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6. Nutritional and Dietary Management of Chronic Kidney Disease Under Conservative and Preservative Kidney Care Without Dialysis.

Author

Wang, Angela, Biruete, Annabel, Kistler, Brandon, Kovesdy, Csaba, Zarantonello, Diana, Ko, Gang, Piccoli, Giorgina, Garibotto, Giacomo, Brunori, Giuliano, Sumida, Keiichi, Lambert, Kelly, Moore, Linda, Han, Seung, Narasaki, Yoko, Kalantar-Zadeh, Kamyar, and Rhee, Connie

Subjects
Nutrition, chronic kidney disease, conservative management, plant-based diets, preservative management, Humans, Renal Dialysis, Dietary Proteins, Disease Progression, Renal Insufficiency, Chronic, Kidney, Diet, Protein-Restricted
Abstract

While dialysis has been the prevailing treatment paradigm for patients with advanced chronic kidney disease (CKD), emphasis on conservative and preservative management in which dietary interventions are a major cornerstone have emerged. Based on high-quality evidence, international guidelines support the utilization of low-protein diets as an intervention to reduce CKD progression and mortality risk, although the precise thresholds (if any) for dietary protein intake vary across recommendations. There is also increasing evidence demonstrating that plant-dominant low-protein diets reduce the risk of developing incident CKD, CKD progression, and its related complications including cardiometabolic disease, metabolic acidosis, mineral and bone disorders, and uremic toxin generation. In this review, we discuss the premise for conservative and preservative dietary interventions, specific dietary approaches used in conservative and preservative care, potential benefits of a plant-dominant low-protein diet, and practical implementation of these nutritional strategies without dialysis.

Published
2023

7. Analysis of the rate of force development reveals high neuromuscular fatigability in elderly patients with chronic kidney disease

Author

Chatrenet, Antoine, Piccoli, Giorgina, Audebrand, Jean Michel, Torreggiani, Massimo, Barbieux, Julien, Vaillant, Charly, Morel, Baptiste, Durand, Sylvain, and Beaune, Bruno

Subjects
Quantitative Biology - Tissues and Organs, Physics - Medical Physics
Abstract

Background Chronic kidney disease (CKD) induces muscle wasting and a reduction in the maximum voluntary force (MVF). Little is known about the neuromuscular fatigability in CKD patients, defined as the reduction of muscle force capacities during exercise. Neuromuscular fatigability is a crucial physical parameter of the daily living. The quantification of explosive force has been shown to be a sensitive means to assess neuromuscular fatigability. Thus, our study used explosive force estimates to assess neuromuscular fatigability in elderly CKD patients. Methods Inclusion criteria for CKD patients were age $\ge$ 60 years old and glomerular filtration rate (GFR) < 45 mL/ min/1.73 m 2 not on dialysis, and those for controls were GFR > 60 mL/min/1.73 m 2 , age and diabetes matched. The fatigability protocol focused on a handgrip task coupled with surface electromyography (sEMG). Scalars were extracted from the rate of force development (RFD): absolute and normalized time periods (50, 75, 100, 150 and 200 ms, RFD 50 , RFD 75 , RFD 100 , RFD 150 and RFD 200 , respectively), peak RFD (RFD peak in absolute; NRFD peak normalized), timeto-peak RFD (t-RFD peak) and the relative force at RFD peak (MVF-RFD peak). A statistical parametric mapping approach was performed on the force, impulse and RFD-time curves. The integrated sEMG with time at 0-30, 0-50, 0-100 and 0-200 ms time intervals relative to onset of sEMG activity was extracted and groups were compared separately for each sex. Results The cohort of 159 individuals had a median age of 69 (9 IQR) years and body mass index was 27.6 (6.2 IQR) kg/ m 2. Propensity-score-matched groups balanced CKD patients and controls by gender with 66 males and 34 females. In scalar analysis, CKD patients manifested a higher decrement than controls in the early phase of contraction, regarding the NRFD peak (P = 0.009; $\eta$ 2 p = 0.034) and RFD 75 and RFD 100 (for both P < 0.001; $\eta$ 2 p = 0.068 and 0.064). The onedimensional analysis confirmed that CKD males manifest higher and delayed neuromuscular fatigability, especially before 100 ms from onset of contraction. sEMG was lower in CKD patients than controls in the 0-100 ms (at rest: P = 0.049, Cohen's d = 0.458) and 0-200 ms (at rest: P = 0.016, Cohen's d = 0.496; during exercise: P = 0.006, Cohen's d = 0.421) time windows. Controls showed greater decrease of sEMG than CKD patients in the 0-30 ms (P = 0.020, Cohen's d = 0.533) and 0-50 ms (P = 0.010, Cohen's d = 0.640) time windows. As opposite to females, males showed almost the same differences between groups. Conclusions Our study is the first to show that CKD patients have higher fatigability than controls, which may be associated with an impaired motor-unit recruitment, highlighting a neural drive disturbance with CKD. Further studies are needed to confirm these findings., Comment: Journal of Cachexia, Sarcopenia and Muscle, In press

Published
2023
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17. History of kidney transplantation: a journey of progression and evolution for success

Author

Tantisattamo, Ekamol, Maggiore, Umberto, and Piccoli, Giorgina Barbara

Subjects
Biomedical and Clinical Sciences, Health Sciences, Graft Survival, Humans, Kidney Failure, Chronic, Kidney Transplantation, Tissue Donors, Tissue and Organ Procurement, End-stage kidney disease, Kidney transplantation, Long-term allograft outcomes, Organ procurement, Organ shortage, Personalized precision medicine, Tolerance, Clinical Sciences, Urology & Nephrology, Biomedical and clinical sciences, Health sciences
Published
2022

