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2. Garden design can reduce wildfire risk and drive more sustainable co-existence with wildfire

Author

Stefania Ondei, Owen F. Price, and David M.J.S. Bowman

Subjects
Meteorology. Climatology, QC851-999, Disasters and engineering, TA495
Abstract

Abstract Destructive wildfire disasters are escalating globally, challenging existing fire management paradigms. The establishment of defensible space around homes in wildland and rural urban interfaces can help to reduce the risk of house loss and provide a safe area for residents and firefighters to defend the property from wildfire. Although defensible space is a well-established concept in fire management, it has received surprisingly limited scientific discussion. Here we reviewed guidelines on the creation of defensible space from Africa, Europe, North America, South America, and Oceania. We developed a conceptual model of defensible space framed around the key recommended approaches to mitigate fire attack mechanisms, which address fuel types, amount, and spatial distribution. We found that zonation within the defensible space is commonly recommended; reduction (or removal) of all fuels, and particularly dead plant material, is usually suggested in close (

Published
2024
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3. Development of a Versatile Nanostructured Lipid Carrier (NLC) Using Design of Experiments (DoE)—Part II: Incorporation and Stability of Butamben with Different Surfactants

Author

Ananda P. Matarazzo, Carlos A. Rios, Gabriela Gerônimo, Roberta Ondei, Eneida de Paula, and Márcia C. Breitkreitz

Subjects
nanostructured lipidic carriers, design of experiment, butamben, Pharmacy and materia medica, RS1-441
Abstract

Nanostructured lipid carriers (NLCs) are typically composed of liquid lipids, solid lipids, and surfactants, enabling the encapsulation of lipophilic drugs. Butamben is a Class II anesthetic drug, according to the Biopharmaceutical Classification System (BCS); it has a log P of 2.87 and is considered a ‘brick dust’ (poorly water-soluble and poorly lipid-soluble) drug. This characteristic poses a challenge for the development of NLCs, as they are not soluble in the liquid lipid present in the NLC core. In a previous study, we developed an NLC core consisting of a solid lipid (CrodamolTM CP), a lipophilic liquid with medium polarity (SRTM Lauryl lactate), and a hydrophilic excipient (SRTM DMI) that allowed the solubilization of ‘brick dust’ types of drugs, including butamben. In this study, starting from the NLC core formulation previously developed we carried out an optimization of the surfactant system and evaluated their performance in aqueous medium. Three different surfactants (CrodasolTM HS HP, SynperonicTM PE/F68, and CroduretTM 40) were studied and, for each of them, a 23 factorial design was stablished, with total lipids, % surfactant, and sonication time (min) as the input variables and particle size (nm), polydispersity index (PDI), and zeta potential (mV) as the response variables. Stable NLCs were obtained using CrodasolTM HS HP and SynperonicTM PE/F68 as surfactants. Through a comparison between NLCs developed with and without SRTM DMI, it was observed that besides helping the solubilization of butamben in the NLC core, this excipient helped in stabilizing the system and decreasing particle size. NLCs containing CrodasolTM HS HP and SynperonicTM PE/F68 presented particle size values in the nanometric scale, PDI values lower than 0.3, and zeta potentials above |10|mV. Concerning NLCs’ stability, SBTB-NLC with SynperonicTM PE/F68 and butamben demonstrated stability over a 3-month period in aqueous medium. The remaining NLCs showed phase separation or precipitation during the 3-month analysis. Nevertheless, these formulations could be freeze-dried after preparation, which would avoid precipitation in an aqueous medium.

Published
2024
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4. Development of a Versatile Lipid Core for Nanostructured Lipid Carriers (NLCs) Using Design of Experiments (DoE) and Raman Mapping

Author

Carlos Alberto Rios, Roberta Ondei, and Márcia Cristina Breitkreitz

Subjects
nanostructured lipid carriers, Raman imaging, design of experiment, classical least squares, Pharmacy and materia medica, RS1-441
Abstract

The objective of this study was to develop a versatile lipid core for the ‘brick-dust type of drugs’ (poorly water-soluble and poorly lipid-soluble drugs). In the first step, excipients of different polarities were classified according to their behavior in aqueous solutions. Subsequently, binary mixtures were prepared with cetyl palmitate (Crodamol™ CP pharma, Campinas, São Paulo, Brazil) as the solid lipid, and its miscibility with other excipients was evaluated using Raman mapping and classical least squares (CLS). Based on the results, the excipients Crodamol™ CP pharma (hydrophobic), Super Refined™ DMI (dimethyl isosorbide; hydrophilic, Mill Hall, PA, USA), and Super Refined™ Lauryl Lactate (lauryl lactate, medium polarity, Mill Hall, PA, USA) were chosen to compose the lipid core. The ideal proportion of these excipients was determined using a mixture design and the standard deviation (STD) of image histograms as the response variables. After statistical evaluation of the DoE results, the final composition was determined, and drugs with different logP (0 to 10) and physicochemical characteristics were evaluated in the optimized mixture. The drugs butamben (Sigma-Aldrich Co., Spruce Street, St. Louis, MO, USA), tacrolimus (NutriFarm, São Paulo, Brazil), atorvastatin calcium, and resveratrol (Botica da Terra, Campinas, Brazil) presented a homogeneous distribution in the optimized lipid core, indicating that this is a promising system to be used in nanostructured lipid carrier (NLC) formulations of such types of drugs.

Published
2024
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5. Association between land use, land cover, plant genera, and pollinator abundance in mixed-use landscapes.

Author

Vishesh L Diengdoh, Barry W Brook, Mark Hunt, and Stefania Ondei

Subjects
Medicine, Science
Abstract

Pollinators are threatened by land-use and land-cover changes, with the magnitude of the threat depending on the pollinating taxa, land-use type and intensity, the amount of natural habitat remaining, and the ecosystem considered. This study aims to determine the effect of land use (protected areas, plantations, pastures), land cover (percentage of forest and open areas within buffers of different sizes), and plant genera on the relative abundance of nectivorous birds (honeyeaters), bees (native and introduced), and beetles in the mixed-use landscape of the Tasman Peninsula (Tasmania, Australia) using mixed-effect models. We found the predictor selected (through model selection based on R2) and the effect of the predictors varied depending on the pollinating taxa. The land-use predictors were selected for only the honeyeater abundance model with protected areas and plantations having substantive positive effects. Land-cover predictors were selected for the honeyeater and native bee abundance models with open land cover within 1500 m and 250 m buffers having substantive negative and positive effects on honeyeaters and native bees respectively. Bees and beetles were observed on 24 plant genera of which only native plants (and not invasive/naturalised) were positively associated with pollinating insects. Pultenaea and Leucopogon were positively associated with native bees while Leucopogon, Lissanthe, Pimelea, and Pomaderris were positively associated with introduced bees. Leptospermum was the only plant genus positively associated with beetles. Our results highlight that one size does not fit all-that is pollinator responses to different landscape characteristics vary, emphasising the importance of considering multiple habitat factors to manage and support different pollinator taxa.

Published
2023
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6. Extinction of the Tasmanian emu and opportunities for rewilding

Author

Tristan Derham, Christopher Johnson, Brianna Martin, Julia Ryeland, Stefania Ondei, Matthew Fielding, and Barry W. Brook

Subjects
Conservation translocation, Ecological replacement, Human wildlife conflict, Megafauna extinction, Population simulation, Species distribution model, Ecology, QH540-549.5
Abstract

The Tasmanian emu (Dromaius novaehollandiae diemenensis) persisted alongside Aboriginal people for ∼40,000 years, for the last ∼14,000 years of which Tasmania was a large, continental island. This population of emus was extirpated soon after European colonization in the 19th century. Is hunting by people sufficient to explain the rapid demise of the emu or should we look to a synergy of pressures? Could wild emus be reintroduced to Tasmania? We investigated the distribution, hunting, and extinction of emus in Tasmania, before and after colonization, using population simulations, species distribution modelling, and land use analysis. We also evaluated the potential for rewilding with emus in present Tasmanian landscapes. The Tasmanian emu was a generalist with respect to vegetation and was widespread in the lowlands of eastern Tasmania. Prior to colonization, the maximum sustainable yield of adult emus was low, less than one per person per year. Following colonization, hunting rates quickly increased to a level that can account for rapid extinction. Large parts of Tasmania have both habitat and land uses suitable for an introduction of Australian mainland emus (D. n. novaehollandiae). This putative reintroduction of emus to Tasmania could reinstate several ecological and cultural roles but successful rewilding would require support from the wider community. We recommend field trial experiments, with methodologies co-designed by local community members.

Published
2023
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7. Isolated and mixed effects of diuron and its metabolites on biotransformation enzymes and oxidative stress response of Nile tilapia (Oreochromis niloticus)

Author

Felício, Andréia Arantes, Freitas, Juliane Silberschmidt, Scarin, Jéssica Bolpeti, de Souza Ondei, Luciana, Teresa, Fabrício Barreto, Schlenk, Daniel, and de Almeida, Eduardo Alves

Subjects
Ecological Applications, Environmental Sciences, Pollution and Contamination, Animals, Biodegradation, Environmental, Biotransformation, Brazil, Cichlids, Cytochrome P-450 CYP1A1, Diuron, Gills, Glutathione Transferase, Herbicides, Oxidative Stress, Water Pollutants, Chemical, Herbicide, Oxidative stress, Fish, Chemical Sciences, Medical and Health Sciences, Strategic, Defence & Security Studies, Environmental engineering, Ecological applications, Epidemiology
Abstract

Diuron is one of the most used herbicide in the world, and its field application has been particularly increased in Brazil due to the expansion of sugarcane crops. Diuron has often been detected in freshwater ecosystems and it can be biodegraded into three main metabolites in the environment, the 3,4-dichloroaniline (DCA), 3,4-dichlorophenylurea (DCPU) and 3,4-dichlorophenyl-N-methylurea (DCPMU). Negative effects under aquatic biota are still not well established for diuron, especially when considering its presence in mixture with its different metabolites. In this study, we evaluated the effects of diuron alone or in combination with its metabolites, DCPMU, DCPU and 3,4-DCA on biochemical stress responses and biotransformation activity of the fish Oreochromis niloticus. Results showed that diuron and its metabolites caused significant but dispersed alterations in oxidative stress markers and biotransformation enzymes, except for ethoxyresorufin-O-deethylase (EROD) activity, that presented a dose-dependent increase after exposure to either diuron or its metabolites. Glutathione S-transferase (GST) activity was significant lower in gills after exposure to diuron metabolites, but not diuron. Diuron, DCPMU and DCA also decreased the multixenobiotic resistance (MXR) activity. Lipid peroxidation levels were increased in gill after exposure to all compounds, indicating that the original compound and diuron metabolites can induce oxidative stress in fish. The integration of all biochemical responses by the Integrated Biomarker Response (IBR) model indicated that all compounds caused significant alterations in O. niloticus, but DCPMU caused the higher alterations in both liver and gill. Our findings imply that diuron and its metabolites may impair the physiological response related to biotransformation and antioxidant activity in fish at field concentrations. Such alterations could interfere with the ability of aquatic animals to adapt to environments contaminated by agriculture.

Published
2018

8. Predicted impacts of climate change and extreme temperature events on the future distribution of fruit bat species in Australia

Author

Vishesh L. Diengdoh, Stefania Ondei, Mark Hunt, and Barry W. Brook

Subjects
Species distribution model, Range shift, Pollinator, Flying fox, Blossom bat, Tube-nosed bat, Ecology, QH540-549.5
Abstract

Fruit bats are important pollinators and seed dispersers whose distribution may be affected by climate change and extreme-temperature events. We assessed the potential impacts of those changes and events on the future distribution of fruit bats in Australia. Correlative species distribution modelling was used to predict the distribution of seven (based on data availability) tropical and temperate fruit bat species. We used bioclimatic variables, the number of days where temperature ≥42 °C (known to induce extreme heat stress and mortality in fruit bats), and land cover (a proxy for habitat) as predictors. An ensemble of machine-learning algorithms was used to make predictions for the current-day distribution and future (2050 and 2070) scenarios, using multiple emission scenarios (RCP 4.5 and 8.5) and global circulation models (Australian Community Climate and Earth System Simulator, Hadley Centre Global Environment Model Carbon Cycle, and the Model for Interdisciplinary Research on Climate). Our results predict, under current conditions, on average, 9.1 % and 90.8 % of the area are suitable and unsuitable, respectively. Under future scenarios, on average, 6.7 % and 89.7 % continued to be suitable and unsuitable, respectively, while there was a 1.1 % gain and 2.4 % loss in suitable areas. Under current conditions, we predict, on average, 5.6 % and 3.4 % are suitable inside and outside species’ IUCN-defined range, respectively. While under future scenarios, 4.8 % (4.4 % stable and 0.4 % gain) and 2.9 % (2.2 % stable and 0.6 % gain) are suitable inside and outside the range respectively. On average, the gain in areas inside the range covers 2703.5 grid cells of size 5 km, while outside the range it is 4070.3 cells. Under future scenarios, the loss in areas is predicted to be 1.2 % and 1.1 % on average, inside and outside species range respectively. Fruit bats are likely to respond to climate change and extreme temperatures by migrating to more suitable areas, including regions not historically inhabited by those species. Our results can be used for identifying areas at risk of new fruit-bat colonisation, such as human settlements and orchards, as well as areas that might be important for habitat conservation.

Published
2022
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9. Fire Cycles and the Spatial Pattern of the Scrub–Sedgeland Mosaic at Blakes Opening in Western Tasmania, Australia

Author

David M. J. S. Bowman, Stefania Ondei, Scott C. Nichols, Scott M. Foyster, and Lynda D. Prior

Subjects
alternative stable state, fire-kill, forest boundary dynamics, immaturity risk, obligate seeder, post-fire regeneration, Physics, QC1-999
Abstract

The cause of large areas of treeless Sedgeland and Scrub communities in western Tasmania, one of the wettest regions of Australia, has long puzzled ecologists, given the climatic suitability for temperate Eucalyptus and rainforests. A pervasive theory, known as the ecological drift model, is that landscape fires have created a dynamic mosaic of fire-adapted and fire-sensitive vegetation. A contrary view, known as the fire cycle model, asserts that fire patterns are a consequence, not a cause, of the mosaics, which are edaphically determined. We leveraged the opportunity presented by a large wildfire that occurred in a Sedgeland tract surrounded by Eucalyptus forest in the Huon Valley in 2019 to help discriminate between these competing models. Specifically, we sought to determine whether there was any evidence that the Sedgeland was becoming infilled with Scrub prior to the 2019 fire, and whether the fire caused the Scrub community to convert to Sedgeland. A field survey was used to assess the mortality of shrubs and their regeneration following the 2019 fire, and we used dendrochronology to determine the age of the fire-killed shrubs. We also used historical aerial photography since the 1980s to map fire scars and the distribution of Sedgeland and Scrub. We found that fire killed most shrubs in the Sedgeland and Scrub communities and initiated a cohort of shrub regeneration. Dendrochronological analysis of the fire-killed shrubs revealed that most were established approximately 40 years ago, following a fire that is apparent from aerial photography and most likely occurred around 1983. An analysis of aerial photography revealed that since 1980, the distribution of the Scrub community has remained stable, although the density of shrubs declined following the 1983 fire. The recovery of the burned Scrub areas in 1983 and the rapid regeneration of the shrubs following the 2019 fire is more consistent with the fire cycle model than the ecological drift model. These findings concord with the demonstrated stability of the Eucalyptus forest boundary at this site revealed by a separate study. The slow growth of the shrubs cautions against frequently burning Sedgelands, because it could cause the collapse of shrub populations by killing the immature cohort initiated by fire.

Published
2023
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10. Fish biomarker responses to perturbation by drought in streams

Author

Luciana de Souza Ondei, Fabrício Barreto Teresa, Danielly Pereira Garcia, Andréia Arantes Felício, Danilo Grünig Humberto da Silva, and Eduardo Alves de Almeida

Subjects
Astyanax elachylepis, Antioxidant response, Brazilian savanna, Preparation for oxidative stress (POS), Seasonal variation, Zoology, QL1-991
Abstract

ABSTRACT Drought can be viewd as a perturbation in running waters and fish are often trapped in isolated pools, where deterioration of water quality may be stressful. We investigated how this extreme condition influences response of oxidative stress biomarkers. The response of the characid Astyanax elachylepis was assessed during the dry and rainy seasons in intermittent and perennial (control) sites in streams from Brazilian savannah (Cerrado). We predicted that the biomarkers would be enhanced in the dry season in intermittent streams only due the environmentally harsh conditions in the few isolated pools that remain filled with water. As predicted, fish from the intermittent stream in the dry season presented higher gill MDA values, indicating greater stress. In the liver, MDA values were higher in the dry season for both intermittent and perennial streams, suggesting a generalized seasonal response. As expected, some antioxidant response enzymes changed in the intermittent sites during the dry season. Therefore, oxidative stress biomarkers vary seasonally, with greater increase in intermittent sites. These evidences contribute for the understanding of the spatio-temporal variation of the fish responses and fish resistance to perturbations by drought in tropical environments.

Published
2020
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11. Missing the wood for the trees? New ideas on defining forests and forest degradation

Author

Jessie C. Buettel, Stefania Ondei, and Barry W. Brook

Subjects
Ecology, QH540-549.5
Abstract

The forest ecology literature is rife with debate about how to: (i) define a ‘forest’ and distinguish it from similar systems, such as woodlands, savannas, parklands or plantations; (ii) identify transitions from ‘forested’ to ‘non-forested’ states and, most challengingly; (iii) quantify intensities of degradation. Here we argue that past attempts to define forests and forest degradation, focusing on attributes of living trees (e.g., height, canopy cover), combined with regenerating processes such as recruitment and succession, whilst useful, are ecologically incomplete. These approaches do not adequately represent processes that, operating over long time scales, determine whether a forest system is structurally healthy (as opposed to degraded), functional and persistent. We support our case using a conceptual model to illustrate how deeper-time processes, as well as instantaneous or chronic disturbances that cause degradation, might be revealed through analysis of the patterns of size structure and density of the fallen wood, in relation to the living trees and standing dead. We propose practical ways in which researchers can incorporate dynamic, long-term processes into definitions of forests and forest degradation, using measurements of dead and fallen trees. Doing so will improve our ability to manage and monitor forest health under global change.

Published
2017
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12. A flexible tool to prioritize areas for conservation combining landscape units, measures of biodiversity, and threats

Author

Stefania Ondei, Barry W. Brook, and Jessie C. Buettel

Subjects
Australia, bioregionalization, Interim Biogeographic Regionalization for Australia, invasive species, irreplaceability, land‐use change, Ecology, QH540-549.5
Abstract

Abstract Expanding the reserve system is a key strategy to enhance biodiversity protection. Yet, conservation outcomes can be undermined by underrepresentation of some habitats and opportunistic placement of protected areas. Irreplaceability and vulnerability, the key principles of conservation, should thus be combined within a bioregionalization framework to implement protection in the habitats that most need it. We proposed a simple and flexible method to prioritize bioregions for conservation based on these principles and used it to rank the 85 bioregions of the Australian continent. To do so, we quantified biodiversity values and threats in each bioregion by gathering open‐access data on species, landscapes, and land use. Bioregions were then ranked using a set of customizable scenarios, including ecologically meaningful combinations of measures of irreplaceability and vulnerability. To identify biodiverse areas under threat but potentially overlooked, we compared our results with the location of already established biodiversity hotspots (i.e., areas identified as important for biodiversity and under threat). We found that bioregions with the highest biodiversity values are predominantly located in the southwest, east, and north of the continent. Similarly, threats, particularly land clearance, are concentrated along the east coast and in the southwest. When ranking bioregions using scenarios including both threats and biodiversity values, the majority (75%) of the highest‐ranking bioregions were already included in biodiversity hotspots. For five of these bioregions, the proportion of protected land to date still falls below the 17% recommended by the Convention on Biological Diversity and thus they likely require prompt prioritization and intervention. The method proposed can support ongoing monitoring and prioritization of land units for conservation. Its simplicity and flexibility mean it can be easily adopted for different areas and adjusted to local priorities.

