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Minutolo R, Provenzano M, Chiodini P, Borrelli S, Garofalo C, Andreucci M, Liberti ME, Bellizzi V, Conte G, De Nicola L, De Nicola L, Minutolo R, Zamboli P, Iodice FC, Borrelli S, Chiodini P, Signoriello S, Gallo C, Conte G, Cianciaruso B, Pota A, Nappi F, Avella F, Di Iorio BR, Bellizzi V, Cestaro R, Martignetti V, Morrone L, Lupo A, Abaterusso C, Donadio C, Bonomini M, Sirolli V, Casino F, Lopez T, Detomaso F, Giannattasio M, Virgilio M, Tarantino G, Cristofano C, Tuccillo S, Chimienti S, Petrarulo F, Giancaspro V, Strippoli M, Laraia E, Gallucci M, Gigante B, Lodeserto C, Santese D, Montanaro A, Giordano R, Caglioti A, Fuiano G, Zoccali C, Caridi G, Postorino M, Savica V, Monardo P, Bellinghieri G, Santoro D, Castellino P, Rapisarda F, Fatuzzo P, Messina A, Dal Canton A, Esposito V, Formica M, Segoloni G, Gallieni M, Locatelli F, Tarchini R, Meneghel G, Oldrizzi L, Cossu M, Di Giulio S, Malaguti M, Pizzarelli F, Quintaliani G, Cianciaruso B, Pisani A, Conte G, De Nicola L, Minutolo R, Bonofiglio R, Fuiano G, Grandaliano G, Bellinghieri G, Santoro D, Cianciaruso B, Russo D, Pota A, Di Micco L, Torraca S, Sabbatini M, Pisani A, Bellizzi V. New-Onset Anemia and Associated Risk of ESKD and Death in Non-Dialysis CKD Patients: A Multi-Cohort Observational Study. Clin Kidney J 2022; 15:1120-1128. [PMID: 35664282 PMCID: PMC9155211 DOI: 10.1093/ckj/sfac004] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2021] [Indexed: 12/03/2022] Open
Abstract
Background Anemia is a common complication of chronic kidney disease (CKD), but its incidence in nephrology settings is poorly investigated. Similarly, the risks of adverse outcomes associated with new-onset anemia are not known. Methods We performed a pooled analysis of three observational cohort studies including 1031 non-anemic CKD patients with eGFR <60 mL/min/1.73 m2 regularly followed in renal clinics. We estimated the incidence of mild anemia (hemoglobin 11–12 g/dL in women and 11–13 g/dL in men) and severe anemia (hemoglobin <11 g/dL or use of erythropoiesis-stimulating agents) during a 3-year follow-up period. Thereafter we estimated the risk of end-stage kidney disease (ESKD) and all-cause death associated with new-onset mild and severe anemia. Results The mean age was 63 ± 14 years, 60% were men and 20% had diabetes. The mean estimated glomerular filtration rate (eGFR) was 37 ± 13 mL/min/1.73 m2 and the median proteinuria was 0.4 g/day [interquartile range (IQR) 0.1–1.1]. The incidence of mild and severe anemia was 13.7/100 patients-year and 6.2/100 patients-year, respectively. Basal predictors of either mild or severe anemia were diabetes, lower hemoglobin, higher serum phosphate, eGFR <30 mL/min/1.73 m2 and proteinuria >0.50 g/day. Male sex, moderate CKD (eGFR 30–44 mL/min/1.73 m2) and moderate proteinuria (0.15–0.50 g/day) predicted only mild anemia. The incidence of anemia increased progressively with CKD stages (from 8.77 to 76.59/100 patients-year) and the proteinuria category (from 13.99 to 25.02/100 patients-year). During a median follow-up of 3.1 years, 232 patients reached ESKD and 135 died. Compared with non-anemic patients, mild anemia was associated with a higher adjusted risk of ESKD {hazard ratio [HR] 1.42 [95% confidence interval (CI) 1.02–1.98]} and all-cause death [HR 1.55 (95% CI 1.04–2.32)]. Severe anemia was associated with an even higher risk of ESKD [HR 1.73 (95% CI 1.20–2.51)] and death [HR 1.83 (95% CI 1.05–3.19)]. Conclusions New-onset anemia is frequent, particularly in patients with more severe renal damage and in those with diabetes mellitus. The occurrence of anemia, even of a mild degree, is associated with mortality risk and faster progression towards ESKD.
