0000000000087789
AUTHOR
Maurizio Li Vecchi
Changes in serum fetuin-A and inflammatory markers levels in end-stage renal disease (ESRD): effect of a single session haemodialysis.
Background: The aim of the present study was to evaluate the effect of a single haemodialysis (HD) session on serum fetuin-A levels, considered a negative acute phase response marker; moreover, we evaluated the behaviour of fibrinogen and high sensitivity C-reactive protein (hsCRP) as acute phase response and chronic/subclinical inflammation markers, respectively, after a single HD session. Methods: Serum fetuin-A, albumin, hsCRP and fibrinogen were measured in 72 patients before and after a single HD session. Results: After a single HD session, we observed a significant increase in fibrinogen levels, while fetuin-A levels decreased (p<0.05). Also, hsCRP levels were significantly increased.…
A longitudinal study of sleep disorders in early-stage chronic kidney disease
Few studies have addressed the problem of sleep disturbances in patients with early-stage chronic kidney disease (CKD). A total of 220 patients newly diagnosed with CKD and 220 patients newly diagnosed with chronic hepatitis C were studied within 1 month from the diagnosis. They were evaluated by using the Charlson Comorbidity Index, the Pittsburgh Sleep Quality Index, and the Beck Depression Inventory. Patients with CKD were followed up for 4 years. Sleep disturbances affected 59.5% of patients with chronic hepatitis C and 84.6% of patients with CKD. Sleeping disorders that were severe and peculiar in early CKD improved significantly over time. Beck Depression Inventory disclosed significa…
INDICATORI DI RISCHIO CARDIOVASCOLARE E METABOLICO IN POPOLAZIONE GENERALE ADULTA SICILIANA
Prevalence and severity of anaemia in patients with type 2 diabetic nephropathy and different degrees of chronic renal insufficiency.
<i>Background/Aim:</i> Type 2 diabetes mellitus is the single most common cause of chronic kidney disease (CKD); however its real impact on renal anaemia has not been established. The aim of this study was to evaluate whether onset, severity, and prevalence of anaemia during the course of CKD is different between type 2 diabetic and non-diabetic patients. <i>Methods:</i> We enrolled 281 patients with: (1) type 2 diabetes and no CKD (n = 75); (2) type 2 diabetes plus CKD (n = 106), and (3) CKD without type 2 diabetes (n = 100). According to K/DOQI guidelines, the patients with renal insufficiency (i.e., those with a glomerular filtration rate <60 ml/min) were subgr…
Anti-C1q Autoantibodies in Lupus Nephritis: Prevalence and Clinical Significance
Recently, anti-C1q autoantibodies have been proposed as a useful marker in systemic lupus erythematosus (SLE) since their occurrence correlates with renal involvement and, possibly, with nephritic activity. We aimed to evaluate the prevalence of anti-C1q antibodies in patients with SLE, with and without renal involvement, and to correlate these markers' presence and levels with the activity of the disease and nephropathy. We studied 61 patients with SLE, 40 of whom had biopsy-proven lupus nephritis; 35 patients with other connective tissue diseases; and 54 healthy controls. In addition, 18 lupus nephritis patients were followed up during the disease time course. Anti-C1q antibodies were mea…
Aspetti psicologici e strategie di coping nella dialisi e nel trapianto renale
Aim. Although with different results, dialysis and kidney transplantation represent two effective strategies in treating chronic uraemia. Our study compares the psychological aspects of two categories of patients: on one hand those who faced kidney transplantation and have been in dialysis, on the other hand the non complaint patients treated with these therapies. Methods. We used a test for the analysis of the personality (MMPI2) and the COPE, that tests the abilities to coping used by the patient in certain conditions that can be perceived us stressful or, in any case, as unusual. With both MMPI2 and COPE we tested 120 patients that have faced haemodialysis and 50 that have been subject t…
A CASE OF CARDIAC COMPRESSION BY HEPATIC CYST IN A WOMAN WITH POLYCYSTIC KIDNEY DISEASE.
