bluuebunny/crossref_metadata_2025_split huggingface dataset:
MO572: Effects of Ketoanalogues on the Evolution of Bone Mineral Metabolism in Patients With Advanced Chronic Kidney Disease
Authors: Kosmadakis Georgios , Isnard Rouchon Myriam , Fuentes Fanny , Ramade Nathalie , Baudenon Julien , Deville Clemence , Enache Ioana , Gueret Claudine , Haskour Abraham , Necoara Aura , Rance Nicole 
Published: May 2022

Abstract

BACKGROUND AND AIMS
There is a mounting volume of evidence on the efficacy of ketoanalogues associated with low protein diets, concerning the nephroprotective effects in patients with advanced chronic kidney disease (CKD). The important number of capsules daily ingested associated with their important calcium content would potentially affect the bone mineral metabolism of this group of patients. The aim of this study is to investigate the effects of ketoanalogues on the evolution of the bone mineral metabolism parameters in patients with advanced CKD.

METHOD
This is a prospective non-randomized controlled comparative study of two groups of patients. The results are shown as mean ± ESM. The first group (intervention) (20 patients, 12/8 M/F, mean age 71.9 ± 2.9, 10 with diabetes) was treated with ketoanalogues associated with a low protein diet and the control group (17 patients, 9/8 M/F, mean age 68.2 ± 3.3, 8 with diabetes) had a conventional follow-up of CKD. We studied the evolution of the body weight, renal function (glomerular filtration rate measured by the CKD-EPI formula in mL/min/1.73 m2), 24 h proteinuria, salt and protein consumption, serum albumin, serum prealbumin, alkaline reserve, serum phosphate levels, serum parathormone levels and calcium levels corrected for serum albumin at baseline as well as 6, 12 and 24 months post-inclusion. We performed a T-test for independent groups in order to study the differences between the two groups in every time point of the study. P-values &lt; 0.05 were considered statistically significant.

RESULTS
The results are shown in the Table 1. There were no differences between the two groups at baseline. There was a significant nephroprotective effect of the ketoanalogues after 12 and 24 months. Alkaline reserve and serum calcium levels were significantly higher in the intervention group after 6, 12 and 24 months. Serum phosphate and serum parathormone levels were significantly higher in the control group 6 months, 1 and 2 years after the baseline. All patients were treated with the appropriate agents for the correction of the perturbed study parameters. During the 2-year follow-up, four patients from the study group (two pre-emptive renal transplantations, one death from oncologic causes and one start of dialysis) and eight patients from the control group (three deaths and five dialysis initiations) quitted the study.

CONCLUSION
In conclusion, the treatment with ketoanalogues and low protein diet has a significantly positive impact on the bone mineral metabolism of the patients with advanced CKD. It is unknown whether this is due to the high calcium content of the capsules or from the fact that the renal function is better preserved in the intervention group
MO576: A Novel Application of Serum Creatinine and Cystatin C to Predict Sarcopenia in Advanced Chronic Kidney Disease
Authors: Teng Yi-Yen , Mitra Sari Santi , Lin Yu-LI , Hsu Bang-Gee 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Sarcopenia is highly prevalent in patients with advanced chronic kidney disease (CKD), yet a reliable serum index has not been established. The product of serum creatinine and the estimated glomerular filtration rate based on cystatin C (Cr × eGFRcys) was recently proposed as a sarcopenia index (SI), approximately to 24-h filtered creatinine through the glomerulus. We aimed to evaluate the diagnostic and prognostic validity of the novel SI in advanced CKD.

METHOD
In 297 patients with non-dialysis stage 3b-5 CKD, aged 68.8 ± 12.9 years, the total skeletal muscle mass (SMM), handgrip strength (HGS) and usual gait speed were assessed. Sarcopenia was defined based on the Asian Working Group for Sarcopenia 2019 consensus update. To validate the prognostic impact of the SI, the CKD registry database of our hospital was retrospectively analyzed.

