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1. Is there long-term value of pathology scoring in immunoglobulin A nephropathy? A validation study of the Oxford Classification for IgA Nephropathy (VALIGA) update

Author

Coppo, R., D'Arrigo, G., Tripepi, G., Russo, M. L., Roberts, I. S. D., Bellur, S., Cattran, D., Cook, T. H., Feehally, J., Tesar, V., Maixnerova, D., Peruzzi, L., Amore, A., Lundberg, S., Di Palma, A. M., Gesualdo, L., Emma, F., Rollino, C., Praga, M., Biancone, L., Pani, A., Feriozzi, S., Polci, R., Barratt, J., Del Vecchio, L., Locatelli, F., Pierucci, A., Caliskan, Y., Perkowska-Ptasinska, A., Durlik, M., Moggia, E., Ballarin, J. C., Wetzels, J. F. M., Goumenos, D., Papasotiriou, M., Galesic, K., Toric, L., Papagianni, A., Stangou, M., Benozzi, L., Cusinato, S., Berg, U., Topaloglu, R., Maggio, M., Ots-Rosenberg, M., D'Amico, M., Geddes, C., Balafa, O., Quaglia, M., Cravero, R., Cirami, C. L., Fellstrom, B., Floege, J., Egido, J., Mallamaci, F., Zoccali, C., Fuiano, L., Beltrame, G., Camilla, R., Segoloni, G., Colla, L., Angioi, A., Piras, L., Cancarini, G., Ravera, S., Ballarin, J., Di Giulio, S., Pugliese, F., Serriello, I., Sever, M., Kilicaslan, I., Peters, H., Carvalho, F., Da Costa Ferreira, A. C., Wiecek, A., Magistroni, R., Bilginer, Y., Giacchino, F., Papastirou, M., Siamopoulos, K., Galliani, M., Stratta, P., Bergia, R., Salvadori, M., Cirami, L., Kloster Smerud, H., Ferrario, F., Stellato, T., Martin, C., Eitner, F., Rauen, T., Lupo, A., Bernich, P., Mene, P., Morosetti, M., Van Kooten, C., Rabelink, T., Reinders, M. E. J., Boria Grinyo, J. M., Savoldi, S., Licata, C., Mizerska-Wasiak, M., Roszkowska-Blaim, M., Martina, G., Messuerotti, A., Dal Canton, A., Esposito, C., Migotto, C., Triolo, G., Mariano, F., Pozzi, C., Boero, R., Mazzucco, G., Giannakakis, C., Honsova, E., Sundelin, B., Gutierrez, E., Asunis, A. M., Tardanico, R., Arce Terroba, J., Fortunato, M., Pantzaki, A., Ozluk, Y., Steenbergen, E., Soderberg, M., Riispere, Z., Furci, L., Orhan, D., Kipgen, D., Casartelli, D., Galesic Ljubanovic, D., Akiopoulou, H., Bertoni, E., Cannata Ortiz, P., Karkoszka, H., Groene, H. J., Stoppacciaro, A., Bajema, I., Bruijn, J., Fulladosa Oliveras, X., Maldyk, J., Ioachim, E., and Internal Medicine

Subjects
Adult, Male, Pathology, medicine.medical_specialty, Adolescent, 030232 urology & nephrology, Renal function, 030204 cardiovascular system & hematology, Kidney, Nephropathy, Cohort Studies, 03 medical and health sciences, Glomerulonephritis, 0302 clinical medicine, renal biopsy, Interquartile range, IgA nephropathy, progression, risk factors, Child, Disease Progression, Female, Follow-Up Studies, Glomerular Filtration Rate, Glomerulonephritis, IGA, Humans, Prognosis, Medicine, Endocapillary hypercellularity, IGA, Transplantation, medicine.diagnostic_test, business.industry, medicine.disease, medicine.anatomical_structure, Renal pathology, Nephrology, Cohort, Renal biopsy, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business
Abstract

Background It is unknown whether renal pathology lesions in immunoglobulin A nephropathy (IgAN) correlate with renal outcomes over decades of follow-up. Methods In 1130 patients of the original Validation Study of the Oxford Classification for IgA Nephropathy (VALIGA) cohort, we studied the relationship between the MEST score (mesangial hypercellularity, M; endocapillary hypercellularity, E; segmental glomerulosclerosis, S; tubular atrophy/interstitial fibrosis, T), crescents (C) and other histological lesions with both a combined renal endpoint [50% estimated glomerular filtration rate (eGFR) loss or kidney failure] and the rate of eGFR decline over a follow-up period extending to 35 years [median 7 years (interquartile range 4.1–10.8)]. Results In this extended analysis, M1, S1 and T1–T2 lesions as well as the whole MEST score were independently related with the combined endpoint (P Conclusion Long-term follow-up analyses of the VALIGA cohort showed that the independent relationship between kidney biopsy findings and the risk of progression towards kidney failure in IgAN remains unchanged across all age groups and decades after the renal biopsy.

Published
2020

2. Risk factors and action thresholds for the novel coronavirus pandemic. Insights from the Italian Society of Nephrology COVID-19 Survey

