bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO584: Effect of Probiotic Supplementation on Endothelial Injury and Inflammation Biomarkers Among Patients with Chronic Kidney Diseases on Hemodialysis
Authors: Érica Maria Rodrigues de Araújo , Gdayllon Cavalcante Meneses , Alice Maria Costa Martins , Elizabeth De Francesco Daher , Geraldo Bezerra Da Silva Junior 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The use of probiotics in chronic kidney disease (CKD) is hypothesized to contribute to decrease inflammation and endothelial injury, thus preventing cardiovascular disease. The aim of this study was to investigate the effects of probiotics supplementation on biomarkers of endothelial injury (syndecan-1) and inflammation (C-reactive protein), as well as overall biochemical parameters of patients with CKD on hemodialysis.

METHOD
This is a double-blind, randomized clinical trial, with 80 patients with CKD on hemodialysis in a specialized healthcare clinic at Fortaleza, northeast Brazil, from February to June 2021, of which 40 were allocated to the placebo group and 40 were allocated to receive the probiotics supplementation. The supplementation consisted of the following encapsulated Gram-positive bacteria: Lactobacillus Plantarum A87, Lactobacillus Rhamnosus, Bifidobacterium bifidum A218 and Bifidobacterium Longum A101 in a concentration of 1 billion colony-forming unity (CFU), totaling 4 billion CFU in each capsule. The dosage consisted of ingesting 1 capsule of the supplement daily, after dinner, for 3 months. Pre-dialysis blood collections were performed before and after the treatment period. The ELISA technique was applied to measure the serum syndecan-1 biomarker and PCR. Total blood count, fast glucose and body mass index (BMI) were also investigated.

RESULTS
About 80% of the recruited patients in the study group completed the trial. When compared with the placebo group, the group that received the probiotics had a significant reduction in syndecan-1 levels (184.3 ± 106 versus 239.48 ± 113.6 ng/mL; P = 0.005) and PCR (1626 ± 617.5 versus 898 ± 313 ng/mL; P = 0.001), increase in hematocrit and hemoglobin, respectively (33.5 ± 5.1 versus 37.1 ± 5.4; P = 0.011; 11.1 ± 1.8 versus 12 ± 1.5; P = 0.036) and decrease in fast glucose levels (146.5 ± 74.6 versus 162.7 ± 112.6 mg/dL; P = 0.026). The BMI classifications did not present significant differences between the groups.

CONCLUSION
Probiotics supplementation for patients with CKD on hemodialysis evidenced benefits, including a decrease in endothelial injury biomarker (syndecan-1) and inflammation (PCR), as well as improvement in biochemical parameters (hematocrit/hemoglobin and fast glucose). Further studies are required to investigate long-term effects of probiotics among CKD patients, including all stages of the disease.
MO593: Study of Cardiopulmonal Parameters in Patients with CKD During Renal Rehabilitation
Authors: Saipova Durdona , Egamberdieva Dano 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Chronic kidney disease is a global health problem in which patients’ performance decreases as renal dysfunction progresses. However, no evidence-based lifestyle recommendations for the primary prevention of CKD have yet been developed.
The aim of the study was to study cardiorespiratory parameters in patients with CKD during aerobic exercise of light and moderate intensity.

METHOD
The study included 130 patients with CKD stages 2–3, aged 45– 65 years, whose average age was 58.7 ± 0.73 years, and the proportion of women in the sample was 47.7%. All patients underwent determination of urea, serum creatinine, measurement of blood pressure and heart rate. To determine exercise tolerance, a cardiorespiratory exercise test was performed. Patients of the main group, depending on the initial cardiorespiratory parameters, were divided into 2 subgroups: 1 subgroup—67 patients who performed light intensity exercises; 2 subgroups—33 patients who performed medium-intensity exercises for 12 weeks 3 times a week. The choice of training intensity was made according to the level of individual or subjective perception of the load and was calculated using the approximate heart rate. The control group consisted of patients with CKD stages 2–3 who did not perform physical training.

