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2. Post-transplant glomerular diseases: update on pathophysiology, risk factors and management strategies.

Author

Regalia, Anna, Abinti, Matteo, Alfieri, Carlo Maria, Campise, Mariarosaria, Verdesca, Simona, Zanoni, Francesca, and Castellano, Giuseppe

Subjects
*KIDNEY glomerulus diseases, *DISEASE risk factors, *MEDICATION therapy management, *GRAFT survival, *KIDNEY transplantation
Abstract

In recent years, advancements in immunosuppressive medications and post-transplant management have led to a significant decrease in acute rejection rates in renal allografts and consequent improvement in short-term graft survival. In contrast, recent data have shown an increased incidence of post-transplant glomerular diseases, which currently represent a leading cause of allograft loss. Although pathogenesis is not fully understood, growing evidence supports the role of inherited and immunological factors and has identified potential pre- and post-transplant predictors. In this review, we illustrate recent advancements in the pathogenesis of post-transplant glomerular disease and the role of risk factors and immunological triggers. In addition, we discuss potential prevention and management strategies. [ABSTRACT FROM AUTHOR]

Published
2024
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3. Post-Kidney Transplant Cancer: A Real-World Retrospective Analysis From a Single Italian Center.

Author

Sartò, Giulia Vanessa Re, Alfieri, Carlo, Cosmai, Laura, Brigati, Emilietta, Campise, Mariarosaria, Regalia, Anna, Verdesca, Simona, Molinari, Paolo, Pisacreta, Anna Maria, Pirovano, Marta, Nardelli, Luca, Gallieni, Maurizio, and Castellano, Giuseppe

Subjects
IMMUNOSUPPRESSIVE agents, MTOR inhibitors, EPIDEMIOLOGY of cancer, OVERALL survival, STEROID drugs
Abstract

We describe the epidemiology of cancer after kidney transplantation (KTx), investigating its risk factors and impact on therapeutic management and survival in KTx recipients (KTRs). The association between modification of immunosuppressive (IS) therapy after cancer and survival outcomes was analyzed. We collected data from 930 KTRs followed for 7 [1--19] years. The majority of KTRs received KTx from a deceased donor (84%). In total, 74% of patients received induction therapy with basiliximab and 26% with ATG. Maintenance therapy included steroids, calcineurin inhibitors, and mycophenolate. Patients with at least one cancer (CA+) amounted to 19%. NMSC was the most common tumor (55%). CA+ were older and had a higher BMI. Vasculitis and ADPKD were more prevalent in CA+. ATG was independently associated with CA+ and was related to earlier cancer development in survival and competing risk analyses (p = 0.01 and <0.0001; basiliximab 89 ± 4 vs. ATG 40 ± 4 months). After cancer diagnosis, a significant prognostic impact was derived from the shift to mTOR inhibitors compared to a definitive IS drug suspension (p = 0.004). Our data confirm the relevance of cancer as a complication in KTRs with ATG as an independent risk factor. An individualized choice of IS to be proposed at the time of KTx is crucial in the prevention of neoplastic risk. Finally, switching to mTORi could represent an important strategy to improve patient survival. [ABSTRACT FROM AUTHOR]

Published
2024
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9. Corrigendum: Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study

Author

Molinari, Paolo, primary, Regalia, Anna, additional, Leoni, Alessandro, additional, Campise, Mariarosaria, additional, Cresseri, Donata, additional, Cicero, Elisa, additional, Vettoretti, Simone, additional, Nardelli, Luca, additional, Brigati, Emilietta, additional, Favi, Evaldo, additional, Messa, Piergiorgio, additional, Castellano, Giuseppe, additional, and Alfieri, Carlo M., additional

Published
2024
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10. Histology for nephrology, from pre-implantation to post-transplant kidney biopsy. Lesson learned from ReBIrth (Renal BIopsy for Kidney Transplantation Therapy)

Author

Caliò, Anna, primary, Barreca, Antonella, additional, Marletta, Stefano, additional, Achenza, Maria Italia Sara, additional, Alessi, Marianna, additional, Angelico, Roberta, additional, Apicella, Luca, additional, Argiolas, Davide, additional, Bossini, Nicola, additional, Carrano, Rosa, additional, Carriero, Concetta, additional, Castellano, Giuseppe, additional, Comai, Giorgia, additional, Di Bella, Caterina, additional, D’Ignoto, Francesco, additional, Gallico, Agnese, additional, Gastaldon, Fiorella, additional, Merlotti, Guido, additional, Paloschi, Vera, additional, Panarese, Alessandra, additional, Parodi, Angelica, additional, Perna, Francesco, additional, Picciotto, Daniela, additional, Regalia, Anna, additional, Rossini, Michele, additional, Russo, Enrico, additional, Salerno, Maria Paola, additional, Toti, Luca, additional, Tulissi, Patrizia, additional, Vischini, Gisella, additional, Zaza, Gianluigi, additional, and Eccher, Albino, additional

Published
2023
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11. Post-Transplant Diabetes Mellitus in Kidney-Transplanted Patients: Related Factors and Impact on Long-Term Outcome.

