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5. Prospective multicenter study of HX575 (biosimilar epoetin-alpha) in patients with chronic kidney disease applying a target hemoglobin of 10 – 12 g/dl

Author

Hörl WH, Locatelli F, Haag Weber M, Ode M, Roth K, Lhotta K, Loipl J, Huspek M, Gstöttenbauer K, Karagyozova R, Monova D, Shikov P, Yovchev T, Bazeva P, Nenchev N, Charasse C, Bockreiss N, Buhl M, Dellanna F, Dragoun GP, Goller M, Klingbeil A, Knee J, Krallinger R, Menzer T, Perschon G, Toussaint K, Wichelhaus T, Kreuzer K, Brückner D, Leistikow F, Marsen T, Sacherer K, Zimmermann U, Kohnle M, Riedasch M, Brehm K, Vogt J, Morgenroth A, Herrnberger S, Zeh M, Dammerboer C, Hofmann T, Kraemer Guth A, Wilpert J, Pröschild F, Krämer B, Lang R, Zanker B, Lubrich Birkner I, Hemstege M, Jäkel D, Perino S, Riedl B, Assenmacher A, Albertazzi A, Colussi G, Garibotto G, Villa G, Gesualdo L, Triolo G, Cusi D, Gallieni M, Quarello F, Malberti F, Tarchini R, Di Iorio BR, Di Luca M, Bordoni E, Brunori G, Della Grotta F, Fracasso A, Guerrini E, Ragaiolo M, Costanzo R, Teatini U, Dimitrov S, Sikole A, Zabzun M, Janakievska P, Petrovska T, Rzanikoski T, Alceva M, Panova B, Daniewska D, Klatko W, Stryjewski D, Książek A, Kopecka Mechlińska L, Kędzierski P, Nowicki M, Szurkowski M, Papliński M, Trafny R, Kuczera M, Sokalski A, Rydzewski A, Liberek T, Uzar J, Bako GC, Ionescu D, Voiculescu M, Ardelean LC, Pitea IV, Demina L, Borsukov A, Marasaev V, Fedosseev A, Dudar I, Kolesnyk M, Kostynenko T, Kuchma I, Kuriata O, Lesovoy V, Martynyuk L, Nikonenko O., STEFONI, SERGIO, Hörl WH, Locatelli F, Haag-Weber M, Ode M, Roth K, Lhotta K, Loipl J, Huspek M, Gstöttenbauer K, Karagyozova R, Monova D, Shikov P, Yovchev T, Bazeva P, Nenchev N, Charasse C, Bockreiss N, Buhl M, Dellanna F, Dragoun GP, Goller M, Klingbeil A, Knee J, Krallinger R, Menzer T, Perschon G, Toussaint K, Wichelhaus T, Kreuzer K, Brückner D, Leistikow F, Marsen T, Sacherer K, Zimmermann U, Kohnle M, Riedasch M, Brehm K, Vogt J, Morgenroth A, Herrnberger S, Zeh M, Dammerboer C, Hofmann T, Kraemer-Guth A, Wilpert J, Pröschild F, Krämer B, Lang R, Zanker B, Lubrich-Birkner I, Hemstege M, Jäkel D, Perino S, Riedl B, Assenmacher A, Albertazzi A, Colussi G, Garibotto G, Villa G, Gesualdo L, Triolo G, Cusi D, Gallieni M, Quarello F, Malberti F, Stefoni S, Tarchini R, Di Iorio BR, Di Luca M, Bordoni E, Brunori G, Della Grotta F, Fracasso A, Guerrini E, Ragaiolo M, Costanzo R, Teatini U, Dimitrov S, Sikole A, Zabzun M, Janakievska P, Petrovska T, Rzanikoski T, Alceva M, Panova B, Daniewska D, Klatko W, Stryjewski D, Książek A, Kopecka-Mechlińska L, Kędzierski P, Nowicki M, Szurkowski M, Papliński M, Trafny R, Kuczera M, Sokalski A, Rydzewski A, Liberek T, Uzar J, Bako GC, Ionescu D, Voiculescu M, Ardelean LC, Pitea IV, Demina L, Borsukov A, Marasaev V, Fedosseev A, Dudar I, Kolesnyk M, Kostynenko T, Kuchma I, Kuriata O, Lesovoy V, Martynyuk L, and Nikonenko O

Subjects
Male, Time Factors, Pharmacology, Adult, Aged, Aged, 80 and over, Anemia, Biomarkers, Biosimilar Pharmaceuticals, Chronic Disease, Epoetin Alfa, Erythropoietin, Europe, Female, Hematinics, Hemoglobins, Humans, Injections, Intravenous, Kidney Diseases, Middle Aged, Neoplasms, Prospective Studies, Recombinant Proteins, Thrombosis, Treatment Outcome, Young Adult, 80 and over, Prospective cohort study, HEMOGLOBIN, media_common, General Medicine, Nephrology, Intravenous, medicine.drug, medicine.medical_specialty, Injections, Internal medicine, medicine, media_common.cataloged_instance, ANEMIA, European union, Adverse effect, CHRONIC KIDNEY DISEASE, business.industry, BIOSIMILAR EPOETIN-Α, PRODUCT, Epoetin alfa, medicine.disease, Clinical trial, business, Kidney disease
Abstract

HX575 was approved in the European Union in August 2007 as the first-ever biosimilar epoetin-α product. The present study extended the safety database on HX575 by monitoring adverse events (AEs) in clinical practice. Hemoglobin (Hb) levels and HX575 doses were recorded for the assessment of efficacy. This open, 6-month single-arm study was conducted in 10 European countries with a target enrollment of 1,500 patients with anemia due to chronic kidney disease (CKD). HX575 was intravenously (i.v.) administered aiming at an Hb target of 10 - 12 g/dl. Most patients (92.3%) had already received erythropoiesis stimulating agents (ESAs) treatment before enrolment into this study; the recorded treatments mainly comprised i.v. or subcutaneous (s.c.) administration of epoetin-α, epoetin-β or darbepoetin. The study period covered 770 patient years. The observed AE profile was in line with expectations for this patient population. Thrombotic vascular events (TVEs) were reported in 11.9% of patients (0.2612 per patient year). Tumor incidence was 1.4% (0.0299 per patient year). No subject developed anti-epoetin antibodies. Mean Hb levels were effectively maintained between 11.2 and 11.3 g/dl following the conversion from a broad spectrum of pre-study ESA treatments with stable overall mean i.v. HX575 doses. The proportion of patients within the Hb target range increased from 57.5% at baseline to 66.8% at study end.

Published
2012
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8. 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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9. Clinical policies on the management of chronic kidney disease patients in Italy

