bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO680: Association of Systemic Inflammation with Changing Peritoneal Membrane Characteristics
Authors: Korucu Berfu , Haci Yeter Hasan , Faruk Akcay Omer , Güz Galip 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Increasing transport status with ultrafiltration (UF) and solute-removal inadequacy is among the most challenging issues in peritoneal dialysis (PD) continuity. Decreased transport status is less frequent but also results in solute clearance. Although the current incidence of peritonitis has reduced considerably, defined membrane disruptions are still frequently observed. Our study examines the relationship between different types of membrane disruptions and the course of systemic inflammation in incident PD patients.

METHOD
This is a retrospective, single-site, cohort study of incident adult PD patients (n = 202) sampled between January 2000 and January 2020. An increase or decrease in transport status is defined as two or more categories of a rise or decline in peritoneal equilibration test (PET) from their baseline during follow-up. The 4-h dialysate/plasma creatinine ratio was used to classify PET categories. C-reactive protein (CRP) values were obtained from the annual tests in the routine controls of the patients.

RESULTS
Baseline demographics, diabetes frequency, residual renal function, baseline laboratory, frequency of renin–angiotensin–aldosterone system blockers, high glucose–containing dialysate and icodextrin use were similar among the groups. Total episodes of peritonitis and peritonitis rates within the first 5 years of follow-up was higher in patients with stable transport status with a median rate of 0 (min:0 to max:5) than patients with increased transport status [median rate of 0 (min:0 to max:3)] and decreased transport status [median rate of 0 (min:0 to max:1)] (P = 0.009). The main time-dependent effect of CRP was statistically significant [Wilks’ λ = 0.76, F (5, 127) = 7.75, P &lt; 0.001]. The joint effect of the mean CRP value depending on time and group was also significant [Wilks’ λ = 0.91, F (10, 254) = 1.10, P = 0.36]. The effect of CRP and time was significantly different between the groups [F (2, 131) = 3.49, P = 0.03; partial η2 = 0.05]. While there was a significant difference between stable and increased transporters in the post-hoc analysis, no similar significance was found between stable and decreased transporters (P = 0.03 and P = 0.99, respectively).

CONCLUSION
Our study shows that the peritoneal membrane kinetics may change into different characteristics in many patients over time, despite the very low frequency of peritonitis episodes and similar baseline characteristics, and may be significantly affected by systemic inflammation. Systemic inflammation, in particular, appears to be related to increased transport status, which is most often responsible for the deterioration of UF and solute clearance over time.
MO719: Contrast Nephropathy in Peritoneal Dialysis Patients: A Single-Center Experience
Authors: Cardoso Fernandes Sara , Carina Ferreira Ana , Fernandes Vasco , Nolasco Fernando 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Peritoneal dialysis (PD) patients are frequently exposed to contrast media through contrast-enhanced computed tomography (CT) and/or coronary angiography, which may be used as diagnostic tools or as part of pretransplant evaluation. However, the risk of contrast nephropathy frequently limits the use of these imaging techniques. The authors aim to evaluate the loss of kidney function after contrasted examination in PD patients.

METHOD
We performed an observational retrospective study in a population of patients with end-stage kidney disease on PD. All patients included had performed an ionized radiation-imaging exam (CT or coronary angiography), with or without contrast media. In patients who performed more than one of the aforementioned exams, only the first one was considered. Demographic and laboratory data including kidney function and dialysis dose before and after the imaging exams were collected. We divided the population into two groups (no contrast use versus contrast use) and compared them using Mann–Whitney test or Chi square. A survival analysis was performed (time to exam; outcome—loss of renal function; predictor—contrast use).

RESULTS
A population of 41 patients in PD, 26 in automated PD (63.4%), with a dialysis vintage of 29 (17–38) months were included in this analysis. The median time since starting PD and the exam was 15 (5–20) months, and contrast was used in 21 exams (51.2%). Five patients underwent coronary angiography and 16 were submitted to contrast-enhanced CT. Only two patients performed contrast nephropathy prophylaxis before contrast exposure.
In univariate analysis, we found no difference between renal residual function, KT/v and creatinine clearance before and after the imaging exam, irrespective of contrast use. After the diagnostic exam, 19 patients lost residual renal function [median GFR 1 (1–2) mL/min/1.73 m2], and the group of patients who did not use contrast were the most affected ones; however, there was no statistical significance difference between the two groups (P = 0.08). Since we found a significant difference in the time to imaging exam between the two studied groups, we performed a survival analysis, and the use of contrast was associated with preservation of renal function (P = 0.02). A multivariate Cox analysis with age, Charlson index, GFRe pre-exam, diabetes, use of RAASi, beta-blocker, loop diuretic and spironolactone as potential confounders showed that use of contrast was not associated with loss of renal function in PD patients.