RESULTS
When studying the indicators of systolic and diastolic blood pressure before and after physical training, moderately severe arterial hypertension was revealed. After 12 weeks of physical training in the group with medium-intensity training in patients, the blood pressure level significantly decreased compared with the baseline values ​​(SBP from 147 mm Hg to 129 mm Hg, DBP from 99 mm Hg) up to 79 mm Hg, P &lt; 0.001), while in the group with physical training of light intensity this indicator practically did not change (SBP decreased from 147 to 138 mm Hg, DBP 93 to 89 mm Hg, respectively). A hypertensive reaction to physical activity was also confirmed, with positive dynamics at the stages of physical rehabilitation.
After 12 weeks, except for the VO2 in VT, the HR in VT and the RCP, all other cardiopulmonary parameters increased in the main group (P &lt; 0.05). The maximum oxygen consumption in the study group before the start of training peak VO2 (mL/kg/min) was 22.8 ± 0.3 after training 26.1 ± 0.4 (P &lt; 0.05). In the control group, it was 23.6 ± 0.8 and 24.2 ± 0.7, respectively. In addition, the dynamics of the indicator of maximum oxygen consumption VO2 peak in the main group was significantly higher compared with the control group and with the baseline values(P &lt; 0.001).

CONCLUSION
Training intensity is essential for improving cardiorespiratory parameters in patients with CKD. When choosing the intensity of training, it is necessary to take into account the baseline cardiorespiratory parameters. The use of physical training in combination with standard therapy improves cardiorespiratory parameters in patients with CKD.
MO603: Effects of Intradialytic Bicycle Ergometer Exercise on Inflammation Transcription Factors in Patients with Chronic Kidney Disease
Authors: Mafra Denise , de Brito Jessyca S , Borges Natalia A , V. Vargas Reis Drielly C M , Santos Da Silva Greicielle , Fonseca Larissa S , Ribeiro Marcia M , Chermut Tuany R , Paiva Bruna R , Cardozo Ludmila , Oliveira Leonardo C , Moura Mariana , Capistrano Estelina S M 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Oxidative stress and inflammation are involved in the pathophysiological mechanisms in patients with chronic kidney disease (CKD) on hemodialysis (HD). In this context, the therapeutic potential of targeting the gene transcription factors associated with these mechanisms has been studied; for instance, nuclear factor erythroid 2-related factor 2 (Nrf2), the master regulator of antioxidant responses and, nuclear factor κappa B (NF-κB) that promotes the inflammatory response. However, the effects of physical exercise on the modulation of these factors are under investigation in CKD patients. Therefore, the aim of the present study was to evaluate the effects of an intradialytic aerobic exercise training program on the expression of transcription factors (Nrf2 and NF-κB) in patients with CKD on HD.

METHODS
This is a longitudinal, randomized clinical trial with a washout period and crossover performed with 18 patients randomized into two groups: Exercise (individualized intradialytic aerobic exercise on an adapted stationary exercise bike) three times per week for 3 months and control (without exercise). After the washout period (1 month), the exercise group became the control, and the other group performed the exercises for another 3 months. Peripheral blood mononuclear cells (PBMCs) were isolated, and quantitative real-time PCR analysis was performed to evaluate Nrf2, NF-kB and NAD(P)H: quinone oxidoreductase-1 (NQO1) mRNA expression. The plasma levels of inflammatory cytokines, tumour necrosis factor-α (TNF-α), C-reactive protein (CRP) and interleukin-6 (IL-6) were evaluated by ELISA.

RESULTS
Eighteen patients [11 men, 44.1 ± 8.4 years, 17.3 (6.6–124) months on HD] completed all the study. The obtained data revealed that the intervention did not affect the mRNA expression of Nrf2, NQO1 and NF-κB (Table 1). Also, TNF-α levels were not changed. However, IL-6 showed a tendency to decrease after the exercise intervention (P = 0.054).

