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1. The unusual couple: a clinical case of coexistence between aHUS and Fabry's disease

Author

Coppola S., Cuomo V., Riccio C. G., d'Apice L., de Simone W., Capasso G., Coppola, S., Cuomo, V., Riccio, C. G., D'Apice, L., de Simone, W., and Capasso, G.

Subjects
Adult, Aortic Valve Insufficiency, Mitral Valve Insufficiency, Antibodies, Monoclonal, Humanized, alpha galactosidase, aHUS, Fabry’s disease, alpha-Galactosidase, Mutation, Fabry Disease, Humans, Female, eculizumab, Atypical Hemolytic Uremic Syndrome, enzyme replacement therapy
Abstract

Atypical hemolytic-uremic syndrome (aHUS) is a rare, potentially lethal (1-4) systemic disorder, capable of affecting both adults and children, causing thrombotic microangiopathy (TMA) (5) that leads to the formation of thrombus within small blood vessels with multiple organ failure. The pathogenesis of the aHUS is part of a sort of chronic and uncontrolled activation of the complement system by genetic mutation of some proteins usually responsible for its self-regulation (6,7). Today, the rapid diagnosis of the disease and the timely start of treatment with eculizumab, improve outcomes of renal failure, stroke and heart attack (8-10). Fabry disease is a rare tesaurismosis, X linked, due to the deficiency of the lysosomal enzyme alpha-galactosidase A (11-13), necessary for the physiological catabolism of glycosphingolipids. Multisystem clinical manifestations lead to a serious degenerative pathology. The diagnostic suspicion based on anamnesis and careful research of the symptoms and then confirmed by the enzymatic dosage of alpha galactosidase or by molecular analysis, allows the early treatment of the patient with enzyme replacement therapy, guaranteeing the resolution and/or slowing down the evolution of the disease, especially in the brain, heart and kidneys. In this report, we describe the clinical case of a patient who is a carrier of both rare diseases.

Published
2019

2. 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

3. Awareness of kidney diseases in general population and in high school students. Italian report for World Kidney Days 2010-2011

Author

Apperti, V, Auricchio, Mr, Barbato, A, Bedani, Pl, Bellinghieri, G, Costantino, G, Boggi, R, Bonomini, M, Calabria, L, Calabria, M, Grimaldi, M, Capuano, M, Terribile, M, Caputo, C, Castellino, S, Centrone, E, Ciccarelli, M, Cicchetti, T, Costantino, E, D'Amaro, E, Dagostino, F, Napolitano, F, Bonifati, C, Dal Canton, A, Esposito, P, Delgado, G, D'Apice, L, Di Luca, M, Farfaglia, P, Cantù, P, Farina, M, Fasianos, E, Feriozzi, S, Galeotti, P, Fiorini, F, Frattolillo, P, Garibotto, Giacomo, Giannattasio, M, Detomaso, F, Latino, A, Li Vecchi, M, Maffucci, G, Anelli, Am, Mangano, S, Meneghel, G, Morrone, L, Mura, C, Novizio, D, Paglia, S, Cardone, F, Parsi, R, Pizzini, M, Polito, P, Prati, E, Brognoli, M, Rubino, F, Turchetta, L, Parravano, M, Sambati, M, Sicignano, M, Tarchini, R, Teatini, U, Gallieni, M, Colussi, G, Limido, A, Pozzi, C, Spotti, D, Brancaccio, D, Traversari, L, Venditti, G, Aucella, F, Garganico, R, Giovanni Rotondo, S, Cenerelli, S, Bozzi, M, Petrarulo, F, Casu, Md, Cavatorta, F, Montesano, C, Ferrara, Dd, Mazzola, Ma, De Simone, W, Del Rosso, G, Sozzo, Ee, Mangione, D, Emiliani, G, Fasianos, R, Ganadu, M, Garibotto, G, Lusenti, T, Manno, C, Orbello, G, Rondanini, V, Russo, D, Battaglia, Y, Sarli, P, Sozzo, E, Napoli, M, Valentini, Wd, Viganò, L., Y., Battaglia 1, L., Russo 1, R., Spadola 1, Russo, Domenico, Battaglia, Y, Russo, L., and Spadola, R.

