Correlation of Serum Vitamin D Levels and One-Year Mortality on Hispanic Patients Receiving Maintenance Hemodialysis

NKF 2017 Spring Clinical Meetings Abstracts Gustavo Borda, Ashfaq Balla. Metrowest Medical Center, Framingham, MA, USA MAJOR DEPRESSION AND LONG-TERM RENAL OUTCOME IN 59 HOSPITAL SevelamerAQUIRED Induced Diffuse AKI. Crystal Colitis: A Case Report of 1,2 a Rarely Reported Side Effect , Emaad M. Abdel-Rahman1, Kenneth Authors: Bolanle A.Omotoso 1 2 1 Scully , Fatiu A Arogundade , Rasheed Balogun Samir Brahmbhatt, Michael Cruise,A.James Simon. Cleveland 2 1 University of Virginia, Charlottesville, VA, USA; Obafemi Awolowo Clinic Foundation, Cleveland, OH, USA University Teaching Hospital, Ile Ife, Nigeria 61 Major An depression Unusual has Case of Hyponatremia Attributed been shown to be associated with higher risktoof Trimethoprim-Sulfamethoxazole Therapy long-term MACE and all-cause mortality in AKI patients. However, little is known about the association between depressive and the Adam Bsiso, Michael Sheffield, Roberto illness Collazodevelopment of chronic kidney disease following AKI. Dallas, This study aims Maldonado. Methodist Dallas Medical Center, TX, to determine the prognostic implication of a clinical diagnosis of USA depression on the development of CKD following AKI. 62 A Enteroccous Causing Bacterial-Endocarditis AssoretrospectiveSpecies cohort study comprising of adults admitted to the University of Virginia Medical Center between 1, 2002 and ciated Glomerulonephritis in an At Risk January Population December 31, 2012Keyrillos who sustained as defined by Juan the KDIGO Emma Bueno, Rizg,AKI, Mario Cisneros, Chique guidelines and had ≥ serum Cr drawn during the follow up period. The Figueroa, Ryan Kunjal, Andreea Poenariu, Raafat F cohort with ICD 9 codes for major depression pre, post AKI event or Makaray. University of Florida of follow Medicineduring the follow up period was identified.College CKD during up was Jacksonville, Jacksonville, FL, USAthat persisted for at least defined as an estimated GFR < 60ml/min All patients were followed up from dayin90aofRenal AKI (toAlloallow 65 3months. Recurrent Thrombotic Microangiopathy forgraft: recovery of function) through Dec 31 2013 A Clinical Conundrum A total of 6727 patients survived beyond 90 days of AKI and had a Olivia data Campa, JoseforA. Morfin. University of depression California complete available analysis. Diagnosis of Major Davis, Sacramento, CA, of USA was present in 2925 (43.4%) the entire population while 954 TheSyndrome relationship between 68 (14.16%) A Rarepatients Case ofdeveloped NeonatalCKD. Bartter depression and the development CKD following 1 2 1 an AKI event was not Tushar Chaturvedi , Rupesh Raina .was Akron Nephrology significant; fully adjusted hazard ratio (HR) 0.965; CI, 0.8182 Associates, 1.069; p 0.327. Akron, OH, USA; Cleveland Clinic Akron General, Akron, USA Major depression wasOH, not associated with subsequent risk of CKD in 71 this Anstudy. Unusual Case of Negative Anion Gap in a Patient with Hypercalcemia Avantika Chenna, Pradeep Reddy Thodima, Rasib Raja. Albert Einstein, Philadelphia, PA, USA 74 Atypical Presentation of Metastatic Esthesioneuroblastoma with Ectopic ACTH Syndrome After 7 Years 226Vamsi Chilluru, Jay Hawkins. University of Nebraska Medical Center,OF Omaha, NE,VITAMIN USA CORRELATION SERUM D LEVELS AND 86ONE-YEAR Prosthetic MORTALITY