Author

Alfieri, Carlo, Campioli, Edoardo, Fiorina, Paolo, Orsi, Emanuela, Grancini, Valeria, Regalia, Anna, Campise, Mariarosaria, Verdesca, Simona, Delfrate, Nicholas Walter, Molinari, Paolo, Pisacreta, Anna Maria, Favi, Evaldo, Messa, Piergiorgio, and Castellano, Giuseppe

Abstract

This study aimed to investigate the prevalence and determinants of glucose metabolism abnormalities and their impact on long-term clinical outcomes in kidney transplant recipients (KTxps). A retrospective analysis of 832 KTxps (2004–2020) was performed. Patients were assessed at 1 (T1), 6 (T6), and 12 (T12) months post-transplantation and clinically followed for an average of 103 ± 60 months. At T6, 484 patients underwent an oral glucose tolerance test for the diagnosis of alterations in glucose metabolism (AMG+) or post-transplant diabetes mellitus (PTDM+). The prevalence of pre-transplant diabetes was 6.2%, with 22.4% of PTDM+ within the 1st year. Patients with AMG were older and exhibited altered lipid profiles, higher body mass index, and increased inflammatory indices. Age at transplantation, lipid profile, and inflammatory status were significant determinants of PTDM. Graft loss was unaffected by glucose metabolism alterations. Survival analysis demonstrated significantly worse long-term survival for KTxps with diabetes (pre- and PTDM+, p = 0.04). In a comparison of the ND and PTDM+ groups, no significant differences in death with a functioning graft were found. The AMG+ group exhibited worse survival (p < 0.001) than AMG−, even after excluding patients with diabetes mellitus. Future randomized controlled trials are necessary to delve deeper into this subject, specifically examining the effects of new antidiabetic treatments. [ABSTRACT FROM AUTHOR]

Published
2024
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12. Impact of hyperparathyroidism and its different subtypes on long term graft outcome: a single Transplant Center cohort study

Author

Molinari, Paolo, primary, Regalia, Anna, additional, Leoni, Alessandro, additional, Campise, Mariarosaria, additional, Cresseri, Donata, additional, Cicero, Elisa, additional, Vettoretti, Simone, additional, Nardelli, Luca, additional, Brigatti, Emilietta, additional, Favi, Evaldo, additional, Messa, Piergiorgio, additional, Castellano, Giuseppe, additional, and Alfieri, Carlo M., additional

Published
2023
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14. Histology for nephrology, from pre-implantation to post-transplant kidney biopsy. Lesson learned from ReBIrth (Renal BIopsy for Kidney Transplantation Therapy)

Author

Caliò, Anna, Barreca, Antonella, Marletta, Stefano, Achenza, Maria Italia Sara, Alessi, Marianna, Angelico, Roberta, Apicella, Luca, Argiolas, Davide, Bossini, Nicola, Carrano, Rosa, Carriero, Concetta, Castellano, Giuseppe, Comai, Giorgia, Di Bella, Caterina, D'Ignoto, Francesco, Gallico, Agnese, Gastaldon, Fiorella, Merlotti, Guido, Paloschi, Vera, Panarese, Alessandra, Parodi, Angelica, Perna, Francesco, Picciotto, Daniela, Regalia, Anna, Rossini, Michele, Russo, Enrico, Salerno, Maria Paola, Toti, Luca, Tulissi, Patrizia, Vischini, Gisella, Zaza, Gianluigi, and Eccher, Albino

Subjects
whole-slide imaging, immunosuppression, kidney biopsy, kidney transplantation, digital pathology
Published
2023

16. Prevalence and Risk Factors of Abnormal Glucose Metabolism and New-Onset Diabetes Mellitus after Kidney Transplantation: A Single-Center Retrospective Observational Cohort Study

Author

Alfieri, Carlo, primary, Favi, Evaldo, additional, Campioli, Edoardo, additional, Cicero, Elisa, additional, Molinari, Paolo, additional, Campise, Mariarosaria, additional, Gandolfo, Maria Teresa, additional, Regalia, Anna, additional, Cresseri, Donata, additional, Messa, Piergiorgio, additional, and Castellano, Giuseppe, additional

