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1. Kidney health management during pregnancy: a dialogue between patients and healthcare professionals

Author

Fantuzzi, Anna Laura, Berri, Elisa, Tartaglione, Lida, Mandreoli, Marcora, Giannini, Rossella, Dominjanni, Sara, Porreca, Silvia, Fantuzzi, Anna Laura, Berri, Elisa, Tartaglione, Lida, Mandreoli, Marcora, Giannini, Rossella, Dominjanni, Sara, and Porreca, Silvia

Abstract

Pregnancy in patients with chronic kidney disease (CKD) represents a significant challenge for nephrologists and healthcare professionals involved in the care pathway, especially in advanced stages of the disease and during dialysis. From an epidemiological standpoint, the exact percentage of women with CKD who become pregnant is unknown. It is estimated that stages 1 and 2 of kidney disease (where kidney function is still preserved or mildly impaired with persistent albuminuria) affect up to 3% of women of childbearing age (20-39 years), while stages 3-5 (glomerular filtration rate < 60 mL/min) affect about 1 out of 150 women of childbearing age. However, due to reduced fertility, these women often experience spontaneous miscarriages in the early months of pregnancy, and 1 out of 750 faces complications in her offspring. As a result, managing pregnancy in CKD patients requires special attention, considering various clinical aspects including the reciprocal influence between the disease and pregnancy, the need to adjust therapies, the modification of treatments, and the high risk of maternal and fetal complications. An appropriate nutritional approach is also a crucial phase in this process, as nutritional status significantly influences maternal and fetal health. In this article, developed through questions posed to physicians and the case manager during routine care, we do not intend to address the entire complex issue linking kidney disease to pregnancy outcomes. Instead, we aim to provide updated answers to various topics of interest for the multidisciplinary team to safeguard the health of both mother and child., Pregnancy in patients with chronic kidney disease (CKD) represents a significant challenge for nephrologists and healthcare professionals involved in the care pathway, especially in advanced stages of the disease and during dialysis. From an epidemiological standpoint, the exact percentage of women with CKD who become pregnant is unknown. It is estimated that stages 1 and 2 of kidney disease (where kidney function is still preserved or mildly impaired with persistent albuminuria) affect up to 3% of women of childbearing age (20-39 years), while stages 3-5 (glomerular filtration rate <60 ml/min) affect about 1 in 150 women of childbearing age. However, due to reduced fertility, these women often experience spontaneous miscarriages in the early months of pregnancy, and 1 in 750 face complications in their offspring. As a result, managing pregnancy in CKD patients requires special attention, considering various clinical aspects including the reciprocal influence between the disease and pregnancy, the need to adjust therapies, the modification of treatments, and the high risk of maternal and fetal complications. An appropriate nutritional approach is also a crucial phase in this process, as nutritional status significantly influences maternal and fetal health. In this article, developed through questions posed to physicians and the case manager during routine care, we do not intend to address the entire complex issue linking kidney disease to pregnancy outcomes. Instead, we aim to provide updated answers to various topics of interest for the multidisciplinary team to safeguard the health of both mother and child.

Published
2024

2. Advanced CKD and gender: a multi-perspective and multi-dimensional vision

Author

Fantuzzi, Anna Laura, Berri, Elisa, Tartagliolne, Lida, Mandreoli, Marcora, Giannini, Rossella, Dominjanni, Sara, Porreca, Silvia, Fantuzzi, Anna Laura, Berri, Elisa, Tartagliolne, Lida, Mandreoli, Marcora, Giannini, Rossella, Dominjanni, Sara, and Porreca, Silvia

Abstract

Chronic kidney disease (CKD) is present in approximately 7% of the population in the world: several studies have highlighted socio-cultural discrimination, to the detriment of women, in referral to specialist nephrological care and access to dialysis and transplantation. Globally, gender discrimination limits the possibility of access to education and medical care and the involvement in clinical trials. Women on dialysis have different comorbidities than men; the choice to follow a predialysis process and the subsequent orientation towards dialysis treatment are certainly influenced by gender as is the choice of dialysis access. As regards kidney transplantation, women are more likely to offer themselves as donors rather than to be beneficiaries. Conventional knowledge supports the belief that there are gender differences in the acquisition, preparation and consumption of food; for this reason it is essential to consider the variables that come into play when defining and agreeing treatment paths, in particular in taking care of people with chronic diseases such as CKD., Chronic kidney disease (CKD or CKD [Chronic Kidney Disease]) is present in approximately 7% of the world population: several studies have highlighted socio-cultural discrimination, to the detriment of women, in referral to specialist nephrological care and access to dialysis and transplantation. Globally, gender discrimination limits the possibility of access to education, medical care and involvement in clinical trials. Women on dialysis have different comorbidities than men; the choice to follow a predialysis process and the subsequent orientation towards dialysis treatment are certainly influenced by gender as is the choice of dialysis access. As regards kidney transplantation, women are more likely to offer themselves as donors rather than to be beneficiaries. Conventional knowledge supports the belief that there are gender differences in the acquisition, preparation and consumption of food, for this reason it is essential to consider the variables that come into play when defining and agreeing treatment paths, in particular in taking care of people with chronic diseases such as CKD

Published
2024

5. Gender and sex in the development and progression of renal diseases

Author

Mandreoli, Marcora and Mandreoli, Marcora

Abstract

Sex-based disparities in nephrology have been a historically understudied area. In nephrology, gender differences exist with regard to the epidemiology, evolution and prognosis of chronic kidney disease (CKD). In some cases, these differences run contrary to the general population trends.  We discuss such gender and sex disparities, including differing impact of traditional and novel risk factors, as well as hormonal factors, all of them potentially influencing propensity, progression and biochemical and psychological aspects of CKD. The factors involved in this gender disparity may include diet, kidney and glomerular size, differences in glomerular hemodynamics, and the direct effects of sex hormones. The progression rate of many renal diseases is affected by sex. In polycystic kidney disease, membranous nephropathy, immunoglobulin A nephropathy, and “chronic renal disease of unknown etiology,” men progress at a faster rate to end-stage renal failure than do women. In many, but not all, animal models of renal disease, estrogens slow progression rate. Animal and experimental studies have tried to offer further mechanistic explanations for gender differences in disease progression. It has been suggested that the gender dimorphism of CKD progression may represent the effects of the interaction of circulating steroids with specific kidney receptors. Endogenous estrogens have in general been considered to have anti-fibrotic and anti-apoptotic effects on the kidney.  On the other hand, the faster kidney function decline in men has been attributed to the specific pro-apoptotic and profibrotic properties of androgens., Sex-based disparities in nephrology have been a historically understudied area. In nephrology, gender differences exist with regard to the epidemiology, evolution and prognosis of chronic kidney disease (CKD). In some cases, these differences run contrary to the general population trends. We discuss such gender and sex disparities, including differing impact of traditional and novel risk factors, as well as hormonal factors, all of them potentially influencing propensity, progression and biochemical and psychological aspects of CKD. The factors involved in this gender disparity may include diet, kidney and glomerular size, differences in glomerular hemodynamics, and the direct effects of sex hormones. The progression rate of many renal diseases is affected by sex. In polycystic kidney disease, membranous nephropathy, immunoglobulin A nephropathy, and “chronic renal disease of unknown etiology”, men progress at a faster rate to end-stage renal failure than women do. In many, but not all, animal models of renal disease, estrogens slow progression rate. Animal and experimental studies have tried to offer further mechanistic explanations for gender differences in disease progression. It has been suggested that the gender dimorphism of CKD progression may represent the effects of the interaction of circulating steroids with specific kidney receptors. Endogenous estrogens have in general been considered to have anti-fibrotic and anti-apoptotic effects on the kidney. On the other hand, the faster decline of kidney function in men has been attributed to the specific pro-apoptotic and pro-fibrotic properties of androgens.

Published
2023

6. Sex and gender disparities in lupus nephropathy and kidney transplantation

Author

Mandreoli, Marcora and Mandreoli, Marcora

Abstract

Systemic lupus erythematosus (SLE) has a clear prevalence in females. Although there are conflicting data, among males affected by SLE to a higher proportion develop lupus nephritis, with a more severe histological and clinical pattern than in females. More frequently males also present an antiphospholipid syndrome. Males are less likely to achieve clinical remission of lupus nephritis. A sex and gender disparity is also present in all the phases preceding the kidney transplant starting from the referral for eligibility and registration on the active waiting list. There is a perception among healthcare staff that women have a greater degree of fragility and are therefore less eligible for kidney transplantation. Women also encounter obstacles in completing the tests necessary for inclusion on the waiting list and in many Health Care contexts they are less likely to have a transplant. In the field of living transplantation, women represent over half of all donors, while males are predominantly recipients. Long-term patient and graft survival appear superior in women compared to men., Systemic lupus erythematosus (SLE) has a clear prevalence in females. Although there are conflicting data, among males affected by SLE a higher proportion develops lupus nephritis, with a more severe histological and clinical pattern than in females. More frequently males also present an antiphospholipid syndrome. Males are less likely to achieve clinical remission of lupus nephritis. A sex and gender disparity is also present in all the phases preceding the kidney transplant from the referral for eligibility to the registration on the active waiting list. There is a perception among healthcare staff that women have a greater degree of fragility and are therefore less eligible for kidney transplantation. Women also encounter obstacles in completing the tests necessary for inclusion in the waiting list and in many Health Care contexts they are less likely to have a transplant. In the field of living transplantation, women represent over half of all donors, while males are predominantly recipients. Long-term patient and graft survival appears superior in women than in men.

