84 results on '"Gembillo G"'
Search Results
2. POS-426 IgAN in a patient with Wilson's Disease: a very rare association
- Author
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GEMBILLO, G., primary, Cernaro, V., additional, Siligato, R., additional, Salvo, A., additional, Torre, F., additional, Saitta, C., additional, and Santoro, D., additional
- Published
- 2021
- Full Text
- View/download PDF
3. POS-425 RECURRENT EPISODES OF FEVER IN A PATIENT WITH AUTOSOMAL DOMINANT POLYCYSTIC KIDNEY DISEASE AND CAROLI DISEASE
- Author
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GEMBILLO, G., primary, Scolari, F., additional, Izzi, C., additional, Siligato, R., additional, Minutoli, F., additional, Mazziotti, S., additional, and Santoro, D., additional
- Published
- 2021
- Full Text
- View/download PDF
4. POS-720 Atypical Cause of Pancytopenia in a Kidney Transplant Patient.
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GEMBILLO, G., primary, D'Ignoto, F., additional, Salis, P., additional, Santoro, D., additional, Liotta, R., additional, Barbaccia, M., additional, Caccamo, C., additional, Buscemi, B., additional, Nardi, C., additional, Cervo, A., additional, and Lamonaca, V., additional
- Published
- 2021
- Full Text
- View/download PDF
5. POS-674 The Challenge of Quality of Life Improvement in End-Stage Renal Disease: A Multicentric Study on Nutritional Management of Hemodialyzed Patients
- Author
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GEMBILLO, G., primary, Gentile, S., additional, Della Corte, T., additional, Romano, C., additional, Alfarone, C., additional, and Satta, E., additional
- Published
- 2021
- Full Text
- View/download PDF
6. POS-259 MHR status as marker of 10-year risk and lifetime risk of recurrent Cardiovascular events in patients with CKD and Diabetes Mellitus
- Author
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GEMBILLO, G., primary, Cernaro, V., additional, Siligato, R., additional, Giuffrida, A.E., additional, Labbozzetta, V., additional, Satta, E., additional, and Santoro, D., additional
- Published
- 2021
- Full Text
- View/download PDF
7. La circolarità nella modellizzazione della Natura da Telesio a Lovelock
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Gembillo, G
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Natura Ambiente Meccanismo Organismo Uomo - Published
- 2020
8. Premesse e attualità delle riflessioni di Marx sul lavoro
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Gembillo, G
- Subjects
Vico Hegel Lavoro Merce Alienazione - Published
- 2020
9. SUN-136 INFLUENCE OF HYPERKALEMIA ON DAYS OF HOSPITALIZATION AND RISK OF REHOSPITALIZATION: A RETROSPECTIVE COHORT STUDY
- Author
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CALABRESE, V., primary, Gembillo, G., additional, battaglia, V., additional, Cernaro, V., additional, Sposito, G., additional, and Santoro, D., additional
- Published
- 2020
- Full Text
- View/download PDF
10. SAT-367 A case of thyroid papillary carcinoma associated with membranous anti-PLA2R positive glomerulonephritis
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Zirino, F., primary, Gembillo, G., additional, Lamanna, F., additional, Calabrese, V., additional, Longhitano, E., additional, Siligato, R., additional, and Santoro, D., additional
- Published
- 2020
- Full Text
- View/download PDF
11. SUN-451 UNRAVELING THE ROLE OF GENETIC VARIANTS OF NPHS2 GENE
- Author
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LONGHITANO, E., primary, Gembillo, G., additional, Zirino, F., additional, Calabrese, V., additional, Cernaro, V., additional, Briuglia, S., additional, and Santoro, D., additional
- Published
- 2020
- Full Text
- View/download PDF
12. SAT-144 MONOCYTE TO HDL RATIO: A NOVEL MARKER OF RESISTANT HYPERTENSION IN CKD PATIENTS
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GEMBILLO, G., primary, Siligato, R., additional, Cernaro, V., additional, Satta, E., additional, Conti, G., additional, Salvo, A., additional, Romeo, A., additional, Calabrese, V., additional, Sposito, G., additional, Ferlazzo, G., additional, and Santoro, D., additional
- Published
- 2020
- Full Text
- View/download PDF
13. L'immaginario e la complessità
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Anselmo, A and Gembillo, G
- Subjects
Immaginario ,Immaginario, complessità, conoscenza, metodo, video ,conoscenza ,metodo ,video ,complessità - Published
- 2018
14. I video come modelli della Complessità
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Gembillo, G and Anselmo, A
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Complessità. modelli ,Complessità. modelli, video, divenire, concretezza ,divenire ,video ,concretezza - Published
- 2018
15. Gembillo G, Il posto di Girolamo Cotroneo (1934-2018) nel pensiero italiano del Novecento
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Gembillo, G.
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Filosofia storicismo conoscenza crocianesimo metodo - Published
- 2018
16. Gembillo G - Anselmo A., L'evoluzione dell'idea di natura come meccanismo, storia, organismo (seconda edizione)
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Gembillo, G. and Anselmo, A.
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Natura ,storicismo ,temporalità ,meccanismo ,organismo ,metodo ,Natura, meccanismo, storicismo, temporalità, organismo, metodo - Published
- 2018
17. Un approccio sistemico, storicistico e complesso alla bioetica
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Gembillo, G
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Complessità ,Natura ,Storicismo ,Bioetica ,Storicismo, Complessità, Bioetica, Uomo, Natura ,Uomo - Published
- 2016
18. La sfida della complessità (seconda edizione)
- Author
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Anselmo, Annamaria and Gembillo, G.
- Published
- 2015
19. I motivi ispiratori dell’intersezione tra storia della filosofia e filosofia nella tradizione filosofica italiana contemporanea. Appunti per una rivisitazione
- Author
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Mancini Sandro, Rosciglione, C, Le Moli A, Agnello, C, Cacciatore, G, Caldarone, R, Carapezza, M, Cicatello, A, Cortella, L, Gembillo, G, Giordano, G, Gulì, S, La Mantia, F, Lo Piparo, F, Lupo, RM, Mancini, S, Nicolaci, G, Pugliese, A, Romano, E, Ruggiu, L, Samonà, L, Tedesco, S, and Mancini Sandro
- Subjects
Filosofia italiana contemporanea, Filosofia e Storiografia filosofica in rapporto ,Settore M-FIL/03 - Filosofia Morale ,Settore M-FIL/06 - Storia Della Filosofia - Abstract
Una riflessione a grandi linee sull'evoluzione del rapporto tra filosofia e storia della filosofia nella cultura italiana a partire dal Risorgimento fino a oggi
- Published
- 2021
20. Lavitalamorte o la genesi dell'aporia
- Author
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Caldarone, R., Rosciglione, C., Agnello, C, Le Moli, A, Borutti, S, Carapezza, M, Cicatello, A, Cortella, L, Gembillo, G, Giordano, G, Gulì, S, La Mantia, F: Lo Piparo, F, Lupo, R.M, Mancini, S, Nicolaci, G, Pugliese, A, Romano, E, Ruggiu, L, Samonà, L, Tedesco, S., and Caldarone, R.
- Subjects
Settore M-FIL/01 - Filosofia Teoretica ,Life, death, Derrida, Freud, pleasure - Abstract
The author finds the genesis of her concept of aporia in the Derrida Seminar of the 1970s on La vie la mort. The essay problematizes the co-belonging between life and death in Plato's Gorgias and starting from this datum compares Derrida's position with the dialectical-metaphysical one.
