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1. Risk for chronic kidney disease in the general population italian reports for the the world kiney days 2007-2009

Author

Galassi, A, Brancaccio, D, Andreucci, Ve, Andreucci, M, Caglioti, A, Faga, T, Mazzitello, G, Antonelli, A, Carlini, A, Giusti, R, Rosati, A, Apperti, V, Auricchio, Mr, Avella, F, Barbato, A, Romano, P, Barzaghi, B, Bedani, Pl, Bellinghieri, G, Costantino, G, Bernardi, A, Bolasco, P, Ferrara, R, Pani, A, Bonomini, M, Busnach, G, Conte, F, Limido, A, Messa, Pg, Sinico, Ra, Spotti, D, Cadinu, F, Campieri, C, Capuano, M, Terribile, M, Cardone, F, Paglia, S, Castellino, P, Di Landro, D, Fatuzzo, P, Liuzzo, G, Sicurezza, E, Casu, Md, Centrone, E, Ciofani, A, Cossu, M, D'Amaro, E, D'Apice, L, Dal Canton, A, Fasoli, G, De Ferrari, G, Cappelli, Gianni, Gusmano, R, De Simone, W, Delgado, G, Di Iorio, B, Di Luca, M, Di Natale, E, Farfaglia, P, Cantú, P, Feriozzi, S, Galeotti, P, Fiorini, F, Frascà, Gm, Gallucci, M, Buongiorno, E, Gesualdo, L, Giannattasio, M, Detomaso, F, Giannetto, M, Gianni, S, Giliberti, A, Grassi, C, Lupi, Gp, Imperiali, P, Juliano, P, Li Vecchi, M, Lucenti, T, Maffucci, G, Anelli, Am, Manno, M, Schena, Fp, Mazzaferro, S, Migliorati, M, Morrone, L, Mura, M, Petrarulo, F, Pizzarelli, F, Ricciardi, B, Riccobene, G, Rondanini, V, Russo, D, Sasdelli, M, Mura, C, Scarpino, L, Selvi, S, Tarchini, R, Tedesco, A, Timio, F, Traversari, L, Venditti, G, Viganò, S, Locatelli, F., Galassi, A., Andreucci, M, Caglioti, A., Faga, T., Mazzitello, G., Antonelli, A., Carlini, A., Giusti, R., Rosati, A., Apperti, V., Auricchio, M. R., Avella, F., Barbato, A., Romano, P., Barzaghi, B., Bedani, P. L., Bellinghieri, G., Costantino, G., Bernardi, A., Bolasco, P., Ferrara, R., Pani, A., Bonomini, M., Brancaccio, D., Busnach, G., Conte, F., Limido, A., Messa, P. G., Sinico, R. A., Spotti, D., Cadinu, F., Campieri, C., Capuano, M., Terribile, M., Cardone, F., Paglia, S., Castellino, P., Di Landro, D., Fatuzzo, P., Liuzzo, G., Sicurezza, E., Casu, M. D., Centrone, E., Ciofani, A., Cossu, M., D'Amaro, E., D'Apice, L., Dal Canton, A., Fasoli, G., De Ferrari, G., Cappelli, G., Gusmano, R., De Simone, W., Delgado, G., Di Iorio, B., Di Luca, M., Di Natale, E., Farfaglia, P., Cantù, P., Feriozzi, S., Galeotti, P., Fiorini, F., Frascà, G. M., Gallucci, M., Buongiorno, E., Gesualdo, L., Giannattasio, M., Detomaso, F., Giannetto, M., Gianni, S., Giliberti, A., Grassi, C., Lupi, G. P., Imperiali, P., Juliano, P., Li Vecchi, M., Lucenti, T., Maffucci, G., Anelli, A. M., Manno, M., Schena, F. P., Mazzaferro, S., Migliorati, M., Morrone, L., Mura, M., Petrarulo, F., Pizzarelli, F., Ricciardi, B., Riccobene, G., Rondanini, V., Russo, Domenico, Sasdelli, M., Mura, C., Scarpino, L., Selvi, S., Tarchini, R., Tedesco, A., Timio, M., Traversari, L., Venditti, G., Viganò, S., Locatelli, F., Galassi, A, Caglioti, A, Faga, T, Mazzitello, G, Antonelli, A, Carlini, A, Giusti, R, Rosati, A, Apperti, V, Auricchio, M, Avella, F, Barbato, A, Romano, P, Barzaghi, B, Bedani, P, Bellinghieri, G, Costantino, G, Bernardi, A, Bolasco, P, Ferrara, R, Pani, A, Bonomini, M, Brancaccio, D, Busnach, G, Conte, F, Limido, A, Messa, P, Sinico, R, Spotti, D, Cadinu, F, Campieri, C, Capuano, M, Terribile, M, Cardone, F, Paglia, S, Castellino, P, Di Landro, D, Fatuzzo, P, Liuzzo, G, Sicurezza, E, Casu, M, Centrone, E, Ciofani, A, Cossu, M, D'Amaro, E, D'Apice, L, Dal Canton, A, Fasoli, G, De Ferrari, G, Cappelli, G, Gusmano, R, De Simone, W, Delgado, G, Di Iorio, B, Di Luca, M, Di Natale, E, Farfaglia, P, Cantù, P, Feriozzi, S, Galeotti, P, Fiorini, F, Frascà, G, Gallucci, M, Buongiorno, E, Gesualdo, L, Giannattasio, M, Detomaso, F, Giannetto, M, Gianni, S, Giliberti, A, Grassi, C, Lupi, G, Imperiali, P, Juliano, P, Li Vecchi, M, Lucenti, T, Maffucci, G, Anelli, A, Manno, M, Schena, F, Mazzaferro, S, Migliorati, M, Morrone, L, Mura, M, Petrarulo, F, Pizzarelli, F, Ricciardi, B, Riccobene, G, Rondanini, V, Russo, D, Sasdelli, M, Mura, C, Scarpino, L, Selvi, S, Tarchini, R, Tedesco, A, Timio, M, Traversari, L, Venditti, G, Viganò, S, and Locatelli, F