CONCLUSION
Three months of intradialytic aerobic exercise were insufficient for modulating the transcription factors associated with antioxidant activity (Nrf2 and NQO1) and inflammation (NF-κB) in patients with CKD.
MO612: Relationship of Renal Timp-1, Stat3 and Inflammatory Factors in Diabetes
Authors: Manzeger Anna , Mikone Krisztina , Mozes Miklos , Stepanova Ganna , Kokeny Gabor 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The balance of matrix metalloproteinases (MMPs) and their tissue inhibitors (TIMP) is disrupted in diabetic nephropathy and renal TIMP-1 overexpression is observed in both animal experimental models and human biopsies. The STAT3 transcription factor participates in several inflammatory pathways; however, its interaction with TIMP-1 in diabetes remains unknown. We aimed to investigate the progression of nephropathy and its relationship to renal STAT3 activation in type-1 diabetic TIMP-1 knock-out (KO) mice.

METHOD
Diabetes was induced in 6-week-old male TIMP-1 KO (DM-KO, n = 8) and C57Bl6 wild type (DM, n = 5) mice by intraperitoneal streptozotocin injections (50 mg/kg/day for 5 days). Control mice (CTL, n = 6) received citrate buffer injections. Eight weeks after onset of diabetes blood and urine chemistries, renal histology, renal mRNA and protein expression were assessed. Statistical significance was evaluated using Kruskal–Wallis test and Tukey post-hoc analysis.

RESULTS
Despite similar hyperglycemia, DM-KO mice developed significantly less proteinuria (P &lt;0.01) and histologically milder glomerulosclerosis and tubular damage as compared with wild type DM mice. Kidneys of DM mice depicted 4-fold STAT3 phosphorylation, but DM-KO kidneys had similar values as CTL nondiabetic controls. DM kidneys also showed 20-fold CCL2, 10-fold C3 and 2.5-fold C4 overexpression, which in DM-KO kidneys remained all near control (CTL) levels.

CONCLUSION
Based on our results, we conclude that TIMP-1 influences the progression of diabetic kidney disease in mice not solely through the inhibition of MMP-s, but also by influencing the extent of renal inflammation via STAT3 phosphorylation. Therefore, TIMP-1 might emerge as promising future therapeutic target.

FUNDING
Hungarian Academy of Sciences BO/00 304/20/5, ÚNKP-21–5-SE-1.
MO615: The Lund Mets Rat, An Obese Type 2 Diabetic Preclinical Model, Develops Non-Alcoholic Steatohepatitis, Diabetic Nephropathy and Heart Failure with Preserved Ejection Fraction Under High Fat/Cholesterol/Fructose Diet
Authors: Briand Francois , Dubroca Caroline , Maupoint Julie , Brousseau Emmanuel , Sulpice Thierry 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Beyond the glucose control, anti-diabetic drugs need to demonstrate benefits on metabolic comorbidities. An animal model that recapitulates obesity and type 2 diabetes (T2D) comorbidities [i.e. non-alcoholic steato-hepatitis (NASH), nephropathy and heart failure with preserved ejection fraction (HFpEF)] is still needed for preclinical drug development. To overcome this limitation, we evaluated the effects of a high fat/cholesterol/fructose (HFCF) diet in the Lund MetS rat, a congenic BBDR.cg-lepr.cp model generated by introgression of the Koletsky leptin receptor mutation into the BioBreeding Diabetes Resistant (BBDR) rat.

METHOD
17-week-old, male, lean control (ctrl) or Lund MetS obese T2D rats were fed a control chow (CC) diet or a HFCF diet, respectively for 8 weeks. Blood biochemistry was measured at 0, 4 and 8 weeks of diet. Kidney, heart and liver parameters were assessed at the end of the 8-week diet period.