Published
2019
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13. First, do no harm: A systematic review of deforestation spillovers from protected areas

Author

Carley Fuller, Stefania Ondei, Barry W. Brook, and Jessie C. Buettel

Subjects
Ecology, QH540-549.5
Abstract

Land-use restrictions in protected areas (PAs) might have unintended spillover effects on non-target, neighboring areas. In the case of leakage, land-use change that would have occurred in the PA is displaced to an unprotected area where it would not have otherwise occurred. The resultant ‘leakages’ can offset benefits achieved inside PAs, confound impact assessments, and exacerbate the problems of opportunistic protection of lands. Conversely, in the case of ‘blockage’, the unprotected surroundings experience less land-use change than would have otherwise occurred due to a positive spillover effect from nearby protected areas. Little is known about the magnitude, ubiquity, and predictability of spillovers that have already occurred in the global PA network. Here we systematically review the literature and collate the existing evidence to quantify deforestation spillovers. We calculated deforestation rates within 3,398 PAs, most of which were found in tropical and subtropical moist forests, and in their unprotected adjacent surroundings and compared these rates to a baseline derived from the wider landscape. Of the 2,575 PAs that effectively restricted deforestation rates within their bounds relative to the baseline, 11.8% showed leakage and 54.8% exhibited blockage. Deforestation rates in the remaining 33.4% were indistinguishable from their respective baselines. Linear modelling of the correlates of leakage and blockage showed that PA-specific characteristics like size and IUCN category were uninformative, whereas national-scale socioeconomic factors like population density and GDP were useful predictors. Although spillovers from land-use restrictions are ultimately driven by socioeconomic factors, their ecological consequences are such that PA assessments should routinely and explicitly account for displaced impacts to the unprotected surroundings. Keywords: Spillover, Leakage, Blockage, Protected areas, Impact assessment, Deforestation

Published
2019
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14. DINAMIZANDO E MOTIVANDO O APRENDIZADO ESCOLAR POR MEIO DOS JOGOS PEDAGÓGICOS

Author

Francyelle de Menezes Brito, Mychelle Gonçalves de São-José, Fabrício Barreto Teresa, and Luciana de Souza Ondei

Subjects
General Works
Abstract

Este estudo objetivou avaliar a eficiência dos jogos pedagógicos para a aprendizagem e o interesse promovido pelo seu uso por meio de uma abordagem experimental. Alunos do Ensino Fundamental (n=72) foram submetidos a um dos três tipos de aulas (tratamentos): (i) aula tradicional; (ii) aula tradicional e aplicação do jogo; (iii) somente aplicação do jogo. Verificou-se que a sala submetida à aula e ao jogo apresentou maior aprendizagem em relação às demais (p

Published
2015
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15. Ramipril and Cardiovascular Outcomes in Patients on Maintenance Hemodialysis: The ARCADIA Multicenter Randomized Controlled Trial

Author

Ruggenenti, P, Podesta, M, Trillini, M, Perna, A, Peracchi, T, Rubis, N, Villa, D, Martinetti, D, Cortinovis, M, Ondei, P, Condemi, C, Guastoni, C, Meterangelis, A, Granata, A, Mambelli, E, Pasquali, S, Genovesi, S, Pieruzzi, F, Bertoli, S, Del Rosso, G, Garozzo, M, Rigotti, A, Pozzi, C, David, S, Daidone, G, Mingardi, G, Mosconi, G, Galfre, A, Romei Longhena, G, Pacitti, A, Pani, A, Hidalgo Godoy, J, Anders, H, Remuzzi, G, Ruggenenti P., Podesta M. A., Trillini M., Perna A., Peracchi T., Rubis N., Villa D., Martinetti D., Cortinovis M., Ondei P., Condemi C. G., Guastoni C. M., Meterangelis A., Granata A., Mambelli E., Pasquali S., Genovesi S., Pieruzzi F., Bertoli S. V., Del Rosso G., Garozzo M., Rigotti A., Pozzi C., David S., Daidone G., Mingardi G., Mosconi G., Galfre A., Romei Longhena G., Pacitti A., Pani A., Hidalgo Godoy J., Anders H. -J., Remuzzi G., Ruggenenti, P, Podesta, M, Trillini, M, Perna, A, Peracchi, T, Rubis, N, Villa, D, Martinetti, D, Cortinovis, M, Ondei, P, Condemi, C, Guastoni, C, Meterangelis, A, Granata, A, Mambelli, E, Pasquali, S, Genovesi, S, Pieruzzi, F, Bertoli, S, Del Rosso, G, Garozzo, M, Rigotti, A, Pozzi, C, David, S, Daidone, G, Mingardi, G, Mosconi, G, Galfre, A, Romei Longhena, G, Pacitti, A, Pani, A, Hidalgo Godoy, J, Anders, H, Remuzzi, G, Ruggenenti P., Podesta M. A., Trillini M., Perna A., Peracchi T., Rubis N., Villa D., Martinetti D., Cortinovis M., Ondei P., Condemi C. G., Guastoni C. M., Meterangelis A., Granata A., Mambelli E., Pasquali S., Genovesi S., Pieruzzi F., Bertoli S. V., Del Rosso G., Garozzo M., Rigotti A., Pozzi C., David S., Daidone G., Mingardi G., Mosconi G., Galfre A., Romei Longhena G., Pacitti A., Pani A., Hidalgo Godoy J., Anders H. -J., and Remuzzi G.

Abstract

BACKGROUND AND OBJECTIVES: Renin-angiotensin system (RAS) inhibitors reduce cardiovascular morbidity and mortality in patients with CKD. We evaluated the cardioprotective effects of the angiotensin-converting enzyme inhibitor ramipril in patients on maintenance hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: In this phase 3, prospective, randomized, open-label, blinded end point, parallel, multicenter trial, we recruited patients on maintenance hemodialysis with hypertension and/or left ventricular hypertrophy from 28 Italian centers. Between July 2009 and February 2014, 140 participants were randomized to ramipril (1.25-10 mg/d) and 129 participants were allocated to non-RAS inhibition therapy, both titrated up to the maximally tolerated dose to achieve predefined target BP values. The primary efficacy end point was a composite of cardiovascular death, myocardial infarction, or stroke. Secondary end points included the single components of the primary end point, new-onset or recurrence of atrial fibrillation, hospitalizations for symptomatic fluid overload, thrombosis or stenosis of the arteriovenous fistula, and changes in cardiac mass index. All outcomes were evaluated up to 42 months after randomization. RESULTS: At comparable BP control, 23 participants on ramipril (16%) and 24 on non-RAS inhibitor therapy (19%) reached the primary composite end point (hazard ratio, 0.93; 95% confidence interval, 0.52 to 1.64; P=0.80). Ramipril reduced cardiac mass index at 1 year of follow-up (between-group difference in change from baseline: -16.3 g/m2; 95% confidence interval, -29.4 to -3.1), but did not significantly affect the other secondary outcomes. Hypotensive episodes were more frequent in participants allocated to ramipril than controls (41% versus 12%). Twenty participants on ramipril and nine controls developed cancer, including six gastrointestinal malignancies on ramipril (four were fatal), compared with none in controls. CONCLUSIONS: Ramipril di

Published
2021

16. Avaliação de fatores preditivos de estresse oxidativo em pessoas saudáveis

Author

Luciana de Souza Ondei, Fabrício Barreto Teresa, and Claudia Regina Bonini-Domingos

Subjects
Antioxidantes, Consumo de álcool, Gênero, Idade, Tabagismo, Science, Biology (General), QH301-705.5
Abstract

O objetivo deste trabalho foi avaliar a influência de fatores como tabagismo, consumo de álcool, uso de medicamentos, contato com produtos químicos, bem como idade e gênero sobre marcadores de estresse oxidativo, em indivíduos saudáveis. Verificou-se o efeito da idade sobre a capacidade antioxidante, com diminuição dos valores em indivíduos mais velhos, o que pode ser a causa do aumento de estresse oxidativo, associado ao envelhecimento. Para os demais fatores, não foram encontradas diferenças nos valores do marcador de peroxidação lipídica e da capacidade antioxidante.

Published
2014
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17. Oxidative stress and antioxidant status in beta-thalassemia heterozygotes

Author

Luciana de Souza Ondei, Isabeth da Fonseca Estevao, Marina Ibelli Pereira Rocha, Sandro Percario, Doroteia Rossi Silva Souza, Marcela Augusta de Souza Pinhel, and Claudia Regina Bonini-Domingos

Subjects
Oxidative stress, Beta-thalassemia, Lipid peroxidation, Beta-globins, Thiobarbituric acid reactive substances, Mutation, Diseases of the blood and blood-forming organs, RC633-647.5
Abstract

Background: Several studies have evaluated the oxidant and antioxidant status of thalassemia patients but most focused mainly on the severe and intermediate states of the disease. Moreover, the oxidative status has not been evaluated for the different beta-thalassemia mutations. Objective: To evaluate lipid peroxidation and Trolox equivalent antioxidant capacity in relation to serum iron and ferritin in beta thalassemia resulting from two different mutations (CD39 and IVS-I-110) compared to individuals without beta-thalassemia. Methods: One hundred and thirty subjects were studied, including 49 who were heterozygous for beta-thalassemia and 81 controls. Blood samples were subjected to screening tests for hemoglobin. Allele-specific polymerase chain reaction was used to confirm mutations for beta-thalassemia, an analysis of thiobarbituric acid reactive species was used to determine lipid peroxidation, and Trolox equivalent antioxidant capacity evaluations were performed. The heterozygous beta-thalassemia group was also evaluated for serum iron and ferritin status. Results: Thiobarbituric acid reactive species (486.24 ± 119.64 ng/mL) and Trolox equivalent antioxidant capacity values (2.23 ± 0.11 mM/L) were higher in beta-thalassemia heterozygotes compared to controls (260.86 ± 92.40 ng/mL and 2.12 ± 0.10 mM/L, respectively; p-value < 0.01). Increased thiobarbituric acid reactive species values were observed in subjects with the CD39 mutation compared with those with the IVS-I-110 mutation (529.94 ± 115.60 ng/mL and 453.39 ± 121.10 ng/mL, respectively; p-value = 0.04). However, average Trolox equivalent antioxidant capacity values were similar for both mutations (2.20 ± 0.08 mM/L and 2.23 ± 0.12 mM/L, respectively; p-value = 0.39). There was no influence of serum iron and ferritin levels on thiobarbituric acid reactive species and Trolox equivalent antioxidant capacity values. Conclusion: This study shows an increase of oxidative stress and antioxidant capacity in beta-thalassemia heterozygotes, mainly in carriers of the CD39 mutation.

Published
2013
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18. Collaborative Research on the Ecology and Management of the ‘Wulo’ Monsoon Rainforest in Wunambal Gaambera Country, North Kimberley, Australia

Author

Tom Vigilante, Stefania Ondei, Catherine Goonack, Desmond Williams, Paul Young, and David M. J. S. Bowman

Subjects
aboriginal natural resource management, Australian monsoon tropics, biodiversity, feral cattle, fire regimes, traditional ecological knowledge, tropical savanna, Agriculture
Abstract

Indigenous groups are increasingly combining traditional ecological knowledge and Western scientific approaches to inform the management of their lands. We report the outcomes of a collaborative research project focused on key ecological questions associated with monsoon vine thickets in Wunambal Gaambera country (Kimberley region, Western Australia). The study mapped monsoon rainforests and analysed the environmental correlates of their current distribution, as well as the historical drivers of patch dynamics since 1949. Remote sensing was used to chart the effectiveness of an intervention designed to re-instate Aboriginal fire regimes according to customary principles. We identified the most vulnerable patches based on size, distance from neighbouring patches, and fire frequency. More than 6000 rainforest patches were mapped. Most were small (

Published
2017
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20. Measuring and estimating GFR and treatment effect in ADPKD patients: results and implications of a longitudinal cohort study.

Author

Piero Ruggenenti, Flavio Gaspari, Antonio Cannata, Fabiola Carrara, Claudia Cella, Silvia Ferrari, Nadia Stucchi, Silvia Prandini, Bogdan Ene-Iordache, Olimpia Diadei, Norberto Perico, Patrizia Ondei, Antonio Pisani, Erasmo Buongiorno, Piergiorgio Messa, Mauro Dugo, Giuseppe Remuzzi, and GFR-ADPKD Study Group

Subjects
Medicine, Science
Abstract

Trials failed to demonstrate protective effects of investigational treatments on glomerular filtration rate (GFR) reduction in Autosomal Dominant Polycystic Kidney Disease (ADPKD). To assess whether above findings were explained by unreliable GFR estimates, in this academic study we compared GFR values centrally measured by iohexol plasma clearance with corresponding values estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) and abbreviated Modification of Diet in Renal Disease (aMDRD) formulas in ADPKD patients retrieved from four clinical trials run by a Clinical Research Center and five Nephrology Units in Italy. Measured baseline GFRs and one-year GFR changes averaged 78.6±26.7 and 8.4±10.3 mL/min/1.73 m(2) in 111 and 71 ADPKD patients, respectively. CKD-Epi significantly overestimated and aMDRD underestimated baseline GFRs. Less than half estimates deviated by

Published
2012
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22. Effect of Cinacalcet on Cardiovascular Disease in Patients Undergoing Dialysis