Author

Nordio, M., Reboldi, G., Di Napoli, A., Quintaliani, G., Alberici, F., Postorino, M., Aucella, F., Messa, P., Brunori, G., Bosco, M., Malberti, F., Mandreoli, M., Mazzaferro, S., Movilli, E., Ravera, M., Salomone, M., Santoro, D., Postorinolimido, M. A., Bonomini, M., Stingone, A., Maccarone, M., Di Loreto, E., Stacchiotti, L., Malandra, R., Chiarella, S., D'Agostino, F., Fuiano, G., Nicodemo, L., Bonofiglio, R., Greco, S., Mallamaci, F., Barreca, E., Caserta, C., Bruzzese, V., Galati, D., Tramontana, D., Viscione, M., Chiuchiolo, L., Tuccillo, S., Sepe, M., Vitale, F., Ciriana, E., Martignetti, V., Caserta, D., Stizzo, A., Romano, A., Iulianiello, G., Cascone, E., Minicone, P., Chiricone, D., Delgado, G., Barbato, A., Celentano, S., Molfino, I., Coppola, S., Raiola, I., Abategiovanni, M., Borrelli, S., Margherita, C., Bruno, F., Ida, M., Aliperti, E., Potito, D., Cuomo, G., De Luca, M., Merola, M., Botta, C., Garofalo, G., Alinei, P., Paglionico, C., Roano, M., Vitale, S., Ierardi, R., Fimiani, V., Conte, G., Di Natale, G., Romano, M., Di Marino, V., Scafarto, A., Meccariello, S., Pecoraro, C., Di Stazio, E., Di Meglio, E., Cuomo, A., Maresca, B., Rotaia, E., Capasso, G., Auricchio, M., Pluvio, C., Maddalena, L., De Maio, A., Palladino, G., Buono, F., Gigliotti, G., Mancini, E., La Manna, G., Storari, A., Mosconi, G., Cappelli, G., Scarpioni, R., Gregorini, M., Rigotti, A., Mancini, W., Bianco, F., Boscutti, G., Amici, G., Tosto, M., Fini, R., Pace, G., Cioffi, A., Boccia, E., Di Lullo, L., Di Zazzo, G., Simonelli, R., Bondatti, F., Miglio, L., Rifici, N., Treglia, A., Muci, M., Baldinelli, G., Rizzi, E., Lonzi, M., De Cicco, C., Forte, F., De Paolis, P., Grandaliano, Giuseppe, Cuzziol, C., Torre, V. M., Sfregola, P., Rossi, V., Fabio, G., Flammini, A., Filippini, A., Onorato, L., Vendola, F., Di Daniela, N., Alfarone, C., Scabbia, L., Ferrazzano, M., Grotta, B. D., Gamberini, M., Fazzari, L., Mene, P., Morgia, A., Catucci, A., Palumbo, R., Puliti, M., Marinelli, R., Polito, P., Marrocco, F., Morabito, S., Rocca, R., Nazzaro, L., Lavini, R., Iamundo, V., Chiappini, M., Casarci, M., Morosetti, M., Hassan, S., Firmi, G., Galliani, M., Serraiocco, M., Feriozzi, S., Valentini, W., Sacco, P., Garibotto, G., Cappelli, V., Saffioti, C., Repetto, M., Rolla, D., Lorenz, M., Pedrini, L., Polonioli, D., Galli, E., Ruggenenti, P., Scolari, F., Bove, S., Costantino, E., Bracchi, M., Mangano, S., Depetri, G., La Milia, V., Farina, M., Zecchini, S., Savino, R., Melandri, M., Guastoni, C., Paparella, M., Gallieni, M., Minetti, E., Bisegna, S., Righetti, M., Badalamenti, S., Alberghini, E., Bertoli, S., Fabbrini, P., Albrizio, P., Rampino, T., Colturi, C., Rombola, G., Lucatello, A., Guerrini, E., Ranghino, A., Lenci, F., Fanciulli, E., Santarelli, S., Damiani, C., Garofalo, D., Sopranzi, F., Santoferrara, A., Di Luca, M., Galiotta, P., Brigante, M., Manganaro, M., Maffei, S., Berto, I., Besso, L., Viglino, G., Cusinato, S., Chiarinottichiappero, D. F., Tognarelli, G., Gianoglio, B., Forneris, G., Biancone, L., Savoldi, S., Vitale, C., Boero, R., Filiberti, O., Borzumati, M., Gesualdo, L., Lomonte, C., Gernone, G., Pallotta, G., Di Paolo, S., Vernaglione, L., Specchio, A., Stallone, G., Dell'Aquila, R., Sandri, G., Russo, F., Napoli, M., Marangi, A., Morrone, L., Di Stratis, C., Fresu, A., Cicu, F., Murtas, S., Manca, O., Pani, A., Pilloni, M., Pistis, R., Cadoni, M., Contu, B., Logias, F., Ivaldi, R., Fancello, S., Cossu, M., Lepori, G., Vittoria, S., Battiati, E., Arnone, M., Rome, M., Barbera, A., Granata, A., Collura, G., Dico, C. L., Pugliese, G., Di Natale, E., Rizzari, G., Cottone, L., Longo, N., Battaglia, G., Marcantoni, C., Giannetto, G., Tumino, G., Randazzo, F., Bellissimo, L., Faro, F. L., Grippaldi, F., Urso, S., Quattrone, G., Todaro, I., Vincenzo, D., Murgo, A., Masuzzo, M., Pisacane, A., Monardo, P., Pontorierro, M., Quari, C., Bauro, A., Chimenz, R. R., Alfio, D., Girasole, F., Cascio, A. L., Caviglia, A., Tornese, F., Sirna, F., Altieri, C., Cusumano, R., Saveriano, V., La Corte, A., Locascio, G., Rotolo, U., Musso, S., Risuglia, L., Blanco, G., Minardo, G., Castellino, S., Zappulla, Z., Randone, S., Di Francesca, M., Cassetti, C. C., Oddo, G., Buscaino, G., Mucaria, F., Barraco, V. I., Di Martino, A., Rallo, D., Dani, L., Campolo, G., Manescalchi, F., Biagini, M., Agate, M., Panichi, V., Casani, A., Traversari, L., Garosi, G., Tabbi, M., Selvi, A., Cencioni, L., Fagugli, R., Timio, F., Leveque, A., Manes, M., Mennella, G., Calo, L., Fiorini, F., Abaterusso, C., Calzavara, P., Meneghel, G., Bonesso, C., Gambaro, G., Gammaro, L., Rugiu, C., Ronco, C., Nordio M., Reboldi G., Di Napoli A., Quintaliani G., Alberici F., Postorino M., Aucella F., Messa P., Brunori G., Bosco M., Malberti F., Mandreoli M., Mazzaferro S., Movilli E., Ravera M., Salomone M., Santoro D., PostorinoLimido M.A., Bonomini M., Stingone A., Maccarone M., Di Loreto E., Stacchiotti L., Malandra R., Chiarella S., D'Agostino F., Fuiano G., Nicodemo L., Bonofiglio R., Greco S., Mallamaci F., Barreca E., Caserta C., Bruzzese V., Galati D., Tramontana D., Viscione M., Chiuchiolo L., Tuccillo S., Sepe M., Vitale F., Ciriana E., Martignetti V., Caserta D., Stizzo A., Romano A., Iulianiello G., Cascone E., Minicone P., Chiricone D., Delgado G., Barbato A., Celentano S., Molfino I., Coppola S., Raiola I., Abategiovanni M., Borrelli S., Margherita C., Bruno F., Ida M., Aliperti E., Potito D., Cuomo G., De Luca M., Merola M., Botta C., Garofalo G., Alinei P., Paglionico C., Roano M., Vitale S., Ierardi R., Fimiani V., Conte G., Di Natale G., Romano M., Di Marino V., Scafarto A., Meccariello S., Pecoraro C., Di Stazio E., Di Meglio E., Cuomo A., Maresca B., Rotaia E., Capasso G., Auricchio M., Pluvio C., Maddalena L., De Maio A., Palladino G., Buono F., Gigliotti G., Mancini E., La Manna G., Storari A., Mosconi G., Cappelli G., Scarpioni R., Gregorini M., Rigotti A., Mancini W., Bianco F., Boscutti G., Amici G., Tosto M., Fini R., Pace G., Cioffi A., Boccia E., Di Lullo L., Di Zazzo G., Simonelli R., Bondatti F., Miglio L., Rifici N., Treglia A., Muci M., Baldinelli G., Rizzi E., Lonzi M., De Cicco C., Forte F., De Paolis P., Grandaliano G., Cuzziol C., Torre V.M., Sfregola P., Rossi V., Fabio G., Flammini A., Filippini A., Onorato L., Vendola F., Di Daniela N., Alfarone C., Scabbia L., Ferrazzano M., Grotta B.D., Gamberini M., Fazzari L., Mene P., Morgia A., Catucci A., Palumbo R., Puliti M., Marinelli R., Polito P., Marrocco F., Morabito S., Rocca R., Nazzaro L., Lavini R., Iamundo V., Chiappini M., Casarci M., Morosetti M., Hassan S., Firmi G., Galliani M., Serraiocco M., Feriozzi S., Valentini W., Sacco P., Garibotto G., Cappelli V., Saffioti C., Repetto M., Rolla D., Lorenz M., Pedrini L., Polonioli D., Galli E., Ruggenenti P., Scolari F., Bove S., Costantino E., Bracchi M., Mangano S., Depetri G., La Milia V., Farina M., Zecchini S., Savino R., Melandri M., Guastoni C., Paparella M., Gallieni M., Minetti E., Bisegna S., Righetti M., Badalamenti S., Alberghini E., Bertoli S., Fabbrini P., Albrizio P., Rampino T., Colturi C., Rombola G., Lucatello A., Guerrini E., Ranghino A., Lenci F., Fanciulli E., Santarelli S., Damiani C., Garofalo D., Sopranzi F., Santoferrara A., Di Luca M., Galiotta P., Brigante M., Manganaro M., Maffei S., Berto I., Besso L., Viglino G., Cusinato S., ChiarinottiChiappero D.F., Tognarelli G., Gianoglio B., Forneris G., Biancone L., Savoldi S., Vitale C., Boero R., Filiberti O., Borzumati M., Gesualdo L., Lomonte C., Gernone G., Pallotta G., Di Paolo S., Vernaglione L., Specchio A., Stallone G., Dell'Aquila R., Sandri G., Russo F., Napoli M., Marangi A., Morrone L., Di Stratis C., Fresu A., Cicu F., Murtas S., Manca O., Pani A., Pilloni M., Pistis R., Cadoni M., Contu B., Logias F., Ivaldi R., Fancello S., Cossu M., Lepori G., Vittoria S., Battiati E., Arnone M., Rome M., Barbera A., Granata A., Collura G., Dico C.L., Pugliese G., Di Natale E., Rizzari G., Cottone L., Longo N., Battaglia G., Marcantoni C., Giannetto G., Tumino G., Randazzo F., Bellissimo L., Faro F.L., Grippaldi F., Urso S., Quattrone G., Todaro I., Vincenzo D., Murgo A., Masuzzo M., Pisacane A., Monardo P., Pontorierro M., Quari C., Bauro A., Chimenz R.R., Alfio D., Girasole F., Cascio A.L., Caviglia A., Tornese F., Sirna F., Altieri C., Cusumano R., Saveriano V., La Corte A., Locascio G., Rotolo U., Musso S., Risuglia L., Blanco G., Minardo G., Castellino S., Zappulla Z., Randone S., Di Francesca M., Cassetti C.C., Oddo G., Buscaino G., Mucaria F., Barraco V.I., Di Martino A., Rallo D., Dani L., Campolo G., Manescalchi F., Biagini M., Agate M., Panichi V., Casani A., Traversari L., Garosi G., Tabbi M., Selvi A., Cencioni L., Fagugli R., Timio F., Leveque A., Manes M., Mennella G., Calo L., Fiorini F., Abaterusso C., Calzavara P., Meneghel G., Bonesso C., Gambaro G., Gammaro L., Rugiu C., and Ronco C.

