Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia最新文献

{"title":"[Competencies of Nephrology Nurses in Italy: A Nationwide Cross-Sectional Study].","authors":"Domenica Gazineo, Desirèe Andreoli, Sara Morales Palomares, Addolorata Palmisano, Mauro Parozzi, Stefano Mancin, Serenella Salvini, Lea Godino","doi":"10.69097/42-03-2025-09","DOIUrl":"https://doi.org/10.69097/42-03-2025-09","url":null,"abstract":"<p><p><b>Background.</b> Nurses working in nephrology play a critical role in managing patients with kidney diseases, providing highly personalized care that integrates advanced technical and specialized competencies. However, the absence of a formal professional profile in Italy limits both professional development and the standardization of competencies. This study aims to explore the basic and advanced competencies of nephrology nurses to propose unified educational and professional standards. <b>Design.</b> A cross-sectional study based on an ad hoc questionnaire was conducted between March and May 2024 among nurses working in nephrology within the National Health Service, with dissemination support from the Society of Nephrology Nurses. The questionnaire was structured into three sections: theoretical knowledge, practical competencies, and professional development, and was validated through a pilot phase. Data were analyzed using SPSS 27 software. <b>Results.</b> The study involved 296 nurses, 77% of whom were employed in hemodialysis. Only 14% reported having completed specific post-basic training courses, while 71% expressed interest in further educational opportunities. Technical-specialist competencies in hemodialysis were widely applied, but significant gaps were identified in pharmacological management (37% with moderate or low competency levels) and nutrition (35% with moderate or low competency levels). Decision-making and communication skills scored higher, with 65% of participants perceiving themselves at a high or excellent level in these areas. <b>Conclusion.</b> This study represents an important step towards defining a comprehensive professional profile for nephrology nurses in Italy. The findings underscore the need of standardized educational and professional frameworks to promote formal recognition of this specialization while enhancing the quality of care through advanced competencies, humanized approaches, and personalized patient support.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553128","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Chronic Kidney Disease and SGLT2 Inhibitors: Single Center Experience].","authors":"Federica Spaltini, Elvira Mancini, Patrizia Vio, Maria Carmela Vella, Loredana Funaro, Francesca Bonvegna, Francesco Laurendi, Pantaleo Ametrano, Maurizio Borzumati","doi":"10.69097/42-03-2025-07","DOIUrl":"10.69097/42-03-2025-07","url":null,"abstract":"<p><p>Chronic kidney disease is a very common condition, often underdiagnosed, and a major risk factor for cardiovascular complications and premature death. There is an increasing interest in scientific society in implementing effective treatments for kidney disease to slow progression. In the last decades angiotensin-converting enzyme (ACE) inhibitors and angiotensin receptor blockers (ARBs) have been the only drugs recommended for chronic kidney disease. More recently a further therapeutic choice has been developed: SGLT2 inhibitors. We present a single center observational study aimed at understanding the efficacy and safety of Dapaglifozin in nephropathic population. The trial started in February 2023, and concluded in June 2024. We collected blood tests monthly and one urine sample for urinecolture in the first month, afterwards only in case of disuric symptoms. We enrolled 21 diabetic patients and 7 nondiabetic patients. They were all receiving a maximum tolerated dose of renin-angiotensin system at enrolment.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553126","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Hyperkalemia in Hemodialysis: Use of Sodium Zirconium Cyclosilicate - A Single-center Experience].","authors":"Stefano Ferraro, Sonila Mocka, Marzia Ciabattoni, Debora Garneri, Ilaria Tallone, Alice Tarroni, Fanny Tosetti, Emanuela Vigo, Monica Repetto","doi":"10.69097/42-03-2025-06","DOIUrl":"10.69097/42-03-2025-06","url":null,"abstract":"<p><p>Potassium is the main intracellular cation, and its serum concentration is finely controlled through various mechanisms to maintain it within the range of 3-5 mmol/L. Hyperkalaemia occurs when the serum concentration of K⁺ exceeds 5.0 mmol/L and can be classified as mild, moderate, or severe. Hyperkalaemia is a serious and potentially life-threatening medical condition, and its incidence tends to increase when comorbid conditions are present, such as diabetes mellitus, heart failure, and renal insufficiency, particularly in the subgroup of patients undergoing haemodialysis, where the incidence of hyperkalaemia is even higher. This leads to an increase in hospitalizations and mortality. Control of potassium in haemodialysis patients has always been a central focus for nephrologists, although chronic management strategies have often been ineffective and poorly tolerated by patients. Recently, two new medications have been introduced for chronic potassium control: Patiromer and Sodium Zirconium Cyclosilicate, the latter approved for use in haemodialysis. We conducted an observational study at our dialysis unit on 28 chronic haemodialysis patients, where after detecting hyperkalaemia, therapy with Sodium Zirconium Cyclosilicate was initiated. We evaluated the potassium levels over time, changes in home treatments, and the drug's tolerability.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Successful Use of HA380 Filter in a Kidney Transplant Patient with Septic Shock].","authors":"Paolo Sipari, Luca Piscitani, Lorenzo Ottavio Di Pietro, Irene Scopacasa, Marilena Tunno","doi":"10.69097/42-03-2025-05","DOIUrl":"10.69097/42-03-2025-05","url":null,"abstract":"<p><p>Septic shock is a high-risk disease secondary to infections by pathogens, often rapidly evolving and requiring complex treatment. Dysregulation of the immune response can lead to organ hypoperfusion, multiorgan failure and death. In this context, multiple studies are being conducted to find new therapeutic strategies that can improve prognosis. Among these, hemoperfusion techniques using adsorbent filters have emerged. In this paper, we describe our experience in the treatment of septic shock in a kidney transplant patient.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Associazioni di pazienti: la voce di chi vive la malattia ogni giorno].","authors":"Arianna Fanuli","doi":"10.69097/42-03-2025-01","DOIUrl":"https://doi.org/10.69097/42-03-2025-01","url":null,"abstract":"","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Clinical Management of Severe Lactic Acidosis Secondary to Metformin Intoxication].","authors":"Lorenzo D'Elia, Annalisa Villani, Deborah Di Vico, Giovanni Otranto, Luigi Cappucci, Luana Sanchini, Vincenzo Barbera","doi":"10.69097/42-03-2025-03","DOIUrl":"10.69097/42-03-2025-03","url":null,"abstract":"<p><p>Lactic acidosis is a severe and life-threatening complication that can occur in patients affected by diabetes mellitus. The severity of this clinical condition is primarily due to the challenging correction of acid-base balance, which often requires continuous renal replacement therapies. This clinical case outlines the main clinical manifestations of the condition, along with its key pathophysiological and management aspects.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deciphering the Complexity: Nephrotic Syndrome in Autosomal Dominant Polycystic Kidney Disease - A Case Report and Literature Review.","authors":"Alessandro Barruscotti, Gabriella Moroni, Liliana Italia De Rosa, Kristiana Kola, Martina Catania, Francesca Tunesi, Matteo Brambilla Pisoni, Sara Farinone, Paolo Manunta, Giuseppe Vezzoli, Maria Teresa Sciarrone Alibrandi","doi":"10.69097/42-03-2025-04","DOIUrl":"10.69097/42-03-2025-04","url":null,"abstract":"<p><p>Autosomal Dominant Polycystic Kidney Disease (ADPKD) is a genetic disorder characterized by the development of multiple renal cysts and the growth of total kidney volume, often leading to progressive kidney failure. While glomerulonephritis is potentially recognized as a complication, the presence of glomerulonephritis among ADPKD patients is considered uncommon, and the incidence of nephrotic syndrome within this population is exceptionally rare. We present a case of a young woman with ADPKD who developed nephrotic syndrome, likely due to minimal change disease. The diagnostic challenges, management strategies, and existing literature on this rare association are here comprehensively reviewed.