Author

Chertow GM, Block GA, Correa-Rotter R, Drüeke TB, Floege J, Goodman WG, Herzog CA, Kubo Y, London GM, Mahaffey KW, Mix TC, Moe SM, Trotman ML, Wheeler DC, Parfrey PS., Evolve Team, Chertow G, Parfrey P, Block G, Drüeke T, Goodman W, Herzog C, London G, Mahaffey K, Moe S, Wheeler D, Hennekens C, Baigent C, Brown W, O'Brien P, Anderson S, Hoel J, Szczech L, Patel U, Wampole J, Pun P, Felker M, Inrig J, Shah S, Hernandez A, Patel C, Brennan M, Albizem M, Capper E, Cauchi L, Cheng S, Dehmel B, Dhami K, Durham C, Francioni M, Gadd S, Goodman B, Guimaraes L, Grey N, Hamlin R, Harris C, Harris E, Heavey S, Heiges T, Heiser D, Jaeger P, James M, James P, Karimi S, Kewalramani R, Kraszewski A, Liang J, Maguire J, McCormick K, McFarlane K, Mix C, Modafferi D, Prathikanti R, Ryan C, Santiago N, Schumacher J, Seder C, Shahinfar S, Soares B, Stolman D, Tisher C, Trotman M, Tseng S, Ulias G, Unger P, Vyshenskaya A, Walsh L, White C, Wilde K, Santos J, Zarazaga C, Marin I, Garrote N, Cusumano A, Penalba N, Del Valle E, Juncos L, Saye J, Lef L, Altobelli V, Petraglia G, Rosa-Diez G, Douthat W, Lobo J, Gallart C, Lafalla A, Diez G, Linares B, Lopez N, Ramirez N, Gonzalez R, Valtuille R, Beresan H, Hermida O, Rudolf G, Marchetta N, Rano M, Ramirez M, Garcia N, Gillies A, Jones B, Pedagogos E, Walker R, Talaulikar G, Bannister K, Suranyi M, Kark A, Roger S, Kerr P, Disney A, Mount P, Fraenkel M, Mathew M, Fassett R, Jose M, Hawley C, Lonergan M, Mackie J, Ferrari P, Menahem S, Sabto J, Hutchison B, Langham R, Pollock C, Holzer H, Oberbauer R, Arias I, Graf H, Mayer G, Lhotta K, Neyer U, Klauser-Braun R, Hoerl W, Horn S, Kovarik J, Kramar R, Eigner M, Dhaene M, Billiouw J, De Meester J, Warling X, Cambier-Dwelschauwers P, Evenepoel P, Daelemans R, Dratwa M, Maes B, Stolear J, Dejagere T, Vanwalleghem J, Bouman K, Jadoul M, Peeters J, Vanholder R, Tielemans C, Donck J, Almeida F, de Oliveira J, Burdmann E, Garcia V, Thome F, Deboni L, Bregman R, Lugon J, Araújo S, Ferreira Filho S, Daher Ede F, Baptista M, Carvalho A, d'Avila D, Moyses Neto M, Yu L, Bastos M, Lacativa P, Jorgetti V, Romão Ede A, da Costa JC, Pecoits Filho R, Gordan P, Salgado N, Araújo M, Coelho S, Oliveira I, Moysés R, Vasconcellos L, Batista P, Gross J, Pedrosa A, Cournoyer S, LeBlanc M, Chow S, Karunakaran S, Wong G, Tobe S, Desmeules S, Zimmerman D, Murphy S, Montambault P, Donnelly S, MacRae J, Culleton B, Soroka S, Rabbat C, Jindal K, Vasilevsky M, Michaud M, Wijeyesinghe E, Zacharias J, Lok C, Muirhead N, Verrelli M, Da Roza G, Sapir D, Olgaard K, Daugaard H, Brandi L, Jensen P, Boulechfar H, Ang K, Simon P, Rieu P, Brunet P, Touchard G, Torres P, Combe C, Durrbach A, Ortiz J, Hannedouche T, Vela C, Lionet A, Ryckelynck P, Zaoui P, Choukroun G, Fessi H, Lang P, Stroumza P, Joly D, Mousson C, Laville M, Dellanna F, Erley C, Braun J, Rambausek M, Riegel W, Klingberg M, Schwertfeger E, Wizemann V, Eckardt K, Reichel H, Passauer J, Hübel E, Frischmuth N, Liebl R, Fiedler R, Schwenger V, Voßkühler A, Kunzendorf U, Renders L, Rattensberger D, Rump L, Ketteler M, Neumayer H, Zantvoort F, Stahl R, Ladanyi E, Braun B, Kulcsar I, Mezei I, Csiky B, Rikker C, Arkossy O, Berta K, Szegedi J, Major L, Ferenczi S, Fekete A, Szabo T, Zakar G, Wagner G, Erdelyine S, Borbas B, Eustace J, Reddan D, Capasso G, Locatelli F, Villa G, Cozzolino M, Brancaccio D, Messa P, Bolasco P, Ricciardi B, Malberti F, Moriero E, Cannella G, Ortalda V, Stefoni S, Frascà G, Cappelli G, Albertazzi A, Zoccali C, Farina M, Elli A, Avella F, Ondei P, Mingardi G, Errico R, Losito A, Di Giulio S, Pertosa G, Schena F, Grandaliano G, Gesualdo L, Auricchio M, Bochicchio-Ricardelli T, Correa-Rotter J, Verástegui F, Peña J, Wong A, Cruz-Valdez J, Zamora M, Solis M, Diaz M, Flores M, Sandoval E, van den Dorpel M, Brink H, Van Kuijk W, Vermeij C, Gregoor P, Hagen E, van der Sande F, Klinger M, Nowicki M, Muszytowski M, Bidas K, Bentkowski W, Wiecek A, Ksiazek A, Marczewski K, Ostrowski M, Switalski M, Sulowicz W, Matuszkiewicz-Rowinska J, Mysliwiec M, Durlik M, Rutkowski B, Macario F, Carvalho B, Frazao J, Machado D, Weigert A, Andrusev A, Khrustalev O, Zemtchenkov A, Gurevich K, Staroselsky K, Khadikova N, Rozhinskaya L, Timokhovskaya G, Strokov A, Balkarova O, Ermolenko V, Kolmakova E, Komandenko M, Timofeev M, Shilo V, Shostka G, Smirnov A, Anashkin V, Volgina G, Domashenko O, Gurevich A, Perlin D, García J, Ribes E, Piera E, Lucas M, Galicia M, Prados M, González M, Romero R, de Francisco ÁM, Montenegro J, Santiago C, García F, de La Ossa J, Arrieta J, Pons J, Martín-Malo A, Amigó J, Cases A, Sterner G, Jensen G, Wikström B, Jacobson S, Lund U, Weiss L, Ståhl A, von Albertini B, Burnier M, Meier P, Martin P, Uehlinger D, Dickenmann M, Yaqoob M, Zehnder D, Kalra P, Padmanabhan N, Roe S, Eadington D, Pritchard N, Hutchison A, Davies S, Wilkie M, Davies M, Pai P, Swift P, Kwan J, Goldsmith D, Tomson C, Stratton J, Dasgupta I, Sarkar S, Moustafa M, Gandhi K, Jamal A, Galindo-Ramos E, Tuazon J, Batlle D, Tucker K, Schiller-Moran B, Assefi A, Martinez C, Samuels L, Goldman J, Cangiano-Rivera J, Darwish R, Lee M, Topf J, Kapatkin K, Baer H, Kopelman R, Acharya M, Tharpe D, Bernardo M, Nader P, Guzman-Rivera J, Pergola P, Sekkarie M, Alas E, Zager P, Liss K, Navarro J, Roppolo M, Denu-Ciocca C, Kshirsagar A, El Khatib M, Kant K, Scott D, Murthyr B, Finkelstein F, Keightley G, McCrary R, Pitone J, Cavalieri T, Tsang A, Pellegrino B, Schmidt R, Ahmad S, Brown C, Friedman E, Mittman N, Fadem S, Shapiro W, Reddy M, Goldberger S, Woredekal Y, Agarwal A, Anger M, Haque M, Chidester P, Kohli R, Rubinstein S, Newman G, Gladish R, Ayodeji O, Soman S, Sprague S, Hunt N, Gehr T, Rizk D, Warnock D, Polack D, Pahl M, Fischer D, Dreyer P, James G, Husserl F, Rogers T, Raff A, Sedor J, Silver M, Smith M, Steinberg S, DelGiorno T, Jones E, Cunha P, Cheng J, Pogue V, Blumenthal S, Brown E, Charytan C, Buerkert J, Cook M, Felsenfeld A, Tareen N, Gupta A, Herman T, Diamond S, Hura C, Laski M, MacLaurin J, Plumb T, Brosnahan G, Kumar J, Henriquez M, Poole C, Osanloo E, Matalon A, Sholer C, Arfeen S, Azer M, Belledonne M, Gross M, Dunnigan E, McConnell K, Becker B, Rigolosi R, Spiegel D, Stegman M, Patak R, Streja D, Ranjit U, Youell T, Wooldridge T, Stafford C, Cottiero R, Weinberg M, Schonefeld M, Shahmir E, Hazzan A, Ashfaq A, Bhandari K, Cleveland W, Culpepper M, Golden J, Lai L, Lien Y, Lorica V, Robertson J, Malireddi K, Morse S, Thakur V, Israelit A, Raguram P, Alfred H, Weise W, Al-Saghir F, El Shahawy M, Rastogi A, Nissenson A, Kopyt N, Lynn R, Lea J, McClellan W, Teredesai P, Ong S, Tolkan S, Sugihara J, Minga T, Mehrotra R, Minasian R, Bhatia D, Specter R, Capelli J, Sidhu P, Dalal S, Dykes P, Khan M, Rahim F, Saklayen M, Thomas A, Michael B, Torres M, Al-Bander H, Murray B, Abukurah A, Gupta B, Nosrati S, Raja R, Zeig S, Braun M, Amatya A, Endsley J, Sharon Z, Dolson G, Dumler F, Ntoso K, Rosansky S, Kumar N, Gura V, Thompson N, Goldfarb D, Halligan R, Middleton J, Widerhorn A, Arbeit L, Arruda J, Crouch T, Friedman L, Khokhar S, Mittleman J, Light P, Taparia B, West C, Cotton J, Dhingra R, Kleinman L, Arif F, Lew S, Nammour T, Sterrett J, Williams M, Ramirez J, Rubin J, McCarthy J, Noble S, Chaffin M, Rekhi A., Chertow, Gm, Block, Ga, Correa-Rotter, R, Drüeke, Tb, Floege, J, Goodman, Wg, Herzog, Ca, Kubo, Y, London, Gm, Mahaffey, Kw, Mix, Tc, Moe, Sm, Trotman, Ml, Wheeler, Dc, Parfrey, Ps., Evolve, Team, Chertow, G, Parfrey, P, Block, G, Drüeke, T, Goodman, W, Herzog, C, London, G, Mahaffey, K, Moe, S, Wheeler, D, Hennekens, C, Baigent, C, Brown, W, O'Brien, P, Anderson, S, Hoel, J, Szczech, L, Patel, U, Wampole, J, Pun, P, Felker, M, Inrig, J, Shah, S, Hernandez, A, Patel, C, Brennan, M, Albizem, M, Capper, E, Cauchi, L, Cheng, S, Dehmel, B, Dhami, K, Durham, C, Francioni, M, Gadd, S, Goodman, B, Guimaraes, L, Grey, N, Hamlin, R, Harris, C, Harris, E, Heavey, S, Heiges, T, Heiser, D, Jaeger, P, James, M, James, P, Karimi, S, Kewalramani, R, Kraszewski, A, Liang, J, Maguire, J, Mccormick, K, Mcfarlane, K, Mix, C, Modafferi, D, Prathikanti, R, Ryan, C, Santiago, N, Schumacher, J, Seder, C, Shahinfar, S, Soares, B, Stolman, D, Tisher, C, Trotman, M, Tseng, S, Ulias, G, Unger, P, Vyshenskaya, A, Walsh, L, White, C, Wilde, K, Santos, J, Zarazaga, C, Marin, I, Garrote, N, Cusumano, A, Penalba, N, Del Valle, E, Juncos, L, Saye, J, Lef, L, Altobelli, V, Petraglia, G, Rosa-Diez, G, Douthat, W, Lobo, J, Gallart, C, Lafalla, A, Diez, G, Linares, B, Lopez, N, Ramirez, N, Gonzalez, R, Valtuille, R, Beresan, H, Hermida, O, Rudolf, G, Marchetta, N, Rano, M, Ramirez, M, Garcia, N, Gillies, A, Jones, B, Pedagogos, E, Walker, R, Talaulikar, G, Bannister, K, Suranyi, M, Kark, A, Roger, S, Kerr, P, Disney, A, Mount, P, Fraenkel, M, Mathew, M, Fassett, R, Jose, M, Hawley, C, Lonergan, M, Mackie, J, Ferrari, P, Menahem, S, Sabto, J, Hutchison, B, Langham, R, Pollock, C, Holzer, H, Oberbauer, R, Arias, I, Graf, H, Mayer, G, Lhotta, K, Neyer, U, Klauser-Braun, R, Hoerl, W, Horn, S, Kovarik, J, Kramar, R, Eigner, M, Dhaene, M, Billiouw, J, De Meester, J, Warling, X, Cambier-Dwelschauwers, P, Evenepoel, P, Daelemans, R, Dratwa, M, Maes, B, Stolear, J, Dejagere, T, Vanwalleghem, J, Bouman, K, Jadoul, M, Peeters, J, Vanholder, R, Tielemans, C, Donck, J, Almeida, F, de Oliveira, J, Burdmann, E, Garcia, V, Thome, F, Deboni, L, Bregman, R, Lugon, J, Araújo, S, Ferreira Filho, S, Daher Ede, F, Baptista, M, Carvalho, A, D'Avila, D, Moyses Neto, M, Yu, L, Bastos, M, Lacativa, P, Jorgetti, V, Romão Ede, A, da Costa, Jc, Pecoits Filho, R, Gordan, P, Salgado, N, Araújo, M, Coelho, S, Oliveira, I, Moysés, R, Vasconcellos, L, Batista, P, Gross, J, Pedrosa, A, Cournoyer, S, Leblanc, M, Chow, S, Karunakaran, S, Wong, G, Tobe, S, Desmeules, S, Zimmerman, D, Murphy, S, Montambault, P, Donnelly, S, Macrae, J, Culleton, B, Soroka, S, Rabbat, C, Jindal, K, Vasilevsky, M, Michaud, M, Wijeyesinghe, E, Zacharias, J, Lok, C, Muirhead, N, Verrelli, M, Da Roza, G, Sapir, D, Olgaard, K, Daugaard, H, Brandi, L, Jensen, P, Boulechfar, H, Ang, K, Simon, P, Rieu, P, Brunet, P, Touchard, G, Torres, P, Combe, C, Durrbach, A, Ortiz, J, Hannedouche, T, Vela, C, Lionet, A, Ryckelynck, P, Zaoui, P, Choukroun, G, Fessi, H, Lang, P, Stroumza, P, Joly, D, Mousson, C, Laville, M, Dellanna, F, Erley, C, Braun, J, Rambausek, M, Riegel, W, Klingberg, M, Schwertfeger, E, Wizemann, V, Eckardt, K, Reichel, H, Passauer, J, Hübel, E, Frischmuth, N, Liebl, R, Fiedler, R, Schwenger, V, Voßkühler, A, Kunzendorf, U, Renders, L, Rattensberger, D, Rump, L, Ketteler, M, Neumayer, H, Zantvoort, F, Stahl, R, Ladanyi, E, Braun, B, Kulcsar, I, Mezei, I, Csiky, B, Rikker, C, Arkossy, O, Berta, K, Szegedi, J, Major, L, Ferenczi, S, Fekete, A, Szabo, T, Zakar, G, Wagner, G, Erdelyine, S, Borbas, B, Eustace, J, Reddan, D, Capasso, G, Locatelli, F, Villa, G, Cozzolino, M, Brancaccio, D, Messa, P, Bolasco, P, Ricciardi, B, Malberti, F, Moriero, E, Cannella, G, Ortalda, V, Stefoni, S, Frascà, G, Cappelli, G, Albertazzi, A, Zoccali, C, Farina, M, Elli, A, Avella, F, Ondei, P, Mingardi, G, Errico, R, Losito, A, Di Giulio, S, Pertosa, G, Schena, F, Grandaliano, G, Gesualdo, L, Auricchio, M, Bochicchio-Ricardelli, T, Correa-Rotter, J, Verástegui, F, Peña, J, Wong, A, Cruz-Valdez, J, Zamora, M, Solis, M, Diaz, M, Flores, M, Sandoval, E, van den Dorpel, M, Brink, H, Van Kuijk, W, Vermeij, C, Gregoor, P, Hagen, E, van der Sande, F, Klinger, M, Nowicki, M, Muszytowski, M, Bidas, K, Bentkowski, W, Wiecek, A, Ksiazek, A, Marczewski, K, Ostrowski, M, Switalski, M, Sulowicz, W, Matuszkiewicz-Rowinska, J, Mysliwiec, M, Durlik, M, Rutkowski, B, Macario, F, Carvalho, B, Frazao, J, Machado, D, Weigert, A, Andrusev, A, Khrustalev, O, Zemtchenkov, A, Gurevich, K, Staroselsky, K, Khadikova, N, Rozhinskaya, L, Timokhovskaya, G, Strokov, A, Balkarova, O, Ermolenko, V, Kolmakova, E, Komandenko, M, Timofeev, M, Shilo, V, Shostka, G, Smirnov, A, Anashkin, V, Volgina, G, Domashenko, O, Gurevich, A, Perlin, D, García, J, Ribes, E, Piera, E, Lucas, M, Galicia, M, Prados, M, González, M, Romero, R, de Francisco, Ám, Montenegro, J, Santiago, C, García, F, de La Ossa, J, Arrieta, J, Pons, J, Martín-Malo, A, Amigó, J, Cases, A, Sterner, G, Jensen, G, Wikström, B, Jacobson, S, Lund, U, Weiss, L, Ståhl, A, von Albertini, B, Burnier, M, Meier, P, Martin, P, Uehlinger, D, Dickenmann, M, Yaqoob, M, Zehnder, D, Kalra, P, Padmanabhan, N, Roe, S, Eadington, D, Pritchard, N, Hutchison, A, Davies, S, Wilkie, M, Davies, M, Pai, P, Swift, P, Kwan, J, Goldsmith, D, Tomson, C, Stratton, J, Dasgupta, I, Sarkar, S, Moustafa, M, Gandhi, K, Jamal, A, Galindo-Ramos, E, Tuazon, J, Batlle, D, Tucker, K, Schiller-Moran, B, Assefi, A, Martinez, C, Samuels, L, Goldman, J, Cangiano-Rivera, J, Darwish, R, Lee, M, Topf, J, Kapatkin, K, Baer, H, Kopelman, R, Acharya, M, Tharpe, D, Bernardo, M, Nader, P, Guzman-Rivera, J, Pergola, P, Sekkarie, M, Alas, E, Zager, P, Liss, K, Navarro, J, Roppolo, M, Denu-Ciocca, C, Kshirsagar, A, El Khatib, M, Kant, K, Scott, D, Murthyr, B, Finkelstein, F, Keightley, G, Mccrary, R, Pitone, J, Cavalieri, T, Tsang, A, Pellegrino, B, Schmidt, R, Ahmad, S, Brown, C, Friedman, E, Mittman, N, Fadem, S, Shapiro, W, Reddy, M, Goldberger, S, Woredekal, Y, Agarwal, A, Anger, M, Haque, M, Chidester, P, Kohli, R, Rubinstein, S, Newman, G, Gladish, R, Ayodeji, O, Soman, S, Sprague, S, Hunt, N, Gehr, T, Rizk, D, Warnock, D, Polack, D, Pahl, M, Fischer, D, Dreyer, P, James, G, Husserl, F, Rogers, T, Raff, A, Sedor, J, Silver, M, Smith, M, Steinberg, S, Delgiorno, T, Jones, E, Cunha, P, Cheng, J, Pogue, V, Blumenthal, S, Brown, E, Charytan, C, Buerkert, J, Cook, M, Felsenfeld, A, Tareen, N, Gupta, A, Herman, T, Diamond, S, Hura, C, Laski, M, Maclaurin, J, Plumb, T, Brosnahan, G, Kumar, J, Henriquez, M, Poole, C, Osanloo, E, Matalon, A, Sholer, C, Arfeen, S, Azer, M, Belledonne, M, Gross, M, Dunnigan, E, Mcconnell, K, Becker, B, Rigolosi, R, Spiegel, D, Stegman, M, Patak, R, Streja, D, Ranjit, U, Youell, T, Wooldridge, T, Stafford, C, Cottiero, R, Weinberg, M, Schonefeld, M, Shahmir, E, Hazzan, A, Ashfaq, A, Bhandari, K, Cleveland, W, Culpepper, M, Golden, J, Lai, L, Lien, Y, Lorica, V, Robertson, J, Malireddi, K, Morse, S, Thakur, V, Israelit, A, Raguram, P, Alfred, H, Weise, W, Al-Saghir, F, El Shahawy, M, Rastogi, A, Nissenson, A, Kopyt, N, Lynn, R, Lea, J, Mcclellan, W, Teredesai, P, Ong, S, Tolkan, S, Sugihara, J, Minga, T, Mehrotra, R, Minasian, R, Bhatia, D, Specter, R, Capelli, J, Sidhu, P, Dalal, S, Dykes, P, Khan, M, Rahim, F, Saklayen, M, Thomas, A, Michael, B, Torres, M, Al-Bander, H, Murray, B, Abukurah, A, Gupta, B, Nosrati, S, Raja, R, Zeig, S, Braun, M, Amatya, A, Endsley, J, Sharon, Z, Dolson, G, Dumler, F, Ntoso, K, Rosansky, S, Kumar, N, Gura, V, Thompson, N, Goldfarb, D, Halligan, R, Middleton, J, Widerhorn, A, Arbeit, L, Arruda, J, Crouch, T, Friedman, L, Khokhar, S, Mittleman, J, Light, P, Taparia, B, West, C, Cotton, J, Dhingra, R, Kleinman, L, Arif, F, Lew, S, Nammour, T, Sterrett, J, Williams, M, Ramirez, J, Rubin, J, Mccarthy, J, Noble, S, Chaffin, M, and Rekhi, A.

Subjects
Adult, Male, Dialysis, Cinacalcet, Cardiovascular Disease, medicine.medical_specialty, Calcimimetic, medicine.medical_treatment, Naphthalenes, Coronary artery disease, Renal Dialysis, Internal medicine, Odds Ratio, medicine, Humans, Intensive care medicine, Aged, Etelcalcetide, Hyperparathyroidism, Hypocalcemia, business.industry, General Medicine, Middle Aged, medicine.disease, Intention to Treat Analysis, Cardiovascular Diseases, Parathyroid Hormone, Cinacalcet Hydrochloride, Kidney Failure, Chronic, Female, Hyperparathyroidism, Secondary, Secondary hyperparathyroidism, business, medicine.drug
Abstract

Disorders of mineral metabolism, including secondary hyperparathyroidism, are thought to contribute to extraskeletal (including vascular) calcification among patients with chronic kidney disease. It has been hypothesized that treatment with the calcimimetic agent cinacalcet might reduce the risk of death or nonfatal cardiovascular events in such patients.In this clinical trial, we randomly assigned 3883 patients with moderate-to-severe secondary hyperparathyroidism (median level of intact parathyroid hormone, 693 pg per milliliter [10th to 90th percentile, 363 to 1694]) who were undergoing hemodialysis to receive either cinacalcet or placebo. All patients were eligible to receive conventional therapy, including phosphate binders, vitamin D sterols, or both. The patients were followed for up to 64 months. The primary composite end point was the time until death, myocardial infarction, hospitalization for unstable angina, heart failure, or a peripheral vascular event. The primary analysis was performed on the basis of the intention-to-treat principle.The median duration of study-drug exposure was 21.2 months in the cinacalcet group, versus 17.5 months in the placebo group. The primary composite end point was reached in 938 of 1948 patients (48.2%) in the cinacalcet group and 952 of 1935 patients (49.2%) in the placebo group (relative hazard in the cinacalcet group vs. the placebo group, 0.93; 95% confidence interval, 0.85 to 1.02; P=0.11). Hypocalcemia and gastrointestinal adverse events were significantly more frequent in patients receiving cinacalcet.In an unadjusted intention-to-treat analysis, cinacalcet did not significantly reduce the risk of death or major cardiovascular events in patients with moderate-to-severe secondary hyperparathyroidism who were undergoing dialysis. (Funded by Amgen; EVOLVE ClinicalTrials.gov number, NCT00345839.).

Published
2012
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23. Supplementary Material for: Sudden Death in End Stage Renal Disease: Comparing Hemodialysis versus Peritoneal Dialysis

Author

Genovesi, S., Porcu, L., Luise, M.C., Riva, H., Nava, E., Contaldo, G., Stella, A., Pozzi, C., Ondei, P., Minoretti, C., Gallieni, M., Pontoriero, G., Conte, F., Torri, V., Bertoli, S., and Vincenti, A.

Abstract

Background/Aims: This study aimed to evaluate total and sudden death (SD) in a cohort of dialysis patients, comparing hemodialysis (HD) vs. peritoneal dialysis (PD). Methods: This is a multicenter retrospective cohort study. Results: Deaths were 626 out of 1,823 in HD and 62 of 249 in PD patients. HD patients had a greater number of comorbidities (p < 0.05). PD patients had a lower risk of death than HD patients (p < 0.001); however, the advantage decreased with time (p < 0.001). Mortality predictors were left ventricular ejection fraction (LVEF) ≤35%, older age, ischemic heart disease, diabetes mellitus, previous stroke, and atrial fibrillation (p < 0.03). SDs were 84:71 in HD and 13 in PD population (12.1 and 22.8% of all causes of death, respectively). A non-significant risk of SD among PD compared to HD patients was detected. SD predictors were older age, ischemic heart disease, and LVEF ≤35% (p < 0.05). Conclusions: HD patients showed a greater presence of comorbidities and reduced survival compared to PD patients; however, the incidence of SD does not differ in the 2 populations. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=464347.