RESULTS
The SI correlated moderately with SMM (r = 0.503, P &lt; 0.001), HGS (r = 0.508, P &lt; 0.001) and gait speed (r = 0.381, P &lt; 0.001); the independency of the SI with three muscle metrics was confirmed after adjustment. For sarcopenia prediction, the SI had acceptable discriminative powers in men (area under the receiver operating characteristic curve [AUC] 0.646, 95% confidence interval [CI] 0.569–0.718) and women (AUC 0.754, 95% CI 0.670–0.826), with optimal cut-off values of 53.9 and 45.8, respectively. In the prognostic cohort, 113 (11.9%) of 946 patients died during a median follow-up of 36 months. Applying the cut-off values above, the low SI group was independently associated with all-cause mortality (hazard ratio [HR] = 2.15, 95% CI = 1.39–3.32, P = 0.001), compared with the normal SI group.

CONCLUSION
Cr × eGFRcys is a promising SI for sarcopenia detection and mortality prediction in advanced CKD. Further studies are needed to expand our investigation.
MO581: Hyperphosphatemia Induces Lung Fibrosis in OLD Mice
Authors: Asenjo-Bueno Ana , Alcalde-Estevez Elena , Martínez Miguel Patricia , Olmos Gemma , Piedad Ruiz-Torres Maria , López-Ongil Susana 
Published: May 2022

Abstract

BACKGROUND AND AIM
Hyperphosphatemia is a common condition associated with chronic kidney disease (CKD) and also with aging. Furthermore, lung dysfunction is described in both cases; however, the relationship between high phosphate levels and lung function is still unknown. The aim of this work is to analyze the effect of hyperphosphatemia in the development of lung fibrosis related to aging.

METHODS
For in vivo studies, C57BL6 male mice of 5 months old (Young) and 24 months old (Old) fed with a standard diet containing 0.6% phosphate were used. Additionally, some old mice were fed with a hypophosphatemic diet containing 0.2% phosphate (Old-Low P) for the last 3 months. Serum phosphate levels were measured with DIPI-500 assay. Lung fibrosis was evaluated by Sirius Red staining and by expression of extracellular matrix proteins such as fibronectin or collagen V assessed by western blot. In vitro studies were performed on a human cell line from lung fibroblasts (Wi-38), which were treated with a phosphate donor called β-glycerophosphate (BGP, 10 mM) at different times. Fibrosis was detected by expression of fibronectin by western blot as in lung tissues. Oxidative stress was measured by confocal microscopy using the fluorogenic probe CellROX. EMSA assays was used to check the activation of fibronectin promoter by NFκB transcription factor.

RESULTS
Old mice that showed higher serum phosphate levels had more lung fibrosis than young mice. Old mice fed with the low phosphate diet, which had less serum phosphate levels, reduced significantly the lung fibrosis respect to old mice fed with the standard diet. In order to elucidate a possible mechanism, in vitro studies were performed in lung fibroblasts treated with BGP. BGP induced a significant increased on fibronectin expression. BGP also rose oxidative stress at short times. As NF-kB transcription factor can be activated by oxidative stress, we checked whether BGP induced the binding of this factor to fibronectin promoter to upregulate this gene. The EMSA analysis showed that BGP promoted the binding of NF-κB to fibronectin promoter. Besides, in the presence of an antioxidant such as catalase, BGP did not induce the binding of NF-kB to fibronectin promoter, suggesting a role for oxidative stress.

CONCLUSION
Old mice showed hyperphosphatemia and lung fibrosis, which both were improved using a low phosphate diet. In vitro studies in lung fibroblasts confirmed that fibrosis induced by BGP seems to be mediated by activation on NF-kB via oxidative stress. These results show a relationship between hyperphosphatemia and lung fibrosis in aging; however, more studies are necessary in order to elucidate the relationship with other chronic diseases related to aging.
MO583: Cafeteria Diet-Induced Obesity Worsens Experimental CKD
Authors: Muyor Karen , Duranton Flore , Cortijo Irene , Laget Jonas , Jover Bernard , Dominique Lajoix Anne , Argiles Ciscart Angel , Gayrard Nathalie 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Obesity is an important risk factor for chronic kidney disease (CKD). It carries hemodynamic and morphologic changes in the kidney resulting in renal function reduction. CKD is associated with glomerulosclerosis and tubulointerstitial fibrosis that involve collagen deposition. The aim of the study was to evaluate the impact of obesity on kidney fibrosis in a model of 5/6th nephrectomized rats fed a cafeteria diet.

