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1. Radiation dose from medical imaging in end stage renal disease patients: a Nationwide Italian Survey

Author

Postorino, M, Lizio, D, De Mauri, A, Marino, C, Tripepi, G, Zoccali, C, Brambilla, M, Balestra, E, Bellino, D, Benevento, R, Bregant, C, Bregant, P, Cannillo, B, Casto, G, Chiarinotti, D, Cimolai, S, Colussi, G, De Agostini, A, Declich, F, Facchini, M, Galione, M, Gavotti, C, Gerini, U, Isoardi, P, Izzo, C, Levrero, F, Lorenzon, E, Maffei, S, Maggi, S, Mari, A, Mattana, F, Menegotto, A, Meniconi, O, Paruccini, N, Pierotti, L, Pieruzzi, F, Pontoriero, G, Postorino, A, Quaglia, M, Rampado, O, Ranghino, A, Reccanello, S, Sabatino, S, Sangalli, G, Sottocornola, C, Sutto, M, Tata, S, Torresin, A, Traino, A, Trianni, A, Zeni, L, Postorino M., Lizio D., De Mauri A., Marino C., Tripepi G. L., Zoccali C., Brambilla M., Balestra E., Bellino D., Benevento R., Bregant C., Bregant P., Cannillo B., Casto G., Chiarinotti D., Cimolai S., Colussi G., De Agostini A., Declich F., Facchini M. G., Galione M. A., Gavotti C., Gerini U., Isoardi P., Izzo C., Levrero F., Lorenzon E., Maffei S., Maggi S., Mari A., Mattana F., Menegotto A., Meniconi O., Paruccini N., Pierotti L., Pieruzzi F., Pontoriero G., Postorino A., Quaglia M., Rampado O., Ranghino A., Reccanello S., Sabatino S., Sangalli G., Sottocornola C., Sutto M., Tata S., Torresin A., Traino A., Trianni A., Zeni L., Postorino, M, Lizio, D, De Mauri, A, Marino, C, Tripepi, G, Zoccali, C, Brambilla, M, Balestra, E, Bellino, D, Benevento, R, Bregant, C, Bregant, P, Cannillo, B, Casto, G, Chiarinotti, D, Cimolai, S, Colussi, G, De Agostini, A, Declich, F, Facchini, M, Galione, M, Gavotti, C, Gerini, U, Isoardi, P, Izzo, C, Levrero, F, Lorenzon, E, Maffei, S, Maggi, S, Mari, A, Mattana, F, Menegotto, A, Meniconi, O, Paruccini, N, Pierotti, L, Pieruzzi, F, Pontoriero, G, Postorino, A, Quaglia, M, Rampado, O, Ranghino, A, Reccanello, S, Sabatino, S, Sangalli, G, Sottocornola, C, Sutto, M, Tata, S, Torresin, A, Traino, A, Trianni, A, Zeni, L, Postorino M., Lizio D., De Mauri A., Marino C., Tripepi G. L., Zoccali C., Brambilla M., Balestra E., Bellino D., Benevento R., Bregant C., Bregant P., Cannillo B., Casto G., Chiarinotti D., Cimolai S., Colussi G., De Agostini A., Declich F., Facchini M. G., Galione M. A., Gavotti C., Gerini U., Isoardi P., Izzo C., Levrero F., Lorenzon E., Maffei S., Maggi S., Mari A., Mattana F., Menegotto A., Meniconi O., Paruccini N., Pierotti L., Pieruzzi F., Pontoriero G., Postorino A., Quaglia M., Rampado O., Ranghino A., Reccanello S., Sabatino S., Sangalli G., Sottocornola C., Sutto M., Tata S., Torresin A., Traino A., Trianni A., and Zeni L.

Abstract

Background and objectives: End stage renal disease (ESRD) patients are exposed to the risk of ionizing radiation during repeated imaging studies. The variability in diagnostic imaging policies and the accompanying radiation doses across various renal units is still unknown. We studied this variability at the centre level and quantified the associated radiation doses at the patient level. Methods: Fourteen Italian nephrology departments enrolled 739 patients on haemodialysis and 486 kidney transplant patients. The details of the radiological procedures performed over one year were recorded. The effective doses and organ doses of radiation were estimated for each patient using standardized methods to convert exposure parameters into effective and organ doses Results: Computed tomography (CT) was the major contributor (> 77%) to ionizing radiation exposure. Among the haemodialysis and kidney transplant patients, 15% and 6% were in the high (≥ 20 mSv per year) radiation dose groups, respectively. In haemodialysis patients, the most exposed organs were the liver (16 mSv), the kidney (15 mSv) and the stomach (14 mSv), while the uterus (6.2 mSv), the lung (5.7 mSv) and the liver (5.5 mSv) were the most exposed in kidney transplant patients. The average cumulative effective dose (CED) of ionizing radiation among centres in this study was highly variable both in haemodialysis (from 6.4 to 18.8 mSv per patient-year; p = 0.018) and even more so in kidney transplant (from 0.6 to 13.7 mSv per patient-year; p = 0.002) patients. Conclusions: Radiation exposure attributable to medical imaging is high in distinct subgroups of haemodialysis and transplant patients. Furthermore, there is high inter-centre variability in radiation exposure, suggesting that nephrology units have substantially different clinical policies for the application of diagnostic imaging studies.

Published
2021

2. Quality of life of hemodialysis patients in light of the DOPPS study

Author

Cavalli, A., Pontoriero, G., Cavalli, A., and Pontoriero, G.

Abstract

No abstract, Il DOPPS (Dialysis Outcomes and Practice Patterns Study) - ampio studio internazionale, prospettico, osservazionale – è iniziato nel 1996 per raccogliere i dati di un vasto campione di pazienti emodializzati con l'obiettivo di migliorare la terapia, la pratica dialitica ed ovviamente la loro qualità di vita. Lo studio DOPPS ha mostrato come i pazienti emodializzati presentino una qualità di vita molto inferiore rispetto ai soggetti di pari età, in tutte le sue diverse componenti (fisica, mentale e legata alla malattia renale cronica), oltre che una maggior prevalenza di sintomatologia depressiva. È inoltre emerso come alcuni fattori socioeconomici (tra cui la disoccupazione, un ridotto livello di formazione, uno scarso supporto sociale familiare e di staff dialitico) e medici (quali l'utilizzo di un catetere venoso centrale, bassi livelli di emoglobina ed albumina, una scarsa qualità del sonno) siano associati a una più bassa qualità della vita. Il DOPPS ha messo in evidenza l'associazione tra più bassi indici di qualità della vita e peggiori outcome clinici, in termini di ospedalizzazione e mortalità, permettendo pertanto di individuare i soggetti “più fragili” dal punto di vista fisico, sociale e clinico su cui intervenire in maniera specifica. Oggigiorno il DOPPS rappresenta, anche nel campo della valutazione della qualità della vita, un importante riferimento scientifico, che dimostra come uno studio osservazionale, eseguito in accordo ad adeguati criteri metodologici, possa diventare uno strumento informativo, credibile e capace di suggerire nuove ipotesi da testare in successivi studi clinici controllati.

Published
2018

5. What is the contribution of the DOPPS study in characterizing the concept of dialysis dose?

Author

Cavalli, A., Pontoriero, G., Cavalli, A., and Pontoriero, G.

Abstract

No abstract, La necessità di misurare oggettivamente la dose di dialisi somministrata ai pazienti ha determinato lo sviluppo di parametri utilizzabili per la valutazione dell'adeguatezza della terapia dialitica, di cui il principale è il Kt/V dell'urea (che mette in relazione la quantità di clearance dell'urea fornita al paziente nel tempo t di trattamento dialitico, con il volume di distribuzione dell'urea). Due importanti trial randomizzati (il “National Cooperative Dialysis Study” e l'Hemo Study) hanno valutato la dose di dialisi al fine di stabilire il livello minimo da garantire ai pazienti per evitare un aumento di morbilità e mortalità. Ad essi, si sono aggiunti numerosi studi osservazionali che hanno contribuito a definire molti degli aspetti correlati alla dose e all'adeguatezza dialitica. Anche il Dialysis Outcomes and Practice Patterns Study (DOPPS) - studio internazionale, prospettico, osservazionale iniziato nel 1996 per raccogliere dati riguardanti le pratiche cliniche di gestione di problematiche attinenti all'emodialisi - ha fornito rilevanti informazioni attinenti a tale argomento. Nel corso degli anni, il DOPPS ha evidenziato una crescente aderenza nei confronti di quanto raccomandato dalle linee guida internazionali, come dimostrato dall'aumento dei valori medi di Kt/V e da una percentuale sempre minore di pazienti che presentano una dose di dialisi inadeguata. Inoltre, sono stati raccolti e valutati periodicamente quei parametri della prescrizione dialitica in grado di influire sul raggiungimento del valore di Kt/V desiderato e suggerire le possibili modalità di intervento per ottenere i target raccomandati. I dati DOPPS, in accordo con un'analisi secondaria dell'HEMO Study, suggeriscono la possibilità che una più alta dose di dialisi possa associarsi a una miglior sopravvivenza nelle donne. Pertanto, oggigiorno, il DOPPS rappresenta, anche in fatto di adeguatezza dialitica, un importante riferimento scientifico e un credibile strumento informativo capace di

Published
2018

6. How the management of anemia for dialysis patients in the light of the DOPPS study has changed

Author

Cavalli, A., Pontoriero, G., Cavalli, A., and Pontoriero, G.

Abstract

No abstract, L'anemia è una frequente complicanza della malattia renale cronica (Chronic Kidney Disease, o più brevemente CKD) e rappresenta un importante fattore di rischio cardiovascolare che aggrava ulteriormente la prognosi dei pazienti nefropatici. Gli agenti stimolanti l'eritropoiesi (ESA) e la supplementazione marziale rappresentano i cardini su cui attualmente si basa la terapia di questa complicanza della CKD. Il Dialysis Outcomes and Practice Patterns Study (DOPPS) - studio internazionale, prospettico, osservazionale - è stato avviato nel 1996 per raccogliere informazioni riguardanti le pratiche cliniche di gestione di molte problematiche attinenti l'emodialisi, tra cui anche il trattamento dell'anemia. Nel corso degli anni, il DOPPS ha evidenziato una crescente aderenza nei confronti di quanto raccomandato dalle linee guida internazionali, come dimostrato dall'aumento dei valori medi di emoglobina, dall'utilizzo di ESA in una percentuale crescente di pazienti e da una maggiore attenzione a garantire adeguate scorte marziali. Il DOPPS, inoltre, ha messo in risalto una rilevante associazione tra valori di emoglobina e rischio di ospedalizzazione e morte nei pazienti emodializzati. Oggigiorno il DOPPS rappresenta, anche nel campo della gestione dell'anemia secondaria alla CKD, un importante riferimento scientifico, che dimostra come uno studio osservazionale, eseguito in accordo ad adeguati criteri metodologici, possa diventare uno strumento informativo, credibile e capace di suggerire nuove ipotesi da testare in successivi studi clinici controllati.

Published
2018

8. Supplementary Material for: Sudden Death in End Stage Renal Disease: Comparing Hemodialysis versus Peritoneal Dialysis

Author

Genovesi, S., Porcu, L., Luise, M.C., Riva, H., Nava, E., Contaldo, G., Stella, A., Pozzi, C., Ondei, P., Minoretti, C., Gallieni, M., Pontoriero, G., Conte, F., Torri, V., Bertoli, S., and Vincenti, A.

Abstract

Background/Aims: This study aimed to evaluate total and sudden death (SD) in a cohort of dialysis patients, comparing hemodialysis (HD) vs. peritoneal dialysis (PD). Methods: This is a multicenter retrospective cohort study. Results: Deaths were 626 out of 1,823 in HD and 62 of 249 in PD patients. HD patients had a greater number of comorbidities (p < 0.05). PD patients had a lower risk of death than HD patients (p < 0.001); however, the advantage decreased with time (p < 0.001). Mortality predictors were left ventricular ejection fraction (LVEF) ≤35%, older age, ischemic heart disease, diabetes mellitus, previous stroke, and atrial fibrillation (p < 0.03). SDs were 84:71 in HD and 13 in PD population (12.1 and 22.8% of all causes of death, respectively). A non-significant risk of SD among PD compared to HD patients was detected. SD predictors were older age, ischemic heart disease, and LVEF ≤35% (p < 0.05). Conclusions: HD patients showed a greater presence of comorbidities and reduced survival compared to PD patients; however, the incidence of SD does not differ in the 2 populations. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=464347.

Published
2017
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15. Sudden Death in End Stage Renal Disease: Comparing Hemodialysis versus Peritoneal Dialysis

Author

Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Contaldo, G, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Bertoli, S, Vincenti, A, GENOVESI, SIMONETTA CARLA, LUISE, MARIA CARMEN, CONTALDO, GINA, STELLA, ANDREA, Vincenti, A., Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Contaldo, G, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Bertoli, S, Vincenti, A, GENOVESI, SIMONETTA CARLA, LUISE, MARIA CARMEN, CONTALDO, GINA, STELLA, ANDREA, and Vincenti, A.

Abstract

This study aimed to evaluate total and sudden death (SD) in a cohort of dialysis patients, comparing hemodialysis (HD) vs. peritoneal dialysis (PD).

Published
2017

16. Mortality, sudden death and indication for cardioverter defibrillator implantation in a dialysis population

Author

Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Vincenti, A, GENOVESI, SIMONETTA CARLA, LUISE, MARIA CARMEN, RIVA, HILARY, STELLA, ANDREA, Vincenti, A., Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Vincenti, A, GENOVESI, SIMONETTA CARLA, LUISE, MARIA CARMEN, RIVA, HILARY, STELLA, ANDREA, and Vincenti, A.