RESULTS
Compared with ctrl, Lund MetS rats were obese (56% higher body weight) and diabetic with significantly higher %HbA1c (up to + 3%) and blood glucose levels (up to 3-fold higher) during the 8-week HFCF diet period. Significantly higher plasma insulin (up to 11-fold), total cholesterol (up to 5-fold), triglycerides (up to 8-fold), transaminases (up to 10-fold higher) levels were also observed in Lund MetS rats, as compared with ctrl. Hepatic total cholesterol, triglycerides and fatty acids levels were significantly higher in Lund Mets rats (14-, 7.3- and 6.7-fold higher as compared to ctrl, respectively). Liver histopathological scoring confirmed a NASH phenotype in Lund MetS rats fed the HFCF diet with strong liver steatosis, hepatic inflammation and portal to bridging fibrosis. Kidney function was substantially altered with a 60% decline in glomerular filtration rate and a 16-fold increase in urine albumin-to-creatinine ratio (both P &lt; 0.0001 versus ctrl). Finally, echocardiography indicated diastolic dysfunction with significantly reduced E/A and greater E/e’ ratios, along with a preserved ejection fraction in Lund MetS rats, as compared with lean ctrl.

CONCLUSION
The present data demonstrate that the Lund MetS rat fed an HFCF diet that recapitulates the major metabolic comorbidities of obesity/T2D and may be a useful model for preclinical drug development.
MO623: Risk Factors of Diabetic Nephropathy Among Newly Detected Type 2 Diabetic Subjects: Preliminary Report from A Tertiary Care Hospital of Bangladesh
Authors: Abdur Rahim Muhammad , Humaira Habib Samira , Mohosin Ul Haque Wasim M D , Afsana Faria , Zaman Shahana , Iqbal Sarwar 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Patients with type 2 diabetes mellitus may present with different macro- and micro-vascular complications including diabetic nephropathy. This preliminary study was designed to evaluate the risk factors for diabetic nephropathy among type 2 diabetic patients at the time of diabetes diagnosis.

METHOD
A case-control study was done at a tertiary care hospital in Dhaka, Bangladesh from January to September 2017. Adult (≥18 years), type 2 diabetic patients, who were detected as diabetic for the first time within the previous 3 months and who tested, at least, two urine samples for urine albumin-to-creatinine ratio (UACR), at least 6 weeks apart, within a 6-month period, were consecutively enrolled for the study. Pregnant ladies, patients with diagnosed kidney disease, patients having features of glomerulonephritis and systemic diseases including systemic lupus erythematosus and vasculitis, history of recent fever, urinary tract infection and menstruation were excluded. Patients having UACR ≥30 mg/g in at least two (out of 3, if tested) samples were taken as cases and those with UACR &lt;30 mg/g were taken as controls. Data were analyzed by statistical package for social sciences (SPSS) version 20.

RESULTS
Total patients were 224 with female predominance (150, 67%). Fifty one (22.8%) patients had diabetic nephropathy (microalbuminuria = 47 and overt proteinuria = 4). Multivariate regression analysis revealed that hypertension {odds ratio (OR) = 3.71 [95% confidence interval (CI) 1.23–4.31], P = 0.003}, smoking [OR = 3.27 (95% CI 2.91–4.79), P = 0.003], family history of diabetes [OR = 2.31 (95% CI 1.84–3.14), P = 0.005] and diabetic nephropathy [OR = 3.34 (95% CI 2.40–4.97), P = 0.001], dyslipidaemia [OR = 2.31 (95% CI 1.98–3.91), P = 0.023], increased body mass index (BMI) [OR = 2.11 (95% CI 1.54–4.87), P = 0.001] and high glycated haemoglobin (HbA1c) [OR 3.21 (95% CI 1.71–5.97), P = 0.034] were significant risk factors for diabetic nephropathy.

