bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO1035: Adipokine Profile and Protein-Energy Wasting in Children with Chronic Kidney Disease
Authors: Karava Vasiliki , Dotis John , Kondou Antonia , Christoforidis Athanasios , Taparkou Anna , Farmaki Evangelia , Liakopoulos Vassilios , Kollios Konstantinos , Printza Nikoleta 
Published: May 2022

Abstract

BACKGROUND AND AIMS
This cross-sectional study investigates the association between adipokine profile, serum interleukin-6 (IL-6) levels and protein-energy wasting (PEW) in children with chronic kidney disease (CKD).

METHOD
Serum adiponectin, leptin, resistin and IL-6 were measured in 53 patients, with a median age of 12.9 years, presenting CKD stage 3–5. Body composition indices, lean tissue (LTI) and fat tissue index (FTI), were measured by bioimpedance analysis spectroscopy. PEW was defined as the presence of muscle wasting [LTI adjusted to height and age (LTI HA) Z-score &lt; −1.65 SD] and at least two of the following criteria: poor growth [height Z-score &lt; −1.88 SD], questionnaire-based reduced appetite, or serum albumin ≤ 3.8 g/dL.

RESULTS
PEW was present in 8 (15.1%) patients. At least 1,2,3 and 4 PEW criteria were present in 25 (47.2%), 16 (30.2%), 9 (17%), 3 (5.6%) patients respectively. Among the PEW criteria, muscle wasting was present in 18 (34%), poor growth in 14 (30.2%), reduced appetite in 8 (15%) and low serum albumin in 13 (24.5%) patients respectively. PEW was more frequent in CKD stage 5 (P = .010). Adiponectin and resistin levels were higher in CKD stage 5 (P &lt; .001, P = .005), while leptin did not differ among CKD stages (P = .440). Adiponectin was negatively correlated to LTI HA (rs =− 0.417, P = .002), leptin was positively correlated to FTI (rs = 0.620, P &lt; .001), while resistin was not correlated to body composition indices. IL-6 was positively correlated only to adipokine resistin (rs = 0.513, P &lt; .001). Adiponectin and IL-6 were associated with PEW after adjustment for CKD stage [odds ratio (OR) 1.239, 95% confidence interval (95% CI) 1.040, 1.475 and OR 1.034, 95% CI 1.007–1.06), leptin was not associated with PEW, while resistin association with PEW lost significance in multivariate analysis.

CONCLUSION
In advanced paediatric CKD, adiponectin and resistin are probably involved in muscle wasting and systemic inflammation process respectively. Serum leptin reflects adiposity status. Apart from serum inflammatory cytokines, serum adiponectin may be a useful biomarker of PEW in children with CKD.
MO1036: 24-H Central Blood Pressure is Related to Renal Lesions in Children with Tuberous Sclerosis Complex
Authors: Skrzypczyk Piotr , Maria Wabik Anna , Szyszka Michał , Jozwiak Sergiusz , Wroniewicz Tobiasz , Bujanowicz Adam , Bombinski Przemyslaw , Jakimow-Kostrzewa Aleksandra , Brzewski Michal , Panczyk-Tomaszewska Malgorzata 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Adult data show that in people with tuberous sclerosis complex (TSC), blood pressure is related to the extent of renal involvement. Central blood pressure and 24-h ambulatory blood pressure are stronger predictors of a cardiovascular burden compared to office peripheral blood pressure. The study aimed to analyse 24-h central blood pressure and its relation with renal involvement in paediatric patients with TSC.

METHOD
In a group of 32 children with TSC (9.6 ± 4.4 years, 16 boys, 16 girls), we evaluated peripheral and central 24-h ambulatory blood pressure, office peripheral blood pressure, medications used, renal lesions in magnetic resonance and ultrasonography, including the presence of angiomyolipoma (AML), atypical AML, cysts and their maximal diameter (mm) and laboratory parameters.