Subjects
Proteinuria, Time Factors, Italy, Risk Factors, Nephrology, Chronic Disease, Diabetic Nephropathies/etiology, Hypertension, Humans, Diabetic Nephropathies, Kidney Diseases
Published
2010

2. Clinical policies on the management of chronic kidney disease patients in Italy

Author

SIR SIN STUDY INVESTIGATORS ACCIARRI P, MENEGATO MA, ANCARANI E, ANDREUCCI V, ANTONELLI A, AURICCHIO MR, BALDUCCI A, BASSI A, BATTAGLIA G, BELLINGHERI G, BELTRAME A, BIAGINI M, BONFANTE L, BONOFIGLIO R, BONOMINI M, BORGHI M, BRIGANTE M, BUCCIANTI G, BUONGIORNO E, CABIBBE M, CANCARINI G, CAPISTRANO M, CAPPELLI G, CAPUANO M, CASCONE C, CATIZONE L, CATUCCI AE, CAVATORTA F, CHIARINOTTI D, CICCHETTI T, CONCAS G, CONCETTI M, CONTE F, CONTI M, CORATELLI P, CORTI MM, COSTANZO R, DAL CANTON A, D'APICE L, DAVID S, DE CRISTOFARO V, DEFERRARI G, DELLA GROTTA F, DE NICOLA, Luca, DE SANTO NG, DE SIMONE W, DI DANIELE N, DI GIULIO S, DI LANDRO D, DI LUZIO V, DI MAGGIO A, FAGUGLI R, FARINA M, FERIANI M, GALLIENI M, GAMBARO G, GIORDANO R, GRECO S, GRILLO C, HUBER W, LIUZZO G, LOCATELLI F, LOMBARDI L, LOPEZ T, MALBERTI F, MANCINI W, MANENTI F, MANISCO G, MARROCCO A, MATOCCI G, MERICO G, MESSA P, MINUTOLO, Roberto, MONARDO P, MORICONI L, MURRONE P, NARDO A, NASO A, NOBILE R, PANARELLO G, PAONE A, PARRAVANO M, PEDRINI L, PIAZZA V, PISTIS R, PROCIDA M, QUARELLO F, RAPISARDA F, RICCIARDI B, RINDI P, RONCO C, ROTOLO U, RUSSO G, SARANITI A, SASDELLI M, SAVICA V, SCANZIANI R, SIDOTI A, SPOTTI D, STALTERI A, STEFONI S, STELLA A, STRIPPOLI P, TEATINI U, TEODORO C, TOZZO C, TRIOLO G, ZOCCALI C., Locatelli F, Zoccali C, Acciarri P, Menegato MA, Ancarani E, Andreucci V, Antonelli A, Auricchio MR, Balducci A, Bassi A, Battaglia G, Bellingheri G, Beltrame A, Biagini M, Bonfante L, Bonofiglio R, Bonomini M, Borghi M, Brigante M, Buccianti G, Buongiorno E, Cabibbe M, Cancarini G, Capistrano M, Cappelli G, Capuano M, Cascone C, Catizone L, Catucci AE, Cavatorta F, Chiarinotti D, Cicchetti T, Concas G, Concetti M, Conte F, Conti M, Coratelli P, Corti MM, Costanzo R, Dal Canton A, D'Apice L, David S, De Cristofaro V, Deferrari