- Published
- 2021
21. Apprendere ad abitare il mondo. Riflessioni pedagogiche e filosofiche sulla consegna educativa
- Author
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Antonio Bellingreri, Agnello, C, Caldarone, R, Cicatello, A, Lupo, RM, Palumbo, G, Ardovino, A, Camera, F, Carapezza, M, Cavalleri, M, Chiereghin, F, Chiurazzi, G, Cortella, L, Costa, V, D'Addelfio, G, Di Martino, C, Duque, F, Galanti Grollo, S, Gembillo, G, Guglielminetti, E, Gulli, M, Illetterati, L, La Mantia, F, Lanfredini, R, Mazzarella, E, Nobile, M, Roccaro, G, Rodriguez, R, Russino, G, Vanzago, L, Venturelli, D, Vergani, M, Vitiello, V, Auteri, L, Ciancio, C, Colonnello, P, Di Stefano, E, Lo Piparo, F, Naro, M, Pepi, L, Picone, G, Rosciglione, C, Rostagno, S, and Antonio Bellingreri
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education ontology, in-depth analysis of the experience, a fundamental pedagogy, the consignment of a meaning heritage, the self-realization, a philosophy of education ,Settore M-PED/01 - Pedagogia Generale E Sociale - Abstract
The text draws the lines of an education ontology, according to progressive levels of in-depth analysis of the experience. The first one is proper of the fundamental pedagogy and sets up its central category: the educative relationship is consignment of a meaning heritage to self-realization. The second one is proper of the philosophy of education, whose purpose is justifying a more original consignment, beyond its ethos, to the history and the being. As a matter of fact, both the immanence in the history and the conscience of a correlated transcendence are constitutive of the consignment. This is a further level and the task becomes foundational: what is not explained within the experience and the spontaneous and scientific knowledge is cleared, so that you can reach certainties that are founded in a profound way. If you do not justify rationally, ideas and ideals tend to deteriorate into ideologies.
- Published
- 2020
22. Ricerca della verità e crescita interiore. Il percoros letterario e umano di Christoph Martin Wieland (Biberach 1733-Weimar 1813)
- Author
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auteri, laura, Agnello, C, Caldarone, R, Cicatello, A, Lupo RM, Palumbo, G, Ardovino, A, Bellingreri, A, Camera F, Carapoezza, M, Cavalleri, M, Chiereghin F, Chiurazzi, G, Cortella, L, Costa, V, D'Addelgio, G, Di Martino, C, Duque, F, Galanti Grollo, S, Gembillo, G, Guglielminetti, E, Gulli, M, Illetterati, L, La Mantia, F, Lanfredini, R, Mazzarella, E, Nobile, M, Roccaro, G, Rodrìguez, R, Russini, G, Vanzago, L, Venturelli, D, Vergani, M, Vitiello, V, Ciancio, C, Colonnello, P, Di Stefano, E, Lo Piparo, F, Naro, M, Pepi, L, Picone, G, Rosciglione, C, Rosragno, S, and auteri, laura
- Subjects
Settore L-LIN/13 - Letteratura Tedesca ,Dibattito filosofico e pedagogico nel 700 di lingua tedesca ,la posizione di Ch.M. Wieland ,ricerca della verità - Abstract
Il saggio esplora la posizione di Ch. M. Wieland all'interno del dibattito filosofico-pedagogico del 700 di lingua tedesca, sia per quanto attiene alla conoscenza sia per quanto attiene alla possibilità di crescita e di formazione dell'individuo. Ci si propone di evidenziare come l'autore nel corso del tempoo rimanga sostanzialmente fedele alla convinzione che ci si debba aprire al confronto con gli altri, e che socraticamente si debba partire dalla conoscenza di sé per intraprendere qualsiasi percorso formativo
- Published
- 2020
23. Pascal e la critica del dominio
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Affronti, F., Agnello, C, Caldarone, R, Cicatello, A, Lupo, RM, Palumbo, G, Affronti, F, Alvira, R, Borutti, S, Canullo, C, Cislaghi, A, Dalmasso, G, Danani, C, Di Piazza, S, Fabris, A, Ferrarin, A, Ferretti, G, Koch, AF, Labate S, Le Moli, A, Licata, G, Magris, A, Mancini, R, Mancini, S, Marcolungo, FL, Nicolaci, G, Paltrinieri, GL, Palumbo, P, Perone, U, Piazza, F, Pugliese, A, Resta, C, Sesta, L, Stadtler, M, Tedesco, S, Totaro, F, Valori, F, Vercellone, F, Vigna, C, Ardovino, A, Bellingreri, A, Camera, F, Carapezza, M, Cavalleri, M, Chiereghin, F, Chiurazzi, G, Cortella, L, Costa, V, D'Addelfio, G, Di Martino, C, Duque, F, Galanti Grollo, S, Gembillo, G, Guglielminetti, E, Gulli, M, Illetterati, L, La Mantia, F, Lanfredini, R, Mazzarella, E, Nobile, M, Roccaro, G, Rodriguez, R, Russino, G, Vanzago, L, Venturelli, D, Vergani, M, Vitiello, V, Auteri, L, Ciancio, C, Colonnello, P, Di Stefano, E, Lo Piparo, F, Naro, M, Pepi, L, Picone, G, Rosciglione, C, Rostagno, S, and Affronti, F.
- Subjects
Settore M-FIL/01 - Filosofia Teoretica ,Pascal, knowledge, thought, truth, domination, intuition, geometry, science, charity - Abstract
The article aims to show the critique of domination and power by means of some texts by Blaise Pascal. The topic focuses on cognitive activity and the faculty of knowledge.
- Published
- 2020
24. Metafisica e poesia
- Author
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Caldarone, R., Agnello, C, Caldarone, R, Cicatello, A, Lupo RM, Palumbo, G., Affronti, F, Alvira, R, Borutti, S, Canullo, C, Cislaghi, A, Dalmasso, G, Danani, C, Di Piazza, S, Fabris, A, Ferrarin, A, Ferretti, G, Koch, AF, Labate, S, Le Moli, A, Licata, G, Magris, A, Mancini, R, Mancini, S, Marcolungo FL, Nicolaci, G, Paltrinieri GL, Palumbo, G, Palumbo, P, Perone, U, Piazza, F, Pugliese, A, Resta, C, Sesta, L, Stadtler, M, Tedesco, S, Totaro, F, Valori, F, Vercellone, F, Vigna, C, Ardovino, A, Bellingreri, A, Camera, F, Carapezza, M, Cavalleri, M, Chiereghin, F, Chiurazzi, G, Cortella, L, Costa, V, D'Addelfio, G, Di Martino, C, Duque, F, Galanti Grillo, S, Gembillo, G, Guglielminetti, E, Gulli, M, Illetterati, L, La Mantia, F, Lanfredini, R, Mazzarella, E, Nobile, M, Roccaro, G, Rodriguez, R, Russino, G, Vanzago, L, Venturelli, D, Vergani, M, Vitiello, V, Auteri, L, Ciancio, C, Colonnello, P, Di Stefano, E, Lo Piparo, F, Caro, M, Pepi, L, Picone, G, Rosciglione, C, Rostagno, S., and Caldarone, R.
- Subjects
Metaphysic ,Aristotle ,philosophy ,Settore M-FIL/01 - Filosofia Teoretica ,Celan ,poetry ,Plato - Abstract
The essay shows, between autobiography and theoretical reflection, the link between metaphysics and poetry in the reflection of the philosopher Leonardo Samonà. The author uses the concept of "retraction" to cross both the vision of Samonà's metaphysics and the vision of poetry.