Abstract

Background The incidence of sudden death among dialysis patients is high, but end stage renal disease was an exclusion criterion in the trials that demonstrated the benefit of implantable cardioverter defibrillator (ICD) for sudden death prevention. Methods Dialysis patients alive on January 2010 or starting dialysis between January 2010 and January 2013 were enrolled and retrospectively evaluated. Patients were divided into three groups: No-Indication, Indication-With ICD and Indication-Without ICD. Cox and Fine and Gray regression models were used to estimate the total and cause-specific (sudden or non-sudden) mortality hazard ratio (HR, HRcpRisk), respectively. Survival was defined as the time from start of dialysis to the time of death. Results 154/2072 patients (7.4%) had indication for ICD implantation and 52 (33.8%) of them received the device; 688 (33.2%) deaths were recorded. Mortality was different among groups [Indication-With ICD vs No-Indication: HR 1.59 (95% CI 1.06-2.38) and Indication-Without ICD vs No-Indication: HR 2.67 (95% CI 2.09-3.39, p < 0.001)]. 84/688 (12.2%) were sudden deaths. The cumulative incidence of sudden death was higher in patients with ICD indication [Indication-With ICD vs No-Indication HRcpRisk 3.21 (95% CI 1.38-7.40) and Indication-Without ICD vs No-Indication: HRcpRisk 4.19 (95% CI 2.38-7.39), p < 0.001], but also No-Indication patients showed a high rate of sudden death [8.5% (95% CI.6.5-10.9) at 8 years of follow-up]. Conclusions Dialysis patients with ICD indication had a worse survival than No-Indication subjects and the prognosis was particularly poor for the Indication-Without ICD group. Sudden death incidence was much higher than in the general population, even among No-Indication subjects.

Published
2015

17. The Dialysis Outcomes and Practice Patterns Study (DOPPS): results of the Italian cohort

Author

Pontoriero, G, Santoro, Domenico, Messina, A, Vitiello, P, Tasco, A, Milei, M, Capiferri, R, Bellazzi, R, Flammini, A, Baroni, A, Morra, M, Cappelli, G, Mucaria, S, Boggi, R, Amico, Me, Volzone, A, D'Andrea, T, Paglionico, C, Antonucci, F, Ivaldi, R, Tentori, F, BRAGG GRESHAM, J, Pisoni, R, Andreucci, Ve, and Locatelli, F.

Subjects
Male, Middle Aged, outcomes, Cohort Studies, Treatment Outcome, Italy, Renal Dialysis, quality, Dialysis, Humans, Kidney Failure, Chronic, Female, Aged
Abstract

The Dialysis Outcomes and Practice Patterns Study (DOPPS) is an international prospective, longitudinal, observational study examining the relationship between dialysis unit practices and outcomes for hemodialysis (HD) patients in seven developed countries France, Germany, Italy, Spain, United Kingdom, Japan and the United States. Results of the DOPPS in Italy are the subject of this report.A national representative sample of 20 dialysis units (21 in Germany) was randomly selected in each of the European DOPPS countries (Euro-DOPPS). In these units, the HD in-center patients were included on a facility census, and their survival rates continuously monitored. A representative sample of incident (269 in Italy, 1553 in the Euro-DOPPS) and prevalent (600 in Italy, 3038 in the Euro-DOPPS) patients was randomly selected from the census for more detailed longitudinal investigation with regard to medical history, laboratory values and hospital admission.Comparing the Italian and Euro-DOPPS cohorts we found comparable mean age for prevalent patients (61.4 vs. 59.5 yrs), but incident patients were older in Italy. Italian prevalent patients had less cardiovascular disease, more satisfactory nutritional status and more frequent use of native vascular access. These data were associated with a comparable mortality (15.7 vs. 16.3 deaths/100 patient yrs), but morbidity was lower in Italy. Kt/V levels were comparable in the two cohorts (1.32 vs. 1.37), but 35% of Italian patients showed a Kt/V below the recommended target. Moreover, hemoglobin levels were below 11 g/dL in 60% of Italian patients.The DOPPS results bring to light several positive aspects and the opportunity for further possible improvements for Italian patients, but at the same time highlight some critical points that could represent a risk for dialysis quality.

Published
2005

18. DIALYSIS VASCULAR ACCESS

Author

Fontsere, N., primary, Mestres, G., additional, Burrel, M., additional, Barrufet, M., additional, Montana, X., additional, Arias, M., additional, Ojeda, R., additional, Maduell, F., additional, Campistol, J. M., additional, Nagaraja, P., additional, Rees, D., additional, Husein, T., additional, Chess, J., additional, Lin, C.-C., additional, Yang, W.-C., additional, Khosravi, M., additional, Kandil, H., additional, Cross, J., additional, Hopkins, S., additional, Collier, S., additional, Lopes, D., additional, Pereira, S., additional, Gomes, A. M., additional, Ventura, A., additional, Martins, V., additional, Seabra, J., additional, Rothuizen, T. C., additional, Damanik, F., additional, Visser, M. J. T., additional, Lavrijsen, T., additional, Cox, M. A. J., additional, Moroni, L., additional, Rabelink, T. J., additional, Rotmans, J. I., additional, Fontsere, N., additional, Cardozo, C., additional, Donate, J., additional, Soriano, A., additional, Muros, M., additional, Pons, M., additional, Mensa, J., additional, Navarro-Gonzalez, J. F., additional, Wijewardane, A., additional, Murley, A., additional, Powers, S., additional, Allen, C., additional, Baharani, J., additional, Wilmink, T., additional, Esenturk, M., additional, Zengin, M., additional, Dal, M., additional, Tahtal , N., additional, Shibata, K., additional, Shinzato, T., additional, Satta, H., additional, Nishihara, M., additional, Koguchi, N., additional, Kuji, T., additional, Kawata, S., additional, Kaneda, T., additional, Yasuda, G., additional, Scrivano, J., additional, Pettorini, L., additional, Rutigliano, T., additional, Ciavarella, G. M., additional, De Biase, L., additional, Punzo, G., additional, Mene, P., additional, Pirozzi, N., additional, El Haggan, W., additional, Belazrague, K., additional, Ehoussou, S., additional, Foucher, V., additional, El Salhy, M., additional, Ouellet, G., additional, Davis, J., additional, Caron, P., additional, Leblanc, M., additional, Romitelli, F., additional, Fazzari, L., additional, Ortu, G., additional, Di Stasio, E., additional, Loizzo, G., additional, Vigano, S. M., additional, Bacchini, G., additional, Rocchi, E., additional, Sala, V., additional, Pontoriero, G., additional, Letachowicz, K., additional, Go  biowski, T., additional, Kusztal, M., additional, Letachowicz, W., additional, Weyde, W., additional, Klinger, M., additional, Hollingsworth, L., additional, Roca-Tey, R., additional, Samon, R., additional, Ibrik, O., additional, Roda, A., additional, Gonzalez-Oliva, J. C., additional, Martinez-Cercos, R., additional, Viladoms, J., additional, Renaud, C. J., additional, Lim, E. K., additional, Seow, T. Y., additional, Teh, H. S., additional, Tosic, J., additional, Jankovic, A., additional, Djuric, P., additional, Radovic Maslarevic, V., additional, Popovic, J., additional, Dimkovic, N., additional, Kazantzi, A., additional, Trigka, K., additional, Buono, F., additional, Laurino, S., additional, Toriello, G., additional, Di Luccio, R., additional, Galise, A., additional, Kim, Y. O., additional, Yoon, S. A., additional, Kim, Y. S., additional, Choi, S. J., additional, Min, J. W., additional, Cheong, M. A., additional, Asano, M., additional, Oguchi, K., additional, Saito, A., additional, Onishi, Y., additional, Yamamoto, Y., additional, Fukuhara, S., additional, Akiba, T., additional, Akizawa, T., additional, Kurokawa, K., additional, Guedes Marques, M., additional, Ibeas, J., additional, Maia, P., additional, Ponce, P., additional, Chang, K. Y., additional, Park, H. S., additional, Kim, H. W., additional, Choi, B. S., additional, Park, C. W., additional, Yang, C. W., additional, Jin, D. C., additional, Likaj, E., additional, Seferi, S., additional, Caco, G., additional, Petrela, E., additional, Barbullushi, M., additional, Idrizi, A., additional, Thereska, N., additional, Lomonte, C., additional, Casucci, F., additional, Libutti, P., additional, Lisi, P., additional, Basile, C., additional, Ancarani, P., additional, Valsuani, G., additional, Cavallo, L., additional, Parodi, D., additional, Lorusso, C., additional, Renaud, C., additional, Lai, B. C., additional, Tho, S., additional, Yeoh, L., additional, Botelho, C., additional, Yankovoy, A., additional, Alexandr, S., additional, Smoliacov, A., additional, Stepanov, V., additional, Parker, C., additional, Davies, P., additional, Taylor, S., additional, Mikhail, A., additional, Gubensek, J., additional, Persic, V., additional, Vajdic, B., additional, Ponikvar, R., additional, Buturovic-Ponikvar, J., additional, Hadimeri, U., additional, Warme, A. V., additional, Stegmayr, B., additional, Suvakov, S., additional, Damjanovic, T., additional, Bajcetic, S., additional, Radovic-Maslarevic, V., additional, Simic, T., additional, Rroji, M., additional, Chua, H. L., additional, Kanda, H., additional, See, S. L., additional, Liew, N. C., additional, Tsuchida, K., additional, Tomo, T., additional, Fukasawa, M., additional, Kawashima, S., additional, Minakuchi, J., additional, Thanaraj, V., additional, Dhaygude, A., additional, Ikeda, K., additional, Forneris, G., additional, Cecere, P., additional, Pozzato, M., additional, Trogolo, M., additional, Vallero, A., additional, Mesiano, P., additional, Roccatello, D., additional, Keskin, L., additional, Casey, J. R., additional, Hanson, C. S., additional, Winkelmayer, W. C., additional, Craig, J., additional, Palmer, S., additional, Strippoli, G., additional, Tong, A., additional, Ferrara, D., additional, Scamarda, S., additional, Bernardino, L., additional, Amico, L., additional, Lorito, M. C., additional, Incalcaterra, f., additional, Visconti, L., additional, Visconti, G., additional, Valenza, F., additional, D'Amato, F., additional, Di Napoli, A., additional, Tazza, L., additional, Chicca, S., additional, Lapucci, E., additional, Silvestri, P., additional, Di Lallo, D., additional, Michelozzi, P., additional, and Davoli, M., additional

Published
2014
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19. DIALYSIS ANAEMIA

Author

Locatelli, F., primary, Choukroun, G., additional, Fliser, D., additional, Moecks, J., additional, Wiggenhauser, A., additional, Gupta, A., additional, Swinkels, D. W., additional, Lin, V., additional, Guss, C., additional, Pratt, R., additional, Carrilho, P., additional, Martins, A. R., additional, Alves, M., additional, Mateus, A., additional, Gusmao, L., additional, Parreira, L., additional, Assuncao, J., additional, Rodrigues, I., additional, Stamopoulos, D., additional, Mpakirtzi, N., additional, Afentakis, N., additional, Grapsa, E., additional, Zitt, E., additional, Sturm, G., additional, Kronenberg, F., additional, Neyer, U., additional, Knoll, F., additional, Lhotta, K., additional, Weiss, G., additional, Robinson, B. M., additional, Larkina, M., additional, Bieber, B., additional, Kleophas, W., additional, Li, Y., additional, Locatelli, F., additional, McCullough, K., additional, Nolen, J. G., additional, Port, F. K., additional, Pisoni, R. L., additional, Kalicki, R. M., additional, Uehlinger, D. E., additional, Ogawa, C., additional, Kanda, F., additional, Tomosugi, N., additional, Maeda, T., additional, Kuji, T., additional, Fujikawa, T., additional, Shino, M., additional, Shibata, K., additional, Kaneda, T., additional, Nishihara, M., additional, Satta, H., additional, Kawata, S.-I., additional, Koguchi, N., additional, Tamura, K., additional, Hirawa, N., additional, Toya, Y., additional, Umemura, S., additional, Chanliau, J., additional, Martin, H., additional, Stamatelou, K., additional, Gonzalez-Tabares, L., additional, Manamley, N., additional, Farouk, M., additional, Addison, J., additional, Donck, J., additional, Schneider, A., additional, Gutjahr-Lengsfeld, L., additional, Ritz, E., additional, Scharnagl, H., additional, Gelbrich, G., additional, Pilz, S., additional, Macdougall, I. C., additional, Wanner, C., additional, Drechsler, C., additional, Kuntsevich, V., additional, Charen, E., additional, Kobena, D., additional, Sheth, N., additional, Siktel, H., additional, Levin, N. W., additional, Winchester, J. F., additional, Kotanko, P., additional, Kaysen, G., additional, Kuragano, T., additional, Kida, A., additional, Yahiro, M., additional, Nanami, M., additional, Nagasawa, Y., additional, Hasuike, Y., additional, Nakanishi, T., additional, Dimitratou, V., additional, Griveas, I., additional, Lianos, E., additional, Sasaki, Y., additional, Yamazaki, S., additional, Fujita, K., additional, Kurasawa, M., additional, Yorozu, K., additional, Shimonaka, Y., additional, Suzuki, N., additional, Yamamoto, M., additional, Zwiech, R., additional, Szczepa ska, J., additional, Bruzda-Zwiech, A., additional, Rao, A., additional, Gilg, J., additional, Caskey, F., additional, Kirkpantur, A., additional, Balci, M. M., additional, Turkvatan, A., additional, Afsar, B., additional, Alkis, M., additional, Mandiroglu, F., additional, Kim, Y. O., additional, Yoon, S. A., additional, Kim, Y. S., additional, Choi, S. J., additional, Min, J. W., additional, Cheong, M. A., additional, Oue, M., additional, Yamamoto, K., additional, Kimura, T., additional, Fukao, W., additional, Kaibe, S., additional, Djuric, P. S., additional, Ikonomovski, J., additional, Tosic, J., additional, Jankovic, A., additional, Majster, Z., additional, Stankovic Popovic, V., additional, Dimkovic, N., additional, Aicardi Spalloni, V., additional, Del Vecchio, L., additional, Longhi, S., additional, Violo, L., additional, La Milia, V., additional, Pontoriero, G., additional, Macdougall, I., additional, Rumjon, A., additional, Mangahis, E., additional, Goldstein, L., additional, Ryzlewicz, T., additional, Becker, F., additional, Kilgallon, W., additional, Fukasawa, M., additional, Otake, Y., additional, Yamagishi, T., additional, Kamiyama, M., additional, Kobayashi, H., additional, Takeda, M., additional, Toida, T., additional, Sato, Y., additional, and Fujimoto, S., additional

