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1. VDRA therapy is associated with improved survival in dialysis patients with serum intact PTH ≤ 150 pg/mL: results of the Italian FARO Survey

Author

Cozzolino M, Brancaccio D, Cannella G, Messa P, Gesualdo L, Marangella M, LoDeserto C, Pozzato M, Rombolà G, Costanzo AM, di Luzio Paparatti U, Mazzaferro S, Andreucci VE, Bellinghieri G, Bigazzi R, Bolasco P, Bonomini M, Cancarini G, Caruso MR, Cascone C, Di Luca M, Emiliani G, Lombardi L, Malberti F, Morosetti M, Panzetta G, Procaccini DA, Procida M, Quarello F, Salvadori M, Schena FP, STEFONI, SERGIO, Cozzolino M, Brancaccio D, Cannella G, Messa P, Gesualdo L, Marangella M, LoDeserto C, Pozzato M, Rombolà G, Costanzo AM, di Luzio Paparatti U, Mazzaferro S, Andreucci VE, Bellinghieri G, Bigazzi R, Bolasco P, Bonomini M, Cancarini G, Caruso MR, Cascone C, Di Luca M, Emiliani G, Lombardi L, Malberti F, Morosetti M, Panzetta G, Procaccini DA, Procida M, Quarello F, Salvadori M, Schena FP, and Stefoni S.

Subjects
PARICALCITOL, CKD-MBD, CALCITRIOL, HAEMODIALYSIS, PTH
Abstract

BACKGROUND: Chronic kidney disease (CKD) patients affected by mineral bone disorders (MBD) have higher rates of all-cause and cardiovascular-related mortality. Approximately, one-third of dialysis patients have low serum parathyroid hormone (PTH) levels (≤ 150 pg/mL). However, the reason why these patients have higher mortality compared to patients with normal PTH levels has not yet been fully elucidated. METHODS: The FARO study was performed on 2453 Italian patients followed prospectively from 28 dialysis centres over a 2-year period. Data were collected every 6 months and end points included time-to-death cumulative probability in patients with serum intact PTH (iPTH) ≤ 150 pg/mL and the effect of vitamin D receptor activation (VDRA) therapy. Kaplan-Meier curves and proportional hazards regression models stratified by PTH levels (i.e. ≤ 150 and >150 pg/mL) were used to determine cumulative probability of time-to-death and adjusted hazard ratios (HRs) for demographic, clinical and CKD-MBD treatment characteristics. RESULTS: The cumulative probability of death was higher (P < 0.01) for patients with serum iPTH levels ≤ 150 pg/mL [25.1%, 95% confidence interval (CI): 22.1-28.5 at 18 months] versus those with serum iPTH levels within the normal range (18.0%, 95% CI: 16.1-20.1). In a model with time-dependent covariates restricted to time periods when patients had iPTH levels ≤ 150 pg/mL, lower mortality was observed in patients treated with VDRA [i.e. HR = 0.62, 95% CI: 0.42-0.92 for oral or intravenous (IV) calcitriol; HR = 0.18, 95% CI: 0.04-0.8 for IV paricalcitol] versus those not receiving any VDRA (P < 0.01) independently of other variables. Patients who received IV paricalcitol, compared with either oral or IV calcitriol, showed reduced mortality, but this was not statistically significant (HR = 0.3, 95% CI: 0.07-1.31, P = 0.11). CONCLUSION: Results from this observational study suggest that VDRA therapy was associated with improved survival in dialysis patients, even with low serum iPTH levels.

Published
2012

2. Management of secondary hyperparathyroidism in Italy: results of the Italian FARO survey

Author

Mazzaferro S, Brancaccio D, Messa P, Andreucci VE, Bellinghieri G, Bigazzi R, Bolasco P, Costanzo AM, di Luzio Paparatti U, Cannella G, Bonomini M, Cancarini G, Caruso MR, Cascone C, Di Luca M, Emiliani G, Gesualdo L, Lodeserto C, Lombardi L, Malberti F, Marangella M, Morosetti M, Panzetta G, Procaccini DA, Procida M, Quarello F, Rombolà G, Salvadori M, Schena FP, STEFONI, SERGIO, Mazzaferro S, Brancaccio D, Messa P, Andreucci VE, Bellinghieri G, Bigazzi R, Bolasco P, Costanzo AM, di Luzio Paparatti U, Cannella G, Bonomini M, Cancarini G, Caruso MR, Cascone C, Di Luca M, Emiliani G, Gesualdo L, Lodeserto C, Lombardi L, Malberti F, Marangella M, Morosetti M, Panzetta G, Procaccini DA, Procida M, Quarello F, Rombolà G, Salvadori M, Schena FP, and Stefoni S

Subjects
Paricalcitol, Male, medicine.medical_specialty, Calcitriol, Urology, Parathyroid hormone, Calcimimetic Agents, Phosphates, hyperparathyroidism, uremia, secondary hyperparathyroidism, PARICALCITOL, medicine, Vitamin D and neurology, Humans, parathyroid hormone, Prospective Studies, Vitamin D, Prospective cohort study, end stage renal disease, phosphate, Aged, Retrospective Studies, Hyperparathyroidism, business.industry, Middle Aged, medicine.disease, calcimimetic, Treatment Outcome, Italy, Nephrology, Health Care Surveys, Chronic Disease, Secondary hyperparathyroidism, Calcium, Female, Hyperparathyroidism, Secondary, Kidney Diseases, calcium, business, medicine.drug, Kidney disease
Abstract