Author

SIR SIN STUDY INVESTIGATORS ACCIARRI P, MENEGATO MA, ANCARANI E, ANDREUCCI V, ANTONELLI A, AURICCHIO MR, BALDUCCI A, BASSI A, BATTAGLIA G, BELLINGHERI G, BELTRAME A, BIAGINI M, BONFANTE L, BONOFIGLIO R, BONOMINI M, BORGHI M, BRIGANTE M, BUCCIANTI G, BUONGIORNO E, CABIBBE M, CANCARINI G, CAPISTRANO M, CAPPELLI G, CAPUANO M, CASCONE C, CATIZONE L, CATUCCI AE, CAVATORTA F, CHIARINOTTI D, CICCHETTI T, CONCAS G, CONCETTI M, CONTE F, CONTI M, CORATELLI P, CORTI MM, COSTANZO R, DAL CANTON A, D'APICE L, DAVID S, DE CRISTOFARO V, DEFERRARI G, DELLA GROTTA F, DE NICOLA, Luca, DE SANTO NG, DE SIMONE W, DI DANIELE N, DI GIULIO S, DI LANDRO D, DI LUZIO V, DI MAGGIO A, FAGUGLI R, FARINA M, FERIANI M, GALLIENI M, GAMBARO G, GIORDANO R, GRECO S, GRILLO C, HUBER W, LIUZZO G, LOCATELLI F, LOMBARDI L, LOPEZ T, MALBERTI F, MANCINI W, MANENTI F, MANISCO G, MARROCCO A, MATOCCI G, MERICO G, MESSA P, MINUTOLO, Roberto, MONARDO P, MORICONI L, MURRONE P, NARDO A, NASO A, NOBILE R, PANARELLO G, PAONE A, PARRAVANO M, PEDRINI L, PIAZZA V, PISTIS R, PROCIDA M, QUARELLO F, RAPISARDA F, RICCIARDI B, RINDI P, RONCO C, ROTOLO U, RUSSO G, SARANITI A, SASDELLI M, SAVICA V, SCANZIANI R, SIDOTI A, SPOTTI D, STALTERI A, STEFONI S, STELLA A, STRIPPOLI P, TEATINI U, TEODORO C, TOZZO C, TRIOLO G, ZOCCALI C., Locatelli F, Zoccali C, Acciarri P, Menegato MA, Ancarani E, Andreucci V, Antonelli A, Auricchio MR, Balducci A, Bassi A, Battaglia G, Bellingheri G, Beltrame A, Biagini M, Bonfante L, Bonofiglio R, Bonomini M, Borghi M, Brigante M, Buccianti G, Buongiorno E, Cabibbe M, Cancarini G, Capistrano M, Cappelli G, Capuano M, Cascone C, Catizone L, Catucci AE, Cavatorta F, Chiarinotti D, Cicchetti T, Concas G, Concetti M, Conte F, Conti M, Coratelli P, Corti MM, Costanzo R, Dal Canton A, D'Apice L, David S, De Cristofaro V, Deferrari G, Della Grotta F, De Nicola L, De Santo NG, De Simone W, Di Daniele N, Di Giulio S, Di Landro D, Di Luzio V, Di Maggio A, Fagugli R, Farina M, Feriani M, Gallieni M, Gambaro G, Giordano R, Greco S, Grillo C, Huber W, Liuzzo G, Lombardi L, Lopez T, Malberti F, Mancini W, Manenti F, Manisco G, Marrocco A, Matocci G, Merico G, Messa P, Minutolo R, Monardo P, Moriconi L, Murrone P, Nardo A, Naso A, Nobile R, Panarello G, Paone A, Parravano M, Pedrini L, Piazza V, Pistis R, Procida M, Quarello F, Rapisarda F, Ricciardi B, Rindi P, Ronco C, Rotolo U, Russo G, Saraniti A, Sasdelli M, Savica V, Scanziani R, Sidoti A, Spotti D, Stalteri A, Stefoni S, Stella A, Strippoli P, Teatini U, Teodoro C, Tozzo C, Triolo G., SIR SIN STUDY INVESTIGATORS ACCIARRI, P, Menegato, Ma, Ancarani, E, Andreucci, V, Antonelli, A, Auricchio, Mr, Balducci, A, Bassi, A, Battaglia, G, Bellingheri, G, Beltrame, A, Biagini, M, Bonfante, L, Bonofiglio, R, Bonomini, M, Borghi, M, Brigante, M, Buccianti, G, Buongiorno, E, Cabibbe, M, Cancarini, G, Capistrano, M, Cappelli, G, Capuano, M, Cascone, C, Catizone, L, Catucci, Ae, Cavatorta, F, Chiarinotti, D, Cicchetti, T, Concas, G, Concetti, M, Conte, F, Conti, M, Coratelli, P, Corti, Mm, Costanzo, R, DAL CANTON, A, D'Apice, L, David, S, DE CRISTOFARO, V, Deferrari, G, DELLA GROTTA, F, DE NICOLA, Luca, DE SANTO, Ng, DE SIMONE, W, DI DANIELE, N, DI GIULIO, S, DI LANDRO, D, DI LUZIO, V, DI MAGGIO, A, Fagugli, R, Farina, M, Feriani, M, Gallieni, M, Gambaro, G, Giordano, R, Greco, S, Grillo, C, Huber, W, Liuzzo, G, Locatelli, F, Lombardi, L, Lopez, T, Malberti, F, Mancini, W, Manenti, F, Manisco, G, Marrocco, A, Matocci, G, Merico, G, Messa, P, Minutolo, Roberto, Monardo, P, Moriconi, L, Murrone, P, Nardo, A, Naso, A, Nobile, R, Panarello, G, Paone, A, Parravano, M, Pedrini, L, Piazza, V, Pistis, R, Procida, M, Quarello, F, Rapisarda, F, Ricciardi, B, Rindi, P, Ronco, C, Rotolo, U, Russo, G, Saraniti, A, Sasdelli, M, Savica, V, Scanziani, R, Sidoti, A, Spotti, D, Stalteri, A, Stefoni, S, Stella, A, Strippoli, P, Teatini, U, Teodoro, C, Tozzo, C, Triolo, G, and Zoccali, C.

Subjects
Nephrology, medicine.medical_specialty, Referral, Anemia, medicine.medical_treatment, Context (language use), Metabolic Diseases, Internal medicine, Surveys and Questionnaires, Italian Society of Nephrology, chronic kidney disease, questionnaire, medicine, Humans, Intensive care medicine, Dialysis, Settore MED/14 - Nefrologia, Transplantation, business.industry, Guideline, medicine.disease, Italy, Chronic Disease, Kidney Diseases, Hemodialysis, Guideline Adherence, business, Kidney disease
Abstract

BACKGROUND: Recent studies have indicated that the implementation of international guidelines for the management of renal patients is suboptimal in Italy. The Italian Society of Nephrology (SIN) decided to undertake a multicentre study to obtain a clear picture of clinical policies on chronic kidney disease (CKD) in Italy. METHODS: A 76-item structured questionnaire, designed to evaluate the organization of clinical care, was administered to the director of each participating centre, within the context of a large observational trial in 100 Italian nephrology centres, collecting information on newly diagnosed CKD patients (K/DOQI stage 3-5) on conservative treatment. This paper reports the questionnaire results related to management of anaemia and bone metabolism disorders; assessment of renal function; creation of a vascular access for dialysis and referral of patients to a nephrologist. RESULTS: Clinical policies at the centre level deviated from guideline recommendations in 70% (timing of vascular access creation) to 25% (assessment of iron deficiency) of centres. Assessment of renal function differed from the recommended approach in 30% of centres; clinical policies related to anaemia and bone disease did not coincide with guideline standards in 50 and 40% of centres, respectively. Directors of renal unit estimates indicate that the creation of a vascular access occurs very late in 38% of patients and that referral to a nephrologist is late in approximately 40% of cases. CONCLUSION: This survey in Italy highlights important deviations of clinical policies at the centre level from guideline recommendations.

Published
2008

10. High Efficiency Hemofiltration

Author

E. Minetti, Teatini U, Luigi Minetti, Giovanni Civati, Guastoni C, Perego A, and Perrino Ml

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, Hemofiltration, Medicine, business, Intensive care medicine
Published
2015
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11. Clinical practice for the diagnosis of cardiac arrhythmias in patients on renal replacement therapy: data from a Lombard survey

Author

Genovesi, S, Nava, E, Pasa, A, Corghi, E, Ondei, P, Marta, E, Bellasi, A, Malberti, F, Teatini, U, Guastoni, C, Spatola, L, Luise, M, Tiboldo, R, Bertoli, S, Messa, P, Doria, M, Gallieni, M, Cozzolino, M, Spotti, D, Sala, V, Sironi, E, Boriani, G, PASA, ALICE, Guastoni, CM, Luise, MC, DORIA, MARIA, SIRONI, ELISABETTA LUCIA, Genovesi, S, Nava, E, Pasa, A, Corghi, E, Ondei, P, Marta, E, Bellasi, A, Malberti, F, Teatini, U, Guastoni, C, Spatola, L, Luise, M, Tiboldo, R, Bertoli, S, Messa, P, Doria, M, Gallieni, M, Cozzolino, M, Spotti, D, Sala, V, Sironi, E, Boriani, G, PASA, ALICE, Guastoni, CM, Luise, MC, DORIA, MARIA, and SIRONI, ELISABETTA LUCIA

Abstract

Among dialysis patients, 40% of deaths are due to cardiovascular causes, and 60% of cardiac deaths are due to an arrhythmia. The purpose of this survey, carried out with the organizational support of the Lombard Section of the Italian Society of Nephrology, is to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in the dialysis centers of Lombardy. Information on the prevalence and type of cardiac devices at December 1, 2016 in this population was also required. Data from 18 centers were collected for a total of 3395 patients in replacement renal therapy, including 2907 (85.6%) in hemodialysis and 488 (14.4%) in peritoneal dialysis. All centers use the 12-lead ECG in case of evocative symptoms of an arrhythmic event and 2/3 perform the exam with programmed cadence (usually once a year). Twenty four-hour ECG Holter is not used as a routine diagnostic tool. The proportion of cardiac devices is relatively high, compared to literature data: n=259, equal to 7.6% of the population. Pace-Maker patients are 166 (4.9%), those with intracardiac defibrillator 52 (1.5%), those with resynchronization therapy 18 (0.5%) and those with resynchronization therapy and intracardiac defibrillator 23 (0.7%). The survey provides interesting information and can be an important starting point for trying to optimize clinical practice and collaboration between nephrologists and cardiologists in front of a major problem like that of arrhythmic disease in patients on renal replacement therapy.