Published
2014
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20. PRIMARY AND SECONDARY GLOMERULONEPHRITIDES 2

Author

Monova, D., primary, Monov, S., additional, Todorov, T., additional, Soderberg, D., additional, Kurz, T., additional, Weiner, M., additional, Eriksson, P., additional, Segelmark, M., additional, Jakuszko, K., additional, Sebastian, A., additional, Bednarz, Z., additional, Krajewska, M., additional, Wiland, P., additional, Madziarska, K., additional, Weyde, W., additional, Klinger, M., additional, Naidoo, J., additional, Wearne, N., additional, Jones, E., additional, Swanepoel, C., additional, Rayner, B., additional, Okpechi, I., additional, Endo, N., additional, Tsuboi, N., additional, Furuhashi, K., additional, Matsuo, S., additional, Maruyama, S., additional, Clerte, M., additional, Levi, C., additional, Touzot, M., additional, Fakhouri, F., additional, Monge, C., additional, Lebas, C., additional, Abboud, I., additional, Huart, A., additional, Durieux, P., additional, Charlin, E., additional, Thervet, E., additional, Karras, A., additional, Smykal-Jankowiak, K., additional, Niemir, Z. I., additional, Polcyn-Adamczak, M., additional, Whatmough, S., additional, Sweeney, N., additional, Fernandez, S., additional, Hussain, M., additional, Dhaygude, A., additional, Gniewek, K., additional, Manenti, L., additional, Urban, M. L., additional, Vaglio, A., additional, Gintoli, E., additional, Galletti, M., additional, Buzio, C., additional, Monova, D., additional, Argirova, T., additional, Wong, I., additional, Ibrahim, F. H., additional, Goh, B. L., additional, Lim, T. S., additional, Chan, M. W., additional, Hiramtasu, R., additional, Ubara, Y., additional, Hoshino, J., additional, Takaichi, K., additional, Ghafoor, V., additional, Sahay, M., additional, Soma, J., additional, Nakaya, I., additional, Sasaki, N., additional, Yoshikawa, K., additional, Sato, H., additional, Kaminskyy, V., additional, ZAbi Ska, M., additional, Ko Cielska-Kasprzak, K., additional, Niemir, Z., additional, Wozniczka, K., additional, Swierzko, A., additional, Cedzynski, M., additional, Sokolowska, A., additional, Szala, A., additional, Arjunan, A., additional, Mikhail, A., additional, Shrivastava, R., additional, Parker, C., additional, Aithal, S., additional, Gursu, M., additional, Ozari, M., additional, Yucetas, E., additional, Sumnu, A., additional, Doner, B., additional, Cebeci, E., additional, Ozkan, O., additional, Aktuglu, M. B., additional, Karaali, Z., additional, Koldas, M., additional, Ozturk, S., additional, Marco, H., additional, Picazo, M., additional, Da Silva, I., additional, Gonzalez, A., additional, Arce, Y., additional, Gracia, S., additional, Corica, M., additional, Llobet, J., additional, Diaz, M., additional, Ballarin, J., additional, Schonermarck, U., additional, Hagele, H., additional, Baumgartner, A., additional, Fischereder, M., additional, Muller, S., additional, Oliveira, C. B. L., additional, Oliveira, A. S. A., additional, Carvalho, C. J. B., additional, Pessoa, C. T. B. C., additional, Sette, L. H. B. C., additional, Fernandes, G. V., additional, Cavalcante, M. A. G. M., additional, Valente, L. M., additional, Wan, Q., additional, Hu, H., additional, He, Y., additional, Li, T., additional, Aazair, N., additional, Houmaid, Z., additional, Rhair, A., additional, Bennani, N., additional, Demin, A., additional, Petrova, O., additional, Kotova, O., additional, Demina, L., additional, Roccatello, D., additional, Sciascia, S., additional, Rossi, D., additional, Naretto, C., additional, Baldovino, S., additional, Alpa, M., additional, Salussola, I., additional, Modena, V., additional, Zakharova, E. V., additional, Vinogradova, O. V., additional, Stolyarevich, E. S., additional, Yap, D. Y. H., additional, Chan, T. M., additional, Thanaraj, V., additional, Ponnusamy, A., additional, Pillai, S., additional, Argentiero, L., additional, Schena, A., additional, Rossini, M., additional, Manno, C., additional, Castellano, G., additional, Martino, M., additional, Mitrotti, A., additional, Giliberti, M., additional, Digiorgio, C., additional, Di Palma, A. M., additional, Battaglia, M., additional, Ditonno, P., additional, Grandaliano, G., additional, Gesualdo, L., additional, Neprintseva, N., additional, Tchebotareva, N., additional, Bobkova, I., additional, Kozlovskaya, L., additional, Rabrenovi , V., additional, Kova Evi , Z., additional, Jovanovi , D., additional, Rabrenovi , M., additional, Anti , S., additional, Ignjatovi , L., additional, Petrovi , M., additional, Longhi, S., additional, Del Vecchio, L., additional, Vigano, S., additional, Casartelli, D., additional, Bigi, M. C., additional, Corti, M., additional, Limardo, M., additional, Tentori, F., additional, Pontoriero, G., additional, Zeraati, A. A., additional, Shariati Sarabi, Z., additional, Davoudabadi Farahani, A., additional, Mirfeizi, Z., additional, and Bae, E., additional

Published
2014
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21. PERITONEAL DIALYSIS 2

Author

Vlahu, C. A., primary, De Graaff, M., additional, Struijk, D. G., additional, Krediet, R. T., additional, Shin, H.-S., additional, Ryu, E.-S., additional, Choi, H.-S., additional, Ryu, D.-R., additional, Choi, K.-B., additional, Kang, D.-H., additional, Sanchez-Alvarez, E., additional, Rodriguez-Suarez, C., additional, Galvan-.Hernandez, J. A., additional, Kim, Y. L., additional, Kee, Y. K., additional, Lee, M. J., additional, Oh, H. J., additional, Park, J. T., additional, Han, S. H., additional, Yoo, T.-H., additional, Kang, S.-W., additional, Zhu, F., additional, Abbas, S. R., additional, Bologa, R., additional, Lanto, B., additional, Kotanko, P., additional, Parikova, A., additional, Smit, W., additional, Rroji ( Molla), M., additional, Seferi, S., additional, Cafka, M., additional, Thereska, N., additional, Huang, C.-C., additional, Wang, I.-K., additional, Shiao, Y.-T., additional, Teixeira, L., additional, Sousa, I., additional, Rodrigues, A., additional, Mendonca, D., additional, Ueda, A., additional, Iwase, M., additional, Usui, T., additional, Hirayama, A., additional, Nagai, K., additional, Saito, C., additional, Yamagata, K., additional, La Milia, V., additional, Pontoriero, G., additional, Locatelli, F., additional, Kim, S. M., additional, Kim, T. Y., additional, Lee, J. E., additional, Teta, D., additional, Guillodo, M.-P., additional, Kolko-Labadens, A., additional, Lasseur, C., additional, Levannier, M., additional, Panaye, M., additional, Fouque, D., additional, HAMADA, C., additional, Hara, K., additional, Kang, S. H., additional, Cho, K. H., additional, Park, J. W., additional, Yoon, K. W., additional, Do, J. Y., additional, Dogan, I., additional, Biro Dr, B., additional, Zakar Dr, G., additional, Foldine, Z., additional, Staudt, S., additional, Martins, A. R., additional, Vizinho, R., additional, Branco, P. Q., additional, Gaspar, M. A., additional, Barata, J. D., additional, Sikorska, D., additional, Klysz, P., additional, Posnik, B., additional, Baum, E., additional, Hoppe, K., additional, Schwermer, K., additional, Wanic-Kossowska, M., additional, Frankiewicz, D., additional, Pawlaczyk, K., additional, Lindholm, B., additional, Oko, A., additional, Busuioc, M., additional, Trolliet, P., additional, Guerraoui, A., additional, Caillette-Beaudoin, A., additional, Hallonet, P., additional, Yang, J.-O., additional, Gursu, M., additional, Topcuoglu, D., additional, Koc, L. K., additional, Yucel, L., additional, Sumnu, A., additional, Cebeci, E., additional, Doner, B., additional, Ozkan, O., additional, Behlul, A., additional, Koc, L., additional, Ozturk, S., additional, Kazancioglu, R., additional, Casas Parra, A. I. I., additional, Gonzalez, M. T. T., additional, Sandoval, D. A., additional, Carlota, G. C., additional, Grinyo, J. M. M., additional, Tseng, C.-H., additional, Chao, C.-T., additional, Yen, C.-J., additional, Chiang, C.-K., additional, Hung, K.-Y., additional, Huang, J.-W., additional, Al Wakeel, J. S., additional, Al Ghonaim, M., additional, Al Suwaida, A., additional, Al Harbi, A., additional, Makoshi, Z., additional, Abdullah, S., additional, Matsushita, Y., additional, Basic-Jukic, N., additional, Coen-Herak, D., additional, Martinovic, Z., additional, Radi -Antoli , M., additional, Kes, P., additional, Wu, T.-J., additional, Chen, J.-S., additional, Lin, S.-H., additional, Shiang, J.-C., additional, Wu, C.-C., additional, Munteanu, D., additional, Gemene, M., additional, Mircescu, G., additional, Opatrna, S., additional, Popperlova, A., additional, Tesar, V., additional, Rychlik, I., additional, Viklicky, O., additional, Jin, K., additional, Park, B.-S., additional, Jeong, H. J., additional, Kim, Y.-W., additional, Hogas, S., additional, Voroneanu, L., additional, Onofriescu, M., additional, Nistor, I., additional, Apetrii, M., additional, Siriopol, D., additional, Cujba, M., additional, Hogas, M., additional, and Covic, A., additional

Published
2014
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22. Discussion of the presentations made at the congress

Author

Ronco, C, Locatelli, F, Bolasco, P, Pontoriero, G, Malberti, F, Feriani, M, Gonella, M, Santoro, A, Di Filippo, S, Ledebo, I, Iorio, L, Basile, C, Boggi, R, Amato, M, Bonforte, G, Zucchelli, P, and Costantini, S

Subjects
Transplantation, Nephrology
Published
2003

23. Phosphate levels in patients treated with low-flux haemodialysis, pre-dilution haemofiltration and haemodiafiltration: post hoc analysis of a multicentre, randomized and controlled trial

Author

Locatelli, F., primary, Altieri, P., additional, Andrulli, S., additional, Sau, G., additional, Bolasco, P., additional, Pedrini, L. A., additional, Basile, C., additional, David, S., additional, Gazzanelli, L., additional, Tampieri, G., additional, Isola, E., additional, Marzolla, O., additional, Memoli, B., additional, Ganadu, M., additional, Reina, E., additional, Bertoli, S., additional, Ferrara, R., additional, Casu, D., additional, Logias, F., additional, Tarchini, R., additional, Mattana, G., additional, Passaghe, M., additional, Fundoni, G., additional, Villa, G., additional, Di Iorio, B. R., additional, Pontoriero, G., additional, and Zoccali, C., additional

Published
2014
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25. Nutrition / inflammation

Author

Wong, M. M. Y., primary, Thijssen, S., additional, Usvyat, L. A., additional, Kotanko, P., additional, Maddux, F. W., additional, Speer, T., additional, Rohrer, L., additional, Blyzszuk, P., additional, Krankel, N., additional, Zewinger, S., additional, Martin, T., additional, von Eckardstein, A., additional, Luscher, T., additional, Landmesser, U., additional, Fliser, D., additional, Prats, M., additional, Font, R., additional, Garcia, C., additional, Cabre, C., additional, Jariod, M., additional, Martinez Vea, A., additional, Costa, E., additional, Ribeiro, S., additional, do Sameiro-Faria, M., additional, Rocha-Pereira, P., additional, Kohlova, M., additional, Fernandes, J., additional, Reis, F., additional, Miranda, V., additional, Quintanilha, A., additional, Bronze-da-Rocha, E., additional, Belo, L., additional, Santos-Silva, A., additional, Nascimento, H., additional, Schepers, E., additional, Glorieux, G., additional, Van den Abeele, T., additional, Neirynck, N., additional, Vanholder, R., additional, Boelaert, J., additional, Liabeuf, S., additional, Massy, Z., additional, Kaynar, K., additional, Kural, B. V., additional, Ulusoy, S., additional, Cansiz, M., additional, Akcan, B., additional, Misir, N., additional, Yaman, S., additional, Kaya, N., additional, Dimas, G. G., additional, Iliadis, F. S., additional, Tegos, T. J., additional, Spiroglou, S. G., additional, Pitsalidis, C. G., additional, Karamouzis, I. M., additional, Didaggelos, T. P., additional, Adamidou, A. P., additional, Savopoulos, C. G., additional, Karamouzis, M. I., additional, Orologas, A. G., additional, Hatzitolios, A. I., additional, Grekas, D. M., additional, Flisinski, M., additional, Brymora, A., additional, Stefanska, A., additional, Strozecki, P., additional, Manitius, J., additional, Khalfina, T. N., additional, Maksudova, A. N., additional, Valeeva, I. K., additional, Bantis, C., additional, Kouri, N.-M., additional, Bamichas, G., additional, Stangou, M., additional, Tsantekidou, E., additional, Natse, T., additional, Fazio, M. R., additional, Basile, G., additional, Lucisano, S., additional, Montalto, G., additional, Valeria, C., additional, Donato, V., additional, Lupica, R., additional, Trimboli, D., additional, Aloisi, C., additional, Buemi, M., additional, Henze, A., additional, Raila, J., additional, Scholze, A., additional, Schweigert, F., additional, Tepel, M., additional, Nakamichi, R., additional, Prates, E., additional, Redublo Quinto, B. M., additional, Zanella, M. T., additional, Batista, M. C., additional, Masajtis-Zagajewska, A., additional, Kurnatowska, I., additional, Wajdlich, M., additional, Nowicki, M., additional, Mennini, F., additional, Russo, S., additional, Marcellusi, A., additional, Quintaliani, G., additional, Andrulli, S., additional, Chiavenna, C., additional, Bigi, M. C., additional, Tentori, F., additional, Crepaldi, M., additional, Corti, M. M., additional, Dell'Oro, C., additional, Bacchini, G., additional, Limardo, M., additional, Pontoriero, G., additional, Williams, C., additional, Abbas, S. R., additional, Zhu, F., additional, Flores-Gama, C., additional, Moskowitz, J., additional, Cartagena, C., additional, Carter, M., additional, Levin, N., additional, de Oliveira, R. B., additional, Okazaki, H., additional, Lenglet, A., additional, Desjardins, L., additional, Lemke, H.-D., additional, Valholder, R., additional, Choukroun, G., additional, and Massy, Z. A., additional

