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Russo G, Di Bartolo P, Candido R, Lucisano G, Manicardi V, Giandalia A, Nicolucci A, Rocca A, Rossi MC, Di Cianni G. Corrigendum to "The AMD ANNALS: A continuous initiative for the improvement of type 2 diabetes care" [Diabetes Res. and Clin. Pract. 199 (2023) 110672]. Diabetes Res Clin Pract 2024; 210:111619. [PMID: 38580525 DOI: 10.1016/j.diabres.2024.111619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Affiliation(s)
- G Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - P Di Bartolo
- Ravenna Diabetes Center - Romagna Local Health Authority, Ravenna, Italy
| | - R Candido
- Department of Medical Surgical and Health Sciences, University of Trieste, Diabetes Center, ASUGI, Trieste, Italy
| | - G Lucisano
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy
| | | | - A Giandalia
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - A Nicolucci
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy
| | - A Rocca
- "G. Segalini" H. Bassini Cinisello Balsamo ASST Nord, Milan, Italy
| | - M C Rossi
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy
| | - G Di Cianni
- USL Tuscany Northwest Location Livorno, Diabetes and Metabolic Disease, Livorno, Italy
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Corbett RW, Beckwith H, Lucisano G, Brown EA. Delivering Person-Centered Peritoneal Dialysis. Clin J Am Soc Nephrol 2024; 19:377-384. [PMID: 37611155 PMCID: PMC10937028 DOI: 10.2215/cjn.0000000000000281] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 08/03/2023] [Indexed: 08/25/2023]
Abstract
Peritoneal dialysis (PD) enables people to have a home-based therapy, permitting greater autonomy for individuals along with enhanced treatment satisfaction compared with in-center dialysis care. The burden of treatment on PD, however, remains considerable and underpins the need for person-centered care. This reflects the need to address the patient as a person with needs and preferences beyond just the medical perspective. Shared decision making is central to the recent International Society for Peritoneal Dialysis recommendations for prescribing PD, balancing the potential benefits of PD on patient well-being with the burden associated with treatment. This review considers the role of high-quality goal-directed prescribing, incremental dialysis, and remote patient monitoring in reducing the burden of dialysis, including an approach to implementing incremental PD. Although patient-related outcomes are important in assessing the response to treatment and, particularly life participation, the corollary of dialysis burden, there are no clear routes to the clinical implementation of patient-related outcome measures. Delivering person-centered care is dependent on treating people both as individuals and as equal partners in their care.
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Affiliation(s)
- Richard W. Corbett
- Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Hannah Beckwith
- MRC London Institute of Medical Sciences (LMS), Imperial College London, London, United Kingdom
| | - Gaetano Lucisano
- Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Edwina A. Brown
- Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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Russo G, Di Bartolo P, Candido R, Lucisano G, Manicardi V, Giandalia A, Nicolucci A, Rocca A, Rossi MC, Di Cianni G. The AMD ANNALS: A continuous initiative for the improvement of type 2 diabetes care. Diabetes Res Clin Pract 2023; 199:110672. [PMID: 37084893 DOI: 10.1016/j.diabres.2023.110672] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
Abstract
AIMS Since 2006, the Italian AMD (Associations of Medical Diabetologists) Annals Initiative promoted a continuous monitoring of the quality of diabetes care, that was effective in improving process, treatment and outcome indicators through a periodic assessment of standardized measures. Here, we show the 2022 AMD Annals data on type 2 diabetes (T2D). METHODS A network involving ∼1/3 of diabetes centers in Italy periodically extracts anonymous data from electronic clinical records, by a standardized software. Process, treatment and outcome indicators, and a validated score of overall care, the Q-score, were evaluated. RESULTS 295 centers provided the annual sample of 502,747 T2D patients. Overall, HbA1c value ≤7.0% was documented in 54.6% of patients, blood pressure <130/80 mmHg in 23.0%, and LDL-cholesterol levels <70 mg/dl in 34.3%, but only 5.2% were at- target for all the risk factors. As for innovative drugs, 29.0% of patients were on SGLT2-i, and 27.5% on GLP1-RAs. In particular, 59.7% were treated with either GLP1-RAs or SGLT2-i among those with established cardiovascular disease (CVD), 26.6% and 49.3% with SGLT2-i among those with impaired renal function and heart failure, respectively. Notably, only 3.2% of T2D patients showed a Q score <15, which correlates with a 80% higher risk of incident CVD events compared to scores >25. CONCLUSIONS The 2022 AMD Annals data show an improvement in the use of innovative drugs and in the overall quality of T2D care in everyday clinical practice. However, additional efforts are needed to reach the recommended targets for HbA1c and major CVD risk factors.
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Affiliation(s)
- G Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - P Di Bartolo
- Ravenna Diabetes Center - Romagna Local Health Authority, Ravenna, Italy
| | - R Candido
- Department of Medical Surgical and Health Sciences, University of Trieste, Diabetes Center, ASUGI, Trieste, Italy
| | - G Lucisano
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy
| | | | - A Giandalia
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy
| | - A Nicolucci
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy
| | - A Rocca
- "G. Segalini" H. Bassini Cinisello Balsamo ASST Nord, Milan, Italy
| | - M C Rossi
- Center for Outcomes Research and Clinical Epidemiology - CORESEARCH, Pescara, Italy
| | - G Di Cianni
- USL Tuscany Northwest Location Livorno, Diabetes and Metabolic Disease, Livorno, Italy
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Russo GT, Giandalia A, Ceriello A, Di Bartolo P, Di Cianni G, Fioretto P, Giorda CB, Manicardi V, Pontremoli R, Viazzi F, Lucisano G, Nicolucci A, De Cosmo S. A prediction model to assess the risk of egfr loss in patients with type 2 diabetes and preserved kidney function: The amd annals initiative. Diabetes Res Clin Pract 2022; 192:110092. [PMID: 36167264 DOI: 10.1016/j.diabres.2022.110092] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 09/05/2022] [Accepted: 09/19/2022] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To develop and validate a model for predicting 5-year eGFR-loss in type 2 diabetes mellitus (T2DM) patients with preserved renal function at baseline. RESEARCH DESIGN AND METHODS A cohort of 504.532 T2DM outpatients participating to the Medical Associations of Diabetologists (AMD) Annals Initiative was splitted into the Learning and Validation cohorts, in which the predictive model was respectively developed and validated. A multivariate Cox proportional hazard regression model including all baseline characteristics was performed to identify predictors of eGFR-loss. A weight derived from regression coefficients was assigned to each variable and the overall sum of weights determined the 0 to 8-risk score. RESULTS A set of demographic, clinical and laboratory parameters entered the final model. The eGFR-loss score showed a good performance in the Validation cohort. Increasing score values progressively identified a higher risk of GFR loss: a score ≥ 8 was associated with a HR of 13.48 (12.96-14.01) in the Learning and a HR of 13.45 (12.93-13.99) in the Validation cohort. The 5 years-probability of developing the study outcome was 55.9% higher in subjects with a score ≥ 8. CONCLUSIONS In the large AMD Annals Initiative cohort, we developed and validated an eGFR-loss prediction model to identify T2DM patients at risk of developing clinically meaningful renal complications within a 5-years time frame.
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Affiliation(s)
- G T Russo
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - A Giandalia
- Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
| | - A Ceriello
- Department of Cardiovascular and Metabolic Diseases, IRCCS Gruppo Multimedica, MI, Italy.
| | | | - G Di Cianni
- Diabetes and Metabolic Diseases Unit, Health Local Unit North-West Tuscany, Livorno, Italy.
| | - P Fioretto
- Department of Medicine, University of Padua, Unit of Medical Clinic 3, Hospital of Padua, Padua, Italy.
| | - C B Giorda
- Diabetes and Metabolism Unit ASL Turin 5 Chieri (TO), Italy.
| | - V Manicardi
- Diabetes Consultant, Salus Hospital, Reggio Emilia, Italy.
| | - R Pontremoli
- Università degli Studi and IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - F Viazzi
- Università degli Studi and IRCCS Ospedale Policlinico San Martino, Genova, Italy.
| | - G Lucisano
- Center for Outcomes Research and Clinical Epidemiology, CORESEARCH, Pescara, Italy.
| | - A Nicolucci
- Center for Outcomes Research and Clinical Epidemiology, CORESEARCH, Pescara, Italy.
| | - S De Cosmo
- Department of Medical Sciences, Scientific Institute "Casa Sollievo della Sofferenza", San Giovanni Rotondo (FG), Italy.
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Clarke C, Lucisano G, Prendecki M, Gleeson S, Martin P, Ali M, McAdoo SP, Lightstone L, Ashby D, Charif R, Griffith M, McLean A, Dor F, Willicombe M. Informing the Risk of Kidney Transplantation Versus Remaining on the Waitlist in the Coronavirus Disease 2019 Era. Kidney Int Rep 2021; 6:46-55. [PMID: 33173838 PMCID: PMC7644242 DOI: 10.1016/j.ekir.2020.10.032] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [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: 09/07/2020] [Revised: 10/15/2020] [Accepted: 10/27/2020] [Indexed: 02/06/2023] Open
Abstract
INTRODUCTION There are limited data pertaining to comparative outcomes of remaining on dialysis versus kidney transplantation as the threat of coronavirus disease 2019 (COVID-19) remains. In this study we delineate the differential risks involved using serologic methods to help define exposure rates. METHODS From a cohort of 1433 patients with end-stage kidney disease (ESKD), we analyzed COVID-19 infection rates and outcomes in 299 waitlist patients compared with 237 transplant recipients within their first year post-transplant. Patients were followed over a 68-day period from the time our transplant program closed due to COVID-19. RESULTS The overall mortality rates in waitlist and transplant populations were equivalent (P = 0.69). However, COVID-19 infection was more commonly diagnosed in the waitlist patients (P = 0.001), who were more likely to be tested by reverse transcriptase polymerase chain reaction (P = 0.0004). Once infection was confirmed, mortality risk was higher in the transplant patients (P = 0.015). The seroprevalence in dialysis and transplant patients with undetected infection was 18.3% and 4.6%, respectively (P = 0.0001). After adjusting for potential screening bias, the relative risk of death after a diagnosis of COVID-19 remained higher in transplant recipients (hazard ratio = 3.36 [95% confidence interval = 1.19-9.50], P = 0.022). CONCLUSIONS Although COVID-19 infection was more common in the waitlist patients, a higher COVID-19‒associated mortality rate was seen in the transplant recipients, resulting in comparable overall mortality rates.
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Affiliation(s)
- Candice Clarke
- Centre for Inflammatory Disease, Division of Immunology and Inflammation, Department of Medicine, Imperial College London, UK
| | - Gaetano Lucisano
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Maria Prendecki
- Centre for Inflammatory Disease, Division of Immunology and Inflammation, Department of Medicine, Imperial College London, UK
| | - Sarah Gleeson
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Paul Martin
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Mahrukh Ali
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Stephen P. McAdoo
- Centre for Inflammatory Disease, Division of Immunology and Inflammation, Department of Medicine, Imperial College London, UK
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Liz Lightstone
- Centre for Inflammatory Disease, Division of Immunology and Inflammation, Department of Medicine, Imperial College London, UK
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Damien Ashby
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Rawya Charif
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Megan Griffith
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Adam McLean
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Frank Dor
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Michelle Willicombe
- Centre for Inflammatory Disease, Division of Immunology and Inflammation, Department of Medicine, Imperial College London, UK
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
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Mamode N, Ahmed Z, Jones G, Banga N, Motallebzadeh R, Tolley H, Marks S, Stojanovic J, Khurram MA, Thuraisingham R, Popoola J, Ghazanfar A, Game D, Sran K, Dor FJMF, Lucisano G, Sinha M, Olsburgh J, Willicombe M. Mortality Rates in Transplant Recipients and Transplantation Candidates in a High-prevalence COVID-19 Environment. Transplantation 2021; 105:212-215. [PMID: 33196624 DOI: 10.1097/tp.0000000000003533] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The risk of COVID-19 infection in transplant recipients (TRs) is unknown. Patients on dialysis may be exposed to greater risk of infection due to an inability to isolate. Consideration of these competing risks is important before restarting suspended transplant programs. This study compared outcomes in kidney and kidney/pancreas TRs with those on the waiting list, following admission with COVID-19 in a high-prevalence region. METHODS Audit data from all 6 London transplant centers were amalgamated. Demographic and laboratory data were collected and outcomes included mortality, intensive care (ITU) admission, and ventilation. Adult patients who had undergone a kidney or kidney/pancreas transplant, and those active on the transplant waiting list at the start of the pandemic were included. RESULTS One hundred twenty-one TRs and 52 waiting list patients (WL) were admitted to hospital with COVID-19. Thirty-six TR died (30%), while 14 WL patients died (27% P = 0.71). There was no difference in rates of admission to ITU or ventilation. Twenty-four percent of TR required renal replacement therapy, and 12% lost their grafts. Lymphocyte nadir and D-dimer peak showed no difference in those who did and did not die. No other comorbidities or demographic factors were associated with mortality, except for age (odds ratio of 4.3 [95% CI 1.8-10.2] for mortality if aged over 60 y) in TR. CONCLUSIONS TRs and waiting list patients have similar mortality rates after hospital admission with COVID-19. Mortality was higher in older TRs. These data should inform decisions about transplantation in the COVID era.
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Affiliation(s)
- Nizam Mamode
- Guys, Evelina and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Zubir Ahmed
- Guys, Evelina and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Gareth Jones
- Royal Free London NHS Foundation Trust, London, United Kingdom
| | - Neal Banga
- Royal Free London NHS Foundation Trust, London, United Kingdom
| | | | | | - Steve Marks
- Great Ormond Street Hospital, London, United Kingdom
| | | | | | | | - Joyce Popoola
- St Georges University Hospital NHS Foundation Trust, London, United Kingdom
| | - Abbas Ghazanfar
- St Georges University Hospital NHS Foundation Trust, London, United Kingdom
| | - David Game
- Guys, Evelina and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Kiran Sran
- Guys, Evelina and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Frank J M F Dor
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
- Department of Surgery and Cancer, Imperial College, London, United Kingdom
| | - Gaetano Lucisano
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - Manish Sinha
- Guys, Evelina and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Jonathon Olsburgh
- Guys, Evelina and St Thomas NHS Foundation Trust, London, United Kingdom
| | - Michelle Willicombe
- Imperial College Renal and Transplant Centre, Hammersmith Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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Willicombe M, Gleeson S, Clarke C, Dor F, Prendecki M, Lightstone L, Lucisano G, McAdoo S, Thomas D. Identification of Patient Characteristics Associated With SARS-CoV-2 Infection and Outcome in Kidney Transplant Patients Using Serological Screening. Transplantation 2021; 105:151-157. [PMID: 33196625 DOI: 10.1097/tp.0000000000003526] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND From population studies, solid organ transplant recipients are at increased risk of mortality from RT-PCR confirmed COVID-19 infection. The risk factors associated with infection acquisition and mortality in transplant recipients using serological data have not been reported. METHODS From 1725 maintenance transplant recipients, 855 consecutive patients were screened for SARS-CoV-2 antibodies. Serological screening utilized assays to detect both the N protein and receptor binding domain antibodies. Thirty-three of 855 (3.9%) of the screened patients had prior infection confirmed with RT-PCR. Twenty-one additional patients from our 1725 maintenance cohort with RT-PCR confirmed infection were included in our analysis. RESULTS Eighty-nine of 855 (10.4%) patients tested positive for SARS-CoV-2 antibodies. Fifty-nine of 89 (66.3%) cases were patients newly identified as exposed, while 30/89 (33.7%) seropositive patients had previous infection confirmed by RT-PCR. A diagnosis of SARS-CoV-2 (RT-PCR or Ab+) was associated with being from a noncaucasoid background, P = 0.015; having a diagnosis of diabetes, P = 0.028 and a history of allograft rejection, P < 0.01. Compared with the RT-PCR+ cohort, patients with serological-proven infection alone were more likely to be receiving tacrolimus monotherapy, P < 0.01, and less likely to have a diagnosis of diabetes, P = 0.012. Seventeen of 113 (15.0%) of all patients with infection (RT-PCR and Ab+) died. Risk factors associated with survival were older age, odds ratio (OR): 1.07 (1.00-1.13), P = 0.041; receiving prednisolone, OR: 5.98 (1.65-21.60), P < 0.01 and the absence of diabetes, OR: 0.27 (0.07-0.99), P = 0.047. CONCLUSIONS This study identifies risk factors and outcome for COVID-19 infection incorporating data on serologically defined infection and highlights the important contribution of immunosuppression regimen on outcomes.
