Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia最新文献_第3页

Is Iohexol a Possible Method for Estimating Glomerular Filtration Rate? 碘己醇是估计肾小球滤过率的可能方法吗？

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-03

Fabrizio Cristiano, Guillermo Rosa-Diez, Carlos Guido Musso, Jenny Cristiano

{"title":"Is Iohexol a Possible Method for Estimating Glomerular Filtration Rate?","authors":"Fabrizio Cristiano, Guillermo Rosa-Diez, Carlos Guido Musso, Jenny Cristiano","doi":"10.69097/42-02-2025-03","DOIUrl":"10.69097/42-02-2025-03","url":null,"abstract":"The measurement of glomerular filtration rate (GFR) is essential in diagnosing and managing chronic kidney disease (CKD) and autosomal dominant polycystic kidney disease (ADPKD), both requiring precise renal function assessment. Traditionally, GFR has been estimated using endogenous markers like creatinine and cystatin C, though these can be inaccurate due to factors unrelated to kidney function, such as muscle mass and diet. The iohexol clearance method provides a more accurate and less invasive alternative to traditional markers like inulin or radioactive markers. Iohexol, a non-ionic, water-soluble contrast agent, is exclusively eliminated by glomerular filtration, making it highly suitable for direct GFR estimation. This paper describes procedures for iohexol clearance, involving defined-interval blood samples after intravenous administration. In patients with normal renal function, sampling intervals are more frequent, while in advanced CKD patients, including those with ADPKD, slower iohexol elimination requires wider intervals to ensure accurate clearance analysis. Iohexol has demonstrated high precision and reproducibility, even compared to other markers. Research supports using iohexol to monitor CKD and ADPKD progression effectively. Particularly in ADPKD, iohexol detects subtle but clinically significant GFR changes, even in early disease stages, making it valuable for evaluating targeted therapies. However, iohexol use is limited to specialized centers due to high costs and strict protocols. Its implementation in advanced European healthcare facilities underscores its efficacy, providing reliable GFR estimates that enhance nephrology practice, despite some limitations.","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":"144009964","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

Boosting Tolvaptan Tolerance in ADPKD: Low-Dose Hydrochlorothiazide Improves Patient Well-being Without Compromising Efficacy - A Case Report. 提高ADPKD患者托伐普坦耐受性：低剂量氢氯噻嗪在不影响疗效的情况下改善患者的健康-一个病例报告。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-06

Kristiana Kola, Martina Catania, Liliana Italia De Rosa, Matteo Brambilla Pisoni, Sara Farinone, Paola Maiucchi, Micaela Petrone, Paolo Manunta, Giuseppe Vezzoli, Maria Teresa Sciarrone Alibrandi

{"title":"Boosting Tolvaptan Tolerance in ADPKD: Low-Dose Hydrochlorothiazide Improves Patient Well-being Without Compromising Efficacy - A Case Report.","authors":"Kristiana Kola, Martina Catania, Liliana Italia De Rosa, Matteo Brambilla Pisoni, Sara Farinone, Paola Maiucchi, Micaela Petrone, Paolo Manunta, Giuseppe Vezzoli, Maria Teresa Sciarrone Alibrandi","doi":"10.69097/42-02-2025-06","DOIUrl":"https://doi.org/10.69097/42-02-2025-06","url":null,"abstract":"ADPKD is the most common inherited kidney disorder, marked by numerous renal cysts, increased total kidney volume and progressive renal function decline. Mutations in the PKD1 and PKD2 genes, leading to altered cAMP signaling, drive cyst growth. Elevated antidiuretic hormone (ADH) levels further exacerbate cystogenesis. Tolvaptan, a vasopressin V2 receptor antagonist, is the only approved treatment for slowing ADPKD progression, but its use often results in significant polyuria and thirst, affecting patient quality of life. This case report presents a 31-year-old female with ADPKD, classified as Mayo Class 1D, who showed improved tolerance to tolvaptan after co-administering low-dose hydrochlorothiazide (HCT). The patient experienced a significant reduction in polyuria and thirst while maintaining stable kidney function over four years. The annual decline in eGFR was less than expected for her disease class and improved compared to the first year of tolvaptan therapy. This case suggests that HCT may enhance tolvaptan tolerability without reducing its efficacy. Ongoing studies, such as the HYDRO-PROTECT trial, aim to further explore the benefits of combining HCT with tolvaptan in ADPKD management.","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":"144012088","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