Subjects
Male, Contextual analysis, medicine.medical_treatment, Population, 030232 urology & nephrology, Recursive partitioning, 030204 cardiovascular system & hematology, Rate ratio, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Classification tree, COVID-19, Renal replacement therapy, Risk Factors, Medical, Surveys and Questionnaires, Health care, medicine, Settore MED/14 - NEFROLOGIA, Humans, education, Pandemics, Societies, Medical, Female, Italy, Nephrology, education.field_of_study, business.industry, Multilevel model, Decision rule, Confidence interval, Original Article, Hemodialysis, business, Contextual analysi, Societies, Demography
Abstract

Background and aim: Over 80% (365/454) of the nation’s centers participated in the Italian Society of Nephrology COVID-19 Survey. Out of 60,441 surveyed patients, 1368 were infected as of April 23rd, 2020. However, center-specific proportions showed substantial heterogeneity. We therefore undertook new analyses to identify explanatory factors, contextual effects, and decision rules for infection containment. Methods: We investigated fixed factors and contextual effects by multilevel modeling. Classification and Regression Tree (CART) analysis was used to develop decision rules. Results: Increased positivity among hemodialysis patients was predicted by center location [incidence rate ratio (IRR) 1.34, 95% confidence interval (CI) 1.20–1.51], positive healthcare workers (IRR 1.09, 95% CI 1.02–1.17), test-all policy (IRR 5.94, 95% CI 3.36–10.45), and infected proportion in the general population (IRR 1.002, 95% CI 1.001–1.003) (all p < 0.01). Conversely, lockdown duration exerted a protective effect (IRR 0.95, 95% CI 0.94–0.98) (p < 0.01). The province-contextual effects accounted for 10% of the total variability. Predictive factors for peritoneal dialysis and transplant cases were center location and infected proportion in the general population. Using recursive partitioning, we identified decision thresholds at general population incidence ≥ 229 per 100,000 and at ≥ 3 positive healthcare workers. Conclusions: Beyond fixed risk factors, shared with the general population, the increased and heterogeneous proportion of positive patients is related to the center’s testing policy, the number of positive patients and healthcare workers, and to contextual effects at the province level. Nephrology centers may adopt simple decision rules to strengthen containment measures timely.

Published
2021

3. Quantifying duration of proteinuria remission and association with clinical outcome in IgA nephropathy

Author

Canney, M., Barbour, S. J., Zheng, Y., Coppo, R., Zhang, H., Liu, Z. -H., Matsuzaki, K., Suzuki, Y., Katafuchi, R., Reich, H. N., Cattran, D., Russo, M. L., Troyanov, S., Cook, H. T., Roberts, I., Tesar, V., Maixnerova, D., Lundberg, S., Gesualdo, L., Emma, F., Fuiano, L., Beltrame, G., Rollino, C., Amore, A., Camilla, R., Peruzzi, L., Praga, M., Feriozzi, S., Polci, R., Segoloni, G., Colla, L., Pani, A., Piras, D., Angioi, A., Cancarini, G., Ravera, S., Durlik, M., Moggia, E., Ballarin, J., Di Giulio, S., Pugliese, F., Serriello, I., Caliskan, Y., Sever, M., Kilicaslan, I., Locatelli, F., Del Vecchio, L., Wetzels, J. F. M., Peters, H., Berg, U., Carvalho, F., da Costa Ferreira, A. C., Maggio, M., Wiecek, A., Ots-Rosenberg, M., Magistroni, R., Topaloglu, R., Bilginer, Y., D'Amico, M., Stangou, M., Giacchino, F., Goumenos, D., Kalliakmani, P., Gerolymos, M., Galesic, K., Geddes, C., Siamopoulos, K., Balafa, O., Galliani, M., Stratta, P., Quaglia, M., Bergia, R., Cravero, R., Salvadori, M., Cirami, L., Fellstrom, B., Kloster Smerud, H., Ferrario, F., Stellato, T., Egido, J., Martin, C., Floege, J., Eitner, F., Lupo, A., Bernich, P., Mene, P., Morosetti, M., van Kooten, C., Rabelink, T., Reinders, M. E. J., Boria Grinyo, J. M., Cusinato, S., Benozzi, L., Savoldi, S., Licata, C., Mizerska-Wasiak, M., Martina, G., Messuerotti, A., Dal Canton, A., Esposito, C., Migotto, C., Triolo, G., Mariano, F., Pozzi, C., Boero, R., Bellur, S., Mazzucco, G., Giannakakis, C., Honsova, E., Sundelin, B., Di Palma, A. M., Gutierrez, E., Asunis, A. M., Barratt, J., Tardanico, R., Perkowska-Ptasinska, A., Arce Terroba, J., Fortunato, M., Pantzaki, A., Ozluk, Y., Steenbergen, E., Soderberg, M., Riispere, Z., Furci, L., Orhan, D., Kipgen, D., Casartelli, D., Galesic Ljubanovic, D., Gakiopoulou, H., Bertoni, E., Cannata Ortiz, P., Karkoszka, H., Groene, H. J., Stoppacciaro, A., Bajema, I., Bruijn, J., Fulladosa Oliveras, X., Maldyk, J., Ioachim, E., Bavbek, N., Cook, T., Alpers, C., Feehally, J., Berthoux, F., Bonsib, S., D'Agati, V., D'Amico, G., Emancipator, S., Emmal, F., Fervenza, F., Florquin, S., Fogo, A., Groene, H., Haas, M., Hill, P., Hogg, R., Hsu, S., Hunley, T., Hladunewich, Jennette, C., Joh, K., Julian, B., Kawamura, T., Lai, F., Leung, C., Li, L., Li, P., Liu, Z., Massat, A., Mackinnon, B., Mezzano, S., Schena, F., Tomino, Y., Walker, P., Wang, H., Weening, J., Yoshikawa, N., Zeng, C. -H., Shi, S., Nogi, C., Suzuki, H., Koike, K., Hirano, K., Yokoo, T., Hanai, M., Fukami, K., Takahashi, K., Yuzawa, Y., Niwa, M., Yasuda, Y., Maruyama, S., Ichikawa, D., Suzuki, T., Shirai, S., Fukuda, A., Fujimoto, S., Trimarchi, H., Anesthesiology, Pathology, Graduate School, ACS - Heart failure & arrhythmias, and ACS - Atherosclerosis & ischemic syndromes

Subjects
Male, Time Factors, glomerular disease, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Gastroenterology, 0302 clinical medicine, Outcome Assessment, Health Care, Clinical endpoint, Medicine, Clinical Epidemiology, Proteinuria, medicine.diagnostic_test, Remission Induction, Hazard ratio, IgA nephropathy, General Medicine, Middle Aged, end stage kidney disease, epidemiology and outcomes, proteinuria, renal function decline, renal pathology, 3. Good health, Renal pathology, Nephrology, Disease Progression, Female, medicine.symptom, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Nephropathy, 03 medical and health sciences, Internal medicine, Biopsy, Humans, Proportional Hazards Models, Retrospective Studies, business.industry, Surrogate endpoint, Glomerulonephritis, IGA, medicine.disease, Confidence interval, Renal disorders Radboud Institute for Molecular Life Sciences [Radboudumc 11], Kidney Failure, Chronic, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business
Abstract

Contains fulltext : 232930.pdf (Publisher’s version ) (Closed access) BACKGROUND: On the basis of findings of observational studies and a meta-analysis, proteinuria reduction has been proposed as a surrogate outcome in IgA nephropathy. How long a reduction in proteinuria needs to be maintained to mitigate the long-term risk of disease progression is unknown. METHODS: In this retrospective multiethnic cohort of adult patients with IgA nephropathy, we defined proteinuria remission as a ≥25% reduction in proteinuria from the peak value after biopsy, and an absolute reduction in proteinuria to

