SMW Established in 1871 Swiss Medical Weekly Formerly: Schweizerische Medizinische Wochenschrift Supplementum 214 An open access, online journal • www.smw.ch ad Swiss Med Wkly 2015;145 November 12, 2015 47th Annual Meeting of the Swiss Society of Nephrology (SGN-SSN) Basel (Switzerland), December 3–4, 2015 TABLE OF CONTENTS 1 S Oral Communications 2 OC 1 – OC 6 Clinical Nephrology / Hypertension / Mineral / Electrolytes 5 OC 7 – OC 12 Basic science / Genetics / Experimental Nephrology 7 OC 13 – OC 18 Hemodialysis / Peritoneal Dialysis 10 OC 19 – OC 24 Transplantation Poster Presentations 13 P 1 – P 37 Clinical Nephrology / Hypertension / Mineral / Electrolytes 26 P 38 – P 48 Basic science / Genetics / Experimental Nephrology 30 P 49 – P 69 Hemodialysis / Peritoneal Dialysis 39 P 70 – P 85 Transplantation Index of first authors 46 Listed in: © EMH Swiss Medical Publishers Ltd. Creative Commons summary: http:// Editorial board: Index Medicus / MEDLINE (EMH), 2015. The Swiss Medical Weekly creativecommons.org/ Prof. Adriano Aguzzi, Zurich (ed. in chief) Web of science is an open access publication of EMH. licenses/by-nc-nd/2.5/ch/deed.en_GB; Prof. Manuel Battegay, Basel Current Contents Accordingly, EMH grants to all users on full licence: Prof. Jean-Michel Dayer, Geneva Science Citation Index the basis of the Creative Commons license http://creativecommons.org/licenses/ Prof. Beat Müller, Aarau EMBASE “Attribution – Non commercial – No by-nc-nd/2.5/ch/legalcode.de Prof. André P. 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ISSN online version: 1424–3997 SWISS MEDICAL WEEKLY 2015;145 (SUPPL 214) WWW.SMW.CH ORAL COMMUNICATIONS – CLINICAL NEPHROLOGY / HYPERTENSION / MINERAL / ELECTROLYTES 2 S OC 01 OC 02 Dietary intake of phosphate stimulates renal salt Therapeutic efficacy and cost effectiveness of high absorptiOn and increases bloOd pressure (NCCR PrOject) cut-off dialyzers compared to cOnventional dialysis Arezoo Daryadel1, Nilufar Mohebbi2, Udo Schnitzbauer3, in patients with cast nephropathy Nicole Gehring1, Michael Föller4, Florian Lang4, Johannes Loffing5, Adriano Curti1, Albin Schwarz1, Yuki Tomonaga2, Patrice Ambühl1 Carsten Wagner3 1Institut für Nephrologie, Stadtspital Waid, Zürich; 2Institut für Sozial- 1Institute of Physiology, University of Zurich, Zurich; 2Division of und Präventivmedizin, Universität Zürich, Zürich 3 Nephrology, University Hospital Zurich, Zurich; Institute of Physiology, Background: Multiple myeloma (MM) associated renal failure in cast Zurich Centre for Integrative Human Physiology, University of Zurich, nephropathy results from tubular precipitates of free light chains (FLC). Zurich; 4Institute of Physiology, University of Tübingen, Germany; 5 High cut-off (HCO) dialysis filters are able to efficiently reduce FLC Institute of Anatomy, University of Zurich, Zurich concentrations in the serum and may improve renal recovery. However, Background: The thiazide-sensitive Na+-Cl– cotransporter NCC is clinical trials which directly compare HCO dialyzers with conventional critical for renal salt reabsorption and blood pressure control. dialysis in cast nephropathy are lacking. The aim of this study was to High intake of dietary phosphate has been linked to increased assess clinical outcomes and economic impact of treatment with HCO cardiovascular morbidity and mortality in healthy subjects and patients dialyzers compared to conventional hemodialysis membranes in with kidney diseases. We examined the regulation of NCC by dietary patients with cast nephropathy. phosphate intake. Methods: Multicenter retrospective analysis of patients treated for Methods: Mice were kept for 1–5 days on low (0.1%) or high (1.2%) renal failure from FLC associated cast nephropathy after July 2005 phosphate (Pi) diets or received an acute bolus of phosphate by with a follow-up until September 2014. Treatment consisted of gavage. Plasma PTH, FGF23 and urinary aldosterone level were Bortezomib and Dexamethasone in all patients, and hemodialysis with measured by ELISA. Systolic blood pressure was monitored by the either HCO (n = 12) or conventional dialyzers (n = 7). tail cuff method. NCC abundance/phosphorylation was analyzed by Results: At the end of follow-up, 4 patients treated with HCO dialyzers