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1. New-onset anemia and associated risk of ESKD and death in non-dialysis CKD patients: A multicohort observational study

Author

Minutolo, R., Provenzano, M., Chiodini, P., Borrelli, S., Garofalo, C., Andreucci, M., Liberti, M. E., Bellizzi, V., Conte, G., De Nicola, L., Zamboli, P., Iodice, F. C., Signoriello, S., Gallo, C., Cianciaruso, B., Pota, A., Nappi, F., Avella, F., Di Iorio, B. R., Cestaro, R., Martignetti, V., Morrone, L., Lupo, A., Abaterusso, C., Donadio, C., Bonomini, M., Sirolli, V., Casino, F., Lopez, T., Detomaso, F., Giannattasio, M., Virgilio, M., Tarantino, G., Cristofano, C., Tuccillo, S., Chimienti, S., Petrarulo, F., Giancaspro, V., Strippoli, M., Laraia, E., Gallucci, M., Gigante, B., Lodeserto, C., Santese, D., Montanaro, A., Giordano, R., Caglioti, A., Fuiano, G., Zoccali, C., Caridi, G., Postorino, M., Savica, V., Monardo, P., Bellinghieri, G., Santoro, D., Castellino, P., Rapisarda, F., Fatuzzo, P., Messina, A., Dal Canton, A., Esposito, V., Formica, M., Segoloni, G., Gallieni, M., Locatelli, F., Tarchini, R., Meneghel, G., Oldrizzi, L., Cossu, M., Di Giulio, S., Malaguti, M., Pizzarelli, F., Quintaliani, G., Pisani, A., Bonofiglio, R., Grandaliano, Giuseppe, Russo, D., Di Micco, L., Torraca, S., Sabbatini, M., Grandaliano G. (ORCID:0000-0003-1213-2177), Minutolo, R., Provenzano, M., Chiodini, P., Borrelli, S., Garofalo, C., Andreucci, M., Liberti, M. E., Bellizzi, V., Conte, G., De Nicola, L., Zamboli, P., Iodice, F. C., Signoriello, S., Gallo, C., Cianciaruso, B., Pota, A., Nappi, F., Avella, F., Di Iorio, B. R., Cestaro, R., Martignetti, V., Morrone, L., Lupo, A., Abaterusso, C., Donadio, C., Bonomini, M., Sirolli, V., Casino, F., Lopez, T., Detomaso, F., Giannattasio, M., Virgilio, M., Tarantino, G., Cristofano, C., Tuccillo, S., Chimienti, S., Petrarulo, F., Giancaspro, V., Strippoli, M., Laraia, E., Gallucci, M., Gigante, B., Lodeserto, C., Santese, D., Montanaro, A., Giordano, R., Caglioti, A., Fuiano, G., Zoccali, C., Caridi, G., Postorino, M., Savica, V., Monardo, P., Bellinghieri, G., Santoro, D., Castellino, P., Rapisarda, F., Fatuzzo, P., Messina, A., Dal Canton, A., Esposito, V., Formica, M., Segoloni, G., Gallieni, M., Locatelli, F., Tarchini, R., Meneghel, G., Oldrizzi, L., Cossu, M., Di Giulio, S., Malaguti, M., Pizzarelli, F., Quintaliani, G., Pisani, A., Bonofiglio, R., Grandaliano, Giuseppe, Russo, D., Di Micco, L., Torraca, S., Sabbatini, M., and Grandaliano G. (ORCID:0000-0003-1213-2177)

Abstract

Background: Anemia is a common complication of chronic kidney disease (CKD), but its incidence in nephrology settings is poorly investigated. Similarly, the risks of adverse outcomes associated with new-onset anemia are not known. Methods: We performed a pooled analysis of three observational cohort studies including 1031 non-anemic CKD patients with eGFR <60 mL/min/1.73 m2 regularly followed in renal clinics. We estimated the incidence of mild anemia (hemoglobin 11-12 g/dL in women and 11-13 g/dL in men) and severe anemia (hemoglobin <11 g/dL or use of erythropoiesis-stimulating agents) during a 3-year follow-up period. Thereafter we estimated the risk of end-stage kidney disease (ESKD) and all-cause death associated with new-onset mild and severe anemia. Results: The mean age was 63 ± 14 years, 60% were men and 20% had diabetes. The mean estimated glomerular filtration rate (eGFR) was 37 ± 13 mL/min/1.73 m2 and the median proteinuria was 0.4 g/day [interquartile range (IQR) 0.1-1.1]. The incidence of mild and severe anemia was 13.7/100 patients-year and 6.2/100 patients-year, respectively. Basal predictors of either mild or severe anemia were diabetes, lower hemoglobin, higher serum phosphate, eGFR <30 mL/min/1.73 m2 and proteinuria >0.50 g/day. Male sex, moderate CKD (eGFR 30-44 mL/min/1.73 m2) and moderate proteinuria (0.15-0.50 g/day) predicted only mild anemia. The incidence of anemia increased progressively with CKD stages (from 8.77 to 76.59/100 patients-year) and the proteinuria category (from 13.99 to 25.02/100 patients-year). During a median follow-up of 3.1 years, 232 patients reached ESKD and 135 died. Compared with non-anemic patients, mild anemia was associated with a higher adjusted risk of ESKD {hazard ratio [HR] 1.42 [95% confidence interval (CI) 1.02-1.98]} and all-cause death [HR 1.55 (95% CI 1.04-2.32)]. Severe anemia was associated with an even higher risk of ESKD [HR 1.73 (95% CI 1.20-2.51)] and death [HR 1.83 (95% CI 1.05-3.19)].

Published
2022

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

Author

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

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

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

Published
2021

6. 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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7. Italian randomized trial of hemoglobin maintenance to prevent or delay left ventricular hypertrophy in chronic kidney disease

Author

Cianciaruso B, Ravani P, Barrett BJ, Levin A, ITA EPO 7 i.n.v.e.s.t.i.g.a.t.o.r.s. Torraca S, Procaccini DA, Isola E, Villa G, De Ferrari G, Civati G, Meneghel G, Spotti P, Bonomini M, Colasanti G, Paoletti E, Del Rosso G, Ambroso G, Amato M, Pedrini L, Del Vecchio L, Marcantoni C, Pizzarelli F, Raimondi A, Jeantet A, Fagugli R, Rotolo U, Grassi C, Andreucci VE, Locatelli F, Maschio G, Piccoli A, Ponticelli C, Zoccali C., STEFONI, SERGIO, SANTORO, ANTONIO, Cianciaruso, Bruno, Ravani, P, Barrett, Bj, Levin, A, ITA EPO 7, i. n. v. e. s. t. i. g. a. t. o. r. s., Cianciaruso B, Ravani P, Barrett BJ, Levin A, ITA-EPO-7 investigators. Torraca S, Procaccini DA, Isola E, Villa G, Stefoni S, Santoro A, De Ferrari G, Civati G, Meneghel G, Spotti P, Bonomini M, Colasanti G, Paoletti E, Del Rosso G, Ambroso G, Amato M, Pedrini L, Del Vecchio L, Marcantoni C, Pizzarelli F, Raimondi A, Jeantet A, Fagugli R, Rotolo U, Grassi C, Andreucci VE, Locatelli F, Maschio G, Piccoli A, Ponticelli C, and Zoccali C.

Subjects
Male, Time Factors, Dose-Response Relationship, Drug, Heart Ventricles, Injections, Subcutaneous, Anemia, Middle Aged, Recombinant Proteins, Epoetin Alfa, Hemoglobins, Treatment Outcome, Erythropoyesis Stimulating Agent, Italy, Echocardiography, Hematinics, Humans, Kidney Failure, Chronic, Female, Hypertrophy, Left Ventricular, Chronic kidney Disease, Erythropoietin, Follow-Up Studies, Retrospective Studies
Abstract

BACKGROUND: This study is part of a 3-country study testing whether normal levels of hemoglobin (Hgb) delay the progression of left ventricular (LV) growth in chronic kidney disease (CKD) patients not on dialysis. METHODS: This was an open-label, randomized, multicenter, controlled trial conducted in 27 tertiary-care hospitals in Italy. Treated subjects (n=46) received epoetin-alpha (EPO-alpha) to maintain Hgb levels in the range 12-14 g/dL. Control subjects (n=49) were not treated unless their Hgb decreased to 9.0 g/dL. Primary outcome was LV mass index (MI) change after 24 months. Subcutaneous EPO-alpha was withdrawn in Europe and the study prematurely terminated; therefore, a 12-month analysis was carried out. RESULTS: Mean age was 57 years (38% were women, 18% with diabetes, 76% taking ACEI or ARB and 22% statins). EPO-alpha median final dose was 2,000 IU/week. Hgb significantly increased (12.4 -/+ 1.1 g/L) for the treatment group and decreased for controls (11.3 -/+ 1.3 g/L; p

Published
2008

8. Management of CKD-MBD in non-dialysis patients under regular nephrology care: a prospective multicenter study

Author

Gallieni, M., De Luca, N., Santoro, D., Meneghel, G., Formica, M., Grandaliano, Giuseppe, Pizzarelli, F., Cossu, M., Segoloni, G., Quintaliani, G., Di Giulio, S., Pisani, A., Malaguti, M., Marseglia, C., Oldrizzi, L., Pacilio, M., Conte, G., Dal Canton, A., Minutolo, R., Grandaliano G. (ORCID:0000-0003-1213-2177), Gallieni, M., De Luca, N., Santoro, D., Meneghel, G., Formica, M., Grandaliano, Giuseppe, Pizzarelli, F., Cossu, M., Segoloni, G., Quintaliani, G., Di Giulio, S., Pisani, A., Malaguti, M., Marseglia, C., Oldrizzi, L., Pacilio, M., Conte, G., Dal Canton, A., Minutolo, R., and Grandaliano G. (ORCID:0000-0003-1213-2177)

Abstract

Background: Knowledge about mineral bone disorder (MBD) management in non-dialysis chronic kidney disease (ND-CKD) patients is scarce, although essential to identifying areas for therapeutic improvement. Methods: We prospectively evaluated current management of CKD-MBD in two visits, performed 6 months apart, in 727 prevalent ND-CKD stage 3b–5 patients from 19 nephrology clinics. Therapeutic inertia was defined as lack of treatment despite hyperphosphatemia and/or hypocalcemia, and/or hyperparathyroidism. The primary endpoint was the prevalence of achieved target for CKD-MBD parameters and related treatments (phosphate binders, vitamin D and calcium supplements). The secondary endpoint was the assessment of prevalence and clinical correlates of therapeutic inertia. Results: Over 65 % of patients did not reach parathormone (PTH) targets, while 15 and 19 % did not reach phosphate and calcium targets, respectively. The proportion of untreated patients decreased from stage 3b to 5 (at baseline, from 60 to 16 %, respectively). From baseline to the 6-month visit, the achievement of targets remained stable. Low protein diet was prescribed in 26 % of patients, phosphate binders in 17.3 % (calcium-based binders 15.5 %, aluminium binders 1.8 %), and vitamin D in 50.5 %. The overall prevalence of therapeutic inertia at the 6-month visit was 34.0 % (for hyperphosphatemia, 54.3 %). Compared to CKD stage 3, the likelihood of therapeutic inertia was 40 and 68 % lower at stage 4 and 5, respectively. Conclusions: PTH, calcium and phosphate targets were not reached in a significant proportion of patients. One-third of patients with at least one MBD parameter not-at-target remained untreated. Therapeutic inertia regarding CKD-MBD treatment may be a major barrier to optimizing the prevention and cure of CKD-MBD.

