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1. Genome-wide association analyses define pathogenic signaling pathways and prioritize drug targets for IgA nephropathy

Author

Kiryluk, Krzysztof, Sanchez-Rodriguez, Elena, Zhou, Xu-Jie, Zanoni, Francesca, Liu, Lili, Mladkova, Nikol, Khan, Atlas, Marasa, Maddalena, Zhang, Jun Y., Balderes, Olivia, Sanna-Cherchi, Simone, Bomback, Andrew S., Canetta, Pietro A., Appel, Gerald B., Radhakrishnan, Jai, Trimarchi, Hernan, Sprangers, Ben, Cattran, Daniel C., Reich, Heather, Pei, York, Ravani, Pietro, Galesic, Kresimir, Maixnerova, Dita, Tesar, Vladimir, Stengel, Benedicte, Metzger, Marie, Canaud, Guillaume, Maillard, Nicolas, Berthoux, Francois, Berthelot, Laureline, Pillebout, Evangeline, Monteiro, Renato, Nelson, Raoul, Wyatt, Robert J., Smoyer, William, Mahan, John, Samhar, Al-Akash, Hidalgo, Guillermo, Quiroga, Alejandro, Weng, Patricia, Sreedharan, Raji, Selewski, David, Davis, Keefe, Kallash, Mahmoud, Vasylyeva, Tetyana L., Rheault, Michelle, Chishti, Aftab, Ranch, Daniel, Wenderfer, Scott E., Samsonov, Dmitry, Claes, Donna J., Akchurin, Oleh, Goumenos, Dimitrios, Stangou, Maria, Nagy, Judit, Kovacs, Tibor, Fiaccadori, Enrico, Amoroso, Antonio, Barlassina, Cristina, Cusi, Daniele, Del Vecchio, Lucia, Battaglia, Giovanni Giorgio, Bodria, Monica, Boer, Emanuela, Bono, Luisa, Boscutti, Giuliano, Caridi, Gianluca, Lugani, Francesca, Ghiggeri, GianMarco, Coppo, Rosanna, Peruzzi, Licia, Esposito, Vittoria, Esposito, Ciro, Feriozzi, Sandro, Polci, Rosaria, Frasca, Giovanni, Galliani, Marco, Garozzo, Maurizio, Mitrotti, Adele, Gesualdo, Loreto, Granata, Simona, Zaza, Gianluigi, Londrino, Francesco, Magistroni, Riccardo, Pisani, Isabella, Magnano, Andrea, Marcantoni, Carmelita, Messa, Piergiorgio, Mignani, Renzo, Pani, Antonello, Ponticelli, Claudio, Roccatello, Dario, Salvadori, Maurizio, Salvi, Erica, Santoro, Domenico, Gembillo, Guido, Savoldi, Silvana, Spotti, Donatella, Zamboli, Pasquale, Izzi, Claudia, Alberici, Federico, Delbarba, Elisa, Florczak, Michał, Krata, Natalia, Mucha, Krzysztof, Pączek, Leszek, Niemczyk, Stanisław, Moszczuk, Barbara, Pańczyk-Tomaszewska, Malgorzata, Mizerska-Wasiak, Malgorzata, Perkowska-Ptasińska, Agnieszka, Bączkowska, Teresa, Durlik, Magdalena, Pawlaczyk, Krzysztof, Sikora, Przemyslaw, Zaniew, Marcin, Kaminska, Dorota, Krajewska, Magdalena, Kuzmiuk-Glembin, Izabella, Heleniak, Zbigniew, Bullo-Piontecka, Barbara, Liberek, Tomasz, Dębska-Slizien, Alicja, Hryszko, Tomasz, Materna-Kiryluk, Anna, Miklaszewska, Monika, Szczepańska, Maria, Dyga, Katarzyna, Machura, Edyta, Siniewicz-Luzeńczyk, Katarzyna, Pawlak-Bratkowska, Monika, Tkaczyk, Marcin, Runowski, Dariusz, Kwella, Norbert, Drożdż, Dorota, Habura, Ireneusz, Kronenberg, Florian, Prikhodina, Larisa, van Heel, David, Fontaine, Bertrand, Cotsapas, Chris, Wijmenga, Cisca, Franke, Andre, Annese, Vito, Gregersen, Peter K., Parameswaran, Sreeja, Weirauch, Matthew, Kottyan, Leah, Harley, John B., Suzuki, Hitoshi, Narita, Ichiei, Goto, Shin, Lee, Hajeong, Kim, Dong Ki, Kim, Yon Su, Park, Jin-Ho, Cho, BeLong, Choi, Murim, Van Wijk, Ans, Huerta, Ana, Ars, Elisabet, Ballarin, Jose, Lundberg, Sigrid, Vogt, Bruno, Mani, Laila-Yasmin, Caliskan, Yasar, Barratt, Jonathan, Abeygunaratne, Thilini, Kalra, Philip A., Gale, Daniel P., Panzer, Ulf, Rauen, Thomas, Floege, Jürgen, Schlosser, Pascal, Ekici, Arif B., Eckardt, Kai-Uwe, Chen, Nan, Xie, Jingyuan, Lifton, Richard P., Loos, Ruth J. F., Kenny, Eimear E., Ionita-Laza, Iuliana, Köttgen, Anna, Julian, Bruce A., Novak, Jan, Scolari, Francesco, Zhang, Hong, and Gharavi, Ali G.

Published
2023
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2. The copy number variation landscape of congenital anomalies of the kidney and urinary tract.

Author

Verbitsky, Miguel, Westland, Rik, Perez, Alejandra, Kiryluk, Krzysztof, Liu, Qingxue, Krithivasan, Priya, Mitrotti, Adele, Fasel, David, Batourina, Ekaterina, Sampson, Matthew, Bodria, Monica, Werth, Max, Kao, Charlly, Martino, Jeremiah, Capone, Valentina, Vivante, Asaf, Shril, Shirlee, Kil, Byum, Marasà, Maddalena, Zhang, Jun, Na, Young-Ji, Lim, Tze, Ahram, Dina, Weng, Patricia, Heinzen, Erin, Carrea, Alba, Piaggio, Giorgio, Gesualdo, Loreto, Manca, Valeria, Masnata, Giuseppe, Gigante, Maddalena, Cusi, Daniele, Izzi, Claudia, Scolari, Francesco, van Wijk, Joanna, Saraga, Marijan, Santoro, Domenico, Conti, Giovanni, Zamboli, Pasquale, White, Hope, Drozdz, Dorota, Zachwieja, Katarzyna, Miklaszewska, Monika, Tkaczyk, Marcin, Tomczyk, Daria, Krakowska, Anna, Sikora, Przemyslaw, Jarmoliński, Tomasz, Borszewska-Kornacka, Maria, Pawluch, Robert, Szczepanska, Maria, Adamczyk, Piotr, Mizerska-Wasiak, Malgorzata, Krzemien, Grazyna, Szmigielska, Agnieszka, Zaniew, Marcin, Dobson, Mark, Darlow, John, Puri, Prem, Barton, David, Furth, Susan, Warady, Bradley, Gucev, Zoran, Lozanovski, Vladimir, Tasic, Velibor, Pisani, Isabella, Allegri, Landino, Rodas, Lida, Campistol, Josep, Jeanpierre, Cécile, Alam, Shumyle, Casale, Pasquale, Wong, Craig, Lin, Fangming, Miranda, Débora, Oliveira, Eduardo, Simões-E-Silva, Ana, Barasch, Jonathan, Levy, Brynn, Wu, Nan, Hildebrandt, Friedhelm, Ghiggeri, Gian, Latos-Bielenska, Anna, Materna-Kiryluk, Anna, Zhang, Feng, Hakonarson, Hakon, Papaioannou, Virginia, Mendelsohn, Cathy, Gharavi, Ali, and Sanna-Cherchi, Simone

