Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia最新文献_第2页

[Un anno di novità per il GIN: innovazione e trasparenza]. [GIN 新的一年：创新与透明]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-31 DOI: 10.69097/41-05-2024-01

Gaetano La Manna

引用次数: 0

[The Educational Programs in Home Hemodialysis: Scoping Review]. [家庭血液透析的教育计划：范围研究]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-31 DOI: 10.69097/41-05-2024-09

Fiammetta Cicala, Francesco Fanari, Monica Petralito

{"title":"[The Educational Programs in Home Hemodialysis: Scoping Review].","authors":"Fiammetta Cicala, Francesco Fanari, Monica Petralito","doi":"10.69097/41-05-2024-09","DOIUrl":"https://doi.org/10.69097/41-05-2024-09","url":null,"abstract":"Introduction. Home hemodialysis is an effective therapeutic option for patients with chronic kidney disease. As highlighted in the literature, its management requires good self-care abilities from the patient and adequate support for self-care from the caregiver. Therefore, the development of educational programs plays a fundamental role in patient care. Aim. The goal of this study is to map the educational programs aimed at caregivers and patients undergoing home hemodialysis treatment, in order to identify gaps in the literature regarding this focus. Methods. A Scoping Review was conducted following the Joanna Briggs Institute guidelines. Potentially relevant articles were identified through a selection process on major databases (PubMed, Scopus, CINAHL, EMBASE, Web of Science, and Google Scholar), without applying any time limits. Results. The educational programs available in the literature for home hemodialysis patients focus on both clinical and psychological aspects; training through a \"practical\" approach is the most commonly used strategy. Discussion and conclusions. The review highlights the crucial role that a multidisciplinary and multidimensional educational approach can provide to home hemodialysis patients. It is necessary to optimize educational strategies for this population to improve patient outcomes.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"41 5","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142604205","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

[Chronic Immunosuppressive Therapy Regimens and Their Significance]. [慢性免疫抑制治疗方案及其意义]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-09

Luigi Biancone, Silvia Mingozzi, Rita Terragoni

{"title":"[Chronic Immunosuppressive Therapy Regimens and Their Significance].","authors":"Luigi Biancone, Silvia Mingozzi, Rita Terragoni","doi":"","DOIUrl":"","url":null,"abstract":"The renal transplant scenario has changed profoundly in the last two decades in both the typology of donors and recipients. This phenomenon has not been accompanied by a significant renewal of the therapeutic arsenal in maintenance therapy, which needs to be more versatile and adapted to the new needs of personalized therapy. Compared to traditional drugs, the only concrete innovation is represented by lymphocyte costimulation inhibitors whose progenitor, and for now the only representative in current practice, is Belatacept with characteristics of absent nephrotoxicity and metabolic impact on dyslipidemia and glucose metabolism, and greater prevention compared to calcineurin inhibitors (CNIs) in the development of donor-specific antibodies. Data from randomized clinical trials clearly indicate a significant long-term GFR gain compared to CNIs. The risk of acute rejections post-conversion to Belatacept is averted by more recent imbrication protocols with CNI. The association with mTOR inhibitors appears promising, allowing us to exploit some peculiar characteristics of this class. In conclusion, new maintenance immunosuppressive regimens may benefit from the synergy of established drugs with belatacept possessing unique characteristics.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"41 Suppl 83","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582807","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

[Convective Methods versus Diffusive Methods: Defined Superiority?] [对流方法与扩散方法：优劣已定？］

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-09

Antonio Santoro, Annalisa Zucchelli

{"title":"[Convective Methods versus Diffusive Methods: Defined Superiority?]","authors":"Antonio Santoro, Annalisa Zucchelli","doi":"","DOIUrl":"","url":null,"abstract":"The technique of dialysis has seen enormous advancements over the past fifty years, evolving from an initial phase, primarily based on diffusion through a semipermeable membrane to the current preference for high-efficiency convection, involving the removal of several liters of ultrafiltrate. Diffusive dialysis, due to its relative simplicity in execution, has allowed the treatment of millions of individuals with ESRD, ensuring them a certain quality of life. However, it is not considered optimal in terms of survival and has some complications inherent to the uremic state. Convection, by removing toxic substances through solvent drag, has enabled the purification of not only small molecules but also medium-to-large molecular weight molecules. As a result, hemodiafiltration techniques have shown improvements in both mortality and intradialytic complications such as cramps and intradialytic hypotension. These results, however, involve fluid exchanges that far exceed 20 liters per session, thus increasing technical complexity and not being applicable to all patients, particularly those with vascular access problems. The recent discovery of so-called medium cut-off (MCO) membranes appears to maintain the benefits of hemodiafiltration techniques without the need for high convective flows. Therefore, the debate between convection and diffusion seems far from over and may hold more surprises in the near future.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"41 Suppl 83","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582808","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

[Biomarkers and Bone Turnover Markers in Chronic Kidney Disease - Mineral and Bone Disorders (CKD-MBD): Recent Advances]. [慢性肾脏病-矿物质和骨骼疾病（CKD-MBD）中的生物标志物和骨转换标志物：最新进展]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-09

Althea Cossettini, Giulia Vanessa Re Sartò, Andrea Aghi, Maurizio Gallieni, Laura Cosmai, Giovanni Tripepi, Mario Plebani, Sandro Giannini, Paolo Simioni, Stefania Stella, Gaetano Paride Arcidiacono, Carmela Marino, Maria Fusaro

