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Preparing your E-Poster
Please review the E-Poster format requirements carefully when preparing your E-Poster. Should your E-Poster not meet the mentioned requirements, it may not be displayed as described above.
E-Poster Submission Deadline
Please prepare and upload your E-Poster no later than March 14, 2026 11.59PM CET. After this date, you will no longer be able to prepare and upload your E-poster and it will not be displayed and accessible on the congress website.
Please follow the instructions below to input your abstract title.
Abstract titles should be brief and reflect the content of the abstract.
CKD-aP is a debilitating itchy skin condition experienced by patients with CKD and end-stage renal disease (ESRD). The exact mechanism of its pathogenesis is still not known. Recently, neutrophils and NETs have been implicated in the pathogenesis of various disorders that affect the kidneys, including acute kidney injury, vasculitis, SLE, and in various aetiologies of chronic kidney disease. Studies have shown reduced phagocytosis capacity, increased neutrophil degranulation, and basal ROS production in neutrophils from CKD patients on hemodialysis compared to controls. Although they are known to interfere with skin homeostasis by immunological regulation and NETosis, their precise role in CKD-aP is unknown. In this study, we aim to investigate the skin infiltration of neutrophils/ NETs, along with their heterogeneous distribution, in the peripheral blood of CKD-aP patients.
CKD-aP patients with moderate to severe itch (n=50) and healthy controls (HC n=25) were recruited for the study. 3mm skin biopsy and 6ml anticoagulated blood were collected and processed for neutrophil isolation and to study their heterogeneous distribution through flow cytometry (immature neutrophils, mature neutrophils, and NET-forming neutrophils). Skin infiltration was studied using IF (anti-MPO-Cy3), (anti-Citrullinated Histone H3), and NETosis through PMA stimulation in vitro and characterized with Sytox dye. Images were acquired using confocal microscopy. NETs quantification was performed with ImageJ software. GraphPad Prism was used to conduct the statistical analysis.
The average age of healthy controls was 56.60±18.31 years, while that of CKD-aP patients was 53.90±10.89 years. The mean levels of serum creatinine and eGFR rate were (5.55±3.1 mg/dl &; 10.2±4.05 mL/min/1.73m²) respectively, in CKD-aP patients. For these patients, the recorded Itch Numeric Rating Scale (NRS) score was 7.0±1.19. The neutrophils of CKD-aP patients had a greater potential for NET formation in vitro compared to HC patients (CKD-aP 15%; HC 3%). Similarly, there is higher infiltration of neutrophils (MPO+) and NETs (MPO+, CitH3+) in the skin of CKD-aP patients compared to HC skin (number of neutrophils/NETs as a mean of 5 fields at 40X magnification in CKD-aP 16; HC 1). The total percentage of isolated neutrophils was about 70.2% in CKD-aP vs 45% in HC, while the percentage of immature neutrophils was significantly higher in CKD-aP patients compared to HC (CKD-aP: 45.10±5.14% vs HC: 10.51±6.98%; p<0.01). Further, the percentage of mature neutrophils was higher in CKD-aP patients compared to HC (CKD-aP: 10.85±1.50% vs HC: 2.12±0.64%; p<0.01). However, the frequency of NET-forming neutrophil is significantly higher in CKD-ap compared to the HC (CKD-aP: 79.02±20.60% vs HC: 25.99±10.41% p<0.01).
The study reveals an accumulation of immature, potentially high NETs forming mature neutrophils in CKD-aP. We also observed their increased infiltration and NETs in CKD-aP skin. Suggesting potentially high neutrophil polarization in CKD-aP patients.