Subjects
Chromosome Deletion, DNA Copy Number Variations, Female, Genetic Predisposition to Disease, Genome-Wide Association Study, Humans, Kidney, Male, Urinary Tract, Urogenital Abnormalities, Vesico-Ureteral Reflux
Abstract

Congenital anomalies of the kidney and urinary tract (CAKUT) are a major cause of pediatric kidney failure. We performed a genome-wide analysis of copy number variants (CNVs) in 2,824 cases and 21,498 controls. Affected individuals carried a significant burden of rare exonic (that is, affecting coding regions) CNVs and were enriched for known genomic disorders (GD). Kidney anomaly (KA) cases were most enriched for exonic CNVs, encompassing GD-CNVs and novel deletions; obstructive uropathy (OU) had a lower CNV burden and an intermediate prevalence of GD-CNVs; and vesicoureteral reflux (VUR) had the fewest GD-CNVs but was enriched for novel exonic CNVs, particularly duplications. Six loci (1q21, 4p16.1-p16.3, 16p11.2, 16p13.11, 17q12 and 22q11.2) accounted for 65% of patients with GD-CNVs. Deletions at 17q12, 4p16.1-p16.3 and 22q11.2 were specific for KA; the 16p11.2 locus showed extensive pleiotropy. Using a multidisciplinary approach, we identified TBX6 as a driver for the CAKUT subphenotypes in the 16p11.2 microdeletion syndrome.

Published
2019

3. L’Analisi del Comportamento Applicata: Tra ricchezza e cattive prassi Applied Behavior Analysis: Richness versus Malpractice

Author

Antonia Zamboli

Subjects
autismo, comportamento, trattamento, Pathology, RB1-214, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571
Abstract

L’Analisi Applicata del Comportamento è una disciplina scientifica in cui i principi dell’analisi del comportamento sono applicati sistematicamente per migliorare comportamenti socialmente significativi. L’attività clinica basata sull’ABA dimostra la ricchezza e le straordinarie possibilità di successo nel trattamento dei disturbi del comportamento. Esistono, tuttavia, numerosi pregiudizi verso questa disciplina i quali, costituendo veri e propri “bias cognitivi”, producono confusione epistemologica rispetto all’ABA e di conseguenza una rappresentazione errata dei suoi principi che portano ad un utilizzo improprio delle tecniche da essi derivanti e alimentano una visione negativa ed erronea di questa disciplina. Questo lavoro si propone di esaminare, pertanto, le potenzialità di questa scienza approfondendo due concetti cardini sui quali essa è basata: il rinforzo e la punizione. Si metterà, pertanto, in luce come sia proprio l’errata comprensione e l’improprio utilizzo di questi strumenti da parte della comunità clinica a generare, frequentemente, cattive prassi. Parole chiave: autismo, comportamento, trattamento.

Published
2021
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4. Color Doppler ultrasound evaluation of arteriovenous grafts for hemodialysis

Author

Zamboli, Pasquale, Punzi, Massimo, Calabria, Maria, Capasso, Marco, Granata, Antonio, and Lomonte, Carlo

Abstract

Although arteriovenous fistula (AVF) continues to be the vascular access of choice for the hemodialysis, arteriovenous graft (AVG) can be the best choice in certain categories of patients and could have several advantages over AVF in a “patient centered approach” to vascular access. In the clinical management of prosthetic fistulas, color Doppler ultrasound (CDU) is the imaging method of choice for identifying stenosis and other AVG complications. In this review, besides highlighting the pivotal role of CDU in the diagnosis of AVG complications, we will underline the key role that ultrasound can play in identifying those stenosis most likely to cause AVG thrombosis. Furthermore, we will emphasize the support that CDU can play in distinguishing the different types of grafts and prosthetic devices such as stent-grafts, in identifying AVG with lower survival, CDU utilities and limitations in the evaluation of freshly-implanted grafts, the different sites available for AVG volume flow measurement and their use based on the configuration of the prosthesis, the time interval elapsed from the surgical intervention and the integrity of the prosthetic walls.

Published
2024
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5. Management of complications of first instance of hepatic trauma in a liver surgery unit: Portal vein ligation as a conservative therapeutic strategy

Author

Rocca Aldo, Andolfi Enrico, Zamboli Anna Ginevra Immacolata, Surfaro Giuseppe, Tafuri Domenico, Costa Gianluca, Frezza Barbara, Scricciolo Marta, Amato Maurizio, Bianco Paolo, Brongo Sergio, Ceccarelli Graziano, Giuliani Antonio, and Amato Bruno

Subjects
portal vein ligation, hepatic trauma, therapeutic choice, liver surgery unit, management of complications, Medicine
Abstract

According to the National Trauma Data Bank, the liver, after the spleen, is the first most injured organ in closed abdominal trauma.

Published
2019
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6. Cell based therapeutic approach in vascular surgery: application and review

Author

Rocca Aldo, Tafuri Domenico, Paccone Marianna, Giuliani Antonio, Zamboli Anna Ginevra Immacolata, Surfaro Giuseppe, Paccone Andrea, Compagna Rita, Amato Maurizo, Serra Raffaele, and Amato Bruno

Subjects
multipotent stem cells, vascular surgery, cell-based therapy, vascular progenitors, arterial aneurysms, peripheral arterial obstructive disease, Medicine
Abstract

Multipotent stem cells - such as mesenchymal stem/stromal cells and stem cells derived from different sources like vascular wall are intensely studied to try to rapidly translate their discovered features from bench to bedside. Vascular wall resident stem cells recruitment, differentiation, survival, proliferation, growth factor production, and signaling pathways transduced were analyzed. We studied biological properties of vascular resident stem cells and explored the relationship from several factors as Matrix Metalloproteinases (MMPs) and regulations of biological, translational and clinical features of these cells. In this review we described a translational and clinical approach to Adult Vascular Wall Resident Multipotent Vascular Stem Cells (VW-SCs) and reported their involvement in alternative clinical approach as cells based therapy in vascular disease like arterial aneurysms or peripheral arterial obstructive disease.

