bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO670: Angiotensin Converting Enzyme Blockers, Angiotensin Receptor Blockers and Statins are Associated with a Reduction of Inflammation Markers Without Modification of the Peritoneal Membrane Transport Status in Peritoneal Dialysis
Authors: Zeiler Matthias , Silvestri Simona , Fioravanti Gilda , Pietro Lorenzo D I , Polci Rosaria , Fioravanti Giuseppe , Santarelli Stefano 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Therapy with angiotensin converting enzyme inhibitors (ACE) and angiotensin receptor blockers (ARB) as well as statins might protect the peritoneal membrane and vessels in peritoneal dialysis. The aim of this study was to analyse the effect of treatment on peritoneal transport and inflammation markers.

METHOD
The first two peritoneal equilibration tests in adult peritoneal dialysis patients, respectively, 6 and 12 months after dialysis start, were analysed for this retrospective study. Use of ACE, ARB and statins was registered. Serum C reactive protein (sCRP), blood leukocyte and platelet count were used as inflammation markers. Data sets of 220 examinations were acquired. Mann–Whitney U-test was performed for the comparison of therapy groups. Median patient age was 67 years.

RESULTS
A total of 84 measurements (38.2%) were without ACE and ARB, whereas 93 measurements (423%) without statins. Dialysate to plasma (D/P) creatinine in patients without ACE, ARB and statins was 0.64 (all median values, n = 41), respectively, in patients under therapy with ACE, ARB and statins 0.66 (n = 52).
Use of ACE and ARB without statins resulted in D/P creatinine 0.64 (n = 54), whereas use of statins alone in D/P creatinine 0.63 (n = 48). The difference between groups was statistically not significant. There was a tendency of higher values of D/P creatinine (median 0.68) in patients under therapy with ACE and statins (Fig. A). sCRP was higher in patients without ACE, ARB and statins compared to patients with ACE, ARB or statins (0.60 versus 0.30 mg/dL, P &lt; 0.05) (Fig. B). Furthermore platelet count was slightly higher in patients without ACE, ARB and statins (25 8000 versus 22 6000/mm3). Blood leukocyte count did not present significant differences (median values 6930 to 6855/mm3).

CONCLUSION
Our data suppose the absence of a protective effect of ACE, ARB and statins on peritoneal transport expressed by P/D creatinine despite reduced signs of systemic inflammation.
MO676: The Ratio Mean Platelet Volume/Platelet Count in Peritoneal Dialysis: Effect of Dialysis and Peritoneal Transport Status
Authors: Zeiler Matthias , Federico Antonio , Silvestri Simona , Fioravanti Giuseppe , Santarelli Stefano 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Mean platelet volume (MPV) is gaining scientific interest with regard to cardiovascular risk stratification. The MPV/platelet count ratio seems to be more specific than MPV alone as a surrogate parameter for platelet activation. The MPV/platelet ratio might be of interest in peritoneal dialysis (PD) as the distribution and integrity of endothelial–platelet interaction in the abdominal space determines its function. The aim of the study was to evaluate the modification of MPV/platelet ratio due to dialysis and its association to peritoneal transport status.

METHOD
In 123 PD patients (median age 65 years) MPV and platelet count were measured together with anthropometric patient data and peritoneal function at catheter placement and after 6 months during the first peritoneal equilibration test (PET). MPV and platelet count were determined with a fully automated hematological analyser. Correlation analysis was performed.

RESULTS
The MPV/platelet ratio decreased significantly from 3.99% at placement to 3.50% at the first PET (median values, Wilcoxon test P &lt; 0.001). Neither anthropometric data, nor creatinine clearance, nor BUN clearance, nor Kt/V (renal, peritoneal, total), nor erythrocyte sedimentation rate, nor C reactive protein were associated to MPV/platelet ratio. Only dialysate to plasma (D/P) urea and D/P creatinine were significantly correlated to MPV/platelet ratio (D/P urea r = 0.223, P = 0.01; D/P creatinine r = 0.199, P = 0.03). Slow transporters presented a significantly lower MPV/platelet ratio than average transporters (median values, 3.49% versus 3.83%, Mann–Whitney test P = 0.03).