Published
2023

9. A clinical stratification tool for chronic kidney disease progression rate based on classification tree analysis

Author

Rucci, Paola, Mandreoli, Marcora, Gibertoni, Dino, Zuccalà, Alessandro, Fantini, Maria Pia, Lenzi, Jacopo, Santoro, Antonio, Scarpioni, Roberto, De Amicis, Sara, Buzio, Carlo, David, Salvatore, Pasquali, Sonia, Corradini, Mattia, Cappelli, Gianni, Olmeda, Fabio, Baraldi, Alberto, Caruso, Francesco, Stefoni, Sergio, Orsi, Claudio, Santoro, Antonio, Cannarile, Cecilia, Mandreoli, Marcora, Di Nicolò, Pierpaolo, Storari, Alda, Russo, Giorgia, Buscaroli, Andrea, Monti, Mattia, Mosconi, Giovanni, Cristino, Stefania, Feletti, Carlo, Baldrati, Leopoldo, Rigotti, Angelo, and Flachi, Marta

Published
2014
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14. Effect of SGLT2 Inhibitors on Stroke and Atrial Fibrillation in Diabetic Kidney Disease

Author

Zhou, Zien, primary, Jardine, Meg J., additional, Li, Qiang, additional, Neuen, Brendon L., additional, Cannon, Christopher P., additional, de Zeeuw, Dick, additional, Edwards, Robert, additional, Levin, Adeera, additional, Mahaffey, Kenneth W., additional, Perkovic, Vlado, additional, Neal, Bruce, additional, Lindley, Richard I., additional, Ahuad Guerrero, Rodolfo Andres, additional, Aizenberg, Diego, additional, Albisu, Juan Pablo, additional, Alvarisqueta, Andres, additional, Bartolacci, Ines, additional, Berli, Mario Alberto, additional, Bordonava, Anselmo, additional, Calella, Pedro, additional, Cantero, Maria Cecilia, additional, Cartasegna, Luis Rodolfo, additional, Cercos, Esteban, additional, Coloma, Gabriela Cecilia, additional, Colombo, Hugo, additional, Commendatore, Victor, additional, Cuadrado, Jesus, additional, Cuneo, Carlos Alberto, additional, Cusumano, Ana Maria, additional, Douthat, Walter Guillermo, additional, Dran, Ricardo Dario, additional, Farias, Eduardo, additional, Fernandez, Maria Florencia, additional, Finkelstein, Hernan, additional, Fragale, Guillermo, additional, Fretes, Jose Osvaldo, additional, Garcia, Nestor Horacio, additional, Gastaldi, Anibal, additional, Gelersztein, Elizabeth, additional, Glenny, Jorge Archibaldo, additional, Gonzalez, Joaquin Pablo, additional, del Carmen Gonzalez Colaso, Patricia, additional, Goycoa, Claudia, additional, Greloni, Gustavo Cristian, additional, Guinsburg, Adrian, additional, Hermida, Sonia, additional, Juncos, Luis Isaias, additional, Klyver, Maria Isabel, additional, Kraft, Florencia, additional, Krynski, Fernando, additional, Lanchiotti, Paulina Virginia, additional, Leon de la Fuente, Ricardo Alfonso, additional, Marchetta, Nora, additional, Mele, Pablo, additional, Nicolai, Silvia, additional, Novoa, Pablo Antonio, additional, Orio, Silvia Ines, additional, Otreras, Fabian, additional, Oviedo, Alejandra, additional, Raffaele, Pablo, additional, Resk, Jorge Hector, additional, Rista, Lucas, additional, Rodriguez Papini, Nelson, additional, Sala, Jorgelina, additional, Santos, Juan Carlos, additional, Schiavi, Lilia Beatriz, additional, Sessa, Horacio, additional, Smith Casabella, Tomas, additional, Ulla, Maria Rosa, additional, Valdez, Maria, additional, Vallejos, Augusto, additional, Villarino, Adriana, additional, Visco, Virginia Esther, additional, Wassermann, Alfredo, additional, Zaidman, Cesar Javier, additional, Cheung, Ngai Wah, additional, Droste, Carolyn, additional, Fraser, Ian, additional, Johnson, David, additional, Mah, Peak Mann, additional, Nicholls, Kathy, additional, Packham, David, additional, Proietto, Joseph, additional, Roberts, Anthony, additional, Roger, Simon, additional, Tsang, Venessa, additional, Abrão Raduan, Roberto, additional, Alves da Costa, Fernando Augusto, additional, Amodeo, Celso, additional, Andreotti Turatti, Luiz Alberto, additional, Bregman, Rachel, additional, Camelo Sanches, Fernanda Cristina, additional, Canani, Luis Henrique, additional, Chacra, Antônio Roberto, additional, Cunha Borges, João Lindolfo, additional, Cunha Vêncio, Sérgio Alberto, additional, da Silva Franco, Roberto Jorge, additional, d’Avila, Domingos, additional, de Souza Portes, Evandro, additional, de Souza, Pedro, additional, Deboni, Luciane Mônica, additional, Fraige Filho, Fadlo, additional, Geloneze Neto, Bruno, additional, Gomes, Marcus, additional, Keiko Kohara, Suely, additional, Keitel, Elizete, additional, Kerr Saraiva, Jose Francisco, additional, Kurtz Lisboa, Hugo Roberto, additional, Loss de Carvalho Contieri, Fabiana, additional, Milagres, Rosângela, additional, Montenegro Junior, Renan, additional, Moreira de Brito, Claudia, additional, Nasser Hissa, Miguel, additional, Nazario Sabbag, Ângela Regina, additional, Noronha, Irene, additional, Panarotto, Daniel, additional, Pecoits Filho, Roberto, additional, Pereira, Márcio Antônio, additional, Saporito, Wladmir, additional, Scafuto Scotton, Antonio, additional, Schuch, Tiago, additional, Simões de Almeida, Roberto, additional, Slompo Ramos, Cássio, additional, Soares Felício, João, additional, Thomé, Fernando, additional, Tibes Hachmann, Jean Carlo, additional, Yamada, Sérgio, additional, Yoiti Hayashida, Cesar, additional, Zanata Petry, Tarissa Beatrice, additional, Zanella, Maria Teresa, additional, Andreeva, Viktoria, additional, Angelova, Angelina, additional, Dimitrov, Stefan, additional, Genadieva, Veselka, additional, Genova-Hristova, Gabriela, additional, Hristozov, Kiril, additional, Kamenov, Zdravko, additional, Koundurdjiev, Atanas, additional, Lozanov, Lachezar, additional, Margaritov, Viktor, additional, Nonchev, Boyan, additional, Rangelov, Rangel, additional, Shinkov, Alexander, additional, Temelkova, Margarita, additional, Velichkova, Ekaterina, additional, Yakov, Andrian, additional, Aggarwal, Naresh, additional, Aronson, Ronnie, additional, Bajaj, Harpreet, additional, Cherney, David, additional, Chouinard, Guy, additional, Conway, James, additional, Cournoyer, Serge, additional, DaRoza, Gerald, additional, De Serres, Sacha, additional, Dubé, François, additional, Goldenberg, Ronald, additional, Gupta, Anil, additional, Gupta, Milan, additional, Henein, Sam, additional, Khandwala, Hasnain, additional, Leiter, Lawrence, additional, Madore, François, additional, McMahon, Alan, additional, Muirhead, Norman, additional, Pichette, Vincent, additional, Rabasa-Lhoret, Remi, additional, Steele, Andrew, additional, Tangri, Navdeep, additional, Torshizi, Ali, additional, Woo, Vincent, additional, Zalunardo, Nadia, additional, Fernández Montenegro, María Alicia, additional, Godoy Jorquera, Juan Gonzalo, additional, Medina Fariña, Marcelo, additional, Saavedra Gajardo, Victor, additional, Vejar, Margarita, additional, Chen, Nan, additional, Chen, Qinkai, additional, Gan, Shenglian, additional, Kong, Yaozhong, additional, Li, Detian, additional, Li, Wenge, additional, Li, Xuemei, additional, Lin, Hongli, additional, Liu, Jian, additional, Lu, Weiping, additional, Mao, Hong, additional, Ren, Yan, additional, Song, Weihong, additional, Sun, Jiao, additional, Sun, Lin, additional, Tu, Ping, additional, Wang, Guixia, additional, Yang, Jinkui, additional, Yin, Aiping, additional, Yu, Xueqing, additional, Zhao, Minghui, additional, Zheng, Hongguang, additional, Accini Mendoza, Jose Luis, additional, Arcos, Edgar, additional, Avendano, Jorge, additional, Diaz Ruiz, Jorge Ernesto Andres, additional, Garcia Ortiz, Luis Hernando, additional, Gonzalez, Alexander, additional, Hernandez Triana, Eric, additional, Higuera, Juan Diego, additional, Malaver, Natalia, additional, Molina de Salazar, Dora Inés, additional, Rosero, Ricardo, additional, Terront Lozano, Monica Alexandra, additional, Valderrama Cometa, Luis, additional, Valenzuela, Alex, additional, Vargas Alonso, Ruben Dario, additional, Villegas, Ivan, additional, Yupanqui, Hernan, additional, Bartaskova, Dagmar, additional, Barton, Petr, additional, Belobradkova, Jana, additional, Dohnalova, Lenka, additional, Drasnar, Tomas, additional, Ferkl, Richard, additional, Halciakova, Katarina, additional, Klokocnikova, Vera, additional, Kovar, Richard, additional, Lastuvka, Jiri, additional, Lukac, Martin, additional, Pesickova, Satu, additional, Peterka, Karel, additional, Pumprla, Jiri, additional, Rychlik, Ivan, additional, Saudek, Frantisek, additional, Tesar, Vladimir, additional, Valis, Martin, additional, Weiner, Pavel, additional, Zemek, Stanislav, additional, Alamartine, Eric, additional, Borot, Sophie, additional, Cariou, Bertrand, additional, Dussol, Bertrand, additional, Fauvel, Jean-Pierre, additional, Gourdy, Pierre, additional, Klein, Alexandre, additional, Le Meur, Yannick, additional, Penfornis, Alfred, additional, Roussel, Ronan, additional, Saulnier, Pierre-Jean, additional, Thervet, Eric, additional, Zaoui, Philippe, additional, Burst, Volker, additional, Faghih, Markus, additional, Faulmann, Grit, additional, Haller, Hermann, additional, Jerwan-Keim, Reinhold, additional, Maxeiner, Stephan, additional, Paschen, Björn, additional, Plassmann, Georg, additional, Rose, Ludger, additional, Gonzalez