- Published
- 2020
25. Croce e la tradizione dell'hegelismo napoletano
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VANZULLI, MARCO, Cacciatore, G, Cantillo, G, Coniglione, F, Cotroneo, G, Della Pelle, P, Di Bella, S, Di Giovanni, P, D'Angelo, P, Fusaro, D, Gembillo, G, Genna, C, Irti, N, Maggi, M, Morani, R, Mustè, M, Paolizzi, E, Petrucciani, S, Rockmore, T, Tessitore, F, Vanzulli, M, Viti Cavaliere, R, Vitiello, V, and Tuozzolo, C
- Subjects
Croce, hegelismo ,M-FIL/06 - STORIA DELLA FILOSOFIA - Published
- 2016
26. Nota Introduttiva
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Le Moli, A, Giuffrida, P, Aristotele, Le Moli, A, Rosciglione, C, Agnello, C, Borutti, S, Cacciatore, G, Caldarone, R, Carapezza, M, Cicatello, A, Cortella, L, Gembillo, G, Giordano, G, Gulì, S, La Mantia, F, Lo Piparo, F, Lupo, RM, Mancini, S, Nicolaci, G, Pugliese, A, Romano, E, Ruggiu, L, Samonà, L, and Tedesco, S
- Subjects
Animali ,History od Philosophy ,Movimento ,Aristotele ,Settore M-FIL/06 - Storia Della Filosofia - Abstract
Nota introduttiva alla nuova edizione italiana del De Motu Animalium di Aristotele
- Published
- 2014
27. How histopathological diagnosis interacts with kidney ultrasound parameters and glomerular filtration rate.
- Author
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Andrulli S, Gigante A, Rossini M, D'Angio' P, Vischini G, Luchetta F, Aucella F, Valsecchi G, Infante B, Vario MG, Giannese D, Granata A, Moggia E, Gembillo G, Cianci R, Bonomini M, Manenti F, Lazzarin R, Renzo BD, Zanchelli F, Garozzo M, Manes M, Battaglia Y, Sciri R, Fabritiis M, Quaglia M, Cavoli GL, Gintoli E, Conte MM, Borzumati M, Benozzi L, Pasquariello G, Andrulli G, Leoni M, Seminara G, Corbani V, Sabiu G, Maggio AD, Pollastro RM, and Gesualdo L
- Abstract
The evaluation of estimated GFR (eGFR) is a pivotal staging step in patients with chronic kidney disease (CKD), and renal ultrasound plays an important role in diagnosis, prognosis and progression of CKD. The interaction between histopathological diagnosis and ultrasound parameters in eGFR determination has not been fully investigated yet. The study examined the results of native kidney biopsies performed in 48 Italian centers between 2012 and 2020. The primary goal was if and how the histopathological diagnosis influences the relationship between ultrasound parameters and eGFR. After exclusion of children, patients with acute kidney injury and patients without measure of kidney length or parenchymal thickness, 2795 patients have been selected for analysis. The median values were 52 years for patient age, 11 cm for bipolar kidney diameter, 16 mm for parenchymal thickness, 2.5 g/day for proteinuria and 70 ml/min/1.73 m
2 for eGFR. The bipolar kidney diameter and the parenchymal thickness were directly related with eGFR values (R square 0.064). Diabetes and proteinuria were associated with a consistent reduction of eGFR, improving the adjusted R square up to 0.100. Addition of histopathological diagnosis in the model increased the adjusted R square to 0.216. There is a significant interaction between histopathological diagnosis and longitudinal kidney diameter (P 0.006). Renal bipolar length and parenchymal thickness are directly related with eGFR. The magnitude of proteinuria and histopathological kidney diagnosis are associated with eGFR. The relationship between kidney length and the level of eGFR depends on the nature of the kidney disease., (© 2024. The Author(s).)- Published
- 2024
- Full Text
- View/download PDF
28. Differences in Efficacy between Antibacterial Lock Therapy and the Standard of Care for CVC-Related Infections: A Systematic Review and Meta-Analysis.
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Calabrese V, Farina A, Maressa V, Cernaro V, Gembillo G, Messina RM, Longhitano E, Ferio C, Venanzi Rullo E, and Santoro D
- Abstract
Background : Central Venous Catheter (CVC)-related infections cannot always be solved by replacement, due to some vascular anomalies or an emergency status. This comprehensive, evidence-based review aimed to define the efficacy of antibacterial lock therapy (ALT) compared to the standard of care (SoC) in CVC-related infections. Methods : We performed a systematic search in PubMed, Embase, and Google Scholar, looking for randomized controlled trials (RCTs) and cohort or case-control observational studies. The eligible studies considered the subjects with a diagnosis of CVC-related infections treated with antibacterial lock therapy (ALT) compared to the standard of care (SoC). Results: Among 609 records at the end of the selection process, five articles, referring to observational studies, were included in this systematic review. In pooled analyses, including a total of 276 individuals, microbiological healing (OR 3.78; 95% CI; 2.03-7.03) showed significant differences between ALT and the SoC, with a follow-up varying from 2 weeks to 3 months. Conclusions: Our results suggested that ALT could improve the preservation of CVCs and could be considered when their replacement is not possible as a result of vascular problems. However, only observational studies were included and RCTs are needed to confirm these findings and to increase the level of evidence.
- Published
- 2024
- Full Text
- View/download PDF
29. Biomarkers of chronic kidney disease in older individuals: navigating complexity in diagnosis.
- Author
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Muglia L, Di Dio M, Filicetti E, Greco GI, Volpentesta M, Beccacece A, Fabbietti P, Lattanzio F, Corsonello A, Gembillo G, Santoro D, and Soraci L
- Abstract
Chronic kidney disease (CKD) in older individuals is a matter of growing concern in the field of public health across the globe. Indeed, prevalence of kidney function impairment increases with advancing age and is often exacerbated by age-induced modifications of kidney function, presence of chronic diseases such as diabetes, hypertension, and cardiovascular disorders, and increased burden related to frailty, cognitive impairment and sarcopenia. Accurate assessment of CKD in older individuals is crucial for timely intervention and management and relies heavily on biomarkers for disease diagnosis and monitoring. However, the interpretation of these biomarkers in older patients may be complex due to interplays between CKD, aging, chronic diseases and geriatric syndromes. Biomarkers such as serum creatinine, estimated glomerular filtration rate (eGFR), and albuminuria can be significantly altered by systemic inflammation, metabolic changes, and medication use commonly seen in this population. To overcome the limitations of traditional biomarkers, several innovative proteins have been investigated as potential, in this review we aimed at consolidating the existing data concerning the geriatric aspects of CKD, describing the challenges and considerations in using traditional and innovative biomarkers to assess CKD in older patients, highlighting the need for integration of the clinical context to improve biomarkers' accuracy., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The author(s) declared that they were an editorial board member of Frontiers, at the time of submission. This had no impact on the peer review process and the final decision., (Copyright © 2024 Muglia, Di Dio, Filicetti, Greco, Volpentesta, Beccacece, Fabbietti, Lattanzio, Corsonello, Gembillo, Santoro and Soraci.)
- Published
- 2024
- Full Text
- View/download PDF
30. What about the Use of Ice Cream as a Supplementary Diet in Chronic Kidney Disease? A Case-Control Study.
- Author
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Metro D, Corallo F, Cardile D, Gembillo G, Manasseri L, Santoro D, Buda M, Calabrò RS, and Bonanno L
- Subjects
- Humans, Female, Male, Middle Aged, Case-Control Studies, Aged, Retrospective Studies, Adult, Nutritional Status, Renal Insufficiency, Chronic diet therapy, Ice Cream
- Abstract
Maintaining a healthy lifestyle can extend life expectancy and improve a person's health status. In addition to physical activity and bad habits related to smoking and alcohol, diet is also a determining factor. Following a healthy diet pattern over time and supporting a healthy body weight contributes to reducing the risk of developing more severe complications associated with very common diseases such as chronic kidney disease (CKD), diabetes, or cardiovascular diseases. The 2015-2020 Dietary Guidelines for Americans promote the adoption of fat-free or low-fat diets and discourage the consumption of foods with added sugar and solid fats, such as ice creams and other frozen desserts. On the other hand, ice cream, from a nutritional and healthy point of view, can be considered a possible food choice, due to its greater palatability and high nutritional content, but its consumption must be scheduled in a balanced diet. In this retrospective study, 36 patients with chronic renal failure were enrolled. Two different diets were proposed (A and B). In Diet B, lemon sorbet was added twice a week as an alternative food to replace fruit or snacks making the diet more varied and palatable. Nutritional status and biohumoral, immunological, and blood parameters were evaluated after 6 months. A statistical analysis shows a significant inter-group difference in creatinine and azotemia between T0 and T1. Intra-group significant differences were found in lymphocytes ( p = 0.005) and azotemia ( p < 0.001) in Diet A, and in azotemia ( p < 0.001) and transferrin ( p < 0.001) in Diet B. The results indicated that ice cream represented a good alternative food in both groups of patients regarding nutritional values and patient satisfaction. Furthermore, the treatment with ice cream allowed for better control of azotemia, maintaining stable levels even in patients with advanced CKD. This study concludes that ice cream could exert beneficial effects in addition to CKD patients' dietary regimens.
- Published
- 2024
- Full Text
- View/download PDF
31. Financial Toxicity in Renal Patients (FINTORE) Study: A Cross-Sectional Italian Study on Financial Burden in Kidney Disease-A Project Protocol.
- Author
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Siligato R, Gembillo G, Di Simone E, Di Maria A, Nicoletti S, Scichilone LM, Capone M, Vinci FM, Bondanelli M, Malaventura C, Storari A, Santoro D, Di Muzio M, Dionisi S, and Fabbian F
- Abstract
Financial toxicity (FT) refers to the negative impact of health-care costs on clinical conditions. In general, social determinants of health, especially poverty, socioenvironmental stressors, and psychological factors, are increasingly recognized as important determinants of non-communicable diseases, such as chronic kidney disease (CKD), and their consequences. We aim to investigate the prevalence of FT in patients at different stages of CKD treated in our universal health-care system and from pediatric nephrology, hemodialysis, peritoneal dialysis and renal transplantation clinics. FT will be assessed with the Patient-Reported Outcome for Fighting Financial Toxicity (PROFFIT) score, which was first developed by Italian oncologists. Our local ethics committee has approved the study. Our population sample will answer the sixteen questions of the PROFFIT questionnaire, seven of which are related to the outcome and nine the determinants of FT. Data will be analyzed in the pediatric and adult populations and by group stratification. We are confident that this study will raise awareness among health-care professionals of the high risk of adverse health outcomes in patients who have both kidney disease and high levels of FT. Strategies to reduce FT should be implemented to improve the standard of care for people with kidney disease and lead to truly patient-centered care.
- Published
- 2024
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32. Investigational new drugs for the treatment of chronic renal failure: an overview of the literature.
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Terzo C, Gembillo G, Cernaro V, Longhitano E, Calabrese V, Casuscelli C, Peritore L, and Santoro D
- Subjects
- Humans, Drugs, Investigational therapeutic use, Diabetes Mellitus, Type 2, Kidney Failure, Chronic prevention & control, Renal Insufficiency, Chronic drug therapy, Sodium-Glucose Transporter 2 Inhibitors pharmacology, Sodium-Glucose Transporter 2 Inhibitors therapeutic use
- Abstract
Introduction: Chronic kidney disease (CKD) is widespread throughout the world, with a high social and health impact. It is considered a 'silent killer' for its sudden onset without symptoms in the early stages of the disease. The main goal of nephrologists is to slow the progression of kidney disease and treat the associated symptoms with a range of new medications., Areas Covered: The aim of this systematic review is to analyze the new investigational drugs for the treatment of chronic renal failure. Data were obtained from the available scientific literature and from the ClinicalTrials.gov website., Expert Opinion: Among the drugs currently being researched, SGLT2 inhibitors appear to be the most promising drugs for the treatment of CKD, has they have slower progression of CKD and protection of cardiorenal function. An important role in the future of CKD treatment is played by autologous cell-therapy, which appears to be a new frontier in the treatment of CKD. Other therapeutic strategies are currently being investigated and have been shown to slow the progression of CKD. However, further studies are needed to determine whether these approaches may offer benefits in slowing the progression of CKD in the near future.
- Published
- 2024
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33. Review and Practical Excursus of the Propensity Score: Low Protein Diet Compared to Mediterranean Diet in Patients With Chronic Kidney Disease.
- Author
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Calabrese V, Gembillo G, Buda M, Cernaro V, Longhitano E, Pontoriero A, Polizzi M, Metro D, and Santoro D
- Subjects
- Humans, Diet, Protein-Restricted, Propensity Score, Diet, Mediterranean, Renal Insufficiency, Chronic
- Abstract
Although Randomized clinical trials (RCT) represent the gold standard to compare two or more treatments, the impact of observational studies cannot be ignored. Obviously, these latter are performed on unbalanced sample, and differences among the compared groups could be detected. These differences could have an impact on the estimated association between our allocation and our outcome. To avoid it, some methods should be applied in the analysis of observational cohort. Propensity score (PS) can be considered as a value which sums up and balances the known variables. It aims to adjust or balance the probability of receiving a specific allocation group, and could be used to match, stratify, weight, and perform a covariate adjustment. PS is calculated with a logistic regression, using allocation groups as the outcome. Thanks to PS, we compute the probability of being allocated to one group and we can match patients obtaining two balanced groups. It avoids computing analysis in unbalanced groups. We compared low protein diet (LPD) and the Mediterranean diet in CKD patients and analysed them using the PS methods. Nutritional therapy is fundamental for the prevention, progression and treatment of Chronic Kidney Disease (CKD) and its complications. An individualized, stepwise approach is essential to guarantee high adherence to nutritional patterns and to reach therapeutic goals. The best dietary regimen is still a matter of discussion. In our example, unbalanced analysis showed a significant renal function preservation in LPD, but this correlation was denied after the PS analysis. In conclusion, although unmatched analysis showed differences between the two diets, after propensity analysis no differences were detected. If RCT cannot be performed, balancing the PS score allows to balance the sample and avoids biased results., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
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- 2023
34. How to Choose the Right Treatment for Membranous Nephropathy.
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Peritore L, Labbozzetta V, Maressa V, Casuscelli C, Conti G, Gembillo G, and Santoro D
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- Pregnancy, Child, Humans, Female, Immunosuppressive Agents therapeutic use, Rituximab therapeutic use, Autoantibodies, Glomerulonephritis, Membranous drug therapy, Glomerulonephritis, Membranous diagnosis, Nephrotic Syndrome drug therapy, Kidney Failure, Chronic complications
- Abstract
Membranous nephropathy is an autoimmune disease affecting the glomeruli and is one of the most common causes of nephrotic syndrome. In the absence of any therapy, 35% of patients develop end-stage renal disease. The discovery of autoantibodies such as phospholipase A2 receptor 1, antithrombospondin and neural epidermal growth factor-like 1 protein has greatly helped us to understand the pathogenesis and enable the diagnosis of this disease and to guide its treatment. Depending on the complications of nephrotic syndrome, patients with this disease receive supportive treatment with diuretics, ACE inhibitors or angiotensin-receptor blockers, lipid-lowering agents and anticoagulants. After assessing the risk of progression of end-stage renal disease, patients receive immunosuppressive therapy with various drugs such as cyclophosphamide, steroids, calcineurin inhibitors or rituximab. Since immunosuppressive drugs can cause life-threatening side effects and up to 30% of patients do not respond to therapy, new therapeutic approaches with drugs such as adrenocorticotropic hormone, belimumab, anti-plasma cell antibodies or complement-guided drugs are currently being tested. However, special attention needs to be paid to the choice of therapy in secondary forms or in specific clinical contexts such as membranous disease in children, pregnant women and patients undergoing kidney transplantation.
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- 2023
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35. Personalized Medicine in Kidney Disease.
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Gembillo G, Siligato R, and Santoro D
- Abstract
The Special Issue "Personalized Medicine in Kidney Disease" is focused on the importance of customized medicine in nephrology as it represents one of the main characteristics of successful therapeutic results [...].