CONCLUSION
Our study showed that contrast nephropathy is not frequent in PD patients and that we can allow contrast media (low or iso-osmolal) as it was not associated with loss of residual renal function.
MO728: Association of Interleukin-6 with Subendocardial Viability Ratio in Haemodialysis Patients
Authors: Ekart Robert , Piko Nejc , Vodošek Hojs Nina , Stropnik Galuf Tina , Hren Martin , Zorman Tadej , Hojs Radovan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Inflammation is an important process in the pathogenesis of atherosclerosis, and chronic kidney disease (CKD) is recognized as a proinflammatory state. Interleukin-6 (IL-6) is associated with cardiovascular events and also predicts mortality in individuals with CKD patients.
The subendocardial viability ratio (SEVR) is one of the pulse wave analysis parameters and represents a non-invasive measure of coronary perfusion. In a non-dialysis CKD population, we previously reported about the prognostic value of SEVR for cardiovascular outcome in these patients.
The aim of this study was to investigate the association between inflammatory markers IL-6, tumour necrosis factor-α (TNF-α), high-sensitive C-reactive protein (hsCRP) and SEVR in CKD patients undergoing maintenance hemodialysis (HD).

METHOD
In a cross-sectional study, we enrolled only HD patients. SEVR was assessed using a generalized transfer function applied to the radial artery pressure wave form (Sphygmocor, Atcor Medical, Sydney, Australia). Plasma IL-6, TNF-α and hsCRP were measured by an enzyme-linked immunosorbent assay.

RESULTS
A total of 40 HD patients (mean age 65.2 ± 11.8 years, 72.5% male) were included. Other descriptive parameters are presented in Table 1. A statistically significant correlation was found between SEVR and IL-6 (r = 0.379; P = 0.016), but not between SEVR and TNF-α (P = 0.195), nor between SEVR and hsCRP (P = 0.686).
In a multivariate adjusted model with SEVR as dependent variable and IL-6, TNF-α and hsCRP as independent variables we found a statistically significant association only between SEVR and IL-6 (β = 0.393; P = 0.017).

CONCLUSION
This study suggests an association between IL-6 and SEVR in HD patients.
MO748: The Effect of Warfarin-TG2-MVS Axis in Vascular Calcification
Authors: Liu Yuqiu , Liang Zhang Xiao 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Warfarin is a common anticoagulant drug. How to effectively reduce vascular calcification induced by warfarin while ensuring its anticoagulant effect is an urgent problem to be solved. Previous studies have found that warfarin enhances the expression and activity of transglutaminase 2 (TG2) in vascular smooth muscle cells (VSMCs), which mediates communication between cells and extracellular matrix (ECM). Matrix vesicles (MVs) are the center of hydroxyapatite crystal precipitation, which is released to ECM and interacts with ECM protein to initiate mineralization and form calcification core. This study observed the role of the warfarin-TG2-MVs axis in vascular calcification by culturing VSMCs in vitro.

METHOD
VSMCs were cultured in normal or osteogenic medium (OM) and stimulated with 10 μm warfarin for 3–14 days. The expressions of SM22α, Runx2, ALP, OPN and OPG were detected by RT-PCR and western blot. Alizarin red and von Kossa staining were performed to evaluate calcification, and calcium content was determined. Meanwhile, the expression and activity of TG2 were detected. Differential centrifugation was used to extract MVs and evaluate their release. Type I collagen was coated in the culture dish to determine the calcification of MV-collagen.