Orellana, Ronaldo Arturo, additional, Haase, Franklin Paul, additional, Moreira Diaz, Juan Pablo, additional, Ramirez Roca, Luis Alberto, additional, Sánchez Arenales, Jose Antonio, additional, Sanchez Polo, José Vicente, additional, Turcios Juarez, Erick, additional, Csecsei, Gyongyi, additional, Csiky, Botond, additional, Danos, Peter, additional, Deak, Laszlo, additional, Dudas, Mihaly, additional, Harcsa, Eleonora, additional, Keltai, Katalin, additional, Keresztesi, Sandor, additional, Kiss, Krisztian, additional, Konyves, Laszlo, additional, Major, Lajos, additional, Mileder, Margit, additional, Molnar, Marta, additional, Mucsi, Janos, additional, Oroszlan, Tamas, additional, Ory, Ivan, additional, Paragh, Gyorgy, additional, Peterfai, Eva, additional, Petro, Gizella, additional, Revesz, Katalin, additional, Takacs, Robert, additional, Vangel, Sandor, additional, Vasas, Szilard, additional, Zsom, Marianna, additional, Oomman, Abraham, additional, Raju, Sree Bhushan, additional, Dewan, Deepak, additional, Fernando, M. Edwin, additional, Gopalakrishnan, Natarajan, additional, Gracious, Noble, additional, Alva, Hansraj, additional, Jain, Dinesh, additional, Keshavamurthy, C. B., additional, Khullar, Dinesh, additional, Sahay, Manisha, additional, Peringat, Jayameena, additional, Prasad, Narayan, additional, Rao, K. Satyanarayana, additional, Reddy, Sreedhar, additional, Melemadathil, Sreelatha, additional, Sudhakar, Bhimavarapu, additional, Vyasam, Ramesh Chandra, additional, Bonadonna, Riccardo, additional, Castellino, Pietro, additional, Ceriello, Antonio, additional, Chiovato, Luca, additional, De Cosmo, Salvatore, additional, De Nicola, Luca, additional, Derosa, Giuseppe, additional, Di Carlo, Alberto, additional, Di Cianni, Graziano, additional, Frascà, Giovanni, additional, Fuiano, Giorgio, additional, Gambaro, Giovanni, additional, Garibotto, Giacomo, additional, Giorda, Carlo, additional, Malberti, Fabio, additional, Mandreoli, Marcora, additional, Mannucci, Edoardo, additional, Orsi, Emanuela, additional, Piatti, Piermarco, additional, Santoro, Domenico, additional, Sasso, Ferdinando Carlo, additional, Serviddio, Gaetano, additional, Stella, Andrea, additional, Trevisan, Roberto, additional, Veronelli, Anna Maria, additional, Zanoli, Luca, additional, Akiyama, Hitoshi, additional, Aoki, Hiromi, additional, Asano, Akimichi, additional, Iitsuka, Tadashi, additional, Kajiyama, Shizuo, additional, Kashine, Susumu, additional, Kawada, Toshio, additional, Kodera, Takamoto, additional, Kono, Hiroshi, additional, Koyama, Kazunori, additional, Kumeda, Yasuro, additional, Miyauchi, Shozo, additional, Mizuyama, Kazuyuki, additional, Niiya, Tetsuji, additional, Oishi, Hiroko, additional, Ota, Satoshi, additional, Sakakibara, Terue, additional, Takai, Masahiko, additional, Tomonaga, Osamu, additional, Tsujimoto, Mitsuru, additional, Wada, Takashi, additional, Wakasugi, Masakiyo, additional, Wakida, Yasushi, additional, Watanabe, Takayuki, additional, Yamada, Masayo, additional, Yanagida, Kazuhiro, additional, Yanase, Toshihiko, additional, Yumita, Wataru, additional, Gaupsiene, Egle, additional, Kozloviene, Dalia, additional, Navickas, Antanas, additional, Urbanaviciene, Egle, additional, Abdul Ghani, Rohana, additional, Abdul Kadir, Khalid, additional, Ali, Norsiah, additional, Che Yusof, Mohd Daud, additional, Gan, Chye Lee, additional, Ismail, Mastura, additional, Kong, Wei Yen, additional, Lam, Swee Win, additional, Lee, Li Yuan, additional, Lim, Soo Kun, additional, Loh, Chek Loong, additional, Manocha, Anita Bhajan, additional, Ng, Kee Sing, additional, Nik Ahmad, Nik Nur Fatnoon, additional, Ratnasingam, Vanassa, additional, Shudim, Saiful Shahrizal Bin, additional, Vengadasalam, Paranthaman, additional, Abraira Munoz, Luis David, additional, Alpizar Salazar, Melchor, additional, Baas Cruz, Juan, additional, Burgos Soto, Mario, additional, Chevaile Ramos, Jose, additional, Chew Wong, Alfredo, additional, Correa Rotter, Jose Ricardo, additional, Diaz Escalante, Tonatiu, additional, Enriquez Sosa, Favio Edmundo, additional, Flores Lozano, Fernando, additional, Flota Cervera, Luis Fernando, additional, Frenk Baron, Paul, additional, Garcia Ballesteros, Cecilia, additional, Gomez Rangel, Jose David, additional, Herrera Jimenez, Luis Enrique, additional, Irizar Santana, Sergio Saul, additional, Jimenez Flores, Fernando, additional, Laviada Molina, Hugo, additional, Luna Ceballos, Rosa Isela, additional, Martin del Campo Blanco, Belia, additional, Morales Franco, Guadalupe, additional, Moreno Loza, Oscar Tarsicio, additional, Mustieles Rocha, Cynthia, additional, Obrador Vera, Gregorio, additional, Orozco Castellanos, Ricardo, additional, Peralta Calcaneo, Juan, additional, Reyes Rosano, Miguel Angel, additional, Rodriguez Pattzi, Hiromi, additional, Rosas Guzman, Juan, additional, Rucker Joerg, Isabel Erika, additional, Saavedra Sanchez, Sandra Berenice, additional, Sanchez Mijangos, Jose Hector, additional, Serrano Sanson, Pablo, additional, Tamayo y Orozco, Juan Alfredo, additional, Tellez Chavez, Eloisa, additional, Valdes Cepeda, Alejandro, additional, Venegas Carrillo, Luis, additional, Villagordoa Mesa, Juan, additional, Zamarripa Escobedo, Rolando, additional, Baker, John, additional, Noonan, Paul, additional, Scott, Russell, additional, Walker, Robert, additional, Watson, Edward, additional, Williams, Michael, additional, Young, Simon, additional, Abejuela, Zaynab, additional, Agra, Jeimeen, additional, Aquitania, Grace, additional, Caringal, Clodoaido, additional, Comia, Rhea Severina, additional, Delos Santos, Lalaine, additional, Gomez, Olivert, additional, Jimeno, Cecilia, additional, Santos, Florence, additional, Tan, Gerry, additional, Tolentino, Marsha, additional, Yao, Christy, additional, Yap, Yvette Ethel, additional, Ygpuara, Ma. Dovie Lallaine, additional, Bijata-Bronisz, Renata, additional, Hotlos, Lucyna, additional, Januszewicz, Andrzej, additional, Kaczmarek, Barbara, additional, Kaminska, Anna, additional, Lazuka, Lech, additional, Madej, Andrzej, additional, Mazur, Stanislaw, additional, Mlodawska-Choluj, Dorota, additional, Nowicki, Michal, additional, Orlowska-Kowalik, Grazyna, additional, Popenda, Grazyna, additional, Rewerska, Barbara, additional, Sowinski, Dariusz, additional, Angelescu, Liliana Monica, additional, Anghel, Veronica, additional, Avram, Rodica-Ioana, additional, Busegeanu, Mihaela-Magdalena, additional, Cif, Adriana, additional, Cosma, Dana, additional, Crisan, Carmen, additional, Demian, Luiza Despina, additional, Ferariu, Ioana Emilia, additional, Halmagyi, Ildiko, additional, Hancu, Nicolae, additional, Munteanu, Mircea, additional, Negru, Doru, additional, Onaca, Adriana Gabriela, additional, Petrica, Ligia, additional, Popa, Amorin Remus, additional, Ranetti, Aurelian-Emil, additional, Serafinceanu, Cristian, additional, Toarba, Cristina, additional, Agafyina, Alina, additional, Barbarash, Olga, additional, Barysheva, Olga, additional, Chizhov, Daniil, additional, Dobronravov, Vladimir, additional, Dreval, Alexander, additional, Glinkina, Irina, additional, Grineva, Elena, additional, Khirmanov, Vladimir, additional, Kolmakova, Elena, additional, Koroleva, Tatiana, additional, Kvitkova, Liudmila, additional, Marasaev, Viacheslav, additional, Mkrtumyan, Ashot, additional, Morugova, Tatiana, additional, Nagibovich, Galina, additional, Nagibovich, Oleg, additional, Nedogoda, Sergei, additional, Osipova, Irina, additional, Raskina, Tatiana, additional, Samoylova, Yulia, additional, Sazonova, Olga, additional, Shamkhalova, Minara, additional, Shutemova, Elena, additional, Shwartz, Yuriy, additional, Uriasyev, Oleg, additional, Vorobyev, Sergey, additional, Zateyshchikova, Anna, additional, Zateyshshikov, Dmitry, additional, Zykova, Tatyana, additional, Antic, Slobodan, additional, Djordjevic, Miodrag, additional, Kendereski, Aleksandra, additional, Lalic, Katarina, additional, Lalic, Nebojsa, additional, Popovic-Radinovic, Vesna, additional, Babikova, Jana, additional, Benusova, Olga, additional, Buganova, Ingrid, additional, Culak, Jan, additional, Dzupina, Andrej, additional, Dzuponova, Jana, additional, Fulop, Peter, additional, Ilavska, Adriana, additional, Martinka, Emil, additional, Ochodnicka, Zuzana, additional, Pella, Daniel, additional, Smatanova, Iveta, additional, Ahmed, Fayzal, additional, Badat, Aysha, additional, Breedt, Johannes, additional, Distiller, Lawrence, additional, Govender, Vimladhevi, additional, Govender, Ravendran, additional, Joshi, Mukesh, additional, Jurgens, Jaco, additional, Latiff, Gulam, additional, Lombard, Landman, additional, Mookadam, Mohamed, additional, Ngcakani, Nomangesi, additional, Nortje, Hendrik, additional, Oosthuizen, Helena, additional, Pillay-Ramaya, Larisha, additional, Prozesky, Hans, additional, Reddy, Jeevren, additional, Rheeder, Paul, additional, Seeber, Mary, additional, Chae, Dong-Wan, additional, Cho, Young Min, additional, Jeong, In-Kyung, additional, Kim, Sin Gon, additional, Kim, Yeong Hoon, additional, Kwon, Hyuk-Sang, additional, Kwon, Min Jeong, additional, Lee, Byung-Wan, additional, Lee, JungEun, additional, Lee, Moon-Kyu, additional, Nam, Moon-Suk, additional, Oh, Kook-Hwan, additional, Park, Cheol-Young, additional, Park, Sun-Hee, additional, Yoon, Kun Ho, additional, Alvarez Garcia, Pere, additional, Asmarats Mercadal, Luis, additional, Barrios, Clara, additional, Cereto Castro, Fernando, additional, Cigarran Guldris, Secundino, additional, Dominguez Lopez, Marta, additional, Egido de los Rios, Jesus, additional, Fernandez Fresnedo, Gema, additional, Galan Serrano, Antonio, additional, Garcia, Isabel, additional, Gonzalez Martinez, Francisco Javier, additional, Jodar Gimeno, Jose Esteban, additional, Lopez Mendoza, Manuel, additional, Malek Marin, Tamara, additional, Morales Portillo, Cristobal, additional, Munar Vila, Maria Antonia, additional, Muñoz Torres, Manuel, additional, Nieto Iglesias, Javier, additional, Pantoja Perez, Jonay, additional, Perez Vera, Merce, additional, Portoles Perez, Jose Mª, additional, Quesada Simón, María Angustias, additional, Simo Canonge, Rafael, additional, Soto Gonzalez, Alfonso, additional, Terns Riera, Manel, additional, Tinahones Madueno, Francisco Jose, additional, Velo Plaza, Mercedes, additional, Chang, Chwen-Tzuei, additional, Chuang, Lee-Ming, additional, Hsia, Te-Lin, additional, Hsieh, Chang-Hsun, additional, Hwang, Shang-Jyh, additional, Lin, Chih-Ching, additional, Lu, Yung-Chuan, additional, Sheu, Wayne H-H, additional, Barna, Olga, additional, Bilyk, Svitlana D., additional, Botsyurko, Volodymyr, additional, Dudar, Iryna, additional, Fushtey, Ivan, additional, Godlevska, Olga, additional, Golovchenko, Oleksandr, additional, Gyrina, Olga, additional, Kazmirchuk, Anatoliy, additional, Kolesnyk, Mykola, additional, Komisarenko, Iuliia, additional, Korzh, Oleksii, additional, Kravchun, Nonna, additional, Legun, Oleg, additional, Mankovskyy, Borys, additional, Martynyuk, Liliya, additional, Mostovoy, Yuriy, additional, Pashkovska, Nataliia, additional, Pererva, Larysa, additional, Pertseva, Tetyana, additional, Samoylov, Oleksandr, additional, Smirnov, Ivan, additional, Svyshchenko, Yevgeniya, additional, Tomashkevych, Halyna, additional, Topchii, Ivan, additional, Tryshchuk, Nadiya, additional, Tseluyko, Vira, additional, Vizir, Vadym, additional, Vlasenko, Maryna, additional, Zlova, Tetiana, additional, Zub, Liliia, additional, Abusnana, Salah, additional, Railey, Mohamed, additional, Abouglila, Kamal, additional, Ainsworth, Paul, additional, Ali, Zishan, additional, Arutchelvam, Vijayaraman, additional, Barnard, Maria, additional, Bellary, Srikanth, additional, Davies, Emyr, additional, Davies, Mark, additional, Davies, Simon, additional, Dawson, Alison, additional, El Kossi, Mohsen, additional, English, Patrick, additional, Fraser, Donald, additional, Gnudi, Luigi, additional, Gunstone, Anthony, additional, Hall, Timothy, additional, Hanif, Wasim, additional, Jackson, Alan, additional, Johnson, Andrew, additional, Joseph, Franklin, additional, Krishnan, Singhan, additional, Kumwenda, Mick, additional, MacDougall, Iain, additional, Nixon, Paul, additional, O’Hare, Joseph, additional, Philip, Sam, additional, Ramtoola, Shenaz, additional, Saxena, Manish, additional, Sennik, Davesh, additional, Simon, Godwin, additional, Singh, Baldev, additional, Stephens, Jeffrey, additional, Strzelecka, Anna, additional, Symonds, Rehan, additional, Turner, Wayne, additional, Wahba, Mona, additional, Wakeling, John, additional, Wheeler, David, additional, Winocour, Peter, additional, Abdallah, Joseph, additional, Abdullah, Raied, additional, Abramowitz, Matthew, additional, Acosta, Idalia, additional, Aiello, Joseph, additional, Akright, Laura, additional, Akyea-Djamson, Ayim, additional, Alappan, Rajendran, additional, Alicic, Radica, additional, Al-Karadsheh, Amer, additional, Allison, Dale Crawford, additional, Arauz-Pacheco, Carlos, additional, Arfeen, Shahabul, additional, Arif, Ahmed, additional, Arvind, Moogali, additional, Atray, Naveen, additional, Awad, Ahmed, additional, Bakris, George, additional, Barnhill, Peggy, additional, Barranco, Elizabeth, additional, Barrera, Carlos, additional, Beacom, Matthew, additional, Behara, Venkata, additional, Belo, Diogo, additional, Bentley-Lewis, Rhonda, additional, Berenguer, Ramon, additional, Bermudez, Lidia, additional, Bernardo, Marializa, additional, Biscoveanu, Mihaela, additional, Bowman-Stroud, Cynthia, additional, Brandon, Donald, additional, Brusco, Osvaldo, additional, Busch, Robert, additional, Canaan, Yamil, additional, Chilito, Alicia, additional, Christensen, Tom, additional, Christiano, Cynthia, additional, Christofides, Elena, additional, Chuateco, Caroucel, additional, Cohen, Kenneth, additional, Cohen, Robert, additional, Cohen-Stein, Debbie, additional, Cook, Charles, additional, Coyne, Daniel, additional, Daboul, Nizar, additional, Darwish, Riad, additional, Daswani, Adarsh, additional, Deck, Kenneth, additional, Desouza, Cyrus, additional, Dev, Devasmita, additional, Dhillon, Monika, additional, Dua, Sohan, additional, Eder, Frank, additional, Elosegui, Ana Maria, additional, El-Shahawy, Mohamed, additional, Ervin, John, additional, Esquenazi, Alberto, additional, Evans, John, additional, Fishbane, Steven, additional, Frias, Juan, additional, Galindo-Ramos, Eugenia, additional, Galphin, Claude, additional, Ghazi, Adline, additional, Gonzalez, Enrique, additional, Gorson, David, additional, Gowda, Anupama, additional, Greco, Barbara, additional, Grubb, Stephen, additional, Gulati, Rakesh, additional, Hammoud, Jamal, additional, Handelsman, Stuart, additional, Hartman, Israel, additional, Hershon, Kenneth, additional, Hiser, Daniel, additional, Hon, George, additional, Jacob, Radu, additional, Jaime, Maria, additional, Jamal, Aamir, additional, Kaupke, Charles, additional, Keightley, Gerald, additional, Kern, Elizabeth, additional, Khanna, Rakhi, additional, Khitan, Zeid, additional, Kim, Sun, additional, Kopyt, Nelson, additional, Kovesdy, Csaba, additional, Krishna, Gopal, additional, Kropp, Jeffrey (Jay), additional, Kumar, Amrendra, additional, Kumar, Jayant, additional, Kumar, Neil, additional, Kusnir, Jorge, additional, Lane, Wendy, additional, Lawrence, Mary, additional, Lehrner, Lawrence, additional, Lentz, John, additional, Levinson, Dennis, additional, Lewis, Derek, additional, Liss, Kenneth, additional, Maddux, Andreas, additional, Maheshwari, Hiralal, additional, Mandayam, Sreedhar, additional, Marar, Isam, additional, Mehta, Bhasker, additional, Middleton, John, additional, Mordujovich, Jorge, additional, Moreda, Ramon, additional, Moustafa, Moustafa, additional, Mujica Trenche, Samuel, additional, Narayanan, Mohanram, additional, Narvarte, Javier, additional, Nassar, Tareq, additional, Newman, George, additional, Nichol, Brian, additional, Nicol, Philip, additional, Nisnisan, Josier, additional, Nossuli, A. Kaldun, additional, Obialo, Chamberlain, additional, Olelewe, Sarah, additional, Oliver, Michael, additional, O’Shaughnessy, Andrew, additional, Padron, John, additional, Pankhaniya, Rohit, additional, Parker, Reginald, additional, Patel, Devesh, additional, Patel, Gnyandev, additional, Patel, Nina, additional, Pavon, Humberto, additional, Perez, Armando, additional, Perez, Carlos, additional, Perlman, Alan, additional, Pettis, Karlton, additional, Pharr, Walter, additional, Phillips, Andrea, additional, Purighalla, Raman, additional, Quesada-Suarez, Luis, additional, Ranjan, Rajiv, additional, Rastogi, Sanjeev, additional, Reddy, Jakkidi, additional, Rendell, Marc, additional, Rich, Lisa, additional, Robinson, Michael, additional, Rodriguez, Hector, additional, Rosas, Sylvia, additional, Saba, Fadi, additional, Sankaram, Rallabhandi, additional, Sarin, Ravi, additional, Schreiman, Robert, additional, Scott, David, additional, Sekkarie, Mohamed, additional, Sensenbrenner, John, additional, Shakeel, Muhammad, additional, Shanik, Michael, additional, Shaw, Sylvia, additional, Smith, Stephen, additional, Solomon, Richard, additional, Sprague, Amy, additional, Spry, Leslie, additional, Suchinda, Pusadee, additional, Sultan, Senan, additional, Surampudi, Prasanth, additional, Sussman, Sherry, additional, Tan, Anjanette, additional, Terrelonge, Antonio, additional, Thompson, Michael, additional, Trespalacios, Fernando, additional, Trippe, Bruce, additional, Trueba, Pilar, additional, Twahirwa, Marcel, additional, Updegrove, John, additional, Van Buren, Peter, additional, Vannorsdall, Mark, additional, Varghese, Freemu, additional, Velasquez-Mieyer, Pedro, additional, Ventrapragada, Sailaja, additional, Vukotic, Goga, additional, Wadud, Khurram, additional, Warren, Mark, additional, Watson, Henry, additional, Watts, Ronald, additional, Weiner, Daniel, additional, Welker, James, additional, Welsh, Jean, additional, Williams, Shelley, additional, and Zaniewski-Singh, Michelle, additional