Published
2017

12. Old and New Perspectives on Peritoneal Dialysis in Italy Emerging from the Peritoneal Dialysis Study Group Census

Author

Marinangeli, G, Cabiddu, G, Neri, L, Viglino, G, Russo, R, Teatini, U, Bonfante, Luciana, Italian Society of Nephrology Peritoneal Dialysis Study Group, Marinangeli, G, Cabiddu, G, Neri, L, Viglino, G, Russo, R, Teatini, U on behalf of the Italian Society of Nephrology Peritoneal Dialysis Group including, and Vezzoli, G

Subjects
medicine.medical_specialty, medicine.medical_treatment, Peritonitis, Peritoneal dialysis, Peritoneal Dialysis, Continuous Ambulatory, Surveys and Questionnaires, Internal medicine, medicine, Humans, Dialysis, business.industry, Incidence, Incidence (epidemiology), Censuses, Peritoneal Fibrosis, Original Articles, General Medicine, medicine.disease, Surgery, Survival Rate, Transplantation, Catheter, Italy, Nephrology, Ambulatory, Hemodialysis, business, Peritoneal Dialysis
Abstract

Background To understand how peritoneal dialysis (PD) was being used in Italy in 2005 and 2008, a census of all centers was carried out. Methods In 2005 and 2008, data were collected from, respectively, 222 and 223 centers, with respect to 4432 and 4094 prevalent patients. Results In the two periods, the PD incidence remained stable (24.3% vs 22.9%), varying from center to center. Continuous ambulatory PD (CAPD) was the main initial method (55%), but APD was more widespread among prevalent patients (53%). Among patients returning to dialysis from transplantation (Tx), PD was used in 10%. The use of incremental CAPD increased significantly from 2005 to 2008, in terms both of the number of centers (27.0% vs 40.9%) and of patients (13.6% vs 25.7%). Late referrals remained stable at 28%, with less use of PD. The overall drop-out rate (episodes/100 patient–years) remained unchanged (31.0 vs 32.8), with 13.1 and 12.9 being the result of death, and 11.8 and 12.4 being the result of a switch to hemodialysis, mainly after peritonitis. A dialysis partner was required by 21.8% of the PD patients. The incidence of peritonitis was 1 episode in 36.5 and 41.1 patient–months, with negative cultures occurring in 17.1% of cases in both periods. The incidence of encapsulating peritoneal sclerosis (episodes/100 patient–years) was 0.70, representing 1.26% of patients treated. The catheter types used and the sites and methods of insertion varied widely from center to center. Conclusions These censuses confirm the good results of PD in Italy, and provide insight into little-known aspects such as the use of incremental PD, the presence of a dialysis partner, and the incidence of encapsulating peritoneal sclerosis.

Published
2012

13. Prognostic role of LDL cholesterol in non-dialysis chronic kidney disease: Multicenter prospective study in Italy

Author

De Nicola, Luca, Provenzano, Michele, Chiodini, Paolo, D'Arrigo, Graziella, Tripepi, Giovanni, Del Vecchio, Lucia, Conte, Giuseppe, Locatelli, Francesco, Zoccali, Carmine, Minutolo, RobertoAcciarri P, Adorati, M, Ancarani, E, Andreucci, V, Antonelli, A, Auricchio, Mr, Balducci, A, Bassi, A, Battaglia, G, Bellingheri, G, Beltrame, A, Biagini, M, Bonfante, L, Bonofiglio, R, Bonomini, M, Borghi, M, Brigante, M, Buccianti, G, Buongiorno, E, Cabibbe, M, Cancarini, Giovanni, Capistrano, M, Cappelli, G, Capuano, M, Cascone, C, Catizone, L, Catucci, Ae, Cavatorta, F, Chiarinotti, D, Cicchetti, T, Concas, G, Concetti, M, Conte, F, Conte, G, Conti, M, Coratelli, P, Corti, Mm, Costanzo, R, Dal Canton, A, D'Apice, L, David, S, De Cristofaro, V, Deferrari, G, Della Grotta, F, De Santo NG, De Simone, W, Di Daniele, N, Di Giulio, S, Di Landro, D, Di Luzio, V, Di Maggio, A, Fagugli, R, Farina, M, Feriani, M, Gallieni, M, Gambaro, G, Giordano, R, Greco, S, Grillo, C, Huber, W, Liuzzo, G, Locatelli, F, Lombardi, L, Lopez, T, Malberti, F, Mancini, W, Manenti, F, Manisco, G, Marrocco, A, Matocci, G, Merico, G, Messa, P, Minutolo, R, Monardo, P, Moriconi, L, Murrone, P, Nardo, A, Naso, A, Nobile, R, Panarello, G, Paone, A, Parravano, M, Pedrini, L, Piazza, V, Pistis, R, Procida, M, Quarello, F, Rapisarda, F, Ricciardi, B, Rindi, P, Ronco, C, Rotolo, U, Russo, G, Santoro, D, Saraniti, A, Sasdelli, M, Savica, V, Scanziani, R, Sidoti, A, Spotti, D, Stalteri, A, Stefoni, S, Stella, A, Strippoli, P, Teatini, U, Teodoro, C, Tozzo, C, Triolo, G, Zoccali, C., De Nicola, L, Provenzano, M, Chiodini, P, D'Arrigo, G, Tripepi, G, Del Vecchio, L, Conte, G, Locatelli, F, Zoccali, C, and Minutolo, R

Subjects
Male, Nephrology, Endocrinology, Diabetes and Metabolism, medicine.medical_treatment, Medicine (miscellaneous), Kidney Function Tests, Severity of Illness Index, chemistry.chemical_compound, Endocrinology, Risk Factors, Chronic kidney disease, 80 and over, Prospective Studies, Renal Insufficiency, Chronic, Prospective cohort study, Cardiovascular risk, Cholesterol, ESRD, LDL, Renal clinic, Nutrition and Dietetics, Cardiology and Cardiovascular Medicine, Aged, 80 and over, Medicine (all), Middle Aged, Prognosis, Diabetes and Metabolism, Italy, Cardiovascular Diseases, Female, Glomerular Filtration Rate, medicine.medical_specialty, Renal function, Median follow-up, Internal medicine, Diabetes mellitus, medicine, Humans, Renal replacement therapy, Renal Insufficiency, Chronic, Aged, business.industry, Cholesterol, LDL, medicine.disease, chemistry, business, Kidney disease
Abstract

Background and aims The prognostic role of LDL in non-dialysis chronic kidney disease (CKD) is still undefined. We addressed this question in a multicenter prospective study including patients referred to nephrologist for management. Methods and results 1306 patients with CKD stage III–V were studied at basal visit in 79 Italian nephrology clinics in 2004–2006, and then followed for survival analyses. Study endpoints were incident cardiovascular -CV events (fatal and major non-fatal) and renal events (start of renal replacement therapy or eGFR halving). Mean age was 67.6 ± 11.8 years, male 65%, diabetes 25%, CV disease 27%, and eGFR 35.8 ± 12.5 mL/min/1.73 m 2 . LDL was 119 ± 40 mg/dL, with high levels in 50.1% and 82.8% defined on the basis of the individual CV risk profile estimated according to ATPIII 2001 and ESC 2012 guidelines (LDL 100 to 160, and >70 or >100 mg/dL, respectively). Over a median follow up of 2.87 years, 178 CV and 181 renal events occurred. At multivariable Cox analyses, CV risk linearly increased with higher LDL (hazard ratio-HR per 40 mg/dL higher LDL: 1.20, 95% confidence intervals-CI 1.03–1.39); risk doubled when considering high LDL defined according to ESC 2012 (HR 2.37, 95%CI 1.39–4.03) while this association was not significant when considering the higher threshold levels of ATPIII 2001 (HR 1.10, 95%CI 0.82–1.49). No association emerged between LDL and renal risk. Conclusion In non-dialysis CKD patients, CV risk increases linearly with higher LDL and is more than doubled when considering the lower threshold values currently indicated for defining optimal LDL level.

Published
2015

14. Guidelines on water and solutions for dialysis

Author

FUIANO G, ALLOATTI S, BOLASCO P, CANAVESE C, CAPPELLI G, PEDRINI L, PIZZARELLI F, PONTONIERO G, SANTORO A, TEATINI U., ANASTASIO, Pietro, Fuiano, G, Alloatti, S, Bolasco, P, Canavese, C, Cappelli, G, Pedrini, L, Pizzarelli, F, Pontoniero, G, Santoro, A, Anastasio, Pietro, and Teatini, U.

Published
2005

15. Clinical policies on the management of chronic kidney disease patients in Italy

Author

Locatelli, F, Zoccali, C, SIR SIN STUDY INVESTIGATORS, COLLABORATORS ACCIARRI, P, Menegato, Ma, Ancarani, E, Andreucci, V, Antonelli, A, Auricchio, Mr, Balducci, A, Bassi, A, Battaglia, G, Bellingheri, G, Beltrame, A, Biagini, M, Bonfante, L, Bonofiglio, R, Bonomini, M, Borghi, M, Brigante, M, Buccianti, G, Buongiorno, E, Cabibbe, M, Cancarini, Giovanni, Capistrano, M, Cappelli, G, Capuano, M, Cascone, C, Catizone, L, Catucci, Ae, Cavatorta, F, Chiarinotti, D, Cicchetti, T, Concas, G, Concetti, M, Conte, F, Conti, M, Coratelli, P, Corti, Mm, Costanzo, R, Dal, Canton, A, D'Apice, L, David, S, DE CRISTOFARO, V, Deferrari, G, DELLA GROTTA, F, Nicola, L, DE SANTO NG, DE SIMONE, W, DI DANIELE, N, DI GIULIO, S, DI LANDRO, D, Luzio, V, DI MAGGIO, A, Fagugli, R, Farina, M, Feriani, M, Gallieni, M, Gambaro, G, Giordano, R, Greco, S, Grillo, C, Huber, W, Liuzzo, G, Lombardi, L, Lopez, T, Malberti, F, Mancini, W, Manenti, F, Manisco, G, Marrocco, A, Matocci, G, Merico, G, Messa, P, Minutolo, R, Monardo, P, Moriconi, L, Murrone, P, Nardo, A, Naso, A, Nobile, R, Panarello, G, Paone, A, Parravano, M, Pedrini, L, Piazza, V, Pistis, R, Procida, M, Quarello, F, Rapisarda, F, Ricciardi, B, Rindi, P, Ronco, C, Rotolo, U, Russo, G, Saraniti, A, Sasdelli, M, Savica, V, Scanziani, R, Sidoti, A, Spotti, D, Stalteri, A, Stefoni, S, Stella, A, Strippoli, P, Teatini, U, Teodoro, C, Tozzo, C, Triolo, G, and Zoccali, C.

Subjects
Chrinic kidney disease, anemia
Published
2008

17. High Efficiency Hemofiltration

Author

Minetti, L., primary, Guastoni, C., additional, Perego, A., additional, Teatini, U., additional, Minetti, E., additional, Perrino, M. L., additional, and Civati, G,, additional

