bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO917: Self-Reported Perceptions of Haemodialysis Patients´ Cognitive State––The Goodrenal Project
Authors: Mesa-Gresa Patricia , Elena Marin Alexandra , Avesani Carla , Clyne Naomi , Garcia-Testal Alicia , Kouidi Evangelia , Van Craenenbroeck Amaryllis , Antonio Lozano-Quilis José , Lindholm Bengt , Yang Kevin , Kougioumtzidou Ourania , Cana-Poyatos Alicia , Moscoso Paula , Moura Reboredo Maycon , Lauer Andreas , Segura Eva 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Patients with chronic kidney disease have an increased risk of developing cognitive impairment and neurocognitive disorders including Alzheimer's disease that affect their quality of life. Changes involve deterioration of domains such as learning and memory, language, attention, executive function, perceptual motor or social cognition. We explored the subjective perception that the patients have regarding their cognitive state.

METHOD
This study is part of the GoodRENAL project, which is funded by the European Community Erasmus + and involves four countries: Belgium, Greece, Spain and Sweden. Exploratory questionnaires regarding patients’ cognitive state were answered by 38 patients (mean age 58 ± 0.5 years; 50% women) randomly allocated to this study from the dialysis shifts. The questionnaire had 10 questions with answers rated as 1 (never), 2 (sometimes), 3 (half of the time), 4 (more than half of the time) and 5 (almost all the time), plus 1 open question about main barriers, difficulties or needs related to their cognitive state.

RESULTS
To analyse the descriptive data, the response frequency was grouped into items based on the frequency of the occurrence (almost all the time and all the time). The table below summarizes answers received from patients.

CONCLUSION
The patients’ perception of their attention capacity, memory function and learning capacity was in general positive. However, further studies using validated questionnaires regarding different aspects such as attention, memory or learning functionality are needed to confirm these findings.
MO938: Variability of Serum Phosphate in Incident Hemodialysis Patients: Association With All-Cause Mortality
Authors: (Janice) Ye Xiaoling , Ter Meulen Karlien , Usvyat Len A , Van Der Sande Frank , Konings Constantijn , Kooman Jeroen , Kotanko Peter , Maddux Frank 
Published: May 2022

Abstract

BACKGROUND AND AIMS
In maintenance hemodialysis, both low and high serum phosphate levels are related to patient outcomes. We aimed to further explore the relation between serum phosphate (P) variability and all-cause mortality.

METHOD
All adult incident hemodialysis patients treated in U.S. Fresenius Kidney Care clinics between January 2010 and October 2018 were included. The first 6 months on hemodialysis were defined as baseline, months 7–18 as the follow-up period. All-cause mortality was recorded during follow-up. We quantitated variability as directional range (DR), a metric that describes during baseline the difference between the largest and the smallest value; the DR is positive when the smallest value precedes the largest; otherwise, the DR is negative. Cox proportional hazards models with spline terms were applied to explore the association between DR and SD of serum P and all-cause mortality. Additionally, tensor product smoothing splines were computed to study the interactions of P with the DR and SD of P and their joint associations with outcomes. All analyses were adjusted for demographics, comorbidities and nutritional parameters.

RESULTS
A total of 281 356 patients were included, 258 741 patients were studied. The average age was 62.3 years, 58% were males, 68% were diabetic, 10% with COPD and 25% with CHF. Baseline mean serum P was 5.07 mg/dL, the median DR was + 1.7 mg/dL and the median SD was 0.97. Our results indicate that both higher and lower levels of DR are associated with a higher risk of mortality (Fig. 1). With higher levels of serum P, both lower (negative) and higher levels of DR of serum P were associated with a higher risk of mortality (Fig. 2). In patients with lower levels of serum P, a negative level of DR is associated with a high mortality risk, while the association is attenuated in patients with higher (positive) levels of DR (Fig. 2). On all levels of serum P, higher SD is associated with a higher risk of mortality.