RESULTS
In the studied group, 20 (62.5%) children had renal angiomyolipomas, including 5 (15.6%) with atypical angiomyolipomas, 22 (68.8%) with renal cysts and 4 children (12.5%) were treated with mTOR inhibitors (2 patients with everolimus and 2 patients with sirolimus) at the moment of evaluation, glomerular filtration rate (GFR) was 127.4 ± 36.7, one patient had GFR 80.5, 22 patients had GFR between 90 and 139 and 9 patients had hyperfiltration defined as GFR &gt; 140 mL/min/1.73 m2. A total of 4 (12.5%) children had elevated blood pressure in ABPM. The 24-h central systolic and diastolic blood pressure correlated with maximal diameter of renal cysts (mm) (r = 0.359, P = .044; r = 0.466, P = .029) and urinary albumin loss (mg/24-h) (r = 0.511, P = .004; r = 0.478, P = .021), 24-h central systolic, mean blood pressure and pulse pressure with serum cystatin-C (ng/mL) (r = 0.523, P = .005; r = 0.464, P = .015; r = 0.419, P = .029); 24-h peripheral MAP Z-score correlated with cyst size (mm) (r = 0.571, P = .021). No significant correlations between presence and AML size and peripheral and central blood pressure were found in the study group. There were following positive correlations of arterial stiffness parameters: 24-h central augmentation index (24hcAI x 75HR) with total cholesterol (r = 0.357, P = .045) and ambulatory arterial stiffness index (AASI) with uric acid (r = 0.520, P = .003). Size of AML correlated with age (r = 0.468, P = .007), whereas there was no correlation between cyst size and age (r = 0.145, P = .416).

CONCLUSION
MO1037: Insulin Sensitivity in Children with Autosomal Dominant Polycystic Kidney Disease
Authors: Dachy Angélique , De Rechter Stéphanie , Breysem Luc , Vennekens Rudi , Mathieu Chantal , Casteels Kristina , Van Hoorenbeeck Kim , Jouret François , Mekahli Djalila 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Autosomal Dominant Polycystic Kidney Disease (ADPKD) is the most common inherited kidney disorder. Defective glucose metabolism was identified as a key feature in ADPKD, and several ‘metabolic’ approaches are currently under evaluation in adults with ADPKD. Whether this defective glucose metabolism could be an early primary event and a potential therapeutic option in the early disease stages is still unknown. In this study, we evaluated the insulin sensitivity profile in genotyped children with ADPKD.

METHOD
We performed a cross-sectional study to evaluate the insulin sensitivity profile in a genotyped cohort of ADPKD children (&lt;19 years) with preserved renal function [estimated glomerular filtration rate (eGFR) ≥60 mL/min/1.73 m2]. Overweight/obese children were respectively defined as body mass index (BMI) 25–30 and &gt; 30 kg/m2. The Homeostasis Model Assessment Index (HOMA-IR) was calculated: fasting insulin (μIU mL− 1) x fasting glucose (mmol L − 1)/22.5. The Quantitative Insulin Sensitivity Check Index (QUICKI) was calculated: 1/[log (fasting insulin μU/mL) + log (fasting glucose mg/dL)].

RESULTS
A total of 37 ADPKD patients (22 boys) were included with a mean ($ \pm $ SD) age at diagnosis was 10.3 $ \pm $ 4.2 years. A total of 36 patients had PKD1 mutation (one GANAB mutation). Median BMI was 16.8 ± 4.3 kg/m2. Median serum fasting glucose: 86.0 ± 9.3 mg/dL, median fasting insulin: 6.1 ± 7.2 μU/mL and median serum C-peptide: 0.4 ± 0.3 nmol/L. Median HOMA-IR was 1.4 ± 1.7 and median QUICKI was 0.4 ± 0.1. A total of 16 patients presented a HOMA-IR &gt; 1.6 and 6 normal-weight children had a HOMA-IR &gt; 2.3. No patient displayed glucosuria. An oral glucose tolerance test was performed on five overweight patients, four of them showed insulin resistance and were treated with metformin.

CONCLUSION
Even with normal BMI, ADPKD children displayed a high index of insulin resistance. Further clinical studies are needed to determine whether ADPKD could be an additional risk factor for insulin resistance.
MO1042: Challenges of Diagnosing and Treating Urinary Tract Infection Throuh the Centuries
Authors: Tasic Danijela , Glogovac Stevan , Dimitrijevic Zorica , Radenkovic Sonja 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Numerous epidemiological studies indicate the great importance of diagnosing and treating urinary tract infections. Whether they are treated by urology specialists as provided by international guides while clinical practice is provided, or they are treated by nephrologists as practiced in Serbia, the end result is bacterial resistance to antibiotics. Patients often request from doctors for “natural” nonpharmacological drugs, especially when it comes to treating uranium infection and calculosis. Therefore, the aim of our work is to investigate the ways of diagnosing and treating urinary tract infections, hematuria and calculosis in the past.

METHOD
Numerous resources, including MEDLINE, books, magazines, encyclopedias and data bases, were used to collect the information described in this paper.