Published
2017
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7. Transurethral resection of the prostate, bladder explosion and hyponatremic encephalopathy: a rare case report of malpractice

Author

Vacchiano Giuseppe, Rocca Aldo, Compagna Rita, Zamboli Anna Ginevra Immacolata, Cirillo Vera, Di Domenico Lorenza, Di Nardo Veronica, Servillo Giuseppe, and Amato Bruno

Subjects
turp, bladder explosion, hyponatremia, encephalopathy, medical liability, Medicine
Abstract

We present an original case report of a bladder explosion during a TURP intervention for benign prostatic hypertrophy, that was brought on by the absorption of about 5 liters of glycine 1.5% and then onset of a severe hyponatremia. The quick and inappropriate correction of this electrolyte imbalance led the onset of encephalopathy and the death of the patient. The authors discuss the pathogenesis of these uncommon diseases and, considering the most recent Italian Legislation, they highlight the importance to respect good clinical practice standards and guidelines to ensure the most appropriate treatments for the patient and remove any assumptions of medical liability.

Published
2017
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8. Sicurezza nella scelta dell'Inibitore di Pompa Protonica nel nefropatico cronico

Author

M. J. Sequenza, M.R. Loi, F. Londrino, P. Sale, S. Andrulli, A. Noce, O. Durante, P. Zamboli, F. Floccari, F. Fiorini, A. D’Amelio, Luca di Lullo, A. Granata, A. Mudoni, and F. Logias

Subjects
Efficacia IPP, Secrezione acida, Tollerabilità, Internal medicine, RC31-1245, Diseases of the genitourinary system. Urology, RC870-923
Abstract

Il paziente nefropatico cronico facilmente presenta alterazioni morfologiche e funzionali dell'apparato gastroenterico. I segni più comuni e precoci nella sindrome uremica cronica sono rappresentati dai disturbi gastrointestinali. Da alcuni decenni abbiamo a disposizione dei farmaci con potente azione inibente la secrezione acida gastrica: gli inibitori di pompa protonica (IPP) hanno una struttura chimica affine, uno stesso meccanismo d'azione e sono molto importanti per il trattamento delle patologie acido correlate, per l'eradicazione dell'Helicobacter Pylori, per la prevenzione e la cura della gastropatia da farmaci antinfiammatori non steroidei (FANS). Somministriamo ai nostri pazienti questa classe di farmaci, con terapie che continuano nel tempo, nonostante la risoluzione della malattia (gastroprotezione). Ma gli IPP possono essere utilizzati indistintamente nei nefropatici cronici oppure sarebbe utile conoscere il profilo del farmaco per una corretta scelta? In questo articolo si argomenta che i loro effetti collaterali non sono molto rilevanti e sono abbastanza simili: il loro impiego nel lungo termine è sicuro. La potenza e l'efficacia dei vari IPP, dall'analisi comparativa dei vari trial clinici, risulta essere molto simile sulla base dei milligrammi di sostanza utilizzata. L'unica eccezione illustrata in questo lavoro è rappresentata da 6 pazienti in emodialisi, trattati con lansoprazolo (15 mg), che presentavano gastriti e ulcere peptiche complicate da gravi episodi di ematemesi e melena con conseguente anemia. Tutti gli IPP hanno dimostrato un'efficacia clinica sovrapponibile, tuttavia vanno valutati di volta in volta i vantaggi (relativi) di ciascun IPP. I criteri di scelta di un IPP sembrano basati, principalmente sulle indicazioni autorizzate, sulle formulazioni disponibili, sul profilo di sicurezza del farmaco.

Published
2018
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9. 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

11. Author Correction: The copy number variation landscape of congenital anomalies of the kidney and urinary tract

Author

Verbitsky, Miguel, Westland, Rik, Perez, Alejandra, Kiryluk, Krzysztof, Liu, Qingxue, Krithivasan, Priya, Mitrotti, Adele, Fasel, David A., Batourina, Ekaterina, Sampson, Matthew G., Bodria, Monica, Werth, Max, Kao, Charlly, Martino, Jeremiah, Capone, Valentina P., Vivante, Asaf, Shril, Shirlee, Kil, Byum Hee, Marasa, Maddalena, Zhang, Jun Y., Na, Young-Ji, Lim, Tze Y., Ahram, Dina, Weng, Patricia L., Heinzen, Erin L., Carrea, Alba, Piaggio, Giorgio, Gesualdo, Loreto, Manca, Valeria, Masnata, Giuseppe, Gigante, Maddalena, Cusi, Daniele, Izzi, Claudia, Scolari, Francesco, van Wijk, Joanna A. E., Saraga, Marijan, Santoro, Domenico, Conti, Giovanni, Zamboli, Pasquale, White, Hope, Drozdz, Dorota, Zachwieja, Katarzyna, Miklaszewska, Monika, Tkaczyk, Marcin, Tomczyk, Daria, Krakowska, Anna, Sikora, Przemyslaw, Jarmoliński, Tomasz, Borszewska-Kornacka, Maria K., Pawluch, Robert, Szczepanska, Maria, Adamczyk, Piotr, Mizerska-Wasiak, Malgorzata, Krzemien, Grazyna, Szmigielska, Agnieszka, Zaniew, Marcin, Dobson, Mark G., Darlow, John M., Puri, Prem, Barton, David E., Furth, Susan L., Warady, Bradley A., Gucev, Zoran, Lozanovski, Vladimir J., Tasic, Velibor, Pisani, Isabella, Allegri, Landino, Rodas, Lida M., Campistol, Josep M., Jeanpierre, Cécile, Alam, Shumyle, Casale, Pasquale, Wong, Craig S., Lin, Fangming, Miranda, Débora M., Oliveira, Eduardo A., Simoes-e-Silva, Ana Cristina, Barasch, Jonathan M., Levy, Brynn, Wu, Nan, Hildebrandt, Friedhelm, Ghiggeri, Gian Marco, Latos-Bielenska, Anna, Materna-Kiryluk, Anna, Zhang, Feng, Hakonarson, Hakon, Papaioannou, Virginia E., Mendelsohn, Cathy L., Gharavi, Ali G., and Sanna-Cherchi, Simone

Published
2019
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22. Geographic differences in genetic susceptibility to IgA nephropathy: GWAS replication study and geospatial risk analysis.

Author

Krzysztof Kiryluk, Yifu Li, Simone Sanna-Cherchi, Mersedeh Rohanizadegan, Hitoshi Suzuki, Frank Eitner, Holly J Snyder, Murim Choi, Ping Hou, Francesco Scolari, Claudia Izzi, Maddalena Gigante, Loreto Gesualdo, Silvana Savoldi, Antonio Amoroso, Daniele Cusi, Pasquale Zamboli, Bruce A Julian, Jan Novak, Robert J Wyatt, Krzysztof Mucha, Markus Perola, Kati Kristiansson, Alexander Viktorin, Patrik K Magnusson, Gudmar Thorleifsson, Unnur Thorsteinsdottir, Kari Stefansson, Anne Boland, Marie Metzger, Lise Thibaudin, Christoph Wanner, Kitty J Jager, Shin Goto, Dita Maixnerova, Hussein H Karnib, Judit Nagy, Ulf Panzer, Jingyuan Xie, Nan Chen, Vladimir Tesar, Ichiei Narita, Francois Berthoux, Jürgen Floege, Benedicte Stengel, Hong Zhang, Richard P Lifton, and Ali G Gharavi

Subjects
Genetics, QH426-470
Abstract

IgA nephropathy (IgAN), major cause of kidney failure worldwide, is common in Asians, moderately prevalent in Europeans, and rare in Africans. It is not known if these differences represent variation in genes, environment, or ascertainment. In a recent GWAS, we localized five IgAN susceptibility loci on Chr.6p21 (HLA-DQB1/DRB1, PSMB9/TAP1, and DPA1/DPB2 loci), Chr.1q32 (CFHR3/R1 locus), and Chr.22q12 (HORMAD2 locus). These IgAN loci are associated with risk of other immune-mediated disorders such as type I diabetes, multiple sclerosis, or inflammatory bowel disease. We tested association of these loci in eight new independent cohorts of Asian, European, and African-American ancestry (N = 4,789), followed by meta-analysis with risk-score modeling in 12 cohorts (N = 10,755) and geospatial analysis in 85 world populations. Four susceptibility loci robustly replicated and all five loci were genome-wide significant in the combined cohort (P = 5×10⁻³²-3×10⁻¹⁰), with heterogeneity detected only at the PSMB9/TAP1 locus (I² = 0.60). Conditional analyses identified two new independent risk alleles within the HLA-DQB1/DRB1 locus, defining multiple risk and protective haplotypes within this interval. We also detected a significant genetic interaction, whereby the odds ratio for the HORMAD2 protective allele was reversed in homozygotes for a CFHR3/R1 deletion (P = 2.5×10⁻⁴). A seven-SNP genetic risk score, which explained 4.7% of overall IgAN risk, increased sharply with Eastward and Northward distance from Africa (r = 0.30, P = 3×10⁻¹²⁸). This model paralleled the known East-West gradient in disease risk. Moreover, the prediction of a South-North axis was confirmed by registry data showing that the prevalence of IgAN-attributable kidney failure is increased in Northern Europe, similar to multiple sclerosis and type I diabetes. Variation at IgAN susceptibility loci correlates with differences in disease prevalence among world populations. These findings inform genetic, biological, and epidemiological investigations of IgAN and permit cross-comparison with other complex traits that share genetic risk loci and geographic patterns with IgAN.

Published
2012
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28. Author Correction: The copy number variation landscape of congenital anomalies of the kidney and urinary tract (Nature Genetics, (2019), 51, 1, (117-127), 10.1038/s41588-018-0281-y)

Author

Verbitsky, M., Westland, R., Perez, A., Kiryluk, K., Liu, Q., Krithivasan, P., Mitrotti, A., Fasel, D. A., Batourina, E., Sampson, M. G., Bodria, M., Werth, M., Kao, C., Martino, J., Capone, V. P., Vivante, A., Shril, S., Kil, B. H., Marasa, M., Zhang, J. Y., Y. -J., Na, Lim, T. Y., Ahram, D., Weng, P. L., Heinzen, E. L., Carrea, A., Piaggio, G., Gesualdo, L., Manca, V., Masnata, G., Gigante, M., Cusi, D., Izzi, C., Scolari, F., van Wijk, J. A. E., Saraga, M., Santoro, D., Conti, G., Zamboli, P., White, H., Drozdz, D., Zachwieja, K., Miklaszewska, M., Tkaczyk, M., Tomczyk, D., Krakowska, A., Sikora, P., Jarmolinski, T., Borszewska-Kornacka, M. K., Pawluch, R., Szczepanska, M., Adamczyk, P., Mizerska-Wasiak, M., Krzemien, G., Szmigielska, A., Zaniew, M., Dobson, M. G., Darlow, J. M., Puri, P., Barton, D. E., Furth, S. L., Warady, B. A., Gucev, Z., Lozanovski, V. J., Tasic, V., Pisani, I., Allegri, L., Rodas, L. M., Campistol, J. M., Jeanpierre, C., Alam, S., Casale, P., Wong, C. S., Lin, F., Miranda, D. M., Oliveira, E. A., Simoes-e-Silva, A. C., Barasch, J. M., Levy, B., Wu, N., Hildebrandt, F., Ghiggeri, G. M., Latos-Bielenska, A., Materna-Kiryluk, A., Zhang, F., Hakonarson, H., Papaioannou, V. E., Mendelsohn, C. L., Gharavi, A. G., and Sanna-Cherchi, S.

Subjects
renal, genetics, cakut
Published
2019

29. Sicurezza nella scelta dell'Inibitore di Pompa Protonica nel nefropatico cronico

Author

Sequenza, M. J., Loi, M.R., Londrino, F., Sale, P., Andrulli, S., Noce, A., Durante, O., Zamboli, P., Floccari, F., Fiorini, F., D’Amelio, A., di Lullo, Luca, Granata, A., Mudoni, A., Logias, F., Sequenza, M. J., Loi, M.R., Londrino, F., Sale, P., Andrulli, S., Noce, A., Durante, O., Zamboli, P., Floccari, F., Fiorini, F., D’Amelio, A., di Lullo, Luca, Granata, A., Mudoni, A., and Logias, F.