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovations in randomized clinical trials in Nephrology: from study design to patient's activism.","authors":"Giuseppe Pezzi, Roberta Arena, Giuliana Papalia, Raffaella Sbano, Fiorella Iorio, Chiara Summaria, Angela Greco, Rosita Greco, Rocco Malivindi, Pierangelo Veltri, Gaetano La Manna, Lilio Hu, Gianluigi Zaza, Michele Provenzano","doi":"10.69097/42-03-2025-02","DOIUrl":"https://doi.org/10.69097/42-03-2025-02","url":null,"abstract":"<p><p>Current clinical practice is guided by novel robust evidence from randomized clinical trials (RCT). These studies usually follow a rigorous prospective design with pre-defined visits and planned exams during follow-up. In the context of Nephrology, RCTs have been mainly designed to test the efficacy of new therapies in reducing the risk for kidney failure, estimated Glomerular Filtration Rate decline and mortality or cardiovascular events. However, the progress of informatics is reflected in an improvement and expansion of technologies and innovations in present and future RCTs. We here present some innovations and future directions of RCTs in Chronic Kidney Disease patients.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Kidney Failure Risk Equation predictive tool to improve predialysis patient management?","authors":"Fabrizio Cristiano, Julian Camilo Ramirez-Acosta, Guillermo Rosa-Diez, Gustavo Aroca, Carlos Guido Musso","doi":"10.69097/42-03-2025-08","DOIUrl":"https://doi.org/10.69097/42-03-2025-08","url":null,"abstract":"<p><p>The Kidney Failure Risk Equation (KFRE) is a predictive tool that estimates the risk of progression to end-stage renal disease (ESKD) in patients with chronic kidney disease (CKD). This study evaluated the systematic implementation of KFRE in our nephrology center to improve the management of pre-dialysis patients. Through the analysis of 100 patients followed in the pre-dialysis pathway in the last 36 months, we observed a significant reduction in the initiation of dialysis in late referral mode, a lower use of temporary central venous catheters and an increase in timely preparation of vascular or peritoneal access. The comparison with historical pre-implementation data (2017-2020) highlighted an improvement in clinical organization and patient awareness in the choice of dialysis modality. The KFRE has proven to be a valid tool for risk stratification, optimizing the timing of renal replacement therapy and improving the allocation of healthcare resources. The integration of KFRE into clinical practice could represent a step towards precision nephrology, promoting more informed and personalized therapeutic decisions.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 3","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144553133","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Does the High Renal Resistive Index Reveal an Increased Risk of Acute Kidney Injury? A Protocol for Systematic Review.","authors":"Giuseppe Cuttone, Giulio Geraci, Luigi La Via, Nicola Sinatra, Maria Rita Stancanelli, Vincenzo Calabrese","doi":"10.69097/42-02-2025-02","DOIUrl":"10.69097/42-02-2025-02","url":null,"abstract":"<p><p><b>Introduction.</b> Acute Kidney Injury (AKI) is a serious complication in critically ill patients associated with significant morbidity and mortality. Early detection and risk stratification remain challenging, particularly in complex conditions such as septic shock where hemodynamic alterations complicate the clinical picture. Renal Resistive Index (RRI), measured through Doppler ultrasonography, has emerged as a promising non-invasive tool for assessing renal hemodynamics and microcirculatory changes. While various studies have investigated the relationship between RRI and AKI, there has not been a comprehensive systematic evaluation of RRI's utility in predicting and assessing AKI in critical care settings. <b>Objective.</b> The main aim is to evaluate the difference in RRI between patients who manifested AKI and patients who did not manifest AKI. Furthermore, the risk of AKI occurrence related to RRI will be computed. <b>Methods.</b> We will perform systematic research in PubMed and Scopus according to the PRISMA Guidelines. We will screen observational studies, with both retrospective and prospective designs on critically ill patients, without sex or age restriction. <b>Expected results.</b> This systematic review is expected to provide a comprehensive and extensive evaluation of the relationship between RRI and AKI. It will be based on observational studies, as RRI is a risk factor not subject to control by the investigator. In addition to assessing the association between RRI and AKI, the study also aims to highlight potential gaps in current knowledge and suggest directions for future research. <b>Conclusions.</b> The present systematic review protocol will include all existing evidence from published articles evaluating the RRI values in patients manifesting or not AKI.</p>","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"42 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144012056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}