Published
2013
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33. Effects of different membranes and dialysis technologies on patient treatment tolerance and nutritional parameters

Author

Locatelli, F, Mastrangelo, F, Redaelli, B, Ronco, C, Marcelli, D, Lagreca, G, Orlandini, G, Corti, M, Pontoriero, G, Difilippo, S, Rossi, R, Farma, R, Colantonio, P, Martinelli, D, Vasile, A, Allegra, V, Mengozzi, G, Martinbianco, L, Bonomini, V, Stefoni, C, Coli, L, Cianciolo, G, Desanctis, L, Deblasi, V, Alfonso, L, Rizzelli, S, Patruno, P, Brendolan, A, Crepaldi, C, Casu, Md, Mureddu, S, Maiorca, R, Cristinelli, L, Setti, G, Camerini, C, Salvadori, M, Bandini, S, Rosati, A, Mancini, G, Panzetta, G, Ianche, M, Delmastro, G, Cogoni, G, Accalai, Gp, Sechi, Ma, Alloatti, S, Paternoster, G, Gaiter, A, Manes, M, Schena, Fp, Pertosa, G, Bottalico, D, Cantafio, S, Salvo, E, Dagostino, F, Guido, A, Limido, D, Beretta, P, Vigano, Mr, Dadone, G, Verzetti, G, Navino, C, Barbe, Mc, Ruva, Ce, Amato, M, Aterini, S, Ippolito, E, Splendiani, G, Sturniolo, A, Costanzi, S, Passalacqua, S, Scatizzi, A, Dimaggio, A, Montemurro, N, Vercellone, A, Segoloni, G, Pacitti, A, Maffei, S, Scaccia, F, Fini, R, Bandiani, G, Antiga, G, Nicolini, Ma, Asproni, E, Cadinu, F, Salvietti, N, Urti, D, Lorusso, P, Dani, L, Peona, C, Filiberti, O, Porcu, Mc, Barbieri, C, Costa, S, Nicrosini, F, Mioli, V, Bibiano, L, Carletti, P, Panichi, N, Melappioni, M, Mecca, G, Mingardi, G, Perticucci, E, Huber, W, Riegler, P, Giacon, B, Altieri, P, Ferrara, R, Bolasco, Pg, Cabiddu, G, Paolillo, A, Morgante, F, Cascone, C, Deluca, M, Demin, Am, Capotorto, M, Ungaro, N, Specchio, A, Albertazzi, A, Delrosso, G, Bonomini, M, Surian, M, Bonforte, G, Dozio, B, Frizzi, V, Ciciani, Am, Ravaglia, F, Giachino, F, Bosticardo, Gm, Francisco, M, Biasioli, S, Petrosino, L, Chimienti, S, Cristofano, C, Perrone, F, Grassi, C, Orazi, E, Bisegna, S, Bracchi, O, Bazzato, G, Toffoletto, Pp, Tesio, F, Faimondi, A, Boggi, R, Campogiani, V, Gentili, F, Bolasco, F, Pistis, R, Pillosu, I, Stallone, C, Aucella, F, Procaccini, D, Avanzi, C, Sorba, G, Solinas, R, Cossu, M, Deangelis, S, Ripani, R, Piccoli, G, Martina, G, Quarello, F, Borghi, M, Massazza, M, Tagliaferri, M, Pascucci, M, Galiotta, P, Bertolucci, E, Sessa, A, Conte, F, Serbelloni, P, Virgilio, M, Delvino, A, Conte, M, Mura, C, Conti, P, Pinna, A, Neumair, F, Bonadonna, A, Stanic, L, Munaretto, G, Ciccarelli, P, Stefoni, A, Biagini, M, Gerace, Ms, Capece, R, Bordoni, E, Petroselli, F, Scaffone, V, Lombardo, V, Coppola, E, Micucci, G, Concetti, M, Capponi, E, Lisi, E, Raccosta, G, Sanna, Gm, Calvisi, L, Cherchi, Gl, Vitali, P, Castelli, P, Estivi, R, Saporiti, E, Dececco, G, Lorenzi, S, Maschio, G, Tessitore, N, Loschiavo, C, Rovati, C, Andreotti, C, Gilli, P, Depaoli, E, Natili, G, and Pensalfini, V

Subjects
medicine.medical_specialty, Beta-2 microglobulin, business.industry, medicine.medical_treatment, Synthetic membrane, Urology, Ultrafiltration, Liter, Surgery, chemistry.chemical_compound, Membrane, chemistry, Nephrology, medicine, Polysulfone, Hemodialysis, business, Dialysis
Abstract

Effects of different membranes and dialysis technologies on patient treatment tolerance and nutritional parameters. There is increasing evidence that the biochemical and cellular phenomena induced by blood/membrane/dialysate interactions contribute to dialysis-related intradialytic and long-term complications. However, there is a lack of large, prospective, randomized trials comparing biocompatible and bioincompatible membranes, and convective and diffusive treatment modalities. The primary aim of this prospective, randomized trial was to evaluate whether the use of polysulfone membrane with bicarbonate dialysate offers any advantages (in terms of treatment tolerance, nutritional parameters and pre-treatment β 2 -microglobulin levels) over a traditional membrane (Cuprophan®). A secondary aim was to assess whether the use of more sophisticated methods consisting of a biocompatible synthetic membrane with different hydraulic permeability at different ultrafiltration rate (highflux hemodialysis and hemodiafiltration) offers any further advantages. Seventy-one Centers were involved and stratified according to the availability of only the first two or all four of the following techniques: Cuprophan® hemodialysis (Cu-HD), low-flux polysulfone hemodialysis (LfPS-HD), high-flux polysulfone high-flux hemodialysis (HfPS-HD), and high-flux polysulfone hemodiafiltration (HfPS-HDF). The 380 eligible patients were randomized to one of the two or four treatments (132 to Cu-HD, 147 to LfPS-HD, 51 to HfPS-HD and 50 to HfPS-HDF). The follow-up was 24 months. No statistical difference was observed in the algebraic sum of the end points between bicarbonate dialysis with Cuprophan® or with low-flux polysulfone, or among the four dialysis methods under evaluation. There was a significant decrease in pre-dialysis plasma β 2 -microglobulin levels in high-flux dialysis of 9.04 ± 10.46 mg/liter (23%) and in hemodiafiltration of 6.35 ± 12.28 mg/liter (16%), both using high-flux polysulfone membrane in comparison with Cuprophan® and low-flux polysulfone membranes (P = 0.032). The significant decrease in pre-dialysis plasma β 2 -microglobulin levels could have a clinical impact when one considers that β 2 -microglobulin accumulation and amyloidosis are important long-term dialysis-related complications.

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35. New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of Nephrologists form Lombardy

Author

Bellasi, A., Mario Cozzolino, Malberti, F., Cancarini, G., Esposito, C., Genderini, A., Guastoni, C. M., Ondei, P., Pontoriero, G., Teatini, U., Vezzoli, G., Messa, P., Locatelli, F., Bellasi, Antonio, Cozzolino, Mario, Malberti, Fabio, Cancarini, Giovanni, Esposito, Ciro, Genderini, Augusto, Guastoni, Carlo Maria, Ondei, Patrizia, Pontoriero, Giuseppe, Teatini, Ugo, Vezzoli, Giuseppe, Messa, Piergiorgio, and Locatelli, Francesco

Subjects
etelcalcetide, secondary hyperparathyroidism, CKD-MBD, cinacalcet, PTH
Abstract

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago. Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

36. New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of working group on CKD-MBD of the Italian Society of Nephrology

Author

Piergiorgio Messa, Giuseppe Vezzoli, Mario Cozzolino, Ciro Esposito, Patrizia Ondei, Giovanni Cancarini, Antonio Bellasi, Francesco Locatelli, Giuseppe Pontoriero, Marzia Pasquali, Carlo Guastoni, Fabio Malberti, Ugo Teatini, Bellasi, A., Cozzolino, M., Malberti, F., Cancarini, G., Esposito, C., Guastoni, C. M., Ondei, P., Pontoriero, G., Teatini, U., Vezzoli, G., Pasquali, M., Messa, P., and Locatelli, F.

Subjects
Nephrology, medicine.medical_specialty, Calcimimetic, medicine.medical_treatment, Population, urologic and male genital diseases, Chronic kidney disease-mineral and bone disorder, Internal medicine, CKD-MBD, medicine, Humans, Position papers and Guidelines, Intensive care medicine, education, Dialysis, Chronic Kidney Disease-Mineral and Bone Disorder, Etelcalcetide, education.field_of_study, business.industry, medicine.disease, female genital diseases and pregnancy complications, Secondary hyperparathyroidism, Italy, Position paper, Cinacalcet, Peptides, business, PTH, Kidney disease
Abstract

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

Published
2019
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37. Sudden Death in End Stage Renal Disease: Comparing Hemodialysis versus Peritoneal Dialysis

Author

Patrizia Ondei, Maurizio Gallieni, Maria Carmen Luise, Simonetta Genovesi, Gina Contaldo, Claudio Minoretti, Valter Torri, Giuseppe Pontoriero, Claudio Pozzi, Hilary Riva, Silvio Bertoli, Ferruccio Conte, Luca Porcu, Andrea Stella, Elisa Nava, Antonio Vincenti, Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Contaldo, G, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Bertoli, S, and Vincenti, A

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, 030232 urology & nephrology, MEDLINE, Hematology, General Medicine, 030204 cardiovascular system & hematology, Dialysis patients, Sudden death, End stage renal disease, Peritoneal dialysis, 03 medical and health sciences, 0302 clinical medicine, Hemodialysis, peritoneal dialysis, mortality, sudden death, Nephrology, Internal medicine, Cohort, Cardiology, medicine, Hemodialysis, business
Abstract

Background/Aims: This study aimed to evaluate total and sudden death (SD) in a cohort of dialysis patients, comparing hemodialysis (HD) vs. peritoneal dialysis (PD). Methods: This is a multicenter retrospective cohort study. Results: Deaths were 626 out of 1,823 in HD and 62 of 249 in PD patients. HD patients had a greater number of comorbidities (p < 0.05). PD patients had a lower risk of death than HD patients (p < 0.001); however, the advantage decreased with time (p < 0.001). Mortality predictors were left ventricular ejection fraction (LVEF) ≤35%, older age, ischemic heart disease, diabetes mellitus, previous stroke, and atrial fibrillation (p < 0.03). SDs were 84:71 in HD and 13 in PD population (12.1 and 22.8% of all causes of death, respectively). A non-significant risk of SD among PD compared to HD patients was detected. SD predictors were older age, ischemic heart disease, and LVEF ≤35% (p < 0.05). Conclusions: HD patients showed a greater presence of comorbidities and reduced survival compared to PD patients; however, the incidence of SD does not differ in the 2 populations. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=464347.