G, Della Grotta F, De Nicola L, De Santo NG, De Simone W, Di Daniele N, Di Giulio S, Di Landro D, Di Luzio V, Di Maggio A, Fagugli R, Farina M, Feriani M, Gallieni M, Gambaro G, Giordano R, Greco S, Grillo C, Huber W, Liuzzo G, Lombardi L, Lopez T, Malberti F, Mancini W, Manenti F, Manisco G, Marrocco A, Matocci G, Merico G, Messa P, Minutolo R, Monardo P, Moriconi L, Murrone P, Nardo A, Naso A, Nobile R, Panarello G, Paone A, Parravano M, Pedrini L, Piazza V, Pistis R, Procida M, Quarello F, Rapisarda F, Ricciardi B, Rindi P, Ronco C, Rotolo U, Russo G, Saraniti A, Sasdelli M, Savica V, Scanziani R, Sidoti A, Spotti D, Stalteri A, Stefoni S, Stella A, Strippoli P, Teatini U, Teodoro C, Tozzo C, Triolo G., SIR SIN STUDY INVESTIGATORS ACCIARRI, P, Menegato, Ma, Ancarani, E, Andreucci, V, Antonelli, A, Auricchio, Mr, Balducci, A, Bassi, A, Battaglia, G, Bellingheri, G, Beltrame, A, Biagini, M, Bonfante, L, Bonofiglio, R, Bonomini, M, Borghi, M, Brigante, M, Buccianti, G, Buongiorno, E, Cabibbe, M, Cancarini, G, Capistrano, M, Cappelli, G, Capuano, M, Cascone, C, Catizone, L, Catucci, Ae, Cavatorta, F, Chiarinotti, D, Cicchetti, T, Concas, G, Concetti, M, Conte, F, Conti, M, Coratelli, P, Corti, Mm, Costanzo, R, DAL CANTON, A, D'Apice, L, David, S, DE CRISTOFARO, V, Deferrari, G, DELLA GROTTA, F, DE NICOLA, Luca, DE SANTO, Ng, DE SIMONE, W, DI DANIELE, N, DI GIULIO, S, DI LANDRO, D, DI LUZIO, V, DI MAGGIO, A, Fagugli, R, Farina, M, Feriani, M, Gallieni, M, Gambaro, G, Giordano, R, Greco, S, Grillo, C, Huber, W, Liuzzo, G, Locatelli, F, Lombardi, L, Lopez, T, Malberti, F, Mancini, W, Manenti, F, Manisco, G, Marrocco, A, Matocci, G, Merico, G, Messa, P, Minutolo, Roberto, Monardo, P, Moriconi, L, Murrone, P, Nardo, A, Naso, A, Nobile, R, Panarello, G, Paone, A, Parravano, M, Pedrini, L, Piazza, V, Pistis, R, Procida, M, Quarello, F, Rapisarda, F, Ricciardi, B, Rindi, P, Ronco, C, Rotolo, U, Russo, G, Saraniti, A, Sasdelli, M, Savica, V, Scanziani, R, Sidoti, A, Spotti, D, Stalteri, A, Stefoni, S, Stella, A, Strippoli, P, Teatini, U, Teodoro, C, Tozzo, C, Triolo, G, and Zoccali, C.

