bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO1032: Assessing the Effectiveness of Ready Steady Go—Peeer Project Youth Work in Meeting the Psychosocial Needs of Children and Young People
Authors: Nagra Arvind , Shameti Sarah , Stubbs Eleanor , Gilbert Rodney , Haq Mushfaquar , Anderson Caroline , Preka Evgenia , Recio-Saucedo Alejandra , Darlington Anne-Sophie 
Published: May 2022

Abstract

BACKGROUND
Studies show that young people (YP) with chronic kidney disease do less well than their well peers in terms of mental health and employability. In the UK 30% of YP on renal replacement therapy have mental health issues compared to 15% of the general population and more are unemployed compared with their well peers. Many of the issues start in childhood as studies show that children with chronic kidney disease have significant psychosocial issues including:
To address these issues, we developed the PEEER project to help improve Patient Empowerment, self-Esteem, Employability and Resilience.
Pre-coronavirus disease (COVID-19) PEEER youth worker support was delivered face-to-face (F2F) in a 1:1 setting or group sessions in the hospital, youth spaces, or educational settings.
With the onset of lockdown due to the COVID-19 pandemic from 23 March 2020 PEEER youth worker support was adapted to be delivered virtually on the ZOOM platform to meet the needs of CYP.

AIMS
To assess the effectiveness of PEEER youth work project in meeting the psychosocial needs of children and young people with kidney disease when delivered virtually compared with F2F.

METHOD
Group 1: Pre-COVID-19 lockdown: 1 January 2020–23 March 2020 CYP and their families received youth worker support F2F. Group 2: During COVID-19 lockdown: 23 March 2020–31 December 2020 youth work was delivered virtually.
CYP in Groups 1 and 2 received 1:1 sessions, fun group activities and workshops. Feedback was collected on the effectiveness of these sessions.

RESULTS
CYP: Group 1 n = 105. Group 2 n = 639. In Group 2 there was a 102% increase/month in CYP accessing PEEER events. In both Groups, 100% said they enjoyed the sessions, would like to attend future sessions. CYP in both Groups felt part of a friendship group, said the sessions allowed them to socialize with their peers. CYP in both Groups felt more confident, more independent and good about themselves. (See Table 2.)

CONCLUSION
PEEER youth worker support is effective and can meet the psychosocial needs of CYP when delivered virtually and F2F. More work is needed on a hybrid approach of F2F and virtual delivery.
MO1040: Idiopathic Nephrotic Syndrome After 10 Years of Age: Is Systematic Renal Biopsy Appropriate?
Authors: Smith Anna , Dossier Claire 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Renal biopsy (RB) is recommended at diagnosis for children presenting with isolated nephrotic syndrome (NS) after the age of 10–12 years, unlike in younger children, because of a higher frequency of other diagnoses than MCD or FSGS. Recent reports, local practices and new serological biomarkers for membranous nephropathy now question this approach. Therefore, the objective of our study was to evaluate the causes of NS and indications for RB in a population-based cohort of adolescents with NS.

METHOD
We conducted a retrospective multicenter study, including children aged 10–18 years diagnosed with Idiopathic-like NS between December 2007 and June 2020 in 35 paediatric and 3 paediatric nephrology (PN) departments of the Paris area (NEPHROVIR network) and patients with Idiopathic-looking NS biopsied in the three PN departments.

RESULTS
A total of 103 children were included (54 males). The mean age at diagnosis was 13.4 ± 2 years. A renal biopsy was performed in 76 patients: at presentation because of atypical symptoms (such as hypertension, macroscopic haematuria, organic renal failure) in 15 or for no other reason than age in 39 and after 4 weeks for steroid resistance +/– atypies in 22 patients. Histological findings were MCD (n = 49), FSGS (n = 13), mesangial proliferation (n = 3), membranous nephropathy (n = 6) and IgAN (n = 5).

CONCLUSION
NS was secondary in only 11% of adolescents presenting with Idiopathic-like NS, and first-line treatment with oral prednisone was appropriate in all cases. In addition, more than 40% of RB could have been avoided in steroid-sensitive NS patients. Finally, we propose that RB should only be performed in case of atypical clinical or biological history or steroid resistance after 4 weeks, as in the younger population.
MO1043: Influenza Vaccine Awareness and Acceptance Among Individuals with Glomerulonephritis and Renal Vasculitis During the Corononavirus Disease 2019 Pandemic
Authors: Lim Cynthia , Hong Liew Zhong , Zhuan Tan Hui , Mok Irene , Jie Leeu Jun , Choo Jason 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Patients with glomerulonephritis may have an increased risk of influenza infection and morbidity, but vaccine coverage remained low with little data on acceptance in glomerulonephritis. We aimed to assess influenza vaccine awareness among patients with glomerulonephritis and identify determinants of vaccine acceptance.

METHOD
Single-center cross-sectional study of patients with glomerulonephritis who completed a survey in the clinic or over the telephone between June and August 2021. Sociodemographic data, health literacy measured by HLS-EU-47 questionnaire, influenza and the coronavirus disease (COVID-19) vaccine awareness and determinants of vaccine acceptance according to the World Health Organization framework.

RESULTS
Among 86 patients who completed the survey, influenza vaccine awareness was lower than COVID-19 vaccine awareness (75.6% versus 100%). After adjusting for the survey type, use of English language at home and at healthcare settings, higher income and professional or executive occupation were significantly associated with influenza vaccine awareness, while older age and lower education level were associated with reduced awareness. The healthcare provider was the most frequent information source and &gt; 90% trusted that healthcare providers and the government considered the patients’ best interests and gave correct information. Only half thought their medical condition and medications would affect their vaccine decision while a quarter to half did not understand how the vaccine worked and thought there were better ways to protect against infection.

CONCLUSION
Healthcare providers can actively identify and advocate influenza vaccines to the unaware and overcome potential barriers to reduce influenza infections and morbidity in glomerulonephritis.
MO1055: Effect of Duration of Adjuvant Chemotherapy for Patients with Colorectal Cancer on the Deterioration of Glomerular Filtration Rate
Authors: Gładyś Aleksandra , Kozak Sylwia , Gisterek Iwona , Chudek Jerzy 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Six-month adjuvant chemotherapy (CTH) is the current standard of care in locally advanced colorectal cancer (CRC). Recent studies have shown that shortening the treatment to 3 months results in moderately worse (0%–4% difference) overall survival. A longer duration of CTH may pose a risk of nephrotoxicity. We aimed to assess the effect of the duration of adjuvant CTH for CRC on kidney excretory function.

METHOD
We retrospectively studied medical records of 96 patients aged 38–83 (51% males) treated with adjuvant CTH for CRC. Patients underwent CTH either with regimens containing oxaliplatin and 5-fluorouracil/capecitabine (FOLFOX—31.3%; or XELOX—18.8%) or regimens containing 5-fluorouracil only (5-FU/LV; 50%). Glomerular filtration rate (calculated with the CKD-EPI formula) was analysed in three time points: before CTH, after 3 and 6 months of therapy. The deterioration of eGFR by 1.5 mL/min/1.73 m2 or more after 3 months and by 3 mL/min/1.73 m2 or more after 6 months was considered clinically significant.

RESULTS
We observed a clinically significant loss of eGFR after 3 months in 56.3% of patients. The risk of eGFR loss after 3 months was not related to gender, CTH regimen, clinical stage, initially low eGFR or comorbidities (P &gt; 0.05). However, the clinically significant loss of eGFR was related to age (mean age 65.1 versus 61.3 years without eGFR loss; P = 0.03).
Two-thirds (66.8%) of all patients were assessed in a 6-month time point. In this group, a significant eGFR loss was present in 42.4% of cases. Similarly, eGFR deterioration after 6 months was not related to proposed risk factors such as gender, CTH regimen type, clinical stage, low eGFR or comorbidities (P &lt; 0.05), but was associated with age (mean age 66.3 versus 60.9 years without eGFR loss; P = 0.04). We observed a significant deterioration of eGFR more frequently in patients treated with 5-FU/LV regimens than with FOLFOX or XELOX (P = 0.03). However, patients, who underwent CTH with 5-FU/LV were older (P &lt; 0.001), had lower initial eGFR (P = 0.02) and had hypertension more often (P = 0.03) than patients treated with oxaliplatin-containing regimens.
In 92.9% of patients with significant eGFR loss after 6 months, we were able to observe rapid eGFR loss earlier, in a 3-month time point. However, one-third (31.6%) of patients with significant eGFR loss after 3 months did not present it after 6 months (P &lt; 0.001). In patients with significant loss after 3 months, further deterioration after the next 3-month period occurred in 8 cases (21.1%), with a mean loss of 7.7 mL/min/1.73 m2.