Abstract

Il paziente nefropatico cronico facilmente presenta alterazioni morfologiche e funzionali dell'apparato gastroenterico. I segni più comuni e precoci nella sindrome uremica cronica sono rappresentati dai disturbi gastrointestinali. Da alcuni decenni abbiamo a disposizione dei farmaci con potente azione inibente la secrezione acida gastrica: gli inibitori di pompa protonica (IPP) hanno una struttura chimica affine, uno stesso meccanismo d'azione e sono molto importanti per il trattamento delle patologie acido correlate, per l'eradicazione dell'Helicobacter Pylori, per la prevenzione e la cura della gastropatia da farmaci antinfiammatori non steroidei (FANS). Somministriamo ai nostri pazienti questa classe di farmaci, con terapie che continuano nel tempo, nonostante la risoluzione della malattia (gastroprotezione). Ma gli IPP possono essere utilizzati indistintamente nei nefropatici cronici oppure sarebbe utile conoscere il profilo del farmaco per una corretta scelta? In questo articolo si argomenta che i loro effetti collaterali non sono molto rilevanti e sono abbastanza simili: il loro impiego nel lungo termine è sicuro. La potenza e l'efficacia dei vari IPP, dall'analisi comparativa dei vari trial clinici, risulta essere molto simile sulla base dei milligrammi di sostanza utilizzata. L'unica eccezione illustrata in questo lavoro è rappresentata da 6 pazienti in emodialisi, trattati con lansoprazolo (15 mg), che presentavano gastriti e ulcere peptiche complicate da gravi episodi di ematemesi e melena con conseguente anemia. Tutti gli IPP hanno dimostrato un'efficacia clinica sovrapponibile, tuttavia vanno valutati di volta in volta i vantaggi (relativi) di ciascun IPP. I criteri di scelta di un IPP sembrano basati, principalmente sulle indicazioni autorizzate, sulle formulazioni disponibili, sul profilo di sicurezza del farmaco., Chronic nephropathic patients often present morphological and functional alterations of the gastro-enteric apparatus. Gastrointestinal diseases represent the most common and early signs. PPIs presented for many decades an important inhibitory effect on gastric acid secretion: they have a common chemical structure, a common mechanism of action and they are very important for treating acid-related pathologies, for Helicobacter Pylori eradication, for preventing and curing NSAIDs gastropathies. We prescribe this class of drugs to our patients even after the pathology resolution (gastroprotection). However can PPIs be indiscriminately used with chronic nephropathic patients or is it necessary to know the drug profile, in order to make a better choice? In this paper we argue that collateral effects are not very relevant and that they are very similar: their long-term usage is very safe. Power and efficacy of the different PPIs results very similar on the basis of how many milligrams of substance has been used and on the basis of clinical trials. The only exception that is shown in this paper is represented by 6 haemodialysis patients, which have been treated with lansoprazol (15 mgs). They presented gastritis and peptic ulcers, which were complicated by episodes of severe hematemesis and melena, with a consequent anaemia. Even though all PPIs have shown a similar clinical efficacy it is important to evaluate from time to time the (relative) advantages of each PPI. Criteria for a correct choice should be based mainly on official indications, on available doses and on the safety of the drug.

Published
2018

30. PPIs in Chronic Nephropatic Patient

Author

Sequenza, M. J., Loi, M.R., Londrino, F., Sale, P., Andrulli, S., Noce, A., Durante, O., Zamboli, P., Floccari, F., Fiorini, F., D’Amelio, A., di Lullo, Luca, Granata, A., Mudoni, A., Logias, F., Sequenza, M. J., Loi, M.R., Londrino, F., Sale, P., Andrulli, S., Noce, A., Durante, O., Zamboli, P., Floccari, F., Fiorini, F., D’Amelio, A., di Lullo, Luca, Granata, A., Mudoni, A., and Logias, F.

Abstract

Chronic nephropathic patients often present morphological and functional alterations of the gastro-enteric apparatus. Gastrointestinal diseases represent the most common and early signs. PPIs presented for many decades an important inhibitory effect on gastric acid secretion: they have a common chemical structure, a common mechanism of action and they are very important for treating acid-related pathologies, for Helicobacter Pylori eradication, for preventing and curing NSAIDs gastropathies. We prescribe this class of drugs to our patients even after the pathology resolution (gastroprotection). However can PPIs be indiscriminately used with chronic nephropathic patients or is it necessary to know the drug profile, in order to make a better choice? In this paper we argue that collateral effects are not very relevant and that they are very similar: their long-term usage is very safe. Power and efficacy of the different PPIs results very similar on the basis of how many milligrams of substance has been used and on the basis of clinical trials. The only exception that is shown in this paper is represented by 6 haemodialysis patients, which have been treated with lansoprazol (15 mgs). They presented gastritis and peptic ulcers, which were complicated by episodes of severe hematemesis and melena, with a consequent anaemia. Even though all PPIs have shown a similar clinical efficacy it is important to evaluate from time to time the (relative) advantages of each PPI. Criteria for a correct choice should be based mainly on official indications, on available doses and on the safety of the drug., Il paziente nefropatico cronico facilmente presenta alterazioni morfologiche e funzionali dell'apparato gastroenterico. I segni più comuni e precoci nella sindrome uremica cronica sono rappresentati dai disturbi gastrointestinali. Da alcuni decenni abbiamo a disposizione dei farmaci con potente azione inibente la secrezione acida gastrica: gli inibitori di pompa protonica (IPP) hanno una struttura chimica affine, uno stesso meccanismo d'azione e sono molto importanti per il trattamento delle patologie acido correlate, per l'eradicazione dell'Helicobacter Pylori, per la prevenzione e la cura della gastropatia da farmaci antinfiammatori non steroidei (FANS). Somministriamo ai nostri pazienti questa classe di farmaci, con terapie che continuano nel tempo, nonostante la risoluzione della malattia (gastroprotezione). Ma gli IPP possono essere utilizzati indistintamente nei nefropatici cronici oppure sarebbe utile conoscere il profilo del farmaco per una corretta scelta? In questo articolo si argomenta che i loro effetti collaterali non sono molto rilevanti e sono abbastanza simili: il loro impiego nel lungo termine è sicuro. La potenza e l'efficacia dei vari IPP, dall'analisi comparativa dei vari trial clinici, risulta essere molto simile sulla base dei milligrammi di sostanza utilizzata. L'unica eccezione illustrata in questo lavoro è rappresentata da 6 pazienti in emodialisi, trattati con lansoprazolo (15 mg), che presentavano gastriti e ulcere peptiche complicate da gravi episodi di ematemesi e melena con conseguente anemia. Tutti gli IPP hanno dimostrato un'efficacia clinica sovrapponibile, tuttavia vanno valutati di volta in volta i vantaggi (relativi) di ciascun IPP. I criteri di scelta di un IPP sembrano basati, principalmente sulle indicazioni autorizzate, sulle formulazioni disponibili, sul profilo di sicurezza del farmaco.

