/mL; P &lt; 0.001 and versus 584 ± 669 AU/mL; P &lt; 0.001, respectively). Among 15/39 patients who did not receive the third dose, 4/15 with an average titer of 739 AU/mL died from other causes, 3/15 with an average titer of 25 468 AU/mL were hospitalized for COVID-19 and discharged and 8/15 showed further titer decrease (2117 ± 4887 to 950 ± 1855 AU/mL; P = 0.031). After the third dose higher S-Abs were observed in healthy controls compared with HD patients (18 050 ± 15 374 versus 9285 ± 11 202 AU/mL; P = 0.032).

CONCLUSION
Healthy controls showed a better humoral immune response compared with patients. Two doses of mRNA BNT162b2 vaccine induced an initial satisfactory humoral response in HD patients but S-Abs significantly declined subsequently [2]. Humoral response was significantly better after the third dose and booster immunization seems necessary [3].
MO840: A Survey on the Impact of Pruritus Associated With Chronic Kidney Disease (CKD-AP) In the Quality of Life of Patients Undergoing Haemodialysis in Spain
Authors: Reyes Victor , Caro Johanna , Pais Beatriz , Buades F Juan M , De Sequera Ortiz Patricia , Espín Jaime , Tombás Antonio , Moreno Marta , Carlos Julián Mauro Juan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Chronic kidney disease (CKD) patients can be affected by pruritus. In Spain, CKD associated pruritus (CKD-aP) affects 60% of CKD patients on haemodialysis (HD). CKD-aP severely impacts in physical and mental health of patients, resulting in sleep disturbance, depressed mood, increased risk of infection and a low quality of life [1]. In Spain, there is a lack of data regarding CKD-aP patient's quality of life (QoL). The aim of the study is to determine how CKD-aP affects the HD patients’ QoL in Spain.

METHOD
The study was structured in two phases: The first phase involved the design and the validation (by a multidisciplinary panel of 9 experts) of a survey to assess CDK-aP patient's QoL. The second phase consisted in sending the survey to CKD patients and subsequent results analysis.

RESULTS
The survey was structured in 10 domains with 25 questions that collected relevant aspects of the CKD-aP patients’ QoL.
A total of 189 HD patients answered the survey, 97 (51%) of whom had CKD-aP. The main results are showed in Table 1.
CKD-aP HD patients reported a health status significantly lower than HD patients without pruritus (mean = 46 versus 53 out of 100, respectively, P-value = 0.02). Moreover, the health status worsened when increasing severity of pruritus (mild = 51/100; moderate = 48/100; severe = 32/100). Out of 10, 6 CKD-aP patients suffer from it always or sometimes a day. A total of 30% of patients reported pruritus throughout the day, while 29% suffer from it at night. 39% of CKD-aP patients, of which 39% have severe pruritus and 62% moderate, reported having difficulty falling asleep sometimes a week or more. A total of 44% of patients experienced irritability once a week or more, 32% frustration, 21% distress, 11% depression and 7% embarrassment. In addition, pruritus limits patients’ daily and social activities (12% patients were limited once a week or more), preventing them from doing sports, housework, going to restaurants and/or engaging in cultural activities. It also alters patients’ cognitive function, leading to a lack of concentration and/or confusion (22% patients had an altered cognitive function once a week or more). 10% of patients had infections or fistula damage due to scratching. 62% of CKD-aP patients were not treated for pruritus, and of those treated, 47% were dissatisfied with their treatment.

CONCLUSION
This study shows that CKD-aP is a distressing condition with a huge impact in CKD HD patients’ QoL in Spain. However, there is an unmet need in terms of treatment, meaning that new treatments for CKD-aP are necessary to improve patients’ QoL.
MO841: Anxiety and Depression in Maintenance Hemodialysis Patients: Prevalence and Their Effects on Health-Related Quality of Life
Authors: Nagy Eman , Tharwat Samar , Mohammed Elsayed Abdelrahman , Shabaka Shimaa , Kamal Nassar Mohammed 
Published: May 2022

Abstract

BACKGROUND AND AIMS
End-stage renal disease and hemodialysis (HD) can afflict psychological status of patients causing various mood disorders including anxiety and depression. These mood disorders can negatively affect quality of life (QOL) of those patients. The aims of the study are to assess prevalence of anxiety and depression, to explore their associated factors, and to discover impact of these disorders on QOL in maintenance hemodialysis (MHD) patients.