Published
2017
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24. Cinacalcet, fibroblast growth factor-23, and cardiovascular disease in hemodialysis: The evaluation of cinacalcet HCl therapy to lower cardiovascular events (EVOLVE) trial

Author

Moe S. M., Chertow G. M., Parfrey P. S., Kubo Y., Block G. A., Correa-Rotter R., Drueke T. B., Herzog C. A., London G. M., Mahaffey K. W., Wheeler D. C., Stolina M., Dehmel B., Goodman W. G., Floege J., Santos J., Najun Zarazaga C., Marin I., Garrote N., Cusumano A., Penalba N., Del Valle E., Juncos L., Martinez Saye J., Lef L., Altobelli V., Petraglia G., Rosa Diez G., Douthat W., Lobo J., Gallart C., Lafalla A., Diez G., Linares B., Lopez N., Ramirez N., Gonzalez R., Valtuille R., Beresan H., Hermida O., Rudolf G., Marchetta N., Rano M., Ramirez M., Garcia N., Gillies A., Jones B., Pedagogos E., Walker R., Talaulikar G., Bannister K., Suranyi M., Kark A., Roger S., Kerr P., Disney A., Mount P., Fraenkel M., Mathew M., Fassett R., Jose M., Hawley C., Lonergan M., Mackie J., Ferrari P., Menahem S., Sabto J., Hutchison B., Langham R., Pollock C., Holzer H., Oberbauer R., Arias I., Graf H., Mayer G., Lhotta K., Neyer U., Klauser R., Hoerl W., Horn S., Kovarik J., Kramar R., Eigner M., Dhaene M., Billiouw J., De Meester J., Warling X., Cambier-Dwelschauwers P., Evenepoel P., Daelemans R., Dratwa M., Maes B., Stolear J., Dejagere T., Vanwalleghem J., Bouman K., Jadoul M., Peeters J., Vanholder R., Tielemans C., Donck J., Almeida F., Picollo De Oliveira J., Burdmann E., Garcia V., Saldanha Thome F., Deboni L., Bregman R., Lugon J., Araujo S., Ferreira Filho S., De Francesco Daher E., Sperto Baptista M., Carvalho A., D'Avila D., Moyses Neto M., Yu L., Bastos M., Sampaio Lacativa P., Jorgetti V., De Almeida Romao E., Cardeal Da Costa J., Pecoits Filho R., Gordan P., Salgado N., Teixeira Araujo M., Neiva Coelho S., Oliveira I., Moyses R., Vasconcellos L., Batista P., Luiz Gross J., Pedrosa A., Cournoyer S., LeBlanc M., Chow S., Karunakaran S., Wong G., Tobe S., Desmeules S., Zimmerman D., Murphy S., Montambault P., Donnelly S., MacRae J., Culleton B., Soroka S., Rabbat C., Jindal K., Vasilevsky M., Michaud M., Wijeyesinghe E., Zacharias J., Lok C., Muirhead N., Verrelli M., Da Roza G., Sapir D., Olgaard K., Daugaard H., Brandi L., Jensen P., Boulechfar H., Ang K., Simon P., Rieu P., Brunet P., Touchard G., Urena Torres P., Combe C., Durrbach A., Ortiz J., Hannedouche T., Vela C., Lionet A., Ryckelynck P., Zaoui P., Choukroun G., Fessi H., Lang P., Stroumza P., Joly D., Mousson C., Laville M., Dellanna F., Erley C., Braun J., Rambausek M., Riegel W., Klingberg M., Schwertfeger E., Wizemann V., Eckardt K., Reichel H., Passauer J., Hubel E., Frischmuth N., Liebl R., Fiedler R., Schwenger V., Vosskuhler A., Kunzendorf U., Renders L., Rattensberger D., Rump L., Ketteler M., Neumayer H., Zantvoort F., Stahl R., Ladanyi E., Kulcsar I., Mezei I., Csiky B., Rikker C., Arkossy O., Berta K., Szegedi J., Major L., Ferenczi S., Fekete A., Szabo T., Zakar G., Wagner G., Kazup Erdelyine S., Borbas B., Eustace J., Reddan D., Capasso G., Locatelli F., Villa G., Cozzolino M., Brancaccio D., Messa P., Bolasco P., Ricciardi B., Malberti F., Moriero E., Cannella G., Ortalda V., Stefoni S., Frasca G., Cappelli G., Albertazzi A., Zoccali C., Farina M., Elli A., Avella F., Ondei P., Mingardi G., Errico R., Losito A., Di Giulio S., Pertosa G., Schena F., Grandaliano G., Gesualdo L., Auricchio M., Bochicchio-Ricardelli T., Aranda Verastegui F., Pena J., Chew Wong A., Cruz-Valdez J., Torres Zamora M., Solis M., Sebastian Diaz M., Vital Flores M., Alvarez Sandoval E., Van Den Dorpel M., Brink H., Van Kuijk W., Vermeij C., Smak Gregoor P., Hagen E., Van Der Sande F., Klinger M., Nowicki M., Muszytowski M., Bidas K., Bentkowski W., Wiecek A., Ksiazek A., Marczewski K., Ostrowski M., Switalski M., Sulowicz W., Matuszkiewicz-Rowinska J., Mysliwiec M., Durlik M., Rutkowski B., Macario F., Carvalho B., Frazao J., Machado D., Weigert A., Andrusev A., Khrustalev O., Zemtchenkov A., Gurevich K., Staroselsky K., Khadikova N., Rozhinskaya L., Timokhovskaya G., Strokov A., Balkarova O., Ermolenko V., Kolmakova E., Komandenko M., Timofeev M., Shilo V., Shostka G., Smirnov A., Anashkin V., Volgina G., Domashenko O., Gurevich A., Perlin D., Martinez Garcia J., Andres Ribes E., Coll Piera E., Fernandez Lucas M., Galicia M., Prados M., Gonzalez M., Romero R., Martin de Francisco A., Montenegro J., Santiago C., Garcia F., Alcazar De La Ossa J., Arrieta J., Pons J., Martin-Malo A., Soler Amigo J., Cases A., Sterner G., Jensen G., Wikstrom B., Jacobson S., Lund U., Weiss L., Stahl A., Von Albertini B., Burnier M., Meier P., Martin P., Uehlinger D., Dickenmann M., Yaqoob M., Zehnder D., Kalra P., Padmanabhan N., Roe S., Eadington D., Pritchard N., Hutchison A., Davies S., Wilkie M., Davies M., Pai P., Swift P., Kwan J., Goldsmith D., Tomson C., Stratton J., Dasgupta I., Sarkar S., Moustafa M., Gandhi K., Jamal A., Galindo-Ramos E., Tuazon J., Batlle D., Tucker K., Schiller-Moran B., Assefi A., Martinez C., Samuels L., Goldman J., Cangiano-Rivera J., Darwish R., Lee M., Topf J., Kapatkin K., Baer H., Kopelman R., Acharya M., Tharpe D., Bernardo M., Nader P., Guzman-Rivera J., Pergola P., Sekkarie M., Alas E., Zager P., Liss K., Navarro J., Roppolo M., Denu-Ciocca C., Kshirsagar A., El Khatib M., Kant K., Scott D., Murthyr B., Finkelstein F., Keightley G., McCrary R., Pitone J., Cavalieri T., Tsang A., Pellegrino B., Schmidt R., Ahmad S., Brown C., Friedman E., Mittman N., Fadem S., Shapiro W., Reddy M., Goldberger S., Woredekal Y., Agarwal A., Anger M., Haque M., Chidester P., Kohli R., Rubinstein S., Newman G., Gladish R., Ayodeji O., Soman S., Sprague S., Hunt N., Gehr T., Rizk D., Warnock D., Polack D., Pahl M., Fischer D., Dreyer P., James G., Husserl F., Rogers T., Raff A., Sedor J., Silver M., Smith M., Steinberg S., DelGiorno T., Jones E., Cunha P. D., Cheng J., Pogue V., Blumenthal S., Brown E., Charytan C., Buerkert J., Cook M., Felsenfeld A., Tareen N., Gupta A., Herman T., Diamond S., Hura C., Laski M., MacLaurin J., Plumb T., Brosnahan G., Kumar J., Henriquez M., Poole C., Osanloo E., Matalon A., Sholer C., Arfeen S., Azer M., Belledonne M., Gross M., Dunnigan E., McConnell K., Becker B., Skinner F., Rigolosi R., Spiegel D., Stegman M., Patak R., Streja D., Ranjit U., Youell T., Wooldridge T., Stafford C., Cottiero R., Weinberg M., Schonefeld M., Shahmir E., Hazzan A., Ashfaq A., Bhandari K., Cleveland W., Culpepper M., Golden J., Lai L., Lien Y., Lorica V., Robertson J., Malireddi K., Morse S., Thakur V., Israelit A., Raguram P., Alfred H., Weise W., Al-Saghir F., El Shahawy M., Rastogi A., Nissenson A., Kopyt N., Lynn R., Lea J., McClellan W., Teredesai P., Ong S., Tolkan S., Sugihara J., Minga T., Mehrotra R., Minasian R., Bhatia D., Specter R., Capelli J., Sidhu P., Dalal S., Dykes P., Khan M., Rahim F., Saklayen M., Thomas A., Michael B., Torres M., Al-Bander H., Murray B., Abukurah A., Gupta B., Nosrati S., Raja R., Zeig S., Braun M., Amatya A., Endsley J., Sharon Z., Dolson G., Dumler F., Ntoso K., Rosansky S., Kumar N., Gura V., Thompson N., Goldfarb D., Halligan R., Middleton J., Widerhorn A., Arbeit L., Arruda J., Crouch T., Friedman L., Khokhar S., Mittleman J., Light P., Taparia B., West C., Cotton J., Dhingra R., Kleinman L., Arif F., Lew S., Nammour T., Sterrett J., Williams M., Ramirez J., Rubin J., McCarthy J., Noble S., Chaffin M., Rekhi A., Moe, S. M., Chertow, G. M., Parfrey, P. S., Kubo, Y., Block, G. A., Correa-Rotter, R., Drueke, T. B., Herzog, C. A., London, G. M., Mahaffey, K. W., Wheeler, D. C., Stolina, M., Dehmel, B., Goodman, W. G., Floege, J., Santos, J., Najun Zarazaga, C., Marin, I., Garrote, N., Cusumano, A., Penalba, N., Del Valle, E., Juncos, L., Martinez Saye, J., Lef, L., Altobelli, V., Petraglia, G., Rosa Diez, G., Douthat, W., Lobo, J., Gallart, C., Lafalla, A., Diez, G., Linares, B., Lopez, N., Ramirez, N., Gonzalez, R., Valtuille, R., Beresan, H., Hermida, O., Rudolf, G., Marchetta, N., Rano, M., Ramirez, M., Garcia, N., Gillies, A., Jones, B., Pedagogos, E., Walker, R., Talaulikar, G., Bannister, K., Suranyi, M., Kark, A., Roger, S., Kerr, P., Disney, A., Mount, P., Fraenkel, M., Mathew, M., Fassett, R., Jose, M., Hawley, C., Lonergan, M., Mackie, J., Ferrari, P., Menahem, S., Sabto, J., Hutchison, B., Langham, R., Pollock, C., Holzer, H., Oberbauer, R., Arias, I., Graf, H., Mayer, G., Lhotta, K., Neyer, U., Klauser, R., Hoerl, W., Horn, S., Kovarik, J., Kramar, R., Eigner, M., Dhaene, M., Billiouw, J., De Meester, J., Warling, X., Cambier-Dwelschauwers, P., Evenepoel, P., Daelemans, R., Dratwa, M., Maes, B., Stolear, J., Dejagere, T., Vanwalleghem, J., Bouman, K., Jadoul, M., Peeters, J., Vanholder, R., Tielemans, C., Donck, J., Almeida, F., Picollo De Oliveira, J., Burdmann, E., Garcia, V., Saldanha Thome, F., Deboni, L., Bregman, R., Lugon, J., Araujo, S., Ferreira Filho, S., De Francesco Daher, E., Sperto Baptista, M., Carvalho, A., D'Avila, D., Moyses Neto, M., Yu, L., Bastos, M., Sampaio Lacativa, P., Jorgetti, V., De Almeida Romao, E., Cardeal Da Costa, J., Pecoits Filho, R., Gordan, P., Salgado, N., Teixeira Araujo, M., Neiva Coelho, S., Oliveira, I., Moyses, R., Vasconcellos, L., Batista, P., Luiz Gross, J., Pedrosa, A., Cournoyer, S., Leblanc, M., Chow, S., Karunakaran, S., Wong, G., Tobe, S., Desmeules, S., Zimmerman, D., Murphy, S., Montambault, P., Donnelly, S., Macrae, J., Culleton, B., Soroka, S., Rabbat, C., Jindal, K., Vasilevsky, M., Michaud, M., Wijeyesinghe, E., Zacharias, J., Lok, C., Muirhead, N., Verrelli, M., Da Roza, G., Sapir, D., Olgaard, K., Daugaard, H., Brandi, L., Jensen, P., Boulechfar, H., Ang, K., Simon, P., Rieu, P., Brunet, P., Touchard, G., Urena Torres, P., Combe, C., Durrbach, A., Ortiz, J., Hannedouche, T., Vela, C., Lionet, A., Ryckelynck, P., Zaoui, P., Choukroun, G., Fessi, H., Lang, P., Stroumza, P., Joly, D., Mousson, C., Laville, M., Dellanna, F., Erley, C., Braun, J., Rambausek, M., Riegel, W., Klingberg, M., Schwertfeger, E., Wizemann, V., Eckardt, K., Reichel, H., Passauer, J., Hubel, E., Frischmuth, N., Liebl, R., Fiedler, R., Schwenger, V., Vosskuhler, A., Kunzendorf, U., Renders, L., Rattensberger, D., Rump, L., Ketteler, M., Neumayer, H., Zantvoort, F., Stahl, R., Ladanyi, E., Kulcsar, I., Mezei, I., Csiky, B., Rikker, C., Arkossy, O., Berta, K., Szegedi, J., Major, L., Ferenczi, S., Fekete, A., Szabo, T., Zakar, G., Wagner, G., Kazup Erdelyine, S., Borbas, B., Eustace, J., Reddan, D., Capasso, G., Locatelli, F., Villa, G., Cozzolino, M., Brancaccio, D., Messa, P., Bolasco, P., Ricciardi, B., Malberti, F., Moriero, E., Cannella, G., Ortalda, V., Stefoni, S., Frasca, G., Cappelli, G., Albertazzi, A., Zoccali, C., Farina, M., Elli, A., Avella, F., Ondei, P., Mingardi, G., Errico, R., Losito, A., Di Giulio, S., Pertosa, G., Schena, F., Grandaliano, G., Gesualdo, L., Auricchio, M., Bochicchio-Ricardelli, T., Aranda Verastegui, F., Pena, J., Chew Wong, A., Cruz-Valdez, J., Torres Zamora, M., Solis, M., Sebastian Diaz, M., Vital Flores, M., Alvarez Sandoval, E., Van Den Dorpel, M., Brink, H., Van Kuijk, W., Vermeij, C., Smak Gregoor, P., Hagen, E., Van Der Sande, F., Klinger, M., Nowicki, M., Muszytowski, M., Bidas, K., Bentkowski, W., Wiecek, A., Ksiazek, A., Marczewski, K., Ostrowski, M., Switalski, M., Sulowicz, W., Matuszkiewicz-Rowinska, J., Mysliwiec, M., Durlik, M., Rutkowski, B., Macario, F., Carvalho, B., Frazao, J., Machado, D., Weigert, A., Andrusev, A., Khrustalev, O., Zemtchenkov, A., Gurevich, K., Staroselsky, K., Khadikova, N., Rozhinskaya, L., Timokhovskaya, G., Strokov, A., Balkarova, O., Ermolenko, V., Kolmakova, E., Komandenko, M., Timofeev, M., Shilo, V., Shostka, G., Smirnov, A., Anashkin, V., Volgina, G., Domashenko, O., Gurevich, A., Perlin, D., Martinez Garcia, J., Andres Ribes, E., Coll Piera, E., Fernandez Lucas, M., Galicia, M., Prados, M., Gonzalez, M., Romero, R., Martin de Francisco, A., Montenegro, J., Santiago, C., Garcia, F., Alcazar De La Ossa, J., Arrieta, J., Pons, J., Martin-Malo, A., Soler Amigo, J., Cases, A., Sterner, G., Jensen, G., Wikstrom, B., Jacobson, S., Lund, U., Weiss, L., Stahl, A., Von Albertini, B., Burnier, M., Meier, P., Martin, P., Uehlinger, D., Dickenmann, M., Yaqoob, M., Zehnder, D., Kalra, P., Padmanabhan, N., Roe, S., Eadington, D., Pritchard, N., Hutchison, A., Davies, S., Wilkie, M., Davies, M., Pai, P., Swift, P., Kwan, J., Goldsmith, D., Tomson, C., Stratton, J., Dasgupta, I., Sarkar, S., Moustafa, M., Gandhi, K., Jamal, A., Galindo-Ramos, E., Tuazon, J., Batlle, D., Tucker, K., Schiller-Moran, B., Assefi, A., Martinez, C., Samuels, L., Goldman, J., Cangiano-Rivera, J., Darwish, R., Lee, M., Topf, J., Kapatkin, K., Baer, H., Kopelman, R., Acharya, M., Tharpe, D., Bernardo, M., Nader, P., Guzman-Rivera, J., Pergola, P., Sekkarie, M., Alas, E., Zager, P., Liss, K., Navarro, J., Roppolo, M., Denu-Ciocca, C., Kshirsagar, A., El Khatib, M., Kant, K., Scott, D., Murthyr, B., Finkelstein, F., Keightley, G., Mccrary, R., Pitone, J., Cavalieri, T., Tsang, A., Pellegrino, B., Schmidt, R., Ahmad, S., Brown, C., Friedman, E., Mittman, N., Fadem, S., Shapiro, W., Reddy, M., Goldberger, S., Woredekal, Y., Agarwal, A., Anger, M., Haque, M., Chidester, P., Kohli, R., Rubinstein, S., Newman, G., Gladish, R., Ayodeji, O., Soman, S., Sprague, S., Hunt, N., Gehr, T., Rizk, D., Warnock, D., Polack, D., Pahl, M., Fischer, D., Dreyer, P., James, G., Husserl, F., Rogers, T., Raff, A., Sedor, J., Silver, M., Smith, M., Steinberg, S., Delgiorno, T., Jones, E., Cunha, P. D., Cheng, J., Pogue, V., Blumenthal, S., Brown, E., Charytan, C., Buerkert, J., Cook, M., Felsenfeld, A., Tareen, N., Gupta, A., Herman, T., Diamond, S., Hura, C., Laski, M., Maclaurin, J., Plumb, T., Brosnahan, G., Kumar, J., Henriquez, M., Poole, C., Osanloo, E., Matalon, A., Sholer, C., Arfeen, S., Azer, M., Belledonne, M., Gross, M., Dunnigan, E., Mcconnell, K., Becker, B., Skinner, F., Rigolosi, R., Spiegel, D., Stegman, M., Patak, R., Streja, D., Ranjit, U., Youell, T., Wooldridge, T., Stafford, C., Cottiero, R., Weinberg, M., Schonefeld, M., Shahmir, E., Hazzan, A., Ashfaq, A., Bhandari, K., Cleveland, W., Culpepper, M., Golden, J., Lai, L., Lien, Y., Lorica, V., Robertson, J., Malireddi, K., Morse, S., Thakur, V., Israelit, A., Raguram, P., Alfred, H., Weise, W., Al-Saghir, F., El Shahawy, M., Rastogi, A., Nissenson, A., Kopyt, N., Lynn, R., Lea, J., Mcclellan, W., Teredesai, P., Ong, S., Tolkan, S., Sugihara, J., Minga, T., Mehrotra, R., Minasian, R., Bhatia, D., Specter, R., Capelli, J., Sidhu, P., Dalal, S., Dykes, P., Khan, M., Rahim, F., Saklayen, M., Thomas, A., Michael, B., Torres, M., Al-Bander, H., Murray, B., Abukurah, A., Gupta, B., Nosrati, S., Raja, R., Zeig, S., Braun, M., Amatya, A., Endsley, J., Sharon, Z., Dolson, G., Dumler, F., Ntoso, K., Rosansky, S., Kumar, N., Gura, V., Thompson, N., Goldfarb, D., Halligan, R., Middleton, J., Widerhorn, A., Arbeit, L., Arruda, J., Crouch, T., Friedman, L., Khokhar, S., Mittleman, J., Light, P., Taparia, B., West, C., Cotton, J., Dhingra, R., Kleinman, L., Arif, F., Lew, S., Nammour, T., Sterrett, J., Williams, M., Ramirez, J., Rubin, J., Mccarthy, J., Noble, S., Chaffin, M., Rekhi, A., and Clinical sciences

Subjects
Adult, Male, Fibroblast growth factor 23, medicine.medical_specialty, Cinacalcet, Calcimimetic, medicine.medical_treatment, Naphthalenes, Hyperthyroidism, Gastroenterology, ventricular remodeling, Renal Dialysis, Cinacalcet Hydrochloride, Physiology (medical), Internal medicine, medicine, Humans, renal insufficiency, chronic, Aged, Etelcalcetide, calcium, business.industry, Research Support, Non-U.S. Gov't, death, sudden, cardiac, Middle Aged, arrhythmias, cardiac, Cardiovascular Diseases, Female, Fibroblast Growth Factors, Cardiology and Cardiovascular Medicine, medicine.disease, Fibroblast Growth Factor-23, Endocrinology, Randomized Controlled Trial, Secondary hyperparathyroidism, Hemodialysis, business, medicine.drug, Kidney disease
Abstract

Background— Patients with kidney disease have disordered bone and mineral metabolism, including elevated serum concentrations of fibroblast growth factor-23 (FGF23). These elevated concentrations are associated with cardiovascular and all-cause mortality. The objective was to determine the effects of the calcimimetic cinacalcet (versus placebo) on reducing serum FGF23 and whether changes in FGF23 are associated with death and cardiovascular events. Methods and Results— This was a secondary analysis of a randomized clinical trial comparing cinacalcet to placebo in addition to conventional therapy (phosphate binders/vitamin D) in patients receiving hemodialysis with secondary hyperparathyroidism (intact parathyroid hormone ≥300 pg/mL). The primary study end point was time to death or a first nonfatal cardiovascular event (myocardial infarction, hospitalization for angina, heart failure, or a peripheral vascular event). This analysis included 2985 patients (77% of randomized) with serum samples at baseline and 2602 patients (67%) with samples at both baseline and week 20. The results demonstrated that a significantly larger proportion of patients randomized to cinacalcet had ≥30% (68% versus 28%) reductions in FGF23. Among patients randomized to cinacalcet, a ≥30% reduction in FGF23 between baseline and week 20 was associated with a nominally significant reduction in the primary composite end point (relative hazard, 0.82; 95% confidence interval, 0.69–0.98), cardiovascular mortality (relative hazard, 0.66; 95% confidence interval, 0.50–0.87), sudden cardiac death (relative hazard, 0.57; 95% confidence interval, 0.37–0.86), and heart failure (relative hazard, 0.69; 95% confidence interval, 0.48–0.99). Conclusions— Treatment with cinacalcet significantly lowers serum FGF23. Treatment-induced reductions in serum FGF23 are associated with lower rates of cardiovascular death and major cardiovascular events. Clinical Trial Registration— URL: http://www.clinicaltrials.gov . Unique identifier: NCT00345839.