Subjects
Nephrology, medicine.medical_specialty, Referral, Anemia, medicine.medical_treatment, Context (language use), Metabolic Diseases, Internal medicine, Surveys and Questionnaires, Italian Society of Nephrology, chronic kidney disease, questionnaire, medicine, Humans, Intensive care medicine, Dialysis, Settore MED/14 - Nefrologia, Transplantation, business.industry, Guideline, medicine.disease, Italy, Chronic Disease, Kidney Diseases, Hemodialysis, Guideline Adherence, business, Kidney disease
Abstract

BACKGROUND: Recent studies have indicated that the implementation of international guidelines for the management of renal patients is suboptimal in Italy. The Italian Society of Nephrology (SIN) decided to undertake a multicentre study to obtain a clear picture of clinical policies on chronic kidney disease (CKD) in Italy. METHODS: A 76-item structured questionnaire, designed to evaluate the organization of clinical care, was administered to the director of each participating centre, within the context of a large observational trial in 100 Italian nephrology centres, collecting information on newly diagnosed CKD patients (K/DOQI stage 3-5) on conservative treatment. This paper reports the questionnaire results related to management of anaemia and bone metabolism disorders; assessment of renal function; creation of a vascular access for dialysis and referral of patients to a nephrologist. RESULTS: Clinical policies at the centre level deviated from guideline recommendations in 70% (timing of vascular access creation) to 25% (assessment of iron deficiency) of centres. Assessment of renal function differed from the recommended approach in 30% of centres; clinical policies related to anaemia and bone disease did not coincide with guideline standards in 50 and 40% of centres, respectively. Directors of renal unit estimates indicate that the creation of a vascular access occurs very late in 38% of patients and that referral to a nephrologist is late in approximately 40% of cases. CONCLUSION: This survey in Italy highlights important deviations of clinical policies at the centre level from guideline recommendations.

Published
2008

3. Measuring and estimating GFR and treatment effect in ADPKD patients: results and implications of a longitudinal cohort study

Author

Ruggenenti P, Gaspari F, Cannata A, Carrara F, Cella C, Ferrari S, Stucchi N, Prandini S, Ene Iordache B, Diadei O, Perico N, Ondei P, Buongiorno E, Messa P, Dugo M, Remuzzi G, GFR ADPKD Study Group, PISANI, ANTONIO, Ruggenenti, P, Gaspari, F, Cannata, A, Carrara, F, Cella, C, Ferrari, S, Stucchi, N, Prandini, S, Ene Iordache, B, Diadei, O, Perico, N, Ondei, P, Pisani, Antonio, Buongiorno, E, Messa, P, Dugo, M, Remuzzi, G, and GFR ADPKD Study, Group

Subjects
Nephrology, Adult, Male, medicine.medical_specialty, Anatomy and Physiology, Clinical Research Design, Iohexol, Science, Urology, Autosomal dominant polycystic kidney disease, Renal function, urologic and male genital diseases, Cohort Studies, chemistry.chemical_compound, Internal medicine, medicine, Polycystic kidney disease, Humans, Biology, Creatinine, Multidisciplinary, Models, Statistical, business.industry, urogenital system, Reproducibility of Results, Renal System, Middle Aged, medicine.disease, Polycystic Kidney, Autosomal Dominant, female genital diseases and pregnancy complications, Endocrinology, Treatment Outcome, chemistry, Research Design, Disease Progression, Medicine, Female, sense organs, business, medicine.drug, Kidney disease, Cohort study, Research Article, Glomerular Filtration Rate
Abstract

Trials failed to demonstrate protective effects of investigational treatments on glomerular filtration rate (GFR) reduction in Autosomal Dominant Polycystic Kidney Disease (ADPKD). To assess whether above findings were explained by unreliable GFR estimates, in this academic study we compared GFR values centrally measured by iohexol plasma clearance with corresponding values estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) and abbreviated Modification of Diet in Renal Disease (aMDRD) formulas in ADPKD patients retrieved from four clinical trials run by a Clinical Research Center and five Nephrology Units in Italy. Measured baseline GFRs and one-year GFR changes averaged 78.6±26.7 and 8.4±10.3 mL/min/1.73 m(2) in 111 and 71 ADPKD patients, respectively. CKD-Epi significantly overestimated and aMDRD underestimated baseline GFRs. Less than half estimates deviated by