CONCLUSION
Almost 23% of type 2 diabetic patients had diabetic nephropathy during diabetes diagnosis in this study and most patients had microalbuminuria. Presence of hypertension, dyslipidaemia, smoking, family history of diabetes and diabetic nephropathy, increased BMI and high HbA1c were significant risk factors for diabetic nephropathy among patients with type 2 diabetes at diagnosis.
MO625: Effects of Dietary Sodium and Protein Intake on Early DIP of GFR Levels in Subjects with Type 2 Diabetes Treated with SGLT2 Inhibitors
Authors: Gaudio Costanza , Colombi Claudia , Merciai Chiara , Seghieri Marta , Spatoliatore Giuseppe , Rosati Alberto 
Published: May 2022

Abstract

BACKGROUND AND AIMS
SGLT2 inhibitors (SGLT2i) are able to decrease proteinuria and slow down eGFR decline in DKD patients. The effect is mainly obtained by increase of natriuresis and glucose-induced osmotic diuresis, resulting in a reduction in intraglomerular pressure. These hemodynamic changes are beneficial in long-term period, but up to 28% of patients treated with SGLT2i experience an acute, usually transient, eGFR reduction of more than 10% [1]. Moreover, in some case, the decrease of eGFR can be more pronounced and compromise the maintenance of therapy. High sodium and protein intake can lead to intraglomerular pressure increase and predispose to a deeper fall of eGFR. We aimed at investigating whether measured creatinine clearance (CrCl) is a more sensitive method to detect the initial dip of GFR in patients with T2D treated with SGLT2i, and if dietary sodium and protein intake can influence the extent of the early change in GFR.

METHOD
Subjects with type 2 diabetes (T2D) were consecutively recruited among those referring to the inpatients of combined Nephrology and Diabetology clinic in years 2020–2021. Those eligible for treatment with SGLT2i were asked to collect 24-h urinary samples for sodium and urea determination, to estimate sodium and protein intake, respectively, before and 1, 3 and 6 months after treatment initiation.

RESULTS
At baseline, 27 patients (M 23/F 4; age 69 ± 7 years; BMI 28.2 ± 3.6 kg/m2; HbA1c 56 ± 16 mmol/mol) had a CrCl of 83.23 ± 25.52 mL/min/1.73 m2 (eGFR 67.32 ± 16.07), which dropped by 19% at month 1 (eGFR by 6%, although not significantly) and then increased to comparable baseline values at month 6. Exploring the potential correlation between changes in renal function and salt intake, ΔCrCl and baseline urinary sodium were inversely related at month 1 (r = −0.61; P &lt;0.01), at month 3 (r = −0.51; P = 0.01) and month 6 (r= −0,48; P &lt; 0.05) (Fig. 1). Likewise, an inverse correlation between ΔCrCl and baseline urinary urea (Fig. 2) was demonstrated at month 1 and 3 (r = −0.46; P &lt;0.05 for both), at month 6 a similar, not significant, trend was observed (r = −0.47; P = 0.054). Proteinuria showed a significant reduction from baseline (P &lt; 0.05); no significant relationship between change in proteinuria and urinary sodium or urea was observed.

CONCLUSION
The present study suggests that a higher dietary sodium and protein intake may amplify the extent of early dip in glomerular filtration rate, detected with measured CrCl, in diabetic patients undergoing SGLT2i treatment. We believe that measured creatinine clearance is a very sensitive method to detect it. Further studies are needed to confirm the results of our pilot study.
MO646: Effect of a High-Flux Dialyzer Applied to HFR Supra on the Removal of Large Uraemic Toxins in Haemodialysis Patients: Results from a Randomized Controlled Study
Authors: Molina Pablo , Valero Alejandro , Vizcaíno Belén , González Moya Mercedes , García-Valdelvira María , Montesa Marín María , Molina Mariola D , Beltrán Sandra , Estañ Nuria , Sancho Asunción 
Published: May 2022

Abstract

BACKGROUND AND AIMS
HFR-Supra (haemodiafiltration with the regeneration of the ultrafiltrate) is a highly biocompatible dialysis technique characterized by an adsorptive resin cartridge with high protein-bound toxin adsorption capacity without removal of albumin, mimicking both glomerular and tubular functions. However, the low-flux dialyzer contained in the second diffusive stage of the HFR Supra system may hamper the removal of large uraemic toxins. This study assessed the large uraemic toxin removal ability of a new HFR system (HFR-H) which combines adsorption such as in HFR-Supra, with a high-efficiency high-flux haemodialysis membrane.