AIMS: In recent years, treatment options for secondary hyperparathyroidism (SHPT) have increased (e.g., paricalcitol, calcimimetics). To determine the impact these new treatments have on achieving K/DOQI targets, an observational, prospective survey was undertaken. METHODS: Four 6-month time-spaced surveys of 2,637 patients in 28 Italian dialysis units were performed. Patient demographic information; use of vitamin D or calcimimetics; and changes in parathyroid hormone (PTH), calcium (Ca) and phosphate (P) levels were evaluated. RESULTS: Over the course of the survey, use of calcitriol decreased (from 62.1% at baseline to 44.5% at month 18; p

Published
2011

3. Achievement of NKF/K-DOQI recommended target values for bone and mineral metabolism in incident hemodialysis patients: Results of the FARO-2 cohort

Author

Cozzolino, M, Messa, P, Brancaccio, D, Cannella G, Bolasco P, Di Luca, M, Costanzo, Am, Paparatti, U, Festa, V, Gualberti, G, Mazzaferro, S, Bonomini, M, Cancarini, Giovanni, Caruso, Mr, Galfré, A, Gesualdo L, Lodeserto C, Malberti, F, Marangella, M, Morosetti, M, Quarello, F, Rombolà, G, and Stefoni, S.

Subjects
Male, Questionnaires, medicine.medical_specialty, NKF/K-DOQI, Survival, medicine.medical_treatment, Urology, Aged, Aged, 80 and over, Biomarkers, Bone and Bones, Calcium, Female, Humans, Kidney Failure, Chronic, Middle Aged, Parathyroid Hormone, Phosphorus, Practice Guidelines as Topic, Prospective Studies, Surveys and Questionnaires, Survival Analysis, Renal Dialysis, Lower risk, Kidney Failure, 80 and over, Medicine, Mineral metabolism, In patient, Chronic, Prospective cohort study, Survival analysis, Cardiovascular mortality, Mineral Bone Disorders, Settore MED/14 - Nefrologia, business.industry, Medicine (all), General Medicine, Hematology, Surgery, Nephrology, Incident haemodialysis, Biological Markers, Cohort, Hemodialysis, business
Abstract

Background: Mineral Bone Disorders (MBD) is prevalent in hemodialysis (HD) patients and associated with increased cardiovascular mortality. The FARO-2 study evaluated the achievement of the NKF/K-DOQI guidelines on recommended target values for serum calcium (Ca), phosphorous (P) and intact parathyroid hormone (PTH) levels on survival in incident HD patients. Methods: Data were collected by questionnaire from 568 incident HD patients followed prospectively over a 3-year period from 26 Italian dialysis units. The cumulative probability of time-to-death for CKD-MBD treatment characteristics was determined by the Kaplan-Meier curves. Results: Serum PTH levels (median values at 6 months vs. 36 months; 225 vs. 254 pg/ml), Ca (8.8 vs. 8.9 g/dl) and P (5.1 vs. 4.8 mg/dl) were not significantly different at 6 months versus follow-up. The majority of incident HD patients (60-70%) who were followed up for 36 months did not achieve the NKF/K-DOQI recommended target values. Survival rates were higher in patients on target for three parameters versus patients off target (survival at 24 months: at target 95.7% (95% CI: 84.0-98.9) versus not on target 71.1% (95% CI: 66.3-75.4, p < 0.01)). The 30.1% of patients on target for three MBD parameters at least once during the follow-up period had better survival rates compared to those not reaching these targets (survival at 24 months: at least once 88.0% (95% CI: 81.9-92.1); 67.7% (95% CI: 61.9-72.8, p < 0.01)). Conclusion: Our findings indicate that incident HD patients who achieved target levels (for three MBD parameters) for at least one visit have a lower risk of mortality.

Published
2014

4. Diagnosi e trattamento dell'anemia nell'IRC in terapia conservativa. Dati preliminari dello studio SIN-SIR (Studio italiano Indicatori di Risultato multipli - Epidemiologia dell'IRC in Italia) della Società Italiana di Nefrologia

Author

Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Di Landro D, Adorati Menegato M, Altieri P, Lodeserto C, D'Angelo A, Imbasciati E, Spotti D, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Moriconi L, Dal Canton A, Auricchio MR, Corti MM, Della Grotta F, Grillo C, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Gallieni M, Brambilla N, Piacentini A, Merico G, Del Santo A, Bottalico D., STEFONI, SERGIO, Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Di Landro D, Adorati Menegato M, Altieri P, Lodeserto C, D'Angelo A, Imbasciati E, Spotti D, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Moriconi L, Dal Canton A, Stefoni S, Auricchio MR, Corti MM, Della Grotta F, Grillo C, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Gallieni M, Brambilla N, Piacentini A, Merico G, Del Santo A, and Bottalico D.