Published
2012

4. Prevalence and progression of cardiovascular calcifications in peritoneal dialysis patients: A prospective study

Author

Gallieni M, Caputo F, Filippini A, Gabella P, Giannattasio M, Stingone A, Farina M, Amato M, Avella F, Bertoli M, Bocci C, Borgatti P, Buongiorno E, Cavatorta F, Cabiddu G, Coratelli P, Costanzo R, Daidone G, D'Angelo A, Della Grotta F, De Vecchi A, Ferrari G, Gaggiotti E, Fanciulli E, Fusaroli M, La Rosa R, Malberti F, Marinangeli G, Mauro MM, Oliva B, Orazi E, Rapisarda F, Rocca AR, Ronco C, Sacchetti A, Sasdelli M, Scanziani R, Sessa A, Spinelli C, STEFONI, SERGIO, Viglino G., Gallieni M, Caputo F, Filippini A, Gabella P, Giannattasio M, Stingone A, Farina M, Amato M, Avella F, Bertoli M, Bocci C, Borgatti P, Buongiorno E, Cavatorta F, Cabiddu G, Coratelli P, Costanzo R, Daidone G, D'Angelo A, Della Grotta F, De Vecchi A, Ferrari G, Gaggiotti E, Fanciulli E, Fusaroli M, La Rosa R, Malberti F, Marinangeli G, Mauro MM, Oliva B, Orazi E, Rapisarda F, Rocca AR, Ronco C, Sacchetti A, Sasdelli M, Scanziani R, Sessa A, Spinelli C, Stefoni S, and Viglino G.

Subjects
Adult, Male, medicine.medical_specialty, Histology, Physiology, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Population, Left ventricular hypertrophy, Gastroenterology, Peritoneal dialysis, Young Adult, Cardiovascular calcification, PERITONEAL DIALYSIS, Internal medicine, medicine, Prevalence, CKD-MBD, Humans, Renal osteodystrophy, Prospective Studies, education, Prospective cohort study, Dialysis, CARDIOVASCULAR CALCIFICATION, Aged, Demography, Aged, 80 and over, education.field_of_study, business.industry, Calcinosis, Phosphorus, Middle Aged, medicine.disease, Survival Analysis, Surgery, Italy, Multivariate Analysis, OBSERVATIONAL STUDY, Disease Progression, SURVIVAL, Calcium, Female, Hypertrophy, Left Ventricular, Hemodialysis, business, Cardiomyopathies
Abstract

Background Patients on dialysis may have abnormal serum levels of Ca, P and parathyroid hormone, with related bone diseases. This population has an increased risk of death, with cardiovascular calcification (CC) a contributing factor. Patients on peritoneal dialysis appear to be at increased risk of hyperlipidemia, a contributing factor to atherosclerotic plaque formation. Although several studies have described the presence and progression of CC in hemodialysis populations, there are fewer data in patients on peritoneal dialysis. Study design The Renal Osteodystrophy and Calcifications: Key factors in Peritoneal Dialysis (ROCK-PD) study was a 36-month, prospective observational study conducted in Italy. The study examined the presence and progression of CC in two cardiac valves and five arterial sites. The potential associations of serum Ca and P with mortality and cardiovascular morbidity, demographic, clinical and blood chemistry variables was investigated. Results CC was present in 77% of patients at baseline ( N = 369) and in 90% of patients by study end ( N = 145), progressing in 73% of patients. There were 42 deaths (11%). Analyses showed a marked correlation between baseline P levels and the presence of left ventricular hypertrophy. However, there were no consistent correlations between serum Ca or P with mortality or morbidity. Conclusions CC was common in peritoneal dialysis patients and progressed in a majority of patients.

