CONCLUSIONS: The increase of GDUT was observed only in 7/18 runners. It was typical for the fastest runners with the highest increase of creatinine. It suggests that IS increase is related to run intensity and kidney function. FP303 CHANGES IN BIOCHEMICAL MARKERS OF RENAL HYPOPERFUSION AFTER EXTREME PHYSICAL EXERCISE Wojciech Ratkowski 1 , Wojciech Wolyniec 2 , Katarzyna Kasprowicz 1 , Patrycja Rita- Tkachenko 3 , Kubanek Alicja 2 , Szafran-Dobrowolska Joanna 4 , Marcin Renke 2 1 University of Physical Education and Sport-AWFIS, Gda nsk, Poland, 2 Gda nski Uniwersytet Medyczny, Gda nsk, Poland, 3 Medical Laboratories Bruss Group ALAB, Gdynia, Poland and 4 Medical University of Warsaw, Warsaw, Poland INTRODUCTION: Physical exercise increases blood perfusion of active muscles, but decreases splanchnic and renal blood flow. There are several biochemical markers of renal hypoperfusion used in clinical practice. The most accurate are fractional excretion of urea (FeUrea) and sodium (FeNa) which are used in differential diagnosis of acute kidney failure. FeUrea < 35% is observed in severe renal hypoperfusion in patients with liver cirrhosis or sepsis. Albuminuria is observed after almost every exercise. The aim of the study was to established the severity of changes in renal hypoperfusion after 100 km race and a relationship between renal hypoperfusion and post exercise proteinuria. METHODS: 27 finishers of 100km run were studied. The first runner competed 100 km race in 9h 45 min and the last 15h 57 min. The mean age was 38,04 6 5,64 (range 25-50) years. All were males. The exclusion criteria were history of kidney disease, GFR < 60 ml/min, albuminuria or hematuria. Blood and urine were collected before and after the race. Urinary albumin/creatinine ratio (ACR), FeNa, FeUrea, plasma urea/ creatinine ratio (pUrea/Cr), urine/plasma creatinine ratio (u/pCr), urinary sodium to potassium ratio (uNa/K), urinary potassium to urinary potassium plus sodium ratio (uK/uK+Na) were calculated. RESULTS: The significant changes in albuminuria and markers of renal hypoperfusion were found. Results of laboratory studies. Before race After race p ACR (mg/g) 6,28 6 3,84 48,43 6 51,64 <0,001 FeNa (%) 0,8260,36 0,4460,37 <0,001 FeUrea (%) 47,28610,73 31,50611,95 <0,001 pUrea/Cr (mg/mg) 38,0467,32 50,50610,11 <0,001 u/pCr (mg/mg) 109,2678,58 151,46662 <0,01 uNa/K (mmol/mmol) 4,5762,06 0,8260,74 <0,001 uK/uK+Na (mmol/mmol) 0,2160,01 0,6160,18 <0,001 15 runners with severe renal hypoperfusion (FeUrea< 35% and uNa/K < 1) had higher ACR than the others: ACR 59,42 6 59,86 vs ACR 34,68 6 37,04, respectively, but without statistical significance. CONCLUSIONS: The severe changes in markers of hypoperfusion are found after extreme exercise. The most discriminating are FeUrea and uNa/K. The changes in renal hemodynamics are probably important but not the only factor playing role in post exercise proteinuria. FP304 BIOIMPEDENCE IN AKIN Krishan lal Gupta 1 , Saurabh Nayak 1 , Raja Ramachandran 2 , Yadav Ashok Kumar 1 1 Postgraduate Institute of medical Edu8cation and Research Chandigarh, Chandigarh, India and 2 PGIMER, Chandigarh, India INTRODUCTION: In the setting of sepsis accurate fluid assessment is always been a widely accepted challenge. Traditionally used approaches for fluid assessment have their own disadvantage. Bioimpedance has been used in chronic kidney disease patients for dry weight assessment with studies showing good correlation with at least cardiovascular outcomes when fluid removal was in accordance with bioimpedance. In this study we have performed bioimpedance analysis in non-critically ill AKI patients with sepsis before commencing on dialysis and thereafter. In this pilot study we aimed at comparing impact of two different mode of solute clearance using online HDF versus HD on fluid overload and inflammatory state markers as derived by bioimpedance. Objective assessment of inflammatory state is also performed by serial plasma cytokine monitoring in patients with AKI and SIRS. METHODS: This pilot study was conducted in post graduate institute of medical education and research, Chandigarh, India between September 2017 to September 2018 in patients with AKI and sepsis requiring renal replacement therapy. ICU patients and patients requiring ionotropic support or mechanical ventillator were excluded. Bioimpedance analysis using MALTRON-SF machine was done before and after dialysis at prespecified intervals before commencement of RRT (alternate day for 1 week then weekly once during hospital stay, at 30th and 90th day after discharge) using single frequency bioimpedance machine, parameters like phase angle, body cell mass (BCM), fat free mass (FFM) and total body water (TBW) percentage were analyzed. All patients were followed for a period of 3 months from discharge. RESULTS: Mean age of cohort was 37.5 years, with male to female ratio being 1.6:1. 