Published
2018

31. Sicurezza nella scelta dell'Inibitore di Pompa Protonica nel nefropatico cronico

Author

Sequenza, M. J., primary, Loi, M.R., additional, Londrino, F., additional, Sale, P., additional, Andrulli, S., additional, Noce, A., additional, Durante, O., additional, Zamboli, P., additional, Floccari, F., additional, Fiorini, F., additional, D’Amelio, A., additional, Di Lullo, Luca, additional, Granata, A., additional, Mudoni, A., additional, and Logias, F., additional

Published
2018
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34. Prevalence and prognosis of mild anemia in non-dialysis chronic kidney disease: a prospective cohort study in outpatient renal clinics

Author

De Nicola, L, Minutolo, R, Chiodini, P, Zamboli, P, Cianciaruso, B, Nappi, F, Signoriello, S, Conte, G, Zoccali, C, Iodice, Fc, Borrelli, S, Scigliano, Rosella, Gallo, C, Materiale, T, Minale, B, Paglionico, C, Pota, A, Andreucci, Ve, Avella, Fabrizio, Di Iorio BR, Bellizzi, V, Cestaro, R, Martignetti, V, Morrone, L, Lupo, A, Abaterusso, C, Donadio, C, Bonomini, M, Sirolli, V, F Lopez T, Casino, 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, Cariddi, G, Postorino, M, Savica, V, Monardo, P, Bellinghieri, G, Santoro, D, Castellino, P, Rapisarda, F, Fatuzzo, P, Messina, A, De Nicola, L, Minutolo, R, Chiodini, P, Zamboli, P, Cianciaruso, Bruno, Nappi, F, Signoriello, S, Conte, G, Zoccali, C, and SIN TABLE CDK Study, Group

Subjects
Male, medicine.medical_specialty, Epoietin- CKD -renal anemia- hemoglobin variability, Survival, Anemia, Renal function, Kaplan-Meier Estimate, Chronic kidney disease, End-stage renal disease, Hemoglobin, Aged, Aged, 80 and over, Ambulatory Care Facilities, Female, Glomerular Filtration Rate, Hemoglobins, Humans, Kidney Failure, Chronic, Longitudinal Studies, Middle Aged, Predictive Value of Tests, Prevalence, Prognosis, Proportional Hazards Models, Prospective Studies, Renal Insufficiency, Chronic, Survival Analysis, Disease Progression, End stage renal disease, Kidney Failure, Internal medicine, 80 and over, medicine, Renal Insufficiency, Chronic, Intensive care medicine, Prospective cohort study, Survival analysis, business.industry, Proportional hazards model, medicine.disease, Nephrology, Predictive value of tests, business, Kidney disease
Abstract

Background/Aims: We evaluated prevalence and prognosis of mild anemia, defined as Hb (g/dl) 11–13.5 in males and 11–12 in females, in a prospective cohort of stage 3–5 chronic kidney disease (CKD) patients. Methods: We enrolled 668 consecutive patients in 25 renal clinics during 2003. Patients with frank anemia (Hb Results: Mild anemia was present in 41.3% at visit 1 and 34.1% at visit 2. We identified PER in 22% patients, RES in 10%, and PRO in 26%. In the subsequent 40 months, 125 patients developed end-stage renal disease (ESRD) and 94 died. At competing risk model, PER predicted ESRD (hazard ratio, HR, 1.82, 95% confidence interval, CI, 1.01–3.29) while PRO predicted both ESRD (HR 1.81, 95% CI 1.02–3.23) and death (HR 1.87, 95% CI 1.04–3.37). Conclusion: In non-dialysis chronic kidney disease, mild anemia is prevalent and it is a marker of risk excess when persistent or progressive over time.

Published
2010

35. Very low protein diet supplemented with ketoanalogs improves blood pressure control in chronic kidney disease

Author

BELLIZZI V., DI IORIO B. R., DE NICOLA L., MINUTOLO R., ZAMBOLI P., TRUCILLO P., CATAPANO F., CRISTOFANO C., CONTE G., SCALFI, LUCA, Bellizzi, V., DI IORIO, B. R., DE NICOLA, L., Minutolo, R., Zamboli, P., Trucillo, P., Catapano, F., Cristofano, C., Scalfi, Luca, and Conte, G.

Abstract

Blood pressure ( BP) is hardly controlled in chronic kidney disease ( CKD). We compared the effect of very low protein diet ( VLPD) supplemented with ketoanalogs of essential amino acids ( 0.35 g/kg/day), low protein diet ( LPD, 0.60 g/kg/day), and free diet ( FD) on BP in patients with CKD stages 4 and 5. Vegetable proteins were higher in VLPD ( 66%) than in LPD ( 48%). LPD was prescribed to 110 consecutive patients; after run-in, they were invited to start VLPD. Thirty subjects accepted; 57 decided to continue LPD; 23 refused either diet ( FD group). At baseline, protein intake ( g/kg/day) was 0.79 +/- 0.09 in VLPD, 0.78 +/- 0.11 in LPD, and 1.11 +/- 0.18 in FD ( P < 0.0001). After 6 months, protein intake was lower in VLPD than LPD and FD ( 0.54 +/- 0.11, 0.78 +/- 0.10, and 1.04 +/- 0.21 g/kg/day, respectively; P < 0.0001). BP diminished only in VLPD, from 143 +/- 19/84 +/- 10 to 128 +/- 16/78 +/- 7mm Hg ( P < 0.0001), despite reduction of antihypertensive drugs ( from 2.671.1 to 1.8 +/- 1.2; P < 0.001). Urinary urea excretion directly correlated with urinary sodium excretion, which diminished in VLPD ( from 181 +/- 32 to 131 +/- 36mEq/day; P < 0.001). At multiple regression analysis ( R-2 = 0.270, P < 0.0001), BP results independently related to urinary sodium excretion ( P = 0.023) and VLPD prescription ( P = 0.003), but not to the level of protein intake. Thus, in moderate to advanced CKD, VLPD has an antihypertensive effect likely due to reduction of salt intake, type of proteins, and ketoanalogs supplementation, independent of actual protein intake.