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18. DIALYSIS. PATHOPHYSIOLOGY AND CLINICAL STUDIES

Author

Humalda, J. K., primary, Assa, S., additional, Navis, G. J., additional, Franssen, C. F. M., additional, De Borst, M. H., additional, Ogawa, H., additional, Ota, Y., additional, Watanabe, T., additional, Watanabe, Y., additional, Nishii, H., additional, Sato, A., additional, Waniewski, J., additional, Debowska, M., additional, Wojcik-Zaluska, A., additional, Ksiazek, A., additional, Zaluska, W., additional, Guastoni, C. M., additional, Turri, C., additional, Toma, L., additional, Rombola, G., additional, Frattini, G., additional, Romei Longhena, G., additional, Teatini, U., additional, Siriopol, D.-C., additional, Stuard, S., additional, Ciolan, A., additional, Mircescu, G., additional, Raluca, D., additional, Nistor, I., additional, Covic, A., additional, De Roij Van Zuijdewijn, C. L., additional, Chapdelaine, I., additional, Nube, M. J., additional, Blankestijn, P. J., additional, Bots, M. L., additional, Konings, S. J., additional, Van Den Dorpel, M. A., additional, Van Der Weerd, N. C., additional, Ter Wee, P. M., additional, Grooteman, M. P., additional, Djuric, P. S., additional, Jankovic, A., additional, Tosic, J., additional, Bajcetic, S., additional, Damjanovic, T., additional, Popovic, J., additional, Dimkovic, N., additional, Marinkovic, J., additional, Djuric, Z., additional, Knezevic, V., additional, Lazarevic, T., additional, Ljubenovic, S., additional, Markovic, R., additional, Rabrenovic, V., additional, Djukanovic, L., additional, Radovic Maslarevic, V., additional, Mathrani, V., additional, Drew, P., additional, Chess, J. I., additional, Williams, A. I., additional, Robertson, S., additional, Jibani, M., additional, Aithal, V. I., additional, Kumwenda, M., additional, Roberts, G., additional, Mikhail, A. I., additional, Grzegorzewska, A. E., additional, Ostromecki, G., additional, Mostowska, A., additional, Sowi ska, A., additional, Jagodzi ski, P. P., additional, Wu, H.-Y., additional, Chen, H.-Y., additional, Hsu, S.-P., additional, Pai, M.-F., additional, Yang, J.-Y., additional, Peng, Y.-S., additional, Hirose, M., additional, Hasegawa, T., additional, Kaneshima, N., additional, Sasai, F., additional, Komukai, D., additional, Takahashi, K., additional, Koiwa, F., additional, Shishido, K., additional, Yoshimura, A., additional, Selim, G., additional, Stojceva-Taneva, O., additional, Tozija, L., additional, Dzekova-Vidimliski, P., additional, Trajceska, L., additional, Petronievic, Z., additional, Gelev, S., additional, Amitov, V., additional, Sikole, A., additional, Moon, S. J., additional, Yoon, S. Y., additional, Shin, D. H., additional, Lee, J. E., additional, Kim, H.-J., additional, Park, H.-C., additional, Hadjiyannakos, D., additional, Filiopoulos, V., additional, Loukas, G., additional, Pagonis, S., additional, Andriopoulos, C., additional, Drakou, A., additional, Vlassopoulos, D., additional, Catarino, C., additional, Cunha, P., additional, Ribeiro, S., additional, Rocha-Pereira, P., additional, Reis, F., additional, Sameiro-Faria, M., additional, Miranda, V., additional, Bronze-Rocha, E., additional, Belo, L., additional, Costa, E., additional, Santos-Silva, A., additional, De Mauri, A., additional, Brambilla, M., additional, Chiarinotti, D., additional, Lizio, D., additional, Matheoud, R., additional, Conti, N., additional, Conte, M. M., additional, Carriero, A., additional, De Leo, M., additional, Karpetas, A. V., additional, Sarafidis, P. A., additional, Georgianos, P. I., additional, Koutroumpas, G., additional, Divanis, D., additional, Vakianis, P., additional, Tzanis, G., additional, Raptopoulou, K., additional, Protogerou, A., additional, Stamatiadis, D., additional, Syrganis, C., additional, Liakopoulos, V., additional, Efstratiadis, G., additional, Lasaridis, A. N., additional, Tersi, M., additional, Stamatiadis, D. N., additional, Kuczera, P., additional, Adamczak, M., additional, Wiecek, A., additional, Bove, S., additional, Giacon, B., additional, Corradini, R., additional, Prati, E., additional, Brognoli, M., additional, Tommasi, A., additional, Sereni, L., additional, Palladino, G., additional, Moriya, H., additional, Mochida, Y., additional, Ishioka, K., additional, Oka, M., additional, Maesato, K., additional, Hidaka, S., additional, Ohtake, T., additional, Kobayashi, S., additional, Moura, A., additional, Madureira, J., additional, Alija, P., additional, Fernandes, J. C., additional, Oliveira, J. G., additional, Lopez, M., additional, Filgueiras, M., additional, Amado, L., additional, Vieira, M., additional, Seok, J.-H., additional, Choi, H. Y., additional, Ha, S. K., additional, Park, H. C., additional, Bossola, M., additional, Laudisio, A., additional, Antocicco, M., additional, Tazza, L., additional, Colloca, G., additional, Tosato, M., additional, Zuccala, G., additional, Ettema, E. M., additional, Kuipers, J., additional, Groen, H., additional, Gansevoort, R. T., additional, Stade, K., additional, Bakker, S. J. L., additional, Gaillard, C. A. J. M., additional, Westerhuis, R., additional, Bacchetta, J., additional, Couchoud, K., additional, Semlali, S., additional, Sellier-Leclerc, A.-L., additional, Bertholet-Thomas, A., additional, Cartier, R., additional, Cochat, P., additional, Ranchin, B., additional, Kim, J. C., additional, Park, K., additional, Van Ende, C., additional, Wilmes, D., additional, Lecouvet, F. E., additional, Labriola, L., additional, Cuvelier, R., additional, Van Ingelgem, G., additional, Jadoul, M., additional, Doriana, C., additional, David, P., additional, Capurro, F., additional, Brustia, M., additional, Ruva, C. E., additional, Giungi, S., additional, Di Stasio, E., additional, Lemesch, S., additional, Leber, B., additional, Horvath, A., additional, Ribitsch, W., additional, Schilcher, G., additional, Zettel, G., additional, Tawdrous, M., additional, Rosenkranz, A. R., additional, Stadlbauer-Kollner, V., additional, Matsushima, H., additional, Oyama, A., additional, Bosch Benitez-Parodi, E., additional, Baamonde Laborda, E., additional, Batista Garcia, F., additional, Perez Suarez, G., additional, Anton Perez, G., additional, Garcia Canton, C., additional, Toledo Gonzalez, A., additional, Lago Alonso, M. M., additional, Checa Andres, M. D., additional, Cobo, G., additional, Di Gioia, C., additional, Camacho, R., additional, Garcia Lacalle, C., additional, Ortega, O., additional, Rodriguez, I., additional, Herrero, J., additional, Oliet, A., additional, Ortiz, M., additional, Mon, C., additional, Vigil, A., additional, Gallar, P., additional, Pellu, V., additional, Nebiolo, P. E., additional, Sasaki, K., additional, Yamguchi, S., additional, Hesaka, A., additional, Iwahashi, E., additional, Sakai, S., additional, Fujimoto, T., additional, Minami, S., additional, Fujita, Y., additional, Yokoyama, K., additional, Shutov, E., additional, Ryabinskya, G., additional, Lashutin, S., additional, Gorelova, E., additional, Volodicheva, E., additional, Podesta, M. A., additional, Cancarini, G., additional, Cucchiari, D., additional, Montanelli, A., additional, Badalamenti, S., additional, Graziani, G., additional, Distasio, E., additional, Pchelin, I., additional, Shishkin, A., additional, Fedorova, Y., additional, Kao, C.-C., additional, Chu, T.-S., additional, Tsai, T.-J., additional, Wu, K.-D., additional, Wu, M.-S., additional, Raikou, V., additional, Kaisidis, P., additional, Tsamparlis, E., additional, Kanellopoulos, P., additional, Boletis, J., additional, Ueda, A., additional, Hirayama, A., additional, Owada, S., additional, Nagai, K., additional, Saito, C., additional, and Yamagata, K., additional

Published
2014
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19. Anaemia in CKD 5D

Author

Mikhail, A., primary, Kaplan, M., additional, Macdougall, I., additional, Schmidt, R. J., additional, Rastogi, A., additional, Wang, W., additional, Tong, S., additional, Mayo, M., additional, Oestreicher, N., additional, Schiller, B., additional, Green, J. M., additional, Verma, R., additional, Leu, K., additional, Mortensen, R. B., additional, Young, P. R., additional, Schatz, P., additional, Wojchowski, D. M., additional, Shimonaka, Y., additional, Sasaki, Y., additional, Yorozu, K., additional, Sasaki, M. N., additional, Ikuta, K., additional, Kohgo, Y., additional, Omori, Y. M., additional, Hiramatsu, M., additional, Momoki, N., additional, Kakio, Y., additional, Shibuto, N., additional, Takeuchi, H., additional, Fukumoto, M., additional, Maruyama, K., additional, Matsuo, Y., additional, Omori, Y., additional, Robinson, B. M., additional, Larkina, M., additional, Goodkin, D. A., additional, Li, Y., additional, Locatelli, F., additional, Nolen, J., additional, Kleophas, W., additional, Pisoni, R. L., additional, Sibbel, S., additional, Brunelli, S., additional, Krishnan, M., additional, Horie, M., additional, Hasegawa, E., additional, Minoshima, K.-i., additional, Ambrus, C., additional, Kerkovits, L., additional, Szegedi, J., additional, Benke, A., additional, Toth, E., additional, Nagy, L., additional, Borbas, B., additional, Rozinka, A., additional, Nemeth, J., additional, Varga, G., additional, Kulcsar, I., additional, Gergely, L., additional, Szakony, S., additional, Kiss, I., additional, Danielson, K., additional, Qureshi, A. R., additional, Heimburger, O., additional, Stenvinkel, P., additional, Lindholm, B., additional, Hylander-Rossner, B., additional, Germanis, G., additional, Hansson, M., additional, Beshara, S., additional, Barany, P., additional, Dueymes, J.-M., additional, Kolko, A., additional, Couchoud, C., additional, Combe, C., additional, Covic, A., additional, Goldsmith, D., additional, Zaoui, P., additional, Gesualdo, L., additional, London, G., additional, Dellanna, F., additional, Mann, J., additional, Turner, M., additional, Muenzberg, M., additional, MacDonald, K., additional, Denhaerynck, K., additional, Abraham, I., additional, Sanchez, M. B., additional, Casero, R. C., additional, Ortiz, R. V., additional, Carmelo, I. G., additional, Munoz, S. C., additional, Gomez, E. R., additional, Rodriguez, C. S., additional, Kuji, T., additional, Fujikawa, T., additional, Kakimoto-Shino, M., additional, Shibata, K., additional, Toya, Y., additional, Umemura, S., additional, Topuzovic, N., additional, Mihaljevic, I., additional, Rupcic, V., additional, Sterner, G., additional, Clyne, N., additional, Toblli, J., additional, Di Gennaro, F., additional, Chmielewski, M., additional, Jagodzinski, P., additional, Lichodziejewska-Niemierko, M., additional, Rutkowski, B., additional, Takasawa, K., additional, Takaeda, C., additional, Ueda, H., additional, Higuchi, M., additional, Maeda, T., additional, Tomosugi, N., additional, Moghazy, T. F., additional, Jakic, M., additional, Zibar, L., additional, Romei Longhena, G., additional, Beck, W., additional, Liebchen, A., additional, Teatini, U., additional, Rottembourg, J. B., additional, Guerin, A., additional, Diaconita, M., additional, Dansaert, A., additional, Koike, K., additional, Fukami, K., additional, Shimamatsu, K., additional, Kawaguchi, A., additional, and Okuda, S., additional