RESULTS
Warfarin stimulation promoted transdifferentiation of VSMCs, and the expression of osteogenic factors Runx2, ALPL and OPN were increased, while the expression of SM22α and calcification inhibitor OPG were decreased. When using OM, the above trend was more obvious. Alizarin red and von Kossa staining were performed when the cells were cultured for 14 days. The results of calcium staining in the warfarin intervention group were all positive. Warfarin promoted the expression and activity of TG2, and it gradually increased with the extension of the intervention time. The same number of cells were cultured for 7 days under different stimuli, and the medium was changed every other day. Then, the supernatant was collected for differential centrifugation. The amount of MVs produced by the warfarin and OM groups was significantly higher than that of other groups, and the ability to mineralize of MVs in type I collagen was increased.

CONCLUSION
Warfarin increased the expression and activity of TG2, promoted the release of MVs from VSMCs, and further cross-linked ECM to aggravate vascular calcification.
MO770: Are There Any Differences in Survival According to the Type of Tunnelled Central Venous Catheters?
Authors: Maria Cases Corona Clara , Gruss Enrique , Cordon Alfredo , Furaz-Czerpak Karina , Patiño Gómez Beatriz , del Mar Andrés Vázquez Maria , Díaz Enamorado Yunayka , Dominguez Torres Patricia , Gallego Valcarce Eduardo , Shabaka Amir , Maria Fernandez Juarez Gema 
Published: May 2022

Abstract

BACKGROUND AND AIMS
An elevated proportion of haemodialysis patients require at some point the utilization of a tunnelled central venous catheter (tCVC) as vascular access. There are several designs for tCVC that differ in the type of material used, the number of lumens, length and tip design. Currently, a scarcity of studies has compared the different types of tCVC. The aim of this study was to analyse whether there were differences in catheter survival between three types of tCVC: symmetrical-tip, step-tip and split-tip catheters.

METHOD
We conducted a prospective observational study that included all incident patients in two haemodialysis centres between 2016 and 2020, with a minimum follow-up of 6 months (until June 2021). The election of tCVC type was performed by the interventional radiologist in a random manner according to available tCVC. We collected demographic data (age, sex, dialysis site), comorbidities (diabetes mellitus, Charlson Index), laboratory values (albumin, haemoglobin, C-reactive protein), dialysis adequacy (KtV, dose of urokinase used for maintaining tCVC patency) and a number of tCVC used.

RESULTS
Table 1 shows the characteristics of the 182 tCVC included in this study, stratified in three groups according to the type of tip, without observing significant differences. We did not find significant differences in catheter survival between the three types of tCVC, neither globally nor after adjusting for other confounding variables. However, catheter survival decreased after the second tCVC independent of the type of tCVC (cumulative incidence: tCVC 1 versus &gt;1: 180 days 7% versus 32%; 360 days 10% versus 34%; 720 days 11% versus 34%, P = 0.001) Catheter survival also decreased in patients &gt;70 years old (cumulative incidence &lt;70 versus &gt;70 years: 360 days 7.6% versus 20%; 720 days 10.8% versus 21.1%, P = 0.035)

CONCLUSION
There are no differences in catheter survival between the three types of tCVC.
The patency of vascular access decreases with age and the number of previously used catheters, being both independent risk factors for catheter dysfunction.
MO807: Tenascin-C is a Promising Marker of High-Turnover Bone Disease and Vascular Calcification in Prevalent Haemodialysis Patients
Authors: El Shinnawy Howayda , Shawky Sahar , Fouad Mohammed , Zaki Abdelmegied Shaimaa 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Tenascin-C is an extracellular matrix glycoprotein associated with high cell turnover, vascular calcification and atherosclerosis. This study determines the frequency of tenascin-C in uncontrolled intact parathyroid hormone (iPTH) and its relation to vascular calcification in prevalent haemodialysis patients.

METHOD
A cross-sectional study included 90 prevalent haemodialysis patients divided into two equal groups: uncontrolled iPTH level &gt;300 pg/mL and controlled iPTH (150–300 pg/mL) groups. Serum tenascin-C was measured by ELISA and vascular calcification was assessed by the Adragao score, by plain X-ray on hands, pelvis and vascular access for all patients.

