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Cangini G, Rusolo D, Cappuccilli M, Donati G, La Manna G. Evolution of the concept of quality of life in the population in end stage renal disease. A systematic review of the literature. Clin Ter 2019; 170:e301-e320. [PMID: 31304520 DOI: 10.7417/ct.2019.2152] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND AND AIMS Given the rising prevalence of end-stage renal disease and subsequent progressive increase of patients starting renal replacement therapy, a great attention is given by scientific community to the assessment of life perception and Quality of Life (QoL) in dialysis patients. A broad literature review was conducted on PubMed and PsyInfo databases for articles published between January 2000 and July 2016 in order to understand the biological and psychosocial variables potentially affecting the QoL of the patients under artificial substitution of kidney function. METHODS Five domains related to the concepts of physical functions, mood, sleep, spirituality, and social support have been identified. RESULTS The findings in this review suggest that the variables related to physical activity and depression seem to have a direct impact on QoL and Health-Related Quality of Life (HRQoL). Others, such as anxiety, awareness, empowerment, the presence of sleep disorders, satisfaction, support from the staff, social support, spirituality and religion have a clear correlation with the QoL dimensions. CONCLUSIONS These results suggest the primary importance of the assessment biological and psychosocial variables by specific tools and the inclusion of effective interventions targeted to patients and their caregivers.
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Affiliation(s)
- G Cangini
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St. Orsola Hospital, University of Bologna, Bologna, Italy
| | - D Rusolo
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St. Orsola Hospital, University of Bologna, Bologna, Italy
| | - M Cappuccilli
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St. Orsola Hospital, University of Bologna, Bologna, Italy
| | - G Donati
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St. Orsola Hospital, University of Bologna, Bologna, Italy
| | - G La Manna
- Department of Experimental Diagnostic and Specialty Medicine (DIMES), Nephrology, Dialysis and Renal Transplant Unit, St. Orsola Hospital, University of Bologna, Bologna, Italy
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Cappuccilli M, Mosconi G, Roi GS, De Fabritiis M, Totti V, Merni F, Trerotola M, Marchetti A, La Manna G, Nanni Costa A. Inflammatory and Adipose Response in Solid Organ Transplant Recipients After a Marathon Cycling Race. Transplant Proc 2017; 48:408-14. [PMID: 27109967 DOI: 10.1016/j.transproceed.2016.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2015] [Revised: 01/19/2016] [Accepted: 02/02/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Organ transplant recipients frequently have chronic inflammation, with a weighty impact on cardiovascular risk. These patients can benefit from exercise, although the role of intense training is unclear. We evaluated the effect of a 130-km cycling race on inflammatory cytokines and adiponectin levels in transplant recipients. METHODS Circulating interleukin (IL)-6, tumor necrosis factor (TNF)-α, interferon (IFN)-γ, and adiponectin were assayed in 35 healthy subjects vs 19 transplant recipients (10 kidney, 8 liver, 1 heart), matched for sex, age, body mass index, and preparation workout. The determinations were performed before the race, at the end, and after 18 to 24 hours. Baseline values of 32 sedentary transplant recipients also were evaluated to explore the possible chronic impact of lifestyle. RESULTS All cyclists had 6- to 8-fold increased IL-6 levels after the race that decreased, without returning to baseline, the day after. Conversely, serum TNF-α and IFN-γ showed a progressive increase starting during physical performance and enduring for the next 18 to 24 hours in healthy subjects, whereas they were unchanged over time in cyclists with transplants. In transplant recipients who did not perform exercise, all of the analytes were significantly higher in comparison to basal levels of physically active subjects. CONCLUSIONS Our data suggest that clinically stable and properly trained transplant recipients can safely perform and progressively benefit from exercise, even at a competitive level. The changes in inflammation parameters were temporary and parallel with those of the healthy subjects. The comparison with sedentary transplant recipients revealed an overall amelioration of inflammatory indexes as a possible effect of regular physical activity on systemic inflammation.
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Affiliation(s)
- M Cappuccilli
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Section of Nephrology, University of Bologna, Bologna, Italy
| | - G Mosconi
- Unit of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - G S Roi
- Isokinetic Medical Group, Bologna, Italy
| | - M De Fabritiis
- Unit of Nephrology and Dialysis, Morgagni-Pierantoni Hospital, Forlì, Italy
| | - V Totti
- Emilia Romagna Transplant Reference Centre (CRT-ER), ANED Sport, S. Orsola-Malpighi University Hospital, Bologna, Italy; Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - F Merni
- Department of Biomedical and Neuromotor Science, University of Bologna, Bologna, Italy
| | - M Trerotola
- Italian National Transplant Centre, Rome, Italy
| | - A Marchetti
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Section of Nephrology, University of Bologna, Bologna, Italy
| | - G La Manna
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Section of Nephrology, University of Bologna, Bologna, Italy
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Gandolfini I, Buzio C, Zanelli P, Palmisano A, Cremaschi E, Vaglio A, Piotti G, Melfa L, La Manna G, Feliciangeli G, Cappuccilli M, Scolari M, Capelli I, Panicali L, Baraldi O, Stefoni S, Buscaroli A, Ridolfi L, D'Errico A, Cappelli G, Bonucchi D, Rubbiani E, Albertazzi A, Mehrotra A, Cravedi P, Maggiore U. The Kidney Donor Profile Index (KDPI) of marginal donors allocated by standardized pretransplant donor biopsy assessment: distribution and association with graft outcomes. Am J Transplant 2014; 14:2515-25. [PMID: 25155294 PMCID: PMC4400114 DOI: 10.1111/ajt.12928] [Citation(s) in RCA: 95] [Impact Index Per Article: 9.5] [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: 02/14/2014] [Revised: 06/11/2014] [Accepted: 06/14/2014] [Indexed: 01/25/2023]
Abstract
Pretransplant donor biopsy (PTDB)-based marginal donor allocation systems to single or dual renal transplantation could increase the use of organs with Kidney Donor Profile Index (KDPI) in the highest range (e.g. >80 or >90), whose discard rate approximates 50% in the United States. To test this hypothesis, we retrospectively calculated the KDPI and analyzed the outcomes of 442 marginal kidney transplants (340 single transplants: 278 with a PTDB Remuzzi score<4 [median KDPI: 87; interquartile range (IQR): 78-94] and 62 with a score=4 [median KDPI: 87; IQR: 76-93]; 102 dual transplants [median KDPI: 93; IQR: 86-96]) and 248 single standard transplant controls (median KDPI: 36; IQR: 18-51). PTDB-based allocation of marginal grafts led to a limited discard rate of 15% for kidneys with KDPI of 80-90 and of 37% for kidneys with a KDPI of 91-100. Although 1-year estimated GFRs were significantly lower in recipients of marginal kidneys (-9.3, -17.9 and -18.8 mL/min, for dual transplants, single kidneys with PTDB score<4 and =4, respectively; p<0.001), graft survival (median follow-up 3.3 years) was similar between marginal and standard kidney transplants (hazard ratio: 1.20 [95% confidence interval: 0.80-1.79; p=0.38]). In conclusion, PTDB-based allocation allows the safe transplantation of kidneys with KDPI in the highest range that may otherwise be discarded.