Hepatorenal Syndrome - AKI in Decompensated Liver Disease: Clinical Characteristics, Risk Factors, Ultrasound Applications, and Outcomes. 肝肾综合征-失代偿性肝病的AKI：临床特征、危险因素、超声应用和结果

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-11

Yarramachu Dharanidhar Reddy, K Sai Sindhu Singh, Pavuluri Lakshmi Aishwarya, J K Jayaram, Indhumathi Elayaperumal

{"title":"Hepatorenal Syndrome - AKI in Decompensated Liver Disease: Clinical Characteristics, Risk Factors, Ultrasound Applications, and Outcomes.","authors":"Yarramachu Dharanidhar Reddy, K Sai Sindhu Singh, Pavuluri Lakshmi Aishwarya, J K Jayaram, Indhumathi Elayaperumal","doi":"10.69097/42-02-2025-11","DOIUrl":"https://doi.org/10.69097/42-02-2025-11","url":null,"abstract":"Background. Acute kidney injury (AKI) is a common and serious complication in patients with decompensated liver disease (DLD), often resulting from ischemic acute tubular necrosis or hepatorenal syndrome. This study examines the role of biochemical markers and ultrasound parameters, such as right atrial pressure, right ventricular hypertrophy, inferior vena cava diameter, hepatic venous flow dynamics, left ventricular diastolic dysfunction, the E/e' ratio, renal peak systolic velocity, renal end-diastolic velocity, and renal resistive index (RI), in predicting AKI severity and outcomes. Methods. A prospective observational study was conducted on 50 DLD patients with AKI, admitted to a tertiary care Hospital. Biochemical parameters including serum creatinine, bilirubin, and albumin along with ultrasound parameters were assessed. AKI was classified according to KDIGO criteria, and renal recovery and mortality were monitored. Diagnostic accuracy was evaluated through ROC analysis. Results. 30% of patients had stage 3 AKI, with 60% of them being male (average age 54 ± 12 years). Stage 3 AKI was a significant predictor of mortality (OR 3.5, p < 0.001), along with renal resistive index (OR 2.8, p = 0.003). ROC analysis showed that serum creatinine and the E/e' ratio, along with the RI, were significant predictors for AKI severity and mortality. Renal recovery occurred in 58%. Conclusion. The simultaneous assessment of clinical, biochemical, and ultrasound parameters enhances the prediction of AKI severity and patient outcomes in DLD. This approach facilitates earlier detection and better management of AKI in this population.","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":"143987296","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

[Peritoneal Dialysis Catheter Design: Variants and Clinical Implications]. [腹膜透析导管设计：变异和临床意义]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-04

Luca Nardelli, Antonio Scalamogna, Giuseppe Castellano

{"title":"[Peritoneal Dialysis Catheter Design: Variants and Clinical Implications].","authors":"Luca Nardelli, Antonio Scalamogna, Giuseppe Castellano","doi":"10.69097/42-02-2025-04","DOIUrl":"https://doi.org/10.69097/42-02-2025-04","url":null,"abstract":"The success of peritoneal dialysis (PD) relies imperatively on the presence of a safe and well-functioning peritoneal access. The ideal catheter should be easy to position and durable, comfortable and practical to use, have minimal aesthetic impact and present low infectious and mechanical complications. Originally, the catheter that came closest to these characteristics was designed by Tenckhoff at the end of the 1960s. Over the next fifty years, different types of devices were developed with the aim of improving their efficiency and at the same time reducing the associated complications. Overall, none of these catheters has demonstrated a clear superiority over the Tenckhoff catheter and yet up to 30% of PD discontinuations are due to access-related complications. However, nowadays the wide range of existing models bestow the possibility of a personalized choice. This approach, together with the placement technique and the experience of the centre, would allow maximizing the benefits deriving from specific features of the PD catheter in relation to peculiar conditions of the recipient. Therefore, for clinicians involved in the positioning and care of peritoneal access, understanding the principles underlying the different configurations of the PD catheter is necessary to establish a \"case by case\" approach.","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":"144016778","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