Published
2016

9. Anaemia management in non-dialysis chronic kidney disease (CKD) patients: a multicentre prospective study in renal clinics

Author

Dal Canton, ., Esposito, V., Formica, M., Segoloni, G., Gallieni, M., Locatelli, F., Tarchini, R., Meneghel, G., Oldrizzi, L., Cossu, M., Di Giulio, S., Malaguti, M., Pizzarelli, F., Quintaliani, G., Cianciaruso, B., Pisani, A., Conte, G., De Nicola, L., Minutolo, R., Bonofiglio, R., Fuiano, G., Grandaliano, G., Bellinghieri, Guido, Santoro, Domenico, Minutolo, Roberto, Locatelli, F, Gallieni, M, Bonofiglio, R, Fuiano, G, Oldrizzi, L, Conte, Giuseppe, DE NICOLA, Luca, Mangione, F, Esposito, P, Dal Canton, A, and REport of COmorbidities in non Dialysis Renal Disease Population in Italy Study, Group

Subjects
Nephrology, Male, medicine.medical_specialty, Anemia, medicine.medical_treatment, Iron, Renal function, Hemoglobins, Renal Dialysis, hemic and lymphatic diseases, Internal medicine, medicine, Clinical endpoint, Prevalence, Humans, Prospective Studies, Renal Insufficiency, Chronic, Erythropoietin, Aged, Transplantation, Transferrin saturation, business.industry, Iron deficiency, medicine.disease, Italy, Dietary Supplements, Ferritins, Female, Hemodialysis, business, Kidney disease
Abstract

Background: Knowledge on anaemia management in non-dialysis chronic kidney disease (ND-CKD) patients regularly followed in renal clinics is scarce although being essential to identifying areas of therapeutic improvement. Methods: We prospectively evaluated anaemia management in two visits, performed 6 months apart, in 755 prevalent ND-CKD stage 3b-5 patients followed in 19 nephrology clinics from ≥6 months. Anaemia was defined as severe (Hb

Published
2013

11. Prevalence of CKD in northeastern Italy: results of the INCIPE study and comparison with NHANES

Author

Gambaro, G., Yabarek, T., Graziani, Mariastella, Gemelli, A., Abaterusso, Cataldo, Frigo, A. C., Marchionna, N., Citron, L., Bonfante, L., Grigoletto, F., Tata, S., Ferraro, P. M., Legnaro, . A., Meneghel, G., Conz, P., Rizzotti, P., D'Angelo, A., Lupo, Antonio, and INCIPE Study Group

Subjects
Male, Gerontology, renal failure, Time Factors, genetic structures, Epidemiology, Kidney, urologic and male genital diseases, Critical Care and Intensive Care Medicine, Severity of Illness Index, chemistry.chemical_compound, Risk Factors, CKD, prevalence, italian population, nhanes, Odds Ratio, Settore MED/14 - NEFROLOGIA, Caucasian population, Aged, 80 and over, Middle Aged, female genital diseases and pregnancy complications, Italy, Nephrology, Creatinine, Female, Kidney Diseases, medicine.symptom, Risk assessment, Glomerular Filtration Rate, Adult, medicine.medical_specialty, Renal function, Risk Assessment, White People, Severity of illness, medicine, Albuminuria, Humans, Aged, Transplantation, business.industry, Original Articles, Health Status Disparities, Odds ratio, Health Surveys, United States, Logistic Models, chemistry, Chronic Disease, business, Biomarkers, Demography
Abstract

Background and objectives: Sufficiently powered studies to investigate the CKD prevalence are few and do not cover southern Europe. Design, setting, participants, & measurements: For the INCIPE study, 6200 Caucasian patients >40 years old were randomly selected in northeastern Italy in 2006. Laboratory determinations were centralized. The albumin to creatinine ratio in urine and estimated GFR from calibrated creatinine (SCr) were determined. A comparison with 2001 through 2006 NHANES surveys was performed. Results: Prevalence of CKD was 13.2% in northeastern (NE) Italy (age and gender standardized to the U.S. 2007 Caucasian population). Prevalence of CKD in U.S. Caucasians is higher (20.3%), the major difference being in CKD 3. Risk factors for CKD are more prevalent in the United States than in Italy. With use of CKD 3a and 3b stages, CKD prevalence decreased in NE Italy (8.5%) and in the United States (12.8%). Conclusions: The prevalence of CKD is high in NE Italy, but lower than that in the United States. A large part of the difference in CKD prevalence in NE Italy versus that in the United States is due to the different prevalence of CKD 3. The higher prevalence of a number of renal risk factors in persons from the United States explains in part the different dimensions of the CKD problem in the two populations. Clin J Am Soc Nephrol 5: 1946–1953, 2010. doi: 10.2215/CJN.02400310

Published
2010

12. Effect of computer-assisted European Best Practice Guideline implementation on adherence and target attainment: ORAMA results

Author

Covic, A, Locatelli, F, Macdougall, Ic, Wiecek, A, Shikov, P, Nikolov, D, Deliyska, B, Paskalev, D, Simeonov, P, Belavic, Z, Jerko, B, Leko, N, Bogadi, I, Winkler, Re, Buhl, M, Wilbrandt, E, Edinger, M, Mall, M, Dammerboer, C, Urzowski, H, Flender, D, Kunowski, G, Müller, A, Anschütz, H, Prager, G, Lüth, Jb, Gaspare De Santo, N, Lodeserto, C, Bonomini, M, Meneghel, G, Ragaiolo, M, Cancarini, Giovanni, Rotolo, U, Zepa, L, Saumane Baza, G, Rivots, G, Rozentals, R, Rydzewski, A, Antczak Jedrzejczak, D, Ratajewski, W, Frankiewicz, D, Mazur, O, Grazyna, B, Kosicki, A, Sydor, A, Muszytowski, M, Mircescu, G, Mugosa Ratkovic, M, Pljesa, S, Nesic, V, Dimkovic, N, Curic, S, Lazarevic, M, and Kovacevic, Z.

Subjects
hemodialysis, erhythropoietin, anemia
Published
2009

13. Renal anemia: comparing current Eastern and Western European management practice (ORAMA)

Author

Wiecek, A, Covic, A, Locatelli, F, Macdougall, Ic, ORAMA STUDY GROUP, COLLABORATORS SHIKOV, P, Nikolov, D, Deliyska, B, Paskalev, D, Simeonov, P, Belavic, Z, Jerko, B, Leko, N, Bogadi, I, Winkler, Re, Buhl, M, Wilbrandt, E, Edinger, M, Mall, M, Dammerboer, C, Urzowski, H, Flender, D, Kunowski, G, Müller, A, Anschütz, H, Prager, G, Johann, Borwin, DE SANTO NG, Lodeserto, C, Bonomini, M, Meneghel, G, Ragaiolo, M, Cancarini, Giovanni, Rotolo, U, Zepa, L, SAUMANE BAZA, G, Ritovs, G, Rozentals, R, Rydzewski, A, ANTCZAK JEDRZEJCZAK, D, Ratajewski, W, Frankiewicz, D, Mazur, O, Grazyna, B, Andrezej, K, Antoni, S, Marek, M, Mircescu, G, Ratkovic, Mm, Pljesa, S, Nesic, V, Dimkovic, N, Curic, S, Lazarevic, M, and Kovacevic, Z.

Subjects
malattia renale cronica, anemia, chronic kidney disease
Published
2008

15. ORAMA: a study to investigate EBPG impact on renal anaemia - design and baseline data

Author

Locatelli, F, Covic, A, Macdougall, Ic, Wiecek, A, ORAMA STUDY GROUP, COLLABORATORS COVIC, A, Shikov, P, Nikolov, D, Deliyska, B, Paskalev, D, Simeonov, P, Belavic, Z, Jerko, B, Leko, N, Winkler, Re, Buhi, M, Wilbrandt, E, Edinger, M, Mall, M, Dammerboer, C, Urzowski, H, Flender, D, Kunowski, G, Müller, A, Anschütz, H, Prager, G, DE SANTO NG, Lodeserto, C, Bonomini, M, Meneghel, G, Ragaiolo, M, Cancarini, Giovanni, Rotolo, U, Zepa, L, SAUMANE BAZA, G, Ritovs, G, Rosentals, R, Rydzewski, A, ANTCZAK JEDRZEJCZAK, D, Ratajewski, W, Frankiewicz, D, Mazur, O, Bogdanowicz, G, Kosicki, A, Sydor, A, Muszytowski, M, Mircescu, G, Ratkovic, Mm, Pljesa, S, Nesic, V, Dimkovic, N, Curic, S, Lazarevic, M, and Kovacevic, Z.

Subjects
anemia, dialysis, erhythropoietin
Published
2008

18. Update of the Italian Society of Nephrology Project No. 1 of the 2004-2006 SIN programme

Author

Manno, C, Virgilio, M, Giangrande, A, Stalteri, A, Contu, B, Quintaliani, G, Spinelli, C, Avella, F, Cappelli, Gianni, Casino, F, Cicchetti, T, DI GIULIO, S, DI LUCA, M, Meneghel, G, Milone, F, Moriconi, L, Panzetta, Go, Procaccini, Ad, Triolo, G, Zoccali, C, and Accreditamento, COMMITTEE QUALITA E.

Subjects
Quality Control, Italian Society of Nephrology, patient satisfaction, Italy, Nephrology, Renal Dialysis, Surveys and Questionnaires, Humans, Kidney Transplantation, Accreditation
Abstract

In the last few years the Italian Society of Nephrology has addressed many technical-scientific and management aspects to better patient satisfaction. Project No. 1 of the 2004-2006 programme on 'Quality and Accreditation of National Renal Units' focuses on four essential points. The first is the questionnaire mailed to all the Presidents and Regional Delegates on the relationship between Nephrology units, Local Government Health-System and the Regional Healthcare Agency. The results evidence that the 'political' decision-making power of nephrologists decreases in the absence of a national strategy. The second point, in collaboration with the National Census Group, includes the quality analysis and the standardization of resources (human and structural) and management of the Renal Units. The third point is based on 'Educational Courses for Quality and Accreditation' held in Rome (3-5 October 2005: L'Accreditamento all'Eccellenza dell'Unita' Operativa di Nefrologia, Dialisi e Trapianto; 17-19 October 2005: Il Manuale di Accreditamento della Specialità di Nefrologia). The courses aim at training members responsible for each region to hold courses in their specific region to create a network including each single Renal Unit to create an acceptable homogenous language on the models of analysis and on the correct use of 'The Guide for Excellence Accreditation'. The fourth point concerns both the on-line Guide for Excellence Accreditation and 'Peer Review Accreditation' and the NEQUASY (Nephrology Quality System) project. The manual must be 'user friendly' allowing each Centre to self-evaluate using national and regional standards.

Published
2006

22. PREVALENCE OF CKD IN NORTHEASTERN ITALY: RESULTS OF THE INCIPE STUDY AND COMPARISON WITH NHANES.

Author

Gambaro, Giovanni, Yabarek, T, Graziani, M, Gemelli, A, Abaterusso, C, Frigo, Ac, Marchionna, N, Citron, L, Bonfante, L, Grigoletto, F, Tata, S, Ferraro, Pietro Manuel, Legnaro, A, Meneghel, G, Conz, P, Rizzotti, P, D'Angelo, A, Lupo, A., Gambaro, Giovanni (ORCID:0000-0001-5733-2370), Ferraro, Pietro Manuel (ORCID:0000-0002-1379-022X), Gambaro, Giovanni, Yabarek, T, Graziani, M, Gemelli, A, Abaterusso, C, Frigo, Ac, Marchionna, N, Citron, L, Bonfante, L, Grigoletto, F, Tata, S, Ferraro, Pietro Manuel, Legnaro, A, Meneghel, G, Conz, P, Rizzotti, P, D'Angelo, A, Lupo, A., Gambaro, Giovanni (ORCID:0000-0001-5733-2370), and Ferraro, Pietro Manuel (ORCID:0000-0002-1379-022X)

Abstract

BACKGROUND AND OBJECTIVES: Sufficiently powered studies to investigate the CKD prevalence are few and do not cover southern Europe. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: For the INCIPE study, 6200 Caucasian patients ≥40 years old were randomly selected in northeastern Italy in 2006. Laboratory determinations were centralized. The albumin to creatinine ratio in urine and estimated GFR from calibrated creatinine (SCr) were determined. A comparison with 2001 through 2006 NHANES surveys was performed. RESULTS: Prevalence of CKD was 13.2% in northeastern (NE) Italy (age and gender standardized to the U.S. 2007 Caucasian population). Prevalence of CKD in U.S. Caucasians is higher (20.3%), the major difference being in CKD 3. Risk factors for CKD are more prevalent in the United States than in Italy. With use of CKD 3a and 3b stages, CKD prevalence decreased in NE Italy (8.5%) and in the United States (12.8%). CONCLUSIONS: The prevalence of CKD is high in NE Italy, but lower than that in the United States. A large part of the difference in CKD prevalence in NE Italy versus that in the United States is due to the different prevalence of CKD 3. The higher prevalence of a number of renal risk factors in persons from the United States explains in part the different dimensions of the CKD problem in the two populations.

Published
2010

27. Prevention of dialysis hypotension episodes using fuzzy logic control system

Author

Mancini, E., primary, Mambelli, E., additional, Irpinia, M., additional, Gabrielli, D., additional, Cascone, C., additional, Conte, F., additional, Meneghel, G., additional, Cavatorta, F., additional, Antonelli, A., additional, Villa, G., additional, Dal Canton, A., additional, Cagnoli, L., additional, Aucella, F., additional, Fiorini, F., additional, Gaggiotti, E., additional, Triolo, G., additional, Nuzzo, V., additional, and Santoro, A., additional

Published
2007
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29. Update of the Italian Society of Nephrology Project No. 1 of the 2004-2006 SIN programme,Update sul progetto SIN n. 1 del programma SIN 2004-2006: qualità e accreditamento delle strutture di nefrologia, dialisi e trapianto

Author

Manno, C., Virgilio, M., Giangrande, A., Stalteri, A., Contu, B., Quintaliani, G., Spinelli, C., Avella, F., Cappelli, G., FRANCESCO CASINO, Cicchetti, T., Di Giulio, S., Di Luca, M., Meneghel, G., Milone, F., Moriconi, L., Panzetta, G. O., Procaccini, A. D., Triolo, G., and Zoccali, C.

32. Management of CKD-MBD in non-dialysis patients under regular nephrology care: a prospective multicenter study

Author

Francesco Pizzarelli, Roberto Minutolo, Moreno Malaguti, Mario Pacilio, Maria Laura Cossu, L. Oldrizzi, Nicola de Luca, Giuseppe Conte, Giuseppe Grandaliano, Maurizio Gallieni, Antonio Dal Canton, Antonio Pisani, Cosimo Marseglia, Domenico Santoro, Giuseppe Paolo Segoloni, Marco Formica, Gina Meneghel, Salvatore Di Giulio, Giuseppe Quintaliani, Gallieni, M, DE NICOLA, Luca, Santoro, D, Meneghel, G, Formica, M, Grandaliano, G, Pizzarelli, F, Cossu, M, Segoloni, G, Quintaliani, G, Di Giulio, S, Pisani, A, Malaguti, M, Marseglia, C, Oldrizzi, L, Pacilio, M, Conte, Giuseppe, Dal Canton, A, Minutolo, Roberto, De Luca, Nicola, Conte, G, and Minutolo, R2.

Subjects
Nephrology, Male, Time Factors, medicine.medical_treatment, 030232 urology & nephrology, 030204 cardiovascular system & hematology, Hyperphosphatemia, 0302 clinical medicine, Chronic kidney disease, 80 and over, Clinical endpoint, Settore MED/14 - NEFROLOGIA, Renal Insufficiency, Prospective Studies, Chronic, Vitamin D, Chelating Agents, Aged, 80 and over, Middle Aged, Treatment Outcome, Italy, Parathyroid Hormone, Practice Guidelines as Topic, Female, Bone Diseases, PTH, medicine.medical_specialty, Therapeutic inertia, Phosphate, Protein-Restricted, Phosphates, 03 medical and health sciences, Calcium, Treatment, Aged, Biomarkers, Bone Diseases, Metabolic, Diet, Protein-Restricted, Humans, Renal Insufficiency, Chronic, Dietary Supplements, Low-protein diet, Internal medicine, medicine, Vitamin D and neurology, Hyperparathyroidism, business.industry, medicine.disease, Diet, Endocrinology, Metabolic, business, Kidney disease
Abstract

Knowledge about mineral bone disorder (MBD) management in non-dialysis chronic kidney disease (ND-CKD) patients is scarce, although essential to identifying areas for therapeutic improvement. We prospectively evaluated current management of CKD-MBD in two visits, performed 6 months apart, in 727 prevalent ND-CKD stage 3b–5 patients from 19 nephrology clinics. Therapeutic inertia was defined as lack of treatment despite hyperphosphatemia and/or hypocalcemia, and/or hyperparathyroidism. The primary endpoint was the prevalence of achieved target for CKD-MBD parameters and related treatments (phosphate binders, vitamin D and calcium supplements). The secondary endpoint was the assessment of prevalence and clinical correlates of therapeutic inertia. Over 65 % of patients did not reach parathormone (PTH) targets, while 15 and 19 % did not reach phosphate and calcium targets, respectively. The proportion of untreated patients decreased from stage 3b to 5 (at baseline, from 60 to 16 %, respectively). From baseline to the 6-month visit, the achievement of targets remained stable. Low protein diet was prescribed in 26 % of patients, phosphate binders in 17.3 % (calcium-based binders 15.5 %, aluminium binders 1.8 %), and vitamin D in 50.5 %. The overall prevalence of therapeutic inertia at the 6-month visit was 34.0 % (for hyperphosphatemia, 54.3 %). Compared to CKD stage 3, the likelihood of therapeutic inertia was 40 and 68 % lower at stage 4 and 5, respectively. PTH, calcium and phosphate targets were not reached in a significant proportion of patients. One-third of patients with at least one MBD parameter not-at-target remained untreated. Therapeutic inertia regarding CKD-MBD treatment may be a major barrier to optimizing the prevention and cure of CKD-MBD.

