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5. The Role of Vitamin K in CKD-MBD

Author

Fusaro, Maria, Tondolo, Francesco, Gasperoni, Lorenzo, Tripepi, Giovanni, Plebani, Mario, Zaninotto, Martina, Nickolas, Thomas L., Ketteler, Markus, Aghi, Andrea, Politi, Cristina, La Manna, Gaetano, Brandi, Maria Luisa, Ferrari, Serge, Gallieni, Maurizio, Mereu, Maria Cristina, and Cianciolo, Giuseppe

Published
2022
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11. Effect of Antidiabetic Drugs on Bone Health in Patients with Normal Renal Function and in Chronic Kidney Disease (CKD): Insight into Clinical Challenges in the Treatment of Type 2 Diabetes

Author

Cipriani, Cristiana, primary, Lauriero, Gabriella, additional, Tripepi, Giovanni, additional, Ferrari, Serge, additional, Bover, Jordi, additional, Ravera, Maura, additional, Barbuto, Simona, additional, Cianciolo, Giuseppe, additional, De Nicola, Luca, additional, Brandi, Maria Luisa, additional, Minisola, Salvatore, additional, Mereu, Maria Cristina, additional, Corrao, Giovanni, additional, Del Vecchio, Lucia, additional, and Fusaro, Maria, additional

Published
2023
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13. Future treatment of vascular calcification in chronic kidney disease

Author

Cozzolino, Mario, primary, Maffei Faccioli, Federico, additional, Cara, Anila, additional, Boni Brivio, Giulia, additional, Rivela, Francesca, additional, Ciceri, Paola, additional, Magagnoli, Lorenza, additional, Galassi, Andrea, additional, Barbuto, Simona, additional, Speciale, Serena, additional, Minicucci, Carlo, additional, and Cianciolo, Giuseppe, additional

Published
2023
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14. #5440 BONE TURNOVER MARKERS AND BONE MINERAL DENSITY 1 YEAR AFTER KIDNEY TRANSPLANTATION

Author

Barbuto, Simona, primary, Aghi, Andrea, additional, Cianciolo, Giuseppe, additional, La Manna, Gaetano, additional, Tripepi, Giovanni Luigi, additional, Pascale, Khairallah, additional, Plebani, Mario, additional, Zaninotto, Martina, additional, Cosma, Chiara, additional, Gasperoni, Lorenzo, additional, Cortez, Natalia, additional, Nickolas, Thomas, additional, and Fusaro, Maria, additional

Published
2023
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15. Real-world usage of Chronic Kidney Disease – Mineral Bone Disorder (CKD–MBD) biomarkers in nephrology practices.

Author

Fusaro, Maria, Barbuto, Simona, Gallieni, Maurizio, Cossettini, Althea, Sartò, Giulia Vanessa Re, Cosmai, Laura, Cianciolo, Giuseppe, Manna, Gaetano La, Nickolas, Thomas, Ferrari, Serge, Bover, Jordi, Haarhaus, Mathias, Marino, Carmela, Mereu, Maria Cristina, Ravera, Maura, Plebani, Mario, Zaninotto, Martina, Cozzolino, Mario, Bianchi, Stefano, and Messa, Piergiorgio

Subjects
RENAL osteodystrophy, CHRONIC kidney failure, FIBROBLAST growth factors
Abstract

Background Chronic kidney disease mineral bone disorder (CKD-MBD) is a condition characterized by alterations of calcium, phosphate, parathyroid hormone (PTH), and fibroblast growth factor 23 (FGF-23) metabolism that in turn promote bone disorders, vascular calcifications, and increase cardiovascular (CV) risk. Nephrologists' awareness of diagnostic, prognostic, and therapeutic tools to manage CKD-MBD plays a primary role in adequately preventing and managing this condition in clinical practice. Methods A national survey (composed of 15 closed questions) was launched to inquire about the use of bone biomarkers in the management of CKD-MBD patients by nephrologists and to gain knowledge about the implementation of guideline recommendations in clinical practice. Results One hundred and six Italian nephrologists participated in the survey for an overall response rate of about 10%. Nephrologists indicated that the laboratories of their hospitals were able to satisfy request of ionized calcium levels, 105 (99.1%) of both PTH and alkaline phosphatase (ALP), 100 (94.3%) of 25(OH)D, and 61 (57.5%) of 1.25(OH)2D; while most laboratories did not support the requests of biomarkers such as FGF-23 (intact: 88.7% and c-terminal: 93.4%), Klotho (95.3%; soluble form: 97.2%), tartrate-resistant acid phosphatase 5b (TRAP-5b) (92.5%), C-terminal telopeptide (CTX) (71.7%), and pro-collagen type 1 N-terminal pro-peptide (P1NP) (88.7%). As interesting data regarding Italian nephrologists' behavior to start treatment of secondary hyperparathyroidism (sHPT), the majority of clinicians used KDOQI guidelines (n  = 55, 51.9%). In contrast, only 40 nephrologists (37.7%) relied on KDIGO guidelines, which recommended referring to values of PTH between two and nine times the upper limit of the normal range. Conclusion Results point out a marked heterogeneity in the management of CKD-MBD by clinicians as well as a suboptimal implementation of guidelines in Italian clinical practice. [ABSTRACT FROM AUTHOR]

Published
2024
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16. Impact of Baseline Clinical Variables on SGLT2i’s Antiproteinuric Effect in Diabetic Kidney Disease

Author

Capelli, Irene, primary, Ribichini, Danilo, additional, Provenzano, Michele, additional, Vetrano, Daniele, additional, Aiello, Valeria, additional, Cianciolo, Giuseppe, additional, Vicennati, Valentina, additional, Tomassetti, Alessandro, additional, Moschione, Ginevra, additional, Berti, Sabrina, additional, Pagotto, Uberto, additional, and La Manna, Gaetano, additional

Published
2023
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18. Real-World Analysis of Outcomes and Economic Burden in Patients with Chronic Kidney Disease with and without Secondary Hyperparathyroidism among a Sample of the Italian Population

Author

Barbuto, Simona, primary, Perrone, Valentina, additional, Veronesi, Chiara, additional, Dovizio, Melania, additional, Zappulo, Fulvia, additional, Vetrano, Daniele, additional, Giannini, Sandro, additional, Fusaro, Maria, additional, Ancona, Domenica Daniela, additional, Barbieri, Antonietta, additional, Ferrante, Fulvio, additional, Lena, Fabio, additional, Palcic, Stefano, additional, Re, Davide, additional, Rizzi, Francesca Vittoria, additional, Cogliati, Paolo, additional, Soro, Marco, additional, Esposti, Luca Degli, additional, and Cianciolo, Giuseppe, additional

Published
2023
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21. Vitamin D and the Kidney: Two Players, One Console

Author

Zappulo, Fulvia, primary, Cappuccilli, Maria, additional, Cingolani, Alessandra, additional, Scrivo, Anna, additional, Chiocchini, Anna Laura Croci, additional, Nunzio, Miriam Di, additional, Donadei, Chiara, additional, Napoli, Marianna, additional, Tondolo, Francesco, additional, Cianciolo, Giuseppe, additional, and La Manna, Gaetano, additional

Published
2022
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23. Time for revival of bone biopsy with histomorphometric analysis in chronic kidney disease (CKD): moving from skepticism to pragmatism

Author

Fusaro, Maria, Re Sarto, Giulia Vanessa, Gallieni, Maurizio, Cosmai, Laura, Messa, Pieregiorgio, Rossini, Maurizio, Chiodini, Iacopo, Plebani, Mario, Evenepoel, Pieter, Harvey, Nicholas, Ferrari, S., Cannata-Andía, Jorge B, Trombetti, Andrea, Brandi, Maria Luisa, Ketteler, Markus, Nickolas, Thomas L., Cunningham, John, Salam, Syazrah, Rocca, Carlo Della, Scarpa, Aldo, Minisola, Salvatore, Malberti, Fabio, Cetani, Filomena, Cozzolino, Mario, Mazzaferro, Sandro, Morrone, Luigi, Tripepi, Giovanni, Zaninotto, Martina, Mereu, Maria Cristina, Ravera, Maura, Cianciolo, Giuseppe, La Manna, Gaetano, Aghi, Andrea, Giannini, Sandro, and Dalle Carbonare, Luca

Abstract

Bone Biopsy (BB) with histomorphometric analysis still represents the gold standard for the diagnosis and classification of different forms of renal osteodystrophy. Bone biopsy is the only technique able to provide comprehensive information on all bone parameters, measuring static and dynamic parameters of turnover, cortical and trabecular microarchitecture, and mineralization defects. In nephrological practice, bone biopsy yields relevant indications to support therapeutic choices in CKD, heavily impacting the management and prognosis of uremic patients. Unfortunately, the use of bone biopsy has decreased; a lack of expertise in performing and interpreting, perceived procedure invasiveness and pain, and reimbursement issues have all contributed to this decline. Nevertheless, both bone biomarkers and instrumental images cannot be considered reliable surrogates for histological findings, being insufficiently accurate to properly evaluate underlying mineral and bone disorders. This is a multidisciplinary position paper from the Nephrology and Osteoporosis Italian Scientific Societies with the purpose of restating the role of bone biopsy in CKD patient management and of providing strong solutions to allow diffusion of this technique in Italy, but potentially also in other countries. The Italian approach through the optimization and standardization of bone biopsy procedure, the construction of the Italian Hub and Spoke network, and a request for adjustment and national homogenization of reimbursement to the Italian Health Ministry has led the way to implement bone biopsy and to improve CKD patient management and prognosis.

Published
2022

25. Fibroblast Growth Factor 23: Mineral Metabolism and Beyond

Author

Grabner, Alexander, primary, Mazzaferro, Sandro, additional, Cianciolo, Giuseppe, additional, Krick, Stefanie, additional, Capelli, Irene, additional, Rotondi, Silverio, additional, Ronco, Claudio, additional, La Manna, Gaetano, additional, and Faul, Christian, additional

Published
2017
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27. Erratum to: A roadmap to parathyroidectomy for kidney transplant candidates

Author

Cianciolo, Giuseppe, primary, Tondolo, Francesco, additional, Barbuto, Simona, additional, Angelini, Andrea, additional, Ferrara, Francesca, additional, Iacovella, Francesca, additional, Raimondi, Concettina, additional, La Manna, Gaetano, additional, Serra, Carla, additional, De Molo, Chiara, additional, Cavicchi, Ottavio, additional, Piccin, Ottavio, additional, D'Alessio, Pasquale, additional, De Pasquale, Loredana, additional, Felisati, Giovanni, additional, Ciceri, Paola, additional, Galassi, Andrea, additional, and Cozzolino, Mario, additional

Published
2022
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28. Alkaline Phosphatase : An Old Friend as Treatment Target for Cardiovascular and Mineral Bone Disorders in Chronic Kidney Disease

Author

Haarhaus, Mathias, Cianciolo, Giuseppe, Barbuto, Simona, La Manna, Gaetano, Gasperoni, Lorenzo, Tripepi, Giovanni, Plebani, Mario, Fusaro, Maria, Magnusson, Per, Haarhaus, Mathias, Cianciolo, Giuseppe, Barbuto, Simona, La Manna, Gaetano, Gasperoni, Lorenzo, Tripepi, Giovanni, Plebani, Mario, Fusaro, Maria, and Magnusson, Per