Lymphoid Peritoneal Fluid as a Variant of Chylous-Like Effluent in Peritoneal Dialysis: Proposal for a New Diagnostic Term. 淋巴样腹膜液是腹膜透析中乳糜样流出物的一种变体：提出一个新的诊断术语。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-09

Nigel Fernandez-Carlos, Maria L Ocampo, Carlos G Musso, Fabrizio Cristiano, Gustavo Aroca-Martinez, Maria C Giordani

{"title":"Lymphoid Peritoneal Fluid as a Variant of Chylous-Like Effluent in Peritoneal Dialysis: Proposal for a New Diagnostic Term.","authors":"Nigel Fernandez-Carlos, Maria L Ocampo, Carlos G Musso, Fabrizio Cristiano, Gustavo Aroca-Martinez, Maria C Giordani","doi":"10.69097/42-02-2025-09","DOIUrl":"10.69097/42-02-2025-09","url":null,"abstract":"The cloudy bag in peritoneal dialysis is generally associated with infectious peritonitis and non-infectious etiologies. These cloudy bags may have increased cellularity or low/acellular counts. In the case of low cell count, the concomitant detection of fibrin or fat can provide guidance on its etiology. The cloudy peritoneal bag with a whitish appearance is usually due to its high fat content (chyloperitoneum). The etiologies include pharmacological, traumatic or inflammatory causes. The elevated fatty component in chyloperitoneum may be triglycerides (chylous), cholesterol (pseudochylous) or lymph. We present the case of a patient with stage 5 chronic kidney disease (CKD). He starts continuous ambulatory peritoneal dialysis and presents turbid but acellular peritoneal effluent with chylous appearance, negative cultures, and low levels of triglycerides and cholesterol on physicochemical evaluation. It doesn't meet the criteria for chylous or pseudochylous fluid, which is why the term lymphoid fluid is here proposed to describe it, because of its resemblance to lymphatic fluid in color. To our knowledge, this is the first case in the literature to report this effluent (milky-looking fluid without high levels of triglycerides or cholesterol) and to propose a specific term to describe it.","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":"144005762","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

Treatment Optimization and Standard of Care Adherence in CKD Primary Care: the TOSCA-CKD project. CKD初级护理的治疗优化和护理依从性标准：TOSCA-CKD项目。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-10

Francesco Pesce, Domenico Pasculli, Giuseppe Castellano, Luca De Nicola, Giovanni Gambaro, Vincenzo Panichi, Domenico Santoro, Francesca Viazzi, Monica Zanella, Loreto Gesualdo

{"title":"Treatment Optimization and Standard of Care Adherence in CKD Primary Care: the TOSCA-CKD project.","authors":"Francesco Pesce, Domenico Pasculli, Giuseppe Castellano, Luca De Nicola, Giovanni Gambaro, Vincenzo Panichi, Domenico Santoro, Francesca Viazzi, Monica Zanella, Loreto Gesualdo","doi":"10.69097/42-02-2025-10","DOIUrl":"https://doi.org/10.69097/42-02-2025-10","url":null,"abstract":"Background. Effective collaboration between general practitioners (GPs) and nephrologists is crucial for optimizing the management of chronic kidney disease (CKD). The TOSCA-CKD project (Treatment Optimization and Standard of Care Adherence in CKD Primary Care) aimed to evaluate the implementation of guidelines and the use of nephroprotective therapies in primary care. Methods. Clinical data were collected from the medical records of GPs across 12 Italian regions. The data were analyzed at baseline (T0) and after 6 months (T6) of collaboration with nephrologists. During this observational period, GPs were involved in remote education programs, which included expert-led webinars and clinical case-based learning. Results. A total of 76 GPs and 9 nephrologists were involved in the study, evaluating a cohort of 124,759 patients. There was an increase of 23.3% in the uACR test from T0 to T6 (3.0% vs. 3.7%; p < 0.001). Similarly, there was an increase of 15.2% in the use of eGFR from T0 to T6 (29.7% vs. 34.2%; p < 0.001). The rate of CKD diagnosis increased by 17.5% among patients with eGFR < 60 mL/min/1.73 m² (from 4% to 4.7%) and by 40% among patients with ACR > 30 mg/g (from 0.5% to 0.7%). The use of ACEi/ARBs remained stable at approximately 50%, while the treatment with SGLT2i, the new standard of care according to the current CKD guidelines, increased by 29.8% (from 4.7% to 6.1%). Conclusions. The TOSCA-CKD project demonstrated that GPs' remote educational program and a structured co-management approach significantly enhanced the early identification and improved the management of CKD in primary care.","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":"143999827","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