RESULTS
The prevalence of tenascin-C was 84.4% (38 patients), and vascular calcification was 46.7% (21 patients) in patients with uncontrolled iPTH. Serum tenascin-C can predict high-turnover bone disease (uncontrolled iPTH) at a cutoff value of 7377 ng/mL with AUC 0.794, sensitivity 84.4% and specificity 60%, while predict vascular calcification at a cutoff value of &gt;8859 ng/mL AUC 0.745, sensitivity 72.7%, specificity 72.1%. Tenascin-C was high in patients with uncontrolled iPTH [median (IQR) 637 (4245) ng/mL] compared with patients with controlled iPTH [median (IQR) 211 (143) ng/mL; P-value &lt; .0001]. According to Adragao calcification score, in uncontrolled iPTH, 31.1% (14 patients) had a score 1 and 15.6% (7 patients) had a score 2. All patients with controlled iPTH had a score 0. Patients with vascular calcification had high tenascin-C [median (IQR) 10 697 (53 974) ng/mL] compared with patients without vascular calcification [median (IQR) 7697 (18 000) ng/mL; P-value &lt; .001]. Patients have elevated tenascin-C had 10.3, 3.7 risk to have high-turnover bone disease and vascular calcification [odds ratio (95% confidence interval) 10.3 (3–34.7), 3.7 (1.2–11.1), respectively]. Tenascin-C was positively correlated with iPTH level (r = 0.494; P &lt; .001) in patients with uncontrolled iPTH.

CONCLUSION
Tenascin-C appears to be a sensitive marker for assessment of high-turnover bone disease and vascular calcification in prevalent haemodialysis patients.
MO819: The Negative Impact of Reuse of Dialyzers on Survival Rates of Dialysis Patients
Authors: Sharapov Olimkhon 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Until 2019, in Uzbekistan, disposable dialyzers for dialysis were reused several times due to underfunding of the system. But in 2018, the President of the Republic of Uzbekistan Shavkat Mirziyoyev signed a decree on improving the nephrological and dialysis services in the country. After that, there is a sharp increase in funding and attention to the provision of hemodialysis care to the population of our country. Thanks to this Resolution, since 2019, in all regions of Uzbekistan, only disposable dialyzers are used for hemodialysis.
To prospectively study the negative impact of the reusable use of disposable dialyzers on dialysis patients in Uzbekistan.

METHOD
The study took place in three dialysis centers in the country at different levels. Our observation of 165 (90 men and 75 women) patients took place for 2 years: from the beginning of 2018 to the end of 2019. The average age of the patients was 49.7 ± 14.1 years. During the first 12 months (before the release of the decree of the President of the Republic and funding), dialysis patients underwent multiple uses of dialyzers. The next 12 months were completely switched to single use. The average age of the patients was 48.1 ± 14.3 years. The average duration of hemodialysis was 37 (6–252) months. Survival was assessed using the Kaplan–Meier method. The confidence interval was determined by Greenwood.

RESULTS
During the 24 months of observation, out of 165 patients, 29.1% (n = 48) patients died, 70.9% (n = 117) survived (of which 11 patients underwent Tx). During 1 year of follow-up (the period of repeated use of disposable dialyzers), 21.2% (n = 35) patients died, 78.8% (n = 130) survived and continued to receive hemodialysis (6 patients Tx). A total of 68.6% (n = 24) of patients died from cardiovascular complications. The survival rate for 1 year (miltiple use period) was S(t) = 0.796 [95% confidence interval (95% CI) 0.736–0.856]. Over the next 12 months (single use period), out of 124 patients continuing to receive hemodialysis, 10.5% (n = 13) patients died, 89.5% (n = 111) patients survived (5 patients Tx). A total of 53.8% (n = 7) of these deceased patients died from CVD. The survival rate at the second year (single use period) was S(t) = 0.894 [95% CI 0.839–0.948].

CONCLUSION
Compliance with the standards for hemodialysis, in particular, the single use of disposable dialyzers for hemodialysis sessions, leads to a decrease in the lethality of dialysis patients. The transition from multiple to single use of disposable dialyzers in one dialysis center in Uzbekistan showed a significant increase in survival of 12.3%.
MO856: Immunogenicity and Adverse Events After Vaccination With GAM-COVID-VAC (Sputnik V) in Patients on Maintenance Haemodialysis Compared With Healthy Controls: A Preliminary Report
Authors: Parshina Ekaterina , Tolkach Alexey , Ivanov Andrey , Kislyy Pavel 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Recent studies evaluated safety and efficacy of vaccines against coronavirus disease (COVID-19), but none of them are currently approved in Russia. Here, we report results on immunogenicity of the recombinant adenovirus (rAd) 26 and rAd5 vector-based COVID-19 vaccine Gam-COVID-Vac (Sputnik V, developed by Gamaleya National Research Centre, Russia) in patients, receiving maintenance haemodialysis (HD). We aimed to compare the strength of humoral and cellular immunity after 2 doses of Gam-COVID-Vac in patients receiving HD and individuals with normal kidney function.