80 patients were enrolled in each arm with similar baseline characteristics after a computer based randomization. most common indication of initiation of RRT was persistence of anuria for 72 hours followed by refractory metabolic acidosis. Among BIA parameters phase angle, BCM, FFM and TBW was not significantly different between groups at baseline. Significant weight loss has been noted in both the arms and the gap between actual and dry body weight as measured by BIA narrowed similarly through the admission. body cell mass and phase angle improved after initiation of RRT without any significant difference between modality of RRT used. bioimpedance predictors of inflammatory markers correlated with qSOFA score and cytokine levels. Hard outcomes like mortality, dialysis dependency and eGFR recovery at 3 months also didnt defer between the arms. Mean estimated GFR at 30 day was 37.28 ml/min and 30 day mortality was 12.5% for whole cohort, which was similar across the arms. mean phase angle at initiation of RRT and at 1 month after discharge was 6.05 and 10.5 respectively (P= 0.628). At 90 days significant improvement in BIA parameters noted with phase angle only (p<0.005), with no statistical difference between the arms. CONCLUSIONS: Conduction of the trial at a larger scale is feasible in public sector. Bioimpedance derived inflammatory markers viz. phase angle and body cell mass correlated with other traditional markers of sepsis. No better outcomes had been noted between two arms. As, bioimpedance showed improvement in inflammatory parameters similarly across the groups we had similar hard outcomes in these patients. These results were in coherence with other literature which had similar outcome in AKI patients with sepsis undergoing CRRT. FP305 CONTRAST-INDUCED NEPHROPATHY: INFLUENCE OF REDUCTION IN THE ADMINISTERED VOLUME OF CONTRAST Erika Gondim Gurgel Ramalho Lima 1 , Danya Bandeira Lima 1 , Tiago Lima Sampaio 1 , Ramon R oseo Paula Pessoa Bezerra Menezes 1 , Gdayllon Cavalcante Meneses 2 , Isabella Evelyn Prado Azevedo 1 , Andre ´ Costa Teixeira 3 , Elizabeth de Francesco Daher 1 , Geraldo Bezerra da Silva Junior 4 , Alice Maria Costa Martins 1 1 Federal University of Cear a - Campus Porangabuc¸u, Fortaleza, Brazil, 2 Federal University of Ceara, Fortaleza, Brazil, 3 Unichristus - Campus Dom Luis, Fortaleza, Brazil and 4 University of Fortaleza, Fortaleza, Brazil INTRODUCTION: Iodinated contrast media (CM) have been used in the last 60 years worldwide and are indispensable in medical practice. Among the complications arising from the use of CM, there is contrast-induced nephropathy (CIN), which is the third most common cause of iatrogenic acute kidney injury (AKI). Patients with diabetes mellitus, chronic renal failure, old age, stroke, heart failure and anemia are considered high-risk. High osmolality CM are widely used in Brazil, due to its low cost. However, it has been demonstrated that they possess greater nephrotoxicity compared to low and iso-osmolar. Also, the amount of CM administrated is an important factor, especially in elderly people. However, there are few data available in this regard. So it is still unclear how the decrease of volume may prevent CIN. In this context, this work aimed to investigate the influence of the reduction on the volume of iodinated CM administrated. METHODS: Male Wistar rats, weighing 180–200 g were housed in groups under controlled conditions (23 6 2  C, 50–70%humidity, with a 12–12 h light–dark cycle, food and water ad libitum). The animals underwent a 24-hour adaptation period in stainless steel metabolic cages. The animals were treated intravenously with different volumes of Ioxithalamate meglumine (high osmolality CM - 2.5 or 5 mL/Kg) and evaluated after 72 hours. Thus, they were divided in three groups (n = 6) according to the dosage received. After the administration, animals were returned to the cages to stay under observation, to undergo urine production measurement. During the last 24 hours, urine volume was collected for additional analysis. Following the observation period, animals were anesthetized (thiopental 50 mg/Kg i.p.) for blood collection. Blood samples were centrifuged to collect plasma. Microalbuminuria, plasmatic and urinary levels of creatinine were measured. Urinary KIM-1 was determined by sandwich enzyme-linked immunosorbent assay (ELISA) and expressed as KIM-1/ urinary creatinine ratio (uKIM-1). The procedures were approved by the Local Ethics Committee on Animal Use, under protocol number 33/2015. The results were expressed as median 6 standard error. Kruskal-Wallis test was used for statisticalcomparisons between groups and then pairs were compared using the Mann- Whitney test, using p <0.05 as the significance criteria. Analyses were performedusing the Statistical Package for Social Sciences, version 22.0 software. RESULTS: Animals treated with CM (2.5 and 5 ml/Kg) were observed for 72 hours. After this time, biochemical analyses were performed to evaluated kidney injury. Microalbuminuria levels (12.97 6 2.4 vs 54.45 6 5.2) and plasmatic creatinine (0.640 6 0.011 vs 1.675 6 0.131) increased and creatinine clearance (0.258 6 0.066 vs 0.046 6 0.015) reduced in the 5 ml/Kg CM group. It was also observed an increase in uKIM-1 (1063 6 217.7 vs 1939 6 98.68) in animals treated with 5 mL/Kg CM. The administrated of CM to 2.5 mL/kg volume had no changes in microalbuminuria levels (12.97 6 2.4 vs 17.52 6 4.3), plasmatic creatinine (0.640 6 0.011 vs 0.691 6 0.190), doi:10.1093/ndt/gfz106 | i147 Nephrology Dialysis Transplantation Abstracts Downloaded from https://academic.oup.com/ndt/article-abstract/34/Supplement_1/gfz106.FP305/5514738 by guest on 12 June 2020