Database : MEDLINE
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  1 / 4178759 MEDLINE  
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[PMID]: 26093143
[Au] Autor:Rombolà G; Quintaliani G; Di Iorio B
[Ti] Title:I pazienti, la nefrologia e la legge "Balduzzi". [Patients, nephrology and Balduzzi decree].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Pt] Publication type:JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  2 / 4178759 MEDLINE  
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[PMID]: 26093142
[Au] Autor:Di Iorio BR; Di Micco L; De Blasio A; Rubino R; Guastaferro P
[Ti] Title:Short report: la variabilità della pressione arteriosa influenza la mortalità cardiovascolare e la morte renale in pazienti con Chronic Kidney Disease (CKD) and long survivors. [A short report: Blood pressure variability and outcomes in chronic kidney disease long survivors patients].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:In the last decade blood pressure variability (BPV) measured during a follow-up of hypertensive chronic kidney disease (CKD) patients or hemodialysis patients has received a even major attention. The aim of our study is to study the relationship between BPV and mortality and/or dialysis initiation in long survivors CKD patients. We conducted a historical prospective observational multicentric study in 131 subjects still alive at 31st December 2010, when ended a our previous study published on Nephrology Dialysis Transplantation. Long Survivors patients were younger (p<0.01) and had a lower BPV compared to the original population. Moreover, they had creatinine levels significantly lower (p<0.019), so as lower phosphate levels (p<0.05) and higher hemoglobin (p<0.05). During a mean follow-up of 80.713.4 months, 63 patients (48.1%) died and 49 of them (37.4%) started dialysis treatment. In this group, 28 patients died after dialysis initiation. Kaplan-Meier curves showed a significant association between BPV and cardiovascular mortality risk (Hazard Ratio [HR]: 1.061; 95% Confidence Interval [CI]: 1.0351.093; p = 0.001) and between BPV and renal death (HR 1.049; 95% CI: 10121.74; P = 0.001). In conclusions, our data in long survivors patients showed that BPV can be used for mortality cardiovascular and renal death risk stratification in CKD patients.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  3 / 4178759 MEDLINE  
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[PMID]: 26093139
[Au] Autor:Savoldi S; Giacchino F; Rollino C; Manganaro M; Besso L; Izzo C; Gianoglio B; Amore A; Fenoglio R; Stratta P
[Ti] Title:Indagine sulla terapia di prevenzione del danno osseo nei pazienti trattati con corticosteroidi in Piemonte e valle d'Aosta. [Bone protection in corticosteroid treated patients].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:The Piedmont Group of Clinical Nephrology compared the activity of 15 nephrology centers in Piedmont and Aosta Valley as regards bone protection in patients on corticosteroids therapy. Fracture prevalence shows great variability: in 4/15 centers (27%) no fractures were found, in 6/15 centers (40%) fractures were present in 1-4% of cases, in 1 center in 18% of patients. Clinical risk of fracture was based on sex, age and postmenopausal status in 11/14 of the centers (79%), history of fractures and bone disease in 4/14 centers (27%), smoking and alcohol consumption in 3 and 2 centers respectively, glucocorticoid dose and duration in 4, in children bone age and calcium phosphorus status. Dual energy X-ray absorptiometry was performed in 12 centers based on risk factors, in 8 (57%) DXA was performed during the follow-up, in 4 it was performed after 12 months and in 2 after 2-3 years. DXA is not prescribed in children. Only in one center, risk assessment is based on FRAX. Most of the patients are treated with vitamin D supplementation at a dose of steroids of 5 mg/d (80%). Calcium carbonate is used in 9 centers (60%), in two it is used only in the presence of low ionized calcium or bone mineral density. Bisphosphonates are used following AIFA prescription, in particular alendronate in all centers, risedronate in seven and denosumab in one. The analysis shows the great variability of the clinical and therapeutic approach regarding bone protection in patients on corticosteroids therapy, in Piedmont and Aosta Valley.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  4 / 4178759 MEDLINE  
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[PMID]: 26093138
[Au] Autor:Virzì GM; Gastaldon F; Corradi V; De Cal M; Cruz DN; Clementi M; Ronco C