Subjects
ANEMIA, TERAPIA CONSERVATIVA, INSUFFICIENZA RENALE CRONICA
Published
2006

5. Studio SIR-SIN (Studio italiano Indicatori di Risultato multipli - Epidemiologia dell'IRC in Italia) della Societa Italiana di Nefrologia nella popolazione affetta da IRC in terapia conservativa. Dati preliminari

Author

Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Di Landro D, Adorati Menegato M, Altieri P, Lodeserto C, D'Angelo A, Imbasciati E, Spotti D, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Moriconi L, Dal Canton A, Auricchio MR, Corti MM, Della Grotta F, Grillo C, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Gallieni M, Brambilla N, Piacentini A, Merico G, Del Santo A, Bottalico D., STEFONI, SERGIO, Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Di Landro D, Adorati Menegato M, Altieri P, Lodeserto C, D'Angelo A, Imbasciati E, Spotti D, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Moriconi L, Dal Canton A, Stefoni S, Auricchio MR, Corti MM, Della Grotta F, Grillo C, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Gallieni M, Brambilla N, Piacentini A, Merico G, Del Santo A, and Bottalico D.

Subjects
INSUFFICIENZA RENAEL CRONICA, TERAPIA CONSERVATIVA
Published
2006

6. Timing di creazione dell'accesso vascolare per emodialisi. Dati preliminari dello studio SIN-SIR (Studio italiano Indicatori di Risultato multipli - Epidemiologia dell'IRC in Italia) della Società Italiana di Nefrologia nella popolazione affetta da IRC in terapia conservativa

Author

Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Di Landro D, Adorati Menegato M, Altieri P, Lodeserto C, D'Angelo A, Imbasciati E, Spotti D, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Moriconi L, Dal Canton A, Auricchio MR, Corti MM, Della Grotta F, Grillo C, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Gallieni M, Brambilla N, Piacentini A, Merico G, Del Santo A, Bottalico D., STEFONI, SERGIO, Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Di Landro D, Adorati Menegato M, Altieri P, Lodeserto C, D'Angelo A, Imbasciati E, Spotti D, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Moriconi L, Dal Canton A, Stefoni S, Auricchio MR, Corti MM, Della Grotta F, Grillo C, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Gallieni M, Brambilla N, Piacentini A, Merico G, Del Santo A, and Bottalico D.

Subjects
ACCESSO VASCOLARE, EMODIALISI, TERAPIA CONSERVATIVA, INSUFFICIENZA RENALE CRONICA
Published
2006

7. Chronic kidney disease (CKD) in Italy: A multicenter study. Results of a questionnaire on the clinical management of CKD stage 3-5 patients

Author

Locatelli, F., Zoccali, C., Catucci, Ae, Savica, V., Liuzzo, G., Nardo, A., Minutolo, R., Nicola, L., Ricciardi, B., Mancini, W., Balducci, A., Costanzo, R., Di Luca, M., Ariano, R., Di Luzio, V., Brigante, M., Battaglia, G., Menegato, Ma, Di Landro, D., Altieri, P., Auricchio, Mr, Lodeserto, C., Stefoni, S., D Angelo, A., Imbasciati, E., Spotti, D., Cristofaro, V., Rapisarda, F., Piazza, V., Claudio Ronco, De Santo NG, Stella, A., Dani, L., Dal Canton, A., Corti, Mm, Teodoro, C., Della Grotta, F., Grillo, C., Catizone, L., Cabibbe, M., Bonofiglio, R., Capistrano, M., Paone, A., Buongiorno, E., Feliciani, Al, Chiarinotti, D., Rotolo, U., Feriani, M., Garibotto, G., Gallieni, M., Merico, G., Del Santo, A., Bottalico, D., Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Adorati Menegato M, Di Landro D, Altieri P, Auricchio MR, Lodeserto C, Stefoni S, D'Angelo A, Imbasciati E, Spotti D, De Cristofaro V, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Dani L, Dal Canton A, Corti MM, Teodoro C, Della Grotta F, Grillo C, Catizone L, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Rotolo U, Feriani M, Garibotto G, Gallieni M, Merico G, Del Santo A, and Bottalico D

Published
2006

8. Modalità di stima del filtrato glomerulare (FG) e inizio della dialisi. Dati preliminari dello studio SIR-SIN (Studio italiano Indicatori di Risultato multipli - Epidemiologia dell'IRC in Italia) della Societa Italiana di Nefrologia nella popolazione affetta da IRC in terapia conservativa

Author

Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Di Landro D, Adorati Menegato M, Altieri P, Lodeserto C, D'Angelo A, Imbasciati E, Spotti D, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Moriconi L, Dal Canton A, Auricchio MR, Corti MM, Della Grotta F, Grillo C, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Gallieni M, Brambilla N, Piacentini A, Merico G, Del Santo A, Bottalico D., STEFONI, SERGIO, Locatelli F, Zoccali C, Catucci AE, Savica V, Liuzzo G, Nardo A, Minutolo R, De Nicola L, Ricciardi B, Mancini W, Balducci A, Costanzo R, Di Luca M, Ariano R, Di Luzio V, Brigante M, Battaglia G, Di Landro D, Adorati Menegato M, Altieri P, Lodeserto C, D'Angelo A, Imbasciati E, Spotti D, Rapisarda F, Piazza V, Ronco C, De Santo NG, Stella A, Moriconi L, Dal Canton A, Stefoni S, Auricchio MR, Corti MM, Della Grotta F, Grillo C, Cabibbe M, Bonofiglio R, Capistrano M, Paone A, Buongiorno E, Feliciani AL, Chiarinotti D, Gallieni M, Brambilla N, Piacentini A, Merico G, Del Santo A, and Bottalico D