19. Correction to: Chronic kidney disease, female infertility, and medically assisted reproduction: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology

Author

Attini, Rossella, Cabiddu, Gianfranca, Ciabatti, Francesca, Montersino, Benedetta, Carosso, Andrea Roberto, Gernone, Giuseppe, Gammaro, Linda, Moroni, Gabriella, Torreggiani, Massimo, Masturzo, Bianca, Santoro, Domenico, Revelli, Alberto, and Piccoli, Giorgina Barbara

Published
2024
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22. The impact of the Russian–Ukrainian war for people with chronic diseases

Author

Piccoli, Giorgina B, Brunori, Giuliano, Gesualdo, Loreto, and Kalantar-Zadeh, Kamyar

Subjects
Biomedical and Clinical Sciences, Clinical Sciences, Clinical Research, Health Services, Good Health and Well Being, Chronic Disease, Humans, Russia, Urology & Nephrology, Clinical sciences
Published
2022

23. Chronic kidney disease, female infertility, and medically assisted reproduction: a best practice position statement by the Kidney and Pregnancy Group of the Italian Society of Nephrology

Author

Attini, Rossella, Cabiddu, Gianfranca, Ciabatti, Francesca, Montersino, Benedetta, Carosso, Andrea Roberto, Gernone, Giuseppe, Gammaro, Linda, Moroni, Gabriella, Torreggiani, Massimo, Masturzo, Bianca, Santoro, Domenico, Revelli, Alberto, and Piccoli, Giorgina Barbara

Published
2023
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37. What a paediatric nephrologist should know about preeclampsia and why it matters

Author

Piccoli, Giorgina Barbara, Torreggiani, Massimo, Crochette, Romain, Cabiddu, Gianfranca, Masturzo, Bianca, Attini, Rossella, and Versino, Elisabetta

Subjects
Children -- Diseases, Preeclampsia -- Complications and side effects, Kidney diseases -- Risk factors, Health
Abstract

Preeclampsia is a protean syndrome causing a kidney disease characterised by hypertension and proteinuria, usually considered transitory and reversible after delivery. Its prevalence ranges from 3-5 to 10% if all the related disorders are considered. This narrative review, on behalf of the Kidney and Pregnancy Study Group of the Italian Society of Nephrology, focuses on three reasons why preeclampsia should concern paediatric nephrologists and how they can play an important role in its prevention, as well as in the prevention of future kidney and cardiovascular diseases. Firstly, all diseases of the kidney and urinary tract diagnosed in paediatric age are associated with a higher risk of adverse pregnancy-related outcomes, including preeclampsia. Secondly, babies with low birth weights (small for gestational age, born preterm, or both) have an increased risk of developing the full panoply of metabolic diseases (obesity, hypertension, early-onset cardiopathy and chronic kidney disease) and girls are at higher risk of developing preeclampsia when pregnant. The risk may be particularly high in cases of maternal preeclampsia, highlighting a familial aggregation of this condition. Thirdly, pregnant teenagers have a higher risk of developing preeclampsia and the hypertensive disorders of pregnancy, and should be followed up as high risk pregnancies. In summary, preeclampsia has come to be seen as a window on the future health of both mother and baby. Identification of subjects at risk, early counselling and careful follow-up can contribute to reducing the high morbidity linked with this disorder., Author(s): Giorgina Barbara Piccoli [sup.1] , Massimo Torreggiani [sup.1] , Romain Crochette [sup.1] , Gianfranca Cabiddu [sup.2] , Bianca Masturzo [sup.3] , Rossella Attini [sup.3] , Elisabetta Versino [sup.4] Author [...]

Published
2022
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39. Glomerular diseases in pregnancy: pragmatic recommendations for clinical management

Author

Fakhouri, Fadi, Schwotzer, Nora, Cabiddu, Gianfranca, Barratt, Jonathan, Legardeur, Hélène, Garovic, Vesna, Orozco-Guillen, Alejandra, Wetzels, Jack, Daugas, Eric, Moroni, Gabriella, Noris, Marina, Audard, Vincent, Praga, Manuel, Llurba, Elisa, Wuerzner, Grégoire, Attini, Rossella, Desseauve, David, Zakharova, Elena, Luders, Claudio, Wiles, Kate, Leone, Filomena, Jesudason, Shilpanjali, Costedoat-Chalumeau, Nathalie, Kattah, Andrea, Soto-Abraham, Virgilia, Karras, Alexandre, Prakash, Jai, Lightstone, Liz, Ronco, Pierre, Ponticelli, Claudio, Appel, Gerald, Remuzzi, Giuseppe, Tsatsaris, Vassilis, and Piccoli, Giorgina Barbara

Published
2023
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45. #1156 Outcomes after kidney transplantation in ANCA-associated vasculitis

Author

Brilland, Benoit, primary, Dekervel, Marine, additional, Traversat, Priscille, additional, Piccoli, Giorgina, additional, Henry, Nicolas, additional, Gatault, Philippe, additional, Thierry, Antoine, additional, Bertrand, Dominique, additional, Golbin, Leonard, additional, Anglicheau, Dany, additional, Duveau, Agnès, additional, and François, Augusto Jean, additional

Published
2024
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47. #1155 Outcomes after kidney transplantation in anti-glomerular basement membrane disease

Author

Brilland, Benoit, primary, Traversat, Priscille, additional, Dekervel, Marine, additional, Piccoