1,721,116 research outputs found
[Ultrasound-guided paracentesis: technical, diagnostic and therapeutic aspects for the modern nefrologist]
No full textAscites is a pathological accumulation of fluid in the peritoneal cavity due to various etiologies, often associated with renal failure. Paracentesis is a simple method of removing ascitic fluid by inserting a needle into the peritoneal cavity, often performed at the patient's bedside. It can be both diagnostic and therapeutic. Ultrasound imaging allows the diagnosis of ascites, the identification of the puncture site on the abdominal wall during the pre-procedural phase, the real time evaluation of the needle and the continuous course of the maneuver. This eco-guide technique has higher effectiveness and lower risk of complications than the "blind" venipuncture technique. Ultrasound-guided paracentesis, when performed by nephrologists, reduces the waiting time both for the execution of paracentesis and for the diagnosis, treatment and follow-up of ascites
On the fragility of outcome measures of two individual patient data analyses from randomized controlled trials on online haemodiafiltration
No full textHaemodialysis (HD) is a life-saving therapy for individuals with kidney failure. Post-filter haemodiafiltration (HDF) and high-flux HD are among the most widely used treatment modalities of kidney failure. To date, 10 randomized controlled trials (RCTs) have compared all-cause and cardiovascular (CV) mortality between pre- or post-filter HDF and low- or high-flux HD in adults undergoing maintenance dialysis for at least 1 year [1–10]
Clinical Significance of FGF-23 in Patients with CKD
Full text linkFGF23 is a bone-derived hormone that plays an important role in the regulation of phosphate and 1,25-dihydroxy vitamin D metabolism. FGF23 principally acts in the kidney to induce urinary phosphate excretion and suppress 1,25-dihydroxyvitamin D synthesis in the presence of FGF receptor 1 (FGFR1) and its coreceptor Klotho. In patients with chronic kidney disease (CKD), circulating FGF23 levels are progressively increased to compensate for persistent phosphate retention, but this results in reduced renal production of 1,25-dihydroxyvitamin D and leads to hypersecretion of parathyroid hormone. Furthermore, FGF23 is associated with vascular dysfunction, atherosclerosis, and left ventricular hypertrophy. This paper summarizes the role of FGF23 in the pathogenesis of mineral, bone, and cadiovascular disorders in CKD
[Physical exercise in chronic kidney disease: an empty narrative or an effective intervention?]
No full textChronic kidney disease (CKD) is growing worldwide, with increasing numbers of patients facing end-stage renal disease, high cardiovascular risk, disability and mortality. Early recognition of CKD and improvements in lifestyle are crucial for maintaining or recovering both physical function and quality of life. It is well known that reducing sedentariness, increasing physical activity and initiating exercise programs counteract cardiovascular risk and frailty, limit deconditioning and sarcopenia, and improve mobility, without side-effects. However, these interventions, often requested by CKD patients themselves, are scarcely available. Indeed, it is necessary to identify and train specialists on exercise in CKD and to sensitize doctors and health personnel, so that they can direct patients towards an active lifestyle. On the other hand, effective and sustainable interventions, capable of overcoming patients' barriers to exercise, remain unexplored. Scientific societies, international research teams and administrators need to work together to avoid that exercise in nephrology remains an empty narrative, a niche interest without any translations into clinical practice, with no benefit to the physical and mental health of CKD patients
[World Kidney Day 2013 and the Italian experience since 2006]
No full text: Renal disease is common, insidious and treatable. The prevalence of chronic kidney disease and its cumulative global costs are rapidly increasing. Since 2006 the World Kidney Day (WKD) has worked to raise awareness of the disease and the importance of its prevention within communities and institutions. Italian Nephrology, through the joint action of the Italian Society of Nephrology (SIN) and the Italian Kidney Foundation (FIR) has worked to convey the message during WKD celebrations,meeting the community directly in Italian town squares and high schools, where informative material was provided together with blood pressure and urine dip-stick testing. This year, the WKD was held on March 14th, and was preceded by an extensive program of information broadcast on TV and radio and published in newspapers and magazines. More than 100 nephrology units in 118 cities were either involved in at least one of the programs organized in Italian town squares, high schools and renal clinics, or provided other spontaneous initiatives. This paper describes the history of the Italian experience in the WKD from its beginning in 2006 until the present day
[Talking about medicine through mass media]
No full text: The ability to communicate is central to all professional activities and therefore being able to communicate effectively with mass media is essential. The medical doctor often needs to communicate not with a single patient or with a group of family members, but with "an important number of patients" through a microphone, a newspaper, a radio or a television. In this case it is not necessary to provide specific information on a single clinical case, but to provide simple, general information on a single pathology or a group of diseases to an interviewer or journalist, who will probably elaborate it at his own discretion making it usable to a diverse and unspecified audience. It is therefore important to be relevant to the question, clear in the presentation, but also synthetic to respect the time limits of interview
[Vascular calcification in chronic kidney disease]
No full text: Cardiovascular risk is higher in patients with chronic kidney disease (CKD) or with End-Stage Renal Disease (ESRD) than general population because in addition to the traditional cardiovascular (CV ) risk factors, CKD patients also have others non-traditional CV risk factors linked to CKD. Among these factors, presence and progression of coronary calcifications (CAC) are considered very important in CKD or ESRD patients in recent years. A number of noninvasive imaging methods are available to detect the presence, extent and progression of CAC. In this review, we discuss the importance of CAC as non-traditional CV risk factors in CKD patients and the noninvasive methods most frequently used to assess CAC
Report sui dati raccolti durante la giornata mondiale del rene in italia negli anni 2015-2016
No full textRisk factors for kidney diseases and awareness of blood pressure and proteinuria in general population and in high school students: Italian report for World Kidney Days 2012-2013
No full textIngles
Tenofovir and kidney transplantation: case report
No full textBackground: Hepatitis B viral
infection (HBV) has been regarded as a contraindication
for kidney transplantation because
of the high risk of viral activation induced by
immunosuppressive therapy. Anti-retroviral
drugs have changed the prognosis of patients
with hepatitis B viral infection (HBV+) who
are candidates for renal transplant; indeed,
therapy with antiretroviral drugs may ensure
lower rates of morbidity and mortality compared
to traditional therapies. Entecavir is
the first-line antiviral therapy recommended
for the treatment of HBV+ kidney-transplanted
patients. In case of resistance to entecavir,
tenofovir may be an alternative drug,
either alone or in combination with entecavir.
However, the best strategy of treatment
is still unknown. In this case-report, a HBV+
kidney-transplanted patient who presented
resistance to entecavir was initially treated
by associating tenofovir to entecavir and
with tenofovir alone afterward. This strategy
induced complete remission of viral replication.
Case presentation: In a HBV+ kidneytransplanted
patient under monotherapy with
entecavir, HBV flare (HBV DNA > 170.000
× 103 UI/mL, HBeAg+, HbeAb–) occurred
9 months after transplantation; at that time,
blood chemistry highlighted: creatinine 1.46
mg/dL, blood urea 65 mg/dL, e-GFR 50 mL/
min, proteinuria 300 mg/24 h, calciuria 2,12
mmol/24 h, phosphaturia 0.56 g/24 h, vitamin
D 11.5 ng/mL, PTH 130 pg/mL, calcemia
2.3 mmol/L, and phosphoremia 2 mg/
dL. Liver elastometry (FibroScan) showed
moderate fibrosis. Tenofovir was associated
to entecavir. Three months after the combination
therapy, reduction in HBV DNA replication
(351 × 103 UI/mL) was obtained. Creatinine
and e-GFR were 1.48 mg/dL and 52
mL/min, respectively. At this point, entecavir
was discontinued. After 13 months of tenofovir
monotherapy, complete remission of viral
replication was achieved but renal function
deteriorated and proteinuria increased
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