Subjects
FILTRATO GLOMERULARE, DIALISI, INSUFFICIENZA RENALE CRONICA
Published
2006

9. VDRA therapy is associated with improved survival in dialysis patients with serum intact PTH ≤ 150 pg/mL: results of the Italian FARO Survey

Author

Cozzolino, M1, Brancaccio, D, Cannella, G, Messa, P, Gesualdo, L, Marangella, M, Lodeserto, C, Pozzato, M, Rombolà, G, Costanzo, Am, di Luzio Paparatti, U, Mazzaferro, S, Andreucci VE, FARO Study G. r. o. u. p., Bellinghieri, G, Bigazzi, R, Bolasco, P, Bonomini, M, Cancarini, Giovanni, Caruso, Mr, Cascone, C, Di Luca, M, Emiliani, G, Lombardi, L, Malberti, F, Morosetti, M, Panzetta, G, Procaccini, Da, Procida, M, Quarello, F, Salvadori, M, Schena, Fp, and Stefoni, S.

Subjects
Male, Paricalcitol, medicine.medical_specialty, medicine.medical_treatment, Parathyroid hormone, Gastroenterology, hyperparathyroidism, Calcification, Physiologic, Renal Dialysis, Chronic kidney disease-mineral and bone disorder, Internal medicine, medicine, Humans, Prospective Studies, VDRA, Survival rate, Dialysis, Aged, Transplantation, Bone Density Conservation Agents, business.industry, Hazard ratio, Middle Aged, Prognosis, medicine.disease, Health Surveys, Survival Rate, Endocrinology, Parathyroid Hormone, Nephrology, Ergocalciferols, dialysis, Kidney Failure, Chronic, Receptors, Calcitriol, Female, Hemodialysis, Bone Diseases, business, Follow-Up Studies, Glomerular Filtration Rate, medicine.drug, Kidney disease
Abstract

BACKGROUND: Chronic kidney disease (CKD) patients affected by mineral bone disorders (MBD) have higher rates of all-cause and cardiovascular-related mortality. Approximately, one-third of dialysis patients have low serum parathyroid hormone (PTH) levels (≤ 150 pg/mL). However, the reason why these patients have higher mortality compared to patients with normal PTH levels has not yet been fully elucidated. METHODS: The FARO study was performed on 2453 Italian patients followed prospectively from 28 dialysis centres over a 2-year period. Data were collected every 6 months and end points included time-to-death cumulative probability in patients with serum intact PTH (iPTH) ≤ 150 pg/mL and the effect of vitamin D receptor activation (VDRA) therapy. Kaplan-Meier curves and proportional hazards regression models stratified by PTH levels (i.e. ≤ 150 and >150 pg/mL) were used to determine cumulative probability of time-to-death and adjusted hazard ratios (HRs) for demographic, clinical and CKD-MBD treatment characteristics. RESULTS: The cumulative probability of death was higher (P < 0.01) for patients with serum iPTH levels ≤ 150 pg/mL [25.1%, 95% confidence interval (CI): 22.1-28.5 at 18 months] versus those with serum iPTH levels within the normal range (18.0%, 95% CI: 16.1-20.1). In a model with time-dependent covariates restricted to time periods when patients had iPTH levels ≤ 150 pg/mL, lower mortality was observed in patients treated with VDRA [i.e. HR = 0.62, 95% CI: 0.42-0.92 for oral or intravenous (IV) calcitriol; HR = 0.18, 95% CI: 0.04-0.8 for IV paricalcitol] versus those not receiving any VDRA (P < 0.01) independently of other variables. Patients who received IV paricalcitol, compared with either oral or IV calcitriol, showed reduced mortality, but this was not statistically significant (HR = 0.3, 95% CI: 0.07-1.31, P = 0.11). CONCLUSION: Results from this observational study suggest that VDRA therapy was associated with improved survival in dialysis patients, even with low serum iPTH levels.

Published
2012

10. Secondary hyperparathyroidism in chronic dialysis patients: results of the Italian FARO survey on treatment and mortality

Author

Brancaccio, D, Cozzolino, M, Cannella, G, Messa, P, Bonomini, M, Cancarini, Giovanni, Caruso, Mr, Cascone, C, Costanzo, Am, di Luzio Paparatti, U, Mazzaferro, S, Collaborators: Andreucci VE, FARO Study G. r. o. u. p., Bellinghieri, G, Bigazzi, R, Bolasco, P, Di Luca, M, Giuseppe, E, Gesualdo, L, Lodeserto, C, Lombardi, L, Malberti, F, Marangella, M, Morosetti, M, Panzetta, G, Procaccini, Da, Procida, M, Quarello, F, Rombolà, G, Salvadori, M, Schena, Fp, and Sergio, S.