Published
2015

34. Reducing salt intake by urine chloride self-measurement in non-compliant patients with chronic kidney disease followed in nephrology clinics: a randomized trial.

Author

Panuccio V, Mallamaci F, Pizzini P, Tripepi R, Garofalo C, Parlongo G, Caridi G, Provenzano M, Mafrica A, Simone G, Cutrupi S, D'Arrigo G, Porto G, Tripepi G, Nardellotto A, Meneghel G, Dattolo P, Pizzarelli F, Rapisarda F, Ricchiuto A, Fatuzzo P, Verdesca S, Gallieni M, Gesualdo L, Conte G, Plebani M, and Zoccali C

Abstract

Background: Adherence to low salt diets and control of hypertension remain unmet clinical needs in chronic kidney disease (CKD) patients., Methods: We performed a 6-month multicentre randomized trial in non-compliant patients with CKD followed in nephrology clinics testing the effect of self-measurement of urinary chloride (69 patients) as compared with standard care (69 patients) on two primary outcome measures, adherence to a low sodium (Na) diet (<100 mmol/day) as measured by 24-h urine Na (UNa) excretion and 24-h ambulatory blood pressure (ABPM) monitoring., Results: In the whole sample (N = 138), baseline UNa and 24-h ABPM were143 ± 64 mmol/24 h and 131 ± 18/72 ± 10 mmHg, respectively, and did not differ between the two study arms. Patients in the active arm of the trial used >80% of the chloride strips provided to them at the baseline visit and at follow-up visits. At the third month, UNa was 35 mmol/24 h (95% CI 10.8-58.8 mmol/24 h; P = 0.005) lower in the active arm than the control arm, whereas at 6 months the between-arms difference in UNa decreased and was no longer significant [23 mmol/24 h (95% CI -5.6-50.7); P = 0.11]. The 24-h ABPM changes as well as daytime and night-time BP changes at 3 and 6 months were similar in the two study arms (Month 3, P = 0.69-0.99; Month 6, P = 0.73-0.91). Office BP, the use of antihypertensive drugs, estimated Glomerular Filtration Rate (eGFR) and proteinuria remained unchanged across the trial., Conclusions: The application of self-measurement of urinary chloride to guide adherence to a low salt diet had a modest effect on 24-h UNa and no significant effect on 24-h ABPM., (© The Author(s) 2020. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

Published
2020
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35. Management of CKD-MBD in non-dialysis patients under regular nephrology care: a prospective multicenter study.

Author

Gallieni M, De Luca N, Santoro D, Meneghel G, Formica M, Grandaliano G, Pizzarelli F, Cossu M, Segoloni G, Quintaliani G, Di Giulio S, Pisani A, Malaguti M, Marseglia C, Oldrizzi L, Pacilio M, Conte G, Dal Canton A, and Minutolo R

Subjects
Aged, Aged, 80 and over, Biomarkers blood, Bone Diseases, Metabolic blood, Bone Diseases, Metabolic diagnosis, Bone Diseases, Metabolic etiology, Calcium blood, Diet, Protein-Restricted, Female, Humans, Italy, Male, Middle Aged, Parathyroid Hormone blood, Phosphates blood, Practice Guidelines as Topic, Prospective Studies, Renal Insufficiency, Chronic blood, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic diagnosis, Time Factors, Treatment Outcome, Vitamin D blood, Bone Diseases, Metabolic drug therapy, Calcium therapeutic use, Chelating Agents therapeutic use, Dietary Supplements, Nephrology, Renal Insufficiency, Chronic therapy, Vitamin D therapeutic use
Abstract

Background: Knowledge about mineral bone disorder (MBD) management in non-dialysis chronic kidney disease (ND-CKD) patients is scarce, although essential to identifying areas for therapeutic improvement., Methods: We prospectively evaluated current management of CKD-MBD in two visits, performed 6 months apart, in 727 prevalent ND-CKD stage 3b-5 patients from 19 nephrology clinics. Therapeutic inertia was defined as lack of treatment despite hyperphosphatemia and/or hypocalcemia, and/or hyperparathyroidism. The primary endpoint was the prevalence of achieved target for CKD-MBD parameters and related treatments (phosphate binders, vitamin D and calcium supplements). The secondary endpoint was the assessment of prevalence and clinical correlates of therapeutic inertia., Results: Over 65 % of patients did not reach parathormone (PTH) targets, while 15 and 19 % did not reach phosphate and calcium targets, respectively. The proportion of untreated patients decreased from stage 3b to 5 (at baseline, from 60 to 16 %, respectively). From baseline to the 6-month visit, the achievement of targets remained stable. Low protein diet was prescribed in 26 % of patients, phosphate binders in 17.3 % (calcium-based binders 15.5 %, aluminium binders 1.8 %), and vitamin D in 50.5 %. The overall prevalence of therapeutic inertia at the 6-month visit was 34.0 % (for hyperphosphatemia, 54.3 %). Compared to CKD stage 3, the likelihood of therapeutic inertia was 40 and 68 % lower at stage 4 and 5, respectively., Conclusions: PTH, calcium and phosphate targets were not reached in a significant proportion of patients. One-third of patients with at least one MBD parameter not-at-target remained untreated. Therapeutic inertia regarding CKD-MBD treatment may be a major barrier to optimizing the prevention and cure of CKD-MBD.