METHOD
Twenty four rats were fed acafeteria diet and 10 rats received a standard diet for 6 months. For each diet group, half of the rats underwent 5/6 nephrectomy (SNx) at 4 months. Expression of collagen type 1, 3, 4 was quantified by immunohistochemistry in kidney sections at 6 months. Adipocyte size was measured in epididymal adipose tissue (eWAT), and the presence of macrophages was determined by CD68 immunostaining.

RESULTS
Rats fed the cafeteria diet were hyperglycemic and hypertensive. Their body weight was higher than those fed the standard diet. SNx rats had increased serum creatinine levels, which were even higher in the cafeteria group (71 ± 10 µM) compared with standard diet group (54 ± 5 µM) (P &lt; 0.05). Serum creatinine level was comparable in non-nephrectomized animals fed the cafeteria (32 ± 1 µM) or standard diet (29 ± 1 µM). Collagen 1 level in kidney tissue was increased in both SNx groups with no clear effect of the diet (respectively, 7.1 ± 0.6% and 8.9 ± 0.9% of tissue area with the standard and cafeteria diets). Renal expression of collagen 3 and 4 was significantly increased in SNx animals with cafeteria diet (8.6 ± 1.5 and 10.9 ± 1.9% tissue area, respectively) compared with control rats fed the same diet (5.2 ± 0.5 and 6.3 ± 0.6% tissue area, respectively). Adipocyte size of eWAT was significantly increased by cafeteria diet but reduced in nephrectomized rats. In the cafeteria-SNx group, CD68 immunostaining showed a significant increase in macrophage number in kidney (P = 0.01) and a consistent tendency in eWAT (Fig. 1).

CONCLUSION
Cafeteria diet-induced obesity worsened the 5/6 nephrectomy-induced CKD. The expression of collagens 3 and 4 as well as the number of macrophages were increased in kidneys from the cafeteria SNx group suggesting an exacerbation by pre-existing obesity of CKD-induced renal inflammation and fibrosis.
MO585: Effects of EPP-AF® Green Propolis Extract Supplementation on Inflammatory Markers in Patients With chronic Kidney Disease on Peritoneal Dialysis
Authors: Mafra Denise , G. Baptista Beatriz , Fanton Susane , M. Ribeiro Marcia , R. Paiva Bruna , Cardozo Ludmila , Alvarenga Livia , A. Berretta Andresa 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Inflammation and oxidative stress are involved in the mortality of patients with chronic kidney disease (CKD) on peritoneal dialysis (PD). In this context, propolis may mitigate inflammation, reducing mRNA expression of nuclear factor-kB (NF-kB) and levels of inflammatory markers as tumor necrosis factor-α (TNF-α). Several studies have been performed in vitro and in animals showing that propolis (a resin made by bees) has excellent anti-inflammatory properties. Only one study evaluated the effects of propolis in patients with CKD (stages 3 and 4) and showed a reduction in proteinuria and urinary MCP-1, but there is no study in patients with CKD on peritoneal dialysis (PD). The present study aimed to evaluate the effects of propolis supplementation on inflammatory markers in patients with CKD on PD.

METHODS
This is a longitudinal, randomized, double-blind, placebo-controlled trial with 19 patients randomized into two groups: propolis (4 capsules of 500 mg/day containing concentrated and standardized dry EPP-AF® green propolis extract) or placebo (4 capsules of 500 mg/day of magnesium stearate, silicon dioxide and microcrystalline cellulose as placebo) for 2 months. The inflammatory cytokines plasma levels such as TNF-α and interleukin-6 (IL-6) were evaluated by ELISA, and quantitative real-time PCR analyses were performed to evaluate the mRNA expression of NF-kB in peripheral blood mononuclear cells (PBMCs). Plasma malondialdehyde (MDA) levels, a peroxidation lipid marker, was measured as thiobarbituric acid reactive substances (TBARS). Routine parameters, including C-reactive protein (CRP), were analyzed using commercial kits.