Published
2017
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38. Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Author

Hiddo J L Heerspink, Hans-Henrik Parving, Dennis L Andress, George Bakris, Ricardo Correa-Rotter, Fan-Fan Hou, Dalane W Kitzman, Donald Kohan, Hirofumi Makino, John J V McMurray, Joel Z Melnick, Michael G Miller, Pablo E Pergola, Vlado Perkovic, Sheldon Tobe, Tingting Yi, Melissa Wigderson, Dick de Zeeuw, Alicia Elbert, Augusto Vallejos, Andres Alvarisqueta, Laura Maffei, Luis Juncos, Javier de Arteaga, Gustavo Greloni, Eduardo Farias, Alfredo Zucchini, Daniel Vogel, Ana Cusumano, Juan Santos, Margaret Fraenkel, Martin Gallagher, Tim Davis, Shamasunder Acharya, Duncan Cooke, Michael Suranyi, Simon Roger, Nigel Toussaint, Carol Pollock, Doris Chan, Stephen Stranks, Richard MacIsaac, Zoltan Endre, Alice Schmidt, Rudolf Prager, Gert Mayer, Xavier Warling, Michel Jadoul, Jean Hougardy, Chris Vercammen, Bruno Van Vlem, Pieter Gillard, Adriana Costa e Forti, Joao Lindolfo Borges, Luis Santos Canani, Freddy Eliaschewitz, Silmara Leite, Fadlo Fraige Filho, Raphael Paschoalin, Jose Andrade Moura Neto, Luciane Deboni, Irene de Lourdes Noronha, Cintia Cercato, Carlos Alberto Prompt, Maria Zanella, Nelson Rassi, Domingos D'Avila, Rosangela Milagres, Joao Felicio, Roberto Pecoits Filho, Miguel Carlos Riella, Joao Salles, Elizete Keitel, Sergio Draibe, Celso Amodeo, Joseph Youmbissi, Louise Roy, Serge Cournoyer, Shivinder Jolly, Vincent Pichette, Gihad Nesrallah, Harpreet Singh Bajaj, Hasnain Khandwala, Ronnie Aronson, Richard Goluch, Paul Tam, Christian Rabbat, Gordon Bailey, Stephen Chow, Alvaro Castillo, Alfredo Danin Vargas, Fernando Gonzalez, Rodrigo Munoz, Vicente Gutierrez, Gonzalo Godoy, Hongwen Zhao, Zhangsuo Liu, Minghui Zhao, Xiaohui Guo, Benli Su, Shuxia Fu, Yan Xu, Jinkui Yang, Bingyin Shi, Guanqing Xiao, Wei Shi, Chuanming Hao, Changying Xing, Fanfan Hou, Qun Luo, Yuxiu Li, Linong Ji, Li Zuo, Song Wang, Zhaohui Ni, Guohua Ding, Nan Chen, Jiajun Zhao, Weiping Jia, Shengqiang Yu, Jian Weng, Gang Xu, Ping Fu, Shiren Sun, Bicheng Liu, Xiaoqiang Ding, Ivan Rychlik, Alexandra Oplustilova, Dagmar Bartaskova, Vaclava Honova, Hana Chmelickova, Martin Petr, Petr Bucek, Vladimir Tesar, Emil Zahumensky, Johan Povlsen, Kenneth Egstrup, Anna Oczachowska-Kulik, Peter Rossing, Jorma Lahtela, Jorma Strand, Ilkka Kantola, Catherine Petit, Christian Combe, Philippe Zaoui, Vincent Esnault, Pablo Urena Torres, Jean-Michel Halimi, Bertrand Dussol, Tasso Bieler, Klemens Budde, Frank Dellanna, Thomas Segiet, Christine Kosch, Hans Schmidt-Guertler, Isabelle Schenkenberger, Volker Vielhauer, Frank Pistrosch, Mark Alscher, Christoph Hasslacher, Christian Hugo, Anja Muehlfeld, Christoph Wanner, Ploumis Passadakis, Theofanis Apostolou, Nikolaos Tentolouris, Ioannis Stefanidis, Konstantinos Mavromatidis, Vasilios Liakopoulos, Dimitrios Goumenos, Konstantinos Siamopoulos, Vincent Yeung, Risa Ozaki, Samuel Fung, Kathryn Tan, Sydney Tang, Sing Leung Lui, Siu Fai Cheung, Seamus Sreenan, Joseph Eustace, Donal O'Shea, Peter Lavin, Austin Stack, Yoram Yagil, Julio Wainstein, Hilla Knobler, Josef Cohen, Irina Kenis, Deeb Daoud, Yosefa Bar-Dayan, Victor Frajewicki, Faiad Adawi, Loreto Gesualdo, Domenico Santoro, Francesco Marino, Andrea Galfre, Chiara Brunati, Piero Ruggenenti, Giuseppe Rombola, Giuseppe Pugliese, Maura Ravera, Fabio Malberti, Giuseppe Pontoriero, Teresa Rampino, Salvatore De Cosmo, Ciro Esposito, Felice Nappi, Cataldo Abaterusso, Giuseppe Conte, Vincenzo Panichi, Davide Lauro, Giovambattista Capasso, Domenico Russo, Jiichi Anzai, Motoji Naka, Keita Ato, Tetsuro Tsujimoto, Toshinori Nimura, Eitaro Nakashima, Tetsuro Takeda, Shinya Fujii, Kunihisa Kobayashi, Hideaki Iwaoka, Koji Nagayama, Hiroyuki Harada, Hajime Maeda, Rui Kishimoto, Tadashi Iitsuka, Naoki Itabashi, Ryuichi Furuya, Yoshitaka Maeda, Daishiro Yamada, Nobuhiro Sasaki, Hiromitsu Sasaki, Shinichiro Ueda, Naoki Kashihara, Shuichi Watanabe, Takehiro Nakamura, Hidetoshi Kanai, Yuichiro Makita, Keiko Ono, Noriyuki Iehara, Daisuke Goto, Keiichiro Kosuge, Kenichi Tsuchida, Toshiaki Sato, Takashi Sekikawa, Hideki Okamoto, Tsuyoshi Tanaka, Naoko Ikeda, Takenobu Tadika, Koji Mukasa, Takeshi Osonoi, Fuminori Hirano, Motonobu Nishimura, Yuko Yambe, Yukio Tanaka, Makoto Ujihara, Takashi Sakai, Mitsuo Imura, Yutaka Umayahara, Shinya Makino, Jun Nakazawa, Yukinari Yamaguchi, Susumu Kashine, Hiroaki Miyaoka, Katsunori Suzuki, Toshihiko Inoue, Sou Nagai, Nobuyuki Sato, Masahiro Yamamoto, Noriyasu Taya, Akira Fujita, Akira Matsutani, Yugo Shibagaki, Yuichi Sato, Akira Yamauchi, Masahiro Tsutsui, Tamayo Ishiko, Shizuka Kaneko, Nobuyuki Azuma, Hirofumi Matsuda, Yasuhiro Hashiguchi, Yukiko Onishi, Mikiya Tokui, Munehide Matsuhisa, Arihiro Kiyosue, Junji Shinoda, Kazuo Ishikawa, Ghazali Ahmad, Shalini Vijayasingham, Nor Azizah Aziz, Zanariah Hussein, Yin Khet Fung, Wan Hasnul Halimi Wan Hassan, Hin Seng Wong, Bak Leong Goh, Norhaliza Mohd Ali, Nor Shaffinaz Yusuf Azmi Merican, Indralingam Vaithilingam, Nik Nur Fatnoon Nik Ahmad, Noor Adam, Norlela Sukor, V Paranthaman P Vengadasalam, Khalid Abdul Kadir, Mafauzy Mohamed, Karina Renoirte Lopez, Aniceto Leguizamo-Dimas, Alfredo Chew Wong, Jose Chevaile-Ramos, Jose Gonzalez Gonzalez, Raul Rico Hernandez, Jose Nino-Cruz, Leobardo Sauque Reyna, Guillermo Gonzalez-Galvez, Magdalena Madero Rovalo, Tomasso Bochicchio-Ricardelli, Jorge Aldrete, Jaime Carranza-Madrigal, Liffert Vogt, Peter Smak Gregoor, JNM Barendregt, Peter Luik, Ronald Gansevoort, Gozewijn Laverman, Helen Pilmore, Helen Lunt, John Baker, Steven Miller, Kannaiyan Rabindranath, Luis Zapata-Rincon, Rolando Vargas-Gonzales, Jorge Calderon Ticona, Augusto Dextre Espinoza, Jose Burga Nunez, Carlos Antonio Zea-Nunez, Benjamin Herrada Orue, Boris Medina-Santander, Cesar Delgado-Butron, Julio Farfan-Aspilcueta, Stanislaw Mazur, Miroslaw Necki, Michal Wruk, Katarzyna Klodawska, Grazyna Popenda, Ewa Skokowska, Malgorzata Arciszewska, Andrzej Wiecek, Kazimierz Ciechanowski, Michal Nowicki, Rita Birne, Antonio Cabrita, Aura Ramos, Manuel Anibal Antunes Ferreira, Evelyn Matta Fontanet, Altagracia Aurora Alcantara-Gonzalez, Angel Comulada-Rivera, Eugenia Galindo Ramos, Jose Cangiano, Luis Quesada-Suarez, Ricardo Calderon Ortiz, Jose Vazquez-Tanus, Rafael Burgos-Calderon, Carlos Rosado, Nicolae Hancu, Ella Pintilei, Cristina Mistodie, Gabriel Bako, Lavinia Ionutiu, Ligia Petrica, Romulus Timar, Liliana Tuta, Livia Duma, Adriana Tutescu, Svetlana Ivanova, Ashot Essaian, Konstantin Zrazhevskiy, Natalia Tomilina, Elena Smolyarchuk, Anatoly Kuzin, Olga Lantseva, Irina Karpova, Minara Shamkhalova, Natalia Liberanskaya, Andrey Yavdosyuk, Yuri Shvarts, Tatiana Bardymova, Olga Blagoveshchenskaya, Oleg Solovev, Elena Rechkova, Natalia Pikalova, Maria Pavlova, Elena Kolmakova, Rustam Sayfutdinov, Svetlana Villevalde, Natalya Koziolova, Vladimir Martynenko, Vyacheslav Marasaev, Adelya Maksudova, Olga Sigitova, Viktor Mordovin, Vadim Klimontov, Yulia Samoylova, Tatiana Karonova, Lee Ying Yeoh, Boon Wee Teo, Marjorie Wai Yin Foo, Adrian Liew, Ivan Tkac, Aniko Oroszova, Jozef Fekete, Jaroslav Rosenberger, Ida Obetkova, Alla Fulopova, Eva Kolesarova, Katarina Raslova, Peter Smolko, Adrian Oksa, Larry Distiller, Julien Trokis, Luthando Adams, Hemant Makan, Padaruth Ramlachan, Essack Mitha, Kathleen Coetzee, Zelda Punt, Qasim Bhorat, Puvenesvari Naiker, Graham Ellis, Louis Van Zyl, Kwan Woo Lee, Min Seon Kim, Soon-Jib Yoo, Kun Ho Yoon, Yong-Wook Cho, Tae-Sun Park, Sang Yong Kim, Moon-Gi Choi, Tae Keun Oh, Kang-Wook Lee, Ho Sang Shon, Sung Hwan Suh, Byung-Joon Kim, Kim Doo-Man, Joo Hark Yi, Sang Ah Lee, Ho Chan Cho, Sin-Gon Kim, Dae-Ryong Cha, Ji A Seo, Kyung Mook Choi, Jeong-Taek Woo, Kyu Jeung Ahn, Jae Hyuk Lee, In-Joo Kim, Moon-Kyu Lee, Hak Chul Jang, Kyong-Soo Park, Beom Seok Kim, Ji Oh Mok, Mijung Shin, Sun Ae Yoon, Il-Seong Nam-Goong, Choon Hee Chung, Tae Yang Yu, Hyoung Woo Lee, Alfonso Soto Gonzalez, Jaume Almirall, Jesus Egido, Francesca Calero Gonzalez, Gema Fernandez Fresnedo, Ildefonso Valera Cortes, Manuel Praga Terente, Isabel Garcia Mendez, Juan Navarro Gonzalez, Jose Herrero Calvo, Secundino Cigarran Guldris, Mario Prieto Velasco, Jose Ignacio Minguela Pesquera, Antonio Galan, Julio Pascual, Maria Marques Vidas, Judith Martins Munoz, Jose Rodriguez-Perez, Cristina Castro-Alonso, Josep Bonet Sol, Daniel Seron, Elvira Fernandez Giraldez, Javier Arrieta Lezama, Nuria Montero, Julio Hernandez-Jaras, Rafael Santamaria Olmo, Jose Ramon Molas Coten, Olof Hellberg, Bengt Fellstrom, Andreas Bock, Dee Pei, Ching-Ling Lin, Kai-Jen Tien, Ching-Chu Chen, Chien-Ning Huang, Ju-Ying Jiang, Du-An Wu, Chih-Hsun Chu, Shih-Ting Tseng, Jung-Fu Chen, Cho-Tsan Bau, Wayne Sheu, Mai-Szu Wu, Ramazan Sari, Siren Sezer, Alaattin Yildiz, Ilhan Satman, Betul Kalender, Borys Mankovskyy, Ivan Fushtey, Mykola Stanislavchuk, Mykola Kolenyk, Iryna Dudar, Viktoriia Zolotaikina, Orest Abrahamovych, Tetyana Kostynenko, Olena Petrosyan, Petro Kuskalo, Olga Galushchak, Oleg Legun, Ivan Topchii, Liliya Martynyuk, Vasyl Stryzhak, Svitlana Panina, Sergii Tkach, Vadym Korpachev, Peter Maxwell, Luigi Gnudi, Sui Phin Kon, Hilary Tindall, Phillip Kalra, Patrick Mark, Dipesh Patel, Mohamed El-Shahawy, Liqun Bai, Romanita Nica, Yeong-Hau Lien, Judson Menefee, Robert Busch, Alan Miller, Azazuddin Ahmed, Ahmed Arif, Joseph Lee, Sachin Desai, Shweta Bansal, Marie Bentsianov, Mario Belledonne, Charles Jere, Raul Gaona, Gregory Greenwood, Osvaldo Brusco, Mark Boiskin, Diogo Belo, Raffi Minasian, Naveen Atray, Mary Lawrence, John Taliercio, Pablo Pergola, David Scott, German Alvarez, Bradley Marder, Thomas Powell, Wa'el Bakdash, George Stoica, Christopher McFadden, Marc Rendell, Jonathan Wise, Audrey Jones, Michael Jardula, Ivy-Joan Madu, Freemu Varghese, Brian Tulloch, Ziauddin Ahmed, Melanie Hames, Imran Nazeer, Newman Shahid, Rekha John, Manuel Montero, David Fitz-Patrick, Lawrence Phillips, Antonio Guasch, Elena Christofides, Aijaz Gundroo, Mohammad Amin, Cynthia Bowman-Stroud, Michael Link, Laura Mulloy, Michael Nammour, Tarik Lalwani, Lenita Hanson, Adam Whaley-Connell, Lee Herman, Rupi Chatha, Sayed Osama, Kenneth Liss, Zeid Kayali, Anuj Bhargava, Ezra Israel, Alfredo Peguero-Rivera, Michael Fang, Judith Slover, Elena Barengolts, Jose Flores, Rosemary Muoneke, Virginia Savin, Stella Awua-Larbi, Andrew Levine, George Newman, Laden Golestaneh, Guillermo Bohm, Efrain Reisin, Lucita Cruz, Robert Weiss, Franklin Zieve, Edward Horwitz, Peale Chuang, James Mersey, John Manley, Ronald Graf, Fadi Bedros, Sudhir Joshi, Juan Frias, Ali Assefi, Andrew O'Shaughnessy, Roman Brantley, Todd Minga, David Tietjen, Samuel Kantor, Aamir Jamal, Ramon Guadiz, Kenneth Hershon, Peter Bressler, Nelson Kopyt, Harold Cathcart, Scott Bloom, Ronald Reichel, Samer Nakhle, Emily Dulude, Joshua Tarkan, Penelope Baker, Steven Zeig, Jaynier