Published
2016
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37. [Lessons learned from the research project ''Institutional formats and organizational models for the range of services in nephrology''].

Author

Del Vecchio M, Coppo R, Tozzi VD, Pizzarelli F, Quintaliani G, Meneghel G, Teatini U, Battaglia GG, Formica M, Enia G, Santoro A, and Feriozzi S

Subjects
Health Facilities standards, Hemodialysis Units, Hospital standards, Humans, International Cooperation, Italy, Kidney Diseases diagnosis, Kidney Diseases economics, Kidney Diseases prevention & control, Models, Organizational, Needs Assessment organization & administration, Organizational Objectives economics, Renal Dialysis economics, Sicily, Urology Department, Hospital economics, Urology Department, Hospital standards, Health Services Research organization & administration, Kidney Diseases therapy, Nephrology, Renal Dialysis standards, Urology Department, Hospital organization & administration
Published
2012

38. Prevalence of CKD in northeastern Italy: results of the INCIPE study and comparison with NHANES.

Author

Gambaro G, Yabarek T, Graziani MS, Gemelli A, Abaterusso C, Frigo AC, Marchionna N, Citron L, Bonfante L, Grigoletto F, Tata S, Ferraro PM, Legnaro A, Meneghel G, Conz P, Rizzotti P, D'Angelo A, and Lupo A

Subjects
Adult, Aged, Aged, 80 and over, Albuminuria epidemiology, Biomarkers urine, Chronic Disease, Creatinine urine, Female, Glomerular Filtration Rate, Health Status Disparities, Health Surveys, Humans, Italy epidemiology, Kidney physiopathology, Kidney Diseases diagnosis, Kidney Diseases ethnology, Kidney Diseases physiopathology, Logistic Models, Male, Middle Aged, Odds Ratio, Prevalence, Risk Assessment, Risk Factors, Severity of Illness Index, Time Factors, United States epidemiology, White People statistics & numerical data, Kidney Diseases epidemiology
Abstract

Background and Objectives: Sufficiently powered studies to investigate the CKD prevalence are few and do not cover southern Europe., Design, Setting, Participants, & Measurements: For the INCIPE study, 6200 Caucasian patients ≥40 years old were randomly selected in northeastern Italy in 2006. Laboratory determinations were centralized. The albumin to creatinine ratio in urine and estimated GFR from calibrated creatinine (SCr) were determined. A comparison with 2001 through 2006 NHANES surveys was performed., Results: Prevalence of CKD was 13.2% in northeastern (NE) Italy (age and gender standardized to the U.S. 2007 Caucasian population). Prevalence of CKD in U.S. Caucasians is higher (20.3%), the major difference being in CKD 3. Risk factors for CKD are more prevalent in the United States than in Italy. With use of CKD 3a and 3b stages, CKD prevalence decreased in NE Italy (8.5%) and in the United States (12.8%)., Conclusions: The prevalence of CKD is high in NE Italy, but lower than that in the United States. A large part of the difference in CKD prevalence in NE Italy versus that in the United States is due to the different prevalence of CKD 3. The higher prevalence of a number of renal risk factors in persons from the United States explains in part the different dimensions of the CKD problem in the two populations.

Published
2010
Full Text
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39. [Update of the Italian Society of Nephrology Project No. 1 of the 2004-2006 SIN programme].

Author

Manno C, Virgilio M, Giangrande A, Stalteri A, Contu B, Quintaliani G, Spinelli C, Avella F, Cappelli G, Casino F, Cicchetti T, Di Giulio S, Di Luca M, Meneghel G, Milone F, Moriconi L, Panzetta GO, Procaccini AD, Triolo G, and Zoccali C

Subjects
Humans, Italy, Quality Control, Surveys and Questionnaires, Accreditation, Kidney Transplantation standards, Nephrology standards, Renal Dialysis standards
Abstract

In the last few years the Italian Society of Nephrology has addressed many technical-scientific and management aspects to better patient satisfaction. Project No. 1 of the 2004-2006 programme on 'Quality and Accreditation of National Renal Units' focuses on four essential points. The first is the questionnaire mailed to all the Presidents and Regional Delegates on the relationship between Nephrology units, Local Government Health-System and the Regional Healthcare Agency. The results evidence that the 'political' decision-making power of nephrologists decreases in the absence of a national strategy. The second point, in collaboration with the National Census Group, includes the quality analysis and the standardization of resources (human and structural) and management of the Renal Units. The third point is based on 'Educational Courses for Quality and Accreditation' held in Rome (3-5 October 2005: L'Accreditamento all'Eccellenza dell'Unita' Operativa di Nefrologia, Dialisi e Trapianto; 17-19 October 2005: Il Manuale di Accreditamento della Specialità di Nefrologia). The courses aim at training members responsible for each region to hold courses in their specific region to create a network including each single Renal Unit to create an acceptable homogenous language on the models of analysis and on the correct use of 'The Guide for Excellence Accreditation'. The fourth point concerns both the on-line Guide for Excellence Accreditation and 'Peer Review Accreditation' and the NEQUASY (Nephrology Quality System) project. The manual must be 'user friendly' allowing each Centre to self-evaluate using national and regional standards.

Published
2006

40. A fatal case of aluminium encephalopathy in a patient with severe chronic renal failure not on dialysis.

Author

Zatta P, Zambenedetti P, Reusche E, Stellmacher F, Cester A, Albanese P, Meneghel G, and Nordio M

Subjects
Aluminum Hydroxide administration & dosage, Anemia chemically induced, Antacids administration & dosage, Drug Combinations, Fatal Outcome, Gastritis drug therapy, Humans, Magnesium Hydroxide administration & dosage, Male, Middle Aged, Self Medication, Aluminum Hydroxide poisoning, Antacids poisoning, Brain Diseases chemically induced, Diabetic Nephropathies therapy, Kidney Failure, Chronic therapy, Magnesium Hydroxide poisoning
Published
2004
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41. Hostility as a feature of elderly suicidal ideators.