western blot. Blood pressure in rats on high and low phosphate diets were still alive, while all patients in the control group had died (p = NS was measured by Telemetry. for Cox regression adjusted for age). With regard to recovery of renal Results: The high Pi diet increased plasma FGF23, PTH, urinary function, a non-significant trend to higher independence of dialysis aldosterone and renal renin expression. Systolic blood pressure was was seen in patients treated with HCO dialyzers. Moreover, trends elevated by high Pi diet and this effect was blunted by thiazide towards better renal function at 12 months after diagnosis of MM as diuretics. Thiazide diuretics on high Pi diet increased urinary NaCl well as lesser time on renal replacement therapy were noted in the excretion more than on low Pi diet. Phosphate increased NCC HCO group. Total treatment costs were CHF 193’000 ± 81’000 and abundance and phosphorylation within 1 hour after gavage. Similar to 242’000 ± 179’000 (p = 0.421) in the HCO and conventional dialyzer the high Pi diet in control mice, mice over expressing FGF23 or treated group, respectively. with recombinant FGF23 showed increased NCC abundance and Conclusions: Hemodialysis treatment with HCO membranes for cast phosphorylation. Also PTH stimulated NCC phosphorylation within nephropathy tended towards faster and better recovery of renal 45 min. However, while the high Pi diet stimulated phosphorylation function versus treatment with conventional dialyzers. However, no of SPAK, a positive regulator of NCC, isolated FGF23 overexpression statistically significant survival benefit could be detected for the HCO or administration did not stimulate SPAK phosphorylation, suggesting treatment group. Total medical costs were not higher in the group that high Pi intake and FGF23 activate NCC by distinct pathways. treated with HCO dialyzers despite the higher product price of the high However, genetic inactivation of SPAK prevented NCC cut-off membranes. phosphorylation. The expression of other Na+ transporters like NHE3, NKCC2 and ENaC remained unchanged. Conclusion: Dietary intake of Pi stimulates NCC activity and increases systolic blood pressure. The effect of Pi on NCC may involve several hormones such as PTH, FGF23 and aldosterone. OC 03 Long-term impact of cardio-renal invOlvement On adverse Background: Fabry disease (FD) is a rare X-linked lysosomal storage outcomes in patients with Fabry disease disease with a deficient activity of the enzyme alpha-galactosidase A Martin Siegenthaler1, Uyen Huynh-Do2, Urs Widmer3, which leads to progressive intralysosomal accumulation of Edouard Battegay1, Pierre-Alexandre Krayenbühl4, Albina Nowak1 globotriaosylceramide (GL-3) in different organs. We aimed to evaluate 1Department of Internal Medicine, University Hospital Zürich, Zürich; risk factors for the incidence of major cardiovascular complications and 2Department of Nephrology, Hypertension and Clinical Pharmacology, death in a prospective FD cohort. Inselspital, Bern University Hospital, Bern; 3Swiss Reinsurance Methods: A total of 104 genetically proven FD patients (mean age Company, Zürich; 4Department of Internal Medicine, Kantonsspital 45 ± 16; total males n = 40; on Enzyme replacement therapy (ERT) Uznach, Uznach 88% males, 45% females) were annually followed up at the University Figure 1: ROC-Curve of GFR an LVMMI to predict major cardiovascular events in patients with Morbus Fabry. GFR = glomerular filtration rate; LVMMI = left-ventricular yom cardial mass index; AUC = area under the curve SWISS MEDICAL WEEKLY 2015;145 (SUPPL 214) WWW.SMW.CH ORAL COMMUNICATIONS – CLINICAL NEPHROLOGY / HYPERTENSION / MINERAL / ELECTROLYTES 3 S Hospitals Zurich and Bern. The main outcome was a composite of OC 04 incident renal replacement therapy (RRT), stroke and death. Survival after acute kidney injury in patients Glomerular filtration rate (GFR) and left ventricular yom cardial mass with acute dyspnea index (LVMMI) where explored as the primary exposure variables. Results: During a median follow-up of 9 [5–12] years, 28 new events Tobias Breidthardt, Raphael Twerenbold, Zaid Sabti, Max Wagener, occurred in 25 patients: 11 died, 4 received RRT, 11 developed strokes, Christian Puelacher, Stefan Osswald, Christian