Valve Endocarditis from PATIENTS Mycobacterium ON HISPANIC Chimaera Infection CausingHEMODIALYSIS. Granulomatous Isabel Interstitial RECEIVING MAINTENANCE Padilla, Ivonne Lopez, Roberto Mangoo-Karim, University of Nephritis Texas Rio Grande Valley, Edinburg, TX, USA. Jonathan Da Costa, Ahmed Abdalrhim, Ivan Porter, Peter We have observed a high prevalence low serum vitamin D Fitzpatrick, Cherise Cortese, Nabeelof Aslam. Mayo Clinic, concentrations Hispanics Jacksonville,inFL, USA with ESRD in South Texas. The correlation between low serum vitamin D levels and mortality in 87this Health Beauty: AisCase of an25-hydroxyvitamin Unusual Cause ofDSevere patientorpopulation unknown. Hypercalcemia (25(OH)D) levels are measured yearly in hemodialysis patients Dangol, Sashicare. Ariyaratne, Hilmer asGulshan part of routine medical We determined the Negrete. prevalenceSt.of Elizabeth Youngstown Hospital,inYoungstown, OH,All-cause USA low serum 25(OH)D concentration this population. wasDense measured duringAa one-year observation period 88mortality Recurrent Disease: Report of Two Cases with while receiving hemodialysis. Mean 25(OH)D levels between Varying Presentations, Pathologic Findings and Patient survivors and deceased were compared using unpaired t-test. Outcomes The patient population was Hispanic (N=379) and Dilini Daswatta, Sharon Graves, Carla Ellis. Emory predominantly diabetic (79%). Male to female ratio was 2:1. University, GA,serum USA vitamin D levels were Patients foundAtlanta, to have low 90receiving Crystalglobulin-Induced Nephropathy and Keratopathy supplementation with cholecalciferol or ergocalciferol prior to and during theSandhya observation period. One Matthew D’Costa, Manohar, Joe hundred Grande, and Samih ninety (50%) had low serum vitamin D levels (<30USA Nasr,patients Marie C. Hogan. Mayo Clinic, Rochester, MN, at baseline despite supplementation. 91ng/ml) Vitamin C Induced Oxalate NephropathyOne-year all-cause mortality was 12.9% (N=49). Mean (+ SEM) 25(OH)D level in Matthew D’Costa, Loren Herrera Hernandez, Sandra deceased patients was 25.4 (+ 2.2) ng/ml compared to 29.9 (+ Herrmann. Clinic, Rochester, MN, cause USA of death was 0.82) ng/ml inMayo survivors (p=0.07). The main 92cardiovascular A Case of Severe Hyponatremia and Acute Kidney Injury disease. Half the Hispanic patients with Bronx ESRD on hemodialysis had Eddyof DeJesus, Nasr, Rabih. Lebanon Hospital low serumBronx, 25(OH)D Center, NY,levels USAdespite supplementation. Patients with ESRD who died within a 12-month observation period had 103 Acute Glomerulonephritis Post Administration of 15% lower serum vitamin D concentrations compared to patients Pegfilgrastim alive after one year on maintenance hemodialysis. Hatem Elabd, Naheed Ansari, Belinda Jim. Jacobi Medical Center, New York, NY, USA

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Am J Kidney Dis. 2017;69(4):A1-A105

108 Refractory Hypomagnesemia During Pregnancy in a Patient with Gitelman Syndrome VALIDATION OF NATIONAL HEALTHCARE SAFETY Thomas Frohwein, Susan Kim, Isaiarasi2015: Gnanasekaran. NETWORK DIALYSIS EVENT DATA — GEORGIA Gianna Lincoln and Mental Health Sanlis, Center, Bronx, NY, Peralta, Jeanne Medical Negley, Elizabeth Smith, Kathryn Cherie USAGeorgia Department of Public Health, Atlanta, GA, USA Drenzek, peopleand in theTreatment United States on hemodialysis care and (RVT) are 110370,000 Diagnosis of rely Renal