[Ti] Title:Ruolo di NGAL nella progressione dell'insufficienza renale determinata da ADPKD. [Plasma NGAL and ADPKD progression].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:Autosomal dominant polycystic kidney disease (ADPKD) is a genetic disease with variable rate of progression. It is associated with inter- and intra-familial variability. Neutrophil gelatinase-associated lipocalin (NGAL) has been implicated in pathological conditions and it is proposed as a biomarker for CKD progression. Our aim was to evaluate whether NGAL could be a good marker for progression of ADPKD, as we hypothesized. ADPKD patients with confirmed mutations (PKD1 n=33; PKD2 n=17) were enrolled and followed in a prospective study. Creatinine (sCr) and NGAL values were measured at baseline and on follow-up. Plasma NGAL was measured by Triage point of care test. CKD progression was defined as 15% decrease in eGFR from baseline to follow-up. Patients were divided into 2 groups based on median baseline NGAL and compared by the Kaplan-Meier curve. We enrolled 50 ADPKD pts (60%M age 41yrs); mean sCr 1.30.7mg/dl and median eGFR was 62 mL/min/1.73m2. NGAL values are inversely correlated with baseline eGFR (r=-0.64, p<0.001). There was weak correlation between baseline NGAL and subsequent change in eGFR (r=0.28, p=0.05). 9/50 of patients had NGAL below limits of detection (60pg/ml); median NGAL level was 79pg/ml. At follow-up, 12 patients (24%) had progression as defined. No statistically significant relationship between higher NGAL and ADPKD progression was observed. We did not observe a relationship between NGAL and CKD progression in ADPKD patients; however 18% of patients had undetectable plasma NGAL levels. This raises doubt about the utility of the current NGAL assay as a biomarker for CKD progression in this population.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  5 / 4178759 MEDLINE  
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[PMID]: 26093137
[Au] Autor:Di Napoli A; Lapucci E; Baglio G; Di Giulio S
[Ti] Title:Confronto delle caratteristiche demografiche, cliniche e di sopravvivenza tra dializzati nati in Italia e all'estero: risultati del registro del Lazio. [Lazio dialysis registry: natives vs foreigners].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:INTRODUCTION: An increasing number of foreigners was observed in Italy even among chronic dialysis patients. We compared demographic, clinical, treatment characteristics and survival probability between groups of Italian and foreign patients with chronic dialysis in Lazio. METHODS: We analysed data from the Lazio Dialysis and Transplantation Registry from 2004 to 2012 (4,076 prevalent chronic dialysis patients in 31-12-2012). Among 7,970 incident patients, we evaluated, by country of birth, survival probability by using Kaplan-Meier method and mortality risk, through multiple Cox regression. RESULTS AND CONCLUSIONS: We observed an increase of foreigners among chronic dialysis patients in Lazio from 2004 (4.4%) up to 2012 (7.6%, test for trend: p<0,001). Compared with Italians, foreign patients were younger (53.816.3 vs. 68.713.6) and more frequently: women (42.7% vs. 37.7%), HbsAg-positive (18.1% vs. 13.9%), not vaccinated if HBV susceptible (26.8% vs. 20.9%), late referral (21.6% vs. 12.9%) and suitable for kidney transplantation (21.7% vs. 9.9%). Foreigners compared with Italians had higher survival probability at 1 year (91.9% vs. 84.7%) and 5 years (74,6% vs. 51,5%) after chronic dialysis has been started. We observed a lower mortality risk (HR=0.71;IC95%:0.58-0.87) among foreign patients even after adjustment for many potential confounding factors. Our findings suggest that health status and treatment of end stage renal disease, including access to kidney transplantation, were similar between groups of Italian and foreign patients in Lazio. Observed differences in patientscharacteristics were probably attributable to younger age of foreigners. However, further analyses are needed to fully explain higher survival probability in chronic dialysis among foreigners compared with Italians.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  6 / 4178759 MEDLINE  
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[PMID]: 26093136
[Au] Autor:Cusimano P; Palermo A; Locascio G
