The kinin B1 receptor (B1R) plays a role in inflammatory and metabolic processes. B1R deletion (B1−/−) protects mice from diet-induced obesity and improves insulin and leptin sensitivity. In contrast, genetic reconstitution of B1R exclusively in adipose tissue reverses the lean phenotype of B1−/− mice. To study the cell-nonautonomous nature of these effects, we transplanted epididymal white adipose tissue (eWAT) from wild-type donors (B1+/+) into B1−/− mice (B1+/+→B1−/−) and compared them with autologous controls (B1+/+→B1+/+ or B1−/−→B1−/−). We then fed these mice a high-fat diet for 16 weeks and investigated their metabolic phenotypes. B1+/+→B1−/− mice became obese but not glucose intolerant or insulin resistant, unlike B1−/−→B1−/− mice. Moreover, the endogenous adipose tissue of B1+/+→B1−/− mice exhibited higher expression of adipocyte markers (e.g., Fabp4 and Adipoq) and changes in the immune cell pool. These mice also developed fatty liver. Wild-type eWAT transplanted into B1−/− mice normalized circulating insulin, leptin, and epidermal growth factor levels. In conclusion, we demonstrated that B1R in adipose tissue controls the response to diet-induced obesity by promoting adipose tissue expansion and hepatic lipid accumulation in cell-nonautonomous manners.

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Background The COVID pandemic has resulted in a major disruption in healthcare that has affected several medical and surgical specialties. European and American Vascular Societies has proposed deferring the creation of an elective vascular access (VA) (autologous or prosthetic arteriovenous fistula (AVF or AVG) in incident patients on hemodialysis (HD) in the era of a COVID pandemic. The aim of this study is to examine the impact of COVID pandemic on VA creation and the CVC-related hospitalizations and complications in HD patients dialyzed in 16 Spanish HD units of 3 different regions. Methods We compared retrospectively two periods of time: the pre-COVID (January 1th 2019-March 11th 2020) and the COVID era (March 12th 2020-June 30th 2021) in all HD patients (prevalent and incident) dialyzed in our 16 HD centers. The variables analyzed were: type of VA (central venous catheter-CVC, AVF and AVG) created, percentage of CVC in incident and prevalent HD, CVC-related hospitalizations and complications (infection, extrusion, disfunction, catheter removal) and percentage of CVC-HD sessions that did not reach the goal of KT(KT> 45) as marker of HD adequacy. Results 1791 VA for HD were created and 905 patients started HD during the study period. Patients who underwent vascular access surgery during COVID period compared to those who did not were significantly younger and a significant decrease of surgical activity to create AVFs and AVGs in older HD patients (> 75 and > 85 years) was observed in COVID period compared to Pre-COVID period. There was a significant increase in CVC placement (from 59.7% to 69.5%) (p<0.001) from the pre-COVID to the COVID time-period. During COVID pandemic a significantly higher number of patients started HD through a CVC (80.3% vs. 69.1%, p<0.001) The percentage of CVC in prevalent HD patients has not decreased 19 months after the start of the pandemic (414 CVC/1058 prevalent patients (39.4%). No significant changes were detected in CVC-related hospitalizations between the pre-COVID and COVID periods. In COVID period a significant increase in catheter replacement and in the percentage of HD session that not reach the HD dose objective (KT> 45) was observed. Conclusions COVID has presented a public health system crisis that has influenced VA for HD with an increase of CVC relative to AVF. A decrease in HD session that not reach the HD dose objective was observed in COVID period compared to preCOVID period.

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Background and Aims Frailty constitutes a syndrome, characterized by loss of lean body mass (sarcopenia), weakness, and decreased resistance to physical exercise, which leads to decreased activity and a poor response to stress. Reduced activity, in turn, worsens sarcopenia and weakness, leading to a vicious cycle toward functional decline and increased risk of death. Frail patients starting HD may lose independence, as their functional capacity deteriorates, with increased frailty and sarcopenia, especially in the elderly. Aims: Observe the clinical differences in elderly patients on hemodialysis depending on whether they are dependent or not and observe if dependence has an impact on the dialysis regimen used. Method Observational descriptive study for 1 year in patients of the chronic hemodialysis program of four out-of-hospital centers and a hospital unit of the Fundación Renal Íñigo Álvarez de Toledo (Spain). Of the total number of patients receiving dialysis in the units, 107 over 75 years of age, who had been in the program for more than 3 months and who had signed the informed consent, were included in the study. The variables considered for the study were: age, sex, height, weight, and body mass index (BMI), etiology of kidney disease, time on hemodialysis, residual diuresis > 500 mL/min, and type of vascular access. In relation to the hemodialysis regimen, the duration variables were collected in hours of the HD session at the beginning of the program and at the time of the study, weekly hours and days per week Analytically determined: albumin, total iron binding capacity (TIBC) and creatinine. In addition, the measure of dialysis efficacy was established by eKt/V To assess the degree of functional dependency, the Barthel index is considered the most appropriate scale to assess the basic activities of daily living (BADL), obtaining a quantitative estimate of the degree of dependency. Results Association between dependency and the rest of the qualitative variables. Data expressed n (%) or mean ± SD. Conclusion Dependent patients have lower residual renal function, greater comorbidity, less ability to walk, and therefore need transportation to go to dialysis, live in residences, and are extremely tired at the end of dialysis.