Subjects
hyperparathyroidism, parathyroid hormone, calcium, phosphate, end stage renal disease, kidney
Published
2011

11. Prevalence and prognosis of mild anemia in non-dialysis chronic kidney disease: a prospective cohort study in outpatient renal clinics

Author

De Nicola, L, Minutolo, R, Chiodini, P, Zamboli, P, Cianciaruso, B, Nappi, F, Signoriello, S, Conte, G, Zoccali, C, Iodice, Fc, Borrelli, S, Scigliano, Rosella, Gallo, C, Materiale, T, Minale, B, Paglionico, C, Pota, A, Andreucci, Ve, Avella, Fabrizio, Di Iorio BR, Bellizzi, V, Cestaro, R, Martignetti, V, Morrone, L, Lupo, A, Abaterusso, C, Donadio, C, Bonomini, M, Sirolli, V, F Lopez T, Casino, Detomaso, F, Giannattasio, M, Virgilio, M, Tarantino, G, Cristofano, C, Tuccillo, S, Chimienti, S, Petrarulo, F, Giancaspro, V, Strippoli, M, Laraia, E, Gallucci, M, Gigante, B, Lodeserto, C, Santese, D, Montanaro, A, Giordano, R, Caglioti, A, Fuiano, G, Cariddi, G, Postorino, M, Savica, V, Monardo, P, Bellinghieri, G, Santoro, D, Castellino, P, Rapisarda, F, Fatuzzo, P, Messina, A, De Nicola, L, Minutolo, R, Chiodini, P, Zamboli, P, Cianciaruso, Bruno, Nappi, F, Signoriello, S, Conte, G, Zoccali, C, and SIN TABLE CDK Study, Group

Subjects
Male, medicine.medical_specialty, Epoietin- CKD -renal anemia- hemoglobin variability, Survival, Anemia, Renal function, Kaplan-Meier Estimate, Chronic kidney disease, End-stage renal disease, Hemoglobin, Aged, Aged, 80 and over, Ambulatory Care Facilities, Female, Glomerular Filtration Rate, Hemoglobins, Humans, Kidney Failure, Chronic, Longitudinal Studies, Middle Aged, Predictive Value of Tests, Prevalence, Prognosis, Proportional Hazards Models, Prospective Studies, Renal Insufficiency, Chronic, Survival Analysis, Disease Progression, End stage renal disease, Kidney Failure, Internal medicine, 80 and over, medicine, Renal Insufficiency, Chronic, Intensive care medicine, Prospective cohort study, Survival analysis, business.industry, Proportional hazards model, medicine.disease, Nephrology, Predictive value of tests, business, Kidney disease
Abstract

Background/Aims: We evaluated prevalence and prognosis of mild anemia, defined as Hb (g/dl) 11–13.5 in males and 11–12 in females, in a prospective cohort of stage 3–5 chronic kidney disease (CKD) patients. Methods: We enrolled 668 consecutive patients in 25 renal clinics during 2003. Patients with frank anemia (Hb Results: Mild anemia was present in 41.3% at visit 1 and 34.1% at visit 2. We identified PER in 22% patients, RES in 10%, and PRO in 26%. In the subsequent 40 months, 125 patients developed end-stage renal disease (ESRD) and 94 died. At competing risk model, PER predicted ESRD (hazard ratio, HR, 1.82, 95% confidence interval, CI, 1.01–3.29) while PRO predicted both ESRD (HR 1.81, 95% CI 1.02–3.23) and death (HR 1.87, 95% CI 1.04–3.37). Conclusion: In non-dialysis chronic kidney disease, mild anemia is prevalent and it is a marker of risk excess when persistent or progressive over time.

Published
2010

12. Effect of computer-assisted European Best Practice Guideline implementation on adherence and target attainment: ORAMA results

Author

Covic, A, Locatelli, F, Macdougall, Ic, Wiecek, A, Shikov, P, Nikolov, D, Deliyska, B, Paskalev, D, Simeonov, P, Belavic, Z, Jerko, B, Leko, N, Bogadi, I, Winkler, Re, Buhl, M, Wilbrandt, E, Edinger, M, Mall, M, Dammerboer, C, Urzowski, H, Flender, D, Kunowski, G, Müller, A, Anschütz, H, Prager, G, Lüth, Jb, Gaspare De Santo, N, Lodeserto, C, Bonomini, M, Meneghel, G, Ragaiolo, M, Cancarini, Giovanni, Rotolo, U, Zepa, L, Saumane Baza, G, Rivots, G, Rozentals, R, Rydzewski, A, Antczak Jedrzejczak, D, Ratajewski, W, Frankiewicz, D, Mazur, O, Grazyna, B, Kosicki, A, Sydor, A, Muszytowski, M, Mircescu, G, Mugosa Ratkovic, M, Pljesa, S, Nesic, V, Dimkovic, N, Curic, S, Lazarevic, M, and Kovacevic, Z.