{"title":"[Biomarkers and Bone Turnover Markers in Chronic Kidney Disease - Mineral and Bone Disorders (CKD-MBD): Recent Advances].","authors":"Althea Cossettini, Giulia Vanessa Re Sartò, Andrea Aghi, Maurizio Gallieni, Laura Cosmai, Giovanni Tripepi, Mario Plebani, Sandro Giannini, Paolo Simioni, Stefania Stella, Gaetano Paride Arcidiacono, Carmela Marino, Maria Fusaro","doi":"","DOIUrl":"","url":null,"abstract":"Chronic Kidney Disease (CKD) provokes biochemical and systemic alterations, causing bone fragility with an increase in bone fracture risk, extraskeletal calcifications, increased morbidity, and cardiovascular mortality. The complex pathophysiological mechanism causes a syndrome called CKD-MBD (Chronic Kidney Disease - Mineral and Bone Disorders), which includes mineral and bone alterations leading to renal osteodystrophy (ROD). An early diagnosis is therefore essential to prevent the onset of more severe complications. A precise diagnosis of bone disorders and the subsequent administration of the best therapy is difficult without performing a bone biopsy. However, lately, the diagnostic focus is shifting to a series of molecules, the bone turnover markers (BTM), generated by the same bone tissue during the remodeling process, which is proving to be a useful diagnostic tool in the definition of ROD. BTMs are divided into bone formation molecules (amino-terminal propeptide of type 1 procollagen, P1NP; osteocalcin, OC; bone alkaline phosphatase, bALP) and bone resorption molecules (carboxy-terminal cross-linked telopeptide of type 1 collagen, CTX; isoform 5b tartrate-resistant acid phosphatase, TRAP-5b). There are also biomarkers of bone metabolism such as parathyroid hormone (PTH), fibroblast growth factor 23 (FGF23), and sclerostin. Although PTH is one of the most used molecules, P1NP, bALP, CTX, and TRAP-5b have proven to be superior in the discrimination of low turnover pathologies. The diagnostic capability of these molecules and their potential still require further studies, but clinicians must include BTMs in the diagnostic process of CKD-MBD.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"41 Suppl 83","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582806","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

[Almost Forty Years of Erythropoietin Therapy: Successes and Limitations]. [促红细胞生成素疗法近四十年：成功与局限]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-09

Lucia Del Vecchio, Giulio Pucci Bella, Francesco Locatelli

引用次数: 0

[News on Peritoneal Dialysis]. [腹膜透析新闻]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-09

Gianfranca Cabiddu, Antonello Pani, Nicola Lepori

引用次数: 0

[Hyperuricemia in Chronic Kidney Disease: To Treat or Not to Treat?] [慢性肾脏病中的高尿酸血症：治还是不治？］

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-09

Marco Manganaro

{"title":"[Hyperuricemia in Chronic Kidney Disease: To Treat or Not to Treat?]","authors":"Marco Manganaro","doi":"","DOIUrl":"","url":null,"abstract":"Numerous studies have shown that hyperuricemia (HU) is an independent risk factor for the development of chronic kidney disease (CKD) and cardiovascular events. However, while some evidence suggests that uric acid (UA) may play not only a predictive but also a causal role in these conditions, a robust and definitive demonstration of this is still lacking. Moreover, despite what appears to be a logical rationale supporting the use of so-called 'urate-lowering therapy' (ULT) for nephroprotection in hyperuricemic patients with CKD, studies and meta-analyses on this topic - sometimes burdened by limitations that may have affected their results - have so far provided highly divergent outcomes, leaving uncertainty about whether drug-induced reduction of uricemia can truly slow the progression of CKD and prevent its cardiovascular complications. This article summarizes current knowledge on UA metabolism and the drugs that interfere with it, discusses theories on the possible multiple pathogenic mechanisms underlying HU related kidney damage, and reviews the results and limitations of the most recent studies that have supported or refuted the nephroprotective role of ULT in CKD, fueling an ongoing scientific controversy.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"41 Suppl 83","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582813","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

[Iron Metabolism and Iron Therapy in Chronic Renal Failure]. [慢性肾功能衰竭的铁代谢和铁治疗]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-09

Chiara Carla Maria Brunati, Davide Barraco, Francesco Munforte, Enrico Minetti

{"title":"[Iron Metabolism and Iron Therapy in Chronic Renal Failure].","authors":"Chiara Carla Maria Brunati, Davide Barraco, Francesco Munforte, Enrico Minetti","doi":"","DOIUrl":"","url":null,"abstract":"Iron therapy in nephropathic patients can allow optimizing treatment with EPO identifying the minimum effective dose capable of improving the patient's quality of life. The most recent studies on iron metabolism and on the interference of iron deficiency syndrome on the performance of some organs, in particular the myocardium, suggest the need to intervene very early, especially in patients with cardiomyopathy and systolic deficit. Setting up an iron therapy in nephropathic patients requires a correct diagnosis. That is particularly difficult in comorbid and inflamed patients because of the poor diagnostic reliability of the main biomarkers (ferritin and transferrin saturation). We need to spread the use of biomarkers that are not influenced by the inflammatory state, not expensive and easily accessible: reticulocyte hemoglobin could meet these requirements. The Pivotal study has delineated the optimal iron treatment in incident hemodialysis patients, treated with EPO not inflamed with classical biomarkers. It is yet to be determined, however, whether the Pivotal results are reproducible in more comorbid patients, also considering new and different therapeutic scenarios that the use of hypoxia-inducible factor-prolyl hydroxyl inhibitors may determine.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"41 Suppl 83","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142582815","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

[ACEi and ARBs: Proteinuria Containment and Nephroprotection]. [ACEi 和 ARBs：蛋白尿抑制和肾脏保护]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-10-09

Filippo Aucella, Rachele Grifa, Francesco Aucella, Giuseppe Gatta

引用次数: 0