Subjects
Male, Nephrology, Health Knowledge, Attitudes, Practice, Pediatrics, Kidney Disease, Global Health, Surveys and Questionnaires, Prevalence, Global health, Surveys and Questionnaire, Young adult, Reagent Strips, Practice, Kidney, education.field_of_study, Health Knowledge, Urinalysi, Awareness, Middle Aged, Proteinuria, Treatment Outcome, medicine.anatomical_structure, Italy, Hypertension, Kidney Diseases, Female, Reagent Strip, Student, Comprehension, Human, Adult, medicine.medical_specialty, Adolescent, Population, Health knowledge, Health literacy, Health Promotion, Urinalysis, Young Adult, Terminology as Topic, Internal medicine, medicine, Humans, Students, education, Aged, business.industry, Blood Pressure Determination, Health Literacy, Adolescent Behavior, Awarene, Health promotion, Attitudes, Family medicine, business
Published
2012
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4. 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

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. [Diagnostic pathway in a case with severe degree of hypertension]

Author

Manganelli R, Iannaccone S, Mario Iannaccone, De Simone E, Ferbo U, Nappi F, Avella F, and De Simone W

Subjects
Adult, Male, Glomerulosclerosis, Focal Segmental, Hypertension, Humans, Antiphospholipid Syndrome, Severity of Illness Index
Abstract

A 29- year-old male was admitted because of exertion dyspnea and intense headache. These symptoms were associated with severe hypertension, small multiple areas of cerebral ischemia, thrombocytopenia, prolonged aPTT and renal failure. The diagnostic tests performed during hospitalization resulted in a diagnosis of Primary Antiphospholipids Syndrome. The renal biopsy sample suggested histopathological features of uncommon simultaneous occurrence of antiphospholipids nephropathy and a "collapsing variant" of segmental focal glomerulosclerosis. It is fundamental to be aware that this syndrome is very likely to occur, and therefore to perform antiphospholipids antibodies assessment, since only an anticoagulant therapy proves effective; nevertheless, in view of the pathological renal findings, other therapies such as steroids might be added.

Published
2006

7. Inflammatory effects of peritoneal dialysis: evidence of systemic monocyte activation

Author

Luca De Nicola, Bruno Memoli, Teresa Rampino, Walter De Simone, Carmelo Libetta, Libetta, C, DE NICOLA, Luca, Rampino, T, DE SIMONE, W, Memoli, B., Libetta, C., DE NICOLA, L., Rampino, T., DE SIMONE, W., and Memoli, Bruno

Subjects
Adult, Male, medicine.medical_specialty, medicine.medical_treatment, Peritonitis, Peripheral blood mononuclear cell, Monocytes, Peritoneal dialysis, Peritoneal Dialysis, Continuous Ambulatory, Renal Dialysis, Internal medicine, Humans, Medicine, Serum amyloid A, Cells, Cultured, Aged, Uremia, Serum Amyloid A Protein, Interleukin-6, business.industry, Beta-2 microglobulin, Monocyte, Continuous ambulatory peritoneal dialysis, Acute-phase protein, Middle Aged, Endocrinology, medicine.anatomical_structure, Nephrology, Immunology, Kidney Failure, Chronic, Regression Analysis, Female, Hemodialysis, beta 2-Microglobulin, business, Biomarkers, Acute-Phase Proteins
Abstract