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Affiliation(s)
- Roberto Minutolo
- Nephrology Unit at University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Michele Provenzano
- Nephrology Unit, “Magna Graecia”, Department of Health Sciences, “Magna Graecia”, University of Catanzaro, Italy, Catanzaro, Italy
| | - Paolo Chiodini
- Medical Statistics Unit, University of Campania “Luigi Vanvitelli” Naples
| | - Silvio Borrelli
- Nephrology Unit at University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Carlo Garofalo
- Nephrology Unit at University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Michele Andreucci
- Nephrology Unit, “Magna Graecia”, Department of Health Sciences, “Magna Graecia”, University of Catanzaro, Italy, Catanzaro, Italy
| | | | - Vincenzo Bellizzi
- Nephrology Unit, University Hospital “San Giovanni di Dio e Ruggi d'Aragona” in Salerno, Italy
| | - Giuseppe Conte
- Nephrology Unit at University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Luca De Nicola
- Nephrology Unit at University of Campania “Luigi Vanvitelli”, Naples, Italy
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Gernone G, Montemurro M, Capurso D, Colucci G, Dell'Anna D, Detomaso F, La Rosa R, La Volpe M, Partipilo F, Pepe V, Ripa E. SP489MID-TERM EVALUATION OF THE NEW MEDIUM CUT-OFF FILTER (THERANOVA) ON REMOVAL EFFICIENCY AND QUALITY OF LIFE. Nephrol Dial Transplant 2018. [DOI: 10.1093/ndt/gfy104.sp489] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- Giuseppe Gernone
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - M Montemurro
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - D Capurso
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - G Colucci
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - D Dell'Anna
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - F Detomaso
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - R La Rosa
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - M La Volpe
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - F Partipilo
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - V Pepe
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
| | - E Ripa
- Nephrology and Dialisys of "Santa Maria degli Angeli" Hospital, ASL BA - Bari, Putignano, Italy
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Rodríguez L, Detomaso F, Braga P, Prendes M, Perosi F, Cernadas G, Balaszczuk A, Fellet A. Neonatal hyperthyroidism on rat heart: interrelation with nitric oxide and sex. J Endocrinol Invest 2015; 38:685-94. [PMID: 25700772 DOI: 10.1007/s40618-015-0244-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2014] [Accepted: 01/14/2015] [Indexed: 02/03/2023]
Abstract
PURPOSE To clarify the mechanism mediating the effect of hyperthyroidism on cardiac function during the second month of life in rats. METHODS Male and female Sprague-Dawley rats were assigned to a control or to a triiodothyronine (T3)-treated group. Treatment of each group was started on the third day after birth. Control rats (Eut) received 0.9 NaCl [0.1 ml/100 g body weight (BW)] every second day during 60 days and T3-treated rats (Hyper) received subcutaneous (SC) T3 injections every second day during 60 days. RESULTS Hyperthyroidism decreased left ventricle volume only in male rats. Female euthyroid rats presented higher atrial nitric oxide synthase (NOS) activity than male rats and hormonal treatment decreased this enzyme's activity in both sexes. Euthyroid male and female rats had similar atrial NOS protein levels, but females had higher caveolin (cav) 3 protein levels. T3 treatment increased this protein only in males. Female rats had lower ventricular NOS activity than male rats; hyperthyroidism increased NOS activity in both sexes but this effect was associated with lower cav 3 protein levels. Hyperthyroidism did not change cav 1 protein levels in both male and female rats. CONCLUSIONS The results of this study demonstrating clinically relevant sex-related differences in the pathophysiology of the hyperthyroid heart have raised new questions regarding the mechanisms responsible for the observed differences. This study suggests that sex-related intrinsic factors such as nitric oxide may modulate the response to hyperthyroidism that leads to cardiovascular dysfunction.