METHOD
In an open, randomized, cross-over, single-center, controlled study, 16 adult chronic haemodialysis patients were treated by haemodiafiltration with the regeneration of the ultrafiltrate with the HFR-Supra or the HFR-H system. All other dialysis parameters were kept constant in both study arms. All the treatments were delivered with Flexya dialysis monitor (Medtronic) in the middle-week session, lasting 4-h. The reduction rate (RR) of urea, creatinine, phosphate, β2-microglobulin, kappa (κFLC) and lambda (λFLC) free light chains and albumin, was intra-individually compared for the two dialysis types with linear mixed models.

RESULTS
The RRs for β2-microglobulin, κFLC and λFLC were significantly higher with the HFR-H system than those obtained with HFR-Supra (Figure). There were no significant differences in the RR for urea, creatinine, phosphate, interleukin-6 and albumin.

CONCLUSION
This study demonstrates that treating patients with an HFR-H instead of an HFR-Supra system significantly increases the elimination of middle and large molecules.
MO655: Anti-Inflammatory Approach in Chronic Dialysis Patients with SARS-CoV-2: ATA or PMMA Dialyzers?
Authors: Gasperoni Lorenzo , Donati Gabriele , Scrivo Anna , Zappulo Fulvia , Abenavoli Chiara , Hu Lilio , Napoli Marianna , Angelini Andrea , Nunzio Miriam D I , Tringali Edoardo , Cingolani Alessandra , Marchegiani Beatrice , Rigotti Angelo , Manna Gaetano L A 
Published: May 2022

Abstract

BACKGROUND AND AIMS
High flux haemodialysis membranes may modulate the cytokine storm of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), but their impact in chronic haemodialysis (CHD) patients is not assessed [1, 2]. The aim of the study was the evaluation of asymmetric cellulose triacetate (ATA) and polymethylmethacrylate (PMMA) dialyzers on inflammatory markers in CHD patients with SARS-CoV-2.

METHOD
A prospective, observational study on CHD patients (age ≥18 years) affected by SARS-CoV-2 was carried out. Patients were enrolled from March 2020 to May 2021 and dialysis was performed at S. Orsola University Hospital (Bologna, Italy) Dialysis Unit. Mechanical ventilation at diagnosis was exclusion criteria. Pre- and post-dialysis C-reactive protein (CRP), procalcitonin (PCT) and interleukin-6 (IL-6) were determined at each session and corrected for haemoconcentration during the complete SARS-CoV-2 period.
Patients who underwent online haemodiafiltration (OLHDF) with PMMA dialyzer (Filtryzer BG-U™, Toray, surface area 2.1 m2 cut-off 20 kDa, KUF 43 mL/h/mmHg) were compared with those who underwent OLHDF with ATA dialyzer (SolaceaTM Nipro, surface area 2.1 m2 cut-off 45 kDa, KUF 72 mL/h/mmHg). The primary endpoint was to assess the differences in the reduction ratio/session (RR) of CRP, PCT and IL-6.

RESULTS
A total of 74 patients were enrolled, 48 were treated with ATA and 26 were with PMMA (420 versus 191 dialysis sessions). The main results are shown in Table 1. Median IL-6RR% was higher for ATA [17.08%, interquartile range (IQR) −9.0 to 40.0 versus 2.95%, IQR −34.63 to 27.32]. CRP and PCT showed higher RR with ATA in comparison to PMMA. When IL-6RR &gt; 25% was the dependent variable in the multiple logistic regression analysis only ATA showed a significant correlation [odds ratio (OR) 1.891, 95% confidence interval (95% CI) 1.273–2.840, P = .0018) while higher CRP favoured the risk of lower IL6RR (OR 0.9101, 95% CI 0.868–0.949, P &lt; 0.0001) (Table 2).

CONCLUSION
In SARS-CoV-2 CHD patients treated with OLHDF, ATA showed a better anti-inflammatory profile than PMMA, in particular regarding IL-6 RR.