Published
2015

25. Sudden Death in End Stage Renal Disease: Comparing Hemodialysis versus Peritoneal Dialysis

Author

Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Contaldo, G, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Bertoli, S, Vincenti, A, GENOVESI, SIMONETTA CARLA, LUISE, MARIA CARMEN, CONTALDO, GINA, STELLA, ANDREA, Vincenti, A., Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Contaldo, G, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Bertoli, S, Vincenti, A, GENOVESI, SIMONETTA CARLA, LUISE, MARIA CARMEN, CONTALDO, GINA, STELLA, ANDREA, and Vincenti, A.

Abstract

This study aimed to evaluate total and sudden death (SD) in a cohort of dialysis patients, comparing hemodialysis (HD) vs. peritoneal dialysis (PD).

Published
2017

26. Clinical practice for the diagnosis of cardiac arrhythmias in patients on renal replacement therapy: data from a Lombard survey

Author

Genovesi, S, Nava, E, Pasa, A, Corghi, E, Ondei, P, Marta, E, Bellasi, A, Malberti, F, Teatini, U, Guastoni, C, Spatola, L, Luise, M, Tiboldo, R, Bertoli, S, Messa, P, Doria, M, Gallieni, M, Cozzolino, M, Spotti, D, Sala, V, Sironi, E, Boriani, G, PASA, ALICE, Guastoni, CM, Luise, MC, DORIA, MARIA, SIRONI, ELISABETTA LUCIA, Genovesi, S, Nava, E, Pasa, A, Corghi, E, Ondei, P, Marta, E, Bellasi, A, Malberti, F, Teatini, U, Guastoni, C, Spatola, L, Luise, M, Tiboldo, R, Bertoli, S, Messa, P, Doria, M, Gallieni, M, Cozzolino, M, Spotti, D, Sala, V, Sironi, E, Boriani, G, PASA, ALICE, Guastoni, CM, Luise, MC, DORIA, MARIA, and SIRONI, ELISABETTA LUCIA

Abstract

Among dialysis patients, 40% of deaths are due to cardiovascular causes, and 60% of cardiac deaths are due to an arrhythmia. The purpose of this survey, carried out with the organizational support of the Lombard Section of the Italian Society of Nephrology, is to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in the dialysis centers of Lombardy. Information on the prevalence and type of cardiac devices at December 1, 2016 in this population was also required. Data from 18 centers were collected for a total of 3395 patients in replacement renal therapy, including 2907 (85.6%) in hemodialysis and 488 (14.4%) in peritoneal dialysis. All centers use the 12-lead ECG in case of evocative symptoms of an arrhythmic event and 2/3 perform the exam with programmed cadence (usually once a year). Twenty four-hour ECG Holter is not used as a routine diagnostic tool. The proportion of cardiac devices is relatively high, compared to literature data: n=259, equal to 7.6% of the population. Pace-Maker patients are 166 (4.9%), those with intracardiac defibrillator 52 (1.5%), those with resynchronization therapy 18 (0.5%) and those with resynchronization therapy and intracardiac defibrillator 23 (0.7%). The survey provides interesting information and can be an important starting point for trying to optimize clinical practice and collaboration between nephrologists and cardiologists in front of a major problem like that of arrhythmic disease in patients on renal replacement therapy.

Published
2017

27. Effect of oral anticoagulant therapy on mortality in end-stage renal disease patients with atrial fibrillation: a prospective study

Author

Genovesi, S, Rebora, P, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Rossi, E, Valsecchi, M, Santoro, A, Genovesi, S, Rebora, P, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Rossi, E, Valsecchi, M, and Santoro, A

Abstract

Background: The aim of this study was to evaluate, in a cohort of haemodialysis patients with atrial fibrillation (AF), the relationship between oral anticoagulant therapy (OAT) and mortality, thromboembolic events and haemorrhage. Methods: Two hundred and ninety patients with AF were prospectively followed for 4 years. Warfarin and antiplatelet intake, age, dialytic age, comorbidities, CHA2DS2-VASc and HAS-BLED scores were considered as predictors of risk of death, thromboembolism and bleeding events. In patients taking OAT, the international normalized ratio (INR) was assessed and the percentage time in the target therapeutic range (TTR) was calculated. Results: At recruitment, 134/290 patients were taking warfarin. During follow-up there were 170 deaths, 28 thromboembolic events and 95 bleedings. After balancing for treatment propensity, intention-to-treat analysis on OAT intake at recruitment did not show differences in total mortality, thromboembolic events and bleedings, while the as-treated analysis, accounting for treatment switch, showed that patients taking OAT at recruitment had a significantly lower mortality than those not taking it [hazard ratio, HR 0.53 (95% confidence interval 0.28–0.90), p = 0.04], with a decrease of thromboembolic events [HR 0.36 (0.13–1.05), p = 0.06], and an increase of bleedings [HR 1.79 (0.72–4.39), p = 0.20], both non-significant. Among patients taking OAT at recruitment, those continuing to take warfarin had a significant reduction in the risk of total [HR 0.28 (0.14–0.53), p < 0.001] and cardiovascular [HR 0.21 (0.11–0.40), p < 0.001] mortality compared to patients stopping OAT. Conclusions: In haemodialysis patients with AF, continuously taking warfarin is associated with a reduction of the risk of total and cardiovascular mortality.

Published
2017

28. Measuring and estimating GFR and treatment effect in ADPKD patients: results and implications of a longitudinal cohort study

Author

Ruggenenti P, Gaspari F, Cannata A, Carrara F, Cella C, Ferrari S, Stucchi N, Prandini S, Ene Iordache B, Diadei O, Perico N, Ondei P, Buongiorno E, Messa P, Dugo M, Remuzzi G, GFR ADPKD Study Group, PISANI, ANTONIO, Ruggenenti, P, Gaspari, F, Cannata, A, Carrara, F, Cella, C, Ferrari, S, Stucchi, N, Prandini, S, Ene Iordache, B, Diadei, O, Perico, N, Ondei, P, Pisani, Antonio, Buongiorno, E, Messa, P, Dugo, M, Remuzzi, G, and GFR ADPKD Study, Group

Subjects
Nephrology, Adult, Male, medicine.medical_specialty, Anatomy and Physiology, Clinical Research Design, Iohexol, Science, Urology, Autosomal dominant polycystic kidney disease, Renal function, urologic and male genital diseases, Cohort Studies, chemistry.chemical_compound, Internal medicine, medicine, Polycystic kidney disease, Humans, Biology, Creatinine, Multidisciplinary, Models, Statistical, business.industry, urogenital system, Reproducibility of Results, Renal System, Middle Aged, medicine.disease, Polycystic Kidney, Autosomal Dominant, female genital diseases and pregnancy complications, Endocrinology, Treatment Outcome, chemistry, Research Design, Disease Progression, Medicine, Female, sense organs, business, medicine.drug, Kidney disease, Cohort study, Research Article, Glomerular Filtration Rate
Abstract

Trials failed to demonstrate protective effects of investigational treatments on glomerular filtration rate (GFR) reduction in Autosomal Dominant Polycystic Kidney Disease (ADPKD). To assess whether above findings were explained by unreliable GFR estimates, in this academic study we compared GFR values centrally measured by iohexol plasma clearance with corresponding values estimated by Chronic Kidney Disease Epidemiology Collaboration (CKD-Epi) and abbreviated Modification of Diet in Renal Disease (aMDRD) formulas in ADPKD patients retrieved from four clinical trials run by a Clinical Research Center and five Nephrology Units in Italy. Measured baseline GFRs and one-year GFR changes averaged 78.6±26.7 and 8.4±10.3 mL/min/1.73 m(2) in 111 and 71 ADPKD patients, respectively. CKD-Epi significantly overestimated and aMDRD underestimated baseline GFRs. Less than half estimates deviated by

Published
2012

29. Atrial fibrillation and low vitamin D levels are associated with severe vascular calcifications in hemodialysis patients

Author

Fusaro, M, Gallieni, M, Rebora, P, Rizzo, M, Luise, M, Riva, H, Bertoli, S, Conte, F, Stella, A, Ondei, P, Rossi, E, Valsecchi, M, Santoro, A, Genovesi, S, REBORA, PAOLA, LUISE, MARIA CARMEN, RIVA, HILARY, STELLA, ANDREA, ROSSI, EMANUELA, VALSECCHI, MARIA GRAZIA, GENOVESI, SIMONETTA CARLA, Fusaro, M, Gallieni, M, Rebora, P, Rizzo, M, Luise, M, Riva, H, Bertoli, S, Conte, F, Stella, A, Ondei, P, Rossi, E, Valsecchi, M, Santoro, A, Genovesi, S, REBORA, PAOLA, LUISE, MARIA CARMEN, RIVA, HILARY, STELLA, ANDREA, ROSSI, EMANUELA, VALSECCHI, MARIA GRAZIA, and GENOVESI, SIMONETTA CARLA

Abstract

Background/Aims: Vascular calcifications (VCs) and fractures are major complications of chronic kidney disease. Hemodialysis patients have a high prevalence of atrial fibrillation (AF) and an increased risk of thromboembolism, which should be prevented with warfarin, a drug potentially causing increased risk of VCs and fractures. Aim of this study is evaluating, in hemodialysis patients with and without AF, the prevalence of VCs and fractures, as well as identifying the associated risk factors. Methods: A total of 314 hemodialysis patients were recruited, 101 with documented AF and 213 without AF. Comorbidities, chronic kidney disease mineral and bone disorder blood tests and therapies were collected. Vertebral quantitative morphometry was carried out centrally for the detection of fractures, defined as vertebral body reduction by ≥20 %. In the same radiograph, the length of aortic calcification was also measured. Logistic regression models were applied for evaluating the independent predictors of presence of VCs and vertebral fractures. Results: In our population VCs were very common (>85 %). Severe VCs (>10 cm) were more common in patients with AF (76 %) than in patients without (33 %). Vertebral fractures were present in 54 % of patients. Multivariable analysis showed that AF (OR 5.41, 95 % CI 2.30–12.73) and 25(OH) vitamin D <20 ng/mL (OR 2.05, 95 % CI 1.10–3.83) were independent predictors of VCs. Age (OR 1.04/year, 95 % CI 1.01–1.07) and male gender (OR 1.76, 95 % CI 1.07–2.90) predicted vertebral fractures. Conclusions: Hemodialysis patients had an elevated prevalence of severe VCs, especially when affected by AF. Low vitamin D levels were strongly associated with severe VCs. Prevalence of vertebral fractures was also remarkably high and associated with older age and male gender.

Published
2016

30. Mortality, sudden death and indication for cardioverter defibrillator implantation in a dialysis population

Author

Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Vincenti, A, GENOVESI, SIMONETTA CARLA, LUISE, MARIA CARMEN, RIVA, HILARY, STELLA, ANDREA, Vincenti, A., Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Vincenti, A, GENOVESI, SIMONETTA CARLA, LUISE, MARIA CARMEN, RIVA, HILARY, STELLA, ANDREA, and Vincenti, A.

Abstract

Background The incidence of sudden death among dialysis patients is high, but end stage renal disease was an exclusion criterion in the trials that demonstrated the benefit of implantable cardioverter defibrillator (ICD) for sudden death prevention. Methods Dialysis patients alive on January 2010 or starting dialysis between January 2010 and January 2013 were enrolled and retrospectively evaluated. Patients were divided into three groups: No-Indication, Indication-With ICD and Indication-Without ICD. Cox and Fine and Gray regression models were used to estimate the total and cause-specific (sudden or non-sudden) mortality hazard ratio (HR, HRcpRisk), respectively. Survival was defined as the time from start of dialysis to the time of death. Results 154/2072 patients (7.4%) had indication for ICD implantation and 52 (33.8%) of them received the device; 688 (33.2%) deaths were recorded. Mortality was different among groups [Indication-With ICD vs No-Indication: HR 1.59 (95% CI 1.06-2.38) and Indication-Without ICD vs No-Indication: HR 2.67 (95% CI 2.09-3.39, p < 0.001)]. 84/688 (12.2%) were sudden deaths. The cumulative incidence of sudden death was higher in patients with ICD indication [Indication-With ICD vs No-Indication HRcpRisk 3.21 (95% CI 1.38-7.40) and Indication-Without ICD vs No-Indication: HRcpRisk 4.19 (95% CI 2.38-7.39), p < 0.001], but also No-Indication patients showed a high rate of sudden death [8.5% (95% CI.6.5-10.9) at 8 years of follow-up]. Conclusions Dialysis patients with ICD indication had a worse survival than No-Indication subjects and the prognosis was particularly poor for the Indication-Without ICD group. Sudden death incidence was much higher than in the general population, even among No-Indication subjects.

Published
2015

31. Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation

Author

Genovesi, S, Rossi, E, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Rebora, P, Valsecchi, M, Santoro, A, GENOVESI, SIMONETTA CARLA, ROSSI, EMANUELA, STELLA, ANDREA, REBORA, PAOLA, VALSECCHI, MARIA GRAZIA, Santoro, A., Genovesi, S, Rossi, E, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Rebora, P, Valsecchi, M, Santoro, A, GENOVESI, SIMONETTA CARLA, ROSSI, EMANUELA, STELLA, ANDREA, REBORA, PAOLA, VALSECCHI, MARIA GRAZIA, and Santoro, A.

Abstract

Background Oral anticoagulation therapy (OAT) is the choice treatment for thromboembolism prevention in atrial fibrillation (AF), although data about OAT use in haemodialysis (HD) patients with AF are contradictory. Methods The effect of OAT on the risk of mortality, stroke and bleeding was prospectively evaluated in a population of HD patients with AF. All the patients of 10 HD Italian centres alive on 31 October 2010 with documented AF episode(s) were recruited and followed-up for 2 years. OAT and antiplatelet intake, age, dialytic age, comorbidities and percentage time in the target international normalized ratio (INR) range (target therapeutic range; TTR) were considered as predictors of hazard of death, thromboembolic and bleeding events. Results At recruitment, 134 patients out of 290 were taking OAT. During the follow-up, 115 patients died (4 strokes, 3 haemorrhagic and 1 thromboembolic). Antiplatelet therapy, but not OAT, was associated with increased mortality (HR 1.71, CI 1.10-2.64, P = 0.02). The estimated survival of patients always taking OAT tended to be higher than that of patients who stopped taking (68.6 versus 49.6%, P = 0.07). OAT was not correlated to a significant decreased risk of thromboembolic events (HR 0.12, CI 0.00-3.59, P = 0.20), while it was associated with an increased risk of bleeding (HR 3.96, CI 1.15-13.68, P = 0.03). Higher TTR was associated with a reduced bleeding risk (HR 0.09, CI 0.01-0.76, P = 0.03), while previous haemorrhagic events were associated with higher haemorrhagic risk (HR 2.17, CI 1.09-4.35, P = 0.03). Conclusions In our population of HD patients with AF, the mortality is very high. OAT is not associated with increased mortality, while antiplatelet drugs are. OAT seems, on the contrary, associated with a better survival; however, it does not decrease the incidence of ischaemic stroke, whereas it increases the incidence of bleeding. Bleeding risk is lower in subjects in whom the INR is kept within the therapeutic ra

Published
2015

32. The nephrologist's anticoagulation treatment patterns/regimens in chronic hemodialysis patients with atrial fibrillation

Author

Genovesi, S, Rossi, E, Pogliani, D, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Valsecchi, M, Santoro, A, GENOVESI, SIMONETTA CARLA, ROSSI, EMANUELA, STELLA, ANDREA, VALSECCHI, MARIA GRAZIA, Santoro, A., Genovesi, S, Rossi, E, Pogliani, D, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Valsecchi, M, Santoro, A, GENOVESI, SIMONETTA CARLA, ROSSI, EMANUELA, STELLA, ANDREA, VALSECCHI, MARIA GRAZIA, and Santoro, A.

Abstract

The prevalence of atrial fibrillation (AF) is high in hemodialysis (HD) patients. It was suggested that oral anticoagulant therapy (OAT), the choice treatment for reducing the thromboembolic risk in AF patients, increases the incidence of both ischemic and hemorrhagic strokes in the HD population. Moreover, the therapy-related bleeding risk is particularly high in these patients. For these reasons there is no agreement on the use of OAT in HD patients with AF. The aim of this study was to evaluate the criteria adopted by nephrologists in prescribing OAT in HD patients with AF.

Published
2014

34. Intermediate Volume on Computed Tomography Imaging Defines a Fibrotic Compartment that Predicts Glomerular Filtration Rate Decline in Autosomal Dominant Polycystic Kidney Disease Patients

Author

Caroli, Anna, Antiga, Luca, Conti, Sara, Sonzogni, Aurelio, Fasolini, Giorgio, Ondei, Patrizia, Perico, Norberto, Remuzzi, Giuseppe, and Remuzzi, Andrea

Abstract

Total kidney and cyst volumes have been used to quantify disease progression in autosomal dominant polycystic kidney disease (ADPKD), but a causal relationship with progression to renal failure has not been demonstrated. Advanced image processing recently allowed to quantify extracystic tissue, and to identify an additional tissue component named “intermediate,” appearing hypoenhanced on contrast-enhanced computed tomography (CT). The aim of this study is to provide a histological characterization of intermediate volume, investigate its relation with renal function, and provide preliminary evidence of its role in long-term prediction of functional loss. Three ADPKD patients underwent contrast-enhanced CT scans before nephrectomy. Histological samples of intermediate volume were drawn from the excised kidneys, and stained with hematoxylin and eosin and with saturated picrosirius solution for histological analysis. Intermediate volume showed major structural changes, characterized by tubular dilation and atrophy, microcysts, inflammatory cell infiltrate, vascular sclerosis, and extended peritubular interstitial fibrosis. A significant correlation (r = −0.69, P< 0.001) between relative intermediate volume and baseline renal function was found in 21 ADPKD patients. Long-term prediction of renal functional loss was investigated in an independent cohort of 13 ADPKD patients, followed for 3 to 8 years. Intermediate volume, but not total kidney or cyst volume, significantly correlated with glomerular filtration rate decline (r = −0.79, P< 0.005). These findings suggest that intermediate volume may represent a suitable surrogate marker of ADPKD progression and a novel therapeutic target.

Published
2011
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35. A validated ensemble method for multinomial land-cover classification.

Author

Diengdoh, Vishesh L., Ondei, Stefania, Hunt, Mark, and Brook, Barry W.