Published
2013
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27. Erythrocyte ferritin in patients on chronic hemodialysis treatment

Author

Brunati, C, Piperno, A, Guastoni, C, Perrino, M, Civati, G, Teatini, U, Perego, A, Fiorelli, G, Minetti, L, Minetti, L., PIPERNO, ALBERTO, Brunati, C, Piperno, A, Guastoni, C, Perrino, M, Civati, G, Teatini, U, Perego, A, Fiorelli, G, Minetti, L, Minetti, L., and PIPERNO, ALBERTO

Abstract

Serum ferritin (SF) and erythrocyte ferritin (EF) were evaluated in 35 patients on chronic hemodialysis treatment (CHD), in 45 healthy subjects and in 22 nonnephropathic females with iron deficiency anemia. Twenty-five CHD patients with basal SF less than 500 micrograms/l were treated orally with 200 mg of Fe2+ for 2 months and the positive (hemoglobin increase greater than 1 g/dl) or negative response to the therapy was correlated to the basal levels of SF and EF. Three groups of CHD patients could be defined on the basis of their basal SF levels (hypo-, normo- or hyperferritinemic). Nine patients with increased SF levels had also EF levels significantly higher than the other CHD patients and controls since they were probably iron-overloaded. In the other 2 groups of CHD patients, EF levels were significantly higher than in controls for each level of SF probably because of the reduced utilization of iron by uremic bone marrow. Among the 25 treated CHD patients, only 5 responded to the therapy: 3 were hypoferritinemic while the other 2 responders had basal SF within the normal range. Four hypoferritinemic patients did not respond to the therapy. Four out of five responders had the lowest EF levels among CHD patients. EF measurement could be an important and useful test in detecting the presence of an iron deficiency erythropoiesis in CHD patients.

Published
1990

32. Uremic Polyneuropathy Can Be Cured by High-Efficiency Hemofiltration

Author

Teatini U, D. D’Urso, V. Grassi, Luigi Minetti, Perego A, Civati G, and Guastoni C

Subjects
medicine.medical_specialty, Resuscitation, business.industry, medicine.medical_treatment, Hematology, General Medicine, medicine.disease, Surgery, Uremic polyneuropathy, Peripheral neuropathy, Nephrology, Hemofiltration, medicine, sense organs, Renal replacement therapy, skin and connective tissue diseases, business, Polyneuropathy
Abstract

13 patients under artificial renal replacement therapy have been studied as to the changes of electromyographic patterns and peripheral neuropathy symptoms. 10 patients have been treated by high-effic

Published
1983
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33. Erythrocyte ferritin in patients on chronic hemodialysis treatment

Author

Giovanni Civati, Luigi Minetti, A. Piperno, Perrino Ml, Teatini U, Perego A, Guastoni C, Brunati C, G. Fiorelli, Brunati, C, Piperno, A, Guastoni, C, Perrino, M, Civati, G, Teatini, U, Perego, A, Fiorelli, G, and Minetti, L

Subjects
Adult, Male, medicine.medical_specialty, Resuscitation, Erythrocytes, Anemia, medicine.medical_treatment, Iron, Gastroenterology, Bone Marrow, Renal Dialysis, Internal medicine, medicine, Humans, Erythropoiesis, Chronic hemodialysis, Serum ferritin, Aged, Anemia, Hypochromic, Ferritin, biology, business.industry, Iron Deficiencies, Iron deficiency, Middle Aged, medicine.disease, Erythrocyte, Red blood cell, medicine.anatomical_structure, Ferritins, Immunology, biology.protein, Female, Hemodialysis, MED/09 - MEDICINA INTERNA, business, Human
Abstract

Serum ferritin (SF) and erythrocyte ferritin (EF) were evaluated in 35 patients on chronic hemodialysis treatment (CHD), in 45 healthy subjects and in 22 nonnephropathic females with iron deficiency anemia. Twenty-five CHD patients with basal SF less than 500 micrograms/l were treated orally with 200 mg of Fe2+ for 2 months and the positive (hemoglobin increase greater than 1 g/dl) or negative response to the therapy was correlated to the basal levels of SF and EF. Three groups of CHD patients could be defined on the basis of their basal SF levels (hypo-, normo- or hyperferritinemic). Nine patients with increased SF levels had also EF levels significantly higher than the other CHD patients and controls since they were probably iron-overloaded. In the other 2 groups of CHD patients, EF levels were significantly higher than in controls for each level of SF probably because of the reduced utilization of iron by uremic bone marrow. Among the 25 treated CHD patients, only 5 responded to the therapy: 3 were hypoferritinemic while the other 2 responders had basal SF within the normal range. Four hypoferritinemic patients did not respond to the therapy. Four out of five responders had the lowest EF levels among CHD patients. EF measurement could be an important and useful test in detecting the presence of an iron deficiency erythropoiesis in CHD patients.

35. Clinical practice for the diagnosis of cardiac arrhythmias in patients on renal replacement therapy: data from a Lombard survey,Pratica clinica per la diagnostica delle aritmie cardiache in pazienti in terapia renale sostitutiva: dati di una survey lombarda

Author

Genovesi, S., Nava, E., Pasa, A., Corghi, E., Ondei, P., Marta, E., Bellasi, A., Malberti, F., Teatini, U., Guastoni, C. M., Spatola, L., Luise, M. C., Tiboldo, R., Bertoli, S., Messa, P., Doria, M., Gallieni, M., Mario Cozzolino, Spotti, D., Sala, V., Sironi, E., and Boriani, G.

36. New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of Nephrologists form Lombardy

Author

Bellasi, A., Mario Cozzolino, Malberti, F., Cancarini, G., Esposito, C., Genderini, A., Guastoni, C. M., Ondei, P., Pontoriero, G., Teatini, U., Vezzoli, G., Messa, P., Locatelli, F., Bellasi, Antonio, Cozzolino, Mario, Malberti, Fabio, Cancarini, Giovanni, Esposito, Ciro, Genderini, Augusto, Guastoni, Carlo Maria, Ondei, Patrizia, Pontoriero, Giuseppe, Teatini, Ugo, Vezzoli, Giuseppe, Messa, Piergiorgio, and Locatelli, Francesco

Subjects
etelcalcetide, secondary hyperparathyroidism, CKD-MBD, cinacalcet, PTH
Abstract

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago. Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

40. New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of working group on CKD-MBD of the Italian Society of Nephrology

Author

Piergiorgio Messa, Giuseppe Vezzoli, Mario Cozzolino, Ciro Esposito, Patrizia Ondei, Giovanni Cancarini, Antonio Bellasi, Francesco Locatelli, Giuseppe Pontoriero, Marzia Pasquali, Carlo Guastoni, Fabio Malberti, Ugo Teatini, Bellasi, A., Cozzolino, M., Malberti, F., Cancarini, G., Esposito, C., Guastoni, C. M., Ondei, P., Pontoriero, G., Teatini, U., Vezzoli, G., Pasquali, M., Messa, P., and Locatelli, F.