Published
2021

4. Validation of an easy questionnaire on the assessment of salt habit: the MINISAL-SIIA Study Program

Author

D’Elia, L., Manfredi, M., Strazzullo, P., Galletti, F., Agabiti-Rosei, E., Arcangeli, E., Artom, A., Barbato, A., Barbiero, M., Belfiore, A., Bernini, G., Boero, R., Berra, E., Biggi, A., Borgheresi, P., Borghi, C., Bosio, A., Caiazza, A., Caielli, P., Caló, L. A., Castellano, M., Catena, C., Cerrato, F., Cilia, C., Cipollini, F., Crippa, M., Cuspidi, C., D’Avino, M., De Giorgi, G. A., De Luca, N., De Pergola, G., Del Giudice, A., Desideri, G., Fallo, F., Ferri, C., Galeone, D., Garavelli, G., Gaudio, G., Giacchetti, G., Gidaro, B., Giovannetti, R., Grandi, A., Guglielmi, M., Iacoviello, L., Leonardis, D., Lonati, C., Lonati, L. M., Malatino, L., Mallamaci, F., Maresca, A. M., Marzano, L., Massara, C., Merletti, L., Meschi, M., Modesti, S., Montanari, A., Morganti, A., Musiari, L., Musso, N., Nardecchia, A., Nazzaro, P., Pallisco, O., Panichi, V., Parati, G., Pascale, C., Pini, C., Pirola, I., Pucci, G., Rabbia, F., Rescaldani, M., Ronchi, E., Rossi, E., Rossi, G., Sala, C., Sarzani, R., Sechi, L. A., Silvestris, F., Stancanelli, B., Trimarco, B., Ungar, A., Veglio, F., Veronesi, M., Vinella, L., D'Elia, L, Manfredi, M, Strazzullo, P, Galletti, F, Agabiti-Rosei, E, Arcangeli, E, Artom, A, Barbato, A, Barbiero, M, Belfiore, A, Bernini, G, Boero, R, Berra, E, Biggi, A, Borgheresi, P, Borghi, C, Bosio, A, Caiazza, A, Caielli, P, Calo, L, Castellano, M, Catena, C, Cerrato, F, Cilia, C, Cipollini, F, Crippa, M, Cuspidi, C, D'Avino, M, De Giorgi, G, De Luca, N, De Pergola, G, Del Giudice, A, Desideri, G, Fallo, F, Ferri, C, Galeone, D, Garavelli, G, Gaudio, G, Giacchetti, G, Gidaro, B, Giovannetti, R, Grandi, A, Guglielmi, M, Iacoviello, L, Leonardis, D, Lonati, C, Lonati, L, Malatino, L, Mallamaci, F, Maresca, A, Marzano, L, Massara, C, Merletti, L, Meschi, M, Modesti, S, Montanari, A, Morganti, A, Musiari, L, Musso, N, Nardecchia, A, Nazzaro, P, Pallisco, O, Panichi, V, Parati, G, Pascale, C, Pini, C, Pirola, I, Pucci, G, Rabbia, F, Rescaldani, M, Ronchi, E, Rossi, E, Rossi, G, Sala, C, Sarzani, R, Sechi, L, Silvestris, F, Stancanelli, B, Trimarco, B, Ungar, A, Veglio, F, Veronesi, M, Vinella, L, L. D’Elia, M. Manfredi, P. Strazzullo, F. Galletti, E. Agabiti-Rosei, E. Arcangeli, A. Artom, A. Barbato, M. Barbiero, A. Belfiore, G. Bernini, R. Boero, E. Berra, A. Biggi, P. Borgheresi, C. Borghi, A. Bosio, A. Caiazza, P. Caielli, L. A. Caló, M. Castellano, C. Catena, F. Cerrato, C. Cilia, F. Cipollini, M. Crippa, C. Cuspidi, M. D’Avino, G. A. De Giorgi, N. De Luca, G. De Pergola, A. Del Giudice, G. Desideri, F. Fallo, C. Ferri, D. Galeone, G. Garavelli, G. Gaudio, G. Giacchetti, B. Gidaro, R. Giovannetti, A. Grandi, M. Guglielmi, L. Iacoviello, D. Leonardi, C. Lonati, L. M. Lonati, L. Malatino, F. Mallamaci, A. M. Maresca, L. Marzano, C. Massara, L. Merletti, M. Meschi, S. Modesti, A. Montanari, A. Morganti, L. Musiari, N. Musso, A. Nardecchia, P. Nazzaro, O. Pallisco, V. Panichi, G. Parati, C. Pascale, C. Pini, I. Pirola, G. Pucci, F. Rabbia, M. Rescaldani, E. Ronchi, E. Rossi, G. Rossi, C. Sala, R. Sarzani, L. A. Sechi, F. Silvestri, B. Stancanelli, B. Trimarco, A. Ungar, F. Veglio, M. Veronesi, and L. Vinella

Subjects
Male, 0301 basic medicine, Validation study, medicine.medical_specialty, media_common.quotation_subject, Medicine (miscellaneous), 030209 endocrinology & metabolism, Nutrition and Dietetic, hypertension, sodium intake, 03 medical and health sciences, 0302 clinical medicine, Surveys and Questionnaires, Internal medicine, Nutrition and Dietetic, medicine, Humans, MINISAL-SIIA, Sodium Chloride, Dietary, Nutrition, media_common, 030109 nutrition & dietetics, Nutrition and Dietetics, Urinary sodium, business.industry, MINISAL-SIIA Study Program, Reproducibility of Results, Middle Aged, Anthropometry, Blood pressure, Italy, Hypertension, Dietary salt intake, Female, Habit, dietary salt intake, business, Dietetic, sodium intake
Abstract

Background/objectives: The aim of the present study was to validate a short questionnaire on habitual dietary salt intake, to quickly and easily identify individuals whose salt consumption exceeds recommended levels. Subjects/methods: A total of 1131 hypertensive subjects participating in the MINISAL-SIIA study were included in the analysis. Anthropometric indexes, blood pressure, and 24-h urinary sodium excretion (NaU) were measured. A fixed-sequence questionnaire on dietary salt intake was administered. Results: NaU was significantly associated with scores, with a linear association across categories (p for trend 85 mmol/day) and “very high NaU” (NaU > 170 mmol/day) was 86 and 35%, respectively. The score of the questionnaire had a significant ability to detect both “high NaU”—with a specificity of 95% at the score of 10 points—and “very high NaU”—with a specificity of 99.6% at score of 13 points. Conclusions: The main results of the study indicates that a higher score of this short questionnaire is distinctive of habitual high salt consumption in hypertensive patients.

Published
2019

5. First considerations on the SARS-CoV-2 epidemic in the Dialysis Units of Piedmont and Aosta Valley, Northern Italy

Author

Manganaro, M., Baldovino, S., Besso, L., Biancone, L., Boero, R., Borzumati, M., Calabrese, G., Cantaluppi, V., Chiappero, F., Chiarinotti, D., Cusinato, S., Filiberti, O., Formica, M., Gianoglio, B., Maffei, S., Manes, M., Roccatello, D., Sacco, C., Salomone, M., Savoldi, S., Tognarelli, G., Viglino, G., Vitale, C., Amoroso, A., and Vanzino, S.

Subjects
Adult, Male, 2019-20 coronavirus outbreak, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Health Personnel, Pneumonia, Viral, Ambulatory Care Facilities, Health personnel, Betacoronavirus, Pandemic, 80 and over, Prevalence, Medicine, Humans, Aged, Aged, 80 and over, Coronavirus Infections, Epidemics, Female, Hospitalization, Italy, Kidney Transplantation, Middle Aged, Pandemics, Peritoneal Dialysis, Preliminary Data, Renal Insufficiency, Chronic, Viral, Renal Insufficiency, Chronic, business.industry, SARS-CoV-2, COVID-19, Pneumonia, Archaeology, Northern italy, Nephrology, Dialysis unit, Dialisis peritoneal, business
Published
2020

6. Evaluating a New International Risk-Prediction Tool in IgA Nephropathy

Author

Barbour, S.J., Coppo, R., Zhang, H., Liu, Z.H., Suzuki, Y., Matsuzaki, K., Katafuchi, R., Er, L., Espino-Hernandez, G., Kim, S.J., Reich, H.N., Feehally, J., Cattran, D.C., Russo, M.L., Troyanov, S., Cook, H.T., Roberts, I., Tesar, V., Maixnerova, D., Lundberg, S., Gesualdo, L., Emma, F., Fuiano, L., Beltrame, G., Rollino, C., Amore, A., Camilla, R., Peruzzi, L., Praga, M., Feriozzi, S., Polci, R., Segoloni, G., Colla, L., Pani, A., Piras, D., Angioi, A., Cancarini, G., Ravera, S., Durlik, M., Moggia, E., Ballarin, J., Giulio, S. di, Pugliese, F., Serriello, I., Caliskan, Y., Sever, M., Kilicaslan, I., Locatelli, F., Vecchio, L. del, Wetzels, J.F.M., Peters, H., Berg, U., Carvalho, F., Ferreira, A.C.D., Maggio, M., Wiecek, A., Ots-Rosenberg, M., Magistroni, R., Topaloglu, R., Bilginer, Y., D'Amico, M., Stangou, M., Giacchino, F., Goumenos, D., Kalliakmani, P., Gerolymos, M., Galesic, K., Geddes, C., Siamopoulos, K., Balafa, O., Galliani, M., Stratta, P., Quaglia, M., Bergia, R., Cravero, R., Salvadori, M., Cirami, L., Fellstrorn, B., Smerud, H.K., Ferrario, F., Stellato, T., Egido, J., Martin, C., Floege, J., Eitner, F., Lupo, A., Bernich, P., Mene, R., Morosetti, M., Kooten, C. van, Rabelink, T., Reinders, M.E.J., Grinyo, J.M.B., Cusinato, S., Benozzi, L., Savoldi, S., Licata, C., Mizerska-Wasiak, M., Martina, G., Messuerotti, A., Canton, A. dal, Esposito, C., Migotto, C., Triolo, G., Mariano, F., Pozzi, C., Boero, R., Bellur, S., Mazzucco, G., Giannakakis, C., Honsova, E., Sundelin, B., Palma, A.M. di, Gutierrez, E., Asunis, A.M., Barratt, J., Tardanico, R., Perkowska-Ptasinska, A., Terroba, J.A., Fortunato, M., Pantzaki, A., Ozluk, Y., Steenbergen, E., Soderberg, M., Riispere, Z., Furci, L., Orhan, D., Kipgen, D., Casartelli, D., Ljubanovic, D.G., Gakiopoulou, H., Bertoni, E., Ortiz, P.C., Karkoszka, H., Groene, H.J., Stoppacciaro, A., Bajema, I., Bruijn, J., Oliveras, X.F., Maldyk, J., Loachim, E., Bavbek, N., Cook, T., Alpers, C., Berthoux, F., Bonsib, S., D'Agati, V., D'Amico, G., Emancipator, S., Emmal, F., Fervenza, F., Florquin, S., Fogo, A., Groene, H., Haas, M., Hill, P., Hogg, R., Hsu, S., Hunley, T., Hladunewich, Jennette, C., Joh, K., Julian, B., Kawamura, T., Lai, F., Leung, C., Li, L., Li, P., Liu, Z., Massat, A., Mackinnon, B., Mezzano, S., Schena, F., Tomino, Y., Walker, P., Wang, H., Weening, J., Yoshikawa, N., Zeng, C.H., Shi, S.F., Nogi, C., Suzuki, H., Koike, K., Hirano, K., Yokoo, T., Hanai, M., Fukami, K., Takahashi, K., Yuzawa, Y., Niwa, M., Yasuda, Y., Maruyama, S., Ichikawa, D., Suzuki, T., Shirai, S., Fukuda, A., Fujimoto, S., Trimarchi, H., Int IgA Nephropathy Network, and Pathology