CONCLUSION
PD is reducing significantly the MPV/platelet ratio. Differences in MPV/platelet ratio are reflected in the peritoneal transport status at 6 months after dialysis start. The reduction of the MPV/platelet ratio might respect a reduced platelet and endothelial activation even in the abdominal space.
MO685: Brain Oxygenation Assessed by Near-Infrared Spectroscopy During a Mental Task and a Mild Physical Stress in Hemodialysis and Peritoneal Dialysis
Authors: Faitatzidou Danai , Dipla Konstantina , Zafeiridis Andreas , Theodorakopoulou Marieta , Koutlas Aggelos , Polychronidou Georgia , Chalkidis Georgios , Dimitriadis Chrysostomos , Tsouchnikas Ioannis , Giamalis Panagiotis , Papagianni Aikaterini , Sarafidis Pantelis 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Cognitive impairment is highly prevalent in end-stage kidney disease (ESKD) individuals. Brain oxygenation is a parameter that plays major role in cognitive function. This study aimed to examine for the first time changes in brain oxygenation during a mental and a mild physical task in hemodialysis (HD) and peritoneal dialysis (PD) patients.

METHOD
A total of 63 ESKD patients (≥18 years old) were enrolled in this cross-sectional study. Patients were allocated in two groups according to dialysis modality (n = 29 HD and n = 34 PD). All participants underwent a mental (countdown from 100 to 0 by 7, performed twice) and a mild physical task (a 3-min intermittent handgrip exercise at 35% of maximal handgrip strength). Changes in brain oxygenation [oxy—(O2Hb), deoxy—(HHb) and total—(tHb) hemoglobin] during the two tasks were continuously recorded via near-infrared spectroscopy (NIRS, Artinis).

RESULTS
Age, sex and dialysis vintage did not differ between the two groups. The average response in brain oxygenation during the mental task (O2Hb change from rest: 1.51 ± 1.68 versus 1.60 ± 1.82 μmol, in HD and PD, respectively, P = 0.841), as well as the duration needed for task completion (191.53 ± 124.27 versus 200.19 ± 118.84 s, P = 0.781) were similar between groups. Furthermore, the average response in brain oxygenation during the handgrip exercise also did not differ between the groups (O2Hb change 1.20 ± 1.03 versus 1.49 ± 0.95 μmol, respectively, P = 0.262). In the total cohort, the average response in brain oxygenation during handgrip exercise was inversely correlated with dialysis vintage (P &lt; 0.05).

CONCLUSION
Dialysis modality does not appear to have an impact on brain oxygenation, as HD and PD patients presented similar responses during a mental and a mild physical task. Dialysis vintage may negatively affect brain oxygenation in ESKD individuals.
MO694: Analysis of Mechanical Complications in Urgent-Start Peritoneal Dialysis
Authors: Nardelli Luca , Scalamogna Antonio , Cicero Elisa , Tripodi Federica , Castellano Giuseppe 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Peritoneal dialysis (PD) is an excellent, but underutilized dialysis technique. Thus, its implementation might depend on the chance to offer this modality of treatment to late referral patients. This approach has been recently named ‘urgent-start peritoneal dialysis’ (UPD). The major barrier to this practice is represented by the belief that peritoneal exchanges can be safely started at least 2 weeks after catheter insertion, due to the concern of early mechanical complications. The study investigated the efficacy and safety of an UPD approach in our PD program.

METHOD
Between 1 January 2009 and 31 December 2019 all prevalent patients needing UPD at our institution were included in the study. During this period, 242 peritoneal catheters were inserted in 222 patients (Table 1). One hundred forty-eight catheters were positioned semi-surgically, while 94 were inserted surgically. In all patients, an anti-leakage/dislocation suture was made. PD was started within 24 h from catheter placement and peritoneal exchange scheme characterized by progressively increasing volume was used; early and late mechanical complications were also analysed. Finally, all the causes of PD technique and catheter failure were reported.

RESULTS
The early incidence of leakages, catheter dislocations, omental wrappings, bleeding, peritonitis and exit-site infections was 11/242 (4.5%), 5/242 (2%), 3/242 (1.2%), 2/242 (0.8%), 6/242 (2.5%) and 4/242 (1.6%), respectively (Table 2). No bowel perforations were observed. The long-term leakage rate and catheter dislocation were 0.016 and 0.019 episodes/patient-year, respectively (Table 3). The survival of the catheter at 3, 6, 12, 24, 36 and 48 months was 93.6, 91.2, 84.8, 77.4, 65.5 and 59.3%, respectively (Fig. 1). The technique survival at 3, 6, 12, 24, 36 and 48 months was 97.2, 94.9, 87.6, 78.9, 66.6 and 60.0%, respectively (Fig. 2). The main cause of PD dropout was represented by infectious complications (nearly 40%) and mechanical complications (17.5%) leading to catheter failure (Fig. 3). No significant difference in the first catheter survival among the semi-surgical and the surgical arm was observed (HR 0.88 [CI 0.54–1.45], P = 0.62 [Fig. 4]).