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- 2023
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36. Progress in pharmacotherapy for the treatment of hyperphosphatemia in renal failure.
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Cernaro V, Longhitano E, Calabrese V, Casuscelli C, Di Carlo S, Spinella C, Gembillo G, and Santoro D
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- Humans, Calcium, Phosphates, Parathyroid Hormone, Sevelamer therapeutic use, Chelating Agents adverse effects, Hyperphosphatemia drug therapy, Hyperphosphatemia etiology, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic drug therapy
- Abstract
Introduction: Among the clinical and metabolic complications of progressive chronic kidney disease (CKD), CKD-mineral bone disorder (CKD-MBD) significantly contributes to morbidity and mortality. While overt and persistent hyperphosphatemia is typical of advanced CKD and requires treatment, other abnormalities of calcium/phosphate metabolism begin to occur since the early stages of the disease., Areas Covered: We searched on the PubMed database, without restrictions for language or time range, for randomized clinical trials and meta-analyses investigating phosphate-lowering therapies. The various phosphate binders show different safety profiles and diverse effects on calcium/phosphate metabolism and vascular calcification. The in-depth knowledge of the characteristics of these drugs is crucial to ensure adequate treatment to CKD patients., Expert Opinion: A proper control of serum phosphate can be achieved using phosphate binders. These medications may induce side effects. Moreover, data on their impact on clinical outcomes are partly controversial or scarce, especially for the new generation drugs. Hyperphosphatemia favors cardiovascular disease and increases the risk for CKD progression. These effects are partially mediated by fibroblast growth factor 23 (FGF23), a phosphaturic hormone that raises to maintain normal serum phosphate. Since there are no data supporting the use of phosphate-lowering agents when phosphataemia is normal, a key role is played by reducing dietary phosphate intake with the aim to control serum phosphate and the compensatory FGF23 and parathyroid hormone (PTH) increase.
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- 2023
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37. Phosphate Control in Peritoneal Dialysis Patients: Issues, Solutions, and Open Questions.
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Cernaro V, Calderone M, Gembillo G, Calabrese V, Casuscelli C, Lo Re C, Longhitano E, and Santoro D
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- Humans, Phosphates, Renal Dialysis adverse effects, Hyperphosphatemia etiology, Hyperphosphatemia prevention & control, Hyperphosphatemia epidemiology, Peritoneal Dialysis adverse effects, Renal Insufficiency, Chronic therapy, Renal Insufficiency, Chronic complications
- Abstract
Hyperphosphatemia is a common complication in advanced chronic kidney disease and contributes to cardiovascular morbidity and mortality. The present narrative review focuses on the management of phosphatemia in uremic patients receiving peritoneal dialysis. These patients frequently develop hyperphosphatemia since phosphate anion behaves as a middle-size molecule despite its low molecular weight. Accordingly, patient transporter characteristics and peritoneal dialysis modalities and prescriptions remarkably influence serum phosphate control. Given that phosphate peritoneal removal is often insufficient, especially in lower transporters, patients are often prescribed phosphate binders whose use in peritoneal dialysis is primarily based on clinical trials conducted in hemodialysis because very few studies have been performed solely in peritoneal dialysis populations. A crucial role in phosphate control among peritoneal dialysis patients is played by diet, which must help in reducing phosphorous intake while preventing malnutrition. Moreover, residual renal function, which is preserved in most peritoneal dialysis patients, significantly contributes to maintaining phosphate balance. The inadequate serum phosphate control observed in many patients on peritoneal dialysis highlights the need for large and well-designed clinical trials including exclusively peritoneal dialysis patients to evaluate the effects of a multiple therapeutic approach on serum phosphate control and on hard clinical outcomes in this high-risk population.
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- 2023
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38. Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy.
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Kiryluk K, Sanchez-Rodriguez E, Zhou XJ, Zanoni F, Liu L, Mladkova N, Khan A, Marasa M, Zhang JY, Balderes O, Sanna-Cherchi S, Bomback AS, Canetta PA, Appel GB, Radhakrishnan J, Trimarchi H, Sprangers B, Cattran DC, Reich H, Pei Y, Ravani P, Galesic K, Maixnerova D, Tesar V, Stengel B, Metzger M, Canaud G, Maillard N, Berthoux F, Berthelot L, Pillebout E, Monteiro R, Nelson R, Wyatt RJ, Smoyer W, Mahan J, Samhar AA, Hidalgo G, Quiroga A, Weng P, Sreedharan R, Selewski D, Davis K, Kallash M, Vasylyeva TL, Rheault M, Chishti A, Ranch D, Wenderfer SE, Samsonov D, Claes DJ, Akchurin O, Goumenos D, Stangou M, Nagy J, Kovacs T, Fiaccadori E, Amoroso A, Barlassina C, Cusi D, Del Vecchio L, Battaglia GG, Bodria M, Boer E, Bono L, Boscutti G, Caridi G, Lugani F, Ghiggeri G, Coppo R, Peruzzi L, Esposito V, Esposito C, Feriozzi S, Polci R, Frasca G, Galliani M, Garozzo M, Mitrotti A, Gesualdo L, Granata S, Zaza G, Londrino F, Magistroni R, Pisani I, Magnano A, Marcantoni C, Messa P, Mignani R, Pani A, Ponticelli C, Roccatello D, Salvadori M, Salvi E, Santoro D, Gembillo G, Savoldi S, Spotti D, Zamboli P, Izzi C, Alberici F, Delbarba E, Florczak M, Krata N, Mucha K, Pączek L, Niemczyk S, Moszczuk B, Pańczyk-Tomaszewska M, Mizerska-Wasiak M, Perkowska-Ptasińska A, Bączkowska T, Durlik M, Pawlaczyk K, Sikora P, Zaniew M, Kaminska D, Krajewska M, Kuzmiuk-Glembin I, Heleniak Z, Bullo-Piontecka B, Liberek T, Dębska-Slizien A, Hryszko T, Materna-Kiryluk A, Miklaszewska M, Szczepańska M, Dyga K, Machura E, Siniewicz-Luzeńczyk K, Pawlak-Bratkowska M, Tkaczyk M, Runowski D, Kwella N, Drożdż D, Habura I, Kronenberg F, Prikhodina L, van Heel D, Fontaine B, Cotsapas C, Wijmenga C, Franke A, Annese V, Gregersen PK, Parameswaran S, Weirauch M, Kottyan L, Harley JB, Suzuki H, Narita I, Goto S, Lee H, Kim DK, Kim YS, Park JH, Cho B, Choi M, Van Wijk A, Huerta A, Ars E, Ballarin J, Lundberg S, Vogt B, Mani LY, Caliskan Y, Barratt J, Abeygunaratne T, Kalra PA, Gale DP, Panzer U, Rauen T, Floege J, Schlosser P, Ekici AB, Eckardt KU, Chen N, Xie J, Lifton RP, Loos RJF, Kenny EE, Ionita-Laza I, Köttgen A, Julian BA, Novak J, Scolari F, Zhang H, and Gharavi AG
- Subjects
- Animals, Mice, Genome-Wide Association Study, Immunoglobulin A genetics, Glomerulonephritis, IGA drug therapy, Glomerulonephritis, IGA genetics, Glomerulonephritis, IGA diagnosis
- Abstract
IgA nephropathy (IgAN) is a progressive form of kidney disease defined by glomerular deposition of IgA. Here we performed a genome-wide association study of 10,146 kidney-biopsy-diagnosed IgAN cases and 28,751 controls across 17 international cohorts. We defined 30 genome-wide significant risk loci explaining 11% of disease risk. A total of 16 loci were new, including TNFSF4/TNFSF18, REL, CD28, PF4V1, LY86, LYN, ANXA3, TNFSF8/TNFSF15, REEP3, ZMIZ1, OVOL1/RELA, ETS1, IGH, IRF8, TNFRSF13B and FCAR. The risk loci were enriched in gene orthologs causing abnormal IgA levels when genetically manipulated in mice. We also observed a positive genetic correlation between IgAN and serum IgA levels. High polygenic score for IgAN was associated with earlier onset of kidney failure. In a comprehensive functional annotation analysis of candidate causal genes, we observed convergence of biological candidates on a common set of inflammatory signaling pathways and cytokine ligand-receptor pairs, prioritizing potential new drug targets., (© 2023. The Author(s), under exclusive licence to Springer Nature America, Inc.)