Published
2021
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19. Canagliflozin and Cardiovascular and Renal Outcomes in Type 2 Diabetes Mellitus and Chronic Kidney Disease in Primary and Secondary Cardiovascular Prevention Groups

Author

Mahaffey, Kw, Jardine, Mj, Bompoint, S, Cannon, Cp, Neal, B, Heerspink, Hjl, Charytan, Dm, Edwards, R, Agarwal, R, Bakris, G, Bull, S, Capuano, G, de Zeeuw, D, Greene, T, Levin, A, Pollock, C, Sun, T, Wheeler, Dc, Yavin, Y, Zhang, H, Zinman, B, Rosenthal, N, Brenner, Bm, Perkovic, V, Guerrero, Raa, Aizenberg, D, Albisu, Jp, Alvarisqueta, A, Bartolacci, I, Berli, Ma, Bordonava, A, Calella, P, Cantero, Mc, Cartasegna, Lr, Cercos, E, Coloma, Gc, Colombo, H, Commendatore, V, Cuadrado, J, Cuneo, Ca, Cusumano, Am, Douthat, Wg, Dran, Rd, Farias, E, Fernandez, Mf, Finkelstein, H, Fragale, G, Fretes, Jo, Garcia, Nh, Gastaldi, A, Gelersztein, E, Glenny, Ja, Gonzalez, Jp, Colaso, Pdg, Goycoa, C, Greloni, Gc, Guinsburg, A, Hermida, S, Juncos, Li, Klyver, Mi, Kraft, F, Krynski, F, Lanchiotti, Pv, de la Fuente, Ral, Marchetta, N, Mele, P, Nicolai, S., Novoa, Pa, Orio, Si, Otreras, F, Oviedo, A, Raffaele, P, Resk, Jh, Rista, L, Papini, Nr, Sala, J, Santos, Jc, Schiavi, Lb, Sessa, H, Casabella, Ts, Ulla, Mr, Valdez, M, Vallejos, A, Villarino, A, Visco, Ve, Wassermann, A, Zaidman, Cj, Cheung, Nw, Droste, C, Fraser, I, Johnson, D, Mah, Pm, Nicholls, K, Packham, D, Proietto, J, Roberts, A, Roger, S, Tsang, V, Raduan, Ra, da Costa, Faa, Amodeo, C, Turatti, Laa, Bregman, R, Sanches, Fcc, Canani, Lh, Chacra, Ar, Cunha Borges, Jl, Vencio, Sac, Franco, Rjd, D'Avila, D, Portes, Ed, de Souza, P, Deboni, Lm, Fraige, F, Neto, Bg, Gomes, M, Kohara, Sk, Keitel, E, Saraiva, Jfk, Lisboa, Hrk, Contieri, Fld, Milagres, R, Montenegro, R, de Brito, Cm, Hissa, Mn, Sabbag, Arn, Noronha, I, Panarotto, D, Pecoits, R, Pereira, Ma, Saporito, W, Scotton, As, Schuch, T, de Almeida, Rs, Ramos, Cs, Felicio, Js, Thome, F, Hachmann, Jct, Yamada, S, Hayashida, Cy, Petry, Tbz, Zanella, Mt, Andreeva, V, Angelova, A, Dimitrov, S, Genadieva, V, Genova-Hristova, G, Hristozov, K, Kamenov, Z, Koundurdjiev, A, Lozanov, L, Margaritov, V, Nonchev, B, Rangelov, R, Shinkov, A., Temelkova, M, Velichkova, E, Yakov, A, Aggarwal, N, Aronson, R, Bajaj, H, Cherney, D, Chouinard, G, Conway, J, Cournoyer, S, Daroza, G, De Serres, S, Dube, F, Goldenberg, R, Gupta, A, Gupta, M, Henein, S, Khandwala, H, Leiter, L, Madore, F, Mcmahon, A, Muirhead, N, Pichette, V, Rabasa-Lhoret, R, Steele, A, Tangri, N, Torshizi, A, Woo, V, Zalunardo, Nadia, Fernandez Montenegro, Maria Alicia, Godoy Jorquera, Juan Gonzalo, Medina Farina, Marcelo, Saavedra Gajardo, Victor, Vejar, Margarita, Chen, Nan, Chen, Qinkai, Gan, Shenglian, Kong, Yaozhong, Detian, Li, Wenge, Li, Xuemei, Li, Lin, Hongli, Liu, Jian, Weiping, Lu, Mao, Hong, Ren, Yan, Song, Weihong, Sun, Jiao, Sun, Lin, Ping, Tu, Wang, Guixia, Yang, Jinkui, Yin, Aiping, Xueqing, Yu, Zhao, Minghui, Zheng, Hongguang, Accini Mendoza, Jose Luis, Arcos, Edgar, Avendano, Jorge, Diaz Ruiz, Jorge Ernesto Andres, Garcia Ortiz, Luis Hernando, Gonzalez, Alexander, Hernandez Triana, Eric, Diego Higuera, Juan, Malaver, Natalia, Ines Molina de Salazar, Dora, Rosero, Ricardo, Terront Lozano, Monica Alexandra, Valderrama Cometa, Luis, Valenzuela, Alex, Vargas Alonso, Ruben Dario, Villegas, Ivan, Yupanqui, Hernan, Bartaskova, Dagmar, Barton, Petr, Belobradkova, Jana, Dohnalova, Lenka, Drasnar, Tomas, Ferkl, Richard, Halciakova, Katarina, Klokocnikova, Vera, Kovar, Richard, Lastuvka, Jiri, Lukac, Martin, Pesickova, Satu, Peterka, Karel, Pumprla, Jiri, Rychlik, Ivan, Saudek, Frantisek, Tesar, Vladimir, Valis, Martin, Weiner, Pavel, Zemek, Stanislav, Alamartine, Eric, Borot, Sophie, Cariou, Bertrand, Dussol, Bertrand, Fauvel, Jean-Pierre, Gourdy, Pierre, Klein, Alexandre, Le Meur, Yannick, Penfornis, Alfred, Roussel, Ronan, Saulnier, Pierre-Jean, Thervet, Eric, Zaoui, Philippe, Burst, Volker, Faghih, Markus, Faulmann, Grit, Haller, Hermann, Jerwan-Keim, Reinhold, Maxeiner, Stephan, Paschen, Bjoern, Plassmann, Georg, Rose, Ludger, Gonzalez Orellana, Ronaldo Arturo, Paul Haase, Franklin, Moreira Diaz, Juan Pablo, Ramirez Roca, Luis Alberto, Sanchez Arenales, Jose Antonio, Sanchez Polo, Jose Vicente, Turcios Juarez, Erick, Csecsei, Gyongyi, Csiky, Botond, Danos, Peter, Deak, Laszlo, Dudas, Mihaly, Harcsa, Eleonora, Keltai, Katalin, Keresztesi, Sandor, Kiss, Konyves, Laszlo, Major, Lajos, Mileder, Margit, Molnar, Marta, Mucsi, Janos, Oroszlan, Tamas, Ory, Ivan, Paragh, Gyorgy, Peterfai, Eva, Petro, Gizella, Revesz, Katalin, Takacs, Robert, Vangel, Sandor, Vasas, Szilard, Zsom, Marianna, Abraham, Oomman, Bhushan, Raju Sree, Deepak, Dewan, Edwin, Fernando M., Gopalakrishnan, Natarajan, Gracious, Noble, Hansraj, Alva, Jain, Dinesh, Keshavamurthy, C. B., Khullar, Dinesh, Manisha, Sahay, Peringat, Jayameena, Prasad, Narayan, Satyanarayana, Rao K., Sreedhar, Reddy, Sreelatha, Melemadathil, Sudhakar, Bhimavarapu, Vyasam, Ramesh Chandra, Bonadonna, Riccardo, Castellino, Pietro, Ceriello, Antonio, Chiovato, Luca, De Cosmo, Salvatore, De Nicola, Luca, Derosa, Giuseppe, Di Carlo, Alberto, Di Cianni, Graziano, Frasca, Giovanni, Fuiano, Giorgio, Gambaro, Giovanni, Garibotto, Giacomo, Giorda, Carlo, Malberti, Fabio, Mandreoli, Marcora, Mannucci, Edoardo, Orsi, Emanuela, Piatti, Piermarco, Santoro, Domenico, Sasso, Ferdinando Carlo, Serviddio, Gaetano, Stella, Andrea, Trevisan, Roberto, Veronelli, Anna Maria, Zanoli, Luca, Akiyama, Hitoshi, Aoki, Hiromi, Asano, Akimichi, Iitsuka, Tadashi, Kajiyama, Shizuo, Kashine, Susumu, Kawada, Toshio, Kodera, Takamoto, Kono, Hiroshi, Koyama, Kazunori, Kumeda, Yasuro, Miyauchi, Shozo, Mizuyama, Kazuyuki, Niiya, Tetsuji, Oishi, Hiroko, Ota, Satoshi, Sakakibara, Terue, Takai, Masahiko, Tomonaga, Osamu, Tsujimoto, Mitsuru, Wada, Takashi, Wakasugi, Masakiyo, Wakida, Yasushi, Watanabe, Takayuki, Yamada, Masayo, Yanagida, Kazuhiro, Yanase, Toshihiko, and Yumita, Wataru

