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Sabiu G, Heidempergher M, De Salvo C, Orani MA, Tricella C, Gallieni M. Influence of peritoneal dialysis catheter type on dislocations and laxative use: a retrospective observational study. J Nephrol 2022; 35:1497-1503. [PMID: 35522428 PMCID: PMC9217771 DOI: 10.1007/s40620-022-01329-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Accepted: 04/03/2022] [Indexed: 11/04/2022]
Abstract
Background There is currently no consensus regarding the optimal type of peritoneal dialysis (PD) catheter. Although few studies showed that weighted catheters result in lower complication rates and superior long-term outcomes than non-weighted catheters, there are no studies on the use of laxatives linked to catheter malfunction, a patient-related outcome potentially affecting the quality of life. Thus, we compared the burden of acute and chronic laxative use in a cohort of PD patients having either weighted or non-weighted catheters. Methods We performed a single-center, retrospective, observational study in two renal units, comparing acute and chronic laxative therapy related to catheter drainage failure in a cohort of 74 PD patient,s divided by peritoneal dialysis catheter type. In addition, we evaluated the number of patients who experienced minor and major dislocations, catheter-related infection rate, hospitalization for catheter malfunctioning, episodes of catheter repositioning, and dropout from PD. Results Laxative use was significantly more common among patients in the non-weighted catheter group (acute: 30.3% vs. 9.8%, p = 0.03; chronic: 36.4% vs. 12.2%; p≤0.02). Furthermore, weighted catheters were superior to non-weighted catheters for all the secondary outcomes (dislocations: 12.2% vs. 45.5%; p = 0.001). Conclusions Weighted self-locating catheters have lower drainage failure, thus reducing the need and burden of acute and chronic laxative use among PD patients. Graphical abstract ![]()
Supplementary Information The online version contains supplementary material available at 10.1007/s40620-022-01329-6.
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Affiliation(s)
- Gianmarco Sabiu
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy.,School of Nephrology, Università di Milano, Milano, Italy
| | | | - Cristina De Salvo
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy.,School of Nephrology, Università di Milano, Milano, Italy
| | | | - Chiara Tricella
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy.,School of Nephrology, Università di Milano, Milano, Italy
| | - Maurizio Gallieni
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy. .,School of Nephrology, Università di Milano, Milano, Italy. .,Department of Biomedical and Clinical Sciences, Università di Milano, Via Giovanni Battista Grassi 74, 20157, Milano, Italy.
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Gallieni M, De Salvo C, Lunati ME, Rossi A, D'Addio F, Pastore I, Sabiu G, Miglio R, Zuccotti GV, Fiorina P. Continuous glucose monitoring in patients with type 2 diabetes on hemodialysis. Acta Diabetol 2021; 58:975-981. [PMID: 33743082 PMCID: PMC8272699 DOI: 10.1007/s00592-021-01699-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 02/27/2021] [Indexed: 12/14/2022]
Abstract
Diabetic kidney disease is the leading cause of end-stage kidney disease in high-income countries. The strict control of glycemic oscillations is the principal therapeutic target, but this could be hard to achieve in uremic patients due to their unpredictable insulin sensitivity. Currently, the evaluation of the glycemic profile relies on serum markers (glycated hemoglobin HbA1c, glycated albumin, and fructosamine), capillary glucose blood control (self-monitoring of blood glucose), and interstitial glucose control (continue glucose monitoring). We conducted a systematic review of published articles on continue glucose monitoring in hemodialysis patients with type 2 diabetes, which included 12 major articles. Four studies found significant fluctuations in glucose levels during hemodialysis sessions. All studies reported a higher mean amplitude of glucose variations on the hemodialysis day. Three studies agreed that continue glucose monitoring is better than glycated hemoglobin in detecting these abnormalities. Moreover, continue glucose monitoring was more accurate and perceived as easier to use by patients and their caregivers. In patients with type 2 diabetes on hemodialysis, glucose levels show different variation patterns than the patients on hemodialysis without diabetes. Considering manageability, accuracy, and cost-effectiveness, continue glucose monitoring could be the ideal diagnostic tool for the patient with diabetes on hemodialysis.
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Affiliation(s)
- Maurizio Gallieni
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Università Di Milano, Milano, Italy.
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy.
| | - Cristina De Salvo
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy
| | | | - Antonio Rossi
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Francesca D'Addio
- International Center for T1D, Pediatric Clinical Research Center Romeo Ed Enrica Invernizzi, Department of Biomedical and Clinical Sciences "L. Sacco", Università Di Milano, Milan, Italy
| | - Ida Pastore
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
| | - Gianmarco Sabiu
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Roberta Miglio
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milano, Italy
| | - Gian Vincenzo Zuccotti
- Pediatric Clinical Research Center Romeo Ed Enrica Invernizzi, Department of Biomedical and Clinical Sciences "L. Sacco", Università Di Milano and Pediatric Department, Buzzi Children's Hospital, Milan, Italy
| | - Paolo Fiorina
- Division of Endocrinology, ASST Fatebenefratelli-Sacco, Milan, Italy
- International Center for T1D, Pediatric Clinical Research Center Romeo Ed Enrica Invernizzi, Department of Biomedical and Clinical Sciences "L. Sacco", Università Di Milano, Milan, Italy
- Nephrology Division, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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Gallieni M, Buskermolen M, Boggio A, De Salvo C, Camerotto C. Plant-based kidney diets prescribed in nutrition clinics: clinical advantages with low risks of hyperkalemia. Intern Emerg Med 2021; 16:23-24. [PMID: 32399955 DOI: 10.1007/s11739-020-02363-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 04/29/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Maurizio Gallieni
- Department of Biomedical and Clinical Sciences "Luigi Sacco", Università Di Milano, Via G.B. Grassi, 74, 20157, Milan, Italy.