CONCLUSION
Adjuvant CTH for CRC may cause a rapid loss of eGFR. The assessment of eGFR after 3 months of CTH is a predictor of further eGFR decline. Further investigation is needed to conclude if the shortage of CTH duration from 6 to 3 months may be beneficial for older patients in the context of nephrotoxicity.
FC002: Humoral and Cellular Immune Responses After a Three-Dose Course of Mrna-1273 Covid-19 Vaccine in Kidney Transplant Recipients: A Prospective Cohort Study
Authors: Cucchiari David , Egri Natalia , Rodríguez Diana , Montagud-Marrahi Enrique , Casals Joaquim , Del Risco Zevallos Jimena , Ventura Aguiar Pedro , Cofan Pujol Federico , Rovira Jordi , Jose Ramirez Maria , Banon Elisenda , Revuelta Ignacio , Oppenheimer Federico , Enriqueta Bayes Genis Beatriu , Diekmann Fritz 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Seroconversion after a two-dose course of mRNA COVID-19 vaccination in kidney transplant recipients ranges between 30% and 50% in different series. We previously demonstrated that a substantial proportion of patients (35%) without a humoral response, develop a cellular response after the second dose assessed by the ELISpot technique. We aim to study the evolution of both humoral and cellular responses in the same cohort before and 1 month after the administration of the third dose of 100 mcg of mRNA-1273 COVID-19 vaccine.

METHOD
Final population included 129 KTRs studied at four time-points: at baseline before the first dose, after the second dose (median 42 days) and before (203 days) and after (232 days) the third dose. At all the time-points, IgG and IgM were assessed as well as N- and S-protein specific ELISpot. The main outcome was seroconversion after the third dose.

RESULTS
After the second dose, 26.7% of naïve cases experienced seroconversion. Before the third dose and in the absence of clinically evident COVID-19, this percentage increased to 61.9%. After the third dose, seroconversion was observed in 80.0% of patients. S-ELISpot positivity after the second dose was significantly associated with final seroconversion [OR (95% CI) 3.14 (1.10–8.96); P = .032], while transplantation &lt; 1 year and previous kidney transplant were negatively associated with [OR (95% CI) 0.23 (0.07–0.80); P = .021 and OR (95% CI) 0.22 (0.06–0.78); P = .020, respectively). IgG after third dose were significantly higher (P &lt; .001) in patients who maintained S-ELISpot positivity throughout the study (34.3%) and were correlated with S-spots after the second dose (r = 0.344, P &lt; .001).

CONCLUSION
A substantial proportion of KTRs vaccinated with mRNA-1273 develops a late seroconversion after two doses and only a fifth remained seronegative after a third. Cellular immunity seems to play a major role in the development of a final strong humoral response.
FC007: The Impact of Sex on the Risk Of Major Adverse Cardiovascular Events in Older Adults with Advanced Chronic Kidney Disease: Results from the Equal Study
Authors: Astley Megan , W. Dekker Friedo , Evans Marie , Caskey Fergus , Torino Claudia , Porto Gaetana , Szymczak Maciej , Drechsler Christiane , Wanner Christoph , Jager Kitty J , Chesnaye Nicholas 
Published: May 2022

Abstract

BACKGROUND AND AIMS
In the general population, men have a higher risk of major adverse cardiovascular events (MACE) compared with women, with this risk difference between men and women decreasing with increasing age. Patients with chronic kidney disease (CKD) are at a higher risk of MACE compared with the general population, but sex differences in this group, especially older adults, are not fully known. We aim to identify differences in the risk of (recurrent) MACE by sex in CKD patients over 65 years old from Europe and explore factors that may explain these differences.

METHOD
The European Quality study (EQUAL study) is a prospective study on stage 4–5 CKD patients not on dialysis from Germany, Italy, Poland, Sweden, the UK and the Netherlands who were ≥ 65 years old. Cox regression and cumulative incidence competing risk curves were used to calculate MACE risks. Mediation analysis was used to identify variables that may explain risk differences between men and women.

RESULTS
In 1136 men and 607 women, over a follow-up period of 5 years, 417 (37%) men and 185 (31%) women experienced at least one MACE, and there was a total of 1247 MACE. Men and women had 123 (14% of total MACE in men) and 54 (14% of total MACE in women) fatal MACE, respectively. The most common type of first MACE was peripheral vascular disease for men and congestive heart failure for women (Fig. 1). Accounting for the competing risk of non-MACE death, the probability of having a first MACE was 43% (95% CI: 40–47%) for men and 39% (95% CI: 34–44%) for women (Fig. 2), corresponding with a 18% lower relative risk of first MACE in women (HR: 0.82; 95% CI: 0.69–0.97; P = 0.02 ). There was no significant difference in the risk of recurrent MACE (HR: 0.91; 95% CI: 0.80–1.03; P = 0.14 ) or fatal MACE (HR: 0.84; 95% CI: 0.61–1.16; P = 0.30) between men and women. Adjusting for pre-existing comorbidities attenuated the MACE risk difference between men and women. MACE risk differences between men and women changed according to age group but not according to diabetes status. In those ≤ 75 years, women had a 25% lower risk of first MACE (HR: 0.75; 95% CI: 0.57–0.99; P = 0.04), which was 15% in those &gt; 75 years old (HR: 0.85; 95% CI: 0.68–1.06; P = 0.14 ). The risk difference of fatal MACE between men and women differed greatly between those ≤ 75 years old (HR: 1.38; 95% CI: 0.82–2.33; P = 0.22 ) and those &gt; 75 years (HR: 0.61; 95% CI: 0.41–0.93; P = 0.02).

CONCLUSION
Men had a higher probability of having a MACE over a 5-year period. Overall, women had lower risks of MACE compared with men, but risk differences between men and women changed with increasing age. Pre-existing comorbidities explained part of this risk difference.
FC015: High Salt Environment Disrupts the Regulatory Effect of Podocin on the Nephrin-Nephrin Distance
Authors: Antal-Kónya Violetta , Pap Domonkos , Schay Gusztáv , Kétszeri Máté , Ungvári-Veres Anita , Tulassay Tivadar , Kellermayer Miklós , Karancsiné Menyhárd Dóra , Tory Kálmán 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The podocin encoding NPHS2 is the most frequently mutated gene in steroid-resistant nephrotic syndrome. Podocin homooligomerizes through C-terminal helical regions [1] and binds nephrin in the glomerular slit diaphragm [2]. We formerly showed that podocin regulates the distance between two neighbouring nephrin molecules in cis, i.e. the shortest dimension of the glomerular pore (3.5-4nm) [3, 4].
High sodium diet has been shown to promote glomerular injury and proteinuria [5]. We aimed to assess the effect of high salt environment on the nephrin-nephrin distance in the presence and absence of podocin.

METHODS
To generate extracellularly tagged nephrin constructs, cDNA sequences encoding YPet or mCherry were inserted in the human wild type nephrin cDNA (YPet-N1 plasmid) replacing the c.3136-3162 nucleotides. Thus, the p.Glu1046-Pro1054 residues of the fibronectin domain, located in the juxtamembraneous extracellular part of nephrin was replaced with either YPet or mCherry. HEK-293 cells were co-transfected with both nephrin constructs with or without wild type HA-tagged podocin construct (pLEX-MCS plasmid). To measure the effect of salt overload, DMEM was supplemented with either 25 mM NaCl or 50 mM mannitol as osmotic control 24-h prior to the FRET measurements. The fluorescence decay curves measured by time-correlated single photon counting (TCSPC) (Chronos BH, ISS Inc.) were decomposed into lifetime components and the longest lifetime population—most suitable for long-range FRET—was used for further calculations. Nonparametric tests were used for statistical analysis.

RESULTS
High salt environment did not influence the nephrin-nephrin distance in the absence of podocin. In accordance with our previous results, podocin decreased the nephrin-nephrin distance in physiological salt environment, as reflected by an increased FRET efficiency between the extracellular YPet and mCherry tags. High salt environment (+25 mM) completely disrupted this effect. Mannitol of similar osmotic concentration did not modify the effect of podocin (Figure 1).

CONCLUSION
High salt environment increases the distance between the nephrin molecules in cis by disrupting the organizing effect of podocin. The deleterious effect of high salt is not explained by an increased osmotic pressure.
FC094: Frax is Useful Tool for Predicting All-Cause Mortality in Addition to the Risk of Fragile Fracture in Hemodialysis Patients
Authors: Fujii Takayuki , Suzuki Satoshi , Tanaka Hiroaki 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The fracture risk assessment tool (FRAX®) was developed to predict the probability of fragile fractures during the next 10 years for the general population, and it is calculated by inputting risk factors of fractures such as age, gender, height, weight, fracture history, presence or absence of rheumatoid arthritis and steroid therapy. Although contents of FRAX do not include CKD as a risk factor, previous studies have shown that FRAX was useful in predicting fracture risk in maintenance dialysis patients. However, many reports are short-term observational studies targeting fracture risk. In the present study, we examined whether FRAX can be useful to predict the risk of fragile fractures and all-cause mortality in hemodialysis patients through the long-term observation.