Abstract

Alkaline phosphatase (ALP) is an evolutionary conserved enzyme and widely used biomarker in clinical practice. Tissue-nonspecific alkaline phosphatase (TNALP) is one of four human isozymes that are expressed as distinct TNALP isoforms after posttranslational modifications, mainly in bone, liver, and kidney tissues. Beyond the well-known effects on bone mineralization, the bone ALP (BALP) isoforms (B/I, B1, B1x, and B2) are also involved in the pathogenesis of ectopic calcification. This narrative review summarizes the recent clinical investigations and mechanisms that link ALP and BALP to inflammation, metabolic syndrome, vascular calcification, endothelial dysfunction, fibrosis, cardiovascular disease, and mortality. The association between ALP, vitamin K, bone metabolism, and fracture risk in patients with chronic kidney disease (CKD) is also discussed. Recent advances in different pharmacological strategies are highlighted, with the potential to modulate the expression of ALP directly and indirectly in CKD-mineral and bone disorder (CKD-MBD), e.g., epigenetic modulation, phosphate binders, calcimimetics, vitamin D, and other anti-fracture treatments. We conclude that the significant evidence for ALP as a pathogenic factor and risk marker in CKD-MBD supports the inclusion of concrete treatment targets for ALP in clinical guidelines. While a target value below 120 U/L is associated with improved survival, further experimental and clinical research should explore interventional strategies with optimal risk-benefit profiles. The future holds great promise for novel drug therapies modulating ALP., Funding Agencies|ALF grants from Region Ostergotland

Published
2022
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29. A roadmap to parathyroidectomy for kidney transplant candidates

Author

Cianciolo, Giuseppe, primary, Tondolo, Francesco, additional, Barbuto, Simona, additional, Angelini, Andrea, additional, Ferrara, Francesca, additional, Iacovella, Francesca, additional, Raimondi, Concettina, additional, La Manna, Gaetano, additional, Serra, Carla, additional, De Molo, Chiara, additional, Cavicchi, Ottavio, additional, Piccin, Ottavio, additional, D'Alessio, Pasquale, additional, De Pasquale, Loredana, additional, Felisati, Giovanni, additional, Ciceri, Paola, additional, Galassi, Andrea, additional, and Cozzolino, Mario, additional

Published
2022
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30. Bone Mineral Density Changes in Long-Term Kidney Transplant Recipients: A Real-Life Cohort Study of Native Vitamin D Supplementation

Author

Battaglia, Yuri, primary, Bellasi, Antonio, additional, Bortoluzzi, Alessandra, additional, Tondolo, Francesco, additional, Esposito, Pasquale, additional, Provenzano, Michele, additional, Russo, Domenico, additional, Andreucci, Michele, additional, Cianciolo, Giuseppe, additional, and Storari, Alda, additional

Published
2022
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32. The Vessels-Bone Axis: Iliac Artery Calcifications, Vertebral Fractures and Vitamin K from VIKI Study

Author

Fusaro, Maria, primary, Tripepi, Giovanni, additional, Plebani, Mario, additional, Politi, Cristina, additional, Aghi, Andrea, additional, Taddei, Fulvia, additional, Schileo, Enrico, additional, Zaninotto, Martina, additional, La Manna, Gaetano, additional, Cianciolo, Giuseppe, additional, Gallieni, Maurizio, additional, Cosmai, Laura, additional, Messa, Piergiorgio, additional, Ravera, Maura, additional, Nickolas, Thomas L., additional, Ferrari, Serge, additional, Ketteler, Markus, additional, Iervasi, Giorgio, additional, Mereu, Maria Cristina, additional, Vettor, Roberto, additional, Giannini, Sandro, additional, Gasperoni, Lorenzo, additional, Sella, Stefania, additional, Brandi, Maria Luisa, additional, Cianferotti, Luisella, additional, and De Caterina, Raffaele, additional

Published
2021
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33. Oral Calcitriol Use, Vertebral Fractures, and Vitamin K in Hemodialysis Patients: A Cross‐Sectional Study

Author

Fusaro, Maria, primary, Cianciolo, Giuseppe, additional, Tripepi, Giovanni, additional, Plebani, Mario, additional, Aghi, Andrea, additional, Politi, Cristina, additional, Zaninotto, Martina, additional, Nickolas, Thomas L., additional, Ferrari, Serge, additional, Ketteler, Markus, additional, La Manna, Gaetano, additional, Gasperoni, Lorenzo, additional, Messa, Piergiorgio, additional, Ravera, Maura, additional, Gallieni, Maurizio, additional, Cosmai, Laura, additional, Locatelli, Francesco, additional, Iervasi, Giorgio, additional, Vettor, Roberto, additional, Mereu, Maria Cristina, additional, Sella, Stefania, additional, Arcidiacono, Gaetano, additional, and Giannini, Sandro, additional