CONCLUSION
Stable serum P levels between 4 and 6 mg/dL are associated with the best outcomes. Negative DR of serum P is associated with particularly high HR for all-cause mortality in the presence of serum P levels &lt;3 mg/dL, possibly because patients are generally malnourished or inflamed, and a further reduction of serum P indicates nutritional deterioration. Serum P &gt; 8 mg/dL is associated with increased all-cause mortality, irrespective of DR.
MO960: Sarcopenia: An Overlooked Diagnosis in Kidney Transplant Recipients
Authors: Gül Özcan Şeyda , Sonmez Ozge , Akman Zafer , Karaca Cebrail , Atli Zeynep , Trabulus Sinan , Seyahi Nurhan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Sarcopenia is characterized by an involuntary loss of skeletal muscle mass, strength, and function and is usually associated with older age. However, sarcopenia may also be seen at younger ages in patients with chronic kidney disease. The European Working Group on Sarcopenia in Older People (EWGSOP) recently proposed a standardized definition of sarcopenia. We aimed to investigate the incidence of sarcopenia and associated factors in renal transplant recipients.

METHOD
We examined consecutive adult (age &gt;18 years) renal transplant recipients under regular follow-up in our outpatient clinic during December 2021. We assessed the muscle strength with a handgrip test using a dynamometer and with a chair stand test. Using the Sergi formula, we used bioimpedance analysis to estimate the appendicular skeletal mass. Finally, we measured the gait speed to assess physical performance. Probable sarcopenia was defined as the presence of low muscle strength. Following that, sarcopenia was diagnosed with low muscle quantity in patients with probable sarcopenia according to the revised criteria by the EWGSOP. We retrieved the clinical and laboratory data from the patients’ medical records.

RESULTS
We recruited a total of 93 kidney transplant recipients (mean age: 59 ± 1.4, male gender 58.1%). About 15.0% of the patients were cadaveric transplants. Probable sarcopenia was found in 31 patients (33.3%), of which 14 (15.0%) were diagnosed with sarcopenia. Diabetes mellitus and lower albumin levels were the significant factors associated with the presence of probable sarcopenia (P = 0.01, P = 0.015, respectively; Table 1). On the other hand, sarcopenia was significantly associated with cadaveric transplantation (P = 0.02; Table 2).

CONCLUSION
We found that probable sarcopenia and sarcopenia were highly prevalent in our relatively young renal transplant recipients. We recommend active screening for the presence of sarcopenia in renal transplant recipients, especially in the cadaveric ones.
MO966: Elective JJ Stent Removal (Ejjr) in Kidney Transplantation: is Routine Ultrasound (US) Useful?
Authors: Haridian Sosa Barrios R. , Burguera Vion Víctor , Viera Ramírez Elizabeth , Eduardo Villa Hurtado Daniel , Galeano Álvarez Cristina , Elías Triviño Sandra , Martin Irene , Fernandez Lucas Milagros , Rivera Maite 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Transplantation (KTx) is considered the best renal replacement therapy nephrologists can offer and improving its outcomes remains a primary challenge in our field. KTx ureteral JJ stenting has been used to prevent urological complications, but there is no consensus about its elective removal timing and literature regarding routine US imaging after EJJR to detect complications is lacking. Our aim was to define the incidence of urological complications diagnosed by routine US after EJJR in KTx, determine US utility and best time interval to perform it.

METHOD
We retrospectively analyzed all routine KTx US performed in our Unit from 2016 until 2020 by an experienced interventional nephrologist. US post EJJR findings were compared with previous patient US. KTx characteristics, treatment and outcomes were recorded.

RESULTS

CONCLUSION
Routine US after EJJR allowed a timely diagnosis and early treatment of urological complications, a key factor for successful transplantation.
KTx US is a cost-effective and reproducible test that provides crucial information to guide clinical decisions, being most efficient when performed 10 days post elective removal. Interventional nephrologists could do this examination promptly.
MO970: Humoral Response After Successive Doses of Mrna Vaccine Against Sars-Cov-2 in Stable Kidney Transplant Recipients
Authors: Manuel Cazorla López Juan , Villanego Florentino , Trujillo Soto Teresa , Antonio Rodríguez Iglesias Manuel , Mazuecos Auxiliadora 
Published: May 2022

Abstract

BACKGROUND AND AIMS
The poor humoral response after vaccination against SARS-CoV-2 in kidney transplant (KT) patients led to the approval of a third dose. Recent data show an increase in the antibody titer, although lower than in the general population. Our aim is to analyze the humoral immune response after the third dose a mRNA vaccine against SARS-CoV-2 and the evolution of the antispike antibody (antiS) titers in KT recipients.