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Affiliation(s)
- Michelle Willicombe
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Inflammatory Disease, Imperial College London, London, United Kingdom
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
| | - Sarah Gleeson
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
| | - Candice Clarke
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Inflammatory Disease, Imperial College London, London, United Kingdom
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
| | - Frank Dor
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
| | - Maria Prendecki
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Inflammatory Disease, Imperial College London, London, United Kingdom
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
| | - Liz Lightstone
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Inflammatory Disease, Imperial College London, London, United Kingdom
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
| | - Gaetano Lucisano
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
| | - Stephen McAdoo
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Inflammatory Disease, Imperial College London, London, United Kingdom
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
| | - David Thomas
- Department of Immunology and Inflammation, Faculty of Medicine, Centre for Inflammatory Disease, Imperial College London, London, United Kingdom
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom
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Dattani R, Hill P, Medjeral-Thomas N, Griffith ME, Ashby D, McAdoo S, Corbett RW, Lucisano G, Beadle J, McCafferty K, Frankel A, Thomas D. Oral potassium binders: increasing flexibility in times of crisis. Nephrol Dial Transplant 2020; 35:1446-1448. [PMID: 32871590 DOI: 10.1093/ndt/gfaa202] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 07/08/2020] [Indexed: 11/13/2022] Open
Affiliation(s)
- Rakesh Dattani
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
| | - Peter Hill
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
| | - Nicholas Medjeral-Thomas
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
- Imperial College London, London, London, UK
| | - Megan E Griffith
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
| | - Damien Ashby
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
| | - Stephen McAdoo
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
- Imperial College London, London, London, UK
| | - Richard W Corbett
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
| | - Gaetano Lucisano
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
| | - Jack Beadle
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
| | | | - Andrew Frankel
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
| | - David Thomas
- Imperial College Healthcare NHS Trust, West London Renal and Transplant Centre London, London, UK
- Imperial College London, London, London, UK
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Lucisano G, Thiruvengadam S, Hassan S, Gueret-Wardle A, Brookes P, Santos-Nunez E, Willicombe M. Donor-specific antibodies detected by single antigen beads alone can help risk stratify patients undergoing retransplantation across a repeat HLA mismatch. Am J Transplant 2020; 20:441-450. [PMID: 31529621 DOI: 10.1111/ajt.15595] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 05/21/2019] [Revised: 08/25/2019] [Accepted: 08/27/2019] [Indexed: 01/25/2023]
Abstract
Whether reexposure to mismatched HLA antigens (RMM) in the setting of a negative crossmatch is associated with increased immunological risk remains an area of uncertainty. This is due to evidence derived predominantly from registry data, which lacks comprehensive information on alloantibody and rejection. In this study, we analyze the impact of low-level preformed donor-specific antibodies (DSA) against an RMM on transplant outcomes. From 1988 consecutive renal transplant recipients, we analyzed 179 patients undergoing retransplantation, of whom 55 had a RMM. All patients were crossmatch negative and preformed DSA were detected by single antigen beads alone. Multivariate analysis revealed that patients with preformed DSA against an RMM were independently at risk of antibody-mediated rejection (HR 8.70 [3.42-22.10], P < .0001) and death-censored allograft loss (HR 3.08 [1.17-8.14], P = .023). In addition, prior transplant nephrectomy (HR 2.04 [1.00-4.17], P = .0495) was also associated with allograft failure, whereas receiving a retransplant that was matched at HLA class II was associated with a favorable outcome (HR 0.37 [0.14-0.99], P = .047). In the absence of preformed DSA, an RMM was not associated with de novo DSA development, rejection, or allograft loss. In conclusion, an RMM portends increased immunological risk only in the presence of a preformed DSA in patients undergoing retransplantation.
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Affiliation(s)
- Gaetano Lucisano
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Srivathsan Thiruvengadam
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Sevda Hassan
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Alexander Gueret-Wardle
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Paul Brookes
- Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Eva Santos-Nunez
- Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK
| | - Michelle Willicombe
- Renal and Transplant Centre, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.,Centre for Inflammatory Disease, Division of Immunology and Inflammation, Department of Medicine, Imperial College London, London, UK
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Pintaudi B, Di Vieste G, Corrado F, Lucisano G, Giunta L, D'Anna R, Di Benedetto A. Effects of myo-inositol on glucose variability in women with gestational diabetes. Eur Rev Med Pharmacol Sci 2019; 22:6567-6572. [PMID: 30338829 DOI: 10.26355/eurrev_201810_16073] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Myo-inositol supplementation prevents gestational diabetes (GDM) in women at risk and reduces insulin resistance in women with GDM. No data are available about its effect on glucose variability. The aim of this study was to evaluate the effects of a supplementation of myo-inositol on glucose variability in women with GDM. PATIENTS AND METHODS Myo-inositol effect on glucose variability was studied in a pilot case-control study involving 12 consecutive pregnant women (median age 34 years, 25.0% insulin-treated) with GDM. Six women received myo-inositol 2 g plus 200 mg folic acid twice a day, the others received only folic acid. Information on side effects was collected. A continuous glucose monitoring system was wore before and at the beginning of the supplementation. Mean amplitude of glucose excursion (MAGE), standard deviation (SD) and variability coefficient were the indexes of glucose variability. RESULTS Myo-inositol lowered glucose levels in the first days after the treatment was started. However, pre-post supplementation overall mean glucose difference was similar between groups (-4.8 vs. 5.0 mg/dL for controls and treated, respectively; p = 0.79). Pre-post differences in SD (13.7 vs. 6.0; p < 0.001), MAGE (3.5 vs.-1.5; p < 0.001) and variability coefficient (0.14 vs. 0.02; p < 0.001) were improved in myo-inositol group. No side effects were recorded. CONCLUSIONS Myo-inositol is effective in reducing glucose variability in women with GDM. It could be a useful strategy for treating GDM.
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Affiliation(s)
- B Pintaudi
- Diabetes Unit, Niguarda Cà Granda Hospital, Milan, Italy.
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11
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Di Martino G, Di Giovanni P, Scampoli P, Meo F, Cedrone F, Lucisano G, Staniscia T. Arsenic metabolism and urothelial cancer risk: a systematic review and meta-analysis. Eur J Public Health 2019. [DOI: 10.1093/eurpub/ckz186.247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Arsenic is a toxic metalloid element frequently found in the environment. Chronic arsenic exposure is a critical public health issue in many countries since the identification of arsenic and its compounds as human carcinogens by the World Health Organization. After absorption, inorganic arsenic (iAs) is mainly methylated into monomethylated and dimethylated compounds (MMA, DMA), which are then excreted through the kidney together with unmethylated iAs. Whether the methylation process is to detoxify or potentiate arsenic toxicity, however, remains an ongoing debate. The purpose of this systematic review was to conduct a comprehensive meta-analysis to estimate the association between arsenic exposure and urothelial cancer.
Methods
10 observational studies met the inclusion criteria and were included in the systematic review. IAs%, MMA% and DMA% were extracted from each paper. Weighted Mean Differences with 95% confidence intervals were defined according to Cases minus Controls. Pooled risk estimates from individual studies were assessed using random effects models. Meta-regression analysis was performed to estimate the extent of urothelial cancer risk as a function of iAs%, MMA% and DMA%.
Results
Results showed as patients with urothelial cancer presented higher level of urinary iAs% (WMD 2.70, 95%CI 0.64-4.76), MMA% (WMD 2.81, 95%CI 1.43-4.20) and DMA% (WMD-3.44, 95%CI-6.57–0.30).
Conclusions
These findings suggest that higher level of iAs% and MMA% and lower level of DMA% were associated with an increased risk of urothelial cancer. Additional population based studies are needed to understand the role of arsenic in cancer development. Understanding the meaning of arsenic metabolism could improve the risk assessment of arsenic toxicity and provide a potential tool for disease prediction and prevention.
Key messages
Higher level of iAs%, MMA% and DMA% were associated with an increased risk of urothelial cancer. Understanding the meaning of arsenic metabolism could improve the risk assessment of arsenic toxicity.
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Affiliation(s)
- G Di Martino
- School of Hygiene and Preventive Medicine, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - P Di Giovanni
- Department of Pharmacy, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - P Scampoli
- School of Hygiene and Preventive Medicine, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - F Meo
- School of Hygiene and Preventive Medicine, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | - F Cedrone
- School of Hygiene and Preventive Medicine, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
| | | | - T Staniscia
- Department of Medicine and Ageing Sciences, “G. d’Annunzio” University of Chieti-Pescara, Chieti, Italy
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12
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Lucisano G, Brookes P, Santos-Nunez E, Firmin N, Gunby N, Hassan S, Gueret-Wardle A, Herbert P, Papalois V, Willicombe M, Taube D. Allosensitization after transplant failure: the role of graft nephrectomy and immunosuppression - a retrospective study. Transpl Int 2019; 32:949-959. [PMID: 30980556 DOI: 10.1111/tri.13442] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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: 11/22/2018] [Revised: 01/07/2019] [Accepted: 04/09/2019] [Indexed: 01/30/2023]
Abstract
There are conflicting data about the role of transplant nephrectomy and immunosuppression withdrawal on the development of allosensitization and the impact on re-transplantation. We divided 109 first graft recipients into two groups according to whether they underwent nephrectomy (NX+, n = 61) or their graft was left in situ (NX-, n = 48). Sera were assessed for HLA-A/B/Cw/DR/DQ antibodies at the time of NX/transplant failure and after 3, 6, 12, 24 months. The NX+ group showed a higher rate of donor specific antibody (DSA) and non-DSA human leukocyte antigen (HLA) antibody production at all the time points. Multivariable analysis showed that nephrectomy was a strong, independent risk factor for the development of DSAs after 12 and 24 months (P = 0.005 and 0.008). In the NX- group, low tacrolimus levels correlated with DSA formation (AUC 0.817, P = 0.002; best cut-off level 2.9 ng/ml). Analysis with a standardized pool of UK donors showed a more difficult grade of HLA matchability following nephrectomy compared with the NX- group. Nephrectomy is followed by the long-term production of DSA and non-DSA HLA antibodies and negatively impacts on the chances of finding a HLA-compatible kidney. Tacrolimus levels ≥3 ng/ml are protective against the development of allosensitization and could facilitate re-transplantation in the NX- group.
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Affiliation(s)
- Gaetano Lucisano
- Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Paul Brookes
- Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, London, UK
| | - Eva Santos-Nunez
- Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, London, UK
| | - Nicola Firmin
- Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, London, UK
| | - Nicola Gunby
- Histocompatibility and Immunogenetics, Imperial College Healthcare NHS Trust, London, UK
| | - Sevda Hassan
- Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Alexander Gueret-Wardle
- Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Paul Herbert
- Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Vassilios Papalois
- Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| | - Michelle Willicombe
- Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
| | - David Taube
- Imperial College Renal and Transplant Centre, Imperial College Healthcare NHS Trust, London, UK
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13
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Giorda CB, Rossi MC, Ozzello O, Gentile S, Aglialoro A, Chiambretti A, Baccetti F, Gentile FM, Romeo F, Lucisano G, Nicolucci A. Healthcare resource use, direct and indirect costs of hypoglycemia in type 1 and type 2 diabetes, and nationwide projections. Results of the HYPOS-1 study. Nutr Metab Cardiovasc Dis 2017; 27:209-216. [PMID: 28017523 DOI: 10.1016/j.numecd.2016.10.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [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: 06/21/2016] [Revised: 10/04/2016] [Accepted: 10/16/2016] [Indexed: 11/17/2022]
Abstract
BACKGROUND AND AIMS To obtain an accurate picture of the total costs of hypoglycemia, including the indirect costs and comparing the differences between type 1 (T1DM) and type 2 diabetes mellitus (T2DM). METHODS AND RESULTS HYPOS-1 was a multicenter, retrospective cohort study which analyzed the data of 2229 consecutive patients seen at 18 diabetes clinics. Data on healthcare resource use and indirect costs by diabetes type were collected via a questionnaire. The domains of inpatient admission and hospital stay, work days lost, and third-party assistance were also explored. Resource utilization was reported as estimated incidence rates (IRs) of hypoglycemic episodes per 100 person-years and estimated costs as IRs per person-years. For every 100 patients with T1DM, 9 emergency room (ER) visits and 6 emergency medical service calls for hypoglycemia were required per year; for every 100 patients with T2DM, 3 ER visits and 1 inpatient admission were required, with over 3 nights spent in hospital. Hypoglycemia led to 58 work days per 100 person-years lost by the patient or a family member in T1DM versus 19 in T2DM. The costs in T1DM totaled €90.99 per person-year and €62.04 in T2DM. Direct and indirect costs making up the total differed by type of diabetes (60% indirect costs in T1DM versus 43% in T2DM). The total cost associated with hypoglycemia in Italy is estimated to be €107 million per year. CONCLUSIONS Indirect costs meaningfully contribute to the total costs associated with hypoglycemia. As compared with T1DM, T2DM requires fewer ER visits and incurs lower indirect costs but more frequent hospital use.