Subjects
Adult, Male, medicine.medical_specialty, Risk Assessment, 01 natural sciences, Nephropathy, 03 medical and health sciences, 0302 clinical medicine, Interquartile range, Internal medicine, Internal Medicine, Humans, Medicine, 030212 general & internal medicine, 0101 mathematics, business.industry, Proportional hazards model, Clinical study design, 010102 general mathematics, Glomerulonephritis, IGA, Middle Aged, Models, Theoretical, medicine.disease, Clinical trial, Cohort, Female, business, Risk assessment, Kidney disease
Abstract

ImportanceAlthough IgA nephropathy (IgAN) is the most common glomerulonephritis in the world, there is no validated tool to predict disease progression. This limits patient-specific risk stratification and treatment decisions, clinical trial recruitment, and biomarker validation. ObjectiveTo derive and externally validate a prediction model for disease progression in IgAN that can be applied at the time of kidney biopsy in multiple ethnic groups worldwide. Design, Setting, and ParticipantsWe derived and externally validated a prediction model using clinical and histologic risk factors that are readily available in clinical practice. Large, multi-ethnic cohorts of adults with biopsy-proven IgAN were included from Europe, North America, China, and Japan. Main Outcomes and MeasuresCox proportional hazards models were used to analyze the risk of a 50% decline in estimated glomerular filtration rate (eGFR) or end-stage kidney disease, and were evaluated using the R-D(2) measure, Akaike information criterion (AIC), C statistic, continuous net reclassification improvement (NRI), integrated discrimination improvement (IDI), and calibration plots. ResultsThe study included 3927 patients; mean age, 35.4 (interquartile range, 28.0-45.4) years; and 2173 (55.3%) were men. The following prediction models were created in a derivation cohort of 2781 patients: a clinical model that included eGFR, blood pressure, and proteinuria at biopsy; and 2 full models that also contained the MEST histologic score, age, medication use, and either racial/ethnic characteristics (white, Japanese, or Chinese) or no racial/ethnic characteristics, to allow application in other ethnic groups. Compared with the clinical model, the full models with and without race/ethnicity had better R-D(2) (26.3% and 25.3%, respectively, vs 20.3%) and AIC (6338 and 6379, respectively, vs 6485), significant increases in C statistic from 0.78 to 0.82 and 0.81, respectively (Delta C, 0.04; 95% CI, 0.03-0.04 and Delta C, 0.03; 95% CI, 0.02-0.03, respectively), and significant improvement in reclassification as assessed by the NRI (0.18; 95% CI, 0.07-0.29 and 0.51; 95% CI, 0.39-0.62, respectively) and IDI (0.07; 95% CI, 0.06-0.08 and 0.06; 95% CI, 0.05-0.06, respectively). External validation was performed in a cohort of 1146 patients. For both full models, the C statistics (0.82; 95% CI, 0.81-0.83 with race/ethnicity; 0.81; 95% CI, 0.80-0.82 without race/ethnicity) and R-D(2) (both 35.3%) were similar or better than in the validation cohort, with excellent calibration. Conclusions and RelevanceIn this study, the 2 full prediction models were shown to be accurate and validated methods for predicting disease progression and patient risk stratification in IgAN in multi-ethnic cohorts, with additional applications to clinical trial design and biomarker research.

Published
2019

7. Tonsillectomy in a European Cohort of 1,147 Patients with IgA Nephropathy

Author

Feehally, J, Coppo, R, Troyanov, S, Bellur, Ss, Cattran, D, Cook, T, Roberts, Is, Verhave, Jc, Camilla, R, Vergano, L, Egido, J, Wiecek, A, Karkoszka, H, Tesar, V, Maixnerova, D, Ots-Rosenberg, M, Quaglia, M, Rollino, C, Magistroni, R, Cusinato, S, Cravero, R, Peruzzi, L, Lundberg, S, Gesualdo, L, Cancarini, G, Feriozzi, S, Ferrario, F, Emma, F, Fuiano, L, Beltrame, G, Amore, A, Praga, M, Polci, R, Biancone, L, Colla, L, Pani, A, Angioi, A, Piras, D, Ravera, S, Durlik, M, Moggia, E, Ballarin, J, Di Giulio, S, Pierucci, A, Caliskan, Y, Sever, M, Kilicaslan, I, Locatelli, F, Del Vecchio, L, Wetzels, Jf, Peters, H, Berg, U, Carvalho, F, da Costa Ferreira AC, Maggio, M, Topaloglu, R, Bilginer, Y, D'Amico, M, Stangou, M, Giacchino, F, Goumenos, D, Kalliakmani, P, Gerolymos, M, Galesic, K, Geddes, C, Siamopoulos, K, Balafa, O, Galliani, M, Stratta, P, Bergia, R, Salvadori, M, Cirami, L, Fellstrom, B, Kloster Smerud, H, Stellato, T, Cleary, C, Floege, J, Rauen, T, Lupo, A, Bernich, P, Menè, P, Morosetti, M, van Kooten, C, Rabelink, T, Reinders, Me, Boria Grinyo JM, Benozzi, L, Savoldi, S, Licata, C, Mizerska-Wasiak, M, Roszkowska-Blaim, M, Martina, G, Messuerotti, A, Dal Canton, A, Esposito, C, Migotto, C, Triolo, G, Mariano, F, Pozzi, C, Di Palma AM, Boero, R, Mazzucco, G, Giannakakis, C, Honsova, E, Sundelin, B, Gutiérrez, E, Asunis, Am, Barratt, J, Tardanico, R, Perkowska-Ptasinska, A, Arce Terroba, J, Fortunato, M, Pantzaki, A, Ozluk, Y, Steenbergen, E, Soderberg, M, Riispere, Z, Furci, L, Orhan, D, Kipgen, D, Casartelli, D, Galesic Ljubanovic, D, Gakiopoulou, H, Bertoni, E, Cannata Ortiz, P, Groene, Hj, Stoppacciaro, A, Bajema, I, Bruijn, J, Fulladosa Oliveras, X, Maldyk, J, and Ioachim, E.

Subjects
Male, Physiology, medicine.medical_treatment, IgA nephropathy, Tonsillectomy, Risk factors, Progression of chronic renal failure, 030232 urology & nephrology, 030204 cardiovascular system & hematology, urologic and male genital diseases, Gastroenterology, Progression of chronic renal failure, Cohort Studies, Kidney Failure, Glomerulonephritis, 0302 clinical medicine, Ethnicity, Chronic, Proteinuria, medicine.diagnostic_test, Age Factors, IgA nephropathy, Middle Aged, Europe, Treatment Outcome, Nephrology, Cohort, Disease Progression, Female, Renal biopsy, medicine.symptom, Glomerular Filtration Rate, Cohort study, Adult, medicine.medical_specialty, Urology, Renal function, Ethnic Groups, Nephropathy, iga nephropathy, tonsillectomy, risk factors, progression of chronic renal failure, 03 medical and health sciences, Sex Factors, Physiology (medical), Internal medicine, Risk factors, Tonsillectomy, medicine, Humans, Follow-Up Studies, Glomerulonephritis, IGA, Kidney Failure, Chronic, Propensity Score, Retrospective Studies, IGA, business.industry, Retrospective cohort study, medicine.disease, Renal disorders Radboud Institute for Health Sciences [Radboudumc 11], business
Abstract

Background: Tonsillectomy has been considered a treatment for IgA nephropathy (IgAN). It is aimed at removing a source of pathogens, reducing mucosa-associated lymphoid tissue and decreasing polymeric IgA synthesis. However, its beneficial effect is still controversial. In Asia, favorable outcomes have been claimed mostly in association with corticosteroids. In Europe, small, single-center uncontrolled studies have failed to show benefits. Methods: The European validation study of the Oxford classification of IgAN (VALIGA) collected data from 1,147 patients with IgAN over a follow-up of 4.7 years. We investigated the outcome of progression to end-stage renal disease (ESRD) and/or 50% loss of estimated glomerular filtration rate (eGFR) and the annual loss of eGFR in 61 patients who had had tonsillectomy. Results: Using the propensity score, which is a logistic regression model, we paired 41 patients with tonsillectomy and 41 without tonsillectomy with similar risk of progression (gender, age, race, mean blood pressure, proteinuria, eGFR at renal biopsy, previous treatments and Oxford MEST scores). No significant difference was found in the outcome. Moreover, we performed an additional propensity score pairing 17 patients who underwent tonsillectomy after the diagnosis of IgAN and 51 without tonsillectomy with similar risk of progression at renal biopsy and subsequent treatments. No significant difference was found in changes in proteinuria, or in the renal end point of 50% reduction in GFR and/or ESRD, or in the annual loss of eGFR. Conclusion: In the large VALIGA cohort of European subjects with IgAN, no significant correlation was found between tonsillectomy and renal function decline.

