Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia最新文献_第8页

[The Outpatient Activity of the Onconephrology Clinic of Cremona in the First Semester of 2023]. [克雷莫纳肿瘤肾病诊所 2023 年第一学期的门诊活动]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-02-28

Marina Foramitti, Francesca Boni, Gianluca Marchi, Laura Cosmai, Fabio Malberti

{"title":"[The Outpatient Activity of the Onconephrology Clinic of Cremona in the First Semester of 2023].","authors":"Marina Foramitti, Francesca Boni, Gianluca Marchi, Laura Cosmai, Fabio Malberti","doi":"","DOIUrl":"","url":null,"abstract":"Despite the rapidly growing area of onconephrology in the last decade, nephropathic patients have been rarely involved in clinical trials of cancer therapy, particularly in the case of chronic kidney disease (CKD) stage 4 (CKD4) or stage 5 (CKD5). We could offer better therapeutic opportunities to our patients thanks to the Onconephrology Clinic and the Multidisciplinary group, in which a dedicated team of specialists guarantees the highest level of possible care. In this paper, we analysed the activity of the first Italian OnconephrologyClinic, twelve years after its foundation. We studied retrospectively a cohort of 174 patients referred to our center in the last six months (from 11/01/2023 to 12/07/2023), with a total of 262 visits (40 first visits). We highlight a prevalence of moderated or advanced kidney disease, in contrast with the literature, which is probably the result of a transversal II level clinic with different specialists involved. Furthermore, in patients with a prolonged follow-up, we observed a progressive better attention to every kidney involvement, particularly in patients in active cancer therapy, by the oncologist colleagues. We observed a reduction of treatment withdrawals due to kidney toxicity, thanks to a multidisciplinary approach and experienced-based management. On the other side, we highlight also a delayed addressing of patients with acute kidney injury (AKI), which often results in chronic kidney damage. This could be related to a delayed identification of the reduced renal function, which is difficult to correctly value in patients with cancer.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139996109","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

[West Nile Infection and Kidney Disease: Description of Two Clinical Cases in Peritoneal Dialysis Patients]. [西尼罗河病毒感染与肾病：腹膜透析患者两个临床病例的描述]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2024-02-28

Roberto Scarpioni, Teresa Valsania, Sara De Amicis, Chiara Rocca, Valentina Blanco, Maria Varì, Michela Frittoli, Vittorio Albertazzi, Marco Ricardi, Luigi Melfa

引用次数: 0

[The Management of Patients with Adult Autosomal Dominant Polycystic Kidney Disease (ADPKD) Requires a Multidisciplinary Approach]. [成人常染色体显性多囊肾病 (ADPKD) 患者的管理需要多学科方法]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-12-22

Romina Bucci, Liliana Italia De Rosa, Matteo Brambilla Pisoni, Sara Farinone, Marta Vespa, Giancarlo Joli, Martina Catania, Kristiana Kola, Francesca Tunesi, Elena Brioni, Paola Carrera, Giulia Mancassola, Lorena Citterio, Paolo Manunta, Giuseppe Vezzoli, Maria Teresa Sciarrone Alibrandi

{"title":"[The Management of Patients with Adult Autosomal Dominant Polycystic Kidney Disease (ADPKD) Requires a Multidisciplinary Approach].","authors":"Romina Bucci, Liliana Italia De Rosa, Matteo Brambilla Pisoni, Sara Farinone, Marta Vespa, Giancarlo Joli, Martina Catania, Kristiana Kola, Francesca Tunesi, Elena Brioni, Paola Carrera, Giulia Mancassola, Lorena Citterio, Paolo Manunta, Giuseppe Vezzoli, Maria Teresa Sciarrone Alibrandi","doi":"","DOIUrl":"","url":null,"abstract":"Autosomal dominant polycystic kidney disease (ADPKD) is the most common genetic kidney disease. Its main feature is the progressive enlargement of both kidneys with progressive loss of kidney function. ADPKD is the fourth leading cause of terminal renal failure in the world. Even today there are still uncertainties and poor information. Patients too often have a renunciatory and passive attitude toward the disease. However, there are currently no internationally accepted clinical practice guidelines, and there are significant regional variations in approaches to the diagnosis, clinical evaluation, prevention, and treatment of ADPKD. Therefore, we believe it is important to point out the conduct of our specialist outpatient clinic for ADPKD, which from the beginning has developed a multidisciplinary approach (nephrologists, geneticists, psychologists, radiologists, nutritionists) to face the disease at 360° and therefore not only from a purely nephrological point of view. Such a strategy not only enables patients to receive a timely and accurate diagnosis of the disease, but also ensures that they will receive a thorough and focused follow-up over time, that can prevent or at least slow down the disease in its evolution providing patients with a serene awareness of their condition as much as possible.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058200","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

[Therapeutic Plasma Exchange in a Patient with Chronic Hemodialysis and a New Diagnosis of Myasthenia Gravis]. [一名慢性血液透析患者的治疗性血浆置换和肌无力新诊断]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-12-22