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Affiliation(s)
- C B Giorda
- Metabolism and Diabetes Unit, ASL TO5, Chieri (TO), Italy.
| | - M C Rossi
- CORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - O Ozzello
- Departmental Service of Diabetology and Metabolic Diseases, ASL TO3, Pinerolo (TO), Italy
| | - S Gentile
- Department of Clinical and Experimental Medicine, Second University of Naples, Naples, Italy
| | - A Aglialoro
- Endocrinology, Metabolism and Diabetes Unit, PUO Villa Scassi, ASL3, Genoa, Italy
| | - A Chiambretti
- Metabolism and Diabetes Unit, ASL TO4, Chivasso, Italy
| | - F Baccetti
- Diabetes Unit, ASL Toscana Nordovest (Presidio Apuane), Italy
| | - F M Gentile
- Metabolism and Diabetes Unit, ASL di Bari, Rutigliano, Italy
| | - F Romeo
- Metabolism and Diabetes Unit, ASL TO5, Chieri (TO), Italy
| | - G Lucisano
- CORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - A Nicolucci
- CORESEARCH - Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
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14
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Manfredini F, Mallamaci F, D'Arrigo G, Baggetta R, Bolignano D, Torino C, Lamberti N, Bertoli S, Ciurlino D, Rocca-Rey L, Barillà A, Battaglia Y, Rapanà RM, Zuccalà A, Bonanno G, Fatuzzo P, Rapisarda F, Rastelli S, Fabrizi F, Messa P, De Paola L, Lombardi L, Cupisti A, Fuiano G, Lucisano G, Summaria C, Felisatti M, Pozzato E, Malagoni AM, Castellino P, Aucella F, Abd ElHafeez S, Provenzano PF, Tripepi G, Catizone L, Zoccali C. Exercise in Patients on Dialysis: A Multicenter, Randomized Clinical Trial. J Am Soc Nephrol 2016; 28:1259-1268. [PMID: 27909047 DOI: 10.1681/asn.2016030378] [Citation(s) in RCA: 216] [Impact Index Per Article: 27.0] [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: 03/31/2016] [Accepted: 09/19/2016] [Indexed: 11/03/2022] Open
Abstract
Previous studies have suggested the benefits of physical exercise for patients on dialysis. We conducted the Exercise Introduction to Enhance Performance in Dialysis trial, a 6-month randomized, multicenter trial to test whether a simple, personalized walking exercise program at home, managed by dialysis staff, improves functional status in adult patients on dialysis. The main study outcomes included change in physical performance at 6 months, assessed by the 6-minute walking test and the five times sit-to-stand test, and in quality of life, assessed by the Kidney Disease Quality of Life Short Form (KDQOL-SF) questionnaire. We randomized 296 patients to normal physical activity (control; n=145) or walking exercise (n=151); 227 patients (exercise n=104; control n=123) repeated the 6-month evaluations. The distance covered during the 6-minute walking test improved in the exercise group (mean distance±SD: baseline, 328±96 m; 6 months, 367±113 m) but not in the control group (baseline, 321±107 m; 6 months, 324±116 m; P<0.001 between groups). Similarly, the five times sit-to-stand test time improved in the exercise group (mean time±SD: baseline, 20.5±6.0 seconds; 6 months, 18.2±5.7 seconds) but not in the control group (baseline, 20.9±5.8 seconds; 6 months, 20.2±6.4 seconds; P=0.001 between groups). The cognitive function score (P=0.04) and quality of social interaction score (P=0.01) in the kidney disease component of the KDQOL-SF improved significantly in the exercise arm compared with the control arm. Hence, a simple, personalized, home-based, low-intensity exercise program managed by dialysis staff may improve physical performance and quality of life in patients on dialysis.
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Affiliation(s)
- Fabio Manfredini
- Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences and.,Vascular Diseases Center, University of Ferrara, Ferrara, Italy
| | - Francesca Mallamaci
- Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy.,Nephrology, Dialysis and Renal Transplantation Unit, Ospedali Riuniti, Reggio Calabria, Italy
| | - Graziella D'Arrigo
- Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy
| | - Rossella Baggetta
- Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy
| | - Davide Bolignano
- Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy
| | - Claudia Torino
- Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy
| | - Nicola Lamberti
- Department of Biomedical and Surgical Specialties Sciences, Section of Sport Sciences and
| | - Silvio Bertoli
- Nephrology and Dialysis Unit, IRCCS Multimedica-Policlinico Multispecialistico, Milan, Italy
| | - Daniele Ciurlino
- Nephrology and Dialysis Unit, IRCCS Multimedica-Policlinico Multispecialistico, Milan, Italy
| | - Lisa Rocca-Rey
- Nephrology and Dialysis Unit, IRCCS Multimedica-Policlinico Multispecialistico, Milan, Italy
| | - Antonio Barillà
- Nephrology Unit, AOU Ferrara Arcispedale Sant' Anna, Ferrara, Italy
| | - Yuri Battaglia
- Nephrology Unit, AOU Ferrara Arcispedale Sant' Anna, Ferrara, Italy
| | | | | | - Graziella Bonanno
- Azzurra Medical Nephrological Ambulatory and Dialysis Techniques, Catania, Italy
| | - Pasquale Fatuzzo
- Department of Internal Medicine and Nephrology chair, University of Catania, Catania, Italy
| | - Francesco Rapisarda
- Department of Internal Medicine and Nephrology chair, University of Catania, Catania, Italy
| | - Stefania Rastelli
- Department of Internal Medicine and Nephrology chair, University of Catania, Catania, Italy
| | - Fabrizio Fabrizi
- Nephrology and Dialysis Unit, IRCCS Cà Granda Ospedale Maggiore-Policlinico, Milano, Italy
| | - Piergiorgio Messa
- Nephrology and Dialysis Unit, IRCCS Cà Granda Ospedale Maggiore-Policlinico, Milano, Italy
| | - Luciano De Paola
- Nephrology and Dialysis Unit, Ospedale Pugliese-Ciaccio, Catanzaro, Italy
| | - Luigi Lombardi
- Nephrology and Dialysis Unit, Ospedale Pugliese-Ciaccio, Catanzaro, Italy
| | - Adamasco Cupisti
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Giorgio Fuiano
- Nephrology and Dialysis Unit, Policlinico Universitario Mater Domini, Catanzaro, Italy
| | - Gaetano Lucisano
- Nephrology and Dialysis Unit, Policlinico Universitario Mater Domini, Catanzaro, Italy
| | - Chiara Summaria
- Nephrology and Dialysis Unit, Policlinico Universitario Mater Domini, Catanzaro, Italy
| | | | - Enrico Pozzato
- Vascular Diseases Center, University of Ferrara, Ferrara, Italy
| | | | - Pietro Castellino
- Department of Internal Medicine and Nephrology chair, University of Catania, Catania, Italy
| | - Filippo Aucella
- Nephrology Unit, Ospedale Casa Sollievo della Sofferenza, San Giovanni Rotondo, Foggia, Italy; and
| | - Samar Abd ElHafeez
- Epidemiology Department, High Institute of Public Health-Alexandria University, Alexandria, Egypt
| | - Pasquale Fabio Provenzano
- Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy
| | - Giovanni Tripepi
- Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy
| | - Luigi Catizone
- Nephrology Unit, AOU Ferrara Arcispedale Sant' Anna, Ferrara, Italy
| | - Carmine Zoccali
- Clinical Epidemiology and Physiopathology of Renal Diseases and Hypertension of Reggio Calabria, National Council of Research, Institute of Clinical Physiology, Reggio Calabria, Italy;
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Nicolucci A, Kovacs Burns K, Holt RIG, Lucisano G, Skovlund SE, Kokoszka A, Massi Benedetti M, Peyrot M. Correlates of psychological outcomes in people with diabetes: results from the second Diabetes Attitudes, Wishes and Needs (DAWN2(™) ) study. Diabet Med 2016; 33:1194-203. [PMID: 27353119 DOI: 10.1111/dme.13178] [Citation(s) in RCA: 41] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/27/2016] [Indexed: 11/28/2022]
Abstract
AIMS To assess country- and individual-level correlates of psychological outcomes, and differences among countries in the associations of individual characteristics with psychological outcomes among adults with diabetes. METHODS The second Diabetes Attitudes, Wishes and Needs (DAWN2(™) ) study assessed self-reported characteristics of people with diabetes in 17 countries, including 1368 adults with Type 1 diabetes and 7228 with Type 2 diabetes. In each country, a sample of 500 adults, stratified by diabetes type and treatment, completed a questionnaire incorporating the validated WHO-5 wellbeing index, the WHOQOL-BREF, and the five-item Problem Areas in Diabetes Scale, as well as the newly developed Diabetes Impact on Life Dimensions that assessed impact ranging from very positive to very negative, with no impact as the midpoint. Multilevel regression analyses identified significant (P < 0.05) independent correlates of psychological outcomes. RESULTS There were significant variations in all outcomes across countries before adjustment for individual-level factors; adjustment reduced between-country disparities. Worse psychological outcomes were associated with more complications, incidence of hypoglycaemia, hypoglycaemic medication, perceived burden of diabetes, family conflict and experience of discrimination. Better psychological outcomes were associated with higher self-rated health, greater access to diabetes education and healthcare, and more psychosocial support from others. The associations of many factors with the outcomes were mediated by modifiable factors. The association of all factors with the outcomes varied across (interacted with) countries, highlighting the need for country-specific analyses. CONCLUSIONS Improvements in modifiable risk factors (reductions in burden and increases in support) may lead to better psychological outcomes in adults with diabetes.
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Affiliation(s)
- A Nicolucci
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - K Kovacs Burns
- Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - R I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - G Lucisano
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | | | - A Kokoszka
- Medical University of Warsaw, Warsaw, Poland
| | | | - M Peyrot
- Loyola University Maryland, Baltimore, MD, USA
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16
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Holt RIG, Nicolucci A, Kovacs Burns K, Lucisano G, Skovlund SE, Forbes A, Kalra S, Menéndez Torre E, Munro N, Peyrot M. Correlates of psychological care strategies for people with diabetes in the second Diabetes Attitudes, Wishes and Needs (DAWN2(™) ) study. Diabet Med 2016; 33:1174-83. [PMID: 26939906 DOI: 10.1111/dme.13109] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2015] [Revised: 01/18/2016] [Accepted: 03/01/2016] [Indexed: 01/30/2023]
Abstract
AIMS To assess the ways in which healthcare professionals address psychological problems of adults with diabetes in the second Diabetes Attitudes, Wishes and Needs (DAWN2(™) ) study. METHODS Approximately 120 primary care physicians, 80 diabetes specialists and 80 nurses and dietitians providing diabetes care participated in each of 17 countries (N=4785). Multiple regression analyses were used to evaluate independent statistically significant associations of respondent attributes concerning psychological care strategies, including assessment of diabetes impact on the patient's life, assessment of depression, provision of psychological assessment and support, and coordination with mental health professionals. RESULTS Psychological care strategies were positively associated with each other but differed by healthcare practice site and discipline; nurses and dietitians were less likely to assess depression than other healthcare professionals, while primary care physicians were less likely to coordinate with mental health specialists or ask patients how diabetes affects their lives. Psychological care was positively associated with healthcare professionals' beliefs that patients need help dealing with emotional issues and that clinical success depends on doing so, and also with level of psychological care training, multidisciplinary team membership and availability of resources for psychological care. There were significant between-country variations in psychological care strategies, before and after adjustment for individual-level factors, and significant country-by-covariate interactions for almost all individual-level factors investigated. CONCLUSIONS Improvements in training and resources, recognition and assessment of psychological problems, and increased belief in the efficacy of psychological support may enhance healthcare professionals' efforts to address psychological problems in adults with diabetes.
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Affiliation(s)
- R I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Nicolucci
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - K Kovacs Burns
- Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - G Lucisano
- Center for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | | | - A Forbes
- Kings College London, London, UK
| | - S Kalra
- Bharti Hospital and BRIDE, Karnal, India
| | | | - N Munro
- University of Surrey, Guildford, UK
| | - M Peyrot
- Loyola University Maryland, Baltimore, MD, USA
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17
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Kovacs Burns K, Holt RIG, Nicolucci A, Lucisano G, Skovlund SE, Comaschi M, Vallis M, Peyrot M. Correlates of psychological outcomes among family members of people with diabetes in the second Diabetes Attitudes, Wishes and Needs (DAWN2(™) ) study. Diabet Med 2016; 33:1184-93. [PMID: 27086909 DOI: 10.1111/dme.13136] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/11/2016] [Indexed: 01/06/2023]
Abstract
AIMS To conduct a second Diabetes Attitudes, Wishes and Needs (DAWN2(™) ) study, examining the experiences of family members caring for adults with diabetes in order to identify correlates of family member psychological outcomes (generic psychological well-being, perceived quality of life, and diabetes-related burden, impact and distress). METHODS A total of 2057 family members living with a person with diabetes and involved in their care participated in an online, telephone or in-person survey. Samples of 120 respondents were recruited in each of 17 countries. Significant (P < 0.05) correlates of psychological outcomes were identified by multi-level multiple regression. RESULTS Outcomes were worse for family members not working because of diabetes or those who had other competing obligations. Outcomes were worse if the person with diabetes was not a partner or parent, used injected diabetes medication, or had more frequent hypoglycaemia. Outcomes were worse for family members who believed that diabetes was more severe, were more involved in diabetes care, had more conflict over diabetes care or were frustrated about not knowing how to help the person with diabetes. Outcomes were better for those who had greater support from others and felt they found good ways to help the person with diabetes. There were significant differences in outcomes among countries before and after adjustment for individual characteristics, and correlates of outcomes varied by country. CONCLUSIONS Several modifiable risk and protective factors for family member psychological outcomes were identified in this study. Diabetes education and social support were associated with improved outcomes, especially if they were helpful in supporting people with diabetes.
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Affiliation(s)
- K Kovacs Burns
- Edmonton Clinic Health Academy, University of Alberta, Edmonton, AB, Canada
| | - R I G Holt
- Human Development and Health, Faculty of Medicine, University of Southampton, Southampton, UK
| | - A Nicolucci
- Centre for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | - G Lucisano
- Centre for Outcomes Research and Clinical Epidemiology, Pescara, Italy
| | | | - M Comaschi
- Istituto Clinico Ligure di Alta Specialità, GVM Care and Research, Rapallo, Italy
| | - M Vallis
- Dalhousie University, Halifax, NS, Canada
| | - M Peyrot
- Loyola University Maryland, Baltimore, MD, USA
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18
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Cianfrone P, Simeoni M, Comi N, Piraina V, Talarico R, Cerantonio A, Gentile I, Fabiano FF, Lucisano G, Foti D, Gulletta E, Fuiano G. How to improve duration and efficiency of the antiproteinuric response to Ramipril: RamiPROT-a prospective cohort study. J Nephrol 2015; 30:95-102. [PMID: 26707494 DOI: 10.1007/s40620-015-0256-3] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [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: 08/07/2015] [Accepted: 12/10/2015] [Indexed: 01/13/2023]
Abstract
BACKGROUND The antiproteinuric pharmacokinetics of Ramipril in response to different doses and modalities of administration has been poorly investigated so far. STUDY DESIGN Prospective, open-label and not placebo controlled study. SETTING AND PARTICIPANTS 40 Caucasian adult patients having GFR ≥ 50 mL/min, proteinuria 1-3 g/day; SBP/DBP ≤ 150/90 mmHg were recruited between June 2014 and November 2014. FACTOR AND OUTCOME Impact on 24 h proteinuria and fractioned proteinuria of Ramipril given at different dosages (2.5 mg/day or Ramipril 5 mg/day or Ramipril 10 mg/day) and with different daily administration modalities (single or two divided doses) for cycles of 10 days. MEASUREMENTS At the end of each cycle, 24 h and fractioned proteinuria on three timed urinary collections (morning, afternoon and night) were measured. RESULTS Compared to baseline, Ramipril significantly reduced 24 h proteinuria at each dose and modality of administration. In particular, the greatest effects were evident with the higher and divided dose of the drug. The analysis of the fractioned proteinuria showed that the greatest reduction was obtained in the night urinary collection by administering Ramipril 10 mg/day in two divided doses. LIMITATIONS Small sample size. CONCLUSIONS Ramipril reduces proteinuria at any of the tested doses. Although the using of high and divided doses seems to maximize the antiproteinuric effect of the drug, possibly due to a better pharmacological coverage of the nocturnal period.