Liver cysts are common extrarenal manifestations of autosomal dominant polycystic kidney disease (ADPKD). They occur more frequently in women, and are also more in number and larger in size, than in men. Liver cysts tend to develop slower than the kidney cysts; their number and size increases with the age (worsening kidney function), number of pregnancies, and estrogen assumption. Although most patients with ADPKD report no liver symptoms, sometimes, chronic manifestations related to progressive increase of the polycystic liver are experienced. The quality of life can be severely impaired with huge hepatomegaly causing abdominal distension, pain, dyspepsia, dyspnoea, fatigue, physical and e…
Anti‐laminin auto antibodies in ANCA‐associated vasculitis
Background. Endothelial cell damage occurs during vasculitic processes in vivo. With the alteration of the endothelium, exposure to basement membrane components may occur with induction of humoral immunity. Methods. In the present study, we evaluated the prevalence of antibodies against the basement membrane antigen laminin (LMN) in patients with ANCA-associated systemic vasculitis (AASV), pathologic controls (systemic lupus erythematosus, mixed cryoglobulinaemia, Henoch Schonlein purpura, primary glomerulonephritis) and normal individuals. Results. By ELISA, 21.6% of AASV (16/74) and 10% of pathologic controls (3/30), but only one of the normal controls (2.8%) had these antibodies (P = 0.0…
Epidemiology of hepatitic C infection in hemodialysis patients of Sicily
Aspetti psicologici nel trapianto renale
Prevalence of organ-specific and non organ-specific autoantibodies in healthy centenarians.
In the present study we have investigated the prevalence of organ-specific and non organ-specific autoantibodies in 26 healthy centenarians (6 men, 20 women; age range 101-106 years), using as controls 54 healthy old (33 men and 21 women, age range 71-93) and 56 young subjects (29 men and 27 women, age range 26-60). We assayed sera of each group for the following organ-specific autoantibodies, anti-gastric mucosa (anti-PCA), anti-thyroglobulin (anti-Tg) and non organ-specific autoantibodies, anti-cardiolipin (anti-APA IgG and IgM), anti-nuclear antigens (anti-ANA), anti-double strand DNA (anti-ds-DNA), anti-extractable nuclear antigens (anti-ENA). Finally, natural anti-alpha-galactosyl (ant…
Sympathetic Activity and Blood Pressure Pattern in Autosomal Dominant Polycystic Kidney Disease Hypertensives
To study the potential role of sympathetic activity in the pathogenesis of arterial hypertension associated with autosomal dominant polycystic kidney disease (ADPKD) and to analyze its relationship with 24-hour blood pressure pattern, plasma catecholamines and 24-hour ambulatory blood pressure monitoring were evaluated in 30 ADPKD hypertensive patients (of which 17 without and 13 with renal failure) and in 50 essential hypertensives. The groups were matched for sex, body mass index, known duration of hypertension, and clinic blood pressure. Plasma catecholamines, determined in resting position, were higher in ADPKD patients without renal failure than in essential hypertensives. Nighttime di…
Low serum fetuin-A in renal failure patients on Hemodialisis
Sodium thiosulfate not always resolves calciphylaxis: an ambiguous response
Calciphylaxis is a severe “vascular ossification–calcification,” associated with a very high mortality rate that involvesarterial wall, venular wall, and nerves resulting in ischemia and necrosis of skin, subcutaneous fat, visceral organs,and skeletal muscles. Sodium thiosulfate has recently been used as a novel treatment option for calciphylaxisbecause of its dual role as an antioxidant and a chelator. Multiple case reports demonstrated that such therapy hasresulted in pain relief and healing of skin ulceration. We report a case of calciphylaxis of large severity that had anambiguous response to sodium thiosulfate treatment (improvement of symptomatology and skin lesions, improve-ment of b…
Serum Fetuin A concentration in patients on haemodialysis
Changes in serum fetuin-A and inflammatory markers levels in end stage renal disease (ESRD): effect of a single session haemodialysis.