Subjects
Nephrology, medicine.medical_specialty, Calcimimetic, medicine.medical_treatment, Population, urologic and male genital diseases, Chronic kidney disease-mineral and bone disorder, Internal medicine, CKD-MBD, medicine, Humans, Position papers and Guidelines, Intensive care medicine, education, Dialysis, Chronic Kidney Disease-Mineral and Bone Disorder, Etelcalcetide, education.field_of_study, business.industry, medicine.disease, female genital diseases and pregnancy complications, Secondary hyperparathyroidism, Italy, Position paper, Cinacalcet, Peptides, business, PTH, Kidney disease
Abstract

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

Published
2019
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41. Clinical practice for the diagnosis of cardiac arrhythmias in patients on renal replacement therapy: data from a Lombard survey

Author

Genovesi, Simonetta, Nava, Elisa, Pasa, Alice, Corghi, Enzo, Ondei, Patrizia, Marta, Elisabetta, Bellasi, Antonio, Malberti, Fabio, Teatini, Ugo, Guastoni, Carlo Maria, Spatola, Leonardo, Luise, Maria Carmen, Tiboldo, Renza, Bertoli, Silvio, Messa, Piergiorgio, Doria, Maria, Gallieni, Maurizio, Cozzolino, Mario, Spotti, Donatella, Sala, Valeria, Sironi, Elisabetta, Boriani, Giuseppe, Genovesi, S, Nava, E, Pasa, A, Corghi, E, Ondei, P, Marta, E, Bellasi, A, Malberti, F, Teatini, U, Guastoni, C, Spatola, L, Luise, M, Tiboldo, R, Bertoli, S, Messa, P, Doria, M, Gallieni, M, Cozzolino, M, Spotti, D, Sala, V, Sironi, E, and Boriani, G

Subjects
Pacemaker, Artificial, Cardiology, Electric Countershock, cardiac devices, Arrhythmias, electrocardiogram, Kidney Failure, Cardiac Resynchronization Therapy, Electrocardiography, Ambulatory, Humans, Chronic, peritoneal dialysis, Patient Care Team, echocardiogram, haemodialysis, Arrhythmias, Cardiac, Defibrillators, Implantable, Disease Management, Electrocardiography, Ambulatory, Health Care Surveys, Heart Arrest, Italy, Kidney Failure, Chronic, Nephrology, Stroke, Renal Replacement Therapy, cardiac device, Pacemaker, haemodialysi, Artificial, Implantable, Cardiac, Arrhythmia, Defibrillators
Abstract

Among dialysis patients, 40% of deaths are due to cardiovascular causes, and 60% of cardiac deaths are due to an arrhythmia. The purpose of this survey, carried out with the organizational support of the Lombard Section of the Italian Society of Nephrology, is to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in the dialysis centers of Lombardy. Information on the prevalence and type of cardiac devices at December 1, 2016 in this population was also required. Data from 18 centers were collected for a total of 3395 patients in replacement renal therapy, including 2907 (85.6%) in hemodialysis and 488 (14.4%) in peritoneal dialysis. All centers use the 12-lead ECG in case of evocative symptoms of an arrhythmic event and 2/3 perform the exam with programmed cadence (usually once a year). Twenty four-hour ECG Holter is not used as a routine diagnostic tool. The proportion of cardiac devices is relatively high, compared to literature data: n=259, equal to 7.6% of the population. Pace-Maker patients are 166 (4.9%), those with intracardiac defibrillator 52 (1.5%), those with resynchronization therapy 18 (0.5%) and those with resynchronization therapy and intracardiac defibrillator 23 (0.7%). The survey provides interesting information and can be an important starting point for trying to optimize clinical practice and collaboration between nephrologists and cardiologists in front of a major problem like that of arrhythmic disease in patients on renal replacement therapy.

Published
2017

42. New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of working group on CKD-MBD of the Italian Society of Nephrology.

Author

Bellasi A, Cozzolino M, Malberti F, Cancarini G, Esposito C, Guastoni CM, Ondei P, Pontoriero G, Teatini U, Vezzoli G, Pasquali M, Messa P, and Locatelli F

Subjects
Humans, Italy, Peptides pharmacology, Chronic Kidney Disease-Mineral and Bone Disorder drug therapy, Peptides therapeutic use
Abstract

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

Published
2020
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43. [New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of Nephrologists form Lombardy].

Author

Bellasi A, Cozzolino M, Malberti F, Cancarini G, Esposito C, Genderini A, Guastoni CM, Ondei P, Pontoriero G, Teatini U, Vezzoli G, Messa P, and Locatelli F

Subjects
Calcimimetic Agents pharmacology, Chronic Kidney Disease-Mineral and Bone Disorder complications, Cinacalcet therapeutic use, Clinical Trials as Topic, Drug Therapy, Combination, Health Services Needs and Demand, Humans, Hypercalcemia etiology, Hypercalcemia prevention & control, Hyperparathyroidism, Secondary blood, Parathyroid Glands pathology, Parathyroid Hormone biosynthesis, Parathyroid Hormone blood, Peptides pharmacology, Renal Dialysis, Renal Insufficiency, Chronic blood, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic therapy, Vitamin D metabolism, Vitamin D therapeutic use, Calcimimetic Agents therapeutic use, Hyperparathyroidism, Secondary drug therapy, Peptides therapeutic use, Receptors, Calcium-Sensing agonists, Receptors, Calcium-Sensing therapeutic use
Abstract

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Published
2018

44. [Clinical practice for the diagnosis of cardiac arrhythmias in patients on renal replacement therapy: data from a Lombard survey].

Author

Genovesi S, Nava E, Pasa A, Corghi E, Ondei P, Marta E, Bellasi A, Malberti F, Teatini U, Guastoni CM, Spatola L, Luise MC, Tiboldo R, Bertoli S, Messa P, Doria M, Gallieni M, Cozzolino M, Spotti D, Sala V, Sironi E, and Boriani G

Subjects
Arrhythmias, Cardiac complications, Arrhythmias, Cardiac mortality, Arrhythmias, Cardiac therapy, Cardiac Resynchronization Therapy, Cardiology, Defibrillators, Implantable, Disease Management, Electric Countershock, Electrocardiography, Ambulatory statistics & numerical data, Health Care Surveys, Heart Arrest etiology, Heart Arrest prevention & control, Humans, Italy epidemiology, Kidney Failure, Chronic therapy, Nephrology, Pacemaker, Artificial, Patient Care Team, Stroke etiology, Stroke prevention & control, Arrhythmias, Cardiac diagnosis, Electrocardiography methods, Electrocardiography statistics & numerical data, Kidney Failure, Chronic complications, Renal Replacement Therapy adverse effects
Abstract

Among dialysis patients, 40% of deaths are due to cardiovascular causes, and 60% of cardiac deaths are due to an arrhythmia. The purpose of this survey, carried out with the organizational support of the Lombard Section of the Italian Society of Nephrology, is to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in the dialysis centers of Lombardy. Information on the prevalence and type of cardiac devices at December 1, 2016 in this population was also required. Data from 18 centers were collected for a total of 3395 patients in replacement renal therapy, including 2907 (85.6%) in hemodialysis and 488 (14.4%) in peritoneal dialysis. All centers use the 12-lead ECG in case of evocative symptoms of an arrhythmic event and 2/3 perform the exam with programmed cadence (usually once a year). Twenty four-hour ECG Holter is not used as a routine diagnostic tool. The proportion of cardiac devices is relatively high, compared to literature data: n=259, equal to 7.6% of the population. Pace-Maker patients are 166 (4.9%), those with intracardiac defibrillator 52 (1.5%), those with resynchronization therapy 18 (0.5%) and those with resynchronization therapy and intracardiac defibrillator 23 (0.7%). The survey provides interesting information and can be an important starting point for trying to optimize clinical practice and collaboration between nephrologists and cardiologists in front of a major problem like that of arrhythmic disease in patients on renal replacement therapy., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Published
2017

45. [Uremic Toxins: how can we improve the removal today?]

Author

Teatini U and Romei Longhena G

Subjects
Hemodiafiltration instrumentation, Humans, Membranes, Artificial, Molecular Weight, Proteins, Renal Dialysis instrumentation, Rheology, Uremia metabolism, Hemodiafiltration methods, Renal Dialysis methods, Toxins, Biological isolation & purification, Uremia therapy
Abstract

Uremic status results from a malfunctioning of kidneys due to the accumulation of compounds which, under normal conditions, are excreted or metabolized by the kidneys. If these compounds are biologically active, they are called uremic toxins. Such compounds have toxic effects on the cardio-vascular system. An useful classification, published by the European Uremic Toxin Work Group (EUTox) is: 1) small water-soluble compounds; 2) protein-bound compounds; 3) the larger "middle molecules". High-flux membranes and more efficient treatment techniques, like HDF, improve the removal of uremic toxins in the middle molecular-weight range, and recent studies suggest that these strategies have better results on the morbidity and mortality. Today new membranes, medium cut-off membranes (MCO), with increased pore size, allow for the removal of higher molecular-weight toxins, such as kappa and lambda light chains and/or mediators of inflammation. For toxins in the 15 to 45 KD-size range, MCO membranes improve the removal in comparison with high-flux HD and/or HDF. Therefore MCO membrane simplifies the treatment of HD patients with a removal spectrum that extend the current possibilities of the best available therapies for End Stage Renal Disease., (Copyright by Società Italiana di Nefrologia SIN, Rome, Italy.)