Published
2016

8. Excess dietary sodium and inadequate potassium intake by hypertensive patients in Italy: results of the MINISAL-SIIA study program

Author

Galletti, F, Agabiti Rosei, E, Bernini, G, Boero, R, Desideri, G, Fallo, F, Mallamaci, F, Morganti, A, Castellano, M, Nazzaro, P, Trimarco, B, Strazzullo, P, Campanozzi, A, Carcea, M, Donfrancesco, C, Galeone, D, Giampaoli, S, Iacoviello, L, Scalfi, L, Siani, A, Modesti, S, Parini, U, Pascale, C, Bosio, A, Cerrato, F, Pallisco, O, Massara, C, Veglio, Franco, Rabbia, F, Testa, E, Musso, N, Martino, S, Artom, A, Pirola, I, Parati, G, Lonati, Lm, Cuspidi, C, Sala, C, Rescaldani, M, Gidaro, B, Lonati, C, Grandi, A, Maresca, Am, Merletti, L, Garavelli, G, Pini, C, Crippa, M, Lazzari, F, Ronchi, E, Gaudio, G, Caló, La, Caielli, P, Rossi, G, Sechi, La, Marzano, L, Catena, C, Ungar, A, Giovannetti, R, Cipollini, F, Arcangeli, E, Borgheresi, P, Panichi, V, Rossi, E, Borghi, C, Veronesi, M, Biggi, A, Musiari, L, Montanari, A, Caiazza, A, Meschi, M, Sarzani, R, Giacchetti, G, Schillaci, G, Pucci, G, Ferri, C, Mezzetti, A, Rinaldi, Po, De Luca, N, Barbato, A, Fazio, V, D'Avino, M, Guglielmi, M, De Giorgi GA, Del Giudice, A, Belfiore, A, Barbiero, M, Murri, A, Nardecchia, A, De Pergola, G, Silvestris, F, Vinella, L, Leonardis, D, Malatino, L, Stancanelli, B, Cilia, C., Galletti, F, Agabiti-Rosei, E, Bernini, G, Boero, R, Desideri, G, Fallo, F, Mallamaci, F, Morganti, A, Castellano, M, Nazzaro, P, Trimarco, B, Strazzullo, P, Borghi, C, and Veronesi, M

Subjects
Adult, Male, medicine.medical_specialty, Potassium intake, Physiology, Potassium, Sodium, chemistry.chemical_element, Blood Pressure, Nutrition Policy, Young Adult, Dietary Sodium, Internal medicine, Internal Medicine, medicine, salt, Humans, Blood pressure, Diet, Hypertension, Aged, business.industry, hypertension, Potassium, Dietary, Sodium, Dietary, Anthropometry, Middle Aged, Endocrinology, chemistry, Italy, Female, Cardiology and Cardiovascular Medicine, business
Abstract

INTRODUCTION:The aim of the study was to assess the age-specific, sex-specific, and region-specific average sodium and potassium intake and its association with anthropometric characteristics in a sample of the Italian adult hypertensive population. METHODS:A total of 1232 hypertensive patients were recruited consecutively by 47 centers recognized by the Italian Society of Hypertension. The enrolled participants were on stable antihypertensive treatment. Anthropometric indices, blood pressure, 24-h urinary sodium, and potassium excretion were measured and used as proxy for the average daily sodium and potassium intake. RESULTS:The average sodium intake was 172 mmol (or 10.1 g of salt/day) among men and 138 (or 8.1) among women, with no difference among geographical areas. Over 90% of men and 81% of women had a consumption higher than the recommended standard dietary intake of 5 g/day. The average potassium intake was 63 and 56 mmol, respectively in men and women, again without geographical differences, nearly 92% of men and 95% of women having an intake lower than the recommended intake (100 mmol/day or 3.9 g/day). There was a significant trend to a gradual decrease in sodium intake with age in both sexes (P

Published
2013

9. Phosphate may promote CKD progression and attenuate renoprotective effect of ACE inhibition

Author

Zoccali, Carmine, Ruggenenti, Piero, Perna, Annalisa, Leonardis, Daniela, Tripepi, Rocco, Tripepi, Giovanni, Mallamaci, Francesca, Remuzzi, Giuseppe, 'REIN Study Group' including Remuzzi, G, Tognoni, G, Ruggenenti, P, Bossini, N, Viola, Bf, Scolari, F, Maiorca, R, Cofano, F, Fellin, G, D'Amico, G, Dissegna, D, Brendolan, A, La Greca, G, Feriozzi, A, Ancarani, E, Gandini, E, D'Amato, I, Giangrande, A, Giannico, G, Vitale, O, Manno, C, Schena, Fp, Mazzi, A, Garini, G, Borghetti, A, Pisoni, R, Mosconi, L, Bertani, T, Scanferla, F, Bazzato, G, Oliva, E, Zoccali, C, Toti, G, Sisca, S, Maggiore, Q, Pignone, E, Boero, R, Piccoli, Giorgina Barbara, Piperno, R, Rosati, A, Salvadori, M, Ene Iordache, B, Remuzzi, A, Perna, A, Benini, R, Tammuzzo, L, Gaspari, F, Arnoldi, F, Ciocca, I, Signorini, O, Ferrari, S, Gritti, D, Roggeri, A, Del Priore, L, Cattaneo, D, Stucchi, N, Migone, L, Marubini, E, Del Favero, A, Ideo, G, Geraci, E, and Loi, U.

Subjects
Ramipril, Adult, Male, medicine.medical_specialty, 030232 urology & nephrology, Urology, Angiotensin-Converting Enzyme Inhibitors, 030204 cardiovascular system & hematology, Aged, Disease Progression, Female, Humans, Middle Aged, Phosphates, Randomized Controlled Trials as Topic, Renal Insufficiency, Chronic, Renin-Angiotensin System, Nephrology, Nephropathy, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, Internal medicine, Renin–angiotensin system, medicine, Renal Insufficiency, Chronic, Risk factor, Ace inhibition, Creatinine, business.industry, Confounding, General Medicine, Phosphate, medicine.disease, 3. Good health, Endocrinology, chemistry, business, medicine.drug
Abstract

Phosphate may promote the onset and progression of chronic nephropathies. Here we evaluated the relationships between baseline serum phosphate levels, disease progression, and response to ACE inhibition in 331 patients with proteinuric nephropathies in the prospective Ramipril Efficacy In Nephropathy (REIN) trial. Independent of treatment, patients with phosphate levels in the highest two quartiles progressed significantly faster either to ESRD or to a composite endpoint of doubling of serum creatinine or ESRD compared with patients with phosphate levels below the median (P < 0.001). Results were similar when we analyzed phosphate as a continuous variable (P ≤ 0.004). The renoprotective effect of ramipril decreased as serum phosphate increased (P ≤ 0.008 for interaction); this modification of the treatment effect by phosphate persisted despite adjusting for potential confounders such as GFR and urinary protein. In summary, these data suggest that phosphate is an independent risk factor for progression of renal disease among patients with proteinuric CKD, and high levels of phosphate may even attenuate the renoprotective effect of ACE inhibitors. Future trials should test whether reducing serum phosphate improves renal outcomes and optimizes the renoprotective effect of ACE inhibition.