Author

Scocco P, Meneghel G, Dello Buono M, and De Leo D

Subjects
Aged, 80 and over, Anxiety psychology, Depression psychology, Female, Humans, Italy, Male, Personality Inventory, Aged psychology, Hostility, Suicide psychology
Abstract

Literature suggests that suicidal feelings are relatively rare in mentally healthy older adults. This research investigated the presence of death or suicidal ideation in a group of home-dwelling elderly people (N = 611, M age = 75.7 yr., SD = 7.2), taking into account their psychopathological profiles assessed by means of the Brief Symptom Inventory. Suicidality was investigated by the Italian translation of the 1974 questions from Paykel, Myers, Lindenthal, and Tanner. Elderly with death or suicidal ideation manifested depressive and anxious symptoms on the Brief Symptom Inventory. This psychopathological profile, which has been reported for these subjects in various contributions to the literature, was also characterized by the presence of hostility. The correlation with higher scores on the hostility scale is difficult to interpret, although these feelings are often accompanied by failure to control impulses, which is an essential characteristic in suicidal behaviour.

Published
2001
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42. In Reply.

Author

De Leo D, Hickey P, Meneghel G, and Cantor CH

Published
2000

43. Blindness, fear of sight loss, and suicide.

Author

De Leo D, Hickey PA, Meneghel G, and Cantor CH

Subjects
Adaptation, Psychological, Adult, Aged, Aged, 80 and over, Deafness psychology, Female, Humans, Male, Middle Aged, Patient Care Team, Suicide Prevention, Blindness psychology, Fear, Sick Role, Suicide psychology
Abstract

Numerous studies have examined the emotional impact exerted by sight loss. Research has tended to focus on clinical-diagnostic rather than therapeutic-preventive aspects. Blindness and sight restoration have been reported to induce both temporary and longer term psychopathology, usually followed by psychosocial readjustment. However, in some cases, readjustment may not occur and suicide may result. Together with an extensive review of available literature, the authors present cases taken from their psychological autopsy study database. When compared with a hearing-impaired control group, impaired sight alone can acutely affect otherwise psychologically healthy individuals. Ophthalmologists need to be aware of this problem and to develop closer collaboration with mental health professionals. Serious consideration of this problem and definition of clear guidelines may prevent suicidal behaviour.

Published
1999
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44. Pharmacological and psychotherapeutic treatment of personality disorders in the elderly.

Author

De Leo D, Scocco P, and Meneghel G

Subjects
Aged, Humans, Interpersonal Relations, Personality Disorders drug therapy, Antidepressive Agents, Tricyclic therapeutic use, Antipsychotic Agents therapeutic use, Cognitive Behavioral Therapy methods, Monoamine Oxidase Inhibitors therapeutic use, Personality Disorders therapy
Abstract

Although estimates as to the incidence of personality disorder in the elderly remain controversial, it is well known that such a disorder is prevalently ego-syntonic and capable of interfering with the onset and treatment of other somatic and psychic pathologies, especially in later life, when individuals tend tobe particularly vulnerable. Misdiagnosis or failure to treat these disorders may greatly diminish the quality of life of older adults and their families. The aim of this work is to define the chief psychopharmacological and psychotherapeutic guidelines for treating personality disorders in the elderly. Pharmacologically, patients require treatment with molecules designed to rebalance neurotransmitter system alterations, which underlie the symptomatological picture. As regards psychotherapeutic treatment, although there are only a few validation studies, we believe that dialectical behavior therapy and interpersonal psychotherapy may constitute valid therapeutic approaches that meet both the needs and the individual characteristics of patients affected by personality disorder and those of elderly patients.

Published
1999
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45. Dimethylformamide risk. An evaluation in the production of artificial organic leather.

Author

Sala C, Bernabeo F, Colombo G, Invernizzi E, and Meneghel G

Subjects
Air Pollutants, Occupational analysis, Environmental Exposure, Formamides urine, Humans, Risk, Time Factors, Dimethylformamide analysis, Polyurethanes, Textiles
Abstract

This study aimed to evaluate the exposure to DMF during the different stages in the production of synthetic polyurethanic leathers. Environmental surveys and biological surveillances were carried out in order to classify the working areas and the tasks of the employees as regards DMF-risk. Design improvements to reduce, as far as possible, environmental pollution are discussed.

Published
1984

46. Peripheral lymphocyte subsets in human chronic pyelonephritis.

Author

Favaro S, Meneghel G, Rouben G, Piccoli A, and Borsatti A

Subjects
Adolescent, Adult, B-Lymphocytes immunology, Chronic Disease, Female, Glomerulonephritis immunology, Humans, Male, Middle Aged, T-Lymphocytes immunology, Pyelonephritis immunology, T-Lymphocytes classification
Abstract

Comparative study of peripheral blood lymphocyte surface markers in chronic pyelonephritis (CP) and chronic glomerulonephritis (GN) patients, and in normal controls showed no differences between controls and GN patients. In CP patients, a significant absolute increase in B cells, and an absolute decrease in T cells were observed as well as significantly lower and higher percentages of OKT4 and OKT8 cells, respectively, leading to a decrease in the OKT4/OKT8 ratio. Furthermore, the percentage of large granular cells was significantly higher in CP patients, while no differences in TIa cells emerged. The overall picture shown by the CP patients is compatible to a cell-mediated immune (CMI) response defect.

Published
1986

50. [Case of folie à deux].

Author

MENEGHEL G

Subjects
Humans, Mental Disorders, Psychotic Disorders, Shared Paranoid Disorder
Published
1950

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