METHOD
We performed a prospective cohort study of stable KT patients from our center who received three doses of a mRNA vaccine from March to November 2021. KT recipients with less than 6 months after transplantation and with active oncological or hematologic disease were excluded. We determined antiS titers (Abbott SARS-CoV-2 IgG chemiluminescent microparticle immunoassay) at baseline, one month after the second dose and one month after the third one. We compared those KT patients who seroconverted with 2 and with 3 doses of vaccine and those who did not seroconvert. To identify risk factors for no seroconversion, a logistic regression analysis was carried out.

RESULTS
We included 83 KT. Mean age was 59.3 years and 62.7% were male. The median time from KT to the first vaccine dose was 94 months and between the second and third dose median time was 4 months. Seroconversion rate was 63.8% after 2 doses and 85.5% after the third one (P &lt; 0.001). Twelve KT did not develop antibodies (Table 1). Patients who did not seroconvert were older (P = 0.047), had a worse renal function (P = 0.009) and had fewer lymphocytes than those that developed antibodies (0.013). Besides, they almost half of them received a KT from a non-heart-beating donor (P = 0.026) and were treated with thymoglobulin in the 2 years prior to the vaccine more frequently (P = 0.007). In patients who seroconverted after 2 doses, we observed a 10-fold increase in the antiS titer after the third vaccine (82 [34–350] UI/mL versus 814 [205–2415] UI/mL; P &lt; 0.001). No patients had neither acute rejection nor serious adverse effects. In the multivariable analysis advanced age, a worse kidney function and recent treatment with thymoglobulin were risk factors for no seroconversion (Table 1).

CONCLUSION
The third dose of a mRNA vaccine against SARS-CoV-2 significantly increased the seroconversion rate and the antiS titers in stable KT patients. Advanced age, poorer kidney function and immunosuppressive treatment are risk factors for no seroconversion.
MO992: Is It Safe to Receive Kidneys from Deceased Kidney Donors Who Tested Positive for Covid-19 Infection?
Authors: Kaies Ibrahim Elsayed Ali Hatem , Mohamed Mahmoud , Briggs David , Krishnan Nithya 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Our modern world is facing extraordinary circumstances while passing through a serious pandemic caused by the novel coronavirus (COVID-19) which may lead to multi-organ system failure and death. COVID-19 deaths may provide a potential source for kidneys available for transplantation. In our study, we are discussing the safety of receiving kidneys from donors who tested positive for the novel coronavirus.

METHOD
All renal transplant recipients registered in UNOS database who had their transplants between 1 March 2020 and 1 June 2021 were retrospectively reviewed. Patients who received kidney transplants from a deceased donor with positive PCR of COVID-19 test were included in our study. Patients were followed up till 1 July 2021. Data about recipient factors (age, sex, ethnicity, diabetes and date of renal transplant), transplant factors (type of induction therapy, maintenance immunosuppressive therapy, delayed graft functions, early post-operative rejection episodes, HLA mismatch, PRA level and cold ischemia time) and donor factors (age, sex, ethnicity, diabetes, hypertension, date of COVID-19 test and type of COVID-19 test) were collected. Outcome measured were post-transplant hospitalisation, acute rejection, delayed graft function, patient, and graft survival till the end of the follow-up.

RESULTS
Eighty-six transplant patients received kidneys from deceased donors who tested positive for COVID-19 infection using PCR test. Sixty patients received kidneys from deceased patients who tested positive for COVID-19 within 30 days pre-transplant. Twenty-six patients received kidneys from deceased patients who tested positive for COVID-19 between 30 and 90 days pre-transplant. Number of post-transplant hospitalisation and acute rejection episodes were nil. 19.76% of the patients had delayed graft functions. Graft loss occurred in one patient due to graft vein thrombosis. Patient survival was 100%.