METHOD
This cross-sectional multi-centric study involved 298 patients, who were maintained on HD for &gt;3 months, in 3 different HD centers in Delta, Egypt from January 2021 to May 2021. Sociodemographic and clinical data of patients were obtained from their records. Anxiety and depression of the patients were evaluated by the usage of the hospital anxiety and depression scale (HADS). This scale divides patients to normal, borderline cases and abnormal cases. Assessment of QOL of the patients was carried out by using Kidney Disease Quality of Life (KDQOLTM-36), which yields symptom/problem list, effect of kidney disease, burden of kidney disease, physical health composite (PHC) and mental health composite (MHC). Comparison between abnormal cases, borderline cases and normal subgroups of anxiety and depression was performed regards various collected data of the patients in addition to 5 component of QOL.

RESULTS
The present study was conducted on 298 MHD patients (male 176, 59.1%) with median age of 49 years and median duration of HD of 5 years. Anxiety cases and borderline cases were identified in 49.7%, 26.1% of the patients, respectively, while depression cases and borderline cases were recognized in 55% and 28.2% of the patients, respectively. Percentage of females was increased significantly in cases with anxiety (26.4%, 41% and 49%, respectively), which did not occur with depression cases. However, there was no statistically significant differences between 3 groups of depression and anxiety regarding age, educational level, comorbidities and socioeconomic status. Abnormal cases of depression and anxiety had significantly longer duration of HD than other two groups (P = 0.001 and 0.013, respectively). All five components of QOL showed statistically significant differences between 3 groups of anxiety and depression (Table 1).

CONCLUSION
Both anxiety and depression are prevalent among MHD patients. These disorders can afflict different components of QOL of those patients.
MO849: Consistency of the Predicted Target Weights and ECW/TBW Using Bia After Hemodialysis in Patients Between Standing and Lying-Down Positions
Authors: Choi Gwangho , Jin Song Young , Kim Hyunsuk 
Published: May 2022

Abstract

BACKGROUND AND AIMS
As hemodialysis is administered with the patient lying down, the distribution of body fluid is stable in the lying position, which is why this position is recommended for bioimpedance analysis (BIA). Although the InBody S10 is widely used for hemodialysis patients in the lying position, clinicians must make the measurements in person. In contrast, patients can use the InBody 770 to obtain measurements by themselves in the standing position, which may be more convenient. Therefore, this study compared the measurements of hemodialysis patients’ estimated target weight and ECW/TBW obtained lying down using the S10 to those obtained in the standing position using the 770.

METHOD
This study was conducted among maintenance hemodialysis patients at Chuncheon Sacred Heart Hospital in October 2020. Measurements from 56 patients before and after hemodialysis were obtained using the 2 machines. Each (S10 or 770) estimated target weight, both pre- and post-hemodialysis, was considered ideal when the ECW/TBW ratio was 0.380. R2 was calculated and the Bland–Altman test was performed.

RESULTS
The patients’ median age was 64 years old, and 51% were men. The actual ultrafiltration was 2 kg, and the mean TBW change measured using the InBody devices was 1.5 L (R2 = 0.718) for the S10 and 1.7 L (R2 = 0.616) for the 770. The estimated target weight at pre- and post-hemodialysis showed a remarkably high correlation with the patients’ actual pre- and post-hemodialysis weight (R2 &gt;0.095). The correlation between these measurements (lying versus standing) before and after hemodialysis was also very close (R2 = 1.0000). In addition, ECW/TBW had a good correlation (R2 ≥ 0.970) The Bland–Altman test of dry weight and ECW/TBW yielded similar results.

CONCLUSION
This study showed that patients’ estimated target weights in the lying position using the InBody S10 device and in the standing position using the InBody 770 device were consistent in both pre- and post-hemodialysis states.
MO851: Impact of COVID-19 on Dialysis Patients: Reported Experience in Qatar
Authors: Fouda Tarek , Yasin Fadumo , Aly Sahar , Ravinder Singh Poonam , Ezzat Hussain Mohammed Mohammed , Elesnawi Mohamed , Hamad Abdullah , Almalki Hassan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Patient-centred care is a concept focussing on meeting the specific health needs of patients as expressed by them. There is increasing evidence to show that patient centred care can help to achieve higher rates of patient satisfaction, clinical outcomes and overall better experience, particularly for patients with chronic disease. Patients Reported Experience Measures (PREM) is another concept associated with patient-cantered care. PREM surveys capture information about the healthcare experience as perceived by patients. Its importance lies in the incorporation of patient feedback into the clinical decisions and service evolution. Dialysis patients play an important role in their treatment and their voice matters to provide proper care. PREM was first conducted in 2019 in our dialysis unit including 200 patients. In 2020, COVID-19 impacted the dialysis services and resulted in many challenges including staff shortage and deployment.