RESULTS
All patients concluded the study: 10 patients in the propolis group [57.2 ± 13.7 years, five men, 6 (6–36) months on DP] and 9 in the placebo group [56.6 ± 14.7 years, two men, 6 (6–57) months on DP]. The obtained data revealed that the intervention did not affect the mRNA expression of NF-κB. However, the plasma levels of TNF-α reduced significantly after propolis supplementation (Table 1 and Fig. 1). There were no significant differences in the placebo group.

CONCLUSION
Short-term EPP-AF® propolis dry extract supplementation seems to mitigate inflammation, reducing the plasma levels of TNF-α in patients with CKD on PD.
MO598: Coping Strategies During the COVID-19 Pandemic: Influence of Patient Activation in People Living With Kidney Disease
Authors: Patel Naeema A , Wilkinson Thomas , Smith Alice , Lightfoot Courtney J 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Patient activation refers to the knowledge, skills and confidence needed to manage one's health [1]. Higher patient activation is associated with better health outcomes in long-term conditions [2] such as kidney disease (KD). The COVID-19 pandemic has presented a myriad of additional challenges for people living with KD. Individuals may display different coping strategies in response to stressful and difficult circumstances such as health management during the pandemic [3]. Our group conducted a multicentre survey to evaluate the impact of the pandemic on kidney patient experiences, lifestyle and health care. As part of this larger study, we hypothesized that higher patient activation may be associated with more effective coping strategies. The purpose of this analysis was to explore coping styles utilised during the pandemic across different levels of patient activation in people with nondialysis CKD (ND-CKD) and kidney transplant recipients (KTR).

METHOD
214 ND-CKD and KTR participants [50.9% male, mean age 60.71 (SD 14.15) years, 56.1% KTRs] completed the Patient Activation Measure (PAM-13). Participants were categorised into ‘low’ and ‘high’ activation based on their PAM-13 score (levels 1–2 as low; 3–4 as high). Coping strategies were assessed using the Brief-COPE questionnaire and categorised into adaptive coping (active coping, information support, positive reframing, planning, emotional support, humour, acceptance and religion) and maladaptive coping (venting, self-blame, self-distraction, denial, substance use and behavioral disengagement) strategies. Chi-square tests were conducted to compare coping strategies used by low- and high-activated patients.

RESULTS
Most participants were classified as having ‘high’ activation levels (n = 164, 77%). Table 1 shows the three most frequently used adaptive and maladaptive coping strategies across activation levels. A significantly greater proportion of those with high activation used acceptance (P = 0.006), active coping (P = 0.045) and positive reframing (P = 0.031) as coping strategies. No significance was observed between maladaptive coping strategies and activation level.

CONCLUSION
The most commonly reported coping strategy was ‘acceptance’ for individuals with high and low activation. The findings suggest that a higher proportion of people with high patient activation used adaptive coping strategies. Worryingly, regardless of activation level, about a third of participants used substance use (i.e. alcohol and drugs) as a form of coping. Identifying people with lower activation in KD can indicate the need for additional support to help them cope in challenging circumstances. Interventions to improve activation may assist in developing effective coping strategies.
MO599: Efficacy and Safety of Optimized Sodium Thiosulfate Therapy for Calciphylaxis in Chinese Patients
Authors: Yang Xin , Liang Zhang Xiao 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Calciphylaxis is a rare life-threatening syndrome. Although sodium thiosulfate (STS) showed clinical improvement, some patients presented with serious adverse events and withdrew from treatment. The optimized STS approach included four features: repeated treatment courses, small initial dose, once daily, and escalating low-to-moderate dose. The optimized STS approach, named ‘Zhong Da STS Therapy’ (Zhong Da: the name of a hospital, affiliated with Southeast University, School of Medicine, Nanjing, Jiangsu, China), was generalized with four features: repeated treatment courses, small initial dose, daily medicine, and daily escalating low-to-moderate dose of STS. STS from the initial dose (5 g) was administered intravenously once daily escalating to the highest daily dose as a maintenance dose (no more than 10 g). This study retrospectively evaluated the efficacy and safety of optimized STS therapy for calciphylaxis in China.