Published
2011

10. A psoriasis vulgaris protective gene maps close to the HLA-C locus on the EH18.2-extended haplotype

Author

Carlo Carcassi, Donatella Valentini, Erika Giuressi, S Lai, Sandro Orru, Francesca Cottoni, Nicola Aste, P. Biggio, Maria Vittoria Masala, Luisa Cappai, Decio Cerimele, Boero R, M Mulargia, and Licinio Contu

Subjects
Adult, Male, Linkage disequilibrium, Adolescent, Immunology, Genes, MHC Class I, Locus (genetics), Human leukocyte antigen, HLA-C Antigens, Biology, Biochemistry, Genetics, Immunology and Allergy, Humans, Psoriasis, Allele, Child, Gene, Alleles, Aged, Gene map, Haplotype, Histocompatibility Antigens Class I, Chromosome Mapping, Infant, Proteins, General Medicine, Middle Aged, Haplotypes, Case-Control Studies, Child, Preschool, Microsatellite, Female, Microsatellite Repeats
Abstract

We determined the molecular haplotypes of the HLA-A, HLA-C and HLA-B loci and the MHC class I-B-related (MIB) microsatellite in 179 unrelated psoriatic patients (72 familial cases) and in 120 controls. The HLA-A * 3002-Cw * 0501-B * 1801-MIB1 haplotype showed a strong negative association with psoriasis vulgaris (PV) and in particular with familial PV, revealing the presence of a PV-protective gene. Analysis of association and linkage disequilibrium of the single alleles and the various two-three-four-locus segments of this haplotype indicated the presence of a protective gene telomeric to the HLA-C locus. This finding was confirmed in 13 informative multiplex PV families, in which at least one parent carried the EH18.2 haplotype. In two families, an affected sibling presented HLA-A/C recombination on the EH18.2 haplotype. A study of 12 polymorphic microsatellites in all members of the informative families, 145 PV patients, 120 controls and 32 EH18.2 homozygous healthy individuals demonstrated that the protection conferred by the EH18.2 haplotype lies within a 170 kb interval between the C143 and C244 loci, most probably in a 60 kb segment between the C132 and C244 loci.

Published
2004

11. Correlations between bone histopathology and serum biochemistry in uremic patients on chronic hemodialysis

Author

Canavese, C., Barolo, S., Gurioli, L., Cadario, A., Portigliatti, M., Isaia, Giovanni Carlo, Thea, A., Marangella, M., Bongiorno, P., Cavagnino, A., Peona, C., Boero, R., D'Amicone, M., Cardelli, R., Rossi, P., and Piccoli, G.

Subjects
Adult, Aged, 80 and over, Chronic Kidney Disease-Mineral and Bone Disorder, Male, Middle Aged, Ilium, Absorptiometry, Photon, Bone Density, Parathyroid Hormone, Predictive Value of Tests, Renal Dialysis, Ferritins, Linear Models, Humans, Female, Bone Resorption, beta 2-Microglobulin, Biomarkers, Aged, Aluminum, Uremia
Abstract

To define which noninvasive investigations are of value in predicting bone histology, we analyzed transiliac bone specimens (66 biopsies, 14 autopsies) from 80 uremic patients on chronic dialysis. Results were compared with values of different measurements of parathyroid hormone (PTH), alkaline phosphatase (APH), osteocalcin, calcitonin, baseline and post-deferroxamine (DFO) aluminium (Al),--beta 2 microglobulin, ferritin and bone mineral density. Among histomorphometric parameters, woven osteoid, active osteoblastic surface and resorption surface showed the best correlations with dynamic and biochemical marks of active bone metabolism. Among biochemical parameters, intact PTH and APH were better related to histomorphometric and dynamic bone parameters than other PTH measurements as well as osteocalcin, while calcitonin was related to no parameters. Stainable Al alone, and not total bone Al content was related to bone histology. Baseline Al was related to lamellar osteoid, while post-DFO Al was related to stainable Al. beta 2 microglobulin was positively related to active osteoid surface and ferritin was inversely related to the mineral apposition rate, while bone mineral density was related only to total bone volume. We conclude that, though definite diagnosis requires the use of histological methods, few simple biochemical parameters may offer insight to the bone metabolic status, useful to the physician in day to day clinical practice.

Published
1998

12. Blood Pressure Behaviour in Hemodialysis Patients Treated for 10 Years

Author

Zuccalà, Negroni D, Boero R, Giorgina Barbara Piccoli, C. Chiarini, Pietro Zucchelli, Degli Esposti E, Antonio Santoro, Alessandra Sturani, and F Quarello

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Adolescent, Systolic hypertension, medicine.medical_treatment, 030232 urology & nephrology, Biomedical Engineering, Medicine (miscellaneous), Blood Pressure, Bioengineering, 030204 cardiovascular system & hematology, Hematocrit, Dialysis patients, Body weight, Biomaterials, Electrocardiography, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Internal medicine, medicine, Humans, Longitudinal Studies, Dialysis, medicine.diagnostic_test, business.industry, Body Weight, Age Factors, General Medicine, Middle Aged, medicine.disease, Blood pressure, Hypertension, Cardiology, Female, Hemodialysis, business
Abstract

A longitudinal analysis of blood pressure was performed in 30 patients on hemodialysis for at least 10 years, in order to clarify the long-term outcome of hypertension in dialysis patients. Before the start of the dialysis treatment 22 (73.3%) patients were hypertensive, while, after 10 years, only 5 (16.6%) were still hypertensive. Body weight tended to decrease progressively thoughout the period of observation. Hypertension disappeared in the younger patients while it remained/appeared in those who were order showing the characteristics of systolic hypertension. Except for hematocrit no significant differences in metabolic findings were found between normotensive and hypertensive patients. ECG abnormalities were found to be more frequent after 10 years of dialysis than before the start of treatment. High blood pressure tends to disappear progressively in hemodialysis patients and to be no longer a problem in long-term survivors.

Published
1983

13. Erythrocyte Na+, K+ pump inhibition after saline infusion in essentially hypertensive subjects: effects of canrenone administration

Author

B. Rolando, Boero R, C. Rosati, Cesare Guarena, M. C. Deabate, G Piccoli, and F Quarello

Subjects
Adult, Male, medicine.medical_specialty, Erythrocytes, medicine.medical_treatment, Biological Transport, Active, Blood Pressure, Sodium Chloride, Essential hypertension, Natriuresis, Excretion, Internal medicine, Canrenone, Pregnadienes, medicine, Humans, Na+/K+-ATPase, Ouabain, Ion transporter, business.industry, Sodium, Middle Aged, medicine.disease, Endocrinology, Blood pressure, Hypertension, Potassium, Female, Diuretic, Cardiology and Cardiovascular Medicine, business, Extracellular Space, medicine.drug
Abstract

The effects of a 2-litre isotonic saline infusion, with and without prior oral canrenone (150 mg) administration, on erythrocyte Na+, K+ pump, urinary sodium excretion and arterial pressure were evaluated in nine patients with essential hypertension. Ouabain-sensitive Na+ efflux in fresh erythrocytes was used as an index of Na+, K+ pump activity, and the inhibitory effect on this ion efflux of preincubation of erythrocytes in plasma was used to test the presence of a circulating ouabain-like substance. Erythrocyte Na+, K+ pump activity decreased significantly (P less than 0.01) after saline infusion; canrenone administration was able to prevent this inhibition. Plasma from hypertensive patients obtained before saline infusion significantly (P less than 0.01) inhibited the Na+, K+ pump of erythrocytes from normal subjects, while plasma taken after the saline infusion plus canrenone was unable to produce any significant inhibition. Both systolic and diastolic arterial pressure fell significantly (P less than 0.05) only at the end of saline infusion with prior canrenone administration. This study supports the hypothesis that protection of Na+, K+ pump against endogenous inhibitors, other than exogenous, seems to be a pharmacological effect of canrenone, and may partly explain its antihypertensive activity.

Published
1989

14. [Regular dialytic treatment in the Piedmont region. Results and prospects]

Author

Quarello, F., Bossi, P., Pacitti, A., Bosticardo, Gm, Belardi, P., Roccatello, Dario, Aprato, A., Boero, R., Basolo, B., Berto, M., Sancipriano, Gp, and Piccoli, G.

Subjects
Adult, Male, Adolescent, Hemodialysis, Home, Middle Aged, Hospitalization, Self Care, Italy, Renal Dialysis, Humans, Kidney Failure, Chronic, Female, Child, Aged, Uremia
Abstract

The Piedmont planning for the prevention and treatment of chronic uremia started in 1976, with the purpose to extending full treatment of the whole region, through the development of home and self care dialysis and intensive use of hospital short dialysis. Hospital dialysis would be reserved either for new treatments or complicated or uncooperative patients. Thank to an intensive exploitation of the existing hospital centers, a 68.7% increment in the number of treated patients was achieved and costs were kept down to a limited acceptable range. With the development of home and self care dialysis, 27% of the patients were located in out-of-hospital centers, and 17% at home. The Piedmont planning concerned itself with the patients' data collected by the Regional Registry under the following items: a) characteristics of dialysis population; b) the present modes of treatment; c) the number of patients apt to varying treatments and renal transplantation; d) the epidemiology of uremia causing nephropathies. At the present time results are only preliminary. Nevertheless, the first observations showed a long and difficult work with good possibilities of success for computerized facilities in the field of dialysis, particularly in respect to regional areas which in the reformed Health Service are now considered to be operating as autonomous.