Published
2012

5. Prognostic role of LDL cholesterol in non-dialysis chronic kidney disease: Multicenter prospective study in Italy

Author

De Nicola, Luca, Provenzano, Michele, Chiodini, Paolo, D'Arrigo, Graziella, Tripepi, Giovanni, Del Vecchio, Lucia, Conte, Giuseppe, Locatelli, Francesco, Zoccali, Carmine, Minutolo, RobertoAcciarri P, Adorati, M, Ancarani, E, Andreucci, V, Antonelli, A, Auricchio, Mr, Balducci, A, Bassi, A, Battaglia, G, Bellingheri, G, Beltrame, A, Biagini, M, Bonfante, L, Bonofiglio, R, Bonomini, M, Borghi, M, Brigante, M, Buccianti, G, Buongiorno, E, Cabibbe, M, Cancarini, Giovanni, Capistrano, M, Cappelli, G, Capuano, M, Cascone, C, Catizone, L, Catucci, Ae, Cavatorta, F, Chiarinotti, D, Cicchetti, T, Concas, G, Concetti, M, Conte, F, Conte, G, Conti, M, Coratelli, P, Corti, Mm, Costanzo, R, Dal Canton, A, D'Apice, L, David, S, De Cristofaro, V, Deferrari, G, Della Grotta, F, De Santo NG, De Simone, W, Di Daniele, N, Di Giulio, S, Di Landro, D, Di Luzio, V, Di Maggio, A, Fagugli, R, Farina, M, Feriani, M, Gallieni, M, Gambaro, G, Giordano, R, Greco, S, Grillo, C, Huber, W, Liuzzo, G, Locatelli, F, Lombardi, L, Lopez, T, Malberti, F, Mancini, W, Manenti, F, Manisco, G, Marrocco, A, Matocci, G, Merico, G, Messa, P, Minutolo, R, Monardo, P, Moriconi, L, Murrone, P, Nardo, A, Naso, A, Nobile, R, Panarello, G, Paone, A, Parravano, M, Pedrini, L, Piazza, V, Pistis, R, Procida, M, Quarello, F, Rapisarda, F, Ricciardi, B, Rindi, P, Ronco, C, Rotolo, U, Russo, G, Santoro, D, Saraniti, A, Sasdelli, M, Savica, V, Scanziani, R, Sidoti, A, Spotti, D, Stalteri, A, Stefoni, S, Stella, A, Strippoli, P, Teatini, U, Teodoro, C, Tozzo, C, Triolo, G, Zoccali, C., De Nicola, L, Provenzano, M, Chiodini, P, D'Arrigo, G, Tripepi, G, Del Vecchio, L, Conte, G, Locatelli, F, Zoccali, C, and Minutolo, R

Subjects
Male, Nephrology, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Medicine (miscellaneous), Kidney Function Tests, Severity of Illness Index, chemistry.chemical_compound, Endocrinology, Risk Factors, Chronic kidney disease, 80 and over, Prospective Studies, Renal Insufficiency, Chronic, Prospective cohort study, Cardiovascular risk, Cholesterol, ESRD, LDL, Renal clinic, Nutrition and Dietetics, Cardiology and Cardiovascular Medicine, Aged, 80 and over, Medicine (all), Middle Aged, Prognosis, Diabetes and Metabolism, Italy, Cardiovascular Diseases, Female, Glomerular Filtration Rate, medicine.medical_specialty, Renal function, Median follow-up, Internal medicine, Diabetes mellitus, medicine, Humans, Renal replacement therapy, Renal Insufficiency, Chronic, Aged, business.industry, Cholesterol, LDL, medicine.disease, chemistry, business, Kidney disease
Abstract

Background and aims The prognostic role of LDL in non-dialysis chronic kidney disease (CKD) is still undefined. We addressed this question in a multicenter prospective study including patients referred to nephrologist for management. Methods and results 1306 patients with CKD stage III–V were studied at basal visit in 79 Italian nephrology clinics in 2004–2006, and then followed for survival analyses. Study endpoints were incident cardiovascular -CV events (fatal and major non-fatal) and renal events (start of renal replacement therapy or eGFR halving). Mean age was 67.6 ± 11.8 years, male 65%, diabetes 25%, CV disease 27%, and eGFR 35.8 ± 12.5 mL/min/1.73 m 2 . LDL was 119 ± 40 mg/dL, with high levels in 50.1% and 82.8% defined on the basis of the individual CV risk profile estimated according to ATPIII 2001 and ESC 2012 guidelines (LDL 100 to 160, and >70 or >100 mg/dL, respectively). Over a median follow up of 2.87 years, 178 CV and 181 renal events occurred. At multivariable Cox analyses, CV risk linearly increased with higher LDL (hazard ratio-HR per 40 mg/dL higher LDL: 1.20, 95% confidence intervals-CI 1.03–1.39); risk doubled when considering high LDL defined according to ESC 2012 (HR 2.37, 95%CI 1.39–4.03) while this association was not significant when considering the higher threshold levels of ATPIII 2001 (HR 1.10, 95%CI 0.82–1.49). No association emerged between LDL and renal risk. Conclusion In non-dialysis CKD patients, CV risk increases linearly with higher LDL and is more than doubled when considering the lower threshold values currently indicated for defining optimal LDL level.