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Affiliation(s)
- Paola Cianfrone
- Department of Nephrology and Dialysis, Magna Graecia University of Catanzaro, University Campus 'Magna Graecia', Viale Europa - Loc. Germaneto, 88100, Catanzaro, Italy
| | - Mariadelina Simeoni
- Department of Nephrology and Dialysis, Magna Graecia University of Catanzaro, University Campus 'Magna Graecia', Viale Europa - Loc. Germaneto, 88100, Catanzaro, Italy.
| | - Nicola Comi
- Department of Nephrology and Dialysis, Magna Graecia University of Catanzaro, University Campus 'Magna Graecia', Viale Europa - Loc. Germaneto, 88100, Catanzaro, Italy
| | - Valentina Piraina
- Department of Nephrology and Dialysis, Magna Graecia University of Catanzaro, University Campus 'Magna Graecia', Viale Europa - Loc. Germaneto, 88100, Catanzaro, Italy
| | - Roberta Talarico
- Department of Nephrology and Dialysis, Magna Graecia University of Catanzaro, University Campus 'Magna Graecia', Viale Europa - Loc. Germaneto, 88100, Catanzaro, Italy
| | - Annamaria Cerantonio
- Department of Nephrology and Dialysis, Magna Graecia University of Catanzaro, University Campus 'Magna Graecia', Viale Europa - Loc. Germaneto, 88100, Catanzaro, Italy.,Kidney and Transplant Unit, Imperial College Healthcare NHS Trust of London, London, UK.,Department of Clinical Pathology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Innocenza Gentile
- Department of Nephrology and Dialysis, Magna Graecia University of Catanzaro, University Campus 'Magna Graecia', Viale Europa - Loc. Germaneto, 88100, Catanzaro, Italy.,Kidney and Transplant Unit, Imperial College Healthcare NHS Trust of London, London, UK.,Department of Clinical Pathology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | | | - Gaetano Lucisano
- Kidney and Transplant Unit, Imperial College Healthcare NHS Trust of London, London, UK
| | - Daniela Foti
- Department of Clinical Pathology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Elio Gulletta
- Department of Clinical Pathology, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giorgio Fuiano
- Department of Nephrology and Dialysis, Magna Graecia University of Catanzaro, University Campus 'Magna Graecia', Viale Europa - Loc. Germaneto, 88100, Catanzaro, Italy
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Lucisano G, Simeoni M, Comi N, Citraro ML, Fuiano L, Fuiano G. Continuous intravenous infusion of furosemide is more effective and safer than coadministration of albumin and furosemide in patients with nephrotic syndrome. MINERVA UROL NEFROL 2015; 67:169-171. [PMID: 25847868] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Affiliation(s)
- G Lucisano
- Nephrology Unit, Magna Graecia University, Catanzaro, Italy -
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Coppolino G, Lucisano G, Rivoli L, Simeoni M, De Paola L, Timpano R, Palmieri C, Fuiano G. FP436SERUM BETA-CROSSLAPS AS PREDICTOR OF LONG-TERM PARATHYROID HORMONE LEVELS IN HEMODIALYSIS PATIENTS. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv177.35] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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21
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Lucisano G, Comi N, Pelagi E, Cianfrone P, Fuiano L, Fuiano G. Can renal sonography be a reliable diagnostic tool in the assessment of chronic kidney disease? J Ultrasound Med 2015; 34:299-306. [PMID: 25614403 DOI: 10.7863/ultra.34.2.299] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVES Kidney size has been found to be correlated with anthropometric features and kidney function. Therefore, we postulate that if the conventionally measured renal sonographic parameters (pole-to-pole length, width, and parenchymal thickness) are taken according to standardized rules and corrected for body height, their association with kidney function could be strengthened, thus helping validate renal sonographic information for a better assessment of chronic kidney disease (CKD) status. METHODS This cross-sectional study included 72 stable adult patients with stage 1 to 4 CKD. Sonographic parameters were obtained from both kidneys and averaged, and the measurements obtained were further corrected for patients' body height. The glomerular filtration rate (GFR) was estimated by the Chronic Kidney Disease Epidemiology Collaboration equation. RESULTS Parenchymal thickness and renal length showed the highest correlation level with the GFR. This significant correlation, however, was greatly ameliorated by the correction for patients' body height (r = 0.537; P < .001; r = 0.510; P < .001, respectively). Of note, the product of these two parameters corrected for body height showed the best degree of correlation with the GFR (r = 0.560; P < .001), as confirmed by analysis of variance after subdivision of the population into CKD stage groups according to the GFR. Receiver operating characteristic curve analysis for discrimination of a GFR of less than 60 mL/min indentified the combined parameter as the one with the highest area under the curve (0.78; 95% confidence interval, 0.66-0.89), followed renal length corrected for height (area under the curve, 0.77; 95% confidence interval, 0.66-0.88). CONCLUSIONS Correction of renal sonographic parameters for body height strengthens the degree of the correlation of renal sonography with the GFR. The improved correlation with the GFR makes renal sonography a reliable tool for a more complete assessment of patients with CKD.
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Affiliation(s)
- Gaetano Lucisano
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy.
| | - Nicolino Comi
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Elena Pelagi
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Paola Cianfrone
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Laura Fuiano
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
| | - Giorgio Fuiano
- Nephrology and Dialysis Unit, Magna Graecia University of Catanzaro, Catanzaro, Italy
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Simeoni M, Cianfrone P, Comi N, Gentile I, Fabiano FF, Piraina V, Talarico R, Lucisano G, Rivoli L, Andreucci M, Fuiano L, Foti D, Gulletta E, Fuiano G. [Is it feasible to improve the duration and the efficiency of Ramipril anti-proteinuric response?]. G Ital Nefrol 2015; 32:gin/00200.9. [PMID: 25774586] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
BACKGROUND Ramipril administered once daily is characterized by an attenuation of its pharmacological activity in the following 24 hours, whose effects on antiproteinuric activity have not yet been investigated. METHODS The antiproteinuric efficacy of Ramipril has been evaluated in a cross-over study in 20 patients with renal disease, proteinuria and hypertension (GFR50 mL / min, proteinuria <3 g / day; SBP/DBP 150/90 mmHg). Proteinuria was measured over 24 hours on three consecutive urine collections (morning, afternoon and night) in the absence of antiproteinuric drugs and after ten days of treatment with single morning administration of Ramipril 2.5 mg or Ramipril 10 mg. RESULTS At baseline: mean proteinuria was not significantlychanged over the course of the three urinary collections (88 7.2 mg/h in the morning of 80 10.5 mg/h in the afternoon and 81 10.1 mg/hr during the night). After Ramipril 2.5 mg/day: slight reduction in mean proteinuria, with no significant differences between collections (80 11 mg/h in the morning, 69 7.4 mg/h in the afternoon and 75 9.1 mg/h during the night). After Ramipril 10 mg/day: afternoon and night values of proteinuria were significantly reduced compared to baseline; noctural proteinuria was significantly lower than morning value (51 7.5 mg/h vs. 81 10 mg/h, p <0.05). CONCLUSION The antiproteinuric effectiveness of Ramipril tends to decrease significantly over the 24hours after a single daily administration. An increase and/or division of Ramipril dose might help to stabilize and to maximizeits antiproteinuric effectiveness.
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Nicolucci A, Rossi MC, Lucisano G, Pintaudi B, Gentile S, Bulotta A, Skovlund SE, Vespasiani G. Benchmarking activities based on person centered measures: a diabetes case study from Italy. Eur J Public Health 2014. [DOI: 10.1093/eurpub/cku151.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Torino C, Manfredini F, Bolignano D, Aucella F, Baggetta R, Barillà A, Battaglia Y, Bertoli S, Bonanno G, Castellino P, Ciurlino D, Cupisti A, D'Arrigo G, De Paola L, Fabrizi F, Fatuzzo P, Fuiano G, Lombardi L, Lucisano G, Messa P, Rapanà R, Rapisarda F, Rastelli S, Rocca-Rey L, Summaria C, Zuccalà A, Tripepi G, Catizone L, Zoccali C, Mallamaci F. Physical Performance and Clinical Outcomes in Dialysis Patients: A Secondary Analysis of the Excite Trial. Kidney Blood Press Res 2014; 39:205-11. [DOI: 10.1159/000355798] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/11/2014] [Indexed: 11/19/2022] Open
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Seiler S, Colbus SM, Lucisano G, Rogacev KS, Gerhart MK, Ziegler M, Fliser D, Heine GH. Erratum. Nephrol Dial Transplant 2014. [DOI: 10.1093/ndt/gfu228] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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26
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Cherubini V, Pintaudi B, Rossi MC, Lucisano G, Pellegrini F, Chiumello G, Frongia AP, Monciotti C, Patera IP, Toni S, Zucchini S, Nicolucci A. Severe hypoglycemia and ketoacidosis over one year in Italian pediatric population with type 1 diabetes mellitus: a multicenter retrospective observational study. Nutr Metab Cardiovasc Dis 2014; 24:538-546. [PMID: 24418381 DOI: 10.1016/j.numecd.2013.11.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [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: 05/14/2013] [Revised: 11/07/2013] [Accepted: 11/10/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND AND AIMS Evaluation of incidence and correlates of severe hypoglycemia (SH) and diabetes ketoacidosis (DKA) in children and adolescents with T1DM. METHODS AND RESULTS Retrospective study conducted in 29 diabetes centers from November 2011 to April 2012. The incidence of SH and DKA episodes and their correlates were assessed through a questionnaire administered to parents of patients aged 0-18 years. Incidence rates and incident rate ratios (IRRs) were estimated through multivariate Poisson regression analysis and multilevel analysis. Overall, 2025 patients were included (age 12.4 ± 3.8 years; 53% males; diabetes duration 5.6 ± 3.5 years; HbA1c 7.9 ± 1.1%). The incidence of SH and DKA were of 7.7 and 2.4 events/100 py, respectively. The risk of SH was higher in females (IRR = 1.44; 95%CI 1.04-1.99), in patients using rapid acting analogues as compared to regular insulin (IRR = 1.48; 95%CI 0.97-2.26) and lower for patients using long acting analogues as compared to NPH insulin (IRR = 0.40; 95%CI 0.19-0.85). No correlations were found between SH and HbA1c levels. The risk of DKA was higher in patients using rapid acting analogues (IRR = 4.25; 95%CI 1.01-17.86) and increased with insulin units needed (IRR = 7.66; 95%CI 2.83-20.74) and HbA1c levels (IRR = 1.63; 95%CI 1.36-1.95). Mother's age was inversely associated with the risk of both SH (IRR = 0.95; 95%CI 0.92-0.98) and DKA (IRR = 0.94; 95%CI 0.88-0.99). When accounting for center effect, the risk of SH associated with the use of rapid acting insulin analogues was attenuated (IRR = 1.48; 95%CI 0.97-2.26); 33% and 16% of the residual variance in SH and DKA risk was explained by center effect. CONCLUSION The risk of SH and DKA is mainly associated with treatment modalities and strongly depends on the practice of specialist centers.
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Affiliation(s)
- V Cherubini
- Division of Paediatric Diabetes in Children and Adolescents, Maternal-Infantile Department, Salesi Hospital, Ancona, Italy
| | - B Pintaudi
- Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, Via Nazionale, S. Maria Imbaro 66030, CH, Italy
| | - M C Rossi
- Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, Via Nazionale, S. Maria Imbaro 66030, CH, Italy
| | - G Lucisano
- Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, Via Nazionale, S. Maria Imbaro 66030, CH, Italy
| | - F Pellegrini
- Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, Via Nazionale, S. Maria Imbaro 66030, CH, Italy
| | - G Chiumello
- Endocrine Unit, Department of Pediatrics, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milano, Italy
| | - A P Frongia
- Pediatric Division, Brotzu Hospital, Cagliari, Italy
| | - C Monciotti
- Women & Children's Health Department, University of Padova, Padova, Italy
| | - I P Patera
- Department of Pediatrics, Bambino Gesù Hospital, Passoscuro (RM), Roma, Italy
| | - S Toni
- Diabetes Unit, Meyer Children Hospital, Firenze, Italy
| | - S Zucchini
- Department of Pediatrics, S.Orsola-Malpighi Hospital, Bologna, Italy
| | - A Nicolucci
- Department of Clinical Pharmacology and Epidemiology, Fondazione Mario Negri Sud, Via Nazionale, S. Maria Imbaro 66030, CH, Italy.
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Baggetta R, Bolignano D, Torino C, Manfredini F, Aucella F, Barillà A, Battaglia Y, Bertoli S, Bonanno G, Castellino P, Ciurlino D, Cupisti A, D'Arrigo G, De Paola L, Fabrizi F, Fatuzzo P, Fuiano G, Lombardi L, Lucisano G, Messa P, Rapanà R, Rapisarda F, Rastelli S, Rocca-Rey L, Summaria C, Zuccalà A, Abd ElHafeez S, Tripepi G, Catizone L, Mallamaci F, Zoccali C. Fitness for Entering a Simple Exercise Program and Mortality: A Study Corollary to the Exercise Introduction to Enhance Performance in Dialysis (Excite) Trial. Kidney Blood Press Res 2014; 39:197-204. [DOI: 10.1159/000355797] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/02/2023] Open
Abstract
<b><i>Background/Aims: </i></b>In this corollary analysis of the EXCITE study, we looked at possible differences in baseline risk factors and mortality between subjects excluded from the trial because non-eligible (n=216) or because eligible but refusing to participate (n=116). <b><i>Methods: </i></b>Baseline characteristics and mortality data were recorded. Survival and independent predictors of mortality were assessed by Kaplan-Meier and Cox regression analyses. <b><i>Results: </i></b>The incidence rate of mortality was higher in non-eligible vs. eligible non-randomized patients (21.0 vs. 10.9 deaths/100 persons-year; P<0.001). The crude excess risk of death in non-eligible patients (HR 1.96; 95% CI 1.36 to 2.77; P<0.001) was reduced after adjustment for risk factors which differed in the two cohorts including age, blood pressure, phosphate, CRP, smoking, diabetes, triglycerides, cardiovascular comorbidities and history of neoplasia (HR 1.60; 95% CI 1.10 to 2.35; P=0.017) and almost nullified after including in the same model also information on deambulation impairment (HR 1.16; 95% CI 0.75 to 1.80; P=0.513). <b><i>Conclusions: </i></b>Deambulation ability mostly explains the difference in survival rate in non-eligible and eligible non-randomized patients in the EXCITE trial. Extending data analyses and outcome reporting also to subjects not taking part in a trial may be helpful to assess the representability of the study population.
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Seiler S, Lucisano G, Ege P, Fell LH, Rogacev KS, Lerner-Gräber A, Klingele M, Ziegler M, Fliser D, Heine GH. Single FGF-23 measurement and time-averaged plasma phosphate levels in hemodialysis patients. Clin J Am Soc Nephrol 2013; 8:1764-72. [PMID: 23846463 DOI: 10.2215/cjn.13021212] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
BACKGROUND AND OBJECTIVES Plasma phosphate levels display considerable intraindividual variability. The phosphatonin fibroblast growth factor 23 is a central regulator of plasma phosphate levels, and it has been postulated to be a more stable marker than conventional CKD-mineral and bone disorder parameters. Thus, fibroblast growth factor 23 has been hypothesized to reflect time-averaged plasma phosphate levels in CKD patients. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Among 40 patients from the outpatient dialysis center, serial measurements of plasma calcium and phosphate (before every dialysis session) as well as C-terminal fibroblast growth factor 23, parathyroid hormone, and alkaline phosphatase (one time weekly) were performed over a study period of 4 weeks in November and December of 2011. Intraindividual variability of repeated plasma fibroblast growth factor 23 measurements compared with other CKD-mineral and bone disorder markers was tested, and the association of a single plasma fibroblast growth factor 23 measurement with time-averaged plasma phosphate levels was analyzed. RESULTS Against expectations, intraindividual variability of fibroblast growth factor 23 (median coefficient of variation=27%; interquartile range=20-35) was not lower than variability of plasma phosphate (median coefficient of variation=15%; interquartile range=10-20), parathyroid hormone (median coefficient of variation=24%; interquartile range=15-39), plasma calcium (median coefficient of variation=3%; interquartile range=2-4), or alkaline phosphatase (median coefficient of variation=5%; interquartile range=3-10). Moreover, the correlation between the last fibroblast growth factor 23 measurement after 4 weeks and time-averaged plasma phosphate did not surpass the correlation between the last fibroblast growth factor 23 measurement and a single plasma phosphate value (r=0.67, P<0.001; r=0.76, P<0.001, respectively). CONCLUSIONS Surprisingly, fibroblast growth factor 23 was not more closely associated to time-averaged plasma phosphate levels than a single plasma phosphate value, and it did not show a lower intraindividual variability than other tested markers of CKD-mineral and bone disorder. Thus, fibroblast growth factor 23 should not be used in clinical practice as a reflector of time-averaged plasma phosphate levels.