Inflammatory effects of peritoneal dialysis: Evidence of systemic monocyte activation. We evaluated in peritonitis-free patients undergoing continuous ambulatory peritoneal dialysis (CAPD) the release of both interleukin-6 (IL-6) and β-2-microglobulin (β2m) by cultured peripheral blood mononuclear cells (PBMC), as well as the levels of serum amyloid A (SAA), that is, the main hepatic acute phase protein during inflammation. The same measurements were obtained in hemodialysis (HD) patients, uremic non-dialyzed patients (ESRD) and healthy controls (CON). In CAPD, IL-6 production from PBMC was markedly increased in comparison to the control value (600.7 ± 104.3 vs. 14.2 ± 3.6 pg/3 × 106 PBMC/24 hr, P < 0.005). Similarly, a striking enhancement of the PBMC release of β2m was detected in CAPD with respect to CON (10.1 ± 2.6 vs. 0.063 ± 0.013 µg/3 × 106 PBMC/24 hr, P < 0.001). Also, the SAA levels were significantly greater in CAPD patients (21.3 ± 8.7 µg/dl) than in controls (3.14 ± 0.17 µg/dl, P < 0.05). Analogous increases of both IL-6 and β2m cell releases, as well as of SAA levels, were observed in HD patients. No difference concerning the three parameters was detected between CON and ESRD. In conclusion, CAPD induces per se PBMC activation with an enhanced release of both IL-6 and β2m; this is associated to higher levels of SAA. These systemic inflammatory effects are comparable to those observed in HD patients indicating that CAPD is similar to HD in terms of biocompatibility of the treatment.

Published
1996

8. Effects of Efficiency and Length of Acetate-Free Biofiltration Session on Postdialysis Solute Rebound

Author

Stefano Spiezia, Biagio Di Iorio, Walter De Simone, Raffaele Scigliano, Filippo Aucella, Giuseppe Conte, Guglielmo Venditti, Carmine Stallone, Rocco Manganelli, Pasquale Zamboli, Roberto Minutolo, Vincenzo Bellizzi, Luca De Nicola, Paolo Giannattasio, Giannattasio, P, Minutolo, Roberto, Bellizzi, V, DI IORIO, Br, Scigliano, R, Zamboli, Pasquale, Venditti, G, Manganelli, R, DE SIMONE, W, Aucella, F, Stallone, C, Spiezia, S, Conte, Giuseppe, and DE NICOLA, Luca

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, Potassium, medicine.medical_treatment, chemistry.chemical_element, Acetates, Phosphates, chemistry.chemical_compound, Animal science, Renal Dialysis, Humans, Urea, Medicine, Acetate-Free Biofiltration, Dialysis, Uremia, Cross-Over Studies, business.industry, Middle Aged, Phosphate, Hemodialysis Solutions, Intermittent hemodialysis, Surgery, chemistry, Parathyroid Hormone, Nephrology, Female, Free form, business
Abstract

Postdialytic rebound (PDR) of plasma solutes is a relevant drawback of intermittent hemodialysis, but its pathophysiological process remains undefined. We assessed the independent effects of efficiency and length of dialytic session on PDR of urea, phosphate, and potassium.Uremic patients were evaluated at the beginning and end of dialysis and after 180 minutes in 2 randomized crossover studies. In study 1, we compared the effect of standard versus higher efficiency acetate-free biofiltration (AFB) while maintaining the same duration of 4 hours. In study 2, we compared the effect of 3- versus 5-hour AFB sessions while maintaining similar efficiency.In study 1, greater Kt/V (1.49 +/- 0.20 versus 1.22 +/- 0.15; P0.0001) was coupled with significant increases in both absolute removal and PDR of urea and phosphate (PDR of urea, +45% versus +29%; PDR of phosphate, +79% versus +52%), but not of potassium. Similarly, in study 2, shortening the AFB session while maintaining similar absolute removal and Kt/V (1.28 +/- 0.09 versus 1.31 +/- 0.09) significantly increased PDR of urea and phosphate (PDR of urea, +32% versus +19%; PDR of phosphate, +63% versus +36%), but not of potassium. In both studies, greater PDRs of urea and phosphate were associated with estimated greater removal of these solutes per hour.The rate of removal of phosphate and urea is a critical determinant of their PDR; conversely, potassium is not influenced by removal rate, likely because of its marked cell compartmentalization.

Published
2006
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9. Nutritional-inflammation status and resistance to erythropoietin therapy in haemodialysis patients

Author

Lucia Del Vecchio, Simeone Andrulli, Marcello Amato, Francesco Locatelli, Bruno Cianciaruso, Giuliano Brunori, Bruno Memoli, Walter De Simone, Antonella Mandalari, Carmine Zoccali, Stefano Aterini, Camilla Maffei, Locatelli, F, Andrulli, S, Memoli, Bruno, Maffei, C, DEL VECCHIO, L, Aterini, S, DE SIMONE, W, Mandalari, A, Brunori, G, Amato, M, Cianciaruso, Bruno, and Zoccali, C.