[Ti] Title:Utilità di questionari di screening ultrabrevi per la stima della prevalenza di sintomi depressivi in pazienti anziani in emodialisi. [Screening for depression in hemodialysis].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:Prevalence of depression symptoms, which is high among geriatric individuals, it is even higher in hemodialysis patients. In this study we performed a screening for depression symptoms in 82 elderly hemodialysis patients, by means of 3 different ultra-brief questionnaires, proposed for geriatric population by the American Geriatric Society Guide-Lines. At the beginning, patients were requested to fill out the ultra-brief Patient Health Questionnaire (PHQ), which consists of only 2 questions. A score of 3 or greater prompted the administration of the brief version of the Geriatric Depression Scale (GDS-5) and of the full PHQ-9. A GDS-5 score of 2 or greater was considered as positive for depression screening. PHQ-9 scores of 5, 10, 15 and 20 represented the cutpoints for mild, moderate, moderately severe and severe depression, respectively. PHQ-2 score was 3 or greater in 43.9% of patients (n= 36), in which GDS-5 resulted as positive in all of the patients. Further, PHQ-9 scores stratified depression symptoms as follows: mild 22.2%, moderate 16.6%, moderately severe 39% and severe 22.2%. Our sample showed high prevalence of depression symptoms, which were relevant (moderate or worse) in almost 80% of patients. PHQ-2 appeared to be extremely useful, since 100% of patients with PHQ-2 score of 3 or greater had positive GDS-5 score. In conclusion, screening of depression symptoms by ultra-brief self-administered questionnaires may be very simple and useful in hemodialysis patients, therefore it should be encouraged.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  7 / 4178759 MEDLINE  
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[PMID]: 26093135
[Au] Autor:Ghiandai G; Ralli C; Imperiali P; Zingarelli A; Duranti E
[Ti] Title:È utile la terapia con Tiosolfato di sodio nel trattamento delle calcificazioni vascolari nei pazienti emodializzati? [Is the Sodium Thiosulfate Therapy useful for vascular calcification in dialysis Pts?].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:Vascular calcifications in uremic patients are associated with a significant increase in cardiovascular morbidity and mortality. Sodium thiosulfate (STS) has been shown to reduce the progression of uremic calcifications in haemodialysis patients. In our study we evaluated the effects on evolution of aortic calcifications of the drug infused during the last 2 hours of dialysis sessions at a dose of 10 grams. 18 hemodialysis patients were evaluated as regards the calcifications index according to Kauppila, calcium-phosphorus metabolism, PTH, and oral chelation therapy. The side effects of STS and the symptomatic effects reported by the patient, were also evaluated using a questionnaire delivered to patients. After 6 months of therapy, a modest reduction of the Kauppila's index (from 16.4 5.5 to 15.1 4.6) was detected. No significant change was detected in blood tests. Even chelation therapy did not suffer variations. It was also showed a clear and statistically significant improvement in signs and symptoms of leg pain, a moderate improvement of' power reserve and a reduction of muscle fatigue. The results of our study, although preliminary and on a small number of patients, confirm a positive effect of STS on vasculopatic symptoms and progression of vascular calcifications.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  8 / 4178759 MEDLINE  
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[PMID]: 26093134
[Au] Autor:Verdesca S; Cucchiari D; Monari M; Podestà MA; Badalamenti S
[Ti] Title:Cristalluria a 'Fascine di grano': complicanza della terapia con sulfametossazolo? [Sulfamethoxazole crystalluria].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:Drug-induced crystalluria is a cause of acute renal failure that has not to be overlooked. Especially sulfonamides are known to be little solubles in acidic urine. Among these drugs, sulfadiazine produces the so-called shocks of wheat crystals, whose formation can be avoided by opportune hydration and alkalinization of the patient. Sulfamethoxazole is another drug of this class that has seldom been reported to cause a pleomorphic crystalluria. We report the case of two patients treated with sulfamethoxazole who developed a crystalluria that is very similar to the sulfadiazine one. Sulfamethoxazole is widely used in clinical practice in association with trimethoprim and it is known to cause acute renal failure, although little is known about the pathogenesis of this nephrotoxicity. Our cases, along with the cases previously reported, may suggest that sulphamethoxazole can act as a nephrotoxic agent through crystals production. Notably, in our cases, discontinuation of the drug led to disappearance of the crystals.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  9 / 4178759 MEDLINE  