Published
2015

6. The Permeability of Dialytic Membranes to Endotoxins: Clinical and Experimental Findings

Author

Donato Fumarola, P. Coratelli, Giuseppe Passavanti, Buongiorno E, and G. De Fino

Subjects
Lipopolysaccharides, 0301 basic medicine, medicine.medical_specialty, Lipopolysaccharide, medicine.medical_treatment, Biomedical Engineering, Medicine (miscellaneous), Bioengineering, 030204 cardiovascular system & hematology, Permeability, Biomaterials, Lipid A, 03 medical and health sciences, chemistry.chemical_compound, 0302 clinical medicine, In vivo, Internal medicine, Hemofiltration, medicine, Humans, Fragmentation (cell biology), Limulus Test, Clinical Trials as Topic, Membranes, Artificial, Biological activity, General Medicine, In vitro, Endotoxins, 030104 developmental biology, Endocrinology, chemistry, Evaluation Studies as Topic, Limulus amebocyte lysate, Kidneys, Artificial
Abstract

This study of 20 endotoxemic patients submitted to 70 hemodialyses (HD) found a reduction of the pre-HD limulus amebocyte lysate (LAL) positivity in 50 HD (71%), without appreciable differences in terms of effectiveness between cuprophan and AN 69 membranes. To define the mechanisms responsible for the reduction in LAL positivity during HD, the membranes were used in two in vitro studies, the first of which showed that the LAL positivity of blood containing lipopolysaccharide (LPS), submitted to hemofiltration (HF) for 300 min, remained unchanged and the ultrafiltrate remained constantly LAL negative. These results suggest that the reduction in LAL positivity observed in HD in vivo, an expression of reduced endotoxemia, cannot be attributed either to the filtration of the LPS as such or to its fragmentation following blood-membrane interaction into theoretically less filtrable molecules or to mechanisms of LPS adsorption on the membrane. The in vivo reduction of LAL positivity is more likely due to removal of the filtrable endotoxin fragments already released in the body, like lipid A, the biologically active component of LPS, known to react to LAL. This hypothesis was borne out by the second in vitro study, where the LAL positivity of blood containing lipid A, treated by HF for 80 min, gradually decreased, and dialytic permeability to lipid A was confirmed by the appearance of LAL positivity in the ultrafiltrate.

Published
1989
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7. Endotoxemia in hemolytic uremic syndrome

Author

P. Coratelli, Buongiorno E, and Giuseppe Passavanti

Subjects
medicine.medical_specialty, Resuscitation, Lipopolysaccharide, Adolescent, medicine.medical_treatment, Kidney Glomerulus, Renal function, Disease, urologic and male genital diseases, Kidney, Gastroenterology, Lipid A, chemistry.chemical_compound, Pre-Eclampsia, Pregnancy, Internal medicine, Medicine, Humans, medicine.diagnostic_test, business.industry, Abortion, Induced, medicine.disease, Arterioles, Endocrinology, chemistry, Hemolytic-Uremic Syndrome, Female, Hemodialysis, Renal biopsy, Endothelium, Vascular, business
Abstract

Hemolytic uremic syndrome (HUS) was diagnosed and confirmed by renal biopsy in an 18-year-old primigravida at the 13th week of pregnancy. Circulating endotoxin was detected and the endotoxemia was progressively reduced by hemodialysis (HD) performed daily from the 3rd to the 9th day of disease. Complete normalization of the renal function was observed on day 34. The authors emphasize the importance of detecting endotoxemia in HUS in order to initiate dialysis early; at the same time they also discuss the pathogenetic role of endotoxin in this disease.