Published
1981

15. [Acute kidney failure caused by cholesterol atheroembolism]

Author

Boero R, Manuel Borca, Gm, Iadarola, Rollino C, Pignataro A, Alfieri V, Ballario R, and Quarello F

Subjects
Aged, 80 and over, Male, Arteriosclerosis, Humans, Female, Acute Kidney Injury, Middle Aged, Aged, Embolism, Cholesterol
Abstract

To describe the clinical aspects of renal failure due to cholesterol atheroembolism.An hospital based observational study on renal failure due to cholesterol atheroembolism was carried out. Twenty-two cases (19 males, mean age 68 yrs, range 53-83 yrs) were identified from January 1992 to September 1998.Clinical symptoms were acute or rapidly progressive renal failure with blue toe and/or skin livedo reticularis in 13/22 cases (59%) and indolent progressive renal failure in 7/22 cases (32%). In 6/22 cases (27%) an abdominal organ involvement was evident; two (9%) had retinal cholesterol emboli, two (9%) peripheral and two (9%) central nervous system impairment. In 7 patients (32%) the cholesterol atheroembolism occurred spontaneously, while in 15 (68%) it followed invasive or interventional radiology (8 cases, 36%); cardiac or vascular surgery (4 cases, 18%); thrombolytic or anticoagulant therapy (3 cases, 14%). The time interval between the procedure at risk and the onset of symptoms or signs of cholesterol atheroembolism ranged between few hours to 60 days. Eleven patients (50%) required dialysis, which was then withheld in 4 cases (36%), owing to partial functional recovery after a median time of 30 days, ranging from 10 to 690 days. Median follow-up was 2.5 months (ranging from 2 days to 68 months), and eleven patients (50%) deceased.Cholesterol atheroembolism is a cause of renal failure associated with high mortality rates; its prevention needs the skill of all physicians involved in the care of patients with severe atherosclerosis.

16. [Inadequate treatment and control of arterial hypertension in patients with type 2 diabetes mellitus]

Author

Boero R, Elena Prodi, Borsa S, Berti V, Fiorio E, Ferraro L, Massara C, and Quarello F

Subjects
Male, Blood Pressure, Comorbidity, Middle Aged, Drug Prescriptions, Drug Utilization, Sampling Studies, Cohort Studies, Random Allocation, Diabetes Mellitus, Type 2, Italy, Risk Factors, Hypertension, Prevalence, Albuminuria, Humans, Hypoglycemic Agents, Insulin, Drug Therapy, Combination, Female, Antihypertensive Agents, Aged
Abstract

Aim of this study is to evaluate the treatment and control of arterial hypertension in patients with type 2 diabetes.We identified 5815 diabetic patients in our health-care district (191,568 inhabitants) through prescriptions for insulin and/or hypoglycaemic drugs in the first 6 months of 2000; 3810 of them (65%) also had prescriptions for antihypertensive drugs. We evaluated a randomly selected sample of 171 patients with type 2 diabetes, 100 of whom were receiving antihypertensive drugs (94 males and 77 females, mean age 66.6 +/- 8 years, mean diabetes duration 12+/-9 years).Fifty-seven out of 71 patients not treated with antihypertensive drugs (80.3%) had a BP = 130/85 mmHg; 24.4% of them had a diastolic BP = 85 mmHg and 79% had a systolic BP = 130 mmHg. Thirteen out of 100 treated patients (13%) had a BP130/85 mmHg. Among the patients treated with antihypertensive drugs 36% received one drug, 36% two drugs and 28%=3 drugs; mean 1.98 +/- 0.9 drugs/patients. Among the patients treated with monotherapy 36.1% received ACE-inhibitors, 36.1% dihydropyridinic calcium-antagonists, 11.1% alpha-blockers, 11%, diuretics, 2.8% non-dihydropyridinic calcium-antagonists, and 2.8% angiotensin II antagonists. Patients treated with two antihypertensive drugs received more frequently an ACE-inhibitor plus a diuretic (31%) or an ACE-inhibitor plus an alpha-blocker (23%) or an ACE-inhibitor plus a dihydropyridinic calcium-antagonists (20%). A diuretic was used in 40% of the patients with two antihypertensive drugs and in 78% of those with= 3 drugs.Many hypertensive type 2 diabetic patients are left untreated and only a minority of those treated reach optimal blood pressure control. The importance of an elevated systolic pressure is underestimated, and the number of antihypertensive drugs prescribed is suboptimal.

17. Pilot prospective open, single-arm multicentre study on off-label use of tocilizumab in patients with severe COVID-19

Author

Sciascia, S., Aprà, F., Baffa, A., Baldovino, S., Boaro, D., Boero, R., Bonora, S., Calcagno, A., Cecchi, I., Cinnirella, G., Converso, M., Cozzi, M., Crosasso, P., Iaco, F., Di Perri, G., Eandi, M., Fenoglio, R., Giusti, M., Imperiale, D., Imperiale, G., Livigni, S., Manno, E., Massara, C., Milone, V., Natale, G., Navarra, M., Oddone, V., Osella, S., Piccioni, P., Massimo Radin, Roccatello, D., and Rossi, D.

Subjects
Male, SARS-CoV-2, Interleukin-6, Pneumonia, Viral, Aged, Antibodies, Monoclonal, Humanized, Coronavirus Infections, Female, Humans, Middle Aged, Off-Label Use, Pandemics, Pilot Projects, Prospective Studies, Receptors, Interleukin-6, Treatment Outcome, Betacoronavirus, COVID-19, Pneumonia, Antibodies, Monoclonal, Receptors, Viral, Humanized
Abstract

No agent has yet been proven to be effective for the treatment of patients with severe COVID-19.We conducted a pilot prospective open, single-arm multicentre study on off-label use of tocilizumab (TCZ) involving 63 hospitalised adult patients (56 males, age 62.6±12.5) with severe COVID-19. Clinical and laboratory parameters were prospectively collected at baseline, day 1, 2, 7 and 14. No moderate-to-severe adverse events attributable to TCZ were recorded.We observed a significant improvement in the levels of ferritin, C-reactive protein, D-dimer. The ratio of the partial pressure of oxygen (Pa02) to the fraction of inspired oxygen (Fi02) improved (mean±SD Pa02/Fi02 at admission: 152±53; at day 7: 283.73±115.9, at day 14: 302.2±126, p0.05). The overall mortality was 11%; D-dimer level at baseline, but not IL-6 levels were predictors of mortality. TCZ administration within 6 days from admission in the hospital was associated with an increased likelihood of survival (HR 2.2 95%CI 1.3-6.7, p0.05).In hospitalised adult patients with severe COVID-19, TCZ could be a safe option. An improvement in respiratory and laboratory parameters was observed. Future controlled trials in patients with severe illness are urgently needed to confirm the definite benefit with IL-6 target therapy.

18. Bone marrow transplantation in thalassemia. The Cagliari team experience

Author

Contu L, Giorgio La Nasa, Pizzati A, Arras M, Vacca A, Ledda A, Carcassi C, Orrù S, Mulargia M, and Boero R

Subjects
Adult, Male, Adolescent, Histocompatibility Testing, Bone Marrow Purging, Graft Survival, beta-Thalassemia, Graft vs Host Disease, Treatment Outcome, Italy, Child, Preschool, Humans, Female, Child, Busulfan, Cyclophosphamide, Bone Marrow Transplantation

19. Allogeneic bone marrow transplantation combined with multiple anti-HIV-1 treatment in a case of AIDS

Author

Contu L, Giorgio La Nasa, Arras M, Pizzati A, Vacca A, Carcassi C, Ledda A, Boero R, Orrù S, and Pintus A

Subjects
Adult, Acquired Immunodeficiency Syndrome, Respiratory Distress Syndrome, Graft vs Host Disease, Granulocyte-Macrophage Colony-Stimulating Factor, Interferon-alpha, Interferon alpha-2, Combined Modality Therapy, Recombinant Proteins, HIV-1, Humans, Transplantation, Homologous, Drug Therapy, Combination, Female, Busulfan, Cyclophosphamide, Zidovudine, Antilymphocyte Serum, Bone Marrow Transplantation
Abstract

A 25-year-old woman with AIDS was submitted to HLA-identical allogeneic BMT after cytoablation with busulphan and cyclophosphamide and combined anti-HIV-1 therapy with zidovudine, IFN-alpha 2 and anti-HIV-1-specific T cell clones. Marrow engraftment occurred after 18 days and tests for HIV-1 were negative after 30 days but the hematologic reconstitution of the patient was poor. A second BM infusion from the same donor was ineffective and treatment with GM-CSF only induced a transient increase of the blood cell count, suggesting iatrogenic damage to the BM microenvironment. The development of ARDS led to the death of the patient 10 months after transplantation. Post-mortem investigation did not reveal any active infections and PCR on autopsy tissues was negative for HIV-1.

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