CONCLUSION
A tight seal between deep cuff and surrounding tissue (double-purse string technique) with a low-volume exchange scheme allows starting UPD soon after catheter insertion minimizing mechanical complications. In patients without previous abdominal interventions semi-surgical technique is as effective as the surgical procedure in preventing early mechanical complications.
MO726: Skin Autofluorescence Profile in Tunisian Hemodialysis Patients with and Without Heart Failure
Authors: Ajimi Khawla , Sabra Aloui , Denden Ghada , Ben Tekaya Nawres , Ben Salem Meriem , Ben Salah Manel , Letaief Ahmed , Hammouda Mouna , Skhiri Habib , Kerkeni Mohsen 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Cardiovascular disease (CVD) is the main reason for morbidity and mortality of patients in hemodialyis. Skin autofluorescence (SAF), a noninvasive measurement method, reflects tissue accumulation of advanced glycation end products (AGEs) that have been implicated in CVD as a strong marker. The aim of this study was to evaluate the SAF profile in hemodialysis patients and to assess the association between SAF and heart failure.

METHOD
In a cross-sectional study, we included 60 hemodialysis (HD) patients who were divided into two groups: a HD group without heart failure (n = 42) and a HD group with heart failure (n = 18). Skin AGE accumulation was measured by the AGE reader device and clinical data was obtained.

RESULTS
HD patients showed an SAF value at 2.90 (2.40–3.60). HD patients with diabetes mellitus has an increased SAF levels compared with HD patients without diabetes [3.20 (2.90–3.95) versus 2.70 (2.30–3.30) AU, P = 0.021, respectively]. Furthermore, HD patients with heart failure showed a significant increased SAF levels compared with HD patients without heart failure [3.65 (2.90–4.12) versus 2.60 (2.30–3.20) AU; P &lt; 0.001, respectively]. SAF was associated with age, gender and duration of dialysis. The ROC analysis indicated that SAF at 3.05 AU was the optimal cut-off point for the presence of heart failure (P &lt; 0.001).

CONCLUSION
SAF might be a rapid and helpful tool in clinical practice as a potential marker for evaluating and screening heart failure in HD patients non-invasively and might be used as a predictor for clinicians.
MO729: Chronic Heart Failure in Haemodialysis Patients
Authors: Borodulina Ekaterina , Shutov Alexander M 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Left ventricular hypertrophy (LVH) and chronic heart failure (CHF) develop before the initiation of renal replacement therapy in most patients. Haemodialysis significantly changes the clinical of CHF. But the problem of CHF in haemodialysis patients remains extremely urgent because CHF is one of the most important causes of the development of life-threatening heart rhythm disturbances, which are the direct cause of death in haemodialysis patients. The aim of this study was to investigate the prevalence of symptomatic (NYHA Class II-IV) CHF in haemodialysis patients.

METHOD
Haemodialysis patients (n = 159; 77 males, 82 females, mean age was 55.6 ± 12.5 years) were studied. Echocardiography and Doppler echocardiography were performed according to the criteria of the American Society of Echocardiography and the European Association of Cardiovascular Imaging. Left ventricular mass index (LVMI) was calculated. Left ventricular ejection fraction (LVEF) was measured by the echocardiographic Simpson method. The parameters of left ventricular diastolic function were evaluated by Doppler echocardiography. CHF was diagnosed according to criteria of the guidelines for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (2016). In addition, the assessment of CHF was carried out according to the ADQI heart failure in ESRD classification system (Table 1).

RESULTS
LVH was diagnosed in 116 (73%) patients. LVMI was 123.23 ± 22.32 g/m2. Concentric left ventricular hypertrophy was revealed in 106 (66.7%) patients, eccentric left ventricular hypertrophy was in 10 (6.3%) patients, concentric left ventricular remodelling was in 34 (21.4%) patients. Left atrial volume index &gt; 34 mL/m2 was identified in 98 (61.6%) patients. E/e’≥13 was determined in 31 (19.5%) patients. Only 6 (3.8%) patients had LVEF˂50%. Symptoms of CHF were found in 49 (30.8%) patients. Class 2R was in 4 (2.5%) patients, class 2NR was in 36 (22.6%) patients, class 3R was in 1 (0.6%) patient and class 3NR was in 8 (5%) patients.