CONCLUSION
Receiving kidneys from deceased donors who tested positive for COVID-19 infection seems safe and does not affect hospitalisation, acute rejection rates, graft or patient survival. Longer follow-up is needed to confirm our results.
MO995: Survival Benefits of Kidney Transplantation for Waitlisted Patients in the Contemporary Era
Authors: Chaudhry Daoud , Peracha Javeria , Sharif Adnan 
Published: May 2022

Abstract

BACKGROUND AND AIMS
BACKGROUND. Kidney transplantation is recognised as the treatment of choice for people living with kidney failure who are suitable for surgery. However, with evolving donor-recipient characteristics, survival benefits attributed to kidney transplantation warrants validation in the contemporary era. Therefore, this national cohort study aimed to examine survival of waitlisted hemodialysis-maintained kidney failure patients from the last two decades, comparing those who proceed with transplantation versus those who did not.

METHOD
A retrospective cohort study was undertaken of prospectively collected registry data of all waitlisted kidney failure patients receiving hemodialysis in the United Kingdom. From 1 January 2000 until 30 September 2019 inclusive, all patients listed for their first single kidney transplant were included. The primary outcome was mortality, with survival analysis conducted according to the intention-to-treat principle. Time-to-death from listing was modelled using weighted estimation of Cox regression to account for non-proportional hazards.

RESULTS
A total of 40 887 waitlisted kidney failure patients formed the study cohort, of whom 31 037 (75.9%) underwent transplantation. Transplant recipients were younger with lower proportion of females, minority ethnics, and diabetes. In a weighted Cox regression model, mortality risk was higher within 30 days of surgery, risk equivalent between 31 and 180 days with survival benefit thereafter. Hazard ratios for mortality within 1 year (HR: 0.575, 95% CI: 0.531–0.623, P&lt; 0.001) and 1–5 years (HR: 0.129, 95% CI: 0.116–0.143, P &lt; 0.001) of surgery favor transplantation. Survival benefit was retained for every donor type in sub-group analysis, but no survival benefit was observed for patients aged ≥70 within 5 years of transplant surgery.

CONCLUSION
In the contemporary era, kidney transplantation remains the superior treatment modality for waitlisted kidney failure patients from a survival perspective but not among older recipients.
MO1020: Alkaline Phosphatase to Prevent Ischemia Reperfusion Injury in Living Kidney Transplantation—A Safety Pilot Study
Authors: van Duin Robert , Steenvoorden Thei , Vogt Liffert , van der Heijden Joost , Rood Janneke 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Ischemia-reperfusion injury (IRI) during kidney transplant procedures can induce acute kidney injury (AKI) [1]. Extracellular ATP is a key player of pro-inflammatory processes during IRI in the kidney [2], whereas conversion of ATP into adenosine has protective effects to the kidney. Alkaline phosphatase (AP) is the only enzyme that converts ATP directly into adenosine by dephosphorylation[3]. In earlier clinical trials of AP in sepsis-associated AKI (SA-AKI), it was suggested that AP has a protective effect on endogenous creatinine clearance and mortality [4]. With the pathophysiologic similarity between SA-AKI and IRI, we aimed to evaluate the effect and feasibility of periprocedural AP to improve kidney function in living donor kidney transplantation.

METHOD
We conducted a pilot, phase II, double-blinded and randomized controlled trial comparing medicinal AP (tradename: `bRESCAP’, courtesy Alloksys Life Sciences) and placebo. All consecutive recipients of living donor kidneys were asked for informed consent. After randomization, intravenous AP (bolus 1000IU and 9000IU continuously) or placebo was administered at the start of the procedure and continued for the following 24 h. Graft function was measured with measured GFR (using an iohexol distribution curve) after 12 months. Plasma creatinine and a panel of novel injury biomarkers and systemic inflammation markers were measured in both urine and serum during the 7 days after the procedure. Drug reactions and adverse events (AEs) were monitored in the first 7 days. Secondary outcomes included all-cause mortality and dialysis dependency.