Published
2022
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17. How Vaccinations Changed the Outcome of COVID-19 Infections in Kidney Transplant Patients: Single-Center Experience

Author

Campise, Mariarosaria, primary, Alfieri, Carlo Maria, additional, Benedetti, Matteo, additional, Perna, Alessandro, additional, Miglio, Roberta, additional, Molinari, Paolo, additional, Cervesato, Angela, additional, Giuliani, Silvia, additional, Gandolfo, Maria Teresa, additional, Regalia, Anna, additional, Cresseri, Donata, additional, Alagna, Laura, additional, Gori, Andrea, additional, and Castellano, Giuseppe, additional

Published
2022
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24. Clinical research in traditional medicine: Priorities and methods

Author

Cardini, Francesco, Wade, Christine, Regalia, Anna Laura, Gui, Suiqi, Li, Wang, Raschetti, Roberto, and Kronenberg, Fredi

Subjects
Public health -- Methods, Medical equipment -- Methods, Physiological apparatus -- Methods, Medical research -- Methods, Medicine, Experimental -- Methods, Alternative medicine -- Methods, Clinical trials -- Methods, Health care industry
Abstract

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ctim.2006.07.003 Byline: Francesco Cardini (a), Christine Wade (b), Anna Laura Regalia (c), Suiqi Gui (d), Wang Li (d), Roberto Raschetti (a), Fredi Kronenberg (b) Keywords: Traditional medicine; Clinical research; Methods; Priorities; Pragmatic trials Abstract: This paper explores the challenges and opportunities associated with the evaluation of treatments arising from traditional medical systems (TMS). Globalization and popular consumer-and industry-driven market forces contribute to the spread of traditional treatments, techniques and technologies, but do not necessarily ensure their usefulness or safety. The international scientific community is obliged to evaluate the safety and efficacy of these treatments because of their potential impact on global public health. Clinical evaluations of traditional treatments, however, have complex methodological and practical challenges, depending on the goals of the research and the audience for the results (country of origin; or new host countries and new patient populations). To address these challenges, the authors offer the following recommendations to identify and prioritize treatments to study and how to design study protocols. Evaluations of traditional treatments are best addressed first by collaborative, international, pragmatic studies. Protocols for observational, prospective, pragmatic pilot study (randomized and controlled, when feasible) should be designed collaboratively and executed simultaneously in the culture of origin and in new contexts. This, in turn, could determine the acceptability, usefulness and feasibility of larger randomized controlled trials (RCTs). International multicentre RCTs would have the potential benefits of evaluating safety and effectiveness and also assessing the transferability of a traditional treatment across social and cultural contexts. Author Affiliation: (a) Istituto Superiore di Sanita, Rome, Italy (b) The Richard and Hinda Rosenthal Center for Complementary and Alternative Medicine, Department of Rehabilitation Medicine, College of Physicians & Surgeons, Columbia, University, New York, NY, USA (c) Obstetrics & Gynecology Department, Hospital S. Gerardo (Monza), Milano Bicocca University, Milan, Italy (d) Obstetrics & Gynecology Hospital, Fudan University, Shanghai, People's Republic of China Article Note: (footnote) [star] This work was supported in part by the ISS Non-Conventional Therapies Project, and NIH/NCCAM Planning Grant for a Center for TCM Research in Women's Health (R21 AT001957).

Published
2006

25. Bone Effect and Safety of One-Year Denosumab Therapy in a Cohort of Renal Transplanted Patients: An Observational Monocentric Study

Author

Alfieri, Carlo, primary, Binda, Valentina, additional, Malvica, Silvia, additional, Cresseri, Donata, additional, Campise, Mariarosaria, additional, Gandolfo, Maria Teresa, additional, Regalia, Anna, additional, Mattinzoli, Deborah, additional, Armelloni, Silvia, additional, Favi, Evaldo, additional, Molinari, Paolo, additional, and Messa, Piergiorgio, additional

Published
2021
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27. Cytomegalovirus Disease in Renal Transplanted Patients: Prevalence, Determining Factors, and Influence on Graft and Patients Outcomes

Author

Alfieri, Carlo Maria, primary, Molinari, Paolo, additional, Gandolfo, Mariateresa, additional, Campise, Mariarosaria, additional, Cresseri, Donata, additional, Regalia, Anna, additional, Favi, Evaldo, additional, Li, Min, additional, Ikehata, Masami, additional, Delbue, Serena, additional, and Messa, Piergiorgio, additional

Published
2021
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39. FP788PREDICTION OF GRAFT OUTCOME IN RENAL TRANSPLANTED PATIENTS WITH ANTIBODY-MEDIATED REJECTION: SUPERIORITY OF HISTOLOGICAL OVER IMMUNOLOGICAL PARAMETERS