Moya Hechevarria, Armando Ropero-Cartier, Gilda De la Calle, Ankur Doshi, Fadi Saba, Teresa Sligh, Sylvia Shaw, Jayant Kumar, Harold Szerlip, George Bayliss, Alan Perlman, Lakhi Sakhrani, Steven Gouge, Georges Argoud, Idalia Acosta, John Elder, Sucharit Joshi, John Sensenbrenner, Steven Vicks, Roberto Mangoo-Karim, Claude Galphin, Carlos Leon-Forero, John Gilbert, Eric Brown, Adeel Ijaz, Salman Butt, Mariana Markell, Carlos Arauz-Pacheco, Lance Sloan, Odilon Alvarado, Serge Jabbour, Eric Simon, Anjay Rastogi, Sam James, Karen Hall, John Melish, Brad Dixon, Allen Adolphe, Csaba Kovesdy, Srinivasan Beddhu, Richard Solomon, Ronald Fernando, Ellis Levin, Charuhas Thakar, Brooks Robey, David Goldfarb, Linda Fried, Geetha Maddukuri, Stephen Thomson, Andrew Annand, Saeed Kronfli, Paramjit Kalirao, Rebecca Schmidt, Neera Dahl, Samuel Blumenthal, Debra Weinstein, Ove Ostergaard, Talia Weinstein, Yasuhiro Ono, Murat Yalcin, Shahana Karim, APH - Health Behaviors & Chronic Diseases, Nephrology, ACS - Amsterdam Cardiovascular Sciences, ACS - Microcirculation, Biomedical Signals and Systems, UCL - SSS/IREC/NEFR - Pôle de Néphrologie, UCL - (SLuc) Service de néphrologie, Groningen Kidney Center (GKC), Real World Studies in PharmacoEpidemiology, -Genetics, -Economics and -Therapy (PEGET), Heerspink, H. J. L., Parving, H. -H., Andress, D. L., Bakris, G., Correa-Rotter, R., Hou, F. -F., Kitzman, D. W., Kohan, D., Makino, H., Mcmurray, J. J. V., Melnick, J. Z., Miller, M. G., Pergola, P. E., Perkovic, V., Tobe, S., Yi, T., Wigderson, M., de Zeeuw, D., Elbert, A., Vallejos, A., Alvarisqueta, A., Maffei, L., Juncos, L., de Arteaga, J., Greloni, G., Farias, E., Zucchini, A., Vogel, D., Cusumano, A., Santos, J., Fraenkel, M., Gallagher, M., Davis, T., Acharya, S., Cooke, D., Suranyi, M., Roger, S., Toussaint, N., Pollock, C., Chan, D., Stranks, S., Macisaac, R., Endre, Z., Schmidt, A., Prager, R., Mayer, G., Warling, X., Jadoul, M., Hougardy, J., Vercammen, C., Van Vlem, B., Gillard, P., Costa e Forti, A., Borges, J. L., Santos Canani, L., Eliaschewitz, F., Leite, S., Fraige Filho, F., Paschoalin, R., Moura Neto, J. A., Deboni, L., de Lourdes Noronha, I., Cercato, C., Prompt, C. A., Zanella, M., Rassi, N., D'Avila, D., Milagres, R., Felicio, J., Pecoits Filho, R., Riella, M. 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S., Khandwala, H., Aronson, R., Goluch, R., Tam, P., Rabbat, C., Bailey, G., Chow, S., Castillo, A., Danin Vargas, A., Gonzalez, F., Munoz, R., Gutierrez, V., Godoy, G., Zhao, H., Liu, Z., Zhao, M., Guo, X., Su, B., Fu, S., Xu, Y., Yang, J., Shi, B., Xiao, G., Shi, W., Hao, C., Xing, C., Hou, F., Luo, Q., Li, Y., Ji, L., Zuo, L., Wang, S., Ni, Z., Ding, G., Chen, N., Zhao, J., Jia, W., Yu, S., Weng, J., Xu, G., Fu, P., Sun, S., Liu, B., Ding, X., Rychlik, I., Oplustilova, A., Bartaskova, D., Honova, V., Chmelickova, H., Petr, M., Bucek, P., Tesar, V., Zahumensky, E., Povlsen, J., Egstrup, K., Oczachowska-Kulik, A., Rossing, P., Lahtela, J., Strand, J., Kantola, I., Petit, C., Combe, C., Zaoui, P., Esnault, V., Urena Torres, P., Halimi, J. -M., Dussol, B., Bieler, T., Budde, K., Dellanna, F., Segiet, T., Kosch, C., Schmidt-Guertler, H., Schenkenberger, I., Vielhauer, V., Pistrosch, F., Alscher, M., Hasslacher, C., Hugo, C., Muehlfeld, A., Wanner, C., Passadakis, P., Apostolou, T., Tentolouris, N., Stefanidis, I., Mavromatidis, K., Liakopoulos, V., Goumenos, D., Siamopoulos, K., Yeung, V., Ozaki, R., Fung, S., Tan, K., Tang, S., Lui, S. 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F., Sreenan, S., Eustace, J., O'Shea, D., Lavin, P., Stack, A., Yagil, Y., Wainstein, J., Knobler, H., Cohen, J., Kenis, I., Daoud, D., Bar-Dayan, Y., Frajewicki, V., Adawi, F., Gesualdo, L., Santoro, D., Marino, F., Galfre, A., Brunati, C., Ruggenenti, P., Rombola, G., Pugliese, G., Ravera, M., Malberti, F., Pontoriero, G., Rampino, T., De Cosmo, S., Esposito, C., Nappi, F., Abaterusso, C., Conte, G., Panichi, V., Lauro, D., Capasso, G., Russo, D., Anzai, J., Naka, M., Ato, K., Tsujimoto, T., Nimura, T., Nakashima, E., Takeda, T., Fujii, S., Kobayashi, K., Iwaoka, H., Nagayama, K., Harada, H., Maeda, H., Kishimoto, R., Iitsuka, T., Itabashi, N., Furuya, R., Maeda, Y., Yamada, D., Sasaki, N., Sasaki, H., Ueda, S., Kashihara, N., Watanabe, S., Nakamura, T., Kanai, H., Makita, Y., Ono, K., Iehara, N., Goto, D., Kosuge, K., Tsuchida, K., Sato, T., Sekikawa, T., Okamoto, H., Tanaka, T., Ikeda, N., Tadika, T., Mukasa, K., Osonoi, T., Hirano, F., Nishimura, M., Yambe, Y., Tanaka, Y., Ujihara, M., Sakai, T., Imura, M., Umayahara, Y., Makino, S., Nakazawa, J., Yamaguchi, Y., Kashine, S., Miyaoka, H., Suzuki, K., Inoue, T., Nagai, S., Sato, N., Yamamoto, M., Taya, N., Fujita, A., Matsutani, A., Shibagaki, Y., Sato, Y., Yamauchi, A., Tsutsui, M., Ishiko, T., Kaneko, S., Azuma, N., Matsuda, H., Hashiguchi, Y., Onishi, Y., Tokui, M., Matsuhisa, M., Kiyosue, A., Shinoda, J., Ishikawa, K., Ahmad, G., Vijayasingham, S., Aziz, N. A., Hussein, Z., Fung, Y. K., Hassan, W. H. H. W., Wong, H. S., Goh, B. L., Ali, N. M., Merican, N. S. Y. A., Vaithilingam, I., Nik Ahmad, N. N. F., Adam, N., Sukor, N., Vengadasalam, V. P. P., Abdul Kadir, K., Mohamed, M., Renoirte Lopez, K., Leguizamo-Dimas, A., Chew Wong, A., Chevaile-Ramos, J., Gonzalez Gonzalez, J., Rico Hernandez, R., Nino-Cruz, J., Sauque Reyna, L., Gonzalez-Galvez, G., Madero Rovalo, M., Bochicchio-Ricardelli, T., Aldrete, J., Carranza-Madrigal, J., Vogt, L., Smak Gregoor, P., Barendregt, J. N. M., Luik, P., Gansevoort, R., Laverman, G., Pilmore, H., Lunt, H., Baker, J., Miller, S., Rabindranath, K., Zapata-Rincon, L., Vargas-Gonzales, R., Calderon Ticona, J., Dextre Espinoza, A., Burga Nunez, J., Zea-Nunez, C. A., Herrada Orue, B., Medina-Santander, B., Delgado-Butron, C., Farfan-Aspilcueta, J., Mazur, S., Necki, M., Wruk, M., Klodawska, K., Popenda, G., Skokowska, E., Arciszewska, M., Wiecek, A., Ciechanowski, K., Nowicki, M., Birne, R., Cabrita, A., Ramos, A., Antunes Ferreira, M. A., Matta Fontanet, E., Alcantara-Gonzalez, A. A., Comulada-Rivera, A., Galindo Ramos, E., Cangiano, J., Quesada-Suarez, L., Calderon Ortiz, R., Vazquez-Tanus, J., Burgos-Calderon, R., Rosado, C., Hancu, N., Pintilei, E., Mistodie, C., Bako, G., Ionutiu, L., Petrica, L., Timar, R., Tuta, L., Duma, L., Tutescu, A., Ivanova, S., Essaian, A., Zrazhevskiy, K., Tomilina, N., Smolyarchuk, E., Kuzin, A., Lantseva, O., Karpova, I., Shamkhalova, M., Liberanskaya, N., Yavdosyuk, A., Shvarts, Y., Bardymova, T., Blagoveshchenskaya, O., Solovev, O., Rechkova, E., Pikalova, N., Pavlova, M., Kolmakova, E., Sayfutdinov, R., Villevalde, S., Koziolova, N., Martynenko, V., Marasaev, V., Maksudova, A., Sigitova, O., Mordovin, V., Klimontov, V., Samoylova, Y., Karonova, T., Yeoh, L. Y., Teo, B. W., Foo, M. W. Y., Liew, A., Tkac, I., Oroszova, A., Fekete, J., Rosenberger, J., Obetkova, I., Fulopova, A., Kolesarova, E., Raslova, K., Smolko, P., Oksa, A., Distiller, L., Trokis, J., Adams, L., Makan, H., Ramlachan, P., Mitha, E., Coetzee, K., Punt, Z., Bhorat, Q., Naiker, P., Ellis, G., Van Zyl, L., Lee, K. W., Kim, M. S., Yoo, S. -J., Yoon, K. H., Cho, Y. -W., Park, T. -S., Kim, S. Y., Choi, M. -G., Oh, T. K., Lee, K. -W., Shon, H. S., Suh, S. H., Kim, B. -J., Doo-Man, K., Yi, J. H., Lee, S. A., Cho, H. C., Kim, S. -G., Cha, D. -R., Seo, J. A., Choi, K. M., Woo, J. -T., Ahn, K. J., Lee, J. H., Kim, I. -J., Lee, M. -K., Jang, H. C., Park, K. -S., Kim, B. S., Mok, J. O., Shin, M., Yoon, S. A., Nam-Goong, I. -S., Chung, C. H., Yu, T. Y., Lee, H. W., Soto Gonzalez, A., Almirall, J., Egido, J., Calero Gonzalez, F., Fernandez Fresnedo, G., Valera Cortes, I., Praga Terente, M., Garcia Mendez, I., Navarro Gonzalez, J., Herrero Calvo, J., Cigarran Guldris, S., Prieto Velasco, M., Minguela Pesquera, J. I., Galan, A., Pascual, J., Marques Vidas, M., Martins Munoz, J., Rodriguez-Perez, J., Castro-Alonso, C., Bonet Sol, J., Seron, D., Fernandez Giraldez, E., Arrieta Lezama, J., Montero, N., Hernandez-Jaras, J., Santamaria Olmo, R., Molas Coten, J. R., Hellberg, O., Fellstrom, B., Bock, A., Pei, D., Lin, C. -L., Tien, K. -J., Chen, C. -C., Huang, C. -N., Jiang, J. -Y., Wu, D. -A., Chu, C. -H., Tseng, S. -T., Chen, J. -F., Bau, C. -T., Sheu, W., Wu, M. -S., Sari, R., Sezer, S., Yildiz, A., Satman, I., Kalender, B., Mankovskyy, B., Fushtey, I., Stanislavchuk, M., Kolenyk, M., Dudar, I., Zolotaikina, V., Abrahamovych, O., Kostynenko, T., Petrosyan, O., Kuskalo, P., Galushchak, O., Legun, O., Topchii, I., Martynyuk, L., Stryzhak, V., Panina, S., Tkach, S., Korpachev, V., Maxwell, P., Gnudi, L., Kon, S. P., Tindall, H., Kalra, P., Mark, P., Patel, D., El-Shahawy, M., Bai, L., Nica, R., Lien, Y. -H., Menefee, J., Busch, R., Miller, A., Ahmed, A., Arif, A., Lee, J., Desai, S., Bansal, S., Bentsianov, M., Belledonne, M., Jere, C., Gaona, R., Greenwood, G., Brusco, O., Boiskin, M., Belo, D., Minasian, R., Atray, N., Lawrence, M., Taliercio, J., Pergola, P., Scott, D., Alvarez, G., Marder, B., Powell, T., Bakdash, W., Stoica, G., Mcfadden, C., Rendell, M., Wise, J., Jones, A., Jardula, M., Madu, I. -J., Varghese, F., Tulloch, B., Ahmed, Z., Hames, M., Nazeer, I., Shahid, N., John, R., Montero, M., Fitz-Patrick, D., Phillips, L., Guasch, A., Christofides, E., Gundroo, A., Amin, M., Bowman-Stroud, C., Link, M., Mulloy, L., Nammour, M., Lalwani, T., Hanson, L., Whaley-Connell, A., Herman, L., Chatha, R., Osama, S., Liss, K., Kayali, Z., Bhargava, A., Israel, E., Peguero-Rivera, A., Fang, M., Slover, J., Barengolts, E., Flores, J., Muoneke, R., Savin, V., Awua-Larbi, S., Levine, A., Newman, G., Golestaneh, L., Bohm, G., Reisin, E., Cruz, L., Weiss, R., Zieve, F., Horwitz, E., Chuang, P., Mersey, J., Manley, J., Graf, R., Bedros, F., Joshi, S., Frias, J., Assefi, A., O'Shaughnessy, A., Brantley, R., Minga, T., Tietjen, D., Kantor, S., Jamal, A., Guadiz, R., Hershon, K., Bressler, P., Kopyt, N., Cathcart, H., Bloom, S., Reichel, R., Nakhle, S., Dulude, E., Tarkan, J., Baker, P., Zeig, S., Moya Hechevarria, J., Ropero-Cartier, A., De la Calle, G., Doshi, A., Saba, F., Sligh, T., Shaw, S., Kumar, J., Szerlip, H., Bayliss, G., Perlman, A., Sakhrani, L., Gouge, S., Argoud, G., Acosta, I., Elder, J., Sensenbrenner, J., Vicks, S., Mangoo-Karim, R., Galphin, C., Leon-Forero, C., Gilbert, J., Brown, E., Ijaz, A., Butt, S., Markell, M., Arauz-Pacheco, C., Sloan, L., Alvarado, O., Jabbour, S., Simon, E., Rastogi, A., James, S., Hall, K., Melish, J., Dixon, B., Adolphe, A., Kovesdy, C., Beddhu, S., Solomon, R., Fernando, R., Levin, E., Thakar, C., Robey, B., Goldfarb, D., Fried, L., Maddukuri, G., Thomson, S., Annand, A., Kronfli, S., Kalirao, P., Schmidt, R., Dahl, N., Blumenthal, S., Weinstein, D., Ostergaard, O., Weinstein, T., Ono, Y., Yalcin, M., Karim, S., Pathology/molecular and cellular medicine, Diabetes Pathology & Therapy, and Diabetes Clinic

