A922 Sequential measurement of 1 hour creatinine clearance (1-CRCL) in critically ill patients at risk of acute kidney injury (AKI)

Meeting abstrac

Circulating Endothelial Progenitor Cells in Kidney Transplant Patients

Background: Kidney transplantation (RTx) leads to amelioration of endothelial function in patients with advanced renal failure. Endothelial progenitor cells (EPCs) may play a key role in this repair process. The aim of this study was to determine the impact of RTx and immunosuppressive therapy on the number of circulating EPCs. Methods: We analyzed 52 RTx patients (58613 years; 33 males, mean 6 SD) and 16 age- and gender-matched subjects with normal kidney function (57617; 10 males). RTx patients received a calcineurin inhibitor (CNI)-based (65%) or a CNI-free therapy (35%) and steroids. EPC number was determined by double positive staining for CD133/VEGFR2 and CD34/VEGFR2 by flow cytometry. Stromal cell-derived factor 1 alpha (SDF-1) levels were assessed by ELISA. Experimentally, to dissociate the impact of RTx from the impact of immunosuppressants, we used the 5/6 nephrectomy model. The animals were treated with a CNI-based or a CNI-free therapy, and EPCs (Sca+cKit+) and CD26+ cells were determined by flow cytometry. Results: Compared to controls, circulating number of CD34+/VEGFR2+ and CD133+/VEGFR2+ EPCs increased in RTx patients. There were no correlations between EPC levels and statin, erythropoietin or use of renin angiotensin system blockers in our study. Indeed, multivariate analysis showed that SDF-1 – a cytokine responsible for EPC mobilization – is independently associated with the EPC number. 5/6 rats presented decreased EPC counts in comparison to control animals. Immunosuppressive therapy was able to restore normal EPC values in 5/6 rats. These effects on EPC number were associated with reduced number of CD26+ cells, which might be related to consequent accumulation of SDF-1. Conclusions: We conclude that kidney transplantation and its associated use of immunosuppressive drugs increases the number of circulating EPCs via the manipulation of the CD26/SDF-1 axis. Increased EPC count may be associated to endothelial repair and function in these patients.

The association between objective walkability, neighborhood socio-economic status, and physical activity in Belgian children

Background: Objective walkability is an important correlate of adults’ physical activity. Studies investigating the relation between walkability and children’s physical activity are scarce. However, in order to develop effective environmental interventions, a profound investigation of this relation is needed in all age groups. The aim of this study was to investigate the association between objective walkability and different domains of children’s physical activity, and to investigate the moderating effect of neighborhood socio-economic status in this relation. Methods: Data were collected between December 2011 and May 2013 as part of the Belgian Environmental Physical Activity Study in children. Children (9–12 years old; n = 606) were recruited from 18 elementary schools in Ghent (Belgium). Children together with one of their parents completed the Flemish Physical Activity Questionnaire and wore an accelerometer for 7 consecutive days. Children’s neighborhood walkability was calculated using geographical information systems. Multilevel cross-classified modeling was used to determine the relationship between children’s PA and objectively measured walkability and the moderating effect of neighborhood SES in this relation. Results: In low SES neighborhoods walkability was positively related to walking for transportation during leisure time (β = 0.381 ± 0.124; 95% CI = 0.138, 0.624) and was negatively related to sports during leisure time (β = −0.245 ± 0.121; 95% CI = −0.482, −0.008). In high socio-economic status neighborhoods, walkability was unrelated to children’s physical activity. No relations of neighborhood walkability and neighborhood socio-economic status with cycling during leisure time, active commuting to school and objectively measured moderate- to vigorous-intensity physical activity were found. Conclusions: No univocal relation between neighborhood walkability and physical activity was found in 9–12 year old children. Results from international adult studies cannot be generalized to children. There is a need in future research to determine the key environmental correlates of children’s physical activity

Low dietary intake of magnesium is associated with increased externalising behaviours in adolescents