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- 2023
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39. Horseshoe Kidney: 500 Years From the First Report in the Literature.
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Gembillo G, Bellinghieri G, Savica V, and Santoro D
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- Humans, Male, Female, Kidney diagnostic imaging, Kidney blood supply, Arteries, Veins, Fused Kidney complications, Fused Kidney diagnostic imaging, Renal Insufficiency, Chronic
- Abstract
Horseshoe kidney or ren arcuatus is the most common renal fusion anomaly, with an incidence of 1:500 in the normal population and a male predominance of 2:1. In >90% of cases, the fusion occurs along the inferior pole. It may vary in location, orientation, and arterial and venous anatomy. In 1522, Berengario da Carpi described this renal malformation for the first time in his masterpiece "Isagogae breves" (Introduction to Anatomy). He reported the results of a postmortem examination in the public autopsy room of the University of Bologna, describing "kidneys that are continuous as if they were a kidney, with two emulsifying veins, two emulsifying arteries, two ureteral outlets." In 1564, Leonardo Botallo described and illustrated the features of this atypical anatomical representation, and later, in 1602, Leonard Doldius added further details by examining this anatomical feature during an autopsy. In 1761, Giovanni Battista Morgagni discussed this condition not only as a rare anatomical curiosity found only in necroscopy but also discussed its physiological aspect. In the nineteenth century, with the advent of renal surgery, the horseshoe kidney played a more important role in urological diagnosis and treatment, and its identification became more frequent. With the advent of pyelography, imaging reports of the horseshoe kidney allowed a more accurate representation of the anatomical variants, which was particularly useful in preoperative assessment and outcomes. Berengario da Carpi laid the foundation for a better knowledge of this anatomical anomaly. Five hundred years after the first report in the literature, relevant advances have been made in the management of complications associated with horseshoe kidney and in diagnosis, confirming the need to monitor individuals with this condition who are at higher risk of developing chronic kidney disease.
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- 2023
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40. Franz Volhard: 150th Birth Anniversary of a Father of Nephrology and Hypertension.
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Santoro D, Bellinghieri G, Savica V, and Gembillo G
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- Humans, History, 20th Century, History, 19th Century, Anniversaries and Special Events, Kidney, Nephrology, Hypertension diagnosis, Hypertension, Renovascular, Glomerulonephritis
- Abstract
Franz Volhard (May 2, 1872, to May 24, 1950) was a German clinician and researcher who made outstanding contributions to the field of nephrology and hyper-tension. His studies led to important developments in knowledge about the pathophysiology of the kidney and its relationship to cardiovascular disease. He contributed to a better understanding of the mechanisms underlying renovascular hypertension by explaining the crucial relationship between the decrease in renal blood flow and the increase in blood pressure. He also introduced a precise classification of the different types of hypertension and the associated renal involvement. In collaboration with Karl Theodor Fahr (1877-1945), he developed a new classification of Bright's disease (nephritis), which was published in the book Die Brightsche Nierenkrankheit. Klinik, Pathologie und Atlas, and revolutionized the concepts behind the mechanisms of glomerulonephritis. During his distinguished career, Volhard headed departments of internal medicine at the Luisenhospital in Dortmund (1905-1910) and in Mannheim (1910-1918). In 1918, he became chairman of the Department of Internal Medicine at the University of Halle, his alma mater, until 1928, the same year he became chairman of the Department of Internal Medicine at the University of Frankfurt until 1938. Volhard continued his successful career until 1950, when he died of complications from a car accident. The worldwide medical com-munity greatly appreciated Franz Volhard's scientific contribution. The International Society of Hypertension posthumously presented him with the "Franz Volhard Award." The aim of this article is to commemorate the importance of this giant of nephrology 150 years after his birth.
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- 2023
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41. The Mysterious Life of Jeronimus Ruscelli and His Contribution to Nephrology (1504-1566).
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Bellinghieri G, Gembillo G, Savica V, and Santoro D
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- Humans, History, 16th Century, Nephrology history
- Abstract
Jeronimo Ruscelli was a mysterious humanist of great fame. He was born in Viterbo between 1504 and 1518 and died in Venice in 1566. Very little is known about Ruscelli's life, but based on his extensive literary output we can assume that he was endowed with remarkable intellectual abilities and a propensity for varied interests. At a young age, he developed a strong interest in classical studies and attended the court of Cardinal Marini Grimani in Utini. After completing his studies at the University of Padua, he participated in the founding of a humanist academy, the Accademia degli Sdegnati (the Scornful Academy). After his fruitful experience in Rome, he moved to the Neapolitan residence of Marquis Alfonso D'Avalos. Here, Ruscelli founded an "Academy of Secrets", composed of a group of humanists and nobles who had an extensive culture and had different experiences but similar interests. During these productive years, under the pseudonym Alexius Pedemontanus, he wrote one of his masterpieces, The Secreti, an important historical documentary manual of great value. In this book, the author proposes therapies for a wide variety of diseases, claiming in most cases that they have been experimentally and successfully tested in the presence of witnesses in at least 3 clinical cases. Ruscelli composed an extensive version of The Secreti, the Secreti Novi. In this book he reported more than a thousand recipes, the substances used were of a great variety and sometimes curious. According to Ruscelli, the recipes in this updated version of the book were "easy for anyone to make, of little effort, and useful for all kinds of people." The topics of this masterpiece range from general medical suggestions to more specific indications, with a wide variety of recipes and treatments of nephrological and urological interest.
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- 2023
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42. Immune Checkpoint Inhibitors and the Kidney: A Focus on Diagnosis and Management for Personalised Medicine.
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Longhitano E, Muscolino P, Lo Re C, Ferrara SA, Cernaro V, Gembillo G, Tessitore D, Speranza D, Figura F, Santarpia M, Silvestris N, Santoro D, and Franchina T
- Abstract
Immunity plays a crucial role in fighting cancer, but tumours can evade the immune system and proliferate and metastasize. Enhancing immune responses is a new challenge in anticancer therapies. In this context, efficacy data are accumulating on immune checkpoint inhibitors and adjuvant therapies for various types of advanced-stage solid tumours. Unfortunately, immune-related adverse events are common. Although infrequent, renal toxicity may occur via several mechanisms and may require temporary or permanent drug suspension, renal biopsy, and/or immunosuppressive treatment. This short review aims to provide a practical approach to the multidisciplinary management of cancer patients with renal toxicity during treatment with immune checkpoint inhibitors., Competing Interests: The authors declare no conflict of interest.
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- 2023
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43. Lung Dysfunction and Chronic Kidney Disease: A Complex Network of Multiple Interactions.
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Gembillo G, Calimeri S, Tranchida V, Silipigni S, Vella D, Ferrara D, Spinella C, Santoro D, and Visconti L
- Abstract
Chronic kidney disease (CKD) is a progressive disease that affects > 10% of the total population worldwide or >800 million people. CKD poses a particularly heavy burden in low- and middle-income countries, which are least able to cope with its consequences. It has become one of the leading causes of death worldwide and is one of the few non-communicable diseases where the number of related deaths has increased over the last two decades. The high number of people affected, and the significant negative impact of CKD should be a reason to increase efforts to improve prevention and treatment. The interaction of lung and kidney leads to highly complex and difficult clinical scenarios. CKD significantly affects the physiology of the lung by altering fluid homeostasis, acid-base balance and vascular tone. In the lung, haemodynamic disturbances lead to the development of alterations in ventilatory control, pulmonary congestion, capillary stress failure and pulmonary vascular disease. In the kidney, haemodynamic disturbances lead to sodium and water retention and the deterioration of renal function. In this article, we would like to draw attention to the importance of harmonising the definitions of clinical events in pneumology and renal medicine. We would also like to highlight the need for pulmonary function tests in routine clinical practise for the management of patients with CKD, in order to find new concepts for pathophysiological based disease-specific management strategies.
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- 2023
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44. Potential Role of Copper in Diabetes and Diabetic Kidney Disease.
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Gembillo G, Labbozzetta V, Giuffrida AE, Peritore L, Calabrese V, Spinella C, Stancanelli MR, Spallino E, Visconti L, and Santoro D
- Abstract
Copper is a fundamental element for the homeostasis of the body. It is the third most abundant essential transition metal in humans. Changes in the concentration of copper in the blood are responsible for numerous diseases affecting various organs, including the heart, brain, kidneys, and liver. Even small copper deficiencies can lead to the development and progression of several pathologies. On the other hand, excessive exposure to copper can cause toxicity in many human organs, leading to various systemic alterations. In the kidney, increased copper concentration in the blood can cause deposition of this element in the kidneys, leading to nephrotoxicity. One of the most interesting aspects of copper balance is its influence on diabetes and the progression of its complications, such as Diabetic Kidney Disease (DKD). Several studies have shown a close relationship between copper serum levels and altered glycemic control. An imbalance of copper can lead to the progression of diabetes-related complications and impaired antioxidant homeostasis. A high Zinc/Copper (Zn/Cu) ratio is associated with improved renal function and reduced risk of poor glycemic control in patients with type two diabetes mellitus (T2DM). Furthermore, the progression of DKD appears to be related to the extent of urinary copper excretion, while regulation of adequate serum copper concentration appears to prevent and treat DKD. The aim of this review is to evaluate the possible role of copper in DKD patients.
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- 2022
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45. Trabecular bone score and phalangeal quantitative ultrasound are associated with muscle strength and fracture risk in hemodialysis patients.
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Catalano A, Gaudio A, Bellone F, La Fauci MM, Xourafa A, Gembillo G, Basile G, Natale G, Squadrito G, Corica F, Morabito N, and Santoro D
- Subjects
- Bicarbonates, Bone Density physiology, Cancellous Bone, Hand Strength, Humans, Lumbar Vertebrae diagnostic imaging, Muscle Strength, Renal Dialysis adverse effects, Ultrasonography, Fractures, Bone diagnostic imaging, Fractures, Bone etiology, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic therapy
- Abstract
There is growing interest in the relationship between chronic kidney disease (CKD) and fragility fracture risk. Bone mineral density (BMD) is a major determinant of bone strength, although its role as a predictor of fracture in advanced CKD and hemodialysis is still under debate. We aimed to further investigate surrogates of bone quality and their associations with muscle strength and fracture risk in hemodialysis. Multiple clinical risk factors for fracture and an estimated 10-year probability of fracture, BMD at lumbar spine and femur, trabecular bone score (TBS), X-ray vertebral morphometry, phalangeal bone quantitative ultrasonography (QUS), tibial pulse-echo ultrasonography (PEUS), and handgrip strength were evaluated in a setting of hemodialysis patients in treatment with acetate-free biofiltration (AFB) or bicarbonate hemodialysis. The bone ultrasound measurements, both at phalangeal and tibial sites, were significantly associated with lumbar and femoral DXA values. Handgrip strength was significantly associated with the 10-year probability of fracture ( r = -0.57, p < 0.001 for major fractures and r = -0.53, p < 0.001 for hip fracture, respectively), with femur neck, total femur, and L1-L4 BMD values ( r = 0.47, p = 0.04; r = 0.48, p = 0.02; r = 0.58, p = 0.007, respectively), with TBS at the lumbar spine ( r = 0.71, p < 0.001) and with the phalangeal QUS measure of AD-SoS ( r = 0.369, p = 0.023). In the hemodialysis group, 10 participants (24.3%) reported at least one morphometric vertebral fracture (Vfx); conversely, only six participants (15%) showed Vfx in the control group. In the hemodialysis group, participants with Vfx compared with participants without Vfx reported significantly different TBS, bone transmission time (BTT), cortical thickness, and handgrip strength ( p < 0.05). At multiple regression analysis, by identifying as dependent variable the 10-year fracture risk for major fracture, after correcting for age, BMI, time since dialysis, AD-SoS, cortical bone thickness, and handgrip strength, only BTT ( β = -15.21, SE = 5.91, p = 0.02) and TBS ( β = -54.69, SE = 21.88, p = 0.02) turned out as independently associated with fracture risk. In conclusion, hemodialysis patients showed a higher fracture risk and lower surrogate indices of bone strength as TBS and QUS parameters. In this cohort of patients, handgrip strength measurements appeared to be a useful instrument to identify high-fracture-risk subjects., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Catalano, Gaudio, Bellone, La Fauci, Xourafa, Gembillo, Basile, Natale, Squadrito, Corica, Morabito and Santoro.)
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- 2022
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46. Indole-3-acetic acid correlates with monocyte-to-high-density lipoprotein (HDL) ratio (MHR) in chronic kidney disease patients.
- Author
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Cernaro V, Calabrese V, Loddo S, Corsaro R, Macaione V, Ferlazzo VT, Cigala RM, Crea F, De Stefano C, Gembillo G, Romeo A, Longhitano E, Santoro D, Buemi M, and Benvenga S
- Subjects
- Biomarkers metabolism, Cholesterol, HDL, Female, Humans, Indoleacetic Acids, Lipoproteins, HDL, Male, Monocytes, Cardiovascular Diseases etiology, Cardiovascular Diseases metabolism, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic metabolism
- Abstract
Purpose: Indole-3-acetic acid is a protein-bound indolic uremic toxin deriving from tryptophan metabolism. Increased levels are associated with higher thrombotic risk and both cardiovascular and all-cause mortality. An emerging biomarker of cardiovascular disease is the monocyte-to-high-density lipoprotein ratio (MHR). The main purpose of this study was to investigate the association of indole-3-acetic acid with MHR and other markers of cardiovascular risk in patients with chronic kidney disease (CKD)., Methods: We enrolled 61 non-dialysis CKD patients and 6 dialysis patients. Indole-3-acetic acid levels were measured with ELISA technique., Results: In the whole cohort of 67 patients, indole-3-acetic acid was directly related to Ca × P (ρ = 0.256; P = 0.0365) and MHR (ρ = 0.321; P = 0.0082). In the 40 patients with previous cardiovascular events, indole-3-acetic acid correlated with uric acid (r = 0.3952; P = 0.0116) and MHR (ρ = 0.380; P = 0.0157). MHR was related with fibrinogen (ρ = 0.426; P = 0.0010), arterial hypertension (ρ = 0.274; P = 0.0251), C-reactive protein (ρ = 0.332; P = 0.0061), gender (ρ = - 0.375; P = 0.0017; 0 = male, 1 = female), and CKD stage (ρ = 0.260; P = 0.0337). A multiple regression analysis suggested that indole-3-acetic acid might be an independent predictor of MHR., Conclusion: This study shows a significant association between indole-3-acetic acid and MHR. Prospective studies are required to evaluate if decreasing indole-3-acetic acid concentrations may reduce MHR levels and cardiovascular events and improve clinical outcomes., (© 2022. The Author(s), under exclusive licence to Springer Nature B.V.)
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- 2022
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47. Comparison between Creatinine Clearance and eGFRcyst-crea: a real-life experience.
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Calabrese V, Labbozzetta V, Lipari A, Labbozzetta V, Gembillo G, Cernaro V, Tripepi GL, and Santoro D
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- C-Reactive Protein, Creatinine, Cross-Sectional Studies, Humans, Procalcitonin, Renal Insufficiency, Chronic diagnosis
- Abstract
Introduction: The evaluation of renal function is computed using the estimated glomerular filtration rate methods or the measured glomerular filtration rate. Cystatin C has been well studied as marker of renal function compared to serum creatinine, but only few studies compare Glomerular Filtration Rates estimated including both creatinine and cystatin (eGFRcyst-crea) to creatinine clearance (CrCl). This cross-sectional study compares CrCl and eGFRcyst-crea with eGFRcrea and searches for correlation with comorbidities. Methods: This cross-sectional study consists of 78 patients hospitalized for acute and/or chronic renal disease. We performed the concordance correlation coefficient analysis between the eGFRcrea and the CrCl and eGFRcyst-crea in the whole sample and in the various subgroups. Results: Steiger's comparison of correlations from dependent samples showed a correlation coefficient between C-reactive protein and eGFRcyst-crea stronger than between C-reactive protein and CrCl (Z: 2.51, p=0.012). Similar results were showed with the association with procalcitonin (Z: 5.24, p<0.001), serum potassium (Z: -3.13, p=0.002), and severe CKD (Z: -2.54, p=0.011). The concordance correlation coefficient test showed major differences between diagnostic methods compared to eGFR-crea in diabetic subgroup, severe CKD, and in procalcitonin higher than 0.5ng/ml. Discussion: The demonstration of a strong concordance between the eGFRcrea and the eGFRcyst-crea allows us to diagnose and to stage CKD better than creatinine clearance in patients with high inflammatory status. Furthermore, this information opens new research scenarios, and further, larger studies are needed to confirm these hypotheses., (Copyright by Società Italiana di Nefrologia SIN, Rome,Italy.)
- Published
- 2022
48. Role of Zinc in Diabetic Kidney Disease.
- Author
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Gembillo G, Visconti L, Giuffrida AE, Labbozzetta V, Peritore L, Lipari A, Calabrese V, Piccoli GB, Torreggiani M, Siligato R, and Santoro D
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- Humans, Insulin, Kidney, Zinc therapeutic use, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Diabetic Nephropathies, Kidney Failure, Chronic complications
- Abstract
Diabetic Kidney Disease (DKD) represents the most common cause of Chronic Kidney Disease (CKD) in developed countries. Approximately 30% to 40% of diabetes mellitus (DM) subjects develop DKD, and its presence significantly increases the risk for morbidity and mortality. In this context, Zinc seems to have a potential role in kidney and body homeostasis in diabetic individuals as well as in patients at a high risk of developing this condition. This essential element has functions that may counteract diabetes-related risk factors and complications, which include stabilization of insulin hexamers and pancreatic insulin storage and improved glycemic control. In our review, we analyzed the current knowledge on the role of zinc in the management of renal impairment in course of DM. Several studies underline the critical role of zinc in reducing oxidative stress levels, which is considered the common denominator of the mechanisms responsible for the progression of kidney disease. Reaching and maintaining a proper serum zinc level could represent a valuable target to reduce symptoms related to DM complications and contrast the progression of kidney impairment in patients with the high risk of developing end-stage renal disease. In conclusion, analyzing the beneficial role of zinc in this review would advance our knowledge on the possible strategies of DM and DKD treatment.
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- 2022
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49. Gender differences in new hypoglycemic drug effects on renal outcomes: a systematic review.
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Gembillo G, Cernaro V, Giuffrida AE, Russo G, Giandalia A, Siligato R, Longhitano E, and Santoro D
- Subjects
- Female, Glucagon-Like Peptide-1 Receptor, Humans, Hypoglycemic Agents adverse effects, Male, Sex Characteristics, Sex Factors, Diabetes Mellitus, Type 2 complications, Diabetes Mellitus, Type 2 drug therapy, Diabetes Mellitus, Type 2 epidemiology, Dipeptidyl-Peptidase IV Inhibitors adverse effects, Sodium-Glucose Transporter 2 Inhibitors pharmacology, Sodium-Glucose Transporter 2 Inhibitors therapeutic use
- Abstract
Introduction: Lifetime diabetes risk is greater in women than in men. Women with diabetes mellitus (DM) have a greater prevalence of diabetic kidney disease (DKD) risk factors. The diagnosis of DM is often delayed in women, with poorer outcomes and with expected therapeutic goals missed., Area Covered: A systematic literature review following PRISMA guidelines was conducted in the PubMed gateway of the MEDLINE database and Clinicaltrials.gov. The purpose of our research was to establish the sex differences on renal outcomes in users of the new hypoglycemic drugs: sodium-glucose transport protein 2 inhibitors (SGLT-2i), dipeptidyl peptidase-IV Inhibitors (DPP-IVi) and glucagon-like peptide-1 inhibitors (GLP-1i)., Expert Opinion: New hypoglycemic drugs represent promising tools in the treatment and prevention of severe complications of diabetes, cardiovascular diseases and chronic kidney disease. Even if renal outcomes are investigated in both randomized controlled trials and cardiovascular outcome trials, gender-based analysis is not always performed. Our systematic review demonstrated that the gap among sexes in DKD can be partially filled using new hypoglycemic drugs. Sexual dimorphism analysis could represent a keystone for the development of adequate gender-specific therapies.
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- 2022
- Full Text
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50. Monocyte to HDL ratio: a novel marker of resistant hypertension in CKD patients.
- Author
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Gembillo G, Siligato R, Cernaro V, Satta E, Conti G, Salvo A, Romeo A, Calabrese V, Sposito G, Ferlazzo G, and Santoro D
- Subjects
- Aged, Aged, 80 and over, Biomarkers blood, Coronary Vasospasm complications, Female, Humans, Hypertension complications, Male, Middle Aged, Renal Insufficiency, Chronic complications, Retrospective Studies, Cholesterol, HDL blood, Coronary Vasospasm blood, Hypertension blood, Monocytes, Renal Insufficiency, Chronic blood
- Abstract
Background: Inflammation, oxidative stress (OS), atherosclerosis and resistant hypertension (RH) are common features of chronic kidney disease (CKD) leading to a higher risk of death from cardiovascular disease. These effects seem to be modulated by impaired anti-oxidant, anti-inflammatory and reverse cholesterol transport actions of high-density lipoprotein cholesterol (HDL). HDL prevents and reverses monocyte recruitment and activation into the arterial wall and impairs endothelial adhesion molecule expression. Recently, monocyte count to HDL-cholesterol ratio (MHR) has emerged as a potential marker of inflammation and OS, demonstrating to be relevant in CKD. Our research was aimed to assess, for the first time, its reliability in RH., Methods: We performed a retrospective study on 214 patients with CKD and arterial hypertension who were admitted between January and June 2019 to our Department, 72 of whom were diagnosed with RH., Results: MHR appeared inversely related to eGFR (ρ = - 0.163; P = 0.0172). MHR was significantly higher among RH patients compared to non-RH ones (12.39 [IQR 10.67-16.05] versus 7.30 [5.49-9.06]; P < 0.0001). Moreover, MHR was significantly different according to the number of anti-hypertensive drugs per patient in the whole study cohort (F = 46.723; P < 0.001) as well as in the non-RH group (F = 14.191; P < 0.001). Moreover, MHR positively correlates with diabetes mellitus (ρ = 0.253; P = 0.0002), white blood cells (ρ = 0.664; P < 0.0001) and C-reactive protein (ρ = 0.563; P < 0.0001)., Conclusions: MHR may be a reliable biomarker due to the connection between HDL and monocytes. Our study suggests that MHR is linked with the use of multiple anti-hypertensive therapy and resistant hypertension in CKD patients, and can be a useful ratio to implement appropriate treatment strategies., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)
- Published
- 2022
- Full Text
- View/download PDF
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