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Affiliation(s)
- Sarah Seiler
- Department for Internal Medicine IV-Nephrology and Hypertension, Saarland University Medical Center, Homburg, Germany, †Psychological Institute, Humboldt-Universität zu Berlin, Berlin, Germany
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Cianci R, Zuccala A, Lucisano G, Barbano B, Martina P, Gigante A, Clemenzia G, Fuiano G. Have We New Therapeutic Strategies in the Treatment of Renovascular Nephropathy? Curr Vasc Pharmacol 2013; 11:531-42. [DOI: 10.2174/1570161111311040017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 03/21/2012] [Accepted: 03/28/2012] [Indexed: 11/22/2022]
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Franciosi M, Lucisano G, Amoretti R, Capani F, Bruttomesso D, Di Bartolo P, Girelli A, Leonetti F, Morviducci L, Vitacolonna E, Nicolucci A. Costs of treatment and complications of adult type 1 diabetes. Nutr Metab Cardiovasc Dis 2013; 23:606-611. [PMID: 22749531 DOI: 10.1016/j.numecd.2012.03.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2011] [Revised: 02/27/2012] [Accepted: 03/01/2012] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Costs associated with diabetes represent a large burden for patients and the health-care system. However, few studies examined the costs for diabetes treatment in adults with type 1 diabetes (T1DM). This analysis was aimed to assess the costs of treatment associated with T1DM among adults in Italy from the national health-care system perspective. METHODS AND RESULTS Data were collected using a questionnaire assessing resource consumption retrospectively (drugs, visits, diagnostics, hospitalisations and self-monitoring of blood glucose (SMBG)). One-year costs were calculated for the 12 months preceding the survey. Cost estimation, referred to 2006, was carried out using univariate and multivariate Poisson regression models. Fifty-eight centres enrolled 1193 patients (49.5% women; aged between 18 and 55 years, average diabetes duration was 16.1 ± 9.8 years). The average annual cost for an adult patient with TDM1 was € 2450 (95% confidence interval (CI): 2358-2544). Insulin therapy and SMBG accounted together for 71.2% of total costs (35.6% and 35.6%, respectively); the remainder was shared by hospitalisations (18%), visits (4.0%), diagnostics (3.9%) and other drugs (2.9%). Univariate analyses showed that the presence of complications was associated with excess of costs, mainly related to the hospitalisation and drugs. Multivariate analyses confirmed these results showing that the presence of micro-vascular plus macrovascular complications doubles the cost of treatment. CONCLUSION Strategies of care for T1DM that can improve disease management and prevent or delay the onset of complications could represent the most important tool to reduce costs in the long term while improving clinical outcomes and quality of life.
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Affiliation(s)
- M Franciosi
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/a, 66030 S. Maria Imbaro (CH), Italy.
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Kim EJ, Han JH, Koo HM, Doh FM, Kim CH, Ko KI, Lee MJ, Oh HJ, Yoo TH, Kang SW, Choi KH, Han SH, Assady S, Tchirkov M, Nasser R, Mashiach T, Ben Izhak O, Housset P, Guillemain R, Nochy D, Roland M, Amrein C, Karras A, Boussaud V, Pezzela V, Thervet E, Simic Ogrizovic SP, Basta Jovanovic G, Radojevic S, Bojic S, Naumovic R, Karim Z, Cyrine K, Rim G, Ezzeddine A, Hafedh H, Hayet K, Soumaya B, Mondher O, Fethi BH, Fethi EY, Taieb BA, Hedi BM, Fatma BM, Adel K, Housset P, Guillemain R, Roland M, Amrein C, Karras A, Boussaud V, Nochy D, Pezzela V, Thervet E, Penescu M, Mandache E, Zumrutdal A, Ozelsancak R, Canpolat T, Barbouch S, Mami I, Mayara M, Jerbi M, Harzallah A, Goucha R, Ben Maiz H, Kedher A, Comi N, Cianfrone P, Piraina V, Talarico R, Giannakakis K, Fuiano G, Lucisano G, Konat K, Szotowska M, Karkoszka H, Adamczak M, Wiecek A, Kwiecien K, Jercan O, Penescu M, Mogoanta L, Miller I, Pan X, Xu J, Ren H, Zhang W, Xu Y, Shen P, Chen X, Feng X, Chen N. Renal histopathology. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Borras M, Roig J, Betriu A, Vilar A, Hernandez M, Martin M, Fernandez ED, Dounousi E, Kiatou V, Papagianni A, Zikou X, Pappas K, Pappas E, Tatsioni A, Tsakiris D, Siamopoulos KC, Kim JK, Kim Y, Kim SG, Kim HJ, Ahn SY, Chin HJ, Oh KH, Ahn C, Chae DW, Yazici R, Altintepe L, Bakdik S, Guney I, Arslan S, Topal M, Karagoz A, Stefan G, Mircescu G, Capusa C, Stancu S, Petrescu L, Alecu S, Nedelcu D, Bennett AHL, Pham H, Garrity M, Magdeleyns E, Vermeer C, Zhang M, Ni Z, Zhu M, Yan J, Mou S, Wang Q, Qian J, Saade A, Karavetian M, ElZein H, de Vries N, de Haseth DE, Lay Penne E, van Dam B, Bax WA, Bots ML, Grooteman MPC, van den Dorpel RA, Blankenstijn PJ, Nube MJ, Wee PM, Park JH, Jo YI, Lee JH, Cianfrone P, Comi N, Lucisano G, Piraina V, Talarico R, Fuiano G, Toyonaga M, Fukami K, Yamagishi SI, Kaida Y, Nakayama Y, Ando R, Obara N, Ueda S, Okuda S, Granatova J, Havrda M, Hruskova Z, Tesar V, Viklicky O, Rysava R, Rychlik I, Kratka K, Honsova E, Vernerova Z, Maluskova J, Vranova J, Bolkova M, Borecka K, Benakova H, Zima T, Lu KC, Yang HY, Su SL, Cao YH, Lv LL, Liu BC, Zeng R, Gao XF, Deng YY, Boelaert J, t' Kindt R, Glorieux G, Schepers E, Jorge L, Neirynck N, Lynen F, Sandra P, Sandra K, Vanholder R, Yamamoto T, Nameta M, Yoshida Y, Uhlen M, Shi Y, Tang J, Zhang J, An Y, Liao Y, Li Y, Tao Y, Wang L, Koibuchi K, Tanaka K, Aoki T, Miyagi M, Sakai K, Aikawa A, Martins AR, Branco PQ, Serra FM, Matias PJ, Lucas CP, Adragao T, Duarte J, Oliveira MM, Saraiva AM, Barata JD, Masola V, Zaza G, Granata S, Proglio M, Pontrelli P, Abaterusso C, Schena F, Gesualdo L, Gambaro G, Lupo A, Pruijm M, Hofmann L, Stuber M, Zweiacker C, Piskunowicz M, Muller ME, Vogt B, Burnier M, Togashi N, Yamashita T, Mita T, Ohnuma Y, Hasegawa T, Endo T, Tsuchida A, Ando T, Yoshida H, Miura T, Bevins A, Assi L, Ritchie J, Jesky M, Stringer S, Kalra P, Hutchison C, Harding S, Cockwell P, Viccica G, Cupisti A, Chiavistelli S, Borsari S, Pardi E, Centoni R, Fumagalli G, Cetani F, Marcocci C, Scully P, O'Flaherty D, Sankaralingam A, Hampson G, Goldsmith DJ, Pallet N, Chauvet S, Beaune P, Nochy D, Thervet E, Karras A, Bertho G, Gallyamov MG, Saginova EA, Severova MM, Krasnova TN, Kopylova AA, Cho E, Jo SK, Kim MG, Cho WY, kim HK, Trivin C, Metzger M, Boffa JJ, Vrtovsnik F, Houiller P, Haymann JP, Flamant M, Stengel B, Thervet E, Roozbeh J, Yavari V, Pakfetrat M, Zolghadr AA, Kim CS, Kim MJ, Kang YU, Choi JS, Bae EH, Ma SK, Kim SW, Lemoine S, Guebre-Egziabher F, Dubourg L, Hadj-Aissa A, Blumberg S, Katzir Z, Biro A, Cernes R, Barnea Z, Vasquez D, Gordillo R, Aller C, Fernandez B, Jabary N, Perez V, Mendiluce A, Bustamante J, Coca A, Goek ON, Sekula P, Prehn C, Meisinger C, Gieger C, Suhre K, Adamski J, Kastenmuller G, Kottgen A, Kuzniewski M, Fedak D, Dumnicka P, Solnica B, Kusnierz-Cabala B, Kapusta M, Sulowicz W, Drozdz R, Zawada AM, Rogacev KS, Hummel B, Fliser D, Geisel J, Heine GH, Kretschmer A, Volsek M, Krahn T, Kolkhof P, Kribben A, Bruck H, Koh ES, Chung S, Yoon HE, Park CW, Chang YS, Shin SJ, Deagostini MC, Vigotti FN, Ferraresi M, Consiglio V, Scognamiglio S, Moro I, Clari R, Daidola G, Versino E, Piccoli GB, Mammadrahim Agayev M, Mehrali Mammadova I, Qarib Ismayilova S, Anguiano L, Riera M, Pascual J, Barrios C, Betriu A, Valdivielso JM, Fernandez E, Soler MJ, Tsarpali V, Liakopoulos V, Panagopoulou E, Kapoukranidou D, Spaia S, Kostopoulou M, Michalaki A, Nikitidou O, Dombros N, Zhu F, Abba S, Flores-Gama C, Williams C, Cartagena C, Carter M, Kotanko P, Levin NW, Kolesnyk M, Stepanova N, Driyanska V, Stashevska N, Kundin V, Shifris I, Dudar I, Zaporozhets O, Keda T, Ishchenko M, Khil M, Choe JY, Nam SA, Kim J, Cha JH, Gliga ML, Irimescu CG, Caldararu CD, Gliga MG, Toma LV, Gomotarceanu A, Park Y, Kim Y, Jeon J, Kwon SK, Kim SJ, Kim SM, Kim HY, Montero N, Soler MJ, Barrios C, Marquez E, Berrada A, Arias C, Prada JA, Orfila MA, Mojal S, Vilaplana C, Pascual J, Vigotti FN, Attini R, Parisi S, Fassio F, Deagostini MC, Ghiotto S, Ferraresi M, Clari R, Biolcati M, Todros T, Piccoli GB, Jin K, Vaziri ND, Tramonti G, Romiti N, Chieli E, Maksudova AN, Khusnutdinova LA, Tang J, Shi Y, Zhang J, Li Y, An Y, Tao Y, Wang L, Reque JE, Quiroga B, Lopez JM, Verdallez UG, Garcia de Vinuesa M, Goicoechea M, Nayara PG, Arroyo DR, Luno J, Tanaka H, Flores-Gama C, Abbas SR, Williams C, Cartagena C, Carter M, Thijssen S, Kotanko P, Levin NW, Zhu F, Berthoux FC, Azzouz L, Afiani A, Ziane A, Mariat C, Fournier H, Kusztal M, Dzierzek P, Witkowski G, Nurzynski M, Golebiowski T, Weyde W, Klinger M, Altiparmak MR, Seyahi N, Trabulus S, Bolayirli M, Andican ZG, Suleymanlar G, Serdengecti K, Niculae A, Checherita IA, Neagoe DN, Ciocalteu A, Seiler S, Rogacev KS, Pickering JW, Emrich I, Fliser D, Heine G, Bargnoux AS, Obiols J, Kuster N, Fessler P, Badiou S, Dupuy AM, Ribstein J, Cristol JP, Yanagisawa N, Ando M, Ajisawa A, Tsuchiya K, Nitta K, Bouquegneau A, Cavalier E, Krzesinski JM, Delanaye P, Tominaga N, Shibagaki Y, Kida K, Miyake F, Kimura K, Ayvazyan A, Rameev V, Kozlovskaya L, Simonyan A, Scholze A, Marckmann P, Tepel M, Rasmussen LM, Hara M, Ando M, Tsuchiya K, Nitta K, Kanai H, Harada K, Tamura Y, Kawai Y, Al-Jebouri MM, Madash SA, Leonidovna Berezinets O, Nicolaevich Rossolovskiy A. Lab methods / biomarkers. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft108] [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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Bantis C, Heering P, Kouri NM, Siekierka-Harreis M, Stangou M, Schwandt C, Efstratiadis G, Rump LC, Ivens K, Haddiya I, Houssaini Squalli T, Laouad I, Ramdani B, Bayahia R, Dimas GG, Tegos TJ, Spiroglou SG, Pitsalidis CG, Sioulis AS, Karamouzis IM, Savopoulos CG, Karamouzis MI, Orologas AG, Hatzitolios AI, Grekas DM, Maixnerova D, Jancova E, Rychlik I, Rysava R, Merta M, Reiterova J, Kolsky A, Honsova E, Skibova J, Tesar V, Kendi Celebi Z, Calayoglu R, Keven K, Kurultak I, Mescigil P, Erbay B, Karatan O, Duman N, Erturk S, Nergizoglu G, Kutlay S, Sengul S, Ates K, Marino F, Martorano C, Bellantoni M, Tripepi R, Zoccali C, Ishizuka K, Harita Y, Kajiho Y, Tsurumi H, Asano T, Nishiyama K, Sugawara N, Chikamoto H, Akioka Y, Yamaguchi Y, Igarashi T, Hattori M, Bantis C, Heering PJ, Kouri NM, Stangou M, Siekierka-Harreis M, Efstratiadis G, Rump LC, Ivens K, Sahay M, Monova DV, Monov SV, Wang YY, Cheng H, Wang GQ, Dong HR, Chen YP, Wang CJ, Tang YL, Buti E, Dervishi E, Bergesio F, Ghiandai G, Mjeshtri A, Paudice N, Caldini AL, Nozzoli C, Minetti EE, Sun L, Feng J, Yao L, Fan Q, Ma J, Wang L, Kirsanova T, Merkusheva L, Ruinihina N, Kozlovskaya N, Elenshleger G, Turgutalp K, Karabulut U, Ozcan T, Helvaci I, Kiykim A, Kaul A, Bhadhuaria D, sharma R, Prasad N, Gupta A, Clajus C, Schmidt J, Haller H, Kumpers P, David S, Sevillano AM, Molina M, Gutierrez E, Morales E, Gonzalez E, Hernandez E, Praga M, Conde Olasagasti JL, Vozmediano Poyatos C, Illescas ML, Tallon S, Uson Carrasco JJ, Roca Munoz A, Rivera Hernandez F, Ismail G, Jurubita R, Andronesi A, Bobeica R, Zilisteanu D, Rusu E, Achim C, Sevillano AM, Molina M, Gutierrez E, Morales E, Huerta A, Hernandez E, Caro J, Gutierrez-Solis E, Praga M, Pasquariello A, Pasquariello G, Innocenti M, Grassi G, Egidi MF, Ozturk O, Yildiz A, Gul CB, Dilek K, Monov SV, Monova DV, Tylicki L, Jakubowska A, Weber E, Lizakowski S, Swietlik D, Rutkowski B, Postorino A, Costa S, Cristadoro S, Magazzu G, Bellinghieri G, Savica V, Buemi M, Santoro D, Lu Y, Shen P, Li X, Xu Y, Pan X, Wang W, Chen X, Zhang W, Ren H, Chen N, Mitic BP, Cvetkovic T, Vlahovic P, Velickovic Radovanovic R, Stefanovic V, Kostic S, Djordjevic V, Ao Q, Ma Q, Cheng Q, Wang X, Liu S, Zhang R, Ozturk S, Ozmen S, Akin D, Danis R, Yilmaz M, Hajri S, Barbouche S, Okpa H, Oviasu E, Ojogwu L, Fotouhi N, Ghaffari A, Hamzavi F, Nasri H, Ardalan M, Stott A, Ullah A, Anijeet H, Ahmed S, Kohli HS, Rajachandran R, Rathi M, Jha V, Sakhuja V, Yenigun E, Dede F, Turgut D, Koc E, Akoglu H, Piskinpasa S, Ozturk R, Odabas A, Bajcsi D, Abraham G, Kemeny E, Sonkodi S, Legrady P, Letoha A, Constantinou K, Ondrik Z, Ivanyi B, Lucisano G, Comi N, Cianfrone P, Summaria C, Piraina V, Talarico R, Camastra C, Fuiano G, Proletov I, Saganova E, Galkina O, Bogdanova E, Zubina I, Sipovskii V, Smirnov A, Bailly E, Pierre D, Kerdraon R, Grezard O, Gnappi E, Delsante M, Galetti M, Maggiore U, Manenti L, Hasan MJ, Muqueet MA, Mostafi M, Chowdhury I, Haque W, Khan T, Kang YJ, Bae EJ, Cho HS, Chang SH, Park DJ, Li X, Xu G, Lin H, Hu Z, Yu X, Xing C, Mei C, Zuo L, Ni Z, Ding X, Li D, Chen N, Ren H, Shen P, Li X, Pan X, Zhang Q, Feng X, Lin L, Zhang W, Chen N. Clinical nephrology - miscellaneous. Nephrol Dial Transplant 2013. [DOI: 10.1093/ndt/gft140] [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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De Berardis G, D'Ettorre A, Graziano G, Lucisano G, Pellegrini F, Cammarota S, Citarella A, Germinario CA, Lepore V, Menditto E, Nicolosi A, Vitullo F, Nicolucci A. The burden of hospitalization related to diabetes mellitus: a population-based study. Nutr Metab Cardiovasc Dis 2012; 22:605-612. [PMID: 21333508 DOI: 10.1016/j.numecd.2010.10.016] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/19/2010] [Revised: 10/15/2010] [Accepted: 10/22/2010] [Indexed: 11/19/2022]
Abstract
BACKGROUND AND AIMS To estimate the impact of diabetes and its complications, overall and in different age classes, on the likelihood of hospital admission for specific causes. METHODS AND RESULTS We carried out a record-linkage analysis of administrative registers including data on 8,940,420 citizens in 21 Local Health Authorities in Italy. Individuals with pharmacologically treated diabetes (≥2 prescriptions of antidiabetic agents during the year 2008) were paired in a 1:1 proportion with those who did not receive such drugs (controls) based on propensity-score matching. Odds Ratios (ORs) of hospitalization for macro and microvascular conditions in individuals with diabetes as compared to controls were estimated. The system identified 498,825 individuals with diabetes pharmacologically treated (prevalence of 5.6%). Prevalence of diabetes in people aged <14 years, 14-39 years, 40-65 years, and ≥65 years was 0.1%, 0.6%, 6.4%, and 18.2%, respectively. Overall, 23.9% of subjects with diabetes and 11.5% of controls had had at least a hospital admission during 12 months for the causes considered. Diabetes increased the likelihood of hospitalization by two to six times for the different causes examined. In absolute terms, diabetes was responsible for an excess of over 12,000 hospital admissions per 100,000 individuals/year. CONCLUSION Despite the availability of effective treatments to prevent or delay major complications, diabetes still places an enormous burden on both patients and the health care system. Given the continuous rise in diabetes prevalence both in middle-aged and elderly individuals, we can expect an additional, hardly sustainable increase in the demand for health care in the near future.
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Affiliation(s)
- G De Berardis
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, Via Nazionale 8/a, S. Maria Imbaro, Italy
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Coentrao L, Ribeiro C, Santos-Araujo C, Neto R, Pestana M, Kleophas W, Kleophas W, Karaboyas A, LI Y, Bommer J, Pisoni R, Robinson B, Port F, Celik G, Burcak Annagur B, Yilmaz M, Demir T, Kara F, Trigka K, Dousdampanis P, Vaitsis N, Aggelakou-Vaitsi S, Turkmen K, Guney I, Turgut F, Altintepe L, Tonbul HZ, Abdel-Rahman E, Sclauzero P, Galli G, Barbati G, Carraro M, Panzetta GO, Van Diepen M, Schroijen M, Dekkers O, Dekker F, Sikole A, Severova- Andreevska G, Trajceska L, Gelev S, Amitov V, Pavleska- Kuzmanovska S, Karaboyas A, Rayner H, LI Y, Vanholder R, Pisoni R, Robinson B, Port F, Hecking M, Jung B, Leung M, Huynh F, Chung T, Marchuk S, Kiaii M, Er L, Werb R, Chan-Yan C, Beaulieu M, Malindretos P, Makri P, Zagkotsis G, Koutroumbas G, Loukas G, Nikolaou E, Pavlou M, Gourgoulianni E, Paparizou M, Markou M, Syrgani E, Syrganis C, Raimann J, Usvyat LA, Bhalani V, Levin NW, Kotanko P, Huang X, Stenvinkel P, Qureshi AR, Riserus U, Cederholm T, Barany P, Heimburger O, Lindholm B, Carrero JJ, Chang JH, Sung JY, Jung JY, Lee HH, Chung W, Kim S, Han JS, Kim S, Chang JH, Jung JY, Chung W, Na KY, Raimann J, Usvyat LA, Kotanko P, Levin NW, Fragoso A, Pinho A, Malho A, Silva AP, Morgado E, Leao Neves P, Joki N, Tanaka Y, Iwasaki M, Kubo S, Hayashi T, Takahashi Y, Hirahata K, Imamura Y, Hase H, Castledine C, Gilg J, Rogers C, Ben-Shlomo Y, Caskey F, Na KY, Kim S, Chung W, Jung JY, Chang JH, Lee HH, Sandhu JS, Bajwa GS, Kansal S, Sandhu J, Jayanti A, Nikam M, Ebah L, Summers A, Mitra S, Agar J, Perkins A, Simmonds R, Tjipto A, Amet S, Launay-Vacher V, Laville M, Tricotel A, Frances C, Stengel B, Gauvrit JY, Grenier N, Reinhardt G, Clement O, Janus N, Rouillon L, Choukroun G, Deray G, Bernasconi A, Waisman R, Montoya AP, Liste AA, Hermes R, Muguerza G, Heguilen R, Iliescu EL, Martina V, Rizzo MA, Magenta P, Lubatti L, Rombola G, Gallieni M, Loirat C, Loirat C, Mellerio H, Labeguerie M, Andriss B, Savoye E, Lassale M, Jacquelinet C, Alberti C, Aggarwal Y, Baharani J, Tabrizian S, Ossareh S, Zebarjadi M, Azevedo P, Travassos F, Frade I, Almeida M, Queiros J, Silva F, Cabrita A, Rodrigues R, Couchoud C, Kitty J, Benedicte S, Fergus C, Cecile C, Couchoud C, Sahar B, Emmanuel V, Christian J, Rene E, Barahimi H, Mahdavi-Mazdeh M, Nafar M, Petruzzi M, De Benedittis M, Sciancalepore M, Gargano L, Natale P, Vecchio MC, Saglimbene V, Pellegrini F, Gentile G, Stroumza P, Frantzen L, Leal M, Torok M, Bednarek A, Dulawa J, Celia E, Gelfman R, Hegbrant J, Wollheim C, Palmer S, Johnson DW, Ford PJ, Craig JC, Strippoli GF, Ruospo M, El Hayek B, Hayek B, Baamonde E, Bosch E, Ramirez JI, Perez G, Ramirez A, Toledo A, Lago MM, Garcia-Canton C, Checa MD, Canaud B, Canaud B, Lantz B, Pisoni R, Granger-Vallee A, Lertdumrongluk P, Molinari N, Ethier J, Jadoul M, Gillespie B, Port F, Bond C, Wang S, Alfieri T, Braunhofer P, Newsome B, Wang M, Bieber B, Guidinger M, Bieber B, Wang M, Zuo L, Pisoni R, Yu X, Yang X, Qian J, Chen N, Albert J, Yan Y, Ramirez S, Bernasconi A, Waisman R, Beresan M, Lapidus A, Canteli M, Heguilen R, Tong A, Palmer S, Manns B, Craig J, Ruospo M, Gargano L, Strippoli G, Mortazavi M, Vahdatpour B, Shahidi S, Ghasempour A, Taheri D, Dolatkhah S, Emami Naieni A, Ghassami M, Khan M, Abdulnabi K, Pai P, Ruospo M, Petruzzi M, De Benedittis M, Sciancalepore M, Gargano L, Vecchio M, Saglimbene V, Natale P, Pellegrini F, Gentile G, Stroumza P, Frantzen L, Leal M, Torok M, Bednarek A, Dulawa J, Celia E, Gelfman R, Hegbrant J, Wollheim C, Palmer S, Johnson DW, Ford PJ, Craig JC, Strippoli GF, Muqueet MA, Muqueet MA, Hasan MJ, Kashem MA, Dutta PK, Liu FX, Noe L, Quock T, Neil N, Inglese G, Qian J, Bieber B, Guidinger M, Bieber B, Chen N, Yan Y, Pisoni R, Wang M, Zuo L, Yu X, Yang X, Wang M, Albert J, Ramirez S, Ossareh S, Motamed Najjar M, Bahmani B, Shafiabadi A, Helve J, Haapio M, Groop PH, Gronhagen-Riska C, Finne P, Helve J, Haapio M, Sund R, Groop PH, Gronhagen-Riska C, Finne P, Cai M, Baweja S, Clements A, Kent A, Reilly R, Taylor N, Holt S, Mcmahon L, Usvyat LA, Carter M, Van der Sande FM, Kooman J, Raimann J, Levin NW, Kotanko P, Usvyat LA, Malhotra R, Ouellet G, Penne EL, Raimann J, Thijssen S, Levin NW, Kotanko P, Etter M, Tashman A, Guinsburg A, Grassmann A, Barth C, Marelli C, Marcelli D, Van der Sande FM, Von Gersdorff G, Bayh I, Kooman J, Scatizzi L, Lam M, Schaller M, Thijssen S, Toffelmire T, Wang Y, Sheppard P, Usvyat LA, Levin NW, Kotanko P, Neri L, Andreucci VA, Rocca-Rey LA, Bertoli SV, Brancaccio D, Tjipto A, Simmonds R, Agar J, Huang X, Stenvinkel P, Qureshi AR, Riserus U, Cederholm T, Barany P, Heimburger O, Lindholm B, Carrero JJ, Vecchio M, Palmer S, De Berardis G, Craig J, Lucisano G, Johnson D, Pellegrini F, Nicolucci A, Sciancalepore M, Saglimbene V, Gargano L, Bonifati C, Ruospo M, Navaneethan SD, Montinaro V, Stroumza P, Zsom M, Torok M, Celia E, Gelfman R, Bednarek-Skublewska A, Dulawa J, Graziano G, Gentile G, Ferrari JN, Santoro A, Zucchelli A, Triolo G, Maffei S, Hegbrant J, Wollheim C, De Cosmo S, Manfreda VM, Strippoli GF, Janus N, Janus N, Launay-Vacher V, Juillard L, Rousset A, Butel F, Girardot-Seguin S, Deray G, Hannedouche T, Isnard M, Berland Y, Vanhille P, Ortiz JP, Janin G, Nicoud P, Touam M, Bruce E, Rouillon L, Laville M, Janus N, Juillard L, Rousset A, Butel F, Girardot-Seguin S, Deray G, Hannedouche T, Isnard M, Berland Y, Vanhille P, Ortiz JP, Janin G, Nicoud P, Touam M, Bruce E, Rouillon L, Laville M, Janus N, Launay-Vacher V, Juillard L, Rousset A, Butel F, Girardot-Seguin S, Deray G, Hannedouche T, Isnard M, Berland Y, Vanhille P, Ortiz JP, Janin G, Nicoud P, Touam M, Bruce E, Rouillon L, Laville M, Grace B, Clayton P, Cass A, Mcdonald S, Baharani J, Furumatsu Y, Kitamura T, Fujii N, Ogata S, Nakamoto H, Iseki K, Tsubakihara Y, Chien CC, Wang JJ, Hwang JC, Wang HY, Kan WC, Kuster N, Kuster N, Patrier L, Bargnoux AS, Morena M, Dupuy AM, Badiou S, Canaud B, Cristol JP, Desmet JM, Fernandes V, Collart F, Spinogatti N, Pochet JM, Dratwa M, Goffin E, Nortier J, Zilisteanu DS, Voiculescu M, Rusu E, Achim C, Bobeica R, Balanica S, Atasie T, Florence S, Anne-Marie S, Michel L, Cyrille C, Emmanuel V, Strakosha A, Strakosha A, Pasko N, Kodra S, Thereska N, Lowney A, Lowney E, Grant R, Murphy M, Casserly L, O' Brien T, Plant WD, Radic J, Radic J, Ljutic D, Kovacic V, Radic M, Dodig-Curkovic K, Sain M, Jelicic I, Fujii N, Hamano T, Nakano C, Yonemoto S, Okuno A, Katayama M, Isaka Y, Nordio M, Limido A, Postorino M, Nichelatti M, Khil M, Dudar I, Khil V, Shifris I, Momtaz M, Soliman AR, El Lawindi MI, Dzekova-Vidimliski P, Pavleska-Kuzmanovska S, Trajceska L, Nikolov I, Selim G, Gelev S, Amitov V, Sikole A, Shoji T, Kakiya R, Hayashi T, Tatsumi-Shimomura N, Tsujimoto Y, Tabata T, Shima H, Mori K, Fukumoto S, Tahara H, Koyama H, Emoto M, Ishimura E, Nishizawa Y, Inaba M. Epidemiology and outcome research in CKD 5D. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs227] [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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Satoh M, Terata S, Kikuya M, Ohkubo T, Hashimoto T, Hara A, Hirose T, Obara T, Metoki H, Inoue R, Asayama K, Nakayama M, Kanno A, Totsune K, Hoshi H, Satoh H, Sato H, Imai Y, Palmer S, Germaine W, Iff S, Craig J, Mitchell P, Wang JJ, Strippoli G, Palmer S, Craig J, Navaneethan S, Tonelli M, Pellegrini F, Strippoli G, Stracke S, Ernst F, Robinson D, Schwahn C, John U, Felix SB, Volzke H, Mysula I, Gozhenko A, Susla O, Minutolo R, Gabbai FB, Agarwal R, Bellizzi V, Nappi F, Conte G, De Nicola L, Smith E, Tomlinson L, Ford M, Mcmahon L, Rajkumar C, Holt S, Lee S, Kim I, Lee D, Rhee H, Song S, Seong E, Kwak I, Redal-Baigorri B, Rasmusen K, Goya Heaf J, Sombolos K, Tsakiris D, John B, Vlahakos D, Siamopoulos K, Vargiemezis V, Nikolaidis P, Iatrou C, Dafnis E, Argyropoulos C, Xynos K, Ramona H, Jos D, Guido F, Patrick D, Dominique L, Begona MYK, Antoon DS, Marc VS, Hellberg M, Wiberg EM, Hoglund P, Simonsen O, Clyne N, Manfredini F, Manfredini F, Bolignano D, Rastelli S, Barilla A, Bertoli S, Ciurlino D, Messa P, Fabrizi F, Zuccala A, Rapana R, Fatuzzo P, Rapisarda F, Bonanno G, Lombardi L, De Paola L, Cupisti A, Fuiano G, Lucisano G, Tripepi G, Catizone L, Zoccali C, Mallamaci F, Ishigami T, Ishigami T, Yamamoto R, Nagasawa Y, Isaka Y, Konta T, Iseki K, Moriyama T, Yamagata K, Tsuruya K, Yoshida H, Fujimoto S, Asahi K, Watanabe T, Morales E, Gutierrez E, Forteza A, Bellot R, Sanchez V, Sanz MP, Evangelista A, Cortina J, Praga M, Hung CC, Yang ML, Hwang SJ, Chen HC, Saglimbene VM, Palmer S, Craig J, Pellegrini F, Vecchio M, Ruospo M, De Berardis G, Strippoli G, DI Iorio B, Bellasi A, Pota A, Russo L, Russo D, Nakano C, Nakano C, Hamano T, Fujii N, Obi Y, Matsui I, Mikami S, Inoue K, Shimomura A, Rakugi H, Isaka Y, Yen CY, Wang HH, Hung CC, Hwang SJ, Chen HC, Postorino M, Postorino M, Cutrupi S, Pizzini P, Marino C, D'arrigo G, Tripepi G, Zoccali C, Ghasemi H, Afshar R, Afshar R, Shabpirai H, Davati A, Zerafatjou N, Abdi S, Khorsand Askari M, Almeida E, Lavinas C, Teixeira C, Raimundo M, Nogueira C, Ferreira M, Sampaio A, Henriques I, Teixeira C, Gomes Da Costa A, Leal M, Ekart R, Hojs N, Pecovnik Balon B, Bevc S, Dvorsak B, Stropnik Galuf T, Hojs R, Lin WH, Guo CY, Wang WM, Yang DC, Kuo TH, Liu MF, Wang MC, Hara S, Tanaka K, Tsuji H, Ohmoto Y, Amaka K, Ubara Y, Arase K, Yilmaz MI, Solak Y, Saglam M, Yaman H, Unal HU, Gok M, Cetinkaya H, Biyik Z, Gaipov A, Caglar K, Tonbul HZ, Turk S, Wang HH, Yen CY, Hung CC, Hwang SJ, Chen HC, Krivoshiev S, Krivoshiev S, Koteva A, Kraev Z, Mihaylov G, Shikov P, David R, Jeffrey J, Andrew S, Michael R, Charmot D, Fouda R, Abdelhamid Y, Alsayed D, Salah S, Belal D, Salem M, Ahmed H, Vecchio M, Palmer S, Saglimbene VM, Ruospo M, Gargano L, Pellegrini F, Strippoli G, Tisljar M, Horvatic I, Bozic B, Crnjakovic Palmovic J, Bacalja J, Bulimbasic S, Galesic Ljubanovic D, Galesic K, Choi JS, Kim CS, Park JW, Bae EH, MA SK, Kim SW, Choi JS, Kim CS, Park JW, Bae EH, MA SK, Kim SW. Clinical Nephrology - Epidemiology I. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs216] [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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Block G, Bell* G, Pickthorn K, Huang S, Martin K, Tentori F, Bieber B, Morgenstern H, Jacobson S, Andreucci V, Fukagawa M, Mendelssohn D, Pisoni R, Robinson B, De Schutter T, Neven E, Behets G, Peter M, Steppan S, Passlick-Deetjen J, D'haese P, Senatore F, Manning A, Nakajima S, Ushirogawa Y, Tsuda K, Egawa H, Lucisano G, Seiler S, Ege P, Romero de Vorsmann F, Klingele M, Lerner-Graber AK, Fliser D, Heine GH, Molony D, Bellasi A, Bellizzi V, Russo D, DI Iorio B. Bone and mineral diseases - 2. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Marie-Lucile F, Laure-Helene N, Yosr C, Anne M, Fadi F, Levi C, Levi C, Meas-Yedid V, Daniliuc C, Karras A, Olivo-Marin JC, Mouthon L, Guiard E, Roland M, Guillevin L, Jacquot C, Nochy D, Thervet E, Chen Q, Skerka C, Uzonyi B, Lindner S, Licht C, Hoppe B, Riedl M, Kirschfink M, Habbich S, Wolf G, Strain L, Goodship TH, Zipfel PF, Kfoury H, Alsuwaida A, Alsaad K, Alhejaili F, Alghonaim M, Alwakeel J, Husain S, Aloudah N, Besso L, Besso L, Tamagnone M, Daidola G, Burdese M, Repetto L, Pasquale G, Colla L, Biancone L, Stratta P, Segoloni GP, Bacalja J, Bauer Segvic AM, Bulimbasic S, Pacic A, Knotek M, Sabljar Matovinovic M, Galesic K, Galesic Ljubanovic D, Zakharova E, Stolyarevich E, Vorobjova O, Tamouza H, Chemouny JM, Flamant M, Raskova Kafkova L, Demion M, Laurent M, Walker F, Julian BA, Tissandie E, Tiwari MK, Novak J, Camara NO, Benhamou M, Vrtovsnik F, Monteiro RC, Moura IC, Samavat S, Ahmadpoor P, Torbati P, Ghaderi R, Poorrezagholi F, Samadian F, Nafar M, MII A, MII A, Shimizu A, Kaneko T, Yasuda F, Fukui M, Masuda Y, Iino Y, Katayama Y, Muller C, Markovic-Lipkovski J, Simic-Ogrizovic S, Naumovic R, Cirovic S, Mitrovic D, Muller G, Wozniak A, Janicka-Jedynska M, Zurawski J, Kaczmarek E, Zachwieja J, Khilji S, Khilji S, Dorman T, O'kelly P, Lampty L, Leung K, Shadivan A, Varghese C, Walshe J, Saito T, Kawano M, Saeki T, Mizushima I, Yamaguchi Y, Imai N, Nakashima H, Umehara H, Shvetsov M, Popova O, Chebotareva N, Ivanov A, Bobkova I, Cremasco D, Ceol M, Peruzzi L, Mazzucco G, Giuseppina M, Vezzoli G, Cristofaro R, D'angelo A, Anglani F, Del Prete D, Coppolino G, Comi N, Bolignano D, Piraina V, Talarico R, Colombo A, Lucisano G, Fuiano G, Bernich P, Lupo A, Of Renal Biopsies TR, Rastaldi MP, Jercan OC, Messa P, Alexandru D, Mogoanta L, Jercan OC, Shvetsov M, Ivanov A, Uribe Villegas V, Popova O. Renal histopathology. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Seiler S, Colbus SM, Lucisano G, Rogacev KS, Gerhart MK, Ziegler M, Fliser D, Heine GH. Ultrasound renal resistive index is not an organ-specific predictor of allograft outcome. Nephrol Dial Transplant 2012; 27:3315-20. [DOI: 10.1093/ndt/gfr805] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Lucisano G, Capria M, Matera G, Presta P, Comi N, Talarico R, Rametti L, Quirino A, Giancotti A, Fuiano G. Coupled plasma filtration adsorption for the treatment of a patient with acute respiratory distress syndrome and acute kidney injury: a case report. NDT Plus 2011; 4:285-8. [PMID: 25984170 PMCID: PMC4421728 DOI: 10.1093/ndtplus/sfr081] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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: 03/12/2011] [Accepted: 06/06/2011] [Indexed: 11/16/2022] Open
Abstract
Coupled plasma filtration adsorption (CPFA) is an extracorporeal blood purification therapy based on non-specific pro- and anti-inflammatory mediator adsorption on a special resin cartridge coupled with continuous veno-venous haemofiltration or continuous veno-venous haemodiafiltration and is one of the emerging treatments for septic patients. However, in the literature, there are limited data about its efficacy in treating patients with acute diseases but without the traditional criteria for sepsis. We describe the case of a 43-year-old male who developed acute respiratory distress syndrome secondary to pneumonia and acute kidney injury, whose clinical conditions rapidly improved after early CPFA therapy.
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Affiliation(s)
- Gaetano Lucisano
- Nephrology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Maria Capria
- Nephrology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Giovanni Matera
- Microbiology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Pierangela Presta
- Nephrology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Nicolino Comi
- Nephrology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Roberta Talarico
- Nephrology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Linda Rametti
- Microbiology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Angela Quirino
- Microbiology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Aida Giancotti
- Microbiology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
| | - Giorgio Fuiano
- Nephrology Unit, 'Magna Graecia' University of Catanzaro, Catanzaro, Italy
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Franciosi M, Lucisano G, Pellegrini F, Cantarello A, Consoli A, Cucco L, Ghidelli R, Sartore G, Sciangula L, Nicolucci A. ROSES: role of self-monitoring of blood glucose and intensive education in patients with Type 2 diabetes not receiving insulin. A pilot randomized clinical trial. Diabet Med 2011; 28:789-96. [PMID: 21342243 DOI: 10.1111/j.1464-5491.2011.03268.x] [Citation(s) in RCA: 111] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To estimate the efficacy of a self-monitoring-based disease management strategy in patients with Type 2 diabetes treated with oral agent monotherapy. METHODS This was an open-label, randomized, pilot study, primarily led by diabetes nurses. Patients were randomly allocated to either a self-monitoring-based disease management strategy or usual care (ratio 3:1) and followed up for 6 months. Education was centred on how to modify lifestyle according self-monitoring readings. Self-monitoring of blood glucose results were discussed during monthly telephone contact. The primary endpoint was mean change in HbA(1c) levels, estimated with an ANOVA for repeated measures. All analyses were intention to treat. RESULTS Three diabetic clinics recruited 62 patients, of whom five were lost to follow-up. At baseline, both groups had a mean HbA(1c) value of 7.9% ± 0.6% (63 ± 6 mmol/mol). After 6 months, mean HbA(1c) reduction was 1.2 ± 0.1% (-13 ± 1 mmol/mol) in the intervention group and 0.7 ± 0.2 (-8 ± 2 mmol/mol) in the control group, with an absolute mean difference between groups of -0.5% (95% CI -0.9 to -0.0%; P = 0.04) (-5 mmol/mol, 95% CI -10 to 0). At study end, 61.9% of patients in the intervention group and 20.0% in the control group reached the target level of HbA(1c) < 7.0% (< 53 mmol/mol) (P = 0.005). Body weight reduction was significantly greater in the intervention group than in the control group (between-group absolute mean difference: -3.99 kg; 95% CI -7.26 to -0.73; P = 0.02). Therapy changes were more frequent in the control group. CONCLUSIONS A self-monitoring disease management strategy, primarily led by diabetes nurses and allowing a timely and efficient use of self-monitoring readings, is able to improve metabolic control, primarily through lifestyle modifications leading to weight loss.
