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Virzì GM, Milan Manani S, Clementi A, Castegnaro S, Brocca A, Riello C, de Cal M, Giuliani A, Battaglia GG, Crepaldi C, Ronco C. Eryptosis Is Altered in Peritoneal Dialysis Patients. Blood Purif 2019; 48:351-357. [PMID: 31291616 DOI: 10.1159/000501541] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2018] [Accepted: 06/04/2019] [Indexed: 11/19/2022]
Abstract
BACKGROUND Red blood cells (RBCs) undergo programmed cell death known as eryptosis. Triggers of eryptosis include increased cytosolic Ca(2+) concentration, oxidative stress, osmotic shock, energy depletion and several uremic toxins. Little is known about the pathogenesis of eryptosis in peritoneal dialysis (PD) patients; furthermore, its relevance in worsening clinical conditions in these patients is still not completely defined. OBJECTIVES We investigated eryptosis levels in PD patients and its association with inflammatory and clinical parameters. MATERIAL AND METHODS A total of 46 PD patients and 17 healthy subjects (CTR) were enrolled. All eryptosis measurements were made in freshly isolated RBCs using the flow cytometer. RESULTS Eryptosis was significantly higher in PD patients than that in CTR (p < 0.001). Eryptosis levels did not differ significantly between PD patients with and without diabetes, with and without hypertension, and with and without cardiovascular disease. Eryptosis showed no significant differences between patients treated with continuous ambulatory PD/automated PD, with Kt/Vurea value ≤1.7 and >1.7, with a negative or positive history of peritonitis. On the contrary, eryptosis showed significantly lower levels in PD patients with weekly creatinine clearance ≥45 L/week/1.73 m2 (2.8%, 1.7-4.9 vs. 5.6%, 5.0-13.5; p= 0.049). Eryptosis showed significantly lower levels in PD patients with residual diuresis (n = 23) than that in patients without (3.7%, 2.6-5.6 vs. 5%, 3.1-16; p = 0.03). In these 23 patients, significant negative correlations between percentage of eryptosis and residual glomerular filtration rate (rGFR; Spearman's rho = -0.51, p = 0.01) and diuresis volume (Spearman's rho = -0.43, p = 0.05) were found. CONCLUSIONS The present study demonstrated higher eryptosis levels in PD patients compared to corresponding levels in CTR. Furthermore, important PD comorbidity and main PD parameters do not influence eryptosis. Importantly, our data have reported an increase in eryptosis levels with progressive residual diuresis and rGFR loss, probably due to decreased uremic toxins clearance.
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Affiliation(s)
- Grazia Maria Virzì
- Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy, .,International Renal Research Institute, IRRIV, Vicenza, Italy,
| | - Sabrina Milan Manani
- Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute, IRRIV, Vicenza, Italy
| | - Anna Clementi
- International Renal Research Institute, IRRIV, Vicenza, Italy.,Department of Nephrology and Dialysis, Santa Marta and Santa Venera Hospital, Acireale, Italy
| | - Silvia Castegnaro
- International Renal Research Institute, IRRIV, Vicenza, Italy.,Hematology Project Foundation, St Bortolo Hospital, Vicenza, Italy
| | - Alessandra Brocca
- Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute, IRRIV, Vicenza, Italy.,Unit of Internal Medicine and Hepatology, Department of Medicine, University of Padova, Padova, Italy
| | - Caterina Riello
- Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy
| | - Massimo de Cal
- Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute, IRRIV, Vicenza, Italy
| | - Anna Giuliani
- Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute, IRRIV, Vicenza, Italy
| | | | - Carlo Crepaldi
- Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute, IRRIV, Vicenza, Italy
| | - Claudio Ronco
- Department of Nephrology, Dialysis and Transplant, St Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute, IRRIV, Vicenza, Italy.,Department of Medicine, University of Padova, Padova, Italy
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Milan Manani S, Crepaldi C, Giuliani A, Virzì GM, Garzotto F, Riello C, de Cal M, Rosner MH, Ronco C. Remote Monitoring of Automated Peritoneal Dialysis Improves Personalization of Dialytic Prescription and Patient's Independence. Blood Purif 2018; 46:111-117. [PMID: 29694954 DOI: 10.1159/000487703] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Accepted: 02/12/2018] [Indexed: 11/19/2022]
Abstract
BACKGROUND Remote monitoring (RM) supports a healthcare model that enhances patients' self-management. We evaluated the utility of RM in patients undergoing automated peritoneal dialysis (APD). METHODS We observed 37 -RM-APD patients, 16 incidents, and 21 prevalents switched from traditional APD (T-APD). We observed the number of changes for APD prescription, the frequency of visits, and PD adequacy parameters during 1 year of RM utilization in APD. RESULTS The APD prescriptions were modified more frequently in RM-APD vs. T-APD in incident (p = 0.002) and prevalent patients (p = 0.045). Visits were significant less in -RM-APD than in T-APD for incident patient (p = 0.008). No significant difference was found between prevalent populations. PD adequacy was similar in both groups. CONCLUSIONS Our results demonstrate that RM allows an efficient use of healthcare resources, helping to improve personalization of APD prescription and to intervene early with "trouble shooting", thereby reducing the frequency of in-person visits for emergency problems.