RESULTS
Between June 2019 and October 2019, 11 patients were enrolled. Patients did not differ between groups, bRESCAP (n = 5) and placebo (n = 6) at baseline: 36% were male; the median age was 58 [interquartile range (IQR) 40–65] years; and the median eGFR 12 (10–15) mL/min/1.73 m2. After 1 year, median measured GFR was similar in the bRESCAP group [52.2 (40.5–61.4)] and placebo group [52.4 (37.6–66.1)] (P = 1.000). Mixed model analysis showed no difference in the fall of plasma creatinine or cystatin-C over the first 7 days after the procedure. There were no adverse events observed in the bRESCAP group.

CONCLUSION
These pilot data indicate that bRESCAP can be administered safely but offers no benefits to recipients of kidneys from living donors. This study opens the way to study recipients of kidneys from deceased donors, where IRI plays a much more prominent role and frequently leads to delayed graft function.
MO1026: Performance of Creatinine and Cystatin-Based Estimates of GFR in Paediatric Kidney Transplant Recipients. Comparison of the CKD-EPI Age- Adjusted Creatinine eGFR with Previous Formulas
Authors: Vilaça Joana , Ferreira Ana , Luisa Carvalho Ana , Cohombo Josefa , Tavares Joana , Rocha Liliana , Teixeira Ana , Costa Liane , Matos Paula , Costa Teresa , Do Sameiro Faria Maria , Conceição Mota Maria 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Estimation of glomerular filtration rate (GFR) is essential for renal function evaluation and the surveillance of kidney transplant recipients. We aimed to compare the GFR estimation by different formulas using creatinine and/or cystatin C, in paediatric kidney transplant recipients and to compare the chronic kidney disease-epidemiology collaboration (CKD-EPI) equation with age-adjusted creatinine values for height-independent estimated GFR (eGFR) calculation. We also intend to evaluate the impact of body mass index (BMI) influence on eGFR.

METHOD
Data on paediatric renal transplant patients (n = 35) with stable graft function for more than 6 months post-transplantation were enrolled. eGFR was calculated using the revised Schwartz (bedside Cr), CKD-EPI (Cr), CKiD (CysC), Zappitelli (CysC), combined Schwartz (Cr/CysC) and combined Zappitelli (Cr/CysC) formulas. The estimation by CKD-EPI formula used age and sex-adjusted creatinine values to adult levels with 40 as assigned age (CKD-EPI40).

RESULTS
A total of 35 patients were included, 26 (76%) were male, with a median age of 16 (4–18) years and a median BMI of 21.27 (15.20–32.29) with a Z-score median of 3.26 (2–5). The median eGFR obtained by the Schwartz [64.39 (23.96–115.16) mL/min/1.73 m2] and by the CKD-EPI40 equation [64.99 (13.98-141.80) mL/min/1.73 m2] was similar (P = .176). When compared with the Schwartz estimation, Cys-based eGFR were significantly lower (by CKiD-CysC, 49.48 (25.47–84.68) (P &lt; .001), by Zappitelli formula 51.31 (24.74–92.61) (P &lt; .001), by combined Schwartz 51.37 (24.07–85.31), (P &lt; .001), by combined Zappitelli 54.83 (20.64–109.68).The correlations between eGFR by all formulas were strong and statistically significant, especially between the combined Schwartz and the combined Zappitelli (r = 0.97). The same pattern of differences between the eGFR estimations was observed when BMI groups (normal versus overweight) were analysed separately, with all formulas being significantly different for Schwartz except for CKD-EPI.

CONCLUSION
As expected, formulas with creatinine were similar to each other but significantly different when compared with formulas that included cystatin. As demonstrated in previous studies, the combined formulas appear to be the closest estimates of the GFR calculated by exogenous methods. Thus, estimates that consider only creatinine may overestimate the GFR. The eGFR obtained by the adjusted CDK-EPI formula is similar to that obtained by the Schwartz bedside, unlike the other formulas. In this study, we did not find differences regarding the BMI, probably due to the number of this sample.