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[PMID]: 26093133
[Au] Autor:Tattoli F; Falconi D; De Prisco O; Gherzi M; Marazzi F; Marengo M; Serra I; Tamagnone M; Formica M
[Ti] Title:Ipopotassiemia in sindrome di Lennox-Gastaut. [Hypokalemia in Lennox-Gastaut syndrome].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:The Lennox-Gastaut Syndrome (LGS) is a childhood epileptic encephalopathy. Incidence: 1/1.000.000/year, prevalence: 15/100.000. LGS covers 5-10% of epileptic patients and 1-2% of childhood epilepsies. Also referred to as cryptogenic or symptomatic generalized epilepsy. LGS is characterized by: multiple seizures (atypical absences, axial tonic seizures and sudden atonic or myoclonic falls), diffuse slow cryptic EEG waves when awake (<3 Hz), fast rhythmic peaks (10 Hz) during sleep, mental retardation and personality disorders. The LGS is not responding to treatment. Some new drugs have proven to be effective in controlling the disease (Felbamate, Lamotrigine, Topiramate, Levetiracetam). The mortality rate is about 5%; only rarely death is due to epilepsy, which is usually caused by stroke or epileptic episodes. Here we describe the case of a 45-year-old female patient with LGS, severe hypokalemia, mental retardation and focal seizures. Normal renal function: creatinine 0.9 mg/dl, urea 26 mg/dl, creatinine clearance 96 ml/min, serum potassium levels to the minimum: 3.5 mEq/L. This level of potassium, however, had been achieved with the assumption of 8 oral tablets/day of potassium chloride. Osmotic diuresis, use of diuretics, Bartter, Gitelman (normal urinary calcium and magnesium) and pseudo-Bartter syndromes were all excluded whereas aldosteronism was found. Our findings lead to hypokalemia related to assumption of topiramate and hyperaldosteronism. Reduction in drug intake was not effective due to the increased seizures, so the drug was maintained, along with potassium supplementation. In conclusion, the patient has been diagnosed with hypokalemia and iatrogenic hyperaldosteronism, rare in our outpatient practice.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review

  10 / 4178759 MEDLINE  
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[PMID]: 26093132
[Au] Autor:Caletti C; Granata S; Tomei P; Dalla Gassa A; Lupo A; Zaza G
[Ti] Title:Farmacogenetica: un possibile strumento per la personalizzazione della terapia immunosoppressiva nel trapianto renale. [Pharmacogenetics: a promising tool to personalize immunosuppressive therapy in renal transplantation].
[So] Source:G Ital Nefrol;32(3), 2015 May-Jun.
[Is] ISSN:1724-5990
[Cp] Country of publication:Italy
[La] Language:ita
[Ab] Abstract:Renal transplantation is the gold standard therapy for patients affected by end stage renal disease. It is a clinical condition characterized by severe biological/biochemical alterations that requires renal replacement therapy to ensure patients survival. In most cases, it is followed by a significant improvement of patients quality of life, reduction in medical expenses and prolongation of life. However, to reach these positive clinical effects, patients need to take several immunosuppressive medications (calcineurin inhibitors, mTOR inhibitors and antimetabolites) characterized by a narrow therapeutic index, that, in some cases, could cause important adverse effects. To avoid toxicities and adverse drug reactions, immunosuppressors should be correctly administered, according to the blood trough levels. Nevertheless, in most of the times, this methodology to adjust drug doses gives inadequate and non-reproducible results. Additionally, as largely described, inherited differences in drug metabolism and disposition and genetic variability in therapeutic targets (e.g. receptors) need to be taken into account because of their role in modulating drug effects and toxicities. Therefore, worldwide researchers are working together to identify biomarkers, useful to personalize therapy based on genetic characteristics of patients. In this context, we believe that the omics techniques could represent a future powerful instruments that, whether employed routinely, could help to reach this objective.
[Pt] Publication type:ENGLISH ABSTRACT; JOURNAL ARTICLE
[Em] Entry month:1506
[Js] Journal subset:IM
[St] Status:In-Data-Review


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