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Nutritional Status, malnutrition, Gastroenterology, Renal Dialysis, EPO resistance, Internal medicine, Medicine, Humans, Erythropoietin, albumin, Aged, chemistry.chemical_classification, Inflammation, Transplantation, C reactive protein, medicine.diagnostic_test, biology, business.industry, Transferrin saturation, C-reactive protein, Body Weight, Albumin, Middle Aged, medicine.disease, haemodialysi, Endocrinology, C-Reactive Protein, Cross-Sectional Studies, chemistry, Nephrology, Transferrin, Serum iron, biology.protein, Kidney Failure, Chronic, Female, Hemodialysis, business, medicine.drug, Kidney disease
Abstract

BACKGROUND: Chronic kidney disease patients who are resistant to erythropoietin (EPO) treatment may suffer from malnutrition and/or inflammation. METHODS: In a cross-sectional study of haemodialysis patients, we investigated the relationship between the natural logarithm of the weekly EPO dose normalized for post-dialysis body weight and outcome measures of nutrition and/or inflammation [BMI, albumin and C reactive protein (CRP)] by means of multiple linear regression analysis. On the basis of the decile distribution of weekly EPO doses, we also evaluated four groups of patients: untreated, hyper-responders, normo-responders and hypo-responders. RESULTS: Six hundred and seventy-seven adult haemodialysis patients were recruited from five Italian centres. BMI and albumin were lower in the hypo-responders than in the other groups (21.3+/-3.8 vs 24.4+/-4.7 kg/m(2), P

Published
2005

10. Interleukin-6 production of uraemic haemodialysed patients: effects of different membranes

Author

Memoli, B., Libetta, C., Rampino, T., Simone, W., Meccariello, S., Stangerlin, P., ANTONIO DAL CANTON, Andreucci, V. E., Memoli, Bruno, Libetta, C, Rampino, T, De Simone, W, Meccariello, S, Stangherlin, P, Dal Canton, A, and Andreucci, Ve

Subjects
Male, Interleukin-6, Renal Dialysis, Humans, Methylmethacrylates, Female, Membranes, Artificial, Middle Aged, Cellulose, Aged, Uremia
Abstract

Interleukin-6 (Il-6) has a complex spectrum of biological activities (growth and differentiation of B cells and synthesis of acute-phase proteins by liver). To evaluate the role of this cytokine in the inflammatory response induced by blood interaction with haemodialysis membranes, we have investigated Il-6 synthesis and release in supernatant of 24-h cultured peripheral blood mononuclear cells (PBMC) isolated from ten haemodialysed patients and eight healthy control subjects. In haemodialysed patients, blood samples were drawn before and after their usual dialytic treatment with cuprophane membranes and following 1 and 2 months with polymethylmethacrylate (PMMA) membranes. Il-6 was determined by 72-h incubation of serial dilutions of PBMC supernatant with Il-6-dependent cell line 7TD1; dilutions of rIl-6 were included as standard. Compared to Il-6 synthesis in control subjects (3.3 +/- 2.8 U/ml) the patients usually haemodialysed with cuprophane membranes showed significantly greater values (9.8 +/- 4.5 U/ml, P less than 0.02 before the treatment, and 10.4 +/- 6.1 U/ml, P less than 0.05 after the treatment). A significant reduction, in comparison with the values obtained with cuprophane membranes, was obtained after 1 month (5.3 +/- 2 U/ml, P less than 0.02 before the treatment, and 7.5 +/- 6 U/ml after the treatment) and especially after 2 months (3.4 +/- 3.2 U/ml, P less than 0.02 before the treatment, and 4.4 +/- 3.4 U/ml, P less than 0.05 after the treatment) of dialysis with PMMA membranes. In conclusion, our results show increased Il-6 production in haemodialysed patients usually treated with cuprophane membranes, suggesting a chronic stimulation.(ABSTRACT TRUNCATED AT 250 WORDS)

Published
1991

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