Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia最新文献_第10页

[Contrast Media Toxicity and Its Prevention]. [造影剂毒性及其预防]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-26

Concetto Sessa, Luca Zanoli, Giovanni Noto, Ivana Alessandrello, Dario Galeano, Elisa Giglio, Alfio Edoardo Giuffrida, Giulio Distefano, Vincenzo Ficara, Roberta Maria Messina, Stella Musumeci, Viviana Scollo, Fortunata Zirino, Carmelo Zuppardo, Walter Morale

{"title":"[Contrast Media Toxicity and Its Prevention].","authors":"Concetto Sessa, Luca Zanoli, Giovanni Noto, Ivana Alessandrello, Dario Galeano, Elisa Giglio, Alfio Edoardo Giuffrida, Giulio Distefano, Vincenzo Ficara, Roberta Maria Messina, Stella Musumeci, Viviana Scollo, Fortunata Zirino, Carmelo Zuppardo, Walter Morale","doi":"","DOIUrl":"","url":null,"abstract":"Intravenous iodinated contrast media are commonly used in clinical practice, ranging from medical imaging to interventional radiology (IR) procedures and endovascular interventions. Compared with patients with normal renal function, nephropathic patients have an increased risk of acute kidney injury (AKI). Nevertheless, this condition cannot represent a limit to diagnostics or endovascular interventions. Despite the literature of the last five years, conflicting management and approaches for nephropathic patients persist, including the use of contrast agents and treatments replacing renal functions, which are often mistakenly considered as part of preventive strategies. Though the issue has been widely discussed, specialists often cope with uncertainty in handling properly the administration of contrast media and renal counselling requests. Furthermore, there is a general difficulty in distinguishing the Post-Contrast Acute Kidney Injury (PC-AKI) from the Contrast-Associated Acute Kidney Injury (CI-AKI). The present review aims to provide an update on the issue and examine strategies to reduce the acute kidney injury risk after the administration of contrast media. These strategies include the early identification of high-risk individuals, the choice of the contrast media and the proper dosage, the suspension of nephrotoxic drugs, the follow-up of the high-risk individuals, and the early identification of AKI.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138444445","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}

引用次数: 0

[Management of Cast Nephropathy]. [铸型肾病的处理]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Emanuele De Simone, Roberta Fenoglio, Simone Cortazzi, Andrea Careddu, Giovanni Geraci, Federico Bugliosi, Savino Sciascia, Dario Roccatello

引用次数: 0

[Onconefrologia: una sfida]. [肿瘤学:挑战]

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Dario Roccatello, Gaetano La Manna, Roberta Fenoglio

引用次数: 0

[Can Patients with History of Malignancy Become Organ Donors?] 有恶性肿瘤病史的患者可以成为器官捐献者吗?］

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Antonio Amoroso

{"title":"[Can Patients with History of Malignancy Become Organ Donors?]","authors":"Antonio Amoroso","doi":"","DOIUrl":"","url":null,"abstract":"Cancer transmission from solid organ donors to recipients is a known risk factor in transplantation. The Italian National Network for Transplantation (CNT) has adopted specific guidelines to evaluate the suitability of donors with history of malignancy. CNT also provides a Second Opinion service to assess oncological cases with a potential risk of neoplastic transmission to the recipient. CNT aims to minimize the risk of disease transmission from donors to recipients. According to CNT guidelines, \"standard\" donors are defined as individuals with no signs of active malignancy and no history of cancer at the time of organ procurement. Unsuitable donors, defined as those with an \"unacceptable risk\", are those patients with evidence of malignancy at the time of donation or in their medical history that carries an unacceptably high risk of disease transmission. Between these two categories, a broad spectrum of \"non-standard\" donors exists, where the risk of transmission is not entirely absent, but remains low enough to consider organ utilization. Malignancy should not be considered an absolute contraindication for organ donation. CNT has also adopted a specific repository for adverse events (AE) after transplantation. Since 2012, with 10.493 donors and 34.193 performed transplants, 283 AE have been recorded, occurring in approximately 3% of donation processes and 1% of performed transplants. Oncological AE represented 13% of all reports. In the majority of cases, oncological AE resulted from missed diagnosis during organ procurement, benchwork, or transplantation surgery. CNT guidelines, the oncological second opinion service, and the repository helped minimize the risk of cancer transmission with transplantation.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 Suppl 81","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440590","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}

引用次数: 0

[Cancer and the Kidney: A Deadly Embrace]. [癌症和肾脏:致命的拥抱]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Dario Roccatello, Simone Cortazzi, Francesca Bertinetto, Alessandra La Rosa, Lorenzo Nescis, Savino Sciascia, Roberta Fenoglio