Subjects
hemodialysis, erhythropoietin, anemia
Published
2009

13. Renal anemia: comparing current Eastern and Western European management practice (ORAMA)

Author

Wiecek, A, Covic, A, Locatelli, F, Macdougall, Ic, ORAMA STUDY GROUP, COLLABORATORS SHIKOV, P, Nikolov, D, Deliyska, B, Paskalev, D, Simeonov, P, Belavic, Z, Jerko, B, Leko, N, Bogadi, I, Winkler, Re, Buhl, M, Wilbrandt, E, Edinger, M, Mall, M, Dammerboer, C, Urzowski, H, Flender, D, Kunowski, G, Müller, A, Anschütz, H, Prager, G, Johann, Borwin, DE SANTO NG, Lodeserto, C, Bonomini, M, Meneghel, G, Ragaiolo, M, Cancarini, Giovanni, Rotolo, U, Zepa, L, SAUMANE BAZA, G, Ritovs, G, Rozentals, R, Rydzewski, A, ANTCZAK JEDRZEJCZAK, D, Ratajewski, W, Frankiewicz, D, Mazur, O, Grazyna, B, Andrezej, K, Antoni, S, Marek, M, Mircescu, G, Ratkovic, Mm, Pljesa, S, Nesic, V, Dimkovic, N, Curic, S, Lazarevic, M, and Kovacevic, Z.

Subjects
malattia renale cronica, anemia, chronic kidney disease
Published
2008

14. ORAMA: a study to investigate EBPG impact on renal anaemia - design and baseline data

Author

Locatelli, F, Covic, A, Macdougall, Ic, Wiecek, A, ORAMA STUDY GROUP, COLLABORATORS COVIC, A, Shikov, P, Nikolov, D, Deliyska, B, Paskalev, D, Simeonov, P, Belavic, Z, Jerko, B, Leko, N, Winkler, Re, Buhi, M, Wilbrandt, E, Edinger, M, Mall, M, Dammerboer, C, Urzowski, H, Flender, D, Kunowski, G, Müller, A, Anschütz, H, Prager, G, DE SANTO NG, Lodeserto, C, Bonomini, M, Meneghel, G, Ragaiolo, M, Cancarini, Giovanni, Rotolo, U, Zepa, L, SAUMANE BAZA, G, Ritovs, G, Rosentals, R, Rydzewski, A, ANTCZAK JEDRZEJCZAK, D, Ratajewski, W, Frankiewicz, D, Mazur, O, Bogdanowicz, G, Kosicki, A, Sydor, A, Muszytowski, M, Mircescu, G, Ratkovic, Mm, Pljesa, S, Nesic, V, Dimkovic, N, Curic, S, Lazarevic, M, and Kovacevic, Z.

Subjects
anemia, dialysis, erhythropoietin
Published
2008

15. MODALITA’ DI STIMA DEL FILTRATO GLOMERULARE(FG) E INIZIO DELLA DIALISI. DATI PRELIMINARI DELLO STUDIO SIR-SIN (STUDIO ITALIANO INDICATORI DI RISULTATI MULTIPLI-EPIDEMIOLOGIA DELL’IRC IN ITALIA) DELLA SOCIETA’ ITALIANA DI NEFROLOGIA NELLA POPOLAZIONE AFFETTA DA IRC IN TERAPIA CONSERVATIVA

Author

Locatelli, F, Zoccali, C, Catucci, Ae, Savica, V, Liuzzo, G, Nardo, A, Minutolo, R, DE NICOLA, L, Ricciardi, B, Mancini, W, Balducci, A, Costanzo, R, DI LUCA, M, Ariano, R, DI LUZIO, V, Brigante, M, Battaglia, G, DI LANDRO, D, ADORATI MENEGATO, M, Altieri, P, Lodeserto, C, Dangelo, A, Imbasciati, E, Spotti, D, Rapisarda, Francesco, Piazza, V, Ronco, C, DE SANTO NG, Stella, A, Moriconi, L, DAL CANTON, A, Stefoni, S, Auricchio, Mr, Corti, Mm, DELLA GROTTA, F, Grillo, C, Cabibbe, M, Bonofiglio, R, Capistrano, M, Paone, A, Buongiorno, E, Feliciani, Al, Chiarinotti, D, Gallieni, M, Brambilla, N, Piacentini, A, Merico, G, DEL SANTO, A, and Bottalico, D.

Published
2006

16. CHRONIC KIDNEY DISEASE IN ITALY: A MULTICENTER STUDY. RESULTS OF A QUESTIONNAIRE ON THE CLINICAL MANAGEMENT OF CKD STAGE 3-5 PATIENTS

Author

Locatelli, F, Zoccali, C, Catucci, Ae, Savica, V, Liuzzo, G, Nardo, A, Minutolo, R, DE NICOLA, L, Ricciardi, B, Mancini, W, Balducci, A, Costanzo, R, DI LUCA, M, Ariano, R, DI LUZIO, V, Brigante, M, Battaglia, G, ADORATI MENEGATO, M, DI LANDRO, D, Altieri, P, Auricchio, M. R., Lodeserto, C, Stefoni, S, Dangelo, A, Imbasciati, E, Spotti, D, DE CRISTOFORO, V, Rapisarda, Francesco, Piazza, V, Ronco, C, DE SANTO NG, Stella, A, Dani, L, DAL CANTON, A, Corti, M. M., Teodoro, C, DELLA GROTTA, F, Grillo, C, Catizone, L, Cabibbe, M, Bonofiglio, R, Capistrano, M, Paone, A, Buongiorno, E, Feliciani, A. L., Chiarinotti, D, Rotolo, U, Feriani, M, Garibotto, G, Gallieni, M, Merico, G, and DEL SANTO, A. AND BOTTALICO D.