METHOD
The medical records of maintenance hemodialysis or CKD patients who were first diagnosed with calciphylaxis and received STS treatment at Zhong Da Hospital affiliated to Southeast University between October 2017 and October 2019 were retrospectively evaluated. The exclusion criteria of this retrospective study were death at the time of diagnosis (retrospectively confirmed cases) and did not receive the optimized STS approach treatment. The data to evaluate the efficacy included the changes in skin lesions, pain relief, survival rate and laboratory data. Adverse events were summarized as safety parameters.

RESULTS
The mean age was 51.10 ± 14.85 years old and 71% of patients were male. By October 2019, 87.1% of patients survived, 74.2% markedly improved and 41.9% of patients were followed up for more than 1 year with 100% survival. About 27 (87.10%) patients had typical skin lesions with 66.70% ulceration and skin lesions showed a predominantly peripheral distribution. After the first course, skin lesions improved by 77.8%, and 38.1% of pain sufferers were free from analgesics. The reduction of the Numerical Pain Rating Scale (NPRS) (P &lt; 0.001) is related significantly to the treatment course. Furthermore, during the entire treatment session, more than half of the patients (54.84%) never experienced adverse events, only one withdrew treatment and no one died from complications. And most adverse events appeared in the course of increasing the STS dose and would be relieved when we stopped adding it or decreased to the day-before dose.

CONCLUSION
Optimized STS therapy is a promising approach for calciphylaxis patients because it is relatively safe and associated with good outcomes.
MO602: Combined and Progressive Intradialytic Exercise Training Keeps Stable the Systemic Inflammation, Endothelial Function Markers and Redox State: A Secondary Analysis of a Randomized Controlled Trial
Authors: Porcher Andrade Francini , Pires Dorneles Gilson , Vaz Leal Diogo , Viana João , Rovedder Paula 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Chronic inflammatory conditions and disturbances in oxidative stress are hallmarks of renal damage and may be a trigger to non-pharmacological therapeutic options, such as exercise training, in chronic kidney disease[1,2]. This study aimed to evaluate the effects of 12-week combined and progressive intradialytic exercise training on systemic inflammation, endothelial function markers, and redox state in hemodialysis (HD) patients.

METHOD
This is a secondary analysis of a randomized controlled trial with HD patients[3] randomly allocated into two groups: exercise group (EXG) (n = 19) and usual care/control group (CON) (n = 19). EXG performed a 12-week combined and progressive intradialytic training period 3 times a week. CON maintained their normal HD routine during the same timeframe. Blood samples were obtained before and after the 12-week period to analyze C-reactive protein (CRP), interleukin (IL)-4, IL-6, IL-10, IL-17A, tumoral necrosis factor-alpha (TNF-α), reactive oxygen species (ROS), total antioxidant capacity (TAC), monocyte chemoattractant protein-1 (MCP-1), interferon-gamma (IFN-γ), vascular endothelial growth factor (VEGF), and nitric oxide (NO). The inflammatory balance was evaluated by IL-6/TNF-α, TNF-α/IL-4 and TNF-α/IL-10 ratios.

RESULTS
A significant effect was only observed in CON but not EXG, with decreased IL-6 (median of 9.93 [IQR: 8.31–14.79] to 8.86 [7.88–9.61] pg/mL; P = 0.044), IL-17A (62.26 [48.87–102.44] to 53.33 [45.29–59.58] pg/mL; P = 0.044), and IFN-γ (28.19 [26.44–31.15] to 27.09 [25.85–27.89] pg/mL; P = 0.006) and an increase in ROS (485.98 [333.17–604.83] to 507.31 [443.48–637.04]; P = 0.049).

CONCLUSION
The HD patients who undertook the 12-week combined and progressive intradialytic exercise training did not experience an alteration in systemic inflammation, endothelial function markers and redox state, in contrast with the increased oxidative stress state observed in CON.

FUNDING SOURCES
Hospital de Clínicas de Porto Alegre–Research Incentive Fund (FIPE) (Grant No. 2015–0151) and Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (CAPES).