Best Award Winners at ERA-EDTA 2016

The ERA-EDTA recognised a selection of authors for what the organisation deemed to be the best presentations of research abstracts at the congress. Eight presenting authors were chosen to receive a diploma in recognition of their having the best abstracts overall. A fund of €50,000 was also allocated for awarding grants to young nephrologists (<40 years old) whose submitted abstracts were also recognised as being of the highest quality in various categories. There were 84 travel grants awarded while eight abstracts received special recognition for being the best presented overall. A selection of these award-winning abstracts have been included below.

Miss Nadia Sarween (UK) was among the eight authors whose presentations were deemed the best at congress. Miss Sarween’s presentation discussed a study noting the limited data available on early pregnancy losses and long-term renal graft outcomes. The study reported on the pregnancy outcomes in renal transplant recipients from Hospital Episode Statistics (HES) data used in England. All women <45 years old who had received a new renal transplant between January 2001 and April 2015, were identified in the data. Out of the total 5,108 women included, 569 pregnancy outcomes were identified in 387 women following transplantation. The outcomes were measured according to loss, abortive, and delivery codes, and the mean time interval from the date of the transplant to a pregnancy outcome was 48 months. In comparison to the general population, 68.5% of women in the transplant cohort had a live delivery versus 79.6%, 13.4% had an abortive loss compared with 11.2%, and 18.1% had a pregnancy loss from another cause compared with 9.2%. The rate of intrauterine growth restriction, gestational diabetes, and hospital admission with a urinary tract infection was found to be significantly higher in the transplantation group.

Mr Jorge Malheiro (Portugal) was another award recipient for the research presented that aimed to improve the prediction of early antibody mediated rejection (AMR) and subsequent shortened graft survival in human leukocyte antigen (HLA)-incompatible kidney transplantation. Data was collected on the immunodominant donor-specific antibody strength (DSA MFI) and C1q-binding ability (C1q-DSA) in a cohort of HLA-incompatible kidney transplantation. Out of 61 patients, 18 experienced early AMR, with a median of 18 days until rejection. These results were significantly associated with shortened kidney graft survival, with 49% of the grafts failing at 6 years in patients that experienced AMR, in contrast to the failure in 16% of patients who did not experience the rejection. The research team constructed an equation to calculate an AMR risk score from a multivariable logistical model. This calculation scored significantly higher as an AMR predictor in comparison with C1q-DSA and DAA MFI≥10k when measured within the area under the curve performance parameter. The research team concluded that their calculated AMR risk score could enable better management of affected patients, aiding in decisions concerning the appropriateness of transplant.

Dr David Jayne (UK) also received an award for best abstract. Dr Jayne’s presentation reported on research efforts investigating the potential of the complement 5a receptor inhibitor CCX168 to either completely or substantially replace steroids while maintaining or improving efficacy in patients with active ANCA-associated vasculitis (AAV) receiving cyclophosphamide (CYC) or rituximab (RTX). There were 67 patients enrolled in a randomised, double-blind, placebo-controlled Phase II trial. They were split into two treatment groups and a control group. The control cohort received a placebo, CYC or RTX, and a 60 mg starting dose of prednisone. The second group received CCX168 30 mg twice daily (bid), CYC or RTX, and a 20 mg starting dose of prednisone. The final group received CCX168 30 mg bid, CYC or RTX, and no prednisone. The results of the study revealed that the Birmingham Vasculitis Activity Score (BVAS) response at Week 12 was numerically superior and statistically non-inferior to the control group. The health-related quality of life measurements improved in the groups receiving CCV168 versus the control group. The research team concluded that CCX168 successfully replaced chronic steroids and this suggested a new paradigm of treatment for AAV.

Miss Chava Ramspek (Netherlands) was among the eight best authors who received a diploma in recognition of their abstract presentation. It looked at prediction models for mortality risk in chronic dialysis patients by examining abstracts and articles about existing prediction models using the PRISMA guidelines and pre-defined inclusion criteria. The results of the study found 15 articles to be included in the systematic review; a full prediction formula was only found in 60% of the articles looked at. External validation was carried out in 1,943 patients from NECOSTAD for a total of seven models. The researchers concluded that the models in external validation performed more poorly than the original models, and suggested that Floege’s proposed system would be the most appropriate for prediction of mortality in dialysis patients over a 1–2-year time period. The team were optimistic that the results of the study would help in the progress towards more personalised information on prognosis.

Miss Francesca Jackson-Spence (UK) received the grant for her presentation on a population-based study, which sought to understand the risk of cancer developing post-transplantation and how it related to the risk of cancer progression to mortality. It analysed data on 18,493 patients >18 years old in England who had received a kidney allograft between 2003 and 2013. It found that all-cause mortality, including cancer, occurred in 2,461 of the patients and cancer-specific mortality occurred in 444 of the patients. Among the patients with a cancer admission post-kidney transplantation, 19.5% had died from cancer-related deaths and 10.6% had died from non-cancer related deaths at follow-up. The study is claimed to be the first to highlight cancer occurrence post-kidney transplantation and the risk of progression to mortality.

Additionally, Dr Niki Prakoura (France) was awarded a grant for her presentation on a study that investigated the activation and function of periostin in renal disease. This protein is found to be highly induced in the diseased kidney in different models of renal disease. It sought to determine whether inhibiting its expression could protect against the progression of renal disease. To test the effect of periostin activation, the protein was compared in wild-type (WT) and knockout mice (KO) with a severe model of chronic kidney disease, nephrotoxic serum-induced glomerulonephritis (NTS). A subsequent pharmacogenetic approach used in vivo administration of antisense oligonucleotides against periostin in the NTS model, once the disease had been established. Among the findings of the study, the periostin KO mice were generally protected from the progression of renal disease. There was a decrease in the expression of inflammatory and fibrotic markers together with a significant improvement of renal function. The authors also noted that expression of integrin beta 3, a proposed periostin receptor, was upregulated in vessels and podocytes of WT mice and blunted in the KO mice. In conclusion, the antisense administration was found to blunt periostin increase which resulted in the preservation of both renal structure and function.

This was just a small selection of the awards that were given out at this year’s ERA-EDTA congress, demonstrating the volume of impressive research and progress being made in the field. The European Medical Journal congratulates all of the winners and looks forward to seeing the immense progress that will be made in research over the coming year.

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