Published
2007

36. Influence du traitement à l'acide gibbérellique sur la teneur en gibbérellines et en acide abscissique des fleurs et des baies de cépages androstériles et hermaphrodites

Author

A. Scienza, C. Visai, M. Zamboli, and M. Boselli

Subjects
Picolit female flower, differentiation phase, gibberelline, hermaphrodite flower, gibberellic acid, abscissic acid, variety, Agriculture, Botany, QK1-989
Abstract

Dans les fleurs femelles de Picolit on a observé, pendant les phases finales de la différenciation des niveaux de substances analogues aux gibbérellines plus élevés que dans les fleurs hermaphrodites de Malvoisie de Candie aromatique. Le traitement à l'acide gibbérellique de Picolit en post-floraison augmente considérablement la teneur des baies en substances analogues aux gibbérellines, sans toutefois modifier leur croissance de manière proportionnelle. Par contre, aucune différence significative n'apparaît dans les teneurs en acide abscissique des fleurs et des baies des deux cépages. +++ ln the Picolit female flowers, it has been observed that, during the final differentiation phases, the level of substances ressembling gibberellines is greater than in the hermaphrodite flowers of Malvoisie de Candie aromatique. The gibberellic acid treatment of Picolit in the post-floral phase considerably increases the level of substances ressembling gibberellines in the grapes, without proportionally modifying their growth. On the other hand, no significative difference appears in the abscissic acid level in the flowers and grapes of two varieties. *** Travail conduit dans le cadre du Projet Finalisé du C.N.R. « Biologie de la reproduction ».

Published
1981
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39. [Use of ECG-EC in the positioning of central venous catheters]

Author

Calabria M, Zamboli P, D'Amelio A, Granata Antonio, Di Lullo L, Floccari F, Logias F, Fiorini F, Gruppo di Studio di Ecografia Renale della Societa' Italiana di Nefrologia (SIN-GSER), Calabria, M, Zamboli, Pasquale, D'Amelio, A, Granata, A, Di Lullo, L, Floccari, F, Logias, F, Fiorini, F, and Gruppo di Studio di Ecografia Renale della Societa' Italiana di, Nefrologia

Published
2012

40. Echocardiography in nephrology

Author

Di Lullo L, Granata Antonio, Logias F, Fiorini F, D'Amelio A, Zamboli P, Malaguti M, Santoboni A, Floccari F, Di Lullo, L, Granata, A, Logias, F, Fiorini, F, D'Amelio, A, Zamboli, Pasquale, Malaguti, M, Santoboni, A, and Floccari, F.

Published
2012

43. Epidemiology of chronic kidney disease in Italy

Author

Zamboli, P., Nicola, L., Conte, G., Roberto Minutolo, Zamboli, Pasquale, DE NICOLA, Luca, Conte, Giuseppe, and Minutolo, Roberto

Subjects
Adult, Aged, 80 and over, Male, Aging, Time Factors, Adolescent, Age Factors, Comorbidity, Middle Aged, Prognosis, Risk Assessment, Young Adult, Italy, Cardiovascular Diseases, Risk Factors, Chronic Disease, Disease Progression, Prevalence, Humans, Female, Kidney Diseases, Aged
Abstract

Chronic kidney disease (CKD) is becoming a major public health problem worldwide. In Italy, only scarce and partial national data of prevalence have been obtained, from small-size cohorts in single settings not representative of the general Italian population. In this article, we review in detail the prevalence data obtained by the Gubbio study and the Italian Society of Nephrology - Health Search study, and describe the emerging problem of CKD definition in the elderly.

Published
2010

44. Global approach to cardiovascular risk in chronic kidney disease: reality and opportunities for intervention

Author

De Nicola, L, Minutolo, R, Chiodini, P, Zoccali, C, Castellino, P, Donadio, C, Strippoli, M, Casino, F, Giannattasio, M, Petrarulo, F, Virgilio, M, Laraia, E, Di Iorio, B, Savica, V, Conte, G, Zamboli, P, Catapano, F, Maione, E, Tirino, G, Venditti, G, Avino, D, Borrelli, S, Scigliano, R, Materiale, T, Signoriello, G, Gallo, C, Cianciaruso, B, Torraca, S, Pota, A, Andreucci, Ve, Nappi, F, Avella, F, Di Iorio BR, Bellizzi, V, D'Apice, L, Mangiacapra, S, Caserta, D, Cestaro, R, Marzano, L, Giannattasio, P, Martignetti, V, Morrone, L, Budetta, F, Gigliotti, G, Iodice, C, Rubino, R, Lupo, A, Conte, M, Panichi, V, Bonomini, M, Sirolli, V, Lopez, T, Detomaso, F, Elia, F, Tarantino, G, Cristofano, C, Chimienti, S, Montanaro, A, Giordano, R, Marangi, A, Giancaspro, V, Gallucci, M, Gigante, B, Lodeserto, C, Santese, D, Caglioti, A, Mancuso, D, Fuiano, G, Mallamaci, F, Postorino, M, Monardo, P, Bellinghieri, G, Mallamace, A, Rapisarda, F, Fatuzzo, P, Messina, A, DE NICOLA, Luca, Minutolo, Roberto, Chiodini, Paolo, Zamboni, P., Zoccali, C., Castellino, P., Donadio, C., Strippoli, M., Casino, F., Giannattasio, M., Petrarulo, F., Virgilio, M., Laraia, E., DI IORIO, B., Savica, V., and Conte, Giuseppe

Subjects
Nephrology, Male, epoietin, medicine.medical_specialty, Anemia, Cross-sectional study, diuretic, Hypercholesterolemia, Severity of Illness Index, Risk Factors, Internal medicine, Diabetes mellitus, medicine, CKD, Diabetes Mellitus, Odds Ratio, Prevalence, Humans, Antihypertensive Agents, Aged, Aged, 80 and over, business.industry, statin, Odds ratio, Middle Aged, medicine.disease, diuretics, Confidence interval, Surgery, Proteinuria, Cross-Sectional Studies, Italy, Cardiovascular Diseases, Chronic Disease, Hypertension, Practice Guidelines as Topic, Female, Hypertrophy, Left Ventricular, Kidney Diseases, sodium excretion, business, Dyslipidemia, Kidney disease
Abstract

The current implementation into nephrology clinical practice of guidelines on treatment of cardiovascular (CV) risk factors in chronic kidney disease (CKD) is unknown. We designed a cross-sectional analysis to evaluate the prevalence and treatment of eight modifiable CV risk factors in 1058 predialysis CKD patients (stage 3: n =486; stage 4: n =430, stage 5: n =142) followed for at least 1 year in 26 Italian renal clinics. The median nephrology follow-up was 37 months (range: 12–391 months). From stages 3 to 5, hypertension was the main complication (89, 87, and 87%), whereas smoking, high calcium-phosphate product and malnutrition were uncommon. The prevalence of proteinuria (25, 38, and 58%), anemia (16, 32, and 51%) and left ventricular hypertrophy (51, 55, and 64%) significantly increased, while hypercholesterolemia was less frequent in stage 5 (49%) than in stages 4 and 3 (59%). The vast majority of patients received multidrug antihypertensive therapy including inhibitors of renin–angiotensin system; conversely, diuretic treatment was consistently inadequate for both frequency and dose despite scarce implementation of low salt diet (19%). Statins were not prescribed in most hypercholesterolemics (78%), and epoietin treatment was largely overlooked in anemics (78%). The adjusted risk for having a higher number of uncontrolled risk factors rose in the presence of diabetes (odds ratio 1.29, 95% confidence interval 1.00–1.66), history of CV disease (odds ratio 1.48, 95% confidence interval 1.15–1.90) and CKD stages 4 and 5 (odds ratio 1.75, 95% confidence interval 1.37–2.22 and odds ratio 2.85, 95% confidence interval 2.01–4.04, respectively). In the tertiary care of CKD, treatment of hypertension is largely inadequate, whereas therapy of anemia and dyslipidemia is frequently omitted. The risk of not achieving therapeutic targets is higher in patients with diabetes, CV disease and more advanced CKD.