METHOD
We used a validated questionnaire from the National Health Service in United Kingedm. It consisted of 7 questions covering demographics, dialysis options, patient portal, patient's relationship with the staff, teamwork and travelling abroad. The survey involved 317 randomly selected patients who have been at least 1 year on dialysis. We performed a comparison of the 2019 and 2020 results using Chi-squared test.

RESULTS
257 patients on hemodialysis and 60 on peritoneal dialysis participated in the survey. Majority of the surveyed patients (65%) were on dialysis from 1–5 years and 32% with more than 5 years’ survival on dialysis. Sixty five % of patients responded that they were on follow up in nephrology or low clearance clinic before starting dialysis. Access to dialysis team, nurses and doctors from home declined in 2020 due to the shortage of staff in the dialysis services and deployment of many staff to COVID-19 facilities, 62% of surveyed patients were able to contact their care givers from home compared with 87% in 2019 (P &lt; 0.0001). Regarding education, 78% of the patients responded that they received education before starting dialysis and it was in an understandable manner while patients' response to the same question was 85% in 2019 (P = 0.047). 44% received education on side effects, which is remarkably less compared with 74% in 2019 (P = 0.0001).

CONCLUSION
Patient reported experience helps in the evaluation of health services. Exploring patient experience in dialysis patients in Qatar, we found negative impact of COVID-19 from patients’ perspectives. Our PREM survey showed significant decline in many parameters likely attributed to COVID-19 consequences including the shortage of staff.
MO860: Dialysis Department Patients’ Mortality During Covid-19 Pandemic—A Single Centre Experience
Authors: Karapandžić Marija , Jemcov Tamara , Kusic Milicevic Jovana , Djurkovic Veselinka , Markovic Rodoljub , Indjic Djordje , Momcilovic-Zivkovic Danijela , Jordanova Elena , Zec Gnjidic Nadezda , Komadina Ljiljana , Apostolovic Branislav , Stajcic Mina , Dodić Jelena 
Published: May 2022

Abstract

BACKGROUND AND AIMS
An epidemic of coronavirus (COVID-19) has been reported in Serbia since March 2020. Patients requiring chronic haemodialysis (HD) are considered particularly vulnerable due to altered immune response. However, severe form of COVID-19 infection has also been associated with multiple organ disfunction that, in some patients, may lead to acute kidney injury (AKI) or acutisation of previously known chronic kidney disease (aCKD). This study aimed to evaluate mortality rates in dialysis dependent patients hospitalized due to COVID-19.

METHOD
This retrospective study included 189 patients hospitalized in Clinical Hospital Centre Zemun between March 2020 and March 2021 due to COVID-19. All patients underwent haemodialysis during hospitalization and have been distributed in three groups depending on their renal status: AKI, HD and aCKD. Clinical presentation of the COVID-19 was defined as asymptomatic, mild, moderate, severe or critical. Demographic data and laboratory analyses were derived from the patients’ electronic record. Statistical analysis of the acquired data was performed in SPSS program.

RESULTS
Out of 189 patients, majority (75.1%) were receiving chronic haemodialysis, while 14.8% had AKI and 10.1% aCKD. The oldest patients were in AKI group, with average age of 70 ± 15 years, although difference did not reach statistical significance. Bilateral pneumonia was a predominant radiography finding in all patients, independently of study group (P = 0.168). Clinical presentation was mostly defined as mild in CHD group, whereas critical in AKI and aCKD group. Regarding complications, AKI group of patients had significantly higher sepsis rate (21.4%, P = 0.027) and respiratory insufficiency (78.5%, P = 0.000) than other groups. Mortality rate among overall population was high, precisely occurred in 64 (34.6%) patients. Statistically significant difference was observed between study groups regarding outcomes (P = 0.000). The worst survival rate was observed in AKI, while the lowest in HD group of patients, 82.1% and 21.9%, respectively.