CONCLUSION
LVH was diagnosed in 73% haemodialysis patients. Most patients have left ventricular diastolic dysfunction. Symptoms of CHF were detected in 30.8% patients. These symptoms persist after RRT/UF in most patients.
MO745: Serum Endocan as a Risk Factor for Aortic Stiffness in Patients on Maintenance Hemodialysis
Authors: Huang Hsiang-Jung , Wu Tzu-Chiang , Lai Yu-Hsien , Lin Yu-LI , Hsu Bang-Gee 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Endocan is secreted by the activated endothelium and plays a central role in inflammation and endothelial dysfunction, angiogenesis and vascular smooth muscle cell proliferation, it is associated with cardiovascular disease. This cross-sectional study aimed to assess the relationship between serum endocan levels and carotid–femoral pulse wave velocity (cfPWV) in patients on maintenance hemodialysis (HD).

METHOD
Blood samples and baseline characteristics were collected from 122 HD patients. Serum endocan concentrations were measured with an enzyme-linked immunosorbent assay kit. Aortic stiffness was defined as a cfPWV of more than 10 m/s.

RESULTS
Of the 122 HD patients, aortic stiffness was diagnosed in 53 (43.4%), and higher percentages of diabetes (P &lt; 0.001) and hypertension (P = 0.030) were of older age (P = 0.007) and had higher systolic blood pressure (P = 0.011) and endocan levels (P &lt; 0.001) in those with aortic stiffness than those without. After adjusting for factors significantly associated with aortic stiffness by multivariate logistic regression analysis, serum endocan [odds ratio (OR) 1.566, 95% confidence interval (95% CI) 1.224–2.002; P &lt; 0.001], age (OR 1.040, 95% CI 1.001–1.080; P = 0.045), and diabetes (OR 4.067, 95% CI 1.532–10.798; P = 0.005) were independently associated with aortic stiffness in patients with chronic HD. Multivariable forward stepwise linear regression analysis also confirmed that the logarithmically transformed endocan level (β =0.405, adjusted R2 change = 0.152; P &lt; 0.001) was an independent predictor of cfPWV values. The area under the receiver operating characteristic (ROC) curve predicting aortic stiffness by serum endocan level was 0.713 (95% CI 0.620–0.806; P &lt; 0.001).

CONCLUSION
Serum endocan level positively correlates with cfPWV and is also an independent predictor of aortic stiffness in maintenance HD patients.
MO754: Impact of Calcium-to-Magnesium Ratio on Carotid Intima-Media Thickness—Cardiovascular Risk Assessment in Haemodialysis
Authors: Calças Marques Roberto , Afonso Rita , Borges Henrique , Carias Eduarda , Guilherme Patricia , Malho Guedes Anabela , Fragoso André , Silva Ana 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Cardiovascular disease (CVD) is the leading cause of death in chronic kidney disease patients. The interaction between calcium and magnesium has been associated with several pathophysiological processes that occur in the vessel wall, such as endothelial dysfunction and vascular calcification. The aim of this study was to assess the relationship between calcium-to-magnesium (Ca: Mg) ratio and carotid intima-media thickness (CIMT), a widely used risk marker for CVD in the assessment of subclinical atherosclerosis. This study also aimed to establish the role of the Ca: Mg ratio as a predictor of cardiovascular mortality in haemodialysis (HD).

METHOD
Prevalent HD patients were enrolled in the longitudinal prospective study in a single tertiary centre. According to CIMT measured through B-mode ultrasound, the patients were divided into two groups: ≥0.9 mm (G1) and &lt;0.9 mm (G2). Data from both groups were compared by Student's t-test. Partial correlation was used to assess the relationship between the variables under analysis and the CIMT, when controlled by dialysis time. The prevalence ratio of predictors of carotid thickening was calculated using a Poisson model with robust variance. Multivariable Cox regression analysis was performed to determine the predictive factors of cardiovascular death.

RESULTS
A total of 120 patients on HD were included with mean age 66.5 ± 13.97 years, 66.7% male. Magnesium (P &lt; 0.001), Ca: Mg ratio (P &lt; 0.001) and Adragão score (P &lt;0.001) were statistically different between the two groups (Table 1). The partial correlation showed a strong positive association between CIMT and Ca: Mg ratio (r = 0.873; P &lt;0.001) and a moderate association between CIMT and Adragão score (r = 0.614, P &lt; 0.001), whereas there was a moderate negative correlation between CIMT and magnesium (r = –0.671, P &lt;0.001). The Poisson model showed high prevalence of carotid thickening for higher values ​​of Ca: Mg ratio [aPR = 1.055, 95% confidence interval (95% Cl) 1.007–2.176] and Adragão score (aPR = 1.106, 95% Cl 1.006–1.351), and for lower magnesium values ​​(aPR = 0.462, 95% CI 0.248–0.861). Using the multivariate Cox model, age (HR = 1.045, 95% CI 1.012–1.084), Adragão score (HR = 1.078, 95% CI 1.006–1.234) and Ca: Mg ratio (HR = 1.154, 95% CI 1.098–2.236) were predictors of cardiovascular mortality.