A Giudicissi, D Vetrano, S Morresi, P F Bruno, L Neri, S Signorotti, V Sgarlato, M Ruggeri, F Zanchelli, M Longoni, A Buscaroli

{"title":"[Therapeutic Plasma Exchange in a Patient with Chronic Hemodialysis and a New Diagnosis of Myasthenia Gravis].","authors":"A Giudicissi, D Vetrano, S Morresi, P F Bruno, L Neri, S Signorotti, V Sgarlato, M Ruggeri, F Zanchelli, M Longoni, A Buscaroli","doi":"","DOIUrl":"","url":null,"abstract":"Case ReportC.S.T. (♂, 71 years old) is a patient with multiple and severe comorbidities, undergoing thrice-weekly chronic hemodialysis since 2008 due to the progression of post-lithiasic uropathy. Over the past 2 months, the patient had been experiencing progressive ptosis of the eyelids, muscle weakness, and ultimately dysphagia and dysarthria that emerged in the last few days. Urgently admitted to the Neurology department, electromyography (EMG) was performed, leading to a diagnosis of predominant cranial myasthenia gravis (with borderline anti-acetylcholine receptor antibody serology). Prompt treatment with pyridostigmine and steroids was initiated. Considering the high risk of acute myasthenic decompensation, therapeutic plasma exchange (TPE) with centrifugation technique was promptly undertaken after femoral CVC placement. TPE sessions were alternated with hemodialysis. The patient's condition complicated after the third TPE session, with septic shock caused by Methicillin-Sensitive Staphylococcus Aureus (MSSA). The patient was transferred to the Intensive Care Unit (ICU). Due to hemodynamic instability, continuous veno-venous hemodiafiltration (CVVHDF) with citrate anticoagulation was administered for 72 hours. After resolving the septic condition, intermittent treatment with Acetate-Free Biofiltration (AFB) technique was resumed. The patient completed the remaining three TPE sessions and, once the acute condition was resolved, was transferred back to Neurology. Here, the patient continued the treatment and underwent a rehabilitation program, showing significant motor and functional recovery until discharge. Conclusions. The multidisciplinary interaction among Nephrologists, Neurologists, Anesthesiologists, and experts from the Immunohematology and Transfusion Medicine Service enabled the management and treatment of a rare condition (MG) in a high-risk chronic hemodialysis patient.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058201","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

Correlation of Beta Trace Protein Levels with Serum Creatinine-Based Estimated Glomerular Filtration Rate Equations in Chronic Kidney Disease. β微量蛋白水平与基于血清肌酸酐的慢性肾脏病肾小球滤过率估算公式的相关性。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-12-22

Rengarajan Geethanjali, Murugan Ganesh, Anjana Vinod, Elumalai Ramprasad, Varadharajan Jayaprakash

{"title":"Correlation of Beta Trace Protein Levels with Serum Creatinine-Based Estimated Glomerular Filtration Rate Equations in Chronic Kidney Disease.","authors":"Rengarajan Geethanjali, Murugan Ganesh, Anjana Vinod, Elumalai Ramprasad, Varadharajan Jayaprakash","doi":"","DOIUrl":"","url":null,"abstract":"Background. Estimated GFR (eGFR) is calculated using serum creatinine (SCr) based equations which have their own limitations. Novel biomarkers like beta trace protein (BTP) are studied for eGFR estimation. The aim of this study is to determine the serum levels of BTP in healthy controls and chronic kidney disease (CKD) cases and to find out the correlation of BTP levels with that of SCr and SCr-based eGFR formulas. Methods. The control group comprised of 20 healthy adults. The cases comprised of 20 patients each in CKD stages 3, 4, and 5, categorized based on eGFR calculated using MDRD formula. Baseline characteristics of the study population were recorded. BTP was measured by ELISA (Enzyme Linked Immunosorbent Assay) method and SCr by modified Jaffe's method. The statistical analyses were performed with the SPSS for Windows, version 16.0. Results. The median value of blood urea nitrogen (BUN) in the cases was 26.50 mg/dL (IQR 19.25-37) and for control it was 9.5 mg/dL (IQR 8-12). The median value of SCr in the cases was 2.75 mg/dL (IQR 1.725-4.45) and in the controls, it was 0.7mg/dL (IQR 0.6 -0.8). The median value of BTP in cases was 6389.25 ng/ml (IQR 5610.875-10713.75) and in controls, it was 1089.5 ng/ml (IQR 900.5-1309.75). Conclusion. Serum BTP levels correlated with SCr levels and renal function. We could establish the relationship between the two biomarkers, SCr and BTP, and derive a regression equation.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058203","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

Review and Practical Excursus of the Propensity Score: Low Protein Diet Compared to Mediterranean Diet in Patients With Chronic Kidney Disease. 倾向评分的回顾与实用要点：慢性肾病患者低蛋白饮食与地中海饮食的比较。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-12-22

Vincenzo Calabrese, Guido Gembillo, Martina Buda, Valeria Cernaro, Elisa Longhitano, Antonello Pontoriero, Matteo Polizzi, Daniela Metro, Domenico Santoro