Subjects
Male, endothelin, albuminuria, nephropathy, inhibition, Diabetes Mellitus, Type 2/drug therapy, Endocrinology, Diabetes and Metabolism, Placebo-controlled study, Administration, Oral, 030204 cardiovascular system & hematology, Settore MED/13 - Endocrinologia, chemistry.chemical_compound, 0302 clinical medicine, ENDOTHELIN, 80 and over, Diabetic Nephropathies, 030212 general & internal medicine, Renal Insufficiency, Chronic, Aged, 80 and over, Diabetic Nephropathies/blood, General Medicine, Middle Aged, Atrasentan/administration & dosage, Editorial Commentary, Treatment Outcome, Nephrology, Creatinine, Administration, young adult, Female, medicine.symptom, Glomerular filtration rate, Type 2, Endothelin A Receptor Antagonists/administration & dosage, medicine.drug, Glomerular Filtration Rate, Human, Oral, Adult, medicine.medical_specialty, ALBUMINURIA, Endothelin A Receptor Antagonists, NEPHROPATHY, Urology, INHIBITION, Renal function, Serum Albumin, Human, Placebo, Nephropathy, 03 medical and health sciences, Young Adult, Double-Blind Method, Atresentan, diabetes, chronic kidney disease, medicine, Diabetes Mellitus, Aged, Atrasentan, Diabetes Mellitus, Type 2, Humans, Renal Insufficiency, Chronic, Serum Albumin, business.industry, Creatinine/blood, medicine.disease, Serum Albumin, Human/urine, n/a OA procedure, chemistry, Albuminuria, Renal Insufficiency, Chronic/blood, business, aged, 80 and over, Kidney disease
Abstract

Background Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes.Methods We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18-85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR) 25-75 mL/min per 1.73 m(2) of body surface area, and a urine albumin-to-creatinine ratio (UACR) of 300-5000 mg/g who had received maximum labelled or tolerated renin-angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0.75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders) were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0.75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for >= 30 days) or end-stage kidney disease (eGFR = 90 days, chronic dialysis for >= 90 days, kidney transplantation, or death from kidney failure) in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials. gov, number NCT01858532.Findings Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325) or placebo group (n=1323). Median follow-up was 2.2 years (IQR 1.4-2.9). 79 (6.0%) of 1325 patients in the atrasentan group and 105 (7.9%) of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR] 0.65 [95% CI 0.49-0.88]; p=0.0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3.5%) of 1325 patients in the atrasentan group and 34 (2.6%) of 1323 patients in the placebo group (HR 1.33 [95% CI 0.85-2.07]; p=0.208). 58 (4.4%) patients in the atrasentan group and 52 (3.9%) in the placebo group died (HR 1.09 [95% CI 0.75-1.59]; p=0.65).Interpretation Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Copyright (C) 2019 Elsevier Ltd. All rights reserved.

Published
2019
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39. Efficacy of a remote web-based lung ultrasound training for nephrologists and cardiologists: a LUST trial sub-project.

Author

Gargani L, Sicari R, Raciti M, Serasini L, Passera M, Torino C, Letachowicz K, Ekart R, Fliser D, Covic A, Balafa O, Stavroulopoulos A, Massy ZA, Fiaccadori E, Caiazza A, Bachelet T, Slotki I, Shavit L, Martinez-Castelao A, Coudert-Krier MJ, Rossignol P, Kraemer TD, Hannedouche T, Panichi V, Wiecek A, Pontoriero G, Sarafidis P, Klinger M, Hojs R, Seiler-Mußler S, Lizzi F, Onofriescu M, Zarzoulas F, Tripepi R, Mallamaci F, Tripepi G, Picano E, London GM, and Zoccali C

Subjects
Cardiovascular Diseases etiology, Cardiovascular Diseases pathology, Feasibility Studies, Humans, Internet, Kidney Failure, Chronic therapy, Lung Diseases etiology, Lung Diseases pathology, Cardiologists education, Cardiovascular Diseases diagnostic imaging, Computer-Assisted Instruction methods, Kidney Failure, Chronic complications, Lung Diseases diagnostic imaging, Nephrologists education, Ultrasonography methods
Abstract

Within the framework of the LUST trial (LUng water by Ultra-Sound guided Treatment to prevent death and cardiovascular events in high-risk end-stage renal disease patients), the European Renal and Cardiovascular Medicine (EURECA-m) working group of the European Renal Association-European Dialysis Transplant Association established a central core lab aimed at training and certifying nephrologists and cardiologists participating in this trial. All participants were trained by an expert trainer with an entirely web-based programme. Thirty nephrologists and 14 cardiologists successfully completed the training. At the end of training, a set of 47 lung ultrasound (US) videos was provided to trainees who were asked to estimate the number of B-lines in each video. The intraclass correlation coefficient (ICC) for the whole series of 47 videos between each trainee and the expert trainer was high (average 0.81 ± 0.21) and >0.70 in all but five cases. After further training, the five underperforming trainees achieved satisfactory agreement with the expert trainer (average post-retraining ICC 0.74 ± 0.14). The Bland-Altman plot showed virtually no bias (difference between the mean 0.03) and strict 95% limits of agreement lines (-1.52 and 1.45 US B-lines). Only four cases overlapped but did not exceed the same limits. Likewise, the Spearman correlation coefficient applied to the same data series was very high (r = 0.979, P < 0.0001). Nephrologists and cardiologists can be effectively trained to measure lung congestion by an entirely web-based programme. This web-based training programme ensures high-quality standardization of US B-line measurements and represents a simple, costless and effective preparatory step for clinical trials targeting lung congestion., (© The Author 2016. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

Published
2016
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40. The Agreement between Auscultation and Lung Ultrasound in Hemodialysis Patients: The LUST Study.

Author

Torino C, Gargani L, Sicari R, Letachowicz K, Ekart R, Fliser D, Covic A, Siamopoulos K, Stavroulopoulos A, Massy ZA, Fiaccadori E, Caiazza A, Bachelet T, Slotki I, Martinez-Castelao A, Coudert-Krier MJ, Rossignol P, Gueler F, Hannedouche T, Panichi V, Wiecek A, Pontoriero G, Sarafidis P, Klinger M, Hojs R, Seiler-Mussler S, Lizzi F, Siriopol D, Balafa O, Shavit L, Tripepi R, Mallamaci F, Tripepi G, Picano E, London GM, and Zoccali C

Subjects
Aged, Aged, 80 and over, Area Under Curve, Female, Hemodiafiltration, Humans, Kidney Failure, Chronic therapy, Male, Middle Aged, Pulmonary Edema diagnostic imaging, Pulmonary Edema etiology, ROC Curve, Severity of Illness Index, Ultrasonography, Auscultation, Edema complications, Extremities, Kidney Failure, Chronic complications, Pulmonary Edema diagnosis, Renal Dialysis, Respiratory Sounds
Abstract

Background and Objectives: Accumulation of fluid in the lung is the most concerning sequela of volume expansion in patients with ESRD. Lung auscultation is recommended to detect and monitor pulmonary congestion, but its reliability in ESRD is unknown., Design, Setting, Participants, & Measurements: In a subproject of the ongoing Lung Water by Ultra-Sound Guided Treatment to Prevent Death and Cardiovascular Complications in High Risk ESRD Patients with Cardiomyopathy Trial, we compared a lung ultrasound-guided ultrafiltration prescription policy versus standard care in high-risk patients on hemodialysis. The reliability of peripheral edema was tested as well. This study was on the basis of 1106 pre- and postdialysis lung ultrasound studies (in 79 patients) simultaneous with standardized lung auscultation (crackles at the lung bases) and quantification of peripheral edema., Results: Lung congestion by crackles, edema, or a combination thereof poorly reflected the severity of congestion as detected by ultrasound B lines in various analyses, including standard regression analysis weighting for repeated measures in individual patients (shared variance of 12% and 4% for crackles and edema, respectively) and κ-statistics (κ ranging from 0.00 to 0.16). In general, auscultation had very low discriminatory power for the diagnosis of mild (area under the receiver operating curve =0.61), moderate (area under the receiver operating curve =0.65), and severe (area under the receiver operating curve =0.68) lung congestion, and the same was true for peripheral edema (receiver operating curve =0.56 or lower) and the combination of the two physical signs., Conclusions: Lung crackles, either alone or combined with peripheral edema, very poorly reflect interstitial lung edema in patients with ESRD. These findings reinforce the rationale underlying the Lung Water by Ultra-Sound Guided Treatment to Prevent Death and Cardiovascular Complications in High Risk ESRD Patients with Cardiomyopathy Trial, a trial adopting ultrasound B lines as an instrument to guide interventions aimed at mitigating lung congestion in high-risk patients on hemodialysis., (Copyright © 2016 by the American Society of Nephrology.)

Published
2016
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42. Ionic conductivity of peritoneal dialysate: a new, easy and fast method of assessing peritoneal membrane function in patients undergoing peritoneal dialysis.

Author

La Milia V, Pontoriero G, Virga G, and Locatelli F

Subjects
Aged, Biological Transport, Female, Humans, Male, Middle Aged, Ultrafiltration, Cell Membrane metabolism, Creatinine metabolism, Dialysis Solutions chemistry, Glucose metabolism, Ions chemistry, Peritoneal Dialysis methods
Abstract

Background: Peritoneal membrane function can be assessed using the peritoneal equilibration test (PET) and similar tests, but these are almost always complicated to use, require a considerable amount of working time and their results cannot always be easily interpreted. Ionic conductivity is a measure of the ability of an electrolyte solution to conduct electricity. We tested the hypothesis that the ionic conductivity of peritoneal dialysate can be used to evaluate peritoneal membrane function in peritoneal dialysis patients., Methods: We measured the ionic conductivity and classic biochemical parameters of peritoneal dialysate in 69 patients during a modified PET and compared their ability to evaluate peritoneal membrane function and to diagnose ultrafiltration failure (UFF)., Results: Ionic conductivity was correlated well with classical parameters of peritoneal transport as glucose reabsorption of glucose (D/D0: r(2) = 0.62, P < 0.0001) and creatinine transport (D/PCreat: r(2) = 0.72, P < 0.0001). Twelve patients (17%) experienced UFF and, in them, the ionic conductivity area under the receiver-operating characteristic curve was 0.91 (95% confidence interval: 0.81-0.96) with sensitivity of 1.00 and specificity of 0.84 at a cut-off value of 12.75 mS/cm., Conclusions: These findings indicate that the ionic conductivity of peritoneal dialysate can be used as a new screening tool to evaluate peritoneal membrane function., (© The Author 2015. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

Published
2015
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43. The effects of colestilan versus placebo and sevelamer in patients with CKD 5D and hyperphosphataemia: a 1-year prospective randomized study.