Published
2006

17. TIMING DI CREAZIONE DELL’ACCESSO VASCOLARE PER EMODIALISI. DATI PRELIMINARI DELLO STUDIO SIR-SIN (STUDIO ITALIANO INDICATORI DI RISULTATI MULTIPLI-EPIDEMIOLOGIA DELL’IRC IN ITALIA) DELLA SOCIETA’ ITALIANA DI NEFROLOGIA NELLA POPOLAZIONE AFFETTA DA IRC IN TERAPIA CONSERVATIVA

Author

Locatelli, F, Zoccali, C, Catucci, Ae, Savica, V, Liuzzo, G, Nardo, A, Minutolo, R, DE NICOLA, L, Ricciardi, B, Mancini, W, Balducci, A, Costanzo, R, DI LUCA, M, Ariano, R, DI LUZIO, V, Brigante, M, Battaglia, G, DI LANDRO, D, ADORATI MENEGATO, M, Altieri, P, Lodeserto, C, Dangelo, A, Imbasciati, E, Spotti, D, Rapisarda, Francesco, Piazza, V, Ronco, C, DE SANTO NG, Stella, A, Moriconi, L, DAL CANTON, A, Stefoni, S, Auricchio, Mr, Corti, Mm, DELLA GROTTA, F, Grillo, C, Cabibbe, M, Bonofiglio, R, Capistrano, M, Paone, A, Buongiorno, E, Feliciani, Al, Chiarinotti, D, Gallieni, M, Brambilla, N, Piacentini, A, Merico, G, DEL SANTO, A, and Bottalico, D.

Published
2006

18. Global approach to cardiovascular risk in chronic kidney disease: reality and opportunities for intervention

Author

De Nicola, L, Minutolo, R, Chiodini, P, Zoccali, C, Castellino, P, Donadio, C, Strippoli, M, Casino, F, Giannattasio, M, Petrarulo, F, Virgilio, M, Laraia, E, Di Iorio, B, Savica, V, Conte, G, Zamboli, P, Catapano, F, Maione, E, Tirino, G, Venditti, G, Avino, D, Borrelli, S, Scigliano, R, Materiale, T, Signoriello, G, Gallo, C, Cianciaruso, B, Torraca, S, Pota, A, Andreucci, Ve, Nappi, F, Avella, F, Di Iorio BR, Bellizzi, V, D'Apice, L, Mangiacapra, S, Caserta, D, Cestaro, R, Marzano, L, Giannattasio, P, Martignetti, V, Morrone, L, Budetta, F, Gigliotti, G, Iodice, C, Rubino, R, Lupo, A, Conte, M, Panichi, V, Bonomini, M, Sirolli, V, Lopez, T, Detomaso, F, Elia, F, Tarantino, G, Cristofano, C, Chimienti, S, Montanaro, A, Giordano, R, Marangi, A, Giancaspro, V, Gallucci, M, Gigante, B, Lodeserto, C, Santese, D, Caglioti, A, Mancuso, D, Fuiano, G, Mallamaci, F, Postorino, M, Monardo, P, Bellinghieri, G, Mallamace, A, Rapisarda, F, Fatuzzo, P, Messina, A, DE NICOLA, Luca, Minutolo, Roberto, Chiodini, Paolo, Zamboni, P., Zoccali, C., Castellino, P., Donadio, C., Strippoli, M., Casino, F., Giannattasio, M., Petrarulo, F., Virgilio, M., Laraia, E., DI IORIO, B., Savica, V., and Conte, Giuseppe

Subjects
Nephrology, Male, epoietin, medicine.medical_specialty, Anemia, Cross-sectional study, diuretic, Hypercholesterolemia, Severity of Illness Index, Risk Factors, Internal medicine, Diabetes mellitus, medicine, CKD, Diabetes Mellitus, Odds Ratio, Prevalence, Humans, Antihypertensive Agents, Aged, Aged, 80 and over, business.industry, statin, Odds ratio, Middle Aged, medicine.disease, diuretics, Confidence interval, Surgery, Proteinuria, Cross-Sectional Studies, Italy, Cardiovascular Diseases, Chronic Disease, Hypertension, Practice Guidelines as Topic, Female, Hypertrophy, Left Ventricular, Kidney Diseases, sodium excretion, business, Dyslipidemia, Kidney disease
Abstract

The current implementation into nephrology clinical practice of guidelines on treatment of cardiovascular (CV) risk factors in chronic kidney disease (CKD) is unknown. We designed a cross-sectional analysis to evaluate the prevalence and treatment of eight modifiable CV risk factors in 1058 predialysis CKD patients (stage 3: n =486; stage 4: n =430, stage 5: n =142) followed for at least 1 year in 26 Italian renal clinics. The median nephrology follow-up was 37 months (range: 12–391 months). From stages 3 to 5, hypertension was the main complication (89, 87, and 87%), whereas smoking, high calcium-phosphate product and malnutrition were uncommon. The prevalence of proteinuria (25, 38, and 58%), anemia (16, 32, and 51%) and left ventricular hypertrophy (51, 55, and 64%) significantly increased, while hypercholesterolemia was less frequent in stage 5 (49%) than in stages 4 and 3 (59%). The vast majority of patients received multidrug antihypertensive therapy including inhibitors of renin–angiotensin system; conversely, diuretic treatment was consistently inadequate for both frequency and dose despite scarce implementation of low salt diet (19%). Statins were not prescribed in most hypercholesterolemics (78%), and epoietin treatment was largely overlooked in anemics (78%). The adjusted risk for having a higher number of uncontrolled risk factors rose in the presence of diabetes (odds ratio 1.29, 95% confidence interval 1.00–1.66), history of CV disease (odds ratio 1.48, 95% confidence interval 1.15–1.90) and CKD stages 4 and 5 (odds ratio 1.75, 95% confidence interval 1.37–2.22 and odds ratio 2.85, 95% confidence interval 2.01–4.04, respectively). In the tertiary care of CKD, treatment of hypertension is largely inadequate, whereas therapy of anemia and dyslipidemia is frequently omitted. The risk of not achieving therapeutic targets is higher in patients with diabetes, CV disease and more advanced CKD.