Subjects
Male, Risk, primary prevention, canagliflozin, clinical trial, diabetes mellitus, renal insufficiency, chronic, secondary prevention, renal insufficiency, Double-Blind Method, Original Research Articles, Humans, Sodium-Glucose Transporter 2 Inhibitors, Proportional Hazards Models, canagliflozin, clinical trial, diabetes mellitus, primary prevention, renal insufficiency, chronic, secondary prevention, Middle Aged, Placebo Effect, chronic, Treatment Outcome, Diabetes Mellitus, Type 2, Cardiovascular Diseases, ComputingMethodologies_DOCUMENTANDTEXTPROCESSING, Kidney Failure, Chronic, Female
Abstract

Supplemental Digital Content is available in the text., Background: Canagliflozin reduces the risk of kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, but effects on specific cardiovascular outcomes are uncertain, as are effects in people without previous cardiovascular disease (primary prevention). Methods: In CREDENCE (Canagliflozin and Renal Events in Diabetes With Established Nephropathy Clinical Evaluation), 4401 participants with type 2 diabetes mellitus and chronic kidney disease were randomly assigned to canagliflozin or placebo on a background of optimized standard of care. Results: Primary prevention participants (n=2181, 49.6%) were younger (61 versus 65 years), were more often female (37% versus 31%), and had shorter duration of diabetes mellitus (15 years versus 16 years) compared with secondary prevention participants (n=2220, 50.4%). Canagliflozin reduced the risk of major cardiovascular events overall (hazard ratio [HR], 0.80 [95% CI, 0.67–0.95]; P=0.01), with consistent reductions in both the primary (HR, 0.68 [95% CI, 0.49–0.94]) and secondary (HR, 0.85 [95% CI, 0.69–1.06]) prevention groups (P for interaction=0.25). Effects were also similar for the components of the composite including cardiovascular death (HR, 0.78 [95% CI, 0.61–1.00]), nonfatal myocardial infarction (HR, 0.81 [95% CI, 0.59–1.10]), and nonfatal stroke (HR, 0.80 [95% CI, 0.56–1.15]). The risk of the primary composite renal outcome and the composite of cardiovascular death or hospitalization for heart failure were also consistently reduced in both the primary and secondary prevention groups (P for interaction >0.5 for each outcome). Conclusions: Canagliflozin significantly reduced major cardiovascular events and kidney failure in patients with type 2 diabetes mellitus and chronic kidney disease, including in participants who did not have previous cardiovascular disease. Clinical Trial Registration: URL: https://www.clinicaltrials.gov. Unique identifier: NCT02065791.

Published
2019

22. Nutritional treatment of advanced CKD: twenty consensus statements

Author

Cupisti, Adamasco, Brunori, Giuliano, Di Iorio, Biagio Raffaele, D'Alessandro, Claudia, Pasticci, Franca, Cosola, Carmela, Bellizzi, Vincenzo, Bolasco, Piergiorgio, Capitanini, Alessandro, Fantuzzi, Anna Laura, Gennari, Annalisa, Piccoli, Giorgina Barbara, Quintaliani, Giuseppe, Salomone, Mario, Sandrini, Massimo, Santoro, Domenico, Babini, Patrizia, Fiaccadori, Enrico, Gambaro, Giovanni, Garibotto, Giacomo, Gregorini, Mariacristina, Mandreoli, Marcora, Minutolo, Roberto, Cancarini, Giovanni, Conte, Giuseppe, Locatelli, Francesco, Gesualdo, Loreto, Gambaro, Giovanni (ORCID:0000-0001-5733-2370), Cupisti, Adamasco, Brunori, Giuliano, Di Iorio, Biagio Raffaele, D'Alessandro, Claudia, Pasticci, Franca, Cosola, Carmela, Bellizzi, Vincenzo, Bolasco, Piergiorgio, Capitanini, Alessandro, Fantuzzi, Anna Laura, Gennari, Annalisa, Piccoli, Giorgina Barbara, Quintaliani, Giuseppe, Salomone, Mario, Sandrini, Massimo, Santoro, Domenico, Babini, Patrizia, Fiaccadori, Enrico, Gambaro, Giovanni, Garibotto, Giacomo, Gregorini, Mariacristina, Mandreoli, Marcora, Minutolo, Roberto, Cancarini, Giovanni, Conte, Giuseppe, Locatelli, Francesco, Gesualdo, Loreto, and Gambaro, Giovanni (ORCID:0000-0001-5733-2370)

Abstract

The Italian nephrology has a long tradition and experience in the field of dietetic-nutritional therapy (DNT), which is an important component in the conservative management of the patient suffering from a chronic kidney disease, which precedes and integrates the pharmacological therapies. The objectives of DNT include the maintenance of an optimal nutritional status, the prevention and/or correction of signs, symptoms and complications of chronic renal failure and, possibly, the delay in starting of dialysis. The DNT includes modulation of protein intake, adequacy of caloric intake, control of sodium and potassium intake, and reduction of phosphorus intake. For all dietary-nutritional therapies, and in particular those aimed at the patient with chronic renal failure, the problem of patient adherence to the dietetic-nutritional scheme is a key element for the success and safety of the DNT and it can be favored by an interdisciplinary and multi-professional approach of information, education, dietary prescription and follow-up. This consensus document, which defines twenty essential points of the nutritional approach to patients with advanced chronic renal failure, has been written, discussed and shared by the Italian nephrologists together with representatives of dietitians (ANDID) and patients (ANED).

Published
2018

26. Interaction of healthcare staff’s attitude with barriers to physical activity in hemodialysis patients: A quantitative assessment.

