Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia最新文献_第4页

[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

[The Treatment of Acute Antibody-Mediated Rejection: Current State and Future Perspectives]. [急性抗体介导的排斥反应的治疗：现状与未来展望]。

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

Alessandra Palmisano, Ilaria Gandolfini, Micaela Gentile, Giuseppe Daniele Benigno, Marco Delsante, Marta D'angelo, Enrico Fiaccadori, Umberto Maggiore

{"title":"[The Treatment of Acute Antibody-Mediated Rejection: Current State and Future Perspectives].","authors":"Alessandra Palmisano, Ilaria Gandolfini, Micaela Gentile, Giuseppe Daniele Benigno, Marco Delsante, Marta D'angelo, Enrico Fiaccadori, Umberto Maggiore","doi":"","DOIUrl":"","url":null,"abstract":"Despite the advances in the immunosuppressive therapies and improvements in short term allograft survival, Antibody-mediated rejection (AMR) still represents the leading cause of late allograft failure in kidney transplant recipients. We present an insidious case of late active AMR that evolved into a severe chronic active antibody-mediated rejection, that we treated with a multidrug approach. Then, we review the current literature on the pathogenesis, diagnosis and treatment of AMR. Antibody-mediated rejection (AMR) typically occurs when anti-HLA donor-specific antibodies (DSA) bind to vascular endothelial cells of the kidney graft. DSAs may preexist to transplantation (preformed DSA) or develop after transplantation (de novo DSA). Pathogenetic mechanisms of AMR involve complement-dependent, and -independent inflammatory pathways that are variably activated depending on antigen and antibody characteristics, or on whether rejection develops early (0-6 months) or late (beyond 6 months) post-transplantation. The Banff classification system categorizes AMR rejection into active antibody-mediated rejection, chronic active antibody-mediated rejection, and chronic (inactive) antibody-mediated rejection. Currently, there are no approved therapies, treatment guidelines being based on low-quality evidence. Therefore, standard of care therapy is consensus-based. In early rejection, it is usually based on plasma exchange, intravenous immune globulin, anti-CD20 antibodies, while complement-inhibitor eculizumab is used in severe and/or refractory cases, treatments with. Recent evidence suggests that late AMR may be effectively treated with anti-CD38 therapy, which targets long lived plasma cells and NK cells.","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":"142582818","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

[Effects of Finerenone on Proteinuria and Progression of Chronic Kidney Disease]. [非奈酮对蛋白尿和慢性肾病进展的影响]。

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

Antonio De Pascalis, Giuseppe Cianciolo, Alessandro Tommassetti, Stefano Bianchi

引用次数: 0

[Gliflozins: Proteinuria Control and Nephroprotection]. [格列吡嗪：控制蛋白尿和保护肾脏]。

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

Simona Barbuto, Veronica Catalano, Marianna Pira, Giuseppe Cianciolo, Giorgia Comai, Irene Capelli, Francesco Tondolo, Federica Maritati, Gaetano La Manna

引用次数: 0

[Hypoxia-Inducible Factor Prolyl Hydroxylase Enzyme Inhibitors: A Novel Therapy for Anemia Treatment in CKD Patients]. [缺氧诱导因子脯氨酰羟化酶抑制剂：治疗慢性肾脏病患者贫血的新疗法]。

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

Andrea Stucchi, Lorenza Magagnoli, Anila Cara, Mario Cozzolino

{"title":"[Hypoxia-Inducible Factor Prolyl Hydroxylase Enzyme Inhibitors: A Novel Therapy for Anemia Treatment in CKD Patients].","authors":"Andrea Stucchi, Lorenza Magagnoli, Anila Cara, Mario Cozzolino","doi":"","DOIUrl":"","url":null,"abstract":"Anemia is a major complication of chronic kidney disease (CKD). Its prevalence increases with advancing age and progression of kidney disease. The main cause of anemia linked to CKD is represented by the reduction erythropoietin secretion. The increase in cardiovascular risk and mortality is strongly associated with the presence of anemia, and grows with the severity of the anemia, as described in numerous studies. The main therapies for the control of anemia have so far been represented by iron supplementation, the use of synthetic erythropoietin and blood transfusions. Despite the availability of adequate therapies, the prevalence of anemia in CKD continues to be significant. Drugs that inhibit the enzyme prolyl hydroxylase of hypoxia inducible factor (HIF-PHi) are able to mimic a condition of hypoxia and increase the production of endogenous erythropoietin. HIF-PHi therefore represents an important therapeutic alternative for the control of anemia linked to CKD. Numerous studies have confirmed the ability of HIF-PHi to correct anemia and maintain hemoglobin at adequate values; they also highlighted other potential beneficial pleiotropic factors on cholesterol control and iron homeostasis. Further studies are needed to confirm the safety of the drug, especially regarding cardiovascular risk, vascular thrombosis and neoplastic growth. This document highlights the mechanism of action, effects and pharmacological characteristics of HIF-PHi.","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":"142582814","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

[What's New in the CKD-BMD Therapy?] [CKD-BMD疗法有何新进展？］

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

Piergiorgio Messa, Shanmugam Sabarinath, Carlo Maria Alfieri, Giuseppe Castellano, Simone Vettoretti

{"title":"[What's New in the CKD-BMD Therapy?]","authors":"Piergiorgio Messa, Shanmugam Sabarinath, Carlo Maria Alfieri, Giuseppe Castellano, Simone Vettoretti","doi":"","DOIUrl":"","url":null,"abstract":"The important advances in scientific knowledge have led to a notable enrichment of therapeutic offers in the field of CKD-MBD, which have allowed better control of the related biochemical parameters compared to the past. However, this has not corresponded to a tangible improvement in the clinical outcomes, both bone and cardiovascular, associated with CKD-MBD, nor has there been a significant drop in the number of pills that nephropathic patients must take, to keep the parameters controlled biochemicals, with the therapeutic cost of these interventions remaining high. All these unsatisfied needs continue to stimulate research to find new solutions that can improve one or more of these objectives not yet achieved. In this review of the most recent literature, we have tried to summarize what has been recently proposed in the therapeutic field of CKD-MBD, underlining the possible advantages of new drugs compared to already available therapies, with particular attention to unmet needs. We have also revisited the recent acquisitions relating to drugs that have already been in use for some time, reporting the most recent evidence that could change the approach to their use.","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":"142582819","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

[ADPKD and IPMN: Mere Coincidence or Double Trouble?] [ADPKD 和 IPMN：巧合还是双重麻烦？］

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-08-26 DOI: 10.69097/41-04-2024-05

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

引用次数: 0

[Lactobacillemia: A Rare Entity in Immunocompromised Patients. Description of a Clinical Case and Literature Review]. [乳酸菌血症：免疫力低下患者中的罕见病例。临床病例描述与文献综述]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-08-26 DOI: 10.69097/41-04-2024-08

Marina Cornacchiari, Anna Mudoni, Amelia Liccardo, Bianca Visciano, Maria Antonietta Rizzo, Paola Cuoccio, Luca Francesco Di Toma

{"title":"[Lactobacillemia: A Rare Entity in Immunocompromised Patients. Description of a Clinical Case and Literature Review].","authors":"Marina Cornacchiari, Anna Mudoni, Amelia Liccardo, Bianca Visciano, Maria Antonietta Rizzo, Paola Cuoccio, Luca Francesco Di Toma","doi":"10.69097/41-04-2024-08","DOIUrl":"https://doi.org/10.69097/41-04-2024-08","url":null,"abstract":"Bacteremia caused by Lactobacillus is rare, data on its clinical significance are based only on case reports and a limited number of studies, often difficult to interpret. Lactobacillus species is a commensal colonizer of the mouth, gastrointestinal and genitourinary tract. Its significance as a pathogen is overlooked frequently. The diagnosis of these infections requires a mutual relationship between the physician and the microbiologist to rule out contamination risk. Most patients with Lactobacillus bacteremia are immunosuppressed or patients at increased risk of symptomatic bacteremia with comorbidities, treated with broad-spectrum antibiotics and have indwelling venous catheters. Risk factors related to Lactobacillus bacteremia include impaired host defenses and severe underlying diseases, as well as prior surgery and prolonged antibiotic therapy ineffective for lactobacilli. We describe an unusual case of a woman, on chronic hemodialysis treatment, with a sepsis due to Lactobacillus casei and review the literature.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"41 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142145527","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

[Stenotic FAV: Success of the Collaboration Between Spoke and HUB]. [Stenotic FAV：Spoke 和 HUB 之间的成功合作]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-08-26 DOI: 10.69097/41-04-2024-09

Ramona Nicotera, Armando Pingitore, Pietro Prunestì, Salvatore Chiarella, Cinzia Donato, Giovanni Mazzitello, Margherita Bovino, Pierpaolo Cannistrà

引用次数: 0