Author

Locatelli F, Spasovski G, Dimkovic N, Wanner C, Dellanna F, and Pontoriero G

Subjects
Adult, Aged, Aged, 80 and over, Biomarkers blood, Calcium blood, Cholesterol blood, Female, Humans, Hyperphosphatemia etiology, Male, Middle Aged, Phosphorus blood, Prospective Studies, Renal Insufficiency, Chronic complications, Sevelamer, Young Adult, Bile Acids and Salts therapeutic use, Hyperphosphatemia drug therapy, Polyamines therapeutic use, Renal Dialysis, Renal Insufficiency, Chronic therapy
Abstract

Background: This study compared the effects of short-term titrated colestilan (a novel non-absorbable, non-calcium, phosphate binder) with placebo, and evaluated the safety and efficacy of colestilan over 1 year compared with sevelamer, in patients with chronic kidney disease (CKD) 5D., Methods: This prospective multicentre study comprised a 4-week phosphate binder washout period, a 16-week short-term, flexible-dose, treatment period (including a 4-week placebo-controlled withdrawal period) and a 40-week extension treatment phase., Results: At Week 16 (the end of the 4-week placebo-controlled withdrawal period), serum phosphorus level was 0.43 mmol/L (1.32 mg/dL) lower with colestilan than placebo (P < 0.001; primary end point). Serum LDL-C level was also lower with colestilan than with placebo (P < 0.001). Both colestilan and sevelamer produced significant reductions from baseline in serum phosphorus levels (P < 0.001), maintained for 1 year, and the proportion of patients achieving target levels of ≤1.78 mmol/L (5.5 mg/dL) or ≤1.95 mmol/L (6.0 mg/dL) at study end were similar (65.3 and 73.3%, respectively, for colestilan, and 66.9 and 77.4%, respectively, for sevelamer). Serum calcium level remained stable in the colestilan group but tended to increase slightly in the sevelamer group (end-of-study increase of 0.035 mmol/L over baseline). Both binders produced similar reductions from baseline in LDL-C level (P < 0.001), and responder rates after 1 year, using a target of <1.83 mmol/L (70 mg/dL) or <2.59 mmol/L (100 mg/dL) were similar in both groups (50.7 and 85.3% for colestilan and 54.0 and 80.6% for sevelamer). Colestilan was generally well tolerated., Conclusions: Colestilan is effective and safe for the treatment of hyperphosphataemia in patients with CKD 5D, and affords similar long-term phosphorus and cholesterol reductions/responder rates to sevelamer.

Published
2014
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44. Effect of MCI-196 on serum phosphate and cholesterol levels in haemodialysis patients with hyperphosphataemia: a double-blind, randomized, placebo-controlled study.

Author

Locatelli F, Dimkovic N, Pontoriero G, Spasovski G, Pljesa S, Kostic S, Manning A, Sano H, and Nakajima S

Subjects
Adult, Aged, Double-Blind Method, Female, Humans, Kidney Diseases blood, Kidney Diseases therapy, Male, Middle Aged, Young Adult, Bile Acids and Salts administration & dosage, Cholesterol blood, Hyperphosphatemia blood, Hyperphosphatemia drug therapy, Phosphorus blood, Renal Dialysis
Abstract

Background: Hyperphosphataemia in patients on haemodialysis (HD) can lead to, or worsen, secondary hyperparathyroidism (with associated bone disease) and extra-skeletal calcifications associated with increased cardiovascular morbidity and mortality. MCI-196 is a new, non-absorbed, non-calcium-based phosphate binder. The aim of this study was to determine the effect of three fixed doses of MCI-196, on serum phosphorus level and other parameters relevant to HD patients., Methods: A total of 120 chronic kidney disease (CKD) stage 5 patients on HD and with the serum phosphorus level >2.1 mmol/l were randomized to receive double-blind treatment with either 3, 6 and 9 g/day MCI-196 or placebo for 3 weeks., Results: Serum phosphorous decreased in all three treatment groups (-0.038, -0.268 and -0.257 mmol/l in the 3, 6 and 9 g/day groups, respectively). The difference between treatment and placebo groups was significant for the 6 and 9 g/day groups (P < 0.05 in both cases). Changes in the mean serum calcium were minimal and without relevant differences between groups. However, calcium-phosphorus product (Ca x P) was significantly reduced in the 6 and 9 g/day groups P < 0.05). MCI-196 at all doses decreased serum intact PTH between baseline and endpoint, and differences between treatment groups and placebo were statistically significant for the 3 and 9 g/day groups (P < 0.02 in both cases). Both serum total and LDL cholesterol decreased significantly in all treatment groups compared to placebo (by 0.71-1.05 mmol/l, for total cholesterol and 0.68-0.94 mmol/l for LDL cholesterol P < 0.001 in all cases). There was minimal change in serum HDL cholesterol. MCI-196 at all doses decreased significantly serum uric acid between baseline and endpoint compared to placebo (P < 0.005 in all cases). The drug was well tolerated., Conclusion: MCI-196 significantly reduced serum phosphorus, Ca x P and PTH, without effecting serum calcium levels. The additional reduction in total cholesterol and LDL cholesterol indicates a possible dual mechanism of action of MCI-196 that has the potential to reduce cardiovascular morbidity in CKD stage 5 patients.

Published
2010
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45. International Study of Health Care Organization and Financing for renal replacement therapy in Italy: an evolving reality.

Author

Pontoriero G, Pozzoni P, Vecchio LD, and Locatelli F

Subjects
Dialysis economics, Health Expenditures, Health Services economics, Health Services statistics & numerical data, Humans, Italy epidemiology, Kidney Failure, Chronic epidemiology, Kidney Transplantation economics, Kidney Transplantation legislation & jurisprudence, National Health Programs economics, Kidney Failure, Chronic economics, Kidney Failure, Chronic therapy, National Health Programs organization & administration
Abstract

The Italian national health system funds universal health care through general taxation, but health services are provided by local institutions. This study examines the epidemiology, provision, and funding of renal replacement therapy (RRT) in Italy. In 2001, prevalence and incidence of RRT in Italy were 0.083% and 0.014%, respectively. A 1999 donation law markedly increased renal transplantation rates. Italy spends 8.3% of its GDP on health care; 1.8% is for end-stage renal disease (ESRD) patients, who represent 0.083% of the general population. The reorganization of the NHS requires attention from the health community so that economic and geographic health disparities are not exacerbated.

Published
2007
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46. Relationship between urea clearance and ionic dialysance determined using a single-step conductivity profile.

Author

Di Filippo S, Pozzoni P, Manzoni C, Andrulli S, Pontoriero G, and Locatelli F

Subjects
Anuria metabolism, Anuria therapy, Humans, Kinetics, Regression Analysis, Renal Dialysis instrumentation, Kidney Failure, Chronic metabolism, Kidney Failure, Chronic therapy, Models, Biological, Renal Dialysis methods, Urea metabolism
Abstract

Background: On-line determination of ionic dialysance (ID) has been used to measure the clearance of small solutes like urea. However, attempts to determine the in vivo relationship between ID and urea clearance have led to discordant findings. The aim of this study was to determine the relationship between the mean values of repeated instantaneous determinations of ID throughout a dialysis session ((m)ID), obtained using a single-step inlet dialysate conductivity profile, and the mean values of urea clearance corrected for access recirculation (K(eu1)), total recirculation (access plus cardiopulmonary recirculation, K(eu2)), and the entire postdialysis urea rebound (K(wb))., Methods: Eighty-two anuric patients on chronic thrice-weekly hemodialysis were studied using an Integra machine equipped with the Diascan module for the automatic determination of ID. The mean values of repeated ID measurements made at 30-minute intervals were compared with K(eu1) (available for only 31 patients), K(eu2), and K(wb)., Results: The results in all 82 patients were: (m)ID = 176 +/- 23 mL/min; K(eu2) = 181 +/- 25 mL/min; K(wb) = 159 +/- 22 mL/min. The mean (m)ID/K(wb) and (m)ID/K(eu2) ratios were, respectively, 1.11 +/- 0.06 and 0.98 +/- 0.06. The results in the 31 patients for whom K(eu1) values were available were: (m)ID = 179 +/- 24 mL/min and K(eu1) = 200 +/- 27 mL/min; the mean (m)ID/K(eu1) ratio was 0.90 +/- 0.05., Conclusion: The mean value of repeated ID determinations obtained using a single-step conductivity profile underestimates urea clearance corrected for access recirculation, and may be considered an adequate estimate of urea clearance corrected for total recirculation.

Published
2005
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47. Long-term outcome in hemodialysis: morbidity and mortality.

Author

Pozzoni P, Del Vecchio L, Pontoriero G, Di Filippo S, and Locatelli F

Subjects
Anemia etiology, Anemia therapy, Cardiovascular Diseases etiology, Humans, Hypertension etiology, Hypertension therapy, Prognosis, Survival Rate, Renal Dialysis adverse effects, Renal Dialysis mortality
Abstract

Despite technical and pharmacological improvements achieved over the past years, long-term prognosis of patients undergoing chronic hemodialysis is still rather poor. Cardiovascular disease is the leading cause of both morbidity and mortality in these patients, mostly because of their severely compromised cardiovascular conditions already at the time of starting hemodialysis. A proper management of factors involved in the development of cardiovascular abnormalities is therefore a basic pre-requisite for improving their clinical outcome. Hypertension and anemia should be adequately evaluated and corrected, in light of their primary involvement in the pathogenesis of left ventricular hypertrophy, whereas treatment of calcium and phosphate metabolism disorders, particularly of high serum phosphorus levels, is needed to prevent the development of severe secondary hyperparathyroidism and mainly vascular calcifications, whose detrimental pathophysiologic consequences on cardiovascular structures are huge. At the same time, the prescription of the hemodialytic treatment should be optimised, with a satisfactory removal of uremic toxins through the delivery of an adequate dialysis dose and with the use of biocompatible membranes, where possible, thus minimizing the inflammatory response secondary to the interaction between blood and the artificial material of the hemodialysis system. The clinical superiority of high-flux membranes, although suggested by all studies performed so far, has still to be demonstrated by well-conducted clinical studies; on-line convective treatments and daily hemodialysis, although promising, also need to be confirmed in randomized trials. In conclusion, long-term outcome of hemodialysis patients may only be improved by a complex, multi-factorial therapeutical approach.

Published
2004

48. Ionic dialysance allows an adequate estimate of urea distribution volume in hemodialysis patients.

Author

Di Filippo S, Manzoni C, Andrulli S, Pontoriero G, Dell'Oro C, La Milia V, Tentori F, Crepaldi M, Bigi MC, and Locatelli F

Subjects
Hemodialysis Solutions metabolism, Humans, Models, Biological, Reference Standards, Urea metabolism, Kidney Failure, Chronic therapy, Renal Dialysis methods, Renal Dialysis standards
Abstract

Background: An adequate estimation of urea distribution volume (V) in hemodialysis patients is useful to monitor protein nutrition. Direct dialysis quantification (DDQ) is the gold standard for determining V, but it is impractical for routine use because it requires equilibrated postdialysis plasma water urea concentration. The single pool variable volume urea kinetic model (SPVV-UKM), recommended as a standard by Kidney Disease Outcomes Quality Initiative (K/DOQI), does not need a delayed postdialysis blood sample but it requires a correct estimate of dialyser urea clearance., Methods: Ionic dialysance (ID) may accurately estimate dialyzer urea clearance corrected for total recirculation. Using ID as input to SPVV-UKM, correct V values are expected when end-dialysis plasma water urea concentrations are determined in the end-of-session blood sample taken with the blood pump speed reduced to 50 mL/min for two minutes (U(pwt2')). The aim of this study was to determine whether the V values determined by means of SPVV-UKM, ID, and U(pwt2') (V(ID)) are similar to those determined by the "gold standard" DDQ method (V(DDQ)). Eighty-two anuric hemodialysis patients were studied., Results: V(DDQ) was 26.3 +/- 5.2 L; V(ID) was 26.5 +/- 4.8 L. The (V(ID)-V(DDQ)) difference was 0.2 +/- 1.6 L, which is not statistically significant (P= 0.242). Anthropometric volume (V(A)) calculated using Watson equations was 33.6 +/- 6.0 L. The (V(A)-V(DDQ)) difference was 7.3 +/- 3.3 L, which is statistically significant (P < 0.001)., Conclusion: Anthropometric-based V values overestimate urea distribution volume calculated by DDQ and SPVV-UKM. ID allows adequate V values to be determined, and circumvents the problem of delayed postdialysis blood samples.

Published
2004
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49. Application of dialysis and transplant registries to clinical practice: the Lombardy Registry.

Author

Locatelli F, Tentori F, Del Vecchio L, and Pontoriero G

Subjects
Aged, Cardiovascular Diseases epidemiology, Cardiovascular Diseases etiology, Humans, Italy epidemiology, Kidney Failure, Chronic complications, Kidney Failure, Chronic epidemiology, Kidney Failure, Chronic therapy, Kidney Transplantation statistics & numerical data, Registries, Renal Dialysis statistics & numerical data
Abstract

Background: Data collected from registries provide a useful source of information for clinical practice. Therefore, several regional and national registries of end-stage renal disease (ESRD) patients have been established. The Lombardy Registry of Dialysis and Transplantation (RLDT) was established in 1982, with participation of all 44 dialysis units that were present at that time within the region., Methods: Demographic and clinical data on ESRD patients are collected yearly. We present here the results of some of the analyses that have been performed on RLDT data since it was started., Results: Briefly, data on epidemiology of ESRD, cardiovascular disease, patterns of care and patients' outcomes have been considered. Comparisons with international registries have also been performed., Conclusions: This analysis shows how data collected from a homogeneous patient population receiving similar patterns of care provide precise information on that population. A clear example is provided by the similar results obtained in the comparison of high-flux vs low-flux membranes in a randomized control trial, the HEMO study, and in an analysis of RLDT data. Therefore, analysis of data collected by registries represents an important tool to improve clinical practice and possibly patients' outcomes.

Published
2004
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