Published
1988

8. Effect of longacting somatostatin analogue on kidney and cyst growth in autosomal dominant polycystic kidney disease (ALADIN): a randomised, placebo-controlled, multicentre trial

Author

Annalisa Perna, Fabiola Carrara, Luca Cancian, Erasmo Buongiorno, Luca Antiga, Flavio Gaspari, Bianca Visciano, Anna Caroli, Silvia Prandini, Nadia Rubis, Antonio De Pascalis, Mauro Dugo, Giuseppe Remuzzi, Andrea Remuzzi, Norberto Perico, Roberta Cerutti, Massimo Imbriaco, Antonio Pisani, Piergiorgio Messa, Paolo Brambilla, Piero Ruggenenti, Caroli, A, Perico, N, Perna, A, Antiga, L, Brambilla, P, Pisani, Antonio, Visciano, B, Imbriaco, Massimo, Messa, P, Cerutti, R, Dugo, M, Cancian, L, Buongiorno, E, De Pascalis, A, Gaspari, F, Carrara, F, Rubis, N, Prandini, S, Remuzzi, A, Remuzzi, G, Ruggenenti, P, and for the ALADIN study, Group

Subjects
Adult, Male, medicine.medical_specialty, Cholecystitis, Acute, Autosomal dominant polycystic kidney disease, Renal function, Kidney, Octreotide, Placebo, law.invention, Gastrointestinal Agents, Randomized controlled trial, Cholelithiasis, law, Internal medicine, Polycystic kidney disease, medicine, Clinical endpoint, Humans, Intention-to-treat analysis, business.industry, Settore ING-IND/34 - Bioingegneria Industriale, Organ Size, General Medicine, Middle Aged, Polycystic Kidney, Autosomal Dominant, medicine.disease, Magnetic Resonance Imaging, Surgery, Treatment Outcome, Italy, Disease Progression, Kidney Failure, Chronic, Female, Somatostatin, business, Follow-Up Studies, Kidney disease
Abstract

Summary Background Autosomal dominant polycystic kidney disease slowly progresses to end-stage renal disease and has no effective therapy. A pilot study suggested that the somatostatin analogue octreotide longacting release (LAR) could be nephroprotective in this context. We aimed to assess the effect of 3 years of octreotide-LAR treatment on kidney and cyst growth and renal function decline in participants with this disorder. Methods We did an academic, multicentre, randomised, single-blind, placebo-controlled, parallel-group trial in five hospitals in Italy. Adult (>18 years) patients with estimated glomerular filtration rate (GFR) of 40 mL/min per 1·73 m 2 or higher were randomly assigned (central allocation by phone with a computerised list, 1:1 ratio, stratified by centre, block size four and eight) to 3 year treatment with two 20 mg intramuscular injections of octreotide-LAR (n=40) or 0·9% sodium chloride solution (n=39) every 28 days. Study physicians and nurses were aware of the allocated group; participants and outcome assessors were masked to allocation. The primary endpoint was change in total kidney volume (TKV), measured by MRI, at 1 year and 3 year follow-up. Analyses were by modified intention to treat. This study is registered with ClinicalTrials.gov, NCT00309283. Findings Recruitment was between April 27, 2006, and May 12, 2008. 38 patients in the octreotide-LAR group and 37 patients in the placebo group had evaluable MRI scans at 1 year follow-up, at this timepoint, mean TKV increased significantly less in the octreotide-LAR group (46·2 mL, SE 18·2) compared with the placebo group (143·7 mL, 26·0; p=0·032). 35 patients in each group had evaluable MRI scans at 3 year follow-up, at this timepoint, mean TKV increase in the octreotide-LAR group (220·1 mL, 49·1) was numerically smaller than in the placebo group (454·3 mL, 80·8), but the difference was not significant (p=0·25). 37 (92·5%) participants in the octreotide-LAR group and 32 (82·1%) in the placebo group had at least one adverse event (p=0·16). Participants with serious adverse events were similarly distributed in the two treatment groups. However, four cases of cholelithiasis or acute cholecystitis occurred in the octreotide-LAR group and were probably treatment-related. Interpretation These findings provide the background for large randomised controlled trials to test the protective effect of somatostatin analogues against renal function loss and progression to end-stage kidney disease. Funding Polycystic Kidney Disease Foundation.

Published
2013
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