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Affiliation(s)
- M Franciosi
- Department of Clinical Pharmacology and Epidemiology, Consorzio Mario Negri Sud, S. Maria Imbaro, Italy
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Seiler S, Cremers B, Ege P, Fehrenz M, Hornof F, Jeken J, Kersting S, Rebling NM, Steimle C, Rogacev KS, Scheller B, Bohm M, Fliser D, Heine GH, Nagler EVT, Webster AC, Vanholder R, Zoccali C, Nagler EVT, Webster AC, Vanholder R, Zoccali C, Chinnappa S, Mooney A, El Nahas M, Tan LB, Lucisano G, Bova F, Presta P, Caglioti C, Caglioti A, Fuiano G, Ikeda A, Konta T, Takasaki S, Mashima Y, Kubota I, Nakamura S, Kokubo Y, Makino H, Takata H, Fujii T, Yoshihara F, Horio T, Kawano Y, Badulescu M, Capusa C, Stancu S, Blaga V, Ilyes A, Anghel C, Mircescu G, Tolkacheva V, Villevalde S, Tyukhmenev E, Kobalava Z, Shalyagin Y, Shvetsov M, Nagaytseva S, Lukshina L, Shilov E, Fusaro M, Tripepi G, Crepaldi G, Maggi S, D'Angelo A, Naso A, Plebani M, Vajente N, Giannini S, Calo L, Miozzo D, Cristofaro R, Gallieni M, Feriozzi S, Torras J, Cibulla M, Nicholls K, Sunder-Plassmann G, West M, Pavlikova E, Villevalde S, Kobalava Z, Moiseev V, Yen CT, Huang CH, Wang MC, Daher E, Silva Junior G, Vieira AP, Couto Bem A, Fiqueiredo Filho A, Lopes Filho A, Guedes A, Eloy Costa C, Holanda de Souza J, Liborio A, Daniel R, Nitsch D, Harper L, EUVAS Group, Little M, Khatami SMR, Mahmoodian M, Zare E, Pashang M, Mc Carroll F, Cooke B, O'Kane M, Moles K, Garrett P, Lindsay J, Yu TM, Chen CH, Wu MJ, Cheng CH, Chuang YW, Shu KH, Cole JC, Oberdhan D, Cheng R, Urwongse J, Krasa H, Czerwiec F, Chapman A, Perrone R, Moranne O, Fafin C, Favre G, Mougel S, Vido A, Seitz B, Dahan P, Albano L, Esnult V, Rama M, Gayathri P, Leelavathi DA, Ravindra PA, Sundaram V, Nageshwar PR, Presta P, Piraina V, Talarico R, Esposito G, Colombo A, Lucisano G, Caglioti C, Mazza G, Cirillo E, Quattrone S, Fuiano G, Marron B, Chen N, Shi H, Ma X, Zhang J, Mao P, He L, Yu J, Ding X, Jiang G, Gu Y, Zhang W, Wang N, Mei C, Ni Z, Tzanno C, Stein G, Nisihara F, Rocha J, Clesca P, Uezima C, Langham H, Tomlin M, Coyne E, Hope W, Bebb C, Johnson C, Byrne C, Li Y, Zhang W, Ren H, Wang W, Shi H, Li X, Chen X, Wu X, Chen N, Canver B, Colak T, Can S, Karakayali H, Bansal V, Davis R, Litinas E, Hoppensteadt D, Thethi I, Fareed J. General & clinical epidemiology CKD 1-5 (1). Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.48] [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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Locsey L, Seres I, Sztanek F, Harangi M, Padra J, Asztalos L, Paragh G, Hutchison CA, Bevins A, Langham R, Mancini E, Wirta O, Cockwell P, Hutchison CA, Keir R, Vigano M, Stella A, Evans N, Chappell M, Cockwell P, Fabbrini P, Onuigbo M, Onuigbo N, Onuigbo M, Kim S, Chang JH, Jung JY, Lee HH, Chung W, Zanoli L, Rastelli S, Marcantoni C, Tamburino C, Castellino P, Cho A, Choi H, Lee JE, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Zanoli L, Rastelli S, Marcantoni C, Tamburino C, Castellino P, Garcia-Fernandez N, Martin-Moreno PL, Varo N, Nunez-Cordoba JM, Schlieper G, Kruger T, Kelm M, Floege J, Westenfeld R, Choi H, Cho AJ, Jang HR, Lee JE, Huh W, Kim YG, Oh HY, Kim DJ, Doganay S, Oguz AK, Ergun I, Bardachenko N, Kuryata O, Bardachenko L, Garcia-Fernandez N, Martin-Moreno PL, Varo N, Nunez-Cordoba JM, Choi H, Cho AJ, Jang HR, Lee JE, Huh W, Kim YG, Oh HY, Kim DJ, Ravani P, Malberti F, Pirelli S, Scolari F, Barrett B, Presta P, Lucisano G, Rubino A, Serraino F, Amoruso T, Renzulli A, Fuiano G, Kielstein JT, Tolk S, Heiden A, Kuhn C, Hoeper MM, Lorenzen J, Broll M, Kaever V, Burhenne H, Hafer C, Haller H, Burkhardt O, Kielstein J, Zahalkova J, Petejova N, Strojil J, Urbanek K, Bertoli S, Musetti C, Cabiati A, Assanelli E, Lauri G, Marana I, De Metrio M, Rubino M, Campodonico J, Grazi M, Moltrasio M, Marenzi G, Unarokov Z, Mukhoedova T, Fidalgo P, Coelho S, Rodrigues B, Fernandes AP, Papoila AL, Liano F, Soto K, Vanmassenhove J, Vanholder R, Glorieux G, Van Biesen W, Challiner R, Ritchie J, Hutchison A, Challiner R, Ritchie J, Hutchison A, Challiner R, Ritchie J, Hutchison A, Zaharie SI, Maria DT, Zaharie M, Vaduva C, Grauntanu C, Cana-Ruiu D, Mota E, Hayer M, Baharani J, Thomas M, Eldehni T, Selby N, McIntyre C, Fluck R, Kolhe N, Fagugli RM, Patera F, Shah PR, Kaswan KK, Kute VB, Vanikar AV, Gumber MR, Patel HV, Munjappa BC, Enginner DP, Sainaresh VV, Trivedi HL, Teixeira C, Nogueira E, Lopes JA, Almeida E, Pais de Lacerda A, Gomes da Costa A, Franca C, Mariano F, Morselli M, Bergamo D, Hollo' Z, Scella S, Maio M, Tetta C, Dellavalle A, Stella M, Triolo G, Cantaluppi V, Quercia AD, Bertinetto P, Giacalone S, Tamagnone M, Basso E, Karvela E, Gai M, Leonardi G, Anania P, Guarena C, Fenocchio CM, Pacitti A, Segoloni GP, Kim YO, Kim HG, Kim BS, Song HCS, Min JK, Kim SY, Park WD, Dalboni M, Narciso R, Quinto M, Grabulosa C, Cruz E, Monte J, Durao M, Cendoroglo M, Santos O, Batista M, Cho A, Choi H, Lee JE, Jang HR, Huh W, Kim YG, Kim DJ, Oh HY, Mancini E, Bellasi A, Giannone S, Mordenti A, Zanoni A, Santoro A, Presta P, Lucisano G, Rubino A, Serraino F, Renzulli A, Fuiano G, Lee JH, Ha SH, Kim JH, Lee GJ, Jung YC, Malindretos P, Koutroumbas G, Patrinou A, Zagkotsis G, Makri P, Togousidis I, Syrganis C, Li Cavoli G, Tortorici C, Bono L, Ferrantelli A, Giammarresi C, Zagarrigo C, Rotolo U, Kim H, Jun K, Choi W, Kim H, Jun K, Choi W, Krzesinski JM, Parotte MC, Vandevelde C, Keenan J, Dieterle F, Sultana S, Pinches M, Ciorciaro C, Schindler R, Schmitz V, Gautier JC, Benain X, Matchem J, Murray P, Adler S, Haase M, Haase-Fielitz A, Devarajan P, Bellomo R, Cruz DN, Wagener G, Krawczeski CD, Koyner JL, Murray PT, Zappitelli M, Goldstein S, Makris K, Ronco C, Martensson J, Martling CR, Venge P, Siew E, Ware LB, Ikizler A, Mertens PR, Lacquaniti A, Buemi A, Donato V, Lucisano S, Buemi M, Vanmassenhove J, Vanholder R, Glorieux G, Van Biesen W, Panagoutsos S, Kriki P, Mourvati E, Tziakas D, Chalikias G, Stakos D, Apostolakis S, Tsigalou C, Gioka T, Konstantinides S, Vargemezis V, Torregrosa I, Montoliu C, Urios A, Aguado C, Puchades MJ, Solis MA, Juan I, Sanjuan R, Blasco M, Pineda J, Carratala A, Ramos C, Miguel A, Niculae A, Checherita IA, Sandulovici R, David C, Ciocalteu A, Espinoza M, Hidalgo J, Lorca E, Santibanez A, Arancibia F, Gonzalez F, Park MY, Kim EJ, Choi SJ, Kim JK, Hwang SD, Lee KH, Seok SJ, Yang JO, Lee EY, Hong SY, Gil HW, Astapenko E, Shutov A, Savinova G, Rechnik V, Melo MJ, Lopes JA, Raimundo M, Viegas A, Camara I, Antunes F, Kim MJ, Kwon SH, Lee SW, Song JH, Lee JW. Acute kidney injury - Human studies. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.29] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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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Bolignano D, Zanoli L, Rastelli S, Marcantoni C, Coppolino G, Lucisano G, Tamburino C, Battaglia E, Castellino P, Coppolino G, Lucisano G, Presta P, Battaglia E, Pedrelli L, Bolignano D, Rastelli S, Zanoli L, Marcantoni C, Bolignano D, Coppolino G, Battaglia E, Tamburino C, Castellino P, Bolignano D, Zanoli L, Rastelli S, Marcantoni C, Coppolino G, Lucisano G, Battaglia E, Tamburino C, Castellino P, Iiadis F, Ntemka A, Didangelos T, Makedou A, Divani M, Moralidis E, Makedou K, Gotzamani-Psarakou A, Grekas D, Selistre L, Souza V, Domanova O, Cochat P, Ranchin B, Varennes A, Dubourg L, Hadj-Aissa A, Leonardis D, Mallamaci F, Enia G, Postorino M, Tripepi G, Zoccali C, MAURO Working Group, Donadio C, Kanaki A, Caprio F, Donadio E, Tognotti D, Olivieri L, Eloot S, Schepers E, Barreto D, Barreto F, Liabeuf S, Van Biesen W, Verbeke F, Glorieux G, Choukroun G, Massy Z, Vanholder R, Chaaban A, Torab F, Abouchacra S, Bernieh B, Hussein Q, Osman M, Gebran N, Kayyal Y, Al Omary H, Nagelkerke N, Horio M, Imai E, Yasuda Y, Takahara S, Watanabe T, Matsuo S, Fujimi A, Ueda S, Fukami K, Obara N, Okuda S, Pecchini P, Mieth M, Mass R, Tripepi G, Malberti F, Mallamaci F, Quinn R, Zoccali C, Ravani P, Fujii H, Kono K, Nakai K, Goto S, Fukagawa M, Nishi S, Havrda M, Granatova J, Vernerova Z, Vranova J, Hornova L, Zabka J, Rychlik I, Kratka K, De Nicola L, Zamboli P, Mascia S, Calabria M, Grimaldi M, Conte G, Minutolo R, Gluhovschi G, Modilca M, Kaycsa A, Velciov S, Gluhovschi C, Bob F, Petrica L, Bozdog G, Methven S, Traynor J, Deighan C, O'Reilly D, MacGregor M, Szotowska M, Chudek J, Adamczak M, Wiecek A, Dudar I, Shifris I, Loboda O, Yanagisawa N, Ando M, Tsuchiya K, Nitta K, Heguilen R, Liste A, Canteli M, Muguerza G, Cohen L, Ortemberg M, Hermes R, Bernasconi A, Galli D, Miani N, Staffolani E, Nicolais R, Borzacchi MS, Tozzo C, Manca di Villahermosa S, Di Daniele N, Musial K, Zwolinska D, Loriga G, Carru C, Zinellu A, Milia A, Satta AE, Frolova I, Kuryata A, Koppe L, Kalabacher E, Pelletier C, Geloen A, Fouque D, Soulage C, Feriozzi S, Torras J, Cybulla M, Nicholls K, Sunder-Plassmann G, West M. Progression & risk factors CKD 1-5 (1). Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.30] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Claure-Del Granado R, Macedo E, Soroko S, Kim YW, Chertow GM, Himmelfarb J, Ikizler TA, Paganini EP, Mehta RL, Martin-Moreno PL, Garcia-Fernandez N, Varo N, Nunez-Cordoba JM, Haase-Fielitz A, Mertens PR, Plass M, Kuppe H, Hetzer R, Westerman M, Prowle JR, Bellomo R, Haase M, Bolignano D, Zanoli L, Rastelli S, Marcantoni C, Coppolino G, Lucisano G, Tamburino C, Battaglia E, Castellino P. Acute kidney injury / Nephrocalcinosis. Clin Kidney J 2011. [DOI: 10.1093/ndtplus/4.s2.16] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Andreucci M, Lucisano G, Faga T, Bertucci B, Tamburrini O, Pisani A, Sabbatini M, Salzano S, Vitale M, Fuiano G, Michael A. Differential activation of signaling pathways involved in cell death, survival and inflammation by radiocontrast media in human renal proximal tubular cells. Toxicol Sci 2010; 119:408-16. [PMID: 21036957 DOI: 10.1093/toxsci/kfq332] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Radiocontrast media (RCM) are widely used in clinical medicine but may lead to radiocontrast-induced nephropathy (RCIN). The pathogenesis of acute renal failure secondary to RCM is not fully understood, but direct toxic effects are believed to be a major cause of RCIN. We have investigated the effect of different types of RCM on signaling pathways known to play a role in cell death, survival, and inflammation. HK-2 cells were incubated with sodium diatrizoate and iomeprol (IOM) at a concentration of 75 mg I/ml for 2 h. Both RCM caused an increase in phosphorylation of p38 mitogen-activated protein kinase (MAPK) (p38) and c-Jun N-terminal kinases (JNKs) and NF-κB (at Ser 276), with sodium diatrizoate having a more drastic effect. Although cell viability was reduced significantly by both RCM, in cells pretreated with IOM the cell viability recovered over a 22-h time period after removal of the RCM. However, viability of diatrizoate-treated cells rose at 5 h but then fell at 22 h after removal of the RCM. The decrease in cell viability in diatrizoate-treated cells corresponded with an increase in phosphorylation of JNKs, p38, and NF-κB and a decrease in phosphorylation of Akt, signal transducer and activator of transcription 3, and forkhead box O3a, as well as poly (ADP-ribose) polymerase and caspase-3 cleavage. The recovery in viability of IOM-treated cells corresponded most notably with an increase in STAT3 phosphorylation and induction of Pim-1 kinase. There was also an increase in interleukin-8 release by diatrizoate-treated cells indicating the possibility of proinflammatory effects of RCM. A knowledge of the signaling pathways by which RCM exert their cytotoxic actions may help in finding future therapies for RCIN.
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Affiliation(s)
- Michele Andreucci
- Department of Nephrology, Magna Graecia University, Catanzaro I-88100, Italy.
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Coppolino G, Lucisano G, Bolignano D, Buemi M. Acute cardiovascular complications of hemodialysis. MINERVA UROL NEFROL 2010; 62:67-80. [PMID: 20424575] [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: 05/29/2023]
Abstract
In patients with chronic renal failure undergoing dialysis the mortality rate from cardiovascular conditions is 10 to 100 fold than in general population. The higher mortality rate is due not only to the influence of traditional risk factors, such as hypertension, diabetes, obesity, dyslipidemia and cigarette smoking, but also to specific factors of uremic patients. Acute complications commonly take place during routine hemodialysis treatments (HD) due to unsteadiness in the cardiovascular system balance. We will review most important cardiovascular complications during HD from hypotension to ventricular hypertrophy, from arrhythmias to sudden death, and finally myocardial ischemia. A large number of structural and functional peripheral vascular and cardiac abnormalities including electrolyte imbalance, hemodynamic instability and neuro-humoral stress exert an overwork on myocardium and lead to occurring of a single cardiovascular complication but are always strictly correlated events.
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Affiliation(s)
- G Coppolino
- Unità Operativa Complessa di Nefrologia e Dialisi, Azienda Ospedaliera Pugliese-Ciaccio Catanzaro, Italia
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Andreucci M, Fuiano G, Presta P, Lucisano G, Leone F, Fuiano L, Bisesti V, Esposito P, Russo D, Memoli B, Faga T, Michael A. Downregulation of cell survival signalling pathways and increased cell damage in hydrogen peroxide-treated human renal proximal tubular cells by alpha-erythropoietin. Cell Prolif 2009; 42:554-61. [PMID: 19508320 PMCID: PMC6496929 DOI: 10.1111/j.1365-2184.2009.00617.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
OBJECTIVE Erythropoietin has been shown to have a protective effect in certain models of ischaemia-reperfusion, and in some cases the protection has been correlated with activation of signalling pathways known to play a role in cell survival and proliferation. We have studied whether erythropoietin would overcome direct toxic effects of hydrogen peroxide (H(2)O(2)) treatment to human renal proximal tubular (HK-2) cells. MATERIALS AND METHODS HK-2 cells were incubated with H(2)O(2) (2 mm) for 2 h with or without erythropoietin at concentrations of 100 and 400 U/ml, and cell viability/proliferation was assessed by chemical reduction of MTT. Changes in phosphorylation state of the kinases Akt, glycogen synthase kinase-3beta (GSK-3beta), mammalian target of rapamycin (mTOR) and extracellular signal-regulated kinase 1 and 2 (ERK1/ERK2) were also analysed. RESULTS Cells incubated with H(2)O(2) alone showed a significant decrease in viability, which did not significantly change by addition of erythropoietin at concentration of 100 U/ml, but was further reduced when concentration of erythropoietin was increased to 400 U/ml. Phosphorylation state of the kinases Akt, GSK-3beta, mTOR and ERK1/ERK2 of H(2)O(2)-treated HK-2 cells was slightly altered in the presence of erythropoietin at concentration of 100 U/ml, but was significantly less in the presence of erythropoietin at a concentration of 400 U/ml. Phosphorylation of forkhead transcription factor FKHRL1 was diminished in cells incubated with H(2)O(2) and erythropoietin at a concentration of 400 U/ml. CONCLUSIONS Erythropoietin, at high concentrations, may significantly increase cellular damage in HK-2 cells subjected to oxidative stress, which may be due in part to decrease in activation of important signalling pathways involved in cell survival and/or cell proliferation.
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