Published
2017

46. Use of ACE inhibition and blood pressure management in deferring dialysis initiation.

Author

Del Vecchio L, Teatini U, and Locatelli F

Subjects
Albuminuria therapy, Antihypertensive Agents therapeutic use, Cardiovascular Diseases therapy, Drug Therapy, Combination, Humans, Hypertension complications, Hypertension physiopathology, Hypertension therapy, Kidney pathology, Kidney Failure, Chronic complications, Kidney Failure, Chronic therapy, Proteinuria, Renin-Angiotensin System, Risk Factors, Time-to-Treatment, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Blood Pressure drug effects, Renal Dialysis methods
Abstract

Elevated blood pressure is one of the most significant risk factor for the development of chronic kidney disease (CKD); its treatment is a milestone in CKD management. While it is accepted that a stricter blood pressure control is indicated in patients with proteinuria or microalbuminuria, the exact degree of blood pressure reduction to be obtained in CKD patients is still under debate. Following more recent interpretation of old trials, a BP target for <140/90 mmHg is suggested for non-proteinuric CKD patients. In those with microalbuminuria/proteinuria, the ideal blood pressure target should be ≤130/80 mmHg. Recently, the SPRINT trial put new emphasis on a stricter blood pressure control, mainly from the cardiovascular point of view. The blockers of the renin-angiotensin system (RAS) are recommended as first line treatment in all CKD hypertensive patients with micro or macroalbuminuria either diabetics or not. However, their nephroprotective efficacy is less relevant in non-proteinuric patients. The dual RAS blockade was proposed as an additional option. Despite a greater antiproteinuric effect, some large trials in patients at high cardiovascular risk did not demonstrate significant advantage on hard endpoint. Its use is now contraindicated in diabetic CKD patients. Given that RAS blockers can cause acute derangements in kidney function and hyperkalemia, caution is needed with their use, especially in frail and old patients with cardiovascular disease or in the presence of advanced CKD.

Published
2017
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47. [Census of the renal and dialysis units by Italian Society of Nephrology: nephrologist's workload for renal patient assistance in Italy (2014-2015)].

Author

Quintaliani G, Di Luca M, Di Napoli A, Viglino G, Postorino M, Amore A, Andrulli S, Bellasi A, Brunori G, Buongiorno E, Castellino S, D'Amelio A, De Nicola L, Gesualdo L, Di Landro D, Feriozzi S, Strippoli G, Teatini U, and Santoro A

Subjects
Humans, Italy epidemiology, Prevalence, Records, Renal Insufficiency epidemiology, Societies, Medical, Time Factors, Workforce, Ambulatory Care Facilities organization & administration, Ambulatory Care Facilities statistics & numerical data, Censuses, Hemodialysis Units, Hospital organization & administration, Hemodialysis Units, Hospital statistics & numerical data, Nephrology statistics & numerical data, Renal Dialysis statistics & numerical data, Renal Insufficiency therapy, Workload
Abstract

Background: Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted acensusof the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to theyear 2014., Methods: An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit., Results: Renal and dialysis activity was performed by over 2718 physicians (45 pmp). The management of the acute renal failure was one of the most frequent activities in the public renal units (12,206 patients in ICU and 140.00 dialysis sessions). There were performed about 9000 AV fistulas and 1700 central vascular catheters insertions. In the census, there are a lot of data regarding organization, workforce and workload of the renal unit in Italy. The benchmark data derived from this census show interesting comparisons between centres, regions and groups of regions. These data realised the clinical management of renal disease in Italy.

Published
2016

48. [Census of the renal and dialysis units by Italian Society of Nephrology: structure and organization for renal patient assistance in Italy (2014-2015)].

Author

Quintaliani G, Di Luca M, Di Napoli A, Viglino G, Postorino M, Amore A, Andrulli S, Bellasi A, Brunori G, Buongiorno E, Castellino S, D'Amelio A, De Nicola L, Gesualdo L, Di Landro D, Feriozzi S, Strippoli G, Teatini U, and Santoro A

Subjects
Humans, Italy, Records, Societies, Medical, Time Factors, Ambulatory Care Facilities organization & administration, Censuses, Hemodialysis Units, Hospital organization & administration, Nephrology, Renal Dialysis statistics & numerical data, Renal Insufficiency therapy
Abstract

Background: Given the public health challenge and burden of chronic kidney disease, the Italian Society of Nephrology (SIN) promoted a census of the renal and dialysis units to analyse structural and human resources, organizational aspects, activities and workload referring to the year 2014., Methods: An online questionnaire, including 64 items exploring structural and human resources, organization aspects, activities and epidemiological data referred to 2014, was sent to chiefs of any renal or dialysis unit., Results: 615 renal units were identified. From these 615 units, 332 were public renal centres (of which 318 centres answered to the census) and 283 were private dialysis centres (of which 113 centres answered to the census). The results show 6 public renal units pmp. Renal biopsies were 4624 (81 pmp). The nephrology beds are about 41 pmp. There are 7.304 nurses working in HD wards, 1.692 in the nephrology wards and only 613 for outpatients clinics. The benchmark data derived from this census show interesting comparisons between centres, regions and groups of regions. These data realised the clinical management of renal disease in Italy.

Published
2016

49. [Italians and nephrology: Doxa opinion survey].

Author

Battaglia G, Guastoni C, Teatini U, and Santoro A

Subjects
Health Knowledge, Attitudes, Practice, Humans, Interviews as Topic, Italy, Self Report, Kidney Diseases, Nephrology
Published
2016

50. Effect of a More Permeable Dialysis Membrane on ESA Resistance in Hemodialysis Patients--A Pilot Investigation.

Author

Teatini U, Liebchen A, Nilsson LG, Beck W, and Longhena GR

Subjects
Aged, Anemia blood, Anemia complications, Anemia pathology, C-Reactive Protein metabolism, Drug Resistance, Female, Hemoglobins metabolism, Hepcidins blood, Humans, Interleukin-6 blood, Kidney Failure, Chronic blood, Kidney Failure, Chronic complications, Kidney Failure, Chronic pathology, Male, Membranes, Artificial, Middle Aged, Permeability, Pilot Projects, Recombinant Proteins therapeutic use, Serum Albumin metabolism, Anemia therapy, Epoetin Alfa therapeutic use, Erythropoietin therapeutic use, Hematinics therapeutic use, Kidney Failure, Chronic therapy, Renal Dialysis instrumentation
Abstract

Background/aims: Hemodialysis (HD) patients often show impaired response to erythropoiesis-stimulating agents (ESAs). Extended HD membrane permeability may potentially improve ESA response., Methods: Twenty-four prevalent HD patients were randomly assigned to 12 weeks use of high cut-off (HCO) membrane (in every second dialysis treatment) or continued treatment with high-flux membrane. We monitored changes in hemoglobin (Hb), ESA dose, and key biochemical markers., Results: The Hb level increased in the study group (from 11.6 ± 1.0 to 12.5 ± 1.5 g/dl; p = 0.038) but was stable in the control group. Variation over time in ESA dose and ESA resistance index did not differ between groups. HCO membrane usage for 12 weeks led to decreased hepcidin level, from 303 ± 189 to 157 ± 83 ng/ml (p = 0.024); serum albumin level decreased and stabilized 15 ± 6% below baseline., Conclusions: These results indicate that use of a more permeable dialysis membrane may improve ESA responsiveness in iron-replete HD patients. Extensive albumin removal may preclude long-term use of the HCO membrane., (© 2015 S. Karger AG, Basel.)

Published
2016
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