{"title":"[Cancer and the Kidney: A Deadly Embrace].","authors":"Dario Roccatello, Simone Cortazzi, Francesca Bertinetto, Alessandra La Rosa, Lorenzo Nescis, Savino Sciascia, Roberta Fenoglio","doi":"","DOIUrl":"","url":null,"abstract":"A deadly embrace occurs between cancer and chronic kidney disease. The estimation of kidney function in cancer patients is of utmost interest due to its direct impact on chemotherapy dosing, selection, and eligibility for chemotherapeutics. Overestimating kidney function (determined as estimated glomerular filtration rate -eGFR) can lead to overdosing and drug toxicity, while underestimating kidney function can prevent patients from receiving novel therapies. Notably, the current measures of eGFR are not validated in transplanted patients yet. The field of onconephrology ranges from nephrotoxicity of existing and novel therapeutics, paraproteinemias, and cancer-associated electrolyte imbalance, fluid and acid-base disturbances, the effects of the destruction of cancer cells, and acute and/or chronic kidney injuries. Recently, the therapeutic armamentarium has been enriched with new agents that interfere with specific proteins involved in oncogenesis. These are the so-called target therapies, which although acquired as \"targeted\" therapies do not have absolute specificity and selectivity and tend to inhibit multiple targets, often involving the kidney. Renal biopsy may be critical in managing these adverse effects. Moreover, primary hematological and oncological disorders can have significant kidney implications in the form of glomerular or nonglomerular diseases presenting with proteinuria, hematuria, hypertension, and kidney function decline, specifically including cast nephropathy or systemic light chain amyloidosis, and paraneoplastic glomerulopathies that occur as a result of occult malignancy, such as Membranous Nephropathy and Minimal Change disease.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 Suppl 81","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440591","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}

引用次数: 0

[Hyponatremia and Electrolyte Disorders in Cancer Patients]. [癌症患者低钠血症和电解质紊乱]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Giulia Florio, Anna Iervolino, Mariadelina Simeoni, Alessandra F Perna, Francesco Trepiccione

引用次数: 0

[Management of Chemotherapy in Patients Subjected in Chronic Dialysis Treatment]. 慢性透析患者化疗的管理

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Marta Pirovano, Giulia Vanessa Re Sartò, Laura Cosmai

引用次数: 0

[Renal Replacement Therapy in Cancer Patients with AKI]. [肾替代疗法在AKI癌症患者中的应用]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Marco Pozzato, Roberta Fenoglio, Nunziante Caruso, Cecilia Ceruti, Giorgio Amore, Savino Sciascia, Dario Roccatello

{"title":"[Renal Replacement Therapy in Cancer Patients with AKI].","authors":"Marco Pozzato, Roberta Fenoglio, Nunziante Caruso, Cecilia Ceruti, Giorgio Amore, Savino Sciascia, Dario Roccatello","doi":"","DOIUrl":"","url":null,"abstract":"Acute renal failure (AKI) is a high-prevalence complication in patients with cancer. The risk of AKI after cancer diagnosis is 18% in the first year, 27% in the fifth year, and 40% of critically ill patients with cancer require renal replacement therapy. The causes of AKI may be pre-renal due to hemodynamic problems, related to the cancer, metabolic complications, and drug or surgical treatment. One must preventively protect renal function by hydration, use of non-nephrotoxic drugs, correction of anemia, prevention of contrast agent-induced AKI (CI-AKI), and adjustment of cancer therapy in patients with CKD. It is essential to check basal renal function, creatinine trend, electrolytes, urinalysis and proteinuria, perform imaging, renal biopsy if necessary. The evaluation of patients should be multidisciplinary and timely including the initiation of renal replacement treatment (RRT). There are different modalities of replacement treatment depending on the clinical picture of the patient with AKI and cancer: intermittent hemodialysis (IHD), intermittent prolonged replacement therapy (PIRRT), and continuous replacement therapy (CRRT). The concept of dose administered, as opposed to prescribed dose, as well as the anticoagulation of extracorporeal circuits, which must be regional with citrate (RCA) as the first choice in the management of CRRT, turns out to be fundamental in order to achieve optimal circuit anticoagulation, with reduction of coagulation episodes and downtime, while maintaining the patient's coagulation status. The onco-nephrologic multidisciplinary approach is crucial to reduce the mortality rate, which is still high in this category of patients.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 Suppl 81","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138440602","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}

引用次数: 0

[Ten Years of Onconephrology]. [十年同象学]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Laura Cosmai

引用次数: 0

How I Approach Light Chain Amyloidosis. 我如何处理轻链淀粉样变性。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-10-03

Raad B Chowdhury, Nelson Leung

引用次数: 0