METHOD
The prospective cohort study (NCT: 04 805 632) included 23 patients treated with maintenance HD and 28 volunteers with normal kidney function. All participates were adult, had been fully vaccinated with Gam-COVID-Vac vaccine and had no prior history of suspected or confirmed COVID-19. Subjects were excluded if they had a history of confirmed SARS-CoV-2 infection, had underlying autoimmune disease, malignancies or concomitant immunosuppressive therapy. In all participants the levels of specific IgG were quantified at 4 weeks after second vaccine dose administration using a semi-quantitative SARS-CoV-2 S1 IgG enzyme-linked immunosorbent assay. In all subjects, specific CD4+ and CD8+ T-lymphocyte responses (count of spots to spike structural peptide of SARS-CoV-2 virus in IGRA test) were evaluated at the same timepoint. All the participants were asked to report adverse events (AEs) following first and second vaccine administration, included general malaise, fever, myalgia, headache, allergic reactions and injection site reactions.

RESULTS
Overall, the incidence of vaccine-associated AEs was less in HD patients than in healthy controls: 32% versus 75% after both first and second vaccine administrations, RR = 0.46 (95% confidence interval 0.24–0.79), P = 009 (Table 1). The most commonly reported AE in both groups was pain in the injection site. No severe or serious AEs occurred in both patients and healthy controls. The seroconversion rate in 4 weeks after second vaccine shot reached 100% (28 of 28) in healthy subjects and 87% (20 of 23) in patients receiving HD. IgG levels did not differ between groups: 4.7 [Q1-Q3: 3.37; 6.25] in HD patients versus 5.5 [Q1-Q3: 3.3; 7.2] in controls, P = 0.219 (Figure 1A). The T-test result was positive in 70% (16 of 23) of HD patients and in 79% (22 of 28) of controls. The magnitude of T-cell response was comparable between groups: 30 spots [Q1-Q3: 11; 48] in HD patients versus 30 spots [Q1-Q3: 14; 51] in controls, P = 0.745 (Figure 1B).

CONCLUSION
Patients receiving HD develop efficient humoral and cellular immune responses after complete vaccination against COVID-19 with Gam-COVID-Vac vaccine, which is comparable with those in healthy adults.
MO858: Early Morning Haemodynamic Changes and Left Ventricular Hypertrophy and Mortality In Haemodialysis Patients
Authors: Mallamaci Francesca , Tripepi Rocco , Torino Claudia , Luigi Tripepi Giovanni , Sarafidis Pantelis , Zoccali Carmine 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Amplified early morning increase in BP, a phenomenon accompanied by a parallel rise in heart rate (HR), is a marker of high cardiovascular risk in the general population. The early morning changes in these parameters have not been investigated in the haemodialysis population.

METHOD
In a pilot, single centre, study including a series of 58 haemodialysis patients we measured the pre-awakening BP and HR surges and the nocturnal dipping of the same parameters as well as other established indicators of autonomic function (weighted 24h systolic BP and HR variability) and tested their relationship with the left ventricular mass index (LVMI) and with the risk of death over a median follow up of 40 months.

RESULTS
The pre-awakening HR surge (r = –0.46; P = 0.001) was inversely associated with LVMI and the risk of death [HR (1 unit): 0.89, 95% confidence interval: 0.83–0.96; P = 0.001] while the corresponding BP surge largely failed to associate with these outcomes. The link between the pre-awakening HR surge with LVMI and death was robust and largely independent of established risk factors in the haemodialysis population, including the nocturnal dipping of BP. Weighted 24 h systolic BP and HR variability did not correlate with LVMI (all P &gt; 0.11) nor with the risk of death (P &gt; 0.11) and these parameters were also independent of the nocturnal dipping of systolic BP and HR.

CONCLUSION
This pilot study suggests that the low early morning changes in HR, likely reflecting enhanced sympathetic activity, entail a high risk for LVH and mortality in the haemodialysis population.