CONCLUSION
Among COVID-19 positive population, patients who develop AKI have higher mortality rate compared with patients with previously acknowledged CKD, irrespectively of pre-hospital initiation of dialysis.
MO866: Evaluating Psychosocial Contributions to Musculoskeletal Disorders in Hemodialysis Patients: A Single Center Experience From Egypt
Authors: Kamal Nassar Mohammed , Abdel-Gawad Sara M , Elrefaey Rabab , A. Elsawi Alaa , Mohammed Elsayed Abdelrahman , Nagy Eman , Shabaka Shimaa , Tharwat Samar 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Patients with end-stage kidney disease (ESKD) on regular hemodialysis (HD) suffer from a high burden of comorbidities. Musculoskeletal disorders (MSDs) are frequently encountered in those patients. The factors linked to MSDs in HD patients are incompletely defined, therefore this study was done to figure out how often musculoskeletal symptoms are in those patients and identify their association with many psychosocial aspects including quality of sleep, social support and fatigue.

METHOD
This cross-sectional study was carried out in the HD unit at Mansoura University Hospital, Egypt in the period from August to December 2021. The sample included 94 ESRD patients on regular HD for more than 3 months. Sociodemographic characteristics, clinical and therapeutic data were collected. The Nordic Musculoskeletal Questionnaire (NMQ-E) was used to determine the prevalence and patterns of MSDs in various parts of the body areas. Moreover, the modified Edmonton Symptom Assessment System, multidimensional Fatigue Inventory (MFI-20), Pittsburgh Sleep Quality Index (PSQI), Perceived Social Support from Family Scales were completed by the patients. MSDs predictors were evaluated by univariate regression analysis.

RESULTS
The mean age of the studied patients was 49.73 years and more than half of them (59.6%) were males. MSDs affected nearly three quarters (72.3%) of patients. The most frequently encountered MSD domains were knee pain (48.9%), low back pain (43.6%), shoulder pain (41.6%), hip/thigh pain (35.1%) and neck pain (35.1%) (Figure 1).
Regarding Pain and symptom burden, patients with MSDs had significantly higher scores of pain (P &lt; 0.001), fatigue (P = 0.01), depression (P = 0.015) and anxiety (P = 0.003). Regarding MFI scale, patients with MSDs experienced reduced activity (P = 0.02). Subjective sleep quality, daytime dysfunction domains and global PSQI score were worse among patients with MSDs (P = 0.02, 0.031 and 0.036, respectively). Patients with MSDs perceived less social support (P = 0.029). Female gender (P = 0.013), higher scores of fatigue (P = 0.012), depression (P = 0.014), anxiety (P = 0.004), reduced activity (P = 0.029) domains and PSQI score (0.027) were the significant predictors of MSDs in the studied HD patients (Table 1).

CONCLUSION
MSDs appears to frequently occur in HD patients. Female gender, fatigue, depression, anxiety, reduced activity and poor sleep quality can predict the occurrence of MSDs in HD patients.
MO873: County-Level Characteristics Associated With Variation in End-Stage Kidney Disease Mortality in the United States, 2010–8
Authors: Snow Kylie , Patzer Rachel , Patel Shivani , Harding Jessica 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Geographic and neighborhood-level factors such as poverty and education have been associated with an increased risk for incident end-stage kidney disease (ESKD), likelihood of receiving pre-ESKD care, and likelihood of receiving a transplant. However, few studies have examined whether these same factors are associated with ESKD mortality. In this study, we examined county-level variation in ESKD mortality and identified county-level characteristics associated with this variation.

METHOD
We identified 1 516 507 individuals (aged 18–84) initiating renal replacement therapy (dialysis or transplant) between 2010 and 2018 using the United States Renal Data System. Among 2807 counties, we estimated county-level all-cause age-standardized mortality rates (ASMR) among patients with ESKD. We then identified county-level demographic (e.g. percentage of female), socioeconomic (e.g. percentage of unemployed), health care (e.g. percentage of without health insurance) and health behavior (e.g. percentage of current smokers) characteristics associated with ASMR using multivariable hierarchical linear mixed models and quantified the percentage of ASMR variation explained by county-level characteristics.

RESULTS
County-level ESKD ASMR ranged from 45 to 1022/1000 person-years (PY) (mean, 119/1000 PY). ASMRs were highest in counties located in the Tennessee Valley and Appalachia regions, and lowest in counties located in New England, Pacific Northwest and southern California (Figure 1). In fully adjusted models, county-level characteristics significantly associated with higher ESKD mortality included a lower percentage of Black residents (−5.67/1000 PY), lower median income (−5.53/1000 PY), lower number of dialysis facilities/population (−2.25/1000 PY) and higher health care expenditures (5.36/1000 PY). Overall, county-level characteristics explained 16.9% of variation in ESKD mortality.

CONCLUSION
Counties with high ESKD-related mortality may benefit from targeted and multi-level interventions that combine knowledge from a growing evidence base on the interplay between individual and community-level factors associated with ESKD mortality.