RESULTS
The first written records made 6000 years ago about the visual observation of the color and appearance of urine by uroscopy date from Babylon. Painful urination and blood in the urine has been associated with Egyptians in the past, although they attached great importance to hygiene. Since ancient Egypt hematuria has been attributed to schistosoma hematobium today known as schistosomiasis. The eggs of this parasite were found in the urinary tract of a mummy dating from 1189 BC. Later Egyptian medical papers from 1550 BC describe calculosis, cystitis and urinary frequency in people who have been in contact with contaminated water. In 1798, French doctors from the time of Napoleon described Egypt as the only country in which men menstruate. Although only described about 86 plants belonging to 43 species in southeastern Serbia, there are few records on how to treat hematuria, urinary tract infections and calculosis. Herbal medicine in Serbia is recorded in the oldest document from the 14th century (The Hodoch Codex) and the 16th century (The Chilandar Medicinal Codex). The health book “Pelagic's Folk's Teacher” was published in 1879 by Vasa Pelagic. He published folk healing experiences for the first time on over 900 pages and thus gained great popularity. Most of the information was collected by University Professor Dr. Jovan Tucakov, who in his book “Herbal Therapy,” first published in 1973, described the use of herbs to treat various diseases, including urinary tract infections. Almost every family in Serbia owns these books and changes their therapy together with conventional medicines. However, little attention is paid to the side effects of such combinations and the importance of the consequences of the length of treatment.

CONCLUSION
Today, treating a urinary tract infection is a major challenge due to bacterial resistance to antibiotics. Knowledge that the culture and social habits of the people are one of the important contexts for improving health care and health education of people and not just the application of technological advances.
MO1047: Patient Reported Outcomes in Glomerulonephritis
Authors: Yeo Fiona , Hui Ho Rou , Choo Jason , Zhuan Tan Hui , Mok Irene , Lim Cynthia 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Glomerulonephritis and its treatment may be associated with disease or treatment-related complications causing significant symptom burden and hospitalizations affecting physical function and quality of life (QoL). Patient-centered care harnessing patient-reported outcome measures (PROMs) can guide physicians to optimize patients’ functional well-being. Few studies have described health-related QoL (HRQOL) in patients with glomerulonephritis. We aimed to describe the HRQOL and determinants of HRQOL among patients with active glomerulonephritis.

METHOD
This was a cross-sectional study of adults with active glomerulonephritis recruited at the Singapore General Hospital Glomerulonephritis Disease Management Clinics between July 2020 and July 2021. HRQOL was assessed using the Short-Form Health Survey (SF-36) and Patient-Reported Outcome Measurement Informative System (PROMIS). Socio-demographic and clinical data were collected. Multivariate linear regression was used to determine predictors of HRQOL.

RESULTS
A total of 60 patients with glomerulonephritis (13 minimal change disease, 9 primary focal segmental glomerulosclerosis, 8 membranous nephropathy, 15 lupus nephritis, 8 IgA nephropathy and 7 other glomerulonephritis) with median age 44.5 years old (IQR 32–57) participated. Most (83%) had received immunosuppressants within 60 days of study enrolment. The scores for general health and energy were lower than other health domains of SF-36 such as physical functioning (Table 1). Health domain scores of those with nephrotic presentations (minimal change disease, FSGS and membranous nephropathy) and nephritic presentations (lupus nephritis and IgA nephropathy) were not significantly different. In the multivariable model accounting for age, gender, eGFR, ethnicity, hematuria, edema and immunosuppressant use (Table 2), age correlated positively with emotional role and social functioning while ethnicity influenced the pain scores. Hematuria was associated with lower physical role scores while eGFR correlated positively with social functioning. Calcineurin inhibitor use was associated with higher global physical health scores.

CONCLUSION
Sociodemographic, clinical and treatment may affect SF-36 and PROMIS HRQOL scores in patients with glomerulonephritis.
FC055: Effect of Atacicept on Renal Function in SLE Patients
Authors: Isenberg David , Lin Celia , Kao Amy , Aydemir Aida , Gordon Caroline 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Atacicept is a dual BLyS/APRIL inhibitor. APRIL-SLE was a double-blind, placebo-controlled phase 2 study, which randomized moderate-to-severe systemic lupus erythematosus (SLE) patients to atacicept 75 mg, atacicept 150 mg or placebo. The primary endpoint was the proportion of subjects who experienced a new flare during the 52-week treatment period. In total, 111 patients in the placebo group, 112 patients in the atacicept 75 mg group and 62 patients in the atacicept 150 mg group completed 52 weeks of treatment. Patients with severe renal disease were excluded, while patients with proteinuria and mild–moderate chronic kidney disease, as assessed by KDIGO criteria, were eligible. The effect of atacicept on measures of renal function in these patients has not previously been reported.