Published
2006

46. Gestione clinica dell'IRC:dati campano-siciliani delo studio table

Author

Minutolo, R, Zamboli, P, Sorrentino, F, Vitello, S, Pota, A, Cianciaruso, B, Mallamace, Bellinghieri, Guido, Monardo, P, Savica, Vincenzo, Messina, A, Rapisarda, F, Fatuzzo, P, Castellino, P, Budetta, F, Nappi, F, Avella Martignetti, V, Morrone, L, Paglionico, C, Materiale, T, Bellizzi, V, Di Iorio BR, Conte, G, and De Nicola, L.

Published
2006

47. GESTIONE CLINICA DELL’IRC: DATI CAMPANO-SICILIANI DELLO STUDIO TABLE

Author

Minutolo, R., Zamboli, P., Sorrentino, F., Vitello, S., Pota, A., Cianciaruso, B., Mallamace, A., Bellinghieri, G., Monardo, P., Savica, V., Messina, A., Rapisarda, Francesco, Fatuzzo, Pasquale Mario, Castellino, Pietro, Budetta, F., Nappi, F., Avella, F., Martignetti, V., Morrone, L., Paglionico, C., Materiale, T., Bellizzi, V., BR DI IORIO, Conte, G., and DE NICOLA, L.

Published
2006

48. Italian audit on therapy of hypertension in chronic kidney disease: the TABLE-CKD study

Author

DE NICOLA, L, Minutolo, R, Zamboli, P, Cestaro, R, Marzano, L, Giannattasio, P, Cristofano, C, Chimienti, S, Savica, Vincenzo, Bellinghieri, Guido, Rapisarda, F, Fatuzzo, P, Conte, G, CA TABLE CKD STUDY GRP, DE NICOLA, Luca, Minutolo, Roberto, Zamboli, Pasquale, Cestaro, R, Marzano, L, Giannattasio, P, Cristofano, C, Chimienti, S, Savica, V, Bellinghieri, G, Rapisarda, F, Fatuzzo, P, Conte, Giuseppe, and FOR THE INVESTIGATORS OF TARGET BLOOD PRESSURE LEVELS IN CHRONIC KIDNEY DISEASE TABLE IN CKD STUDY, Group

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Population, Audit, Disease, Essential hypertension, Risk Assessment, Severity of Illness Index, Drug Administration Schedule, Age Distribution, Renal Dialysis, Internal medicine, medicine, Humans, In patient, Prospective Studies, Sex Distribution, education, Antihypertensive Agents, Aged, education.field_of_study, Medical Audit, Dose-Response Relationship, Drug, business.industry, Blood Pressure Determination, Middle Aged, Reference Standards, medicine.disease, Blood pressure, Italy, Nephrology, Hypertension, Cardiology, Kidney Failure, Chronic, Female, Diuretic, business, Kidney disease, Follow-Up Studies
Abstract

A large body of evidence supports the validity of decreasing blood pressure to target levels in patients with essential hypertension to prevent cardiovascular disease. This issue becomes even more critical in chronic kidney disease because of the remarkably greater risk for cardiovascular fatal and nonfatal events. Indeed, renal patients should maintain blood pressure levels less than those suggested for the general population. Paradoxically, management of hypertension in this high-risk patient population is far from optimal and certainly worse with respect to essential hypertension. The Target Blood Pressure Levels in Chronic Kidney Disease (TABLE-CKD) study, performed in Italian patients with mild to advanced chronic kidney disease regularly followed-up by nephrologists, has shown that the prevalence of patients at target blood pressure is less than 20%. The assessment of antihypertensive strategy in these patients, however, suggests that there is room for improvement; in particular, a more aggressive treatment of volume expansion may ameliorate hypertension control in this population characterized by a high salt sensitivity of blood pressure.

Published
2005

50. High-flow arteriovenous fistula and heart failure: could the indexation of blood flow rate and echocardiography have a role in the identification of patients at higher risk?

Author

Zamboli, Pasquale, Lucà, Sergio, Borrelli, Silvio, Garofalo, Carlo, Liberti, Maria, Pacilio, Mario, Lucà, Stefano, Palladino, Giuseppe, and Punzi, Massimo

Abstract

Although only high-flow arteriovenous fistulas (AVFs) are postulated to cause high-output cardiac failure (HOCF), there are currently no universally accepted criteria defining a high-flow fistula. To verify if vascular access blood flow (Qa) ≥ 2000 ml/min provides an accurate definition of high-flow fistula, we selected 29 consecutive patients with Qa ≥ 2000 ml/min at color-duplex ultrasound examination and assessed them for the presence of cardiac failure symptoms; transthoracic echocardiography was also performed. Nineteen patients (65%) had heart failure symptoms and were classified with HOCF. At receiver operating characteristic (ROC) curve analysis, Qa ml/min values did not identify patients with heart failure symptoms but when AVF blood flow was indexed for height2.7, Qa ≥ 603 ml/min/m2.7detected the occurrence of HOCF with good accuracy (sensitivity 100%, specificity 60%, efficiency 86%, positive predictive value 83%, negative predictive value 100%, area under curve 0.75). At echocardiographic evaluation, patients with Qa ≥ 603 ml/min/m2.7had a more severe increase of left ventricular mass (63 ± 18 vs. 47 ± 7 g/m2.7, p< 0.003), left ventricular diastolic volume (140 ± 42 vs. 109 ± 14 ml, p< 0.007), left atrial volume (53 ± 23 vs. 39 ± 5 ml/m2, p< 0.015), a higher incidence of diastolic dysfunction (70 vs. 17%, p< 0.019) and higher CO reduction after AVF manual compression (2151 ± 875 vs. 1292 ± 527 ml/min, p< 0.009) than patients with Qa < 603 ml/min/m2.7. Indexation of AVF blood flow should be considered in defining high-flow fistula because the effect of Qa may differ in individuals of different sizes. A Qa value ≥ 603 ml/min/m2.7and its association with some echocardiographic alterations could identify patients at higher risk for HOCF.

Published
2018
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