Author

Regolisti, Giuseppe, Maggiore, Umberto, Sabatino, Alice, Gandolfini, Ilaria, Pioli, Sarah, Torino, Claudia, Aucella, Filippo, Cupisti, Adamasco, Pistolesi, Valentina, Capitanini, Alessandro, Caloro, Giorgia, Gregorini, Mariacristina, Battaglia, Yuri, Mandreoli, Marcora, Dani, Lucia, Mosconi, Giovanni, Bellizzi, Vincenzo, Di Iorio, Biagio Raffaele, Conti, Paolo, and Fiaccadori, Enrico

Subjects
PHYSICAL activity, HEALTH behavior, PHYSICAL fitness, HEMODIALYSIS patients, INSULIN resistance
Abstract

Background and aim of the study: In hemodialysis patients, sedentarism is a potentially modifiable mortality risk factor. We explored whether healthcare staff’s attitude towards exercise interacts with patient-perceived barriers in modifying the level of physical activity in this population. Methods: In this prospective, cross-sectional, multicenter study we recruited 608 adult patients and 330 members of the healthcare staff in 16 hemodialysis units in Italy. We assessed patient-perceived barriers to, and healthcare staff’s attitude towards, exercise by specific questionnaires. We fitted multilevel linear models to analyze the relationships of either barriers or staff’s attitude, and their interaction, with a measure of patient self-reported physical activity (the Human Activity Profile–Adjusted Activity Score [HAP-AAS]), adjusting for multiple confounders. We also employed latent class analysis to dichotomize patients into those endorsing or not endorsing barriers. Results: Most barriers were negatively associated with the HAP-AAS (adjusted change attributable to a given barrier ranging between -5.1 [“Feeling too old”, 95% Confidence Interval: -9.4 to -0.8] and -15.6 [“Ulcers on legs and feet”, 95%CI: -24.8 to -6.5]. We found a significant interaction between staff’s attitude and barriers (adjusted P values ranging between 0.03 [“I do not believe that it is physician’s or nurse’s role providing advice on exercise to patients on dialysis”] and 0.001 [“I do not often ask patients about exercise”]). A beneficial effect of a proactive staff’s attitude was evident only in patients not endorsing barriers. Conclusions: Barriers and non-proactive staff’s attitude reduce physical activity in hemodialysis patients. Patients not endorsing barriers benefit the most from a proactive staff’s attitude. [ABSTRACT FROM AUTHOR]

Published
2018
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31. Low-protein diets for chronic kidney disease patients: the Italian experience.

Author

Bellizzi, Vincenzo, Cupisti, Adamasco, Locatelli, Francesco, Bolasco, Piergiorgio, Brunori, Giuliano, Cancarini, Giovanni, Caria, Stefania, De Nicola, Luca, Di Iorio, Biagio R., Di Micco, Lucia, Fiaccadori, Enrico, Garibotto, Giacomo, Mandreoli, Marcora, Minutolo, Roberto, Oldrizzi, Lamberto, Piccoli, Giorgina B., Quintaliani, Giuseppe, Santoro, Domenico, Torraca, Serena, and Viola, Battista F.

Subjects
KIDNEY diseases, PREVENTION of malnutrition, CARDIOVASCULAR diseases risk factors, DIETARY proteins, HEMODIALYSIS, PATHOLOGICAL physiology, NUTRITIONAL status, PATIENTS
Abstract

Background: Nutritional treatment has always represented a major feature of CKD management. Over the decades, the use of nutritional treatment in CKD patients has been marked by several goals. The first of these include the attainment of metabolic and fluid control together with the prevention and correction of signs, symptoms and complications of advanced CKD. The aim of this first stage is the prevention of malnutrition and a delay in the commencement of dialysis. Subsequently, nutritional manipulations have also been applied in association with other therapeutic interventions in an attempt to control several cardiovascular risk factors associated with CKD and to improve the patient's overall outcome. Over time and in reference to multiple aims, the modalities of nutritional treatment have been focused not only on protein intake but also on other nutrients.Discussion: This paper describes the pathophysiological basis and rationale of nutritional treatment in CKD and also provides a report on extensive experience in the field of renal diets in Italy, with special attention given to approaches in clinical practice and management. Italian nephrologists have a longstanding tradition in implementing low protein diets in the treatment of CKD patients, with the principle objective of alleviating uremic symptoms, improving nutritional status and also a possibility of slowing down the progression of CKD or delaying the start of dialysis. A renewed interest in this field is based on the aim of implementing a wider nutritional therapy other than only reducing the protein intake, paying careful attention to factors such as energy intake, the quality of proteins and phosphate and sodium intakes, making today's low-protein diet program much more ambitious than previous. The motivation was the reduction in progression of renal insufficiency through reduction of proteinuria, a better control of blood pressure values and also through correction of metabolic acidosis. One major goal of the flexible and innovative Italian approach to the low-protein diet in CKD patients is the improvement of patient adherence, a crucial factor in the successful implementation of a low-protein diet program. [ABSTRACT FROM AUTHOR]

Published
2016
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33. When stenting in renal artery stenosis? Update on pathophysiology of ischemic nephropathy and management strategies.

Author

Zuccalà, Alessandro, Rapanà, Renato, and Mandreoli, Marcora

Abstract

In recent years, decisions taken on the optimal management of patients with renal artery stenosis have triggered off controversy and debate among clinicians dealing with renovascular disease. The main reason underlying this ongoing controversy may be the heterogeneity of the clinical entities that are normally associated with the umbrella definition of renal artery stenosis. Indeed a causal link between the stenosis and its clinical consequences (i.e. hypertension, renal failure) can often demonstrated in some entities, such as fibromuscular dysplasia, truncal stenosis or arterial stenosis in the transplanted kidney, which can be defined as pure renal artery stenosis. On the contrary, the entity generally called ostial stenosis is a disease of the abdominal aorta where it encroaches the ostium of the renal artery at the end of a long process involving the entire vascular tree. Patients affected by ostial stenosis also suffer from generalized atherosclerosis, and kidney damage is often caused by the atherosclerotic environment with the stenosis acting as an innocent bystander. This may account for the low rate of renal function recovery in subjects with ostial stenosis. In our view, keeping the different entities separate along with a careful understanding of the mechanisms underpinning renal damage, particularly the intrarenal activation of the renin angiotensin system which in turn induces renal inflammation and oxidative stress, may enable clinicians to make the right decisions in regard to revascularization. [ABSTRACT FROM AUTHOR]

Published
2014
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34. Extramedullary haematopoiesis in the kidney.

Author

Ricci, Davide, Mandreoli, Marcora, Valentino, Massimo, Sabattini, Elena, and Santoro, Antonio

Subjects
*HEMATOPOIESIS, *BONE marrow, *RENAL cell carcinoma, *NEEDLE biopsy, *ABDOMEN, *SPLEEN, *LIVER
Abstract

Extramedullary haematopoiesis (EMH) is the development of haematopoietic tissue outside the bone marrow and it most often occurs in the liver and spleen. Renal EMH is quite rare and there are very few case reports concerning the kidney. We describe two cases of ‘renal histologically documented EMH’ and, in particular, in the second of these two, the EMH tissue coexists with a clear cell renal carcinoma. Although rare, these clinical pictures raise some questions about the role of needle biopsy in the management of renal masses that present a diagnostic dilemma, especially in cases without involvement of other abdominal or intrathoracic organs. [ABSTRACT FROM PUBLISHER]

Published
2012
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35. Correction: Interaction of healthcare staff’s attitude with barriers to physical activity in hemodialysis patients: A quantitative assessment.

Author

Regolisti, Giuseppe, Maggiore, Umberto, Sabatino, Alice, Gandolfini, Ilaria, Pioli, Sarah, Torino, Claudia, Aucella, Filippo, Cupisti, Adamasco, Pistolesi, Valentina, Capitanini, Alessandro, Caloro, Giorgia, Gregorini, Mariacristina, Battaglia, Yuri, Mandreoli, Marcora, Dani, Lucia, Mosconi, Giovanni, Bellizzi, Vincenzo, Di Iorio, Biagio Raffaele, Conti, Paolo, and Fiaccadori, Enrico

Subjects
HOSPITAL medical staff, PHYSICAL activity
Published
2018
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36. Sustained virological response after 4-week ritonavir-boosted paritaprevir, ombitasvir and dasabuvir plus ribavirin treatment in a kidney transplant recipient

Author

Pietro Fusaroli, Claudio Calvanese, Giancarlo Caletti, Saverio Fiorenza, Marcora Mandreoli, Andrea Lisotti, Calvanese, Claudio, Lisotti, Andrea, Fiorenza, Saverio, Mandreoli, Marcora, Caletti, Giancarlo, and Fusaroli, Pietro

Subjects
medicine.medical_specialty, Dasabuvir, business.industry, Ribavirin, Gastroenterology, Hepatitis C, medicine.disease, Ombitasvir, Virological response, chemistry.chemical_compound, chemistry, Paritaprevir, Internal medicine, medicine, Ritonavir, Hepatitis C, direct antiviral agents, business, Kidney transplantation, medicine.drug
Published
2017
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37. Nutritional treatment of advanced CKD: twenty consensus statements