METHOD
The study excluded moderate to severe glomerulonephritis, as defined by either of the following: urinary protein/creatinine ratio &gt; 1 mg/mg and/or hematuria or a significant renal impairment as defined by glomerular filtration rate (GFR) &lt; 50 mL/min/1.73 m2. Urine protein/creatinine ratio (UPCR) and GFR were measured at baseline, week 2, and then every 4 weeks until week 52.

RESULTS
In the APRIL-SLE study, the analysis for GFR and UPCR are of all patients (62–111 per group) with up to 15% of patients having a history of SLE-related renal disease. GFR time course showed stability for the atacicept groups compared to a 4.3% decline in the placebo group at week 52 from baseline (figure and table). Furthermore, reductions in UPCR from baseline at week 52 were observed in the atacicept groups compared to an increase in the placebo group.

CONCLUSION
In this phase 2 APRIL-SLE study, analysis of renal data suggests potential for improved renal function with atacicept treatment in SLE renal disease.
FC060: Malignancies in Patients With Anca-Associated Vasculitis Treated within the Euvas Trials
Authors: Sanchez Alamo Beatriz , Moi Laura , Mahr Alfred , Hrušková Zdenka , M. Bajema Ingeborg , Wallquist Carin , Jayne David , W.A. Westman Kerstin 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Patients with ANCA-associated vasculitis (AAV) are known to have an increased risk for the development of malignancies, which has been largely attributed to immunodeficiency or side effects induced by immunosuppressive treatments. Because there is a considerable latency period for cancer development after exposure to immunosuppressive treatments, little data are available on the incidence of cancer for large cohort of patients with AAV and long follow-up. The aim of this study is to describe the cumulative incidence of cancer in patients with AAV who participated in the European Vasculitis Society (EUVAS) therapeutic clinical trials from 1995 to 2012.

METHOD
A total of 848 patients with AAV from 17 European countries were included in the present study. Information was retrieved from questionnaires sent to the principal investigators of the original RCTs (MEPEX, NORAM, CYCAZAREM, CYCLOPS, IMPROVE, RITUXVAS and MYCYC).

RESULTS
Among the total of 848 patients (median follow-up: 8 years, IQR: 2.2–8.8), 149 patients were diagnosed with 181 malignancies. The 10-year cumulative incidence of cancer was estimated at 20.6%. The median duration of start of AAV therapy-to-time of cancer diagnosis was 4.96 years (IQR: 2.24-8.83). The most common cancer types were skin cancer (37.4%), out of which 6 were melanoma and 62 nonmelanoma skin cancer, followed by gastrointestinal cancer (12.6%) and prostatic cancer (9.9%). Patients who developed cancer were significantly older at randomization than those who did not (62 ± 12 versus 57 ± 14 years) (P &lt; 0.001). Considering both remission-induction and remission-maintenance therapies, 94% of the patients received cyclophosphamide, 68.4% azathioprine, 28.2% mycophenolate, 11.4% methotrexate and 10.4% rituximab during the observation period. A total of 6 out of the 28 patients, who were treated with rituximab and two pulses of IV cyclophosphamide as induction therapy, developed cancer. Diagnosis of cancer significantly predicted shorter survival (log-rank = 9.2; P = 0.002).

CONCLUSION
Our findings, which were derived from a large number of patients with AAV enrolled in clinical trials over the past 25 years, estimate the 10-year cumulative incidence of malignancies following the start of AAV therapy at 20.6%. The development of cancer is tightly associated with decreased survival. Analyses of standardized incidence ratios, using the cancer incidence of the background populations as reference, are underway.
MO354: Selenium-Binding Protein 1 (Sepp1) as an Early Sensitive Biomarker of Acute Kidney Injury in Patients Undergoing Cardiopulmonary Bypass
Authors: Zicarelli Mariateresa , Pizzini Patrizia , Jeracitano Federica , Cutrupi Sebastiano , Spoto Belinda , Testa Alessandra , Serraino Filiberto , Mastroroberto Pasquale , Andreucci Michele , Coppolino Giuseppe , Bolignano Davide 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Acute kidney injury (AKI) often occurs in patients undergoing major cardiac surgery with cardiopulmonary bypass (CPB). Despite renal ischemia remains the key trigger, sustained oxidative stress is now acknowledged as a significant contributor. Selenium-binding protein 1 (SEPP1) is an intracellular protein whose blood levels increase in response to systemic cardiovascular and oxidative stress, as well as in the course of chronic kidney injury.