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Affiliation(s)
- I. Gandolfini
- Kidney and kidney-pancreas Transplant Unit (Department of Nephrology), Parma University Hospital, Parma, Italy
| | - C. Buzio
- Kidney and kidney-pancreas Transplant Unit (Department of Nephrology), Parma University Hospital, Parma, Italy
| | - P. Zanelli
- Immunogenetic Unit, Parma University Hospital Parma, Italy
| | - A. Palmisano
- Kidney and kidney-pancreas Transplant Unit (Department of Nephrology), Parma University Hospital, Parma, Italy
| | - E. Cremaschi
- Kidney and kidney-pancreas Transplant Unit (Department of Nephrology), Parma University Hospital, Parma, Italy
| | - A. Vaglio
- Kidney and kidney-pancreas Transplant Unit (Department of Nephrology), Parma University Hospital, Parma, Italy
| | - G. Piotti
- Kidney and kidney-pancreas Transplant Unit (Department of Nephrology), Parma University Hospital, Parma, Italy
| | - L. Melfa
- Kidney and kidney-pancreas Transplant Unit (Department of Nephrology), Parma University Hospital, Parma, Italy
| | - G. La Manna
- Section of Nephrology and Renal Transplant, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - G. Feliciangeli
- Section of Nephrology and Renal Transplant, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - M. Cappuccilli
- Section of Nephrology and Renal Transplant, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - M.P. Scolari
- Section of Nephrology and Renal Transplant, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - I. Capelli
- Section of Nephrology and Renal Transplant, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - L. Panicali
- Section of Nephrology and Renal Transplant, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - O. Baraldi
- Section of Nephrology and Renal Transplant, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - S. Stefoni
- Section of Nephrology and Renal Transplant, Department of Specialistic, Diagnostic and Experimental Medicine, University of Bologna, Bologna, Italy
| | - A. Buscaroli
- Nephrology and Dialysis Unit, Hospital of Ravenna, Italy
| | - L. Ridolfi
- Organ Procurement Organization CRT-Emilia Romagna, Bologna, Italy
| | - A. D'Errico
- Institute of Anatomopathology, University of Bologna, Italy
| | - G. Cappelli
- Nephrology Dialysis and Renal Transplantation Unit, University Hospital of Modena, Modena, Italy
| | - D. Bonucchi
- Nephrology Dialysis and Renal Transplantation Unit, University Hospital of Modena, Modena, Italy
| | - E. Rubbiani
- Nephrology Dialysis and Renal Transplantation Unit, University Hospital of Modena, Modena, Italy
| | - A. Albertazzi
- Nephrology Dialysis and Renal Transplantation Unit, University Hospital of Modena, Modena, Italy
| | - A. Mehrotra
- Renal Division, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - P. Cravedi
- Renal Division, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - U. Maggiore
- Kidney and kidney-pancreas Transplant Unit (Department of Nephrology), Parma University Hospital, Parma, Italy
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Rossi MR, Banfi P, Cappuccilli M, Conter V, de Poli D, Piacentini G, Zurlo MG, Masera G. Prospective randomized comparison of two prophylactic regimens with trimethoprim-sulfamethoxazole in leukemic children: a two year study. Eur J Cancer Clin Oncol 1987; 23:1679-82. [PMID: 3501375 DOI: 10.1016/0277-5379(87)90449-4] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Between 1 July 1984 and 30 June 1986 all children treated for acute hematologic malignancy at our center were randomized to receive continuous (group A) or intermittent (3 days/week, group B) prophylaxis with trimethoprim-sulfamethoxazole (5-25 mg/kg/day/p.o.) against interstitial pneumonia with the aim of investigating if an intermittent regimen is as effective as and less toxic than a continuous regimen. The number of severe infections (group A, 17; group B, 21) and side-effects (group A, 30; group B, 34) was similar in the two groups, and compliance was also similar. We conclude therefore that neither regimen offers advantages over the other and the decision which to use should be based on cost (where regimen B has the advantage) and the children's and parents' preferences and compliance.
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Affiliation(s)
- M R Rossi
- Centro di Ematologia Pediatrica, Università di Milano, Ospedale di Monza, Italy
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