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Affiliation(s)
- Sabrina Milan Manani
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy
| | - Carlo Crepaldi
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy
| | - Anna Giuliani
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy
| | - Grazia Maria Virzì
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy
| | - Francesco Garzotto
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy
| | - Caterina Riello
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy
| | - Massimo de Cal
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy
| | - Mitchell H Rosner
- Department of Medicine, University of Virginia Health System, Charlottesville, Virginia, USA
| | - Claudio Ronco
- Department of Nephrology, Dialysis and Transplant, San Bortolo Hospital, Vicenza, Italy.,International Renal Research Institute Vicenza (IRRIV), Vicenza, Italy
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Fotheringham J, Campbell MJ, Wilkie M, Lopes Barreto D, Sampimon DE, Struijk DG, Krediet RT, Portoles J, Janeiro D, Tato AM, Lopez P, Castellano I, Del Peso G, Rivera M, Fernandez-Reyes MJ, Ortega M, Martinez De Miguel P, Caparros G, Selgas R, Sarmento-Dias M, Santos-Araujo C, Poinhos R, Soares Silva I, Simoes Silva L, Sousa MJ, Correia F, Pestana M, Kang SH, Cho KH, Park JW, Yoon KW, Do JY, Ponce D, Banin V, Bueloni T, Caramori J, Balbi A, Barretti P, Virzi GM, Na HY, Kim YB, Jo YI, Griva K, Yu Z, Foo M, Chang KY, Kim YK, Kim YO, Song HC, Yang CW, Kim SH, Kim YL, Kim YS, Kang SW, Kim NH, Kim HW, Waniewski J, Poleszczuk J, Antosiewicz S, Baczy ski D, Pietribiasi M, Wankowicz Z, Alhwiesh A, Nasreldin MA, Saeed I, Braide M, Milan Manani S, I{middle dot}Nal S, Okyay GU, Ulu MS, Kidir V, Altuntas A, Ahsen A, Unverdi S, Yuksel S, Duranay M, Sezer MT, Mushahar L, Lim WM, Mohd Yusuf WS, Sivathasan S, Ancarani P, Parodi D, Terrile O, Scofferi S, Lenzora G, Martins AR, Vizinho R, Branco PQ, Gaspar MA, Barata JD, Dimkovic N, Lazarevic T, Zdenka M, Pljesa S, Marinkovic J, Djukanovic L, Ahbap E, Kara E, Sahutoglu T, Basturk T, Koc Y, Sakaci T, Sevinc M, Akgol C, Unsal A, Vlahu CA, De Graaff M, Vink H, Struijk DG, Krediet RT, Zeiler M, Marani M, Agostinelli RM, Monteburini T, Marinelli R, Di Luca M, Santarelli S, Moreiras-Plaza M, Blanco-Garcia R, Martin-Baez I, Fernandez-Fleming F, Beato-Coo L, Chang JH, Ro H, Jung JY, Lee HH, Moon SJ, Chung W, Hassan K, Hassan D, Shturman A, Hassan F, Rubinchik I, Hassan S, Atar S, Witoon R, Matsuda A, Tayama Y, Ogawa T, Kogure Y, Okazaki S, Hatano M, Kiba T, Iwashita T, Shimizu T, Hasegawa H, Mitarai T, Rroji ( Molla) M, Seferi S, Burazeri G, Thereska N, Theodoridis M, Gioka T, Bounta T, Kriki P, Mourvati E, Thodis E, Roumeliotis A, Passadakis P, Vargemezis V, Bek S, Eren N, Eraldemir FC, Batman A, Derviso lu E. PERITONEAL DIALYSIS 1. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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