METHOD
A retrospective cohort study was conducted in 273 patients aged 40 to under 90 who started hemodialysis at our hospital between March 2004 and the present and who could be followed for at least 3 years or had a fracture within 3 years. In order to assess the association between FRAX score and fragile fracture or all-cause mortality, a multivariate analysis was performed using the Cox proportional hazard model with factors related to fractures and mortality as covariates. The 10-year probability (%) of major osteoporotic fracture without bone mineral density was adopted as the FRAX score.

RESULTS
The average follow-up period was 6.7 years, and the average age of patients was 66 years, with women accounting for 29%. Of all 273 patients, 55 developed fragile fractures and 97 died. FRAX scores were divided into two groups (lower FRAX score and higher FRAX score) in accordance with a cut-off value of 8.2%, determined by ROC curve for fracture. Univariate analysis of factors associated with fractures revealed that higher FRAX score (8.2 or more) was a significant factor [hazard ratio (HR): 4.49 (2.59–7.85)]. Multivariate analysis conducted with significant factors in univariate analysis (mean serum albumin level, serum phosphorus level, magnesium level, C-reactive protein level and use or non-use of phosphate binder during the 3 years) as the covariates revealed that higher FRAX score was significantly associated with fractures [HR: 2.40 (1.27–4.5)]. Regarding the association between FRAX score and all-cause mortality, in univariate analysis, higher FRAX score was a significant predictive factor [HR: 4.34 (2.84–6. 64)]. In multivariate analysis adjusted with mean serum albumin level, creatinine level, magnesium level, C-reactive protein level, hemoglobin level, use or non-use of phosphate binder and calcimimetics as the covariates, higher FRAX score was found to be a significant factor of all-cause mortality [HR: 3.22 (1.97–5.22)].

CONCLUSION
FRAX score was also a useful tool for predicting fractures and all-cause mortality in hemodialysis patients even in long-term analysis.
FC 109: Microvascular Inflammation in Kidney Transplant Biopsies in the Absence of HLA-DSA Displays Intense Cytotoxic T-Cell and NK Cell but not Plasma Cell Infiltration
Authors: Buxeda Anna , Llinàs-Mallol Laura , Gimeno Javier , Redondo Pachon Dolores , Arias-Cabrales Carlos , Burballa Carla , Puche Adrián , José Pérez-Saéz María , Pascual Julio , Crespo Marta 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Microvascular inflammation (MVI) without evidence of HLA-donor-specific antibodies (HLA-DSA) or C4d+ deposition remains an enigmatic phenotype, which cannot be classified as antibody-mediated rejection (ABMR) according to recent Banff classifications. We aimed to compare peripheral blood lymphocyte (PBL) distribution and infiltrating immune cells in kidney transplant (KT) biopsies presenting MVI (g + ptc ≥ 2) without C4d+ and HLA-DSA, ABMR and normal histology to explore the role of immune cells in these entities.

METHODS
A total of 221 allograft biopsies with ABMR (n = 73), MVI (n = 32) and normal (n = 116) diagnoses were analysed.

RESULTS
MVI patients showed a decrease in the absolute number of T-cells compared with ABMR and normal cases (P = 0.020 and P = 0.006) due to a significant decrease of CD4+ T-cells compared to normal cases (P = 0.013) and a reduction of CD8+ T-cells compared with ABMR (P = 0.029). ABMR and MVI presented a lower absolute number of circulating Natural Killer (NK) cells than normal cases. Immunohistochemistry assessment was performed in 22 ABMR, 13 MVI and 16 normal cases. Glomeruli in ABMR and MVI had more T-cells and CD68+ infiltration than normal biopsies, although TIA1+ was only increased in MVI (P &lt; 0.001), suggesting increased T-cell cytotoxic capacity. Peritubular capillaries displayed more circulating T-cells, CD56+ TIA1+ and CD68+ in ABMR and MVI groups. Contrarily, MVI cases showed mild circulating plasma cell infiltration (CD138+) in peritubular capillaries (P = 0.059) and interstitial aggregates (P = 0.024) compared with ABMR (Figure 1).

CONCLUSION
In conclusion, MVI without HLA-DSA and C4d+ displays decreased circulating T-cell and NK cells, and intense T-cell and NK cell cytotoxic infiltration in the allograft, similar to ABMR. However, the deficiency of plasma cell infiltration in MVI suggests a different underlying stimulus from ABMR.