Author

Regalia, Anna, primary, Campise, Mariarosaria, additional, Alfieri, Carlo, additional, Moroni, Gabriella, additional, Cresseri, Donata, additional, Gandolfo, Maria Teresa, additional, Binda, Valentina, additional, Cardillo, Massimo, additional, Ferraresso, Mariano, additional, and Messa, Piergiorgio, additional

Published
2019
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43. MP718EVALUATION OF VITAMIN D STATUS DURING KIDNEY TRANSPLANTATION: FACTORS RELATED AND EFFECT OF THE TREATMENT

Author

Alfieri, Carlo Maria, primary, Regalia, Anna, additional, Cosa, Francesco, additional, Meneghini, Maria, additional, Ikehata, Masami, additional, Mattinzoli, Deborah, additional, Gandolfo, Maria Teresa, additional, Binda, Valentina, additional, Campise, Maria Rosaria, additional, Fusaro, Maria, additional, Aghi, Andrea, additional, and Messa, Piergiorgio, additional

Published
2016
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44. The Importance of Adherence in the Treatment of Secondary Hyperparathyroidism.

Author

Alfieri, Carlo, Regalia, Anna, Zanoni, Francesca, Vettoretti, Simone, Cozzolino, Mario, and Messa, Piergiorgio

Subjects
*HYPERPARATHYROIDISM, *HYPERPARATHYROIDISM treatment, *PATIENT compliance, *CHRONIC kidney failure, *HEMODIALYSIS, *NUTRITION
Abstract

Secondary hyperparathyroidism (SHPT) is a frequent condition in the presence of chronic kidney disease (CKD). In CKD patients, SHPT is reported to increase both morbidity and mortality, especially cardiovascular. The difficulty in the treatment of SHPT in clinical practice is frequently encountered from a not always adequate conduct of the clinicians and a common non-compliance to the therapy of CKD patients. In this review, the greatest difficulties from clinicians and CKD-patients' point of view in the treatment of SHPT will be addressed, with particular attention to those related to dialysis features, nutritional habits, and medical therapy. [ABSTRACT FROM AUTHOR]

Published
2019
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45. Vitamin D Receptor Activators and Clinical Outcomes in Chronic Kidney Disease

Author

Gravellone, Luciana, Rizzo, Maria Antonietta, Martina, Valentina, Mezzina, Nicoletta, Regalia, Anna, and Gallieni, Maurizio

Subjects
Article Subject
Abstract

Vitamin D deficiency appears to be an underestimated risk factor for cardiovascular disease in patients with chronic kidney disease. Evidence from both basic science and clinical studies supports the possible protective role of vitamin D beyond its effect on mineral metabolism. Toxicity of pharmacologic doses of active vitamin D metabolites, in particular calcitriol, is mainly due to the possibility of positive calcium and phosphorus balance. Therefore, vitamin D analogs have been developed, which suppress PTH secretion and synthesis with reduced calcemic and phosphatemic effects. Observational studies suggest that in hemodialysis patients the use of a vitamin D receptor (VDR) activator, such as calcitriol, doxercalciferol, paricalcitol, or alfacalcidol, is associated with a reduced mortality when compared with nonusers of any VDR activator. In this article the existing literature on the topic is reviewed, although a more robust answer to the question of whether or not VDR activators have beneficial effects in hemodialysis patients will hopefully come from a randomized controlled trial.

Published
2011
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47. Nutritional Vitamin D in Renal Transplant Patients: Speculations and Reality.

Author

Alfieri, Carlo Maria, Messa, Piergiorgio, and Regalia, Anna

Abstract

Reduced levels of nutritional vitamin D are commonly observed in most chronic kidney disease (CKD) patients and particularly in patients who have received a kidney transplant (KTx). In the complex clinical scenario characterizing the recipients of a renal graft, nutritional vitamin D deficiency has been put in relation not only to the changes of mineral and bone metabolism (MBM) after KTx, but also to most of the medical complications which burden KTx patients. In fact, referring to its alleged pleiotropic (non-MBM related) activities, vitamin D has been claimed to play some role in the occurrence of cardiovascular, metabolic, immunologic, neoplastic and infectious complications commonly observed in KTx recipients. Furthermore, low nutritional vitamin D levels have also been connected with graft dysfunction occurrence and progression. In this review, we will discuss the purported and the demonstrated effects of native vitamin D deficiency/insufficiency in most of the above mentioned fields, dealing separately with the MBM-related and the pleiotropic effects. [ABSTRACT FROM AUTHOR]

Published
2017
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