Subjects
PLURALITY voting, SUPPORT vector machines, CLASSIFICATION algorithms, LAND cover, LANDSCAPE assessment
Abstract

Land-cover data provides valuable information for landscape management and can be generated using machine learning algorithms. Ensemble models or model averaging can overcome difficulties in selecting an adequate algorithm and improve model predictions, but its use is limited among ecologists. The objective of this study is to highlight the benefits and limitations of weighted and unweighted majority voting ensemble models for land-cover classification and to enable easy and wider implementation of the method by providing an R-script (for use in the R software). Using a case study of three mixed-use landscapes from southern Australia (Tasmania), land cover was classified into six classes using Landsat 8 imagery and ancillary data, and support vector machine, random forest, k-nearest neighbour and naïve Bayesian as base algorithms. The predicted classifications of the base algorithms were then averaged using both an unweighted and weighted (using the true skill statistic) majority voting ensemble algorithm. Cross-validation results showed the base algorithms achieved similar accuracy making algorithm selection difficult. The base algorithms achieved high and similar predictive accuracy when the classified land-cover and training data belong to the same geographic region but lower and different predictive accuracy when the classified land-cover and training data belong to different geographic regions. The weighted and unweighted ensemble achieved similar overall accuracy, equivalent to the best performing base algorithm. We conclude that the majority voting ensemble can be adopted to overcome difficulties in model selection during land-cover classification. • Using cross-validation resulted in no preferred algorithm for classification. • Different base algorithms achieved the highest accuracy in different scenarios. • The weighted and unweighted ensemble consistently achieved high accuracy. • The ensemble algorithm is provided as a script for use with software R. [ABSTRACT FROM AUTHOR]

Published
2020
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36. Book Reviews

Author

Vreede-de Stuers, Cora, Spiro, Melford E., Ondei, M., Firth, Raymond, Velde, P., Baal, J., Dubbeldam, L.F.B., Tambiah, S.J., Schubert, Rose, Fox, James J., Wassing, R.S., Mylius, Norbert, Heider, Karl G., Cochrane, Glynn, Bloch, Maurice, Galvao, António, Dahm, B., Wassing, R.S., Allard, E., Graaf, H.J., Schlesier, E., Scott-Kemball, Jeune, and Coolhaas, W. Ph.

Published
1972
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37. New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of Nephrologists form Lombardy

Author

Bellasi, A., Mario Cozzolino, Malberti, F., Cancarini, G., Esposito, C., Genderini, A., Guastoni, C. M., Ondei, P., Pontoriero, G., Teatini, U., Vezzoli, G., Messa, P., Locatelli, F., Bellasi, Antonio, Cozzolino, Mario, Malberti, Fabio, Cancarini, Giovanni, Esposito, Ciro, Genderini, Augusto, Guastoni, Carlo Maria, Ondei, Patrizia, Pontoriero, Giuseppe, Teatini, Ugo, Vezzoli, Giuseppe, Messa, Piergiorgio, and Locatelli, Francesco

Subjects
etelcalcetide, secondary hyperparathyroidism, CKD-MBD, cinacalcet, PTH
Abstract

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago. Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

38. New scenarios in secondary hyperparathyroidism: etelcalcetide. Position paper of working group on CKD-MBD of the Italian Society of Nephrology

Author

Piergiorgio Messa, Giuseppe Vezzoli, Mario Cozzolino, Ciro Esposito, Patrizia Ondei, Giovanni Cancarini, Antonio Bellasi, Francesco Locatelli, Giuseppe Pontoriero, Marzia Pasquali, Carlo Guastoni, Fabio Malberti, Ugo Teatini, Bellasi, A., Cozzolino, M., Malberti, F., Cancarini, G., Esposito, C., Guastoni, C. M., Ondei, P., Pontoriero, G., Teatini, U., Vezzoli, G., Pasquali, M., Messa, P., and Locatelli, F.

Subjects
Nephrology, medicine.medical_specialty, Calcimimetic, medicine.medical_treatment, Population, urologic and male genital diseases, Chronic kidney disease-mineral and bone disorder, Internal medicine, CKD-MBD, medicine, Humans, Position papers and Guidelines, Intensive care medicine, education, Dialysis, Chronic Kidney Disease-Mineral and Bone Disorder, Etelcalcetide, education.field_of_study, business.industry, medicine.disease, female genital diseases and pregnancy complications, Secondary hyperparathyroidism, Italy, Position paper, Cinacalcet, Peptides, business, PTH, Kidney disease
Abstract

Bone mineral abnormalities (defined as Chronic Kidney Disease Mineral Bone Disorder; CKD-MBD) are prevalent and associated with a substantial risk burden and poor prognosis in CKD population. Several lines of evidence support the notion that a large proportion of patients receiving maintenance dialysis experience a suboptimal biochemical control of CKD-MBD. Although no study has ever demonstrated conclusively that CKD-MBD control is associated with improved survival, an expanding therapeutic armamentarium is available to correct bone mineral abnormalities. In this position paper of Lombardy Nephrologists, a summary of the state of art of CKD-MBD as well as a summary of the unmet clinical needs will be provided. Furthermore, this position paper will focus on the potential and drawbacks of a new injectable calcimimetic, etelcalcetide, a drug available in Italy since few months ago.

Published
2019
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39. Ramipril and Cardiovascular Outcomes in Patients on Maintenance Hemodialysis: The ARCADIA Multicenter Randomized Controlled Trial

Author

Federico Pieruzzi, Jorge Hidalgo Godoy, Antonello Pani, Claudio Pozzi, Andrea Galfré, Silvio Bertoli, Hans-Joachim Anders, Giovanni Mosconi, Giuseppe Daidone, Simonetta Genovesi, E. Mambelli, Giulio Mingardi, Goffredo Del Rosso, Agnese Meterange-Lis, Annalisa Perna, Piero Ruggenenti, Antonio Granata, Angelo Rigotti, Matias Trillini, Manuel Alfredo Podestà, Salvatore David, Carmela Giuseppina Condemi, Tobia Peracchi, Sonia Pasquali, Patrizia Ondei, Davide Villa, Giorgio Romei Longhena, Carlo Guastoni, Maurizio Garozzo, Nadia Rubis, Monica Cortinovis, Davide Martinetti, Giuseppe Remuzzi, Alfonso Pacitti, Ruggenenti, P, Podesta, M, Trillini, M, Perna, A, Peracchi, T, Rubis, N, Villa, D, Martinetti, D, Cortinovis, M, Ondei, P, Condemi, C, Guastoni, C, Meterangelis, A, Granata, A, Mambelli, E, Pasquali, S, Genovesi, S, Pieruzzi, F, Bertoli, S, Del Rosso, G, Garozzo, M, Rigotti, A, Pozzi, C, David, S, Daidone, G, Mingardi, G, Mosconi, G, Galfre, A, Romei Longhena, G, Pacitti, A, Pani, A, Hidalgo Godoy, J, Anders, H, and Remuzzi, G

Subjects
Ramipril, Male, medicine.medical_specialty, Epidemiology, medicine.medical_treatment, Angiotensin-Converting Enzyme Inhibitors, Critical Care and Intensive Care Medicine, law.invention, Randomized controlled trial, law, Renal Dialysis, Multicenter trial, Internal medicine, ACE inhibitor, medicine, Clinical endpoint, media_common.cataloged_instance, Humans, Prospective Studies, European union, Stroke, media_common, Aged, Transplantation, renin angiotensin system, business.industry, Editorials, Middle Aged, medicine.disease, cardiovascular event, Clinical trial, hemodialysi, Nephrology, Cardiovascular Diseases, Female, Hemodialysis, business, medicine.drug
Abstract

Background and objectives Renin-angiotensin system (RAS) inhibitors reduce cardiovascular morbidity and mortality in patients with CKD. We evaluated the cardioprotective effects of the angiotensin-converting enzyme inhibitor ramipril in patients on maintenance hemodialysis. Design, setting, participants, & measurements In this phase 3, prospective, randomized, open-label, blinded end point, parallel, multicenter trial, we recruited patients on maintenance hemodialysis with hypertension and/or left ventricular hypertrophy from 28 Italian centers. Between July 2009 and February 2014, 140 participants were randomized to ramipril (1.25–10 mg/d) and 129 participants were allocated to non-RAS inhibition therapy, both titrated up to the maximally tolerated dose to achieve predefined target BP values. The primary efficacy end point was a composite of cardiovascular death, myocardial infarction, or stroke. Secondary end points included the single components of the primary end point, new-onset or recurrence of atrial fibrillation, hospitalizations for symptomatic fluid overload, thrombosis or stenosis of the arteriovenous fistula, and changes in cardiac mass index. All outcomes were evaluated up to 42 months after randomization. Results At comparable BP control, 23 participants on ramipril (16%) and 24 on non-RAS inhibitor therapy (19%) reached the primary composite end point (hazard ratio, 0.93; 95% confidence interval, 0.52 to 1.64; P=0.80). Ramipril reduced cardiac mass index at 1 year of follow-up (between-group difference in change from baseline: −16.3 g/m2; 95% confidence interval, −29.4 to −3.1), but did not significantly affect the other secondary outcomes. Hypotensive episodes were more frequent in participants allocated to ramipril than controls (41% versus 12%). Twenty participants on ramipril and nine controls developed cancer, including six gastrointestinal malignancies on ramipril (four were fatal), compared with none in controls. Conclusions Ramipril did not reduce the risk of major cardiovascular events in patients on maintenance hemodialysis. Clinical Trial registry name and registration number: ARCADIA, NCT00985322 and European Union Drug Regulating Authorities Clinical Trials Database number 2008–003529–17.

Published
2021

40. Sudden Death in End Stage Renal Disease: Comparing Hemodialysis versus Peritoneal Dialysis

Author

Patrizia Ondei, Maurizio Gallieni, Maria Carmen Luise, Simonetta Genovesi, Gina Contaldo, Claudio Minoretti, Valter Torri, Giuseppe Pontoriero, Claudio Pozzi, Hilary Riva, Silvio Bertoli, Ferruccio Conte, Luca Porcu, Andrea Stella, Elisa Nava, Antonio Vincenti, Genovesi, S, Porcu, L, Luise, M, Riva, H, Nava, E, Contaldo, G, Stella, A, Pozzi, C, Ondei, P, Minoretti, C, Gallieni, M, Pontoriero, G, Conte, F, Torri, V, Bertoli, S, and Vincenti, A

Subjects
medicine.medical_specialty, business.industry, medicine.medical_treatment, 030232 urology & nephrology, MEDLINE, Hematology, General Medicine, 030204 cardiovascular system & hematology, Dialysis patients, Sudden death, End stage renal disease, Peritoneal dialysis, 03 medical and health sciences, 0302 clinical medicine, Hemodialysis, peritoneal dialysis, mortality, sudden death, Nephrology, Internal medicine, Cohort, Cardiology, medicine, Hemodialysis, business
Abstract

Background/Aims: This study aimed to evaluate total and sudden death (SD) in a cohort of dialysis patients, comparing hemodialysis (HD) vs. peritoneal dialysis (PD). Methods: This is a multicenter retrospective cohort study. Results: Deaths were 626 out of 1,823 in HD and 62 of 249 in PD patients. HD patients had a greater number of comorbidities (p < 0.05). PD patients had a lower risk of death than HD patients (p < 0.001); however, the advantage decreased with time (p < 0.001). Mortality predictors were left ventricular ejection fraction (LVEF) ≤35%, older age, ischemic heart disease, diabetes mellitus, previous stroke, and atrial fibrillation (p < 0.03). SDs were 84:71 in HD and 13 in PD population (12.1 and 22.8% of all causes of death, respectively). A non-significant risk of SD among PD compared to HD patients was detected. SD predictors were older age, ischemic heart disease, and LVEF ≤35% (p < 0.05). Conclusions: HD patients showed a greater presence of comorbidities and reduced survival compared to PD patients; however, the incidence of SD does not differ in the 2 populations. Video Journal Club “Cappuccino with Claudio Ronco” at http://www.karger.com/?doi=464347.

Published
2017
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41. Effect of oral anticoagulant therapy on mortality in end-stage renal disease patients with atrial fibrillation: a prospective study

Author

Paola Rebora, Ferruccio Conte, Fabio Badiali, Andrea Stella, Claudio Pozzi, Patrizia Ondei, Emanuela Rossi, Silvio Bertoli, Giuseppe Bonforte, Simonetta Genovesi, Antonio Santoro, Maurizio Gallieni, Maria Grazia Valsecchi, Sonia Pasquali, Genovesi, S, Rebora, P, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Rossi, E, Valsecchi, M, and Santoro, A

Subjects
Male, Nephrology, Time Factors, 030232 urology & nephrology, Administration, Oral, Comorbidity, Kaplan-Meier Estimate, 030204 cardiovascular system & hematology, 0302 clinical medicine, Risk Factors, Prospective Studies, Prospective cohort study, Stroke, Aged, 80 and over, Hazard ratio, Age Factors, Atrial fibrillation, Middle Aged, Intention to Treat Analysis, Treatment Outcome, Italy, Cohort, Cardiology, Female, medicine.drug, medicine.medical_specialty, Hemorrhage, Haemodialysi, End stage renal disease, 03 medical and health sciences, Renal Dialysis, Thromboembolism, Internal medicine, medicine, Humans, Mortality, Aged, Proportional Hazards Models, business.industry, Bleeding, Warfarin, Anticoagulants, Protective Factors, medicine.disease, Kidney Failure, Chronic, business, Platelet Aggregation Inhibitors
Abstract

Background: The aim of this study was to evaluate, in a cohort of haemodialysis patients with atrial fibrillation (AF), the relationship between oral anticoagulant therapy (OAT) and mortality, thromboembolic events and haemorrhage. Methods: Two hundred and ninety patients with AF were prospectively followed for 4 years. Warfarin and antiplatelet intake, age, dialytic age, comorbidities, CHA2DS2-VASc and HAS-BLED scores were considered as predictors of risk of death, thromboembolism and bleeding events. In patients taking OAT, the international normalized ratio (INR) was assessed and the percentage time in the target therapeutic range (TTR) was calculated. Results: At recruitment, 134/290 patients were taking warfarin. During follow-up there were 170 deaths, 28 thromboembolic events and 95 bleedings. After balancing for treatment propensity, intention-to-treat analysis on OAT intake at recruitment did not show differences in total mortality, thromboembolic events and bleedings, while the as-treated analysis, accounting for treatment switch, showed that patients taking OAT at recruitment had a significantly lower mortality than those not taking it [hazard ratio, HR 0.53 (95% confidence interval 0.28–0.90), p = 0.04], with a decrease of thromboembolic events [HR 0.36 (0.13–1.05), p = 0.06], and an increase of bleedings [HR 1.79 (0.72–4.39), p = 0.20], both non-significant. Among patients taking OAT at recruitment, those continuing to take warfarin had a significant reduction in the risk of total [HR 0.28 (0.14–0.53), p < 0.001] and cardiovascular [HR 0.21 (0.11–0.40), p < 0.001] mortality compared to patients stopping OAT. Conclusions: In haemodialysis patients with AF, continuously taking warfarin is associated with a reduction of the risk of total and cardiovascular mortality.

Published
2016
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42. Atrial fibrillation and low vitamin D levels are associated with severe vascular calcifications in hemodialysis patients

Author

Maria Antonietta Rizzo, Emanuela Rossi, Maria Fusaro, Maria Grazia Valsecchi, Maurizio Gallieni, Maria Carmen Luise, Paola Rebora, Silvio Bertoli, Antonio Santoro, Andrea Stella, Ferruccio Conte, Patrizia Ondei, Simonetta Genovesi, Hilary Riva, Fusaro, M, Gallieni, M, Rebora, P, Rizzo, M, Luise, M, Riva, H, Bertoli, S, Conte, F, Stella, A, Ondei, P, Rossi, E, Valsecchi, M, Santoro, A, and Genovesi, S

Subjects
Male, Nephrology, medicine.medical_specialty, medicine.medical_treatment, Population, 030232 urology & nephrology, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Renal Dialysis, Chronic kidney disease-mineral and bone disorder, Internal medicine, Atrial Fibrillation, medicine, Vitamin D and neurology, Humans, Vitamin D, Vascular Calcification, education, Aged, Chronic Kidney Disease-Mineral and Bone Disorder, education.field_of_study, business.industry, Warfarin, Atrial fibrillation, medicine.disease, Fracture, Cardiology, Female, Hemodialysi, Hemodialysis, business, medicine.drug, Kidney disease
Abstract

Background/Aims: Vascular calcifications (VCs) and fractures are major complications of chronic kidney disease. Hemodialysis patients have a high prevalence of atrial fibrillation (AF) and an increased risk of thromboembolism, which should be prevented with warfarin, a drug potentially causing increased risk of VCs and fractures. Aim of this study is evaluating, in hemodialysis patients with and without AF, the prevalence of VCs and fractures, as well as identifying the associated risk factors. Methods: A total of 314 hemodialysis patients were recruited, 101 with documented AF and 213 without AF. Comorbidities, chronic kidney disease mineral and bone disorder blood tests and therapies were collected. Vertebral quantitative morphometry was carried out centrally for the detection of fractures, defined as vertebral body reduction by ≥20 %. In the same radiograph, the length of aortic calcification was also measured. Logistic regression models were applied for evaluating the independent predictors of presence of VCs and vertebral fractures. Results: In our population VCs were very common (>85 %). Severe VCs (>10 cm) were more common in patients with AF (76 %) than in patients without (33 %). Vertebral fractures were present in 54 % of patients. Multivariable analysis showed that AF (OR 5.41, 95 % CI 2.30–12.73) and 25(OH) vitamin D

Published
2015
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43. Clinical practice for the diagnosis of cardiac arrhythmias in patients on renal replacement therapy: data from a Lombard survey

Author

Genovesi, Simonetta, Nava, Elisa, Pasa, Alice, Corghi, Enzo, Ondei, Patrizia, Marta, Elisabetta, Bellasi, Antonio, Malberti, Fabio, Teatini, Ugo, Guastoni, Carlo Maria, Spatola, Leonardo, Luise, Maria Carmen, Tiboldo, Renza, Bertoli, Silvio, Messa, Piergiorgio, Doria, Maria, Gallieni, Maurizio, Cozzolino, Mario, Spotti, Donatella, Sala, Valeria, Sironi, Elisabetta, Boriani, Giuseppe, Genovesi, S, Nava, E, Pasa, A, Corghi, E, Ondei, P, Marta, E, Bellasi, A, Malberti, F, Teatini, U, Guastoni, C, Spatola, L, Luise, M, Tiboldo, R, Bertoli, S, Messa, P, Doria, M, Gallieni, M, Cozzolino, M, Spotti, D, Sala, V, Sironi, E, and Boriani, G

Subjects
Pacemaker, Artificial, Cardiology, Electric Countershock, cardiac devices, Arrhythmias, electrocardiogram, Kidney Failure, Cardiac Resynchronization Therapy, Electrocardiography, Ambulatory, Humans, Chronic, peritoneal dialysis, Patient Care Team, echocardiogram, haemodialysis, Arrhythmias, Cardiac, Defibrillators, Implantable, Disease Management, Electrocardiography, Ambulatory, Health Care Surveys, Heart Arrest, Italy, Kidney Failure, Chronic, Nephrology, Stroke, Renal Replacement Therapy, cardiac device, Pacemaker, haemodialysi, Artificial, Implantable, Cardiac, Arrhythmia, Defibrillators
Abstract

Among dialysis patients, 40% of deaths are due to cardiovascular causes, and 60% of cardiac deaths are due to an arrhythmia. The purpose of this survey, carried out with the organizational support of the Lombard Section of the Italian Society of Nephrology, is to evaluate the frequency and mode of use of non-invasive instruments for the diagnosis of cardiac arrhythmias in the dialysis centers of Lombardy. Information on the prevalence and type of cardiac devices at December 1, 2016 in this population was also required. Data from 18 centers were collected for a total of 3395 patients in replacement renal therapy, including 2907 (85.6%) in hemodialysis and 488 (14.4%) in peritoneal dialysis. All centers use the 12-lead ECG in case of evocative symptoms of an arrhythmic event and 2/3 perform the exam with programmed cadence (usually once a year). Twenty four-hour ECG Holter is not used as a routine diagnostic tool. The proportion of cardiac devices is relatively high, compared to literature data: n=259, equal to 7.6% of the population. Pace-Maker patients are 166 (4.9%), those with intracardiac defibrillator 52 (1.5%), those with resynchronization therapy 18 (0.5%) and those with resynchronization therapy and intracardiac defibrillator 23 (0.7%). The survey provides interesting information and can be an important starting point for trying to optimize clinical practice and collaboration between nephrologists and cardiologists in front of a major problem like that of arrhythmic disease in patients on renal replacement therapy.

Published
2017

44. The effects of cinacalcet in older and younger patients on hemodialysis: The evaluation of cinacalcet HCL therapy to lower cardiovascular events (EVOLVE) trial

Author

P. Ryckelynck, Y. Woredekal, T. Gehr, Marian Klinger, J. Passauer, K. Liss, E. Del Valle, B. Linares, Ferdinando Avella, Stolear Jc, S. Tolkan, O. Hermida, V. Wizemann, Ricardo Correa-Rotter, J. Santos, Gert Mayer, Michael Anger, B. Pellegrino, B. Wikström, A. Ståhl, H. Al-Bander, Pedro Alejandro Gordan, Philip A. Kalra, E. Galindo-Ramos, Carmine Zoccali, G. Dolson, M. Eigner, Sanjay Dalal, G. Touchard, J Peeters, G. Da Roza, Shannon Murphy, R. Errico, M. Lonergan, A. Andrusev, H. Boulechfar, P. Zaoui, Michael Suranyi, de Francisco Martín de Francisco, S. Jacobson, B. Gupta, C. Stafford, J. Picollo de Oliveira, Ilka Regina Souza de Oliveira, F. Dumler, J. Martinez Saye, E. de Almeida Romão, Emmanuel A. Burdmann, C. Vermeij, N. Kumar, E. Shahmir, J. Stratton, R. Schmidt, Mario Cozzolino, Lars Christian Rump, Rainer Oberbauer, J. Kumar, M. Saklayen, Brian Hutchison, C. Denu-Ciocca, L. Weiss, E. Friedman, L. Renders, K. Gurevich, L. Brandi, W. Shapiro, Kym M. Bannister, K. Berta, Muhammad M. Yaqoob, C. Lok, A. Pedrosa, Rosa M.A. Moysés, K. Bhandari, J. Arrieta, T. Crouch, Brigitte Maes, G. Wong, Myriam González, Matthew R. P. Davies, R. Gonzalez, Geoffrey A. Block, T. Nammour, T. Youell, J. Ramirez, S. Tobe, N. Ramirez, T. Bochicchio-Ricardelli, J. Cangiano-Rivera, D. Streja, J. Endsley, K. Ang, R. Patak, J. Cheng, T. Rogers, Alberto Albertazzi, H. Holzer, G. Choukroun, Jose A.L. Arruda, Philippe Rieu, P. Simon, Stephen Z. Fadem, Jared G. Sugihara, H. Alfred, Bruce F. Culleton, G. Frascà, Giovanni Pertosa, W. Van Kuijk, H. Beresan, Samuel S. Blumenthal, Piergiorgio Messa, H. Baer, Michael C. Braun, B. Rutkowski, W. Riegel, M. Komandenko, V. Ermolenko, Martin Wilkie, N. Muirhead, Peter G. Kerr, D. Rattensberger, J. Sabto, Anjay Rastogi, L. Lef, M. El Shahawy, D. Tharpe, A. Smirnov, J. Pons, F. García, F. Zantvoort, A. Lionet, J. Topf, Marcia R. Silver, Reinhard Kramar, E. Moriero, A. Rekhi, S. Roe, P. Batista, E. Kolmakova, F. Rahim, M. Ostrowski, Janice P. Lea, Patrizia Ondei, C. Martinez, J. Donck, Nicole Lopez, F. Schena, Allen R. Nissenson, Alex P.S. Disney, R. Valtuille, C. Najun Zarazaga, M. Fraenkel, Pieter Evenepoel, R. Cottiero, S. Di Giulio, V. Gura, S. Karunakaran, P. Nader, F. Saldanha Thome, Walter Douthat, A. Fekete, L. Arbeit, W. Sulowicz, I. Marin, Charles R.V. Tomson, Andrzej Wiecek, Luis A. Juncos, G. Mingardi, P. Light, Max Dratwa, H. Reichel, R. Raja, U. Ranjit, G. Sterner, E. Coll Piera, P. Pai, Robert J. Walker, R. Bregman, E. Hübel, M. Timofeev, T. Szabo, A. Elli, N. Padmanabhan, N. Garrote, M. Mysliwiec, David C. Wheeler, J. Cruz-Valdez, R. Klauser, Maree-Ross Smith, Antonio Carlos Carvalho, A. Losito, M. Durlik, G. Petraglia, Gianni Cappelli, Y. Lien, M. Chaffin, N. García, R. Halligan, Glenn M. Chertow, M. Bastos, P. Smak Gregoor, S. Ong, M. Belledonne, Fredric O. Finkelstein, J. Martínez García, R. Pecoits Filho, M. Klingberg, B. Carvalho, S. Noble, T. Plumb, A. Chew Wong, Michael Roppolo, U. Neyer, S. Ahmad, J. Mackie, R. Minasian, M. Verrelli, A. Abukurah, M. Laski, P. Brunet, Madeleine V. Pahl, Daniel Zehnder, E. Alas, Muralidhar Acharya, G. Rudolf, G. Zakar, M. Reddy, R. Specter, G. Grandaliano, I. Kulcsar, A. Amatya, Eugenie Pedagogos, O. Ayodeji, G. Jensen, S. Diamond, Xavier Warling, P. Teredesai, M. Mathew, M. Haque, M. Solis, E. Andrés Ribes, M.A. van den Dorpel, Akhtar Ashfaq, Christian Rabbat, David G. Warnock, M. Sebastian Diaz, C. Mousson, R. Darwish, M. Sperto Baptista, N. Salgado, E. Alvarez Sandoval, M. Vasilevsky, P. Chidester, D. Polack, Simon J. Davies, G. Brosnahan, A. Agarwal, Chaim Charytan, T. Hannedouche, M. Gross, I. Arias, G. James, Jürgen Floege, Tom Dejagere, Patrick S. Parfrey, S. Cournoyer, T. Cavalieri, Gérard M. London, K. Gandhi, A. Kshirsagar, O. Khrustalev, J. Zacharias, Michel Dhaene, Jennifer Tuazon, W. Weise, J. Guzman-Rivera, HS Brink, Alastair J. Hutchison, P. D. Cunha, Robyn G Langham, S. Soman, J. Goldman, S. Kazup Erdelyine, A. Widerhorn, M. Henriquez, N. Hunt, W. Hoerl, O. Arkossy, J. Szegedi, R. Dhingra, M. Fernandez Lucas, Jesus Navarro, A. Kark, Andrey Gurevich, Cynthia J. Brown, Rajnish Mehrotra, L. Kleinman, S. Ferenczi, Loreto Gesualdo, V. Schwenger, M. Ramirez, N. Mittman, Ana María Cusumano, K. Marczewski, Moustafa Moustafa, Sônia M. H. A. Araújo, E. Ladanyi, M. Auricchio, Maurice Laville, P. Urena Torres, C. Gallart, A. Israelit, V. Altobelli, E. Hagen, S. Nosrati, John P. Middleton, Kant Ks, F. Al-Saghir, S. Steinberg, S. Neiva Coelho, Botond Csiky, Philip G Zager, M. Sekkarie, Vanda Jorgetti, Domingos O. d'Avila, Carol A. Pollock, L. Lai, B. von Albertini, Beckie Michael, U. Kunzendorf, N. Frischmuth, A. Durrbach, L. Vasconcellos, Raymond Vanholder, M. Dickenmann, B. Schiller-Moran, Steven D. Soroka, J. Rubin, O. Balkarova, S. Morse, M. Teixeira Araújo, D. Perlin, M. Khan, C. Hura, Dagmar-C. Fischer, D. Machado, Seamas C. Donnelly, D. Sapir, V. Lorica, L. Deboni, M. Jose, M. Galicia, K. Bidas, David Spiegel, David Goldsmith, Peter F Mount, A. Strokov, L. Yu, J. Pitone, Biagio Ricciardi, Alastair Gillies, M. Moyses Neto, Piergiorgio Bolasco, V. Anashkin, John R. Sedor, M. Lee, E.M. Jones, M. Culpepper, G. London, D. Joly, N. Khadikova, Charles A. Herzog, P. Meier, M. Farina, Dana V. Rizk, William M. McClellan, M. Cook, Bastian Dehmel, Patrizia Ferrari, F. Almeida, V. Pogue, R. McCrary, F. Macario, J. Golden, E. Wijeyesinghe, Tilman B. Drüeke, E. Osanloo, M. Muszytowski, F. Arif, Giuseppe Villa, M. Torres Zamora, Steven Zeig, N. Thompson, A. Jamal, C. Sholer, P. Stroumza, D. Reddan, Arun Gupta, J. Montenegro, T. DelGiorno, D. Eadington, G. Shostka, Michel Jadoul, A. Weigert, Sergio Stefoni, P. Dreyer, Carmel M. Hawley, J. Cardeal da Costa, M. Switalski, G. Talaulikar, A. Felsenfeld, J. MacLaurin, T. Herman, N. Pritchard, M. Michaud, K.-U. Eckardt, R. Romero, G. Volgina, Fred E. Husserl, J. Soler Amigó, David S. Goldfarb, A. Matalon, M. D. Torres, P. Sampaio Lacativa, L. Major, U. Lund, A. Lafalla, S. Sarkar, Jennifer M. MacRae, J. Lobo, Liudmila Rozhinskaya, Johann Braun, H. Daugaard, S. Khokhar, S. Rubinstein, D. Bhatia, G. Timokhovskaya, T. Wooldridge, A. Voßkühler, Nelson Kopyt, Pablo E. Pergola, Michel Burnier, L. Samuels, J. Alcázar de La Ossa, J. Billiouw, R. Liebl, P. Sidhu, S. Menahem, P. Montambault, E. Schwertfeger, K. Staroselsky, J. Kovarik, S. Horn, N. Tareen, Simon D. Roger, Francesco Locatelli, Kenneth W. Mahaffey, J Vanwalleghem, Robert I. Lynn, M. Prados, K. Kapatkin, N. Peñalba, Kailash Jindal, M. Stegman, R. Stahl, Joseph A. Eustace, S. Desmeules, A. Hazzan, D. Scott, B. Taparia, G. Keightley, P. Jensen, V. Ortalda, K. McConnell, Alejandro Martin-Malo, Margaret M. Williams, Stuart M. Sprague, S. Chow, Diego Brancaccio, Yumi Kubo, P. Dykes, E. de Francesco Daher, C. Erley, Joanna Matuszkiewicz-Rowińska, T. Minga, I. Dasgupta, Galen S. Wagner, N. Marchetta, R. Rigolosi, P. Raguram, P. Lang, P. Cambier-Dwelschauwers, A. Tsang, M. Schonefeld, W. Bentkowski, Z. Sharon, Daniel Batlle, James T. McCarthy, M. Vital Flores, M. Rambausek, A. Zemtchenkov, Fabio Malberti, V. Thakur, O. Domashenko, D. Wheeler, J. Capelli, Bernard Jones, D. Uehlinger, K. Olgaard, K. Lhotta, M. Bernardo, S. Goldberger, Alison Thomas, E. Dunnigan, A. Ksiazek, A. Assefi, C. Poole, G. Rosa Diez, G. Newman, J. Cotton, C. Combe, B. Murthyr, Sharon M. Moe, H. Neumayer, J. Mittleman, Robert G. Fassett, W. Cleveland, F. van der Sande, C. Vela, H. Fessi, J. Robertson, Giuseppe Cannella, Bryan N. Becker, João M. Frazão, V. Shilo, M. Rano, J. De Meester, R. Fiedler, J. Floege, B. Murray, Giovambattista Capasso, F. Dellanna, J. Luiz Gross, K. Tucker, C. Santiago, Paul J. Martin, M. Nowicki, L. Friedman, William G. Goodman, G. Diez, Markus Ketteler, S. Arfeen, I. Mezei, J. Ortiz, Elizabeth E. Brown, Deborah Zimmerman, Aleix Cases, M. El Khatib, Martine Leblanc, R. Daelemans, K. Malireddi, C. Rikker, R. Gladish, F. Aranda Verástegui, R. Kopelman, B. Borbas, J. Buerkert, K. Ntoso, J. Peña, V. Garcia, C. West, M. Azer, J. Kwan, J. Sterrett, P. Swift, A. Raff, R. Kohli, S. Lew, Steven J. Rosansky, H. Graf, K. Bouman, F. Skinner, C. Tielemans, S. Ferreira Filho, Jocemir Ronaldo Lugon, M. Weinberg, Parfrey, P. S., Drueke, T. B., Block, G. A., Correa-Rotter, R., Floege, J., Herzog, C. A., London, G. M., Mahaffey, K. W., Moe, S. M., Wheeler, D. C., Kubo, Y., Dehmel, B., Goodman, W. G., Chertow, G. M., Santos, J., Najun Zarazaga, C., Marin, I., Garrote, N., Cusumano, A., Penalba, N., Del Valle, E., Juncos, L., Martinez Saye, J., Lef, L., Altobelli, V., Petraglia, G., Rosa Diez, G., Douthat, W., Lobo, J., Gallart, C., Lafalla, A., Diez, G., Linares, B., Lopez, N., Ramirez, N., Gonzalez, R., Valtuille, R., Beresan, H., Hermida, O., Rudolf, G., Marchetta, N., Rano, M., Ramirez, M., Garcia, N., Gillies, A., Jones, B., Pedagogos, E., Walker, R., Talaulikar, G., Bannister, K., Suranyi, M., Kark, A., Roger, S., Kerr, P., Disney, A., Mount, P., Fraenkel, M., Mathew, M., Fassett, R., Jose, M., Hawley, C., Lonergan, M., Mackie, J., Ferrari, P., Menahem, S., Sabto, J., Hutchison, B., Langham, R., Pollock, C., Holzer, H., Oberbauer, R., Arias, I., Graf, H., Mayer, G., Lhotta, K., Neyer, U., Klauser, R., Hoerl, W., Horn, S., Kovarik, J., Kramar, R., Eigner, M., Dhaene, M., Billiouw, J., De Meester, J., Warling, X., Cambier-Dwelschauwers, P., Evenepoel, P., Daelemans, R., Dratwa, M., Maes, B., Stolear, J., Dejagere, T., Vanwalleghem, J., Bouman, K., Jadoul, M., Peeters, J., Vanholder, R., Tielemans, C., Donck, J., Almeida, F., Picollo de Oliveira, J., Burdmann, E., Garcia, V., Saldanha Thome, F., Deboni, L., Bregman, R., Lugon, J., Araujo, S., Ferreira Filho, S., de Francesco Daher, E., Sperto Baptista, M., Carvalho, A., D'Avila, D., Moyses Neto, M., Yu, L., Bastos, M., Sampaio Lacativa, P., Jorgetti, V., de Almeida Romao, E., Cardeal da Costa, J., Pecoits Filho, R., Gordan, P., Salgado, N., Teixeira Araujo, M., Neiva Coelho, S., Oliveira, I., Moyses, R., Vasconcellos, L., Batista, P., Luiz Gross, J., Pedrosa, A., Cournoyer, S., Leblanc, M., Chow, S., Karunakaran, S., Wong, G., Tobe, S., Desmeules, S., Zimmerman, D., Murphy, S., Montambault, P., Donnelly, S., Macrae, J., Culleton, B., Soroka, S., Rabbat, C., Jindal, K., Vasilevsky, M., Michaud, M., Wijeyesinghe, E., Zacharias, J., Lok, C., Muirhead, N., Verrelli, M., Da Roza, G., Sapir, D., Olgaard, K., Daugaard, H., Brandi, L., Jensen, P., Boulechfar, H., Ang, K., Simon, P., Rieu, P., Brunet, P., Touchard, G., London, G., Urena Torres, P., Combe, C., Durrbach, A., Ortiz, J., Hannedouche, T., Vela, C., Lionet, A., Ryckelynck, P., Zaoui, P., Choukroun, G., Fessi, H., Lang, P., Stroumza, P., Joly, D., Mousson, C., Laville, M., Dellanna, F., Erley, C., Braun, J., Rambausek, M., Riegel, W., Klingberg, M., Schwertfeger, E., Wizemann, V., Eckardt, K., Reichel, H., Passauer, J., Hubel, E., Frischmuth, N., Liebl, R., Fiedler, R., Schwenger, V., Vosskuhler, A., Kunzendorf, U., Renders, L., Rattensberger, D., Rump, L., Ketteler, M., Neumayer, H., Zantvoort, F., Stahl, R., Ladanyi, E., Kulcsar, I., Mezei, I., Csiky, B., Rikker, C., Arkossy, O., Berta, K., Szegedi, J., Major, L., Ferenczi, S., Fekete, A., Szabo, T., Zakar, G., Wagner, G., Kazup Erdelyine, S., Borbas, B., Eustace, J., Reddan, D., Capasso, G., Locatelli, F., Villa, G., Cozzolino, M., Brancaccio, D., Messa, P., Bolasco, P., Ricciardi, B., Malberti, F., Moriero, E., Cannella, G., Ortalda, V., Stefoni, S., Frasca, G., Cappelli, G., Albertazzi, A., Zoccali, C., Farina, M., Elli, A., Avella, F., Ondei, P., Mingardi, G., Errico, R., Losito, A., Di Giulio, S., Pertosa, G., Schena, F., Grandaliano, G., Gesualdo, L., Auricchio, M., Bochicchio-Ricardelli, T., Aranda Verastegui, F., Pena, J., Chew Wong, A., Cruz-Valdez, J., Torres Zamora, M., Solis, M., Sebastian Diaz, M., Vital Flores, M., Alvarez Sandoval, E., van den Dorpel, M., Brink, H., Van Kuijk, W., Vermeij, C., Smak Gregoor, P., Hagen, E., van der Sande, F., Klinger, M., Nowicki, M., Muszytowski, M., Bidas, K., Bentkowski, W., Wiecek, A., Ksiazek, A., Marczewski, K., Ostrowski, M., Switalski, M., Sulowicz, W., Matuszkiewicz-Rowinska, J., Mysliwiec, M., Durlik, M., Rutkowski, B., Macario, F., Carvalho, B., Frazao, J., Machado, D., Weigert, A., Andrusev, A., Khrustalev, O., Zemtchenkov, A., Gurevich, K., Staroselsky, K., Khadikova, N., Rozhinskaya, L., Timokhovskaya, G., Strokov, A., Balkarova, O., Ermolenko, V., Kolmakova, E., Komandenko, M., Timofeev, M., Shilo, V., Shostka, G., Smirnov, A., Anashkin, V., Volgina, G., Domashenko, O., Gurevich, A., Perlin, D., Martinez Garcia, J., Andres Ribes, E., Coll Piera, E., Fernandez Lucas, M., Galicia, M., Prados, M., Gonzalez, M., Romero, R., Martin de Francisco, A., Montenegro, J., Santiago, C., Garcia, F., Alcazar de La Ossa, J., Arrieta, J., Pons, J., Martin-Malo, A., Soler Amigo, J., Cases, A., Sterner, G., Jensen, G., Wikstrom, B., Jacobson, S., Lund, U., Weiss, L., Stahl, A., von Albertini, B., Burnier, M., Meier, P., Martin, P., Uehlinger, D., Dickenmann, M., Yaqoob, M., Zehnder, D., Kalra, P., Padmanabhan, N., Roe, S., Eadington, D., Pritchard, N., Hutchison, A., Davies, S., Wilkie, M., Davies, M., Pai, P., Swift, P., Kwan, J., Goldsmith, D., Tomson, C., Stratton, J., Dasgupta, I., Sarkar, S., Moustafa, M., Gandhi, K., Jamal, A., Galindo-Ramos, E., Tuazon, J., Batlle, D., Tucker, K., Schiller-Moran, B., Assefi, A., Martinez, C., Samuels, L., Goldman, J., Cangiano-Rivera, J., Darwish, R., Lee, M., Topf, J., Kapatkin, K., Baer, H., Kopelman, R., Acharya, M., Tharpe, D., Bernardo, M., Nader, P., Guzman-Rivera, J., Pergola, P., Sekkarie, M., Alas, E., Zager, P., Liss, K., Navarro, J., Roppolo, M., Denu-Ciocca, C., Kshirsagar, A., El Khatib, M., Kant, K., Scott, D., Murthyr, B., Finkelstein, F., Keightley, G., Mccrary, R., Pitone, J., Cavalieri, T., Tsang, A., Pellegrino, B., Schmidt, R., Ahmad, S., Brown, C., Friedman, E., Mittman, N., Fadem, S., Shapiro, W., Reddy, M., Goldberger, S., Woredekal, Y., Agarwal, A., Anger, M., Haque, M., Chidester, P., Kohli, R., Rubinstein, S., Newman, G., Gladish, R., Ayodeji, O., Soman, S., Sprague, S., Hunt, N., Gehr, T., Rizk, D., Warnock, D., Polack, D., Pahl, M., Fischer, D., Dreyer, P., James, G., Husserl, F., Rogers, T., Raff, A., Sedor, J., Silver, M., Smith, M., Steinberg, S., Delgiorno, T., Jones, E., Cunha, P. D., Cheng, J., Pogue, V., Blumenthal, S., Brown, E., Charytan, C., Buerkert, J., Cook, M., Felsenfeld, A., Tareen, N., Gupta, A., Herman, T., Diamond, S., Hura, C., Laski, M., Maclaurin, J., Plumb, T., Brosnahan, G., Kumar, J., Henriquez, M., Poole, C., Osanloo, E., Matalon, A., Sholer, C., Arfeen, S., Azer, M., Belledonne, M., Gross, M., Dunnigan, E., Mcconnell, K., Becker, B., Skinner, F., Rigolosi, R., Spiegel, D., Stegman, M., Patak, R., Streja, D., Ranjit, U., Youell, T., Wooldridge, T., Stafford, C., Cottiero, R., Weinberg, M., Schonefeld, M., Shahmir, E., Hazzan, A., Ashfaq, A., Bhandari, K., Cleveland, W., Culpepper, M., Golden, J., Lai, L., Lien, Y., Lorica, V., Robertson, J., Malireddi, K., Morse, S., Thakur, V., Israelit, A., Raguram, P., Alfred, H., Weise, W., Al-Saghir, F., El Shahawy, M., Rastogi, A., Nissenson, A., Kopyt, N., Lynn, R., Lea, J., Mcclellan, W., Teredesai, P., Ong, S., Tolkan, S., Sugihara, J., Minga, T., Mehrotra, R., Minasian, R., Bhatia, D., Specter, R., Capelli, J., Sidhu, P., Dalal, S., Dykes, P., Khan, M., Rahim, F., Saklayen, M., Thomas, A., Michael, B., Torres, M., Al-Bander, H., Murray, B., Abukurah, A., Gupta, B., Nosrati, S., Raja, R., Zeig, S., Braun, M., Amatya, A., Endsley, J., Sharon, Z., Dolson, G., Dumler, F., Ntoso, K., Rosansky, S., Kumar, N., Gura, V., Thompson, N., Goldfarb, D., Halligan, R., Middleton, J., Widerhorn, A., Arbeit, L., Arruda, J., Crouch, T., Friedman, L., Khokhar, S., Mittleman, J., Light, P., Taparia, B., West, C., Cotton, J., Dhingra, R., Kleinman, L., Arif, F., Lew, S., Nammour, T., Sterrett, J., Williams, M., Ramirez, J., Rubin, J., Mccarthy, J., Noble, S., Chaffin, M., and Rekhi, A.