Vein Thrombosis at risk for developing serious infections. Georgia outpatient in the Setting of Lupus Nephritis and Antiphospholipid hemodialysis facilities are required to report dialysis event (DE) data Syndrome (APS)Healthcare Safety Network (NHSN), including monthly to the National intravenous starts (AMX), positive blood cultures (PBC), Pablo antimicrobial Garcia, Felix Renneberg, Maanit Kohli, Steve Bibu, and pus, redness, or increased swelling at the vascular access site (PRS) Navya Kuchipudi, Anne Van Hoven, Shaunak Dwivedi. occurring ≥21 days apart if in the same patient. Facilities also report Saint Peter’s University NewbyBrunswick, NJ, USA denominator data monthly, whichHospital, counts patients vascular access type Scleroderma with the highestRenal infection risk. We validated reporting DEsSystemic 111 Crisis (SRC) in the Settingof of against CDC definitions and identified(ssSSc) barriers. in Pregnancy Sclerosis Sine Scleroderma We reviewed patient records from the period January 1–June 30, Pablo Garcia, Shaylika Chauhan, Kohli, Navya 2015, in 30 hemodialysis facilities in the Atlanta Maanit metropolitan area; 16 wereKuchipudi, randomly selected, and 14 Dwivedi. were selectedSaint due to high catheter Shaunak Peter’s University utilization rates and PBCs, or having reported DEs. At each site, Hospital, NewfewBrunswick, NJ, no USA up to 30 patient records were reviewed. A concordance check was 121 Red Eyes and Renal Insufficiency A Middle performed to classify each event as either correctly-,in under-, or over- Age Gentleman reported. We surveyed staff members responsible for NHSN DE data collection and reporting evaluateMae surveillance Maryam Gondal,toHeidi Timbol,knowledge Jeffery and Turner. Yale practices. University, New Haven, CT, USA We reviewed 876 patient records and identified 315 DEs, including 177 (56%) AMX,Case 51 (16%) and 87 (28%) PRS. Twenty percent 125 Atypical of PBC, Behcet’s Disease Leading to IGA (35) Nephropathy of AMX were under-reported and 11% (20) over-reported; 29% (15) of PBC were under-reported and 12% (6) over-reported; and 70% Gupta, Anastasios Papanagnou, Yorg Al-Azzi. (61) Sanjeev of PRS were under-reported and 17% (15) over-reported. Among 28 surveyed staff members, reporting issues included Westchester Medicalcommon Center, Westchester, NY, USA incorrect reporting of patient vascular access for monthly denominators 126 Cefepime Toxicity Presenting as Status Epilepticus in a (15, 21%); being unable to identify at least one NHSN-defined DE (11, Patient with End Stage Renalrule Disease 15%); and being unaware of the 21-day (9, 13%). 1 Reporting were identifiedDasari among1,allAziz types Bakhous of DEs. All , Raed Mohit deficiencies Gupta1, Jayaprakash 1 have a strong working1knowledge of the CDC Dialysis facilities should Azzem , Donald Dumford , Patrick Gallegos1, Rupesh Event Protocol. Consistent and accurate documentation of DEs can 1 1 Cleveland Clinic Akron General, help Raina facilities. detect problems, identify trends, evaluate Akron, infectionOH, USA prevention activities, and engage staff in quality improvement. 129 Tenofovir Causing Hospitalization Due to Severe Symptomatic Hypophosphatemia Sanjeev Gupta, Anastasios Papanagnau, Savneek Chugh. 