{"title":"Review and Practical Excursus of the Propensity Score: Low Protein Diet Compared to Mediterranean Diet in Patients With Chronic Kidney Disease.","authors":"Vincenzo Calabrese, Guido Gembillo, Martina Buda, Valeria Cernaro, Elisa Longhitano, Antonello Pontoriero, Matteo Polizzi, Daniela Metro, Domenico Santoro","doi":"","DOIUrl":"","url":null,"abstract":"Although Randomized clinical trials (RCT) represent the gold standard to compare two or more treatments, the impact of observational studies cannot be ignored. Obviously, these latter are performed on unbalanced sample, and differences among the compared groups could be detected. These differences could have an impact on the estimated association between our allocation and our outcome. To avoid it, some methods should be applied in the analysis of observational cohort. Propensity score (PS) can be considered as a value which sums up and balances the known variables. It aims to adjust or balance the probability of receiving a specific allocation group, and could be used to match, stratify, weight, and perform a covariate adjustment. PS is calculated with a logistic regression, using allocation groups as the outcome. Thanks to PS, we compute the probability of being allocated to one group and we can match patients obtaining two balanced groups. It avoids computing analysis in unbalanced groups. We compared low protein diet (LPD) and the Mediterranean diet in CKD patients and analysed them using the PS methods. Nutritional therapy is fundamental for the prevention, progression and treatment of Chronic Kidney Disease (CKD) and its complications. An individualized, stepwise approach is essential to guarantee high adherence to nutritional patterns and to reach therapeutic goals. The best dietary regimen is still a matter of discussion. In our example, unbalanced analysis showed a significant renal function preservation in LPD, but this correlation was denied after the PS analysis. In conclusion, although unmatched analysis showed differences between the two diets, after propensity analysis no differences were detected. If RCT cannot be performed, balancing the PS score allows to balance the sample and avoids biased results.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058205","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

[Congenital Nephrotic Syndrome: Role of Podxl Gene]. [先天性肾病综合征：Podxl 基因的作用]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-12-22

Angela Zeni, Luca Pecoraro, Elisa Benetti, Milena Brugnara

引用次数: 0

[Esiste una scuola Italiana di nefrologia? Considerazioni di un nefrologo italiano in Francia]. [意大利肾脏病学学校存在吗？一位在法国的意大利肾病学家的思考]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-12-22

Giorgina Barbara Piccoli

引用次数: 0

[New Mutation of CYP24A1 in a Case of Idiopathic Infantile Hypercalcemia Diagnosed in Adulthood]. [一例成年后才确诊的特发性婴儿高钙血症患者的 CYP24A1 新突变]。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-12-22

F Zanchelli, A Giudicissi, L Neri, V Sgarlato, P F Bruno, M Ruggeri, S Signorotti, D Vetrano, A Buscaroli

{"title":"[New Mutation of CYP24A1 in a Case of Idiopathic Infantile Hypercalcemia Diagnosed in Adulthood].","authors":"F Zanchelli, A Giudicissi, L Neri, V Sgarlato, P F Bruno, M Ruggeri, S Signorotti, D Vetrano, A Buscaroli","doi":"","DOIUrl":"","url":null,"abstract":"Mutations in the 24-hydroxylase gene CYP24A1 have been recognized as causes of childhood idiopathic hypercalcemia (IIH), a rare disease (incidence <1:1,000,000 live births) characterized by increased vitamin D sensitivity, with symptomatic severe hypercalcemia. IIH was first described in Great Britain two years after the start of a program of vitamin D supplementation in milk for the prevention of rickets, manifesting in about 200 children with severe hypercalcemia, dehydration, growth failure, weight loss, muscle hypotonia, and nephrocalcinosis. The association between the epidemic occurrence of IIH and vitamin D administration was quickly attributed to intrinsic hypersensitivity to vitamin D, and the pathogenic mechanism was recognized in the inactivation of Cytochrome P450 family 24 subfamily A member 1 (CYP24A1), which was identified as the molecular basis of the pathology. The phenotypic spectrum of CYP24A1 mutation can be variable, manifesting predominantly with childhood onset and severe symptomatology (severe hypercalcemia, growth retardation, lethargy, muscle hypotonia, dehydration), but also with juvenile-adult onset forms with nephrolithiasis, nephrocalcinosis, and alterations in phosphocalcium homeostasis. We describe the case of a patient in whom the diagnosis of IIH was made in adulthood, presenting with finding of nephrocalcinosis in childhood, and with subsequent onset of severe hypercalcemia with hypercalciuria, hypoparathyroidism, hypervitaminosis D, and recurrent renal lithiasis. Genetic investigation revealed the presence in homozygosity of the c_428_430delAAG_p.Glu143del variant in the CYP24A1 gene with autosomal recessive transmission, a mutation not reported in the literature.","PeriodicalId":12553,"journal":{"name":"Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia","volume":"40 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139058280","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

Kikuchi-Fujimoto's Disease: A Rare and Underdiagnosed Condition with Possible Renal Involvement. 菊池-藤本氏病：一种可能累及肾脏的罕见、诊断不足的疾病。

Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia Pub Date : 2023-12-22

Enrica Falbo

引用次数: 0