Low Fetuin-A plasma levels are associated with the presence of carotid plaques in patients on dialysis.
Changes in serum Fetuin A and inflammatory markers levels in end stage renal disease (ESRD),effect of a single session haemodialysis
The aim of the present study was to evaluate the effect of a single haemodialysis (HD) session on serum fetuin-A levels, considered a negative acute phase response marker; moreover, we evaluated the behaviour of fibrinogen and high sensitivity C-reactive protein (hsCRP) as acute phase response and chronic/subclinical inflammation markers, respectively, after a single HD session. Serum fetuin-A, albumin, hsCRP and fibrinogen were measured in 72 patients before and after a single HD session. After a single HD session, we observed a significant increase in fibrinogen levels, while fetuin-A levels decreased (p<0.05). Also, hsCRP levels were significantly increased. The significant decrease of f…
Role and clinical importance of Helicobacter pylori infection in hemodialysis patients
Dyspepsia is an extrarenal symptom frequently found in hemodialysed patients; it is due to chronic renal failure, and uremic gastritis is a specific associated condition in chronic renal failure (CRF). On the other hand, in the general population, Helicobacter pylori infection is an important dyspepsia-related risk factor; its close connections with gastro-duodenal pathology are already known, above all the peptic disease in a really exclusive way. By observation of a dyalitic group of patients, opportunely matched with a no CRF group, we evaluated CRF-associated uremia and Helicobacter pylori infection which could eventually interact causing symptoms and lesions. A statistical analysis of …
Prevalence of biliary lithiasis in a Sicilian population of chronic renal failure patients.
BACKGROUND The aim of this study was to evaluate the prevalence of biliary lithiasis (BL) and associated risk factors in a population of undialysed patients with chronic renal failure (CRF), and to compare these with findings we had obtained previously in chronic haemodialysis (HD) patients and in subjects from the general population located in the same geographic region. METHODS A total of 118 CRF patients on conservative treatment were included in the study. In all subjects, we measured several clinical and humoral parameters potentially correlated with BL. Liver and biliary tract ultrasonography was performed with a 3.5 MHz linear probe after at least 12 h of fasting. RESULTS The prevale…
Plasma homocysteine levels in patients with chronic renal failure.
Aspetti psicologici in dialisi e nei pazienti non collaboranti
L’emodialisi e la dialisi peritoneale, anche se rappresentano (con il trapianto) la terapia sostitutiva d’elezione dell’insufficienza renale, non sempre vengono vissute positivamente dai pazienti, a causa delle rigide prescrizioni terapeutiche e per i cambiamenti che apportano nella vita quotidiana (1,2). Ciò potrebbe incidere negativamente sulla non compliance che è definita, in entrambi i trattamenti, come l’inosservanza parziale o totale della terapia, che può essere associata alla non accettazione del trattamento sostitutivo (3). In letteratura viene stimato che il 50% dei pazienti in emodialisi ed un terzo di quelli in peritoneale abbia almeno una parziale non compliance che nella magg…
Anderson-Fabry disease:A protean clinical behavior and a chance diagnosis
Role of TLR4 polymorphisms in inflammatory responses: implications for unsuccessful aging.
The total burden of infection at various sites may affect the progression of atherosclerosis and Alzheimer's disease (AD), the risk being modulated by host genotype. The role of lipopolysaccharide (LPS) receptor TLR4 is paradigmatic. It initiates the innate immune response against gram-negative bacteria, and TLR4 single nucleotide polymorphisms (SNPs), such as +896A/G, known to attenuate receptor signaling, have been described. This SNP shows a significantly lower frequency in patients affected by myocardial infarction or AD. Thus, people genetically predisposed to developing lower inflammatory activity seem to have less chance of developing cardiovascular disease (CVD) or AD. In the presen…