Published
2021
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36. MO798ORAL CALCITRIOL USE, VERTEBRAL FRACTURES AND VASCULAR CALCIFICATION IN HEMODIALYSIS PATIENTS: RESULTS FROM VITAMIN K ITALIAN (VIKI) STUDY

Author

Fusaro, Maria, primary, Aghi, Andrea, additional, Politi, Cristina, additional, Nickolas, Thomas, additional, Cianciolo, Giuseppe, additional, La Manna, Gaetano, additional, Gasperoni, Lorenzo, additional, Mereu, Maria Cristina, additional, Gallieni, Maurizio, additional, Ravera, Maura, additional, Giannini, Sandro, additional, Sella, Stefania, additional, Arcidiacono, Gaetano, additional, and Tripepi, Giovanni Luigi, additional

Published
2021
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37. roadmap to parathyroidectomy for kidney transplant candidates.

Author

Cianciolo, Giuseppe, Tondolo, Francesco, Barbuto, Simona, Angelini, Andrea, Ferrara, Francesca, Iacovella, Francesca, Raimondi, Concettina, Manna, Gaetano La, Serra, Carla, Molo, Chiara De, Cavicchi, Ottavio, Piccin, Ottavio, D'Alessio, Pasquale, Pasquale, Loredana De, Felisati, Giovanni, Ciceri, Paola, Galassi, Andrea, and Cozzolino, Mario

Subjects
*RENAL osteodystrophy, *KIDNEY transplantation, *PARATHYROIDECTOMY
Abstract

Chronic kidney disease mineral and bone disorder may persist after successful kidney transplantation. Persistent hyperparathyroidism has been identified in up to 80% of patients throughout the first year after kidney transplantation. International guidelines lack strict recommendations about the management of persistent hyperparathyroidism. However, it is associated with adverse graft and patient outcomes, including higher fracture risk and an increased risk of all-cause mortality and allograft loss. Secondary hyperparathyroidism may be treated medically (vitamin D, phosphate binders and calcimimetics) or surgically (parathyroidectomy). Guideline recommendations suggest medical therapy first but do not clarify optimal parathyroid hormone targets or indications and timing of parathyroidectomy. There are no clear guidelines or long-term studies about the impact of hyperparathyroidism therapy. Parathyroidectomy is more effective than medical treatment, although it is associated with increased short-term risks. Ideally parathyroidectomy should be performed before kidney transplantation to prevent persistent hyperparathyroidism and improve graft outcomes. We now propose a roadmap for the management of secondary hyperparathyroidism in patients eligible for kidney transplantation that includes the indications and timing (pre- or post-kidney transplantation) of parathyroidectomy, the evaluation of parathyroid gland size and the integration of parathyroid gland size in the decision-making process by a multidisciplinary team of nephrologists, radiologists and surgeons. [ABSTRACT FROM AUTHOR]

Published
2022
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45. Vitamin K and Osteoporosis

Author

Fusaro, Maria, primary, Cianciolo, Giuseppe, additional, Brandi, Maria Luisa, additional, Ferrari, Serge, additional, Nickolas, Thomas L., additional, Tripepi, Giovanni, additional, Plebani, Mario, additional, Zaninotto, Martina, additional, Iervasi, Giorgio, additional, La Manna, Gaetano, additional, Gallieni, Maurizio, additional, Vettor, Roberto, additional, Aghi, Andrea, additional, Gasperoni, Lorenzo, additional, Giannini, Sandro, additional, Sella, Stefania, additional, and M. Cheung, Angela, additional

Published
2020
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50. Glifozines and cardiorenal outcomes

Author

Di Lullo, Luca, primary, Bellasi, Antonio, additional, Guastamacchia, Edoardo, additional, Triggiani, Vincenzo, additional, Ronco, Claudio, additional, Lavalle, Carlo, additional, Di Iorio, Biagio R., additional, Russo, Domenico, additional, Cianciolo, Giuseppe, additional, La Manna, Gaetano, additional, and Settembrini, Silvio, additional

Published
2020
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