METHOD
In this pilot prospective study, we measured circulating SEPP1 levels in a cohort of 45 patients undergoing cardiac surgery with CPB in order to test its possible role in predicting the following occurrence of AKI. Serum samples of SEPP1 were collected before CPB (baseline) and at 4, 8 and 12 h after the end of the procedure and measured with a commercially available ELISA kit.

RESULTS
In the whole cohort, there was a significant statistical trend in SEPP1 levels from baseline to 12 h after CPB [39 (10–45) versus 3263 (1886–5042) ng/mL; P &lt; 0.0001]. Within 48 h from CPB end, 12/45 patients (27%) developed AKI, as defined as an increase in serum creatinine &gt;0.3 mg/dL or an absolute 1.5-fold increase from baseline and/or a reduced urine output (&lt;0.5 mL/kg/h). Circulating SEPP1 displayed an earlier and more prominent increase in AKI patients as compared with others [4 h SEPP1: 52 (39–233) versus 546 (260–1000) ng/mL; P &lt; 0.001]. 8 h SEPP1: 638 (437–1254) versus 1959 (1055–5303) ng/mL; P &lt; 0.001; difference between overall trends: P &lt; 0.001 (Fig. 1). At ROC analyses, either 4 or 8 h circulating SEPP1 had a remarkable diagnostic capacity in identifying AKI patients (AUCs 0.854 and 0.790, both P &lt; 0.001). The crude OR of AKI in patients with 4 and 8 h SEPP1 above the best ROC-derived cut-off values (178 and 1840 ng/mL, respectively) was 22 (95%CI 2.5–192.9) and 14.5 (95% CI 2.9–71.2), respectively. At multivariate analysis, such a risk was independent from potential confounders, including CPB duration, clamping time and age.

CONCLUSION
Increased SEPP1 levels in patients undergoing CPB may reflect a sustained response to systemic oxidative stress. Such a response becomes more prominent when renal damage is also occurring. Studies on larger and more heterogeneous cohorts are needed to confirm whether SEPP1 may be a candidate as an early and specific biomarker of AKI in this high-risk setting.
MO365: Single-Cell Profiling Analysis Reveals the Transcriptomic Landscape Of Kidneys in Patients With Acute Kidney Injury
Authors: Tang Rong 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Acute kidney injury (AKI) is a common clinical syndrome associated with considerable mortality and healthcare costs. Up to now, the underlying pathological mechanisms of AKI are still unclear, and specific strategies for early diagnosis and treatment of AKI are lacking. In this research, single-cell RNA sequencing (scRNA-seq) was applied to kidney biopsies of patients with AKI to elucidate novel molecular mechanisms and intercellular communications.

METHOD
The transcriptomes of human kidney specimens obtained from subjects with AKI and renal transplant healthy living donors were defined by scRNA-seq technology. Differentially expressed genes (DEGs) and cell clusters of the kidney were determined. Gene ontology (GO) and the Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis were performed, and cell–cell crosstalk communication analysis among distince cell subtypes were conducted.

RESULTS
A total of 16 distinct cell clusters were determined in kidney from subjects of AKI and control. Proximal tubule cells of AKI had up-regulation of novel pro-apoptotic genes including USP47, RASSF4, EBAG9, IER3 and NUB1, which have not been reported previously. Further, proximal tubule cells highly expressed endoplasmic reticulum stress related genes (PDIA6, ATF6, HSPA5 and DNAJC3), autophagy related genes (S100A11, CLDN1, TMBIM6, RB1CC1 and VMP1) and genes enriched in RIG-1 signaling. PALM3 was overexpressed in proximal tubule cells of AKI at both mRNA and protein levels, which is involved in cell adhesion, TLR4 signaling and infammation response. DEGs overexpressed in other tubular cells were primarily enriched in NOD-like receptor signaling, estrogen signaling, interleukin-12-mediated signaling and IL-17 signaling. Glomerular cells such as EC upregulated DEGs participating in cell adhesion, apoptosis and chemotaxis. Overexpressed genes in kidney-resident immune cells including macrophages, NK-T cells, monocytes and dendritic cells suggested abnormal regulation related with leukocyte activation, chemotaxis, cell adhesion and complement activation. In addition, the ligand-receptor interactions analysis revealed cell–cell communication contributing to adhesion, recruitment and infiltration of inflammatory cells into the kidneys, and cytokine production in the process of AKI.

CONCLUSION
Together, this study reveals distinct cell-specific transcriptional landscapes of kidney in AKI patients, also altered signaling pathways and potential cell-cell crosstalk in development of AKI. These data may provide new insights into the pathogenesis and potential therapeutic strategies of AKI.