Author

Francesco Locatelli, Massimo Sandrini, Franca Pasticci, Loreto Gesualdo, Alessandro Capitanini, Mario Salomone, Giacomo Garibotto, Roberto Minutolo, Patrizia Babini, Enrico Fiaccadori, Giovanni Gambaro, Giuliano Brunori, Giorgina B Piccoli, Claudia D’Alessandro, Giuseppe Conte, Vincenzo Bellizzi, Annalisa Gennari, Giovanni Cancarini, Adamasco Cupisti, Anna Laura Fantuzzi, Carmela Cosola, Domenico Santoro, Biagio Di Iorio, Piergiorgio Bolasco, Giuseppe Quintaliani, Marcora Mandreoli, Mariacristina Gregorini, Cupisti, Adamasco, Brunori, Giuliano, Di Iorio, Biagio Raffaele, D’Alessandro, Claudia, Pasticci, Franca, Cosola, Carmela, Bellizzi, Vincenzo, Bolasco, Piergiorgio, Capitanini, Alessandro, Fantuzzi, Anna Laura, Gennari, Annalisa, Piccoli, Giorgina Barbara, Quintaliani, Giuseppe, Salomone, Mario, Sandrini, Massimo, Santoro, Domenico, Babini, Patrizia, Fiaccadori, Enrico, Gambaro, Giovanni, Garibotto, Giacomo, Gregorini, Mariacristina, Mandreoli, Marcora, Minutolo, Roberto, Cancarini, Giovanni, Conte, Giuseppe, Locatelli, Francesco, and Gesualdo, Loreto

Subjects
Nephrology, Dietary Fiber, Potassium intake, medicine.medical_treatment, 030232 urology & nephrology, Chronic renal failure, CKD, Dialysis, Diet, Kidney transplant, Nutritional treatment, Consensus, Contraindications, Dietary Proteins, Dietary Supplements, Dysbiosis, Humans, Nutrition Assessment, Patient Care Team, Patient Compliance, Patient Education as Topic, Phosphorus, Dietary, Renal Insufficiency, Chronic, Renal Replacement Therapy, Sodium, Dietary, Energy Intake, 030204 cardiovascular system & hematology, 0302 clinical medicine, Medicine, Renal Insufficiency, Chronic, Dialysi, Phosphorus, medicine.medical_specialty, MEDLINE, Dietary, 03 medical and health sciences, Internal medicine, Renal replacement therapy, Medical prescription, Position papers and Guidelines, Intensive care medicine, business.industry, Sodium, medicine.disease, business, Kidney disease
Abstract

The Italian nephrology has a long tradition and experience in the field of dietetic-nutritional therapy (DNT), which is an important component in the conservative management of the patient suffering from a chronic kidney disease, which precedes and integrates the pharmacological therapies. The objectives of DNT include the maintenance of an optimal nutritional status, the prevention and/or correction of signs, symptoms and complications of chronic renal failure and, possibly, the delay in starting of dialysis. The DNT includes modulation of protein intake, adequacy of caloric intake, control of sodium and potassium intake, and reduction of phosphorus intake. For all dietary-nutritional therapies, and in particular those aimed at the patient with chronic renal failure, the problem of patient adherence to the dietetic-nutritional scheme is a key element for the success and safety of the DNT and it can be favored by an interdisciplinary and multi-professional approach of information, education, dietary prescription and follow-up. This consensus document, which defines twenty essential points of the nutritional approach to patients with advanced chronic renal failure, has been written, discussed and shared by the Italian nephrologists together with representatives of dietitians (ANDID) and patients (ANED).

Published
2018

38. Low-protein diets for chronic kidney disease patients: the Italian experience

Author

L. Oldrizzi, Piergiorgio Bolasco, Giuliano Brunori, Luca De Nicola, Lucia Di Micco, Adamasco Cupisti, Serena Torraca, Battista Fabio Viola, Roberto Minutolo, Vincenzo Bellizzi, Francesco Locatelli, Domenico Santoro, Biagio Di Iorio, Marcora Mandreoli, Stefania Caria, Giacomo Garibotto, Enrico Fiaccadori, Giorgina Barbara Piccoli, Giuseppe Quintaliani, Giovanni Cancarini, Bellizzi, Vincenzo, Cupisti, Adamasco, Locatelli, Francesco, Bolasco, Piergiorgio, Brunori, Giuliano, Cancarini, Giovanni, Caria, Stefania, DE NICOLA, Luca, Di Iorio, Biagio R, Di Micco, Lucia, Fiaccadori, Enrico, Garibotto, Giacomo, Mandreoli, Marcora, Minutolo, Roberto, Oldrizzi, Lamberto, Piccoli, Giorgina B, Quintaliani, Giuseppe, Santoro, Domenico, Torraca, Serena, and Viola, Battista F.

Subjects
Nephrology, medicine.medical_specialty, Nephrotic Syndrome, Low protein, medicine.medical_treatment, 030232 urology & nephrology, Psychological intervention, 030204 cardiovascular system & hematology, urologic and male genital diseases, Diabetes Complications, 03 medical and health sciences, 0302 clinical medicine, Chronic kidney disease, Internal medicine, Correspondence, Diet, Protein-Restricted, medicine, Humans, Nephrology, Low protein diet, Chronic kidney disease, amino acids, Medical nutrition therapy, Amino Acids, Renal Insufficiency, Chronic, Intensive care medicine, Dialysis, business.industry, Sodium, Dietary, medicine.disease, Adaptation, Physiological, Low protein diet, Malnutrition, Nutrition Assessment, Italy, Phosphorus, Dietary, Dietary Proteins, Energy Metabolism, business, Nephrotic syndrome, Kidney disease
Abstract

Background Nutritional treatment has always represented a major feature of CKD management. Over the decades, the use of nutritional treatment in CKD patients has been marked by several goals. The first of these include the attainment of metabolic and fluid control together with the prevention and correction of signs, symptoms and complications of advanced CKD. The aim of this first stage is the prevention of malnutrition and a delay in the commencement of dialysis. Subsequently, nutritional manipulations have also been applied in association with other therapeutic interventions in an attempt to control several cardiovascular risk factors associated with CKD and to improve the patient's overall outcome. Over time and in reference to multiple aims, the modalities of nutritional treatment have been focused not only on protein intake but also on other nutrients. Discussion This paper describes the pathophysiological basis and rationale of nutritional treatment in CKD and also provides a report on extensive experience in the field of renal diets in Italy, with special attention given to approaches in clinical practice and management. Summary Italian nephrologists have a longstanding tradition in implementing low protein diets in the treatment of CKD patients, with the principle objective of alleviating uremic symptoms, improving nutritional status and also a possibility of slowing down the progression of CKD or delaying the start of dialysis. A renewed interest in this field is based on the aim of implementing a wider nutritional therapy other than only reducing the protein intake, paying careful attention to factors such as energy intake, the quality of proteins and phosphate and sodium intakes, making today’s low-protein diet program much more ambitious than previous. The motivation was the reduction in progression of renal insufficiency through reduction of proteinuria, a better control of blood pressure values and also through correction of metabolic acidosis. One major goal of the flexible and innovative Italian approach to the low-protein diet in CKD patients is the improvement of patient adherence, a crucial factor in the successful implementation of a low-protein diet program.

Published
2016
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39. Acute renal failure in a young woman with Fisher-Evans' syndrome.

Author

De Sanctis LB, Mandreoli M, Poggi C, Pileri S, Casanova S, and Santoro A

Subjects
Acute Kidney Injury diagnosis, Acute Kidney Injury immunology, Adult, Anemia, Hemolytic immunology, Female, Humans, Lymphatic Diseases diagnosis, Lymphatic Diseases etiology, Lymphatic Diseases immunology, Syndrome, Thrombocytopenia immunology, Acute Kidney Injury etiology, Anemia, Hemolytic complications, Thrombocytopenia complications
Abstract

A young female with Fisher-Evans' syndrome and a previous melanoma developed acute renal failure with generalized lymphoadenopathy and fever. The appearance of renal lesions is common in the course of several hematological disorders, but is unusual in Fisher-Evans' syndrome. Fisher-Evans' syndrome, defined as Coombs' positive hemolytic anemia and immune thrombocytopenia, is more frequently associated with the other autoimmune diseases, but not with renal involvement. In our case report, having excluded amyloidosis, myeloma, interstitial nephritis and sepsis, the rapid involvement of renal function with enlarged renal size seemed to suggest renal lymphoma. However, the lack of a monoclonal T-lymphocyte population in the renal tissue and peripheral blood, along with a clinical course characterized by a rapid reversibility of acute renal failure made this diagnosis rather an unlikely one. Polyclonal lymphocyte infiltration in a patient with a persistent autoimmune disease made us suspect a hyperimmune reaction. This syndrome is a non-neoplastic proliferation of B-cells involving an exaggeration of lymphocyte transformation. However, the clinical course is progressive and fatal, and can trigger a lymphoproliferative systemic disease. In our patient, two elements led us to suspect it was not a typical hyperimmune syndrome: first, polyclonal lymphocytes had massively infiltrated the kidney and, secondly, the clinical outcome was extremely favorable. Therefore, we were faced with an "atypical" and "singular" hyperimmune reaction with renal involvement, polyclonal proliferation of T-lymphocytes that had exhausted itself over time. Infective or toxic agents or drugs such as cyprofloxacin could have triggered the phenomenon, in the presence of a favorable condition such as Fisher-Evans' syndrome.

Published
2004

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