Published
2006

20. The effect of increasing age on the prognosis of non-dialysis patients with chronic kidney disease receiving stable nephrology care

Author

De Nicola, L., Minutolo, R., Chiodini, P., Borrelli, S., Zoccali, C., Postorino, M., Iodice, C., Nappi, F., Fuiano, G., Gallo, C., Conte, G., Nicola, L., Zamboli, P., Signoriello, S., Materiale, T., Minale, B., Paglionico, C., Cianciaruso, B., Pota, A., Avella, F., Di Iorio, B. R., Bellizzi, V., Cestaro, R., Martignetti, V., Morrone, L., Lupo, A., Abaterusso, C., Donadio, C., Bonomini, M., Sirolli, V., Lopez, T., Detomaso, F., Giannattasio, M., Virgilio, M., Tarantino, G., Cristofano, C., Tuccillo, S., Chimienti, S., Petrarulo, F., Giancaspro, V., Strippoli, M., Laraia, E., Gallucci, M., Gigante, B., Lodeserto, C., Santese, D., Montanaro, A., Giordano, R., Caglioti, A., Caridi, G., Savica, Vincenzo, Monardo, P., Bellinghieri, Guido, Santoro, Domenico, Castellino, P., Rapisarda, F., Fatuzzo, P., Messina, A., DE NICOLA, Luca, Minutolo, Roberto, Chiodini, Paolo, Borrelli, Silvio, Zoccali, Carmine, Postorino, Maurizio, Iodice, Carmela, Nappi, Felice, Fuiano, Giorgio, Gallo, Ciro, and Conte, Giuseppe

Subjects
Male, Nephrology, Aging, Time Factors, medicine.medical_treatment, Kaplan-Meier Estimate, Kidney, urologic and male genital diseases, Risk Factors, Age Factor, Prospective Studies, Prospective cohort study, Multivariate Analysi, Aged, 80 and over, Proteinuria, Incidence, Age Factors, Middle Aged, age, chronic kidney disease, elderly, ESRD, nephrology care, survival, Prognosis, female genital diseases and pregnancy complications, Italy, Disease Progression, Female, medicine.symptom, Risk assessment, Glomerular Filtration Rate, Human, medicine.medical_specialty, Time Factor, Prognosi, Renal function, Risk Assessment, Follow-Up Studie, Internal medicine, Diabetes mellitus, medicine, Humans, Renal Insufficiency, Chronic, Intensive care medicine, Dialysis, Proportional Hazards Models, Aged, Chi-Square Distribution, business.industry, Risk Factor, medicine.disease, Prospective Studie, Multivariate Analysis, Proportional Hazards Model, Kidney Failure, Chronic, business, Follow-Up Studies, Kidney disease
Abstract

To define whether age modifies the prognosis of patients with chronic kidney disease (CKD) on nephrology care, we prospectively followed patients with CKD who have been receiving nephrology care in a clinic for 1 year or more. The incidence of end-stage renal disease (ESRD), defined by the occurrence of dialysis or transplant, or death without ESRD was estimated by a competing-risk approach, and interactions between age and risk factors tested in Cox models over a median follow-up period of 62.4 months. Of 1248 patients with stage III-V CKD, 481 were younger than 65, 410 were between 65 and 75, and 357 were over 75 years old. Within each age class, the mean estimated glomerular filtration rate (eGFR) was 31, 32, and 29 ml/min per 1.73 m2, respectively. There were 394 ESRD events and 353 deaths. The risk of ESRD was higher than the risk of death without ESRD for ages 60 years, and independent of eGFR. The ESRD risk diminished with aging but still prevailed for eGFRs of 25-35 in patients between 65 and 75 years and with an eGFR below 15 in those up to 85 years old. Proteinuria significantly increased the risk of ESRD with advancing age. Surprisingly, the unfavorable effects of cardiovascular disease on ESRD and of diabetes on survival significantly decreased with increasing age. Male gender, higher phosphate, lower body mass index, and hemoglobin were age-independent predictors for ESRD, while cardiovascular disease, lower hemoglobin, higher proteinuria and uric acid, and ESRD also predicted death. Thus, in older patients on nephrology care, the risk of ESRD prevailed over mortality even when eGFR was not severely impaired. Proteinuria increases ESRD risk, while the predictive role of other modifiable risk factors was unchanged compared with younger patients. © 2012 International Society of Nephrology.

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