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milan, Italy.
| | | | - Anna Boggio
- Nutritional Service, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Cristina De Salvo
- Nephrology and Dialysis Unit, ASST Fatebenefratelli Sacco, Milan, Italy
| | - Carla Camerotto
- Nutritional Service, Luigi Sacco Hospital, ASST Fatebenefratelli Sacco, Milan, Italy
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Pando MA, De Salvo C, Bautista CT, Eyzaguirre L, Carrion G, Feola M, Lado I, Hoffman M, Biglione MM, Carr JK, Montano SM, Sanchez JL, Weissenbacher M, Avila MM. Human immunodeficiency virus and tuberculosis in Argentina: prevalence, genotypes and risk factors. J Med Microbiol 2008; 57:190-197. [PMID: 18201985 DOI: 10.1099/jmm.0.47492-0] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
The objective of this study was to determine the prevalence and genetic variability of human immunodeficiency virus type 1 (HIV-1) and other sexually transmitted infections (STIs) among 205 patients with clinical diagnosis of tuberculosis (TB) in Buenos Aires in 2001. Infections with hepatitis B virus (HBV), HIV-1, hepatitis C virus (HCV), Treponema pallidum and human T-cell lymphotropic virus types I/II were diagnosed in 37/187 (19.8 %), 35/205 (17.1 %), 22/187 (11.8 %), 13/187 (7.0 %) and 4/181 (2.2 %) patients, respectively. Almost one in three participants (33.1 %) presented at least one infection in addition to TB. Multiresistance to TB drugs (isoniazid plus rifampicin) was detected in the isolates recovered from three patients. Injecting drug use was detected as the main risk factor for HIV, HBV and HCV infections. Of ten patients who died, eight were infected with HIV. HIV genetic characterization showed the presence of two different subtypes. Env subtype F was found in 13/24 samples (54.2 %) and subtype B in 11/24 samples (45.8 %) by heteroduplex mobility assay. Sequencing of the protease/RT region was performed in ten samples: three were characterized as subtype B and seven as B/F recombinants by bootscanning analysis. Phylogenetic analysis of four full-length sequences showed that three were the circulating recombinant form CRF12_BF. The results of this study suggest an urgent need to detect HIV infection in high-risk groups to prevent future HIV transmission as well as morbidity and mortality associated with TB by providing highly active antiretroviral therapy (HAART) and/or TB treatment. Collaboration between TB and HIV programmes seems to be the best approach to decrease the incidence of these diseases, especially in high-prevalence HIV settings.
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Affiliation(s)
- Maria A Pando
- Centro Nacional de Referencia para el SIDA, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Piso 11, C1121ABG, Buenos Aires, Argentina
| | - Cristina De Salvo
- Division Neumotisiologia, Hospital General de Agudos Dr Enrique Tornu, Donato Alvarez 3002, 1406 Buenos Aires, Argentina
| | - Christian T Bautista
- US Military HIV Research Program at the Walter Reed Army Institute of Research, 1 Taft Court, Suite 250, Rockville, MD 20850, USA
| | - Lindsay Eyzaguirre
- Department of Epidemiology, Institute of Human Virology, University of Maryland Biotechnology Institute, 725 W. Lombard Street, Baltimore, MD 21201, USA
| | - Gladys Carrion
- US Naval Medical Research Center Detachment (NMRCD), Unit 3800, APO-AA 34031-3800 Lima, Peru
| | - Miguel Feola
- Tisioneumonologia, Hospital Gral. de Agudos Carlos C. Durand, Av. Díaz Vélez 5044, 1405, Buenos Aires, Argentina
| | - Isabel Lado
- Servicio de Medicina Preventiva, Hospital Gral. Bernardino Rivadavia, Gral. Las Heras 2670, 1425, Buenos Aires, Argentina
| | - Marta Hoffman
- Laboratory, Microbiology Unit, Hospital General de Agudos Dr. Enrique Tornu, Donato Alvarez 3002, 1406, Buenos Aires, Argentina
| | - Mirna M Biglione
- CONICET, Argentina.,Centro Nacional de Referencia para el SIDA, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Piso 11, C1121ABG, Buenos Aires, Argentina
| | - Jean K Carr
- Department of Epidemiology, Institute of Human Virology, University of Maryland Biotechnology Institute, 725 W. Lombard Street, Baltimore, MD 21201, USA
| | - Silvia M Montano
- US Naval Medical Research Center Detachment (NMRCD), Unit 3800, APO-AA 34031-3800 Lima, Peru
| | - José L Sanchez
- Henry M. Jackson Foundation for the Advancement of Military Medicine, Inc., Rockville, MD 20852, USA.,Department of Defense Global Emerging Infections Surveillance and Response System (DoD-GEIS), Walter Reed Army Institute of Research, 2900 Linden Lane, Suite 103, Silver Spring, MD 20910, USA
| | - Mercedes Weissenbacher
- CONICET, Argentina.,Centro Nacional de Referencia para el SIDA, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Piso 11, C1121ABG, Buenos Aires, Argentina
| | - Maria M Avila
- CONICET, Argentina.,Centro Nacional de Referencia para el SIDA, Departamento de Microbiología, Parasitología e Inmunología, Facultad de Medicina, Universidad de Buenos Aires, Paraguay 2155, Piso 11, C1121ABG, Buenos Aires, Argentina
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