[Presentation of the Triveneto Exit-Site Infections Register (RESIsT) and Warm-Up of Peritoneal Dialysis Centers]. [介绍腹膜透析中心的Triveneto出口感染登记（RESIsT）和预热]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-12

Antonino Previti, Pietro Manuel Ferraro, Elisa De Tomi, Giovanni Gambaro

引用次数: 0

[New Genetic Variants Involved in the Pathogenesis of Autosomal Dominant Alport Syndrome: A Familial Case Report]. [常染色体显性阿尔波特综合征发病机制的新遗传变异：家族病例报告]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-07

Sandra La Rosa, Stefania Pesce, Simona Lombardo, Marilena C Fiorino, Antonio Granata

{"title":"[New Genetic Variants Involved in the Pathogenesis of Autosomal Dominant Alport Syndrome: A Familial Case Report].","authors":"Sandra La Rosa, Stefania Pesce, Simona Lombardo, Marilena C Fiorino, Antonio Granata","doi":"10.69097/42-02-2025-07","DOIUrl":"10.69097/42-02-2025-07","url":null,"abstract":"Alport syndrome is a hereditary disorder characterized by hematuria, proteinuria and progressive renal failure, frequently associated with extrarenal manifestations. The pathogenic variants of the COL4A5 gene are associated with X-linked Alport syndrome while those of the COL4A3 and COL4A4 genes are associated with the autosomal recessive (AR) or dominant (AD) form. The disease is characterized by considerable phenotypic variability linked to the different genes involved and the different mutations present, so the symptoms manifest themselves in different frequencies depending on the case. The existence of an autosomal dominant form of Alport syndrome has been identified in recent years thanks to next generation gene sequencing (NGS) techniques which have made it possible to highlight unknown genetic variants of Alport syndrome. The family studied by us presents concomitant heterozygous alterations of the COL4A3 genes (c.1029+5G>A with MAF 0 and c.3211-7A>G with MAF 1:100000), heterozygous alterations of the MTHFR gene (both C677T and A1298C) and homozygous alteration of the PAI-1 gene. While the variant c.3211-7A>G, as shown by genetic databases (ClinVar), appears to be benign, the intronic variant c.1029+5G>A (caused by exon skipping) can be classified as pathogenic due to its characteristics and the fact that it co-segregates with the phenotype within the family. The histological data, in one of the sisters, highlighted the presence of a discrete global glomerular sclerosis and the ultrastructural investigation a thinning of the glomerular basement membrane. New mutational variants of the COL4A3 gene may play a role as risk variants for the development of chronic kidney disease.","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":"144005958","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

Covid-19 and Mortality in Chronic Hemodialysis Patients: Cause or Mere Concomitance? The Experience of Policlinico Gemelli. 慢性血液透析患者的Covid-19与死亡率：原因还是单纯的伴随？《从政的经历》。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-08

Martina Ambrogio, Luigi Cappannoli, Erica Rosati, Gianmarco De Luca, Marta Chiuchiarelli, Andrea Spasiano, Federica Urciuolo, Salvatore Lucio Cutoli, Gennaro De Pascale, Antonella Cingolani, Giuseppe Grandaliano, Nicola Panocchia