CONCLUSION
In our population, the Ca: Mg ratio was a predictor of carotid thickening, so its monitoring can be useful to identify patients at higher cardiovascular risk. The Ca: Mg ratio was further validated as a predictor of cardiovascular mortality in HD patients. More studies are needed to better understand the relationship between this ratio and cardiovascular events.
MO755: Comparison of Techniques for Fluid Status Assessment in Chronic Hemodialysis Patients
Authors: Ekart Robert , Piko Nejc , Vodošek Hojs Nina , Jakopin Eva , Bevc Sebastjan , Hojs Radovan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Several methods have been developed to assess hydration status in chronic haemodialysis (HD) patients. The aim of this study was to compare multifrequency body bioimpedance spectroscopy (MBIS) with ultrasound lung comet scores (ULCs) and inferior vena cava diameters (IVCD) using ultrasound to estimate dry weight on the non-dialysis day.

METHOD
We evaluated MBIS, ULCs at 28 typical sites and IVCD during expiration in 40 HD patients. All measurements were performed on a non-dialysis day. For MBIS measurement, we used the Body Composition Monitor (Fresenius Medical Care, Bad Homburg, Germany), and for ULCs and IVCD, we used an ultrasound device (Esaote MyLabOmega, Genoa, Italy). Overhydration was defined as &gt; 2L with MBIS, &gt; 15 ULCs, and &gt; 11.5 mm/m2 IVCD.

RESULTS
Mean age of patients was 65 (40–89) years, and 29 (72.5%) were men. Other descriptive data are in Table 1. We found a significant correlation between MBIS and ULCs (r = 0.464, P &lt;0.003) and between MBIS and IVCD (r = 0.589, P &lt;0.001). Multiple regression analysis with the MBIS as the dependent variable and ULCs, IVCD, albumin and haemoglobin as independent variables confirmed a statistically significant relationship between MBIS and IVCD (β = 0.436; P &lt; 0.001). According to the overhydration criteria, 14 (35%) patients were overhydrated by MBIS, 8 (20%) patients by ULCs and 9 (22.5%) patients by IVCD. Only 4 (10%) patients met overhydration criteria simultaneously by all three methods (MBIS, ULCs and IVCD).

CONCLUSION
All methods were able to describe overhydration in HD patients on a non-dialysis day. The MBIS was associated with the IVCD.
MO769: Utility of Doppler Ultrasonography in the Evaluation of Arteriovenous Fistula, a Nephrologists Perspective
Authors: Gouthami Bendalam , Prasad Nagaraju Shankar , Attur Prabhu Ravindra , Rangaswamy Dharshan , Ramachandra Rao Indu , Vinayak Shenoy Srinivas , Bhojaraja Mohan V , Mulpuri Niharika 
Published: May 2022

Abstract

BACKGROUND AND AIMS
An arteriovenous (AV) fistula is preferred for long-term haemodialysis vascular access. AV fistula creation requires adequate arterial and venous anatomy to support its creation and a sufficient time interval to allow the AV fistula to mature prior to its use. Failure to mature remains a problem highlighting the importance of the perioperative evaluation of the fistula. Ultrasound and colour doppler are a rapid, non-invasive and repeatable tools that can be used for the early diagnosis of vascular complications.

METHOD
A prospective, observational study was conducted at a tertiary hospital in South India. All the patients with arteriovenous fistulas made in the upper limb between the time period of June 2021–August 2021 were included. A preoperative doppler mapping and assessment of the upper lime was done by the nephrology team and two DUS exams in the post-operative period.

RESULTS
In our study, a total of 134 patients were evaluated with a mean age of 51.89 ± 13.7 years. The total number of males in the study was 115 (85.8%). The aetiology of end-stage renal disease (ESRD) was predominantly nondiabetic in origin seen in 56.7% of the patients. Ischaemic heart disease was seen in 36 patients. There were 116 brachiocephalic,18 radiocephalic AV fistulas in our group of patients. The overall success rate of the fistula was 79.9%. The average vein diameter in patients with successful AV fistula was 3.03 ± 1.05 mm and was 2.25 ± 0.9 mm in those who had a failed fistula. The average blood flow measurement in the proximal artery supplying the fistula was 479.42 ± 113.1 mL/min in the immediate post-op period and 1055.88 ± 227.6 mL/min at 6 weeks. There was a significant difference (P&lt;0.05) in the blood flow measurement between those who achieved primary patency versus those with failure to mature.

CONCLUSION
It is essential for a practicing nephrologist to be acquainted with the technique of doppler to assess AV fistula to assess for maturity and to see for.