Subjects
Parathyroidectomy, Adult, Male, medicine.medical_specialty, Cinacalcet, Epidemiology, medicine.medical_treatment, Calcimimetic Agents, Critical Care and Intensive Care Medicine, Lower risk, Severity of Illness Index, CKD, cardiovascular disease, hemodialysis, hyperparathyroidism, mineral metabolism, Age Factors, Aged, Aged, 80 and over, Cardiovascular Diseases, Cinacalcet Hydrochloride, Female, Humans, Hyperparathyroidism, Secondary, Kidney Failure, Chronic, Kidney Transplantation, Middle Aged, Renal Dialysis, Nephrology, Transplantation, Internal medicine, medicine, Intensive care medicine, Hyperparathyroidism, business.industry, Original Articles, medicine.disease, Secondary hyperparathyroidism, Hemodialysis, business, medicine.drug
Abstract

Background andobjectivesThecalcimimeticcinacalcet reduced therisk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older ($65 years, n=1005) and younger (,65 years, n=2878) patients. Design, setting, participants, & measurements Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) was a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting HPT. The age subgroup analysis was prespecified. ResultsOlderpatients hadhigher baselineprevalenceof diabetesmellitusandCV comorbidity. Annualizedrates of kidney transplantation and parathyroidectomy were .3-fold higher in younger relative to older patients and were more frequent in patients randomized to placebo. In older patients, the adjusted relative hazard (95% confidence interval) for the primary composite (CV) end point (cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients, the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to 1.13). Reduction in the risk of severe unremitting HPT was similar in both groups. Conclusions In the EVOLVE trial, cinacalcet decreased the risk of death and of major CV events in older, but not younger, patients with moderate to severe HPT who were receiving hemodialysis. Effect modification by age may be partly explained by differences in underlying CV risk and differential application of cointerventions that reduce parathyroid hormone. Clin J Am Soc Nephrol 10: ccc–ccc, 2015. doi: 10.2215/CJN.07730814

Published
2015

45. Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation

Author

Maurizio Gallieni, Fabio Badiali, Emanuela Rossi, Patrizia Ondei, Giuseppe Bonforte, Andrea Stella, Paola Rebora, Antonio Santoro, Maria Grazia Valsecchi, Simonetta Genovesi, Sonia Pasquali, Claudio Pozzi, Silvio Bertoli, Ferruccio Conte, Genovesi, S, Rossi, E, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Rebora, P, Valsecchi, M, and Santoro, A

Subjects
Male, medicine.medical_specialty, medicine.medical_treatment, Population, Hemorrhage, Renal Dialysis, Risk Factors, Internal medicine, Atrial Fibrillation, medicine, Risk of mortality, Humans, Prospective Studies, education, Stroke, Aged, Transplantation, education.field_of_study, business.industry, Incidence (epidemiology), Incidence, Warfarin, Anticoagulants, Atrial fibrillation, medicine.disease, bleeding, mortality, haemodialysi, Survival Rate, Increased risk, Italy, Nephrology, Cardiology, Female, Hemodialysis, business, oral anticoagulation therapy, medicine.drug
Abstract

BACKGROUND Oral anticoagulation therapy (OAT) is the choice treatment for thromboembolism prevention in atrial fibrillation (AF), although data about OAT use in haemodialysis (HD) patients with AF are contradictory. METHODS The effect of OAT on the risk of mortality, stroke and bleeding was prospectively evaluated in a population of HD patients with AF. All the patients of 10 HD Italian centres alive on 31 October 2010 with documented AF episode(s) were recruited and followed-up for 2 years. OAT and antiplatelet intake, age, dialytic age, comorbidities and percentage time in the target international normalized ratio (INR) range (target therapeutic range; TTR) were considered as predictors of hazard of death, thromboembolic and bleeding events. RESULTS At recruitment, 134 patients out of 290 were taking OAT. During the follow-up, 115 patients died (4 strokes, 3 haemorrhagic and 1 thromboembolic). Antiplatelet therapy, but not OAT, was associated with increased mortality (HR 1.71, CI 1.10-2.64, P = 0.02). The estimated survival of patients always taking OAT tended to be higher than that of patients who stopped taking (68.6 versus 49.6%, P = 0.07). OAT was not correlated to a significant decreased risk of thromboembolic events (HR 0.12, CI 0.00-3.59, P = 0.20), while it was associated with an increased risk of bleeding (HR 3.96, CI 1.15-13.68, P = 0.03). Higher TTR was associated with a reduced bleeding risk (HR 0.09, CI 0.01-0.76, P = 0.03), while previous haemorrhagic events were associated with higher haemorrhagic risk (HR 2.17, CI 1.09-4.35, P = 0.03). CONCLUSIONS In our population of HD patients with AF, the mortality is very high. OAT is not associated with increased mortality, while antiplatelet drugs are. OAT seems, on the contrary, associated with a better survival; however, it does not decrease the incidence of ischaemic stroke, whereas it increases the incidence of bleeding. Bleeding risk is lower in subjects in whom the INR is kept within the therapeutic range.

Published
2014

46. The nephrologist's anticoagulation treatment patterns/regimens in chronic hemodialysis patients with atrial fibrillation

Author

Maurizio Gallieni, Daniela Pogliani, Giuseppe Bonforte, Maria Grazia Valsecchi, Emanuela Rossi, Simonetta Genovesi, Patrizia Ondei, Fabio Badiali, Claudio Pozzi, Sonia Pasquali, Silvio Bertoli, Ferruccio Conte, Andrea Stella, Antonio Santoro, Genovesi, S, Rossi, E, Pogliani, D, Gallieni, M, Stella, A, Badiali, F, Conte, F, Pasquali, S, Bertoli, S, Ondei, P, Bonforte, G, Pozzi, C, Valsecchi, M, and Santoro, A

Subjects
Nephrology, Male, medicine.medical_specialty, medicine.medical_treatment, Population, Administration, Oral, Logistic regression, Brain Ischemia, Renal Dialysis, Internal medicine, Thromboembolism, Atrial Fibrillation, medicine, Humans, Practice Patterns, Physicians', Renal Insufficiency, Chronic, education, Stroke, Aged, Aged, 80 and over, education.field_of_study, atrial fibrillation, hemodialysis, oral anticoagulant therapy, stroke, business.industry, Incidence (epidemiology), Patient Selection, Warfarin, food and beverages, Anticoagulants, Atrial fibrillation, MED/11 - MALATTIE DELL'APPARATO CARDIOVASCOLARE, medicine.disease, MED/14 - NEFROLOGIA, Cardiology, Female, Hemodialysis, business, Intracranial Hemorrhages, medicine.drug
Abstract

The prevalence of atrial fibrillation (AF) is high in hemodialysis (HD) patients. It was suggested that oral anticoagulant therapy (OAT), the choice treatment for reducing the thromboembolic risk in AF patients, increases the incidence of both ischemic and hemorrhagic strokes in the HD population. Moreover, the therapy-related bleeding risk is particularly high in these patients. For these reasons there is no agreement on the use of OAT in HD patients with AF. The aim of this study was to evaluate the criteria adopted by nephrologists in prescribing OAT in HD patients with AF. All the patients presenting AF (paroxysmal, persistent or permanent) at 31/10/2010 (n = 290) were recruited from 1529 HD patients from ten Italian HD centres. To detect factors related to OAT administration the main clinical features, CHADS2 and HASBLED scores were evaluated in logistic regression models. The presence of permanent AF (OR = 4.28, p < 0.0001) was the only clinical factor directly associated to OAT administration, while previous bleedings (OR = 0.35, p = 0.004) were inversely related. The CHADS2 score was not associated with OAT prescription (OR = 0.85, p = 0.08), while an inverse relation was found with the hemorrhagic risk score (OR = 0.74, p = 0.03). A high AF prevalence was observed in our HD population, but less than 50 % of these patients received OAT. Patients with permanent AF were more frequently treated with warfarin, while OAT administration was uncommon in those with previous bleedings. The thromboembolic risk score was not associated with warfarin prescription, while there was an inverse relation with the hemorrhagic risk score.

Published
2013

47. Ramipril and Cardiovascular Outcomes in Patients on Maintenance Hemodialysis: The ARCADIA Multicenter Randomized Controlled Trial.

Author

Ruggenenti P, Podestà MA, Trillini M, Perna A, Peracchi T, Rubis N, Villa D, Martinetti D, Cortinovis M, Ondei P, Condemi CG, Guastoni CM, Meterangelis A, Granata A, Mambelli E, Pasquali S, Genovesi S, Pieruzzi F, Bertoli SV, Del Rosso G, Garozzo M, Rigotti A, Pozzi C, David S, Daidone G, Mingardi G, Mosconi G, Galfré A, Romei Longhena G, Pacitti A, Pani A, Hidalgo Godoy J, Anders HJ, and Remuzzi G

Subjects
Aged, Female, Humans, Male, Middle Aged, Prospective Studies, Angiotensin-Converting Enzyme Inhibitors therapeutic use, Cardiovascular Diseases prevention & control, Ramipril therapeutic use, Renal Dialysis
Abstract

Background and Objectives: Renin-angiotensin system (RAS) inhibitors reduce cardiovascular morbidity and mortality in patients with CKD. We evaluated the cardioprotective effects of the angiotensin-converting enzyme inhibitor ramipril in patients on maintenance hemodialysis., Design, Setting, Participants, & Measurements: In this phase 3, prospective, randomized, open-label, blinded end point, parallel, multicenter trial, we recruited patients on maintenance hemodialysis with hypertension and/or left ventricular hypertrophy from 28 Italian centers. Between July 2009 and February 2014, 140 participants were randomized to ramipril (1.25-10 mg/d) and 129 participants were allocated to non-RAS inhibition therapy, both titrated up to the maximally tolerated dose to achieve predefined target BP values. The primary efficacy end point was a composite of cardiovascular death, myocardial infarction, or stroke. Secondary end points included the single components of the primary end point, new-onset or recurrence of atrial fibrillation, hospitalizations for symptomatic fluid overload, thrombosis or stenosis of the arteriovenous fistula, and changes in cardiac mass index. All outcomes were evaluated up to 42 months after randomization., Results: At comparable BP control, 23 participants on ramipril (16%) and 24 on non-RAS inhibitor therapy (19%) reached the primary composite end point (hazard ratio, 0.93; 95% confidence interval, 0.52 to 1.64; P =0.80). Ramipril reduced cardiac mass index at 1 year of follow-up (between-group difference in change from baseline: -16.3 g/m 2 ; 95% confidence interval, -29.4 to -3.1), but did not significantly affect the other secondary outcomes. Hypotensive episodes were more frequent in participants allocated to ramipril than controls (41% versus 12%). Twenty participants on ramipril and nine controls developed cancer, including six gastrointestinal malignancies on ramipril (four were fatal), compared with none in controls., Conclusions: Ramipril did not reduce the risk of major cardiovascular events in patients on maintenance hemodialysis., Clinical Trial Registry Name and Registration Number: ARCADIA, NCT00985322 and European Union Drug Regulating Authorities Clinical Trials Database number 2008-003529-17., (Copyright © 2021 by the American Society of Nephrology.)

Published
2021
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48. Warfarin use, mortality, bleeding and stroke in haemodialysis patients with atrial fibrillation.

Author

Genovesi S, Rossi E, Gallieni M, Stella A, Badiali F, Conte F, Pasquali S, Bertoli S, Ondei P, Bonforte G, Pozzi C, Rebora P, Valsecchi MG, and Santoro A

Subjects
Aged, Atrial Fibrillation mortality, Female, Hemorrhage mortality, Humans, Incidence, Italy epidemiology, Male, Prospective Studies, Risk Factors, Stroke mortality, Survival Rate, Anticoagulants adverse effects, Atrial Fibrillation drug therapy, Hemorrhage etiology, Renal Dialysis, Stroke etiology, Warfarin adverse effects
Abstract

Background: Oral anticoagulation therapy (OAT) is the choice treatment for thromboembolism prevention in atrial fibrillation (AF), although data about OAT use in haemodialysis (HD) patients with AF are contradictory., Methods: The effect of OAT on the risk of mortality, stroke and bleeding was prospectively evaluated in a population of HD patients with AF. All the patients of 10 HD Italian centres alive on 31 October 2010 with documented AF episode(s) were recruited and followed-up for 2 years. OAT and antiplatelet intake, age, dialytic age, comorbidities and percentage time in the target international normalized ratio (INR) range (target therapeutic range; TTR) were considered as predictors of hazard of death, thromboembolic and bleeding events., Results: At recruitment, 134 patients out of 290 were taking OAT. During the follow-up, 115 patients died (4 strokes, 3 haemorrhagic and 1 thromboembolic). Antiplatelet therapy, but not OAT, was associated with increased mortality (HR 1.71, CI 1.10-2.64, P = 0.02). The estimated survival of patients always taking OAT tended to be higher than that of patients who stopped taking (68.6 versus 49.6%, P = 0.07). OAT was not correlated to a significant decreased risk of thromboembolic events (HR 0.12, CI 0.00-3.59, P = 0.20), while it was associated with an increased risk of bleeding (HR 3.96, CI 1.15-13.68, P = 0.03). Higher TTR was associated with a reduced bleeding risk (HR 0.09, CI 0.01-0.76, P = 0.03), while previous haemorrhagic events were associated with higher haemorrhagic risk (HR 2.17, CI 1.09-4.35, P = 0.03)., Conclusions: In our population of HD patients with AF, the mortality is very high. OAT is not associated with increased mortality, while antiplatelet drugs are. OAT seems, on the contrary, associated with a better survival; however, it does not decrease the incidence of ischaemic stroke, whereas it increases the incidence of bleeding. Bleeding risk is lower in subjects in whom the INR is kept within the therapeutic range., (© The Author 2014. Published by Oxford University Press on behalf of ERA-EDTA. All rights reserved.)

Published
2015
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49. Sirolimus therapy to halt the progression of ADPKD.

Author

Perico N, Antiga L, Caroli A, Ruggenenti P, Fasolini G, Cafaro M, Ondei P, Rubis N, Diadei O, Gherardi G, Prandini S, Panozo A, Bravo RF, Carminati S, De Leon FR, Gaspari F, Cortinovis M, Motterlini N, Ene-Iordache B, Remuzzi A, and Remuzzi G

Subjects
Adult, Cell Proliferation drug effects, Cross-Over Studies, Female, Glomerular Filtration Rate drug effects, Glomerular Filtration Rate physiology, Humans, Immunosuppressive Agents adverse effects, Immunosuppressive Agents pharmacology, Intracellular Signaling Peptides and Proteins metabolism, Kidney drug effects, Kidney pathology, Male, Middle Aged, Polycystic Kidney, Autosomal Dominant pathology, Polycystic Kidney, Autosomal Dominant physiopathology, Protein Serine-Threonine Kinases metabolism, Signal Transduction drug effects, Signal Transduction physiology, Sirolimus adverse effects, Sirolimus pharmacology, TOR Serine-Threonine Kinases, Treatment Outcome, Disease Progression, Immunosuppressive Agents therapeutic use, Polycystic Kidney, Autosomal Dominant drug therapy, Sirolimus therapeutic use
Abstract

Activation of mammalian target of rapamycin (mTOR) pathways may contribute to uncontrolled cell proliferation and secondary cyst growth in patients with autosomal dominant polycystic kidney disease (ADPKD). To assess the effects of mTOR inhibition on disease progression, we performed a randomized, crossover study (The SIRENA Study) comparing a 6-month treatment with sirolimus or conventional therapy alone on the growth of kidney volume and its compartments in 21 patients with ADPKD and GFR>or=40 ml/min per 1.73 m2. In 10 of the 15 patients who completed the study, aphthous stomatitis complicated sirolimus treatment but was effectively controlled by topical therapy. Compared with pretreatment, posttreatment mean total kidney volume increased less on sirolimus (46+/-81 ml; P=0.047) than on conventional therapy (70+/-72 ml; P=0.002), but we did not detect a difference between the two treatments (P=0.45). Cyst volume was stable on sirolimus and increased by 55+/-75 ml (P=0.013) on conventional therapy, whereas parenchymal volume increased by 26+/-30 ml (P=0.005) on sirolimus and was stable on conventional therapy. Percentage changes in cyst and parenchyma volumes were significantly different between the two treatment periods. Sirolimus had no appreciable effects on intermediate volume and GFR. Albuminuria and proteinuria marginally but significantly increased during sirolimus treatment. In summary, sirolimus halted cyst growth and increased parenchymal volume in patients with ADPKD. Whether these effects translate into improved long-term outcomes requires further investigation.

Published
2010
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50. Computed tomography evaluation of autosomal dominant polycystic kidney disease progression: a progress report.

Author

Antiga L, Piccinelli M, Fasolini G, Ene-Iordache B, Ondei P, Bruno S, Remuzzi G, and Remuzzi A

Subjects
Adult, Disease Progression, Female, Humans, Male, Middle Aged, Polycystic Kidney, Autosomal Dominant physiopathology, Polycystic Kidney, Autosomal Dominant diagnostic imaging, Tomography, X-Ray Computed
Abstract

At the moment, there are no effective therapies to prevent or slow the progression of autosomal dominant polycystic kidney disease (ADPKD). Radiologic evaluations are used to monitor volume of renal cysts and parenchyma during disease evolution. Volumetric quantifications based on computed tomography were used to investigate the relation between structural and functional changes in patients with advanced-stage ADPKD. By use of image-processing techniques, volume of kidneys, renal cysts, fully enhanced parenchyma, and faintly contrast-enhanced parenchyma, referred to as intermediate, was estimated. GFR measurements and computed tomography evaluations were repeated 6 mo later. No statistically significant correlations were found between volumes of cysts and parenchyma and intermediate volume and GFR. However, the ratio of intermediate over parenchymal volume strongly correlated with GFR (r = -0.81, P < 0.001). In addition, there were significant correlations between percentage changes in intermediate volume (absolute or relative to parenchyma) and GFR changes during the observation period (r = -0.70 and r = -0.75, P < 0.01). These data support the hypothesis of a significant relation between radiologic appearance of renal structure and functional changes and suggest new ways that renal dysfunction in ADPKD may be predicted. Further work is necessary to determine the nature of faintly contrast-enhanced parenchyma and its role in renal functional loss.

Published
2006
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