{"title":"Covid-19 and Mortality in Chronic Hemodialysis Patients: Cause or Mere Concomitance? The Experience of Policlinico Gemelli.","authors":"Martina Ambrogio, Luigi Cappannoli, Erica Rosati, Gianmarco De Luca, Marta Chiuchiarelli, Andrea Spasiano, Federica Urciuolo, Salvatore Lucio Cutoli, Gennaro De Pascale, Antonella Cingolani, Giuseppe Grandaliano, Nicola Panocchia","doi":"10.69097/42-02-2025-08","DOIUrl":"https://doi.org/10.69097/42-02-2025-08","url":null,"abstract":"Background. This study evaluated the causes of and risk factors for mortality among patients on chronic HD hospitalised with SARS-CoV-2; in particular, it evaluated whether the cause of death was directly related to coronavirus disease 2019 (Covid-19) or another pathology. The European Renal Association registry showed a 20% mortality rate after 28 days for these patients. Methods. The clinical data of chronic HD patients hospitalised because of SARS-CoV-2 at the Fondazione Policlinico Universitario Agostino Gemelli from 15 March 2020 to 28 February 2022 were analysed. Univariate and multivariate regression analyses were performed to identify risk factors for mortality. The causes of mortality were obtained from the hospital discharge forms. Results. One hundred fifty-two patients on maintenance haemodialysis with positive SARS-CoV-2 test results were hospitalised during the study period. There were 100 male (65.8%) and 52 female (34.2%) patients (mean age, 69 years; standard deviation [SD], 14.14 years). The mean Charlson comorbidity index (CCI) was 6.44 (SD, 2.64), and the average hospitalisation length was 23.57 days (SD, 24.55 days). Forty-two (27.6%) patients died, but only 22 deaths (59%) were directly caused by Covid-19. Conclusions. Only 59% of the deaths of patients with positive Covid-19 test results were directly caused by Covid-19. The survival of patients on chronic HD is independently related to specific patient characteristics (age, CCI, presence of peripheral vascular disease, and intensive care unit admission), but not to Covid-19.","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":"143974359","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

[Gout From the Corpus Hippocraticum to the Renaissance: The Role of Galen]. [痛风从希波克拉底文集到文艺复兴：盖伦的角色]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2025-04-29 DOI: 10.69097/42-02-2025-14

Natale Gaspare De Santo, Carmela Bisaccia, Luca Salvatore De Santo

{"title":"[Gout From the Corpus Hippocraticum to the Renaissance: The Role of Galen].","authors":"Natale Gaspare De Santo, Carmela Bisaccia, Luca Salvatore De Santo","doi":"10.69097/42-02-2025-14","DOIUrl":"https://doi.org/10.69097/42-02-2025-14","url":null,"abstract":"Gout is a common, complex, systemic and well-studied form of chronic inflammatory arthritis due to deposition of sodium monourate crystals in peripheral joints and periarticular tissues driven by hyperuricemia. Gout is the oldest recorded inflammatory arthritis to affect humankind, with roots stretching back to 2640 BCE. To establish the timeline of gout from the Corpus Hippocraticum to the Renaissance, this study focuses on Galen (129-c.215 CE). A princeps English edition of Galen's works is still lacking; therefore, this paper provides a translation of the paragraph on gout from the Latin edition [12] by Carolus Gottlob Kühn (Leipzig, 1821-1833). Galen departs from Hippocrates and displays a vast knowledge of pathogenesis, symptomatology, clinical course, differential diagnosis, therapeutic skills and prognostication. In Galen's view, gout is due to fluid overflow that infiltrates nerves and causes pain. Overflowing fluid may be blood, phlegm, or a mixture of bile, blood, and phlegm. The prevailing humor is crude, mucous, and thick, and by residing in the joint, causes tophi. The nature of infiltrating humor can be diagnosed through color of the joint, symptoms, effects of heat and cold, effects of drugs, and information related to age, diet, quantity and quality of exercise, attitude towards baths of the patient. Treatment, according to Galen, required immediate bloodletting by venesection at the elbow, which could be repeated. Purges, enemas, and/or emetics are additionally needed to evacuate the humor(s). Poultices played a role draining the humor(s) as well as for their emollient-softening properties.","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":"144005757","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