AbstractObjectiveAdequate Zn and Mg intakes may be beneficial for the prevention and treatment of mental health problems, such as depression, anxiety and attention-deficit hyperactivity disorder. We aimed to investigate the prospective association between dietary intakes of Zn and Mg and internalising and externalising behaviour problems in a population-based cohort of adolescents.DesignProspective analysis (general linear mixed models) of dietary intakes of Zn and Mg assessed using a validated FFQ and mental health symptoms assessed using the Youth Self-Report (YSR), adjusting for sex, physical activity, family income, supplement status, dietary misreporting, BMI, family functioning and energy intake.SettingWestern Australian Pregnancy Cohort (Raine) Study.SubjectsAdolescents (n 684) at the 14- and 17-year follow-ups.ResultsHigher dietary intake of Mg (per sd increase) was significantly associated with reduced externalising behaviours (β=−1·45; 95 % CI −2·40, −0·50; P=0·003). There was a trend towards reduced externalising behaviours with higher Zn intake (per sd increase; β=−0·73; 95 % CI −1·57, 0·10; P=0·085).ConclusionsThe study shows an association between higher dietary Mg intake and reduced externalising behaviour problems in adolescents. We observed a similar trend, although not statistically significant, for Zn intake. Randomised controlled trials are necessary to determine any benefit of micronutrient supplementation in the prevention and treatment of mental health problems in adolescents

Low vitamin D levels are associated with symptoms of depression in young adult males

Objective: Results from studies examining associations between serum 25-hydroxyvitamin D (25(OH)D) concentrations and depressive symptoms are equivocal. We investigated the relationship between serum 25(OH)D concentrations and symptoms of depression, anxiety and stress in a cross-sectional analysis of a population-based sample of young adults participating in the Western Australian Pregnancy Cohort (Raine) Study. Methods: Participants provided a blood sample at the 20-year follow-up (March 2010-April 2012) for the measurement of serum 25(OH)D concentrations. Mental health symptoms were assessed using the 21-item Depression Anxiety Stress Scales (DASS-21). Associations between serum 25(OH)D concentrations and total DASS-21 scores and subscale scores of depression, anxiety and stress were explored in males and females using negative binomial regression, adjusting for age, race, body mass index (BMI) and physical activity ( n=735). Models examining subscale scores were also adjusted for the other subscale scores. Results: After adjusting for confounders, an increase in serum 25(OH)D concentrations of 10 nmol/L decreased total DASS-21 scores in males by 9% (rate ratio (RR) 0.91; 95%CI 0.87,0.95; p<0.001) and depression subscale scores in males by 8% (RR 0.92; 95%CI 0.87,0.96; p=0.001). However, in adjusted models there were no significant associations between serum 25(OH)D concentrations and symptoms of anxiety and stress in males. There were no significant associations between serum 25(OH)D concentrations and symptoms of depression, anxiety and stress in females. Conclusions: We found an association between serum 25(OH)D concentrations and symptoms of depression, but not anxiety and stress, in males. Randomised controlled trials are necessary to determine any benefit of vitamin D supplementation in the prevention and treatment of depressive symptoms in young adults

Energy drink intake is associated with insomnia and decreased daytime functioning in young adult females

Objective:To investigate the association between energy drink (ED) use and sleep-related disturbances in a population-based sample of young adults from the Raine Study. Design: Analysis of cross-sectional data obtained from self-administered questionnaires to assess ED use and sleep disturbance (Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire (FOSQ-10) and the Pittsburgh Sleep Symptoms Questionnaire-Insomnia (PSSQ-I)). Regression modelling was used to estimate the effect of ED use on sleep disturbances. All models adjusted for various potential confounders. Setting: Western Australia. Participants: Males and females, aged 22 years, from Raine Study Gen2-22 year follow-up. Results: Of the 1115 participants, 66 % were never/rare users (i.e. once/month to Conclusions: We found a positive association between ED use and sleep disturbances in young adult females. Given the importance of sleep for overall health, and ever-increasing ED use, intervention strategies are needed to curb ED use in young adults, particularly females. Further research is needed to determine causation and elucidate reasons for gender-specific findings. </p