228 Westchester Medical Center, Valhalla, NY, USA CHANGES IN KIDNEY FUNCTION IN PATIENTS CO130 The Significance of Anti-Phospholipase Antibodies in a INFECTED WITH HUMAN IMMUNODEFICIENCY VIRUS with Membranous Nephropathy ANDPatient HEPATITIS C VIRUS BEING TREATED WITH DIRECTACTING AND ANTIRETROVIRALS, Javier Pagan, MohitANTIVIRAL Gupta, Jayaprakash Dasari, Rupesh Raina, Pallavi EfrenReddy. Chavez,Cleveland Antonio Armstrong, Lumen Mendez, Desiree Garcia, Clinic Akron General, Akron, OH, USA Andrew Elden, Fernando Pedraza, Marco Ladino, David Roth, 132 A Mystery Case of Blood Leak Alarm Going On University of Miami, Miami, FL, USA Human immunodeficiency virus(HIV) hepatitis CLohani, virus(HCV) Seifeldin Hakim, Rhyan Maditz,and Sadichhya Sami infections are Oakland risk factorsUniversity for progression of chronic kidneyHospital, disease Zarouk. William Beaumont (CKD). Several the antiretroviral agents(ARV) have been associated Royal Oak,ofMI, USA with an increased risk for progression of CKD. In this analysis we 133 Previously ANCA Vasculitis evaluate the renalUndiagnosed impact of using direct Associated acting antivirals (DAAs) Prein senting with Onethe Month Kidneyco-infected Transplantation combination ARVsAfter for HCV/HIV patients. WeAyman used a retrospective and descriptive design to evaluate S. theYaqub. effect Hallab, Karthik Kannegolla, Mohammad of the treatment of HIV and HCV on blood pressure (BP) and kidney Indiana University School of Indianapolis, IN, function. 43 patients were included. All Medicine, patients were on maintenance ARVUSA therapy and subsequently were initiated on treatment for HCV withCase DAA Report therapy between 2015-2016. SCr with Immunotactoid eGFR (eGFR149 of a Dialysis Dependent MDRD) were obtained. with Favorable Response to Rituximab Glomerulopathy There were 42 men 1 and 1 woman. The 2mean age was 61 years 3 (SD , Rohan Markowitz , Aaron Mehak IdreesDAA 6). The following agentsBhojwani were used:, Glen Sofosbuvir (43/43:100%), 4 1 2 Dommu . Griffinsimeprivir Hospital, Derby, CT, USA;wasFairview ledipasvir (30/43:70%), (11/43:25%). Ribavirin used in combination DAAs inOH, 14 patients The University, following ARV Columbia New Hospital,with Cleveland, USA; 3(36%). 4 (41/43:95%), emtricitabine (23/43: 53%), agents wereNY, used:USA; ritonavir York, Nephrology Associates, Bridgeport, CT, tenofivir (24/43:56%), raltegravir (15/43: 34%), atazanavir (8/43:18%), USA zidovudine (32/43: 74%), lamivudine (11/43:26%), efavirenz 150 De NovoTheAtypical Hemolytic Uremic Syndrome (28/43:65%). mean eGFR before DAA therapy was 86.4 Fourteen mL/min and the mean After eGFR Renal after theTransplant 12 weeks of DAA therapy (calculated at Months SVR 12) was 82.1 mL/min (p=0.125). The mean systolic BP before Olusola Isikalu, Jennifer Thompson, Maria Aurora Posadas therapy was 125 mmHg and 133 mmHg at the completion of DAA Salas.The Medical University Charleston, treatment. mean diastolic BP didof notSouth change Carolina, with DAA treatment. SC, The useUSA of DAA agents to treat HCV in patients concomitantly receiving ARV agents for HIV A wasSeronegative, found to be safe with no AKI 151 “Lone” Lupus Nephritis: Histopathological events or progression of CKD after completion of treatment. Further Diagnosis studies with larger numbers of patients and extended follow-up will be Jamal Janjua, Pratima Kamada, Aiman Riaz. Gundersen needed to determine if treatment with DAA has any impact on the Health ofSystem, WI, USA progression CKD in La thisCrosse, population.

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