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Affiliation(s)
- L Rodríguez
- Department of Physiology, School of Pharmacy and Biochemistry, University of Buenos Aires, IQUIMEFA-CONICET, Junin 956, C1113AAD, Buenos Aires, Argentina
| | - F Detomaso
- Department of Physiology, School of Pharmacy and Biochemistry, University of Buenos Aires, IQUIMEFA-CONICET, Junin 956, C1113AAD, Buenos Aires, Argentina
| | - P Braga
- Department of Physiology, School of Pharmacy and Biochemistry, University of Buenos Aires, IQUIMEFA-CONICET, Junin 956, C1113AAD, Buenos Aires, Argentina
| | - M Prendes
- Department of Physiology, School of Pharmacy and Biochemistry, University of Buenos Aires, IQUIMEFA-CONICET, Junin 956, C1113AAD, Buenos Aires, Argentina
| | - F Perosi
- Department of Cardiology and Internal Medicine, Air Force Hospital, Buenos Aires, Argentina
| | - G Cernadas
- Department of Physiology, School of Pharmacy and Biochemistry, University of Buenos Aires, IQUIMEFA-CONICET, Junin 956, C1113AAD, Buenos Aires, Argentina
- Department of Cardiology and Internal Medicine, Air Force Hospital, Buenos Aires, Argentina
| | - A Balaszczuk
- Department of Physiology, School of Pharmacy and Biochemistry, University of Buenos Aires, IQUIMEFA-CONICET, Junin 956, C1113AAD, Buenos Aires, Argentina
| | - A Fellet
- Department of Physiology, School of Pharmacy and Biochemistry, University of Buenos Aires, IQUIMEFA-CONICET, Junin 956, C1113AAD, Buenos Aires, Argentina.
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Gernone G, Detomaso F, La Rosa R, Giannattasio M. [Are dialysis-patients a risk population for cholelithiasis? Study in an apulian population]. MINERVA UROL NEFROL 2009; 61:21-26. [PMID: 19417724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM The cholelithiasis (CL) has a 10-20% prevalence in the adult population. The end stage renal disease and dialysis would seem factors of risk since uremic patients show increased bile cholesterol, increased saturation indices and lithogenicity. Nevertheless the studies to confirm this hypothesis have furnished contradictory results. The aim of the study was to appraise prevalence of CL in dialysis-patients. METHODS The authors examined 127 patients (92 in hemodialysis and 35 in peritoneal dialysis) comparing them with a non-uremic control group (CNU) and the prevalence in the general population taking as champion the town of Castellana, near to ''S. Maria Degli Angeli'' Hospital, where, previously, an epidemiological study was performed. Sonographic examination was done with Esaote/Biomedica AU3 instrument with 3.5/5 mHz transducer. The evidence of gallstone(s) by ultrasonography or previously cholecystectomy have been considered diagnostics. RESULTS Gallstones were detected in 33 of the 127 dialysis-patients (25.9% prevalence). In the CNU the prevalence was 15% (P=0.046). Furthermore the comparison of prevalence of CL between dialysis-patients and the Castellana population was greater in dialysis-population considering the attended rate (13 vs 9.6) and had a greater attributable risk (35%). A global greater prevalence of CL in older patients (>60 years) showed a possible role of the increasing age as a correlated factor to the CL. Any other considered parameter has shown significant correlations. CONCLUSIONS These results underline a greater risk of CL in the dialysis-patient.
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Affiliation(s)
- G Gernone
- Struttura Complessa di Nefrologia e Dialisi P.O., ''S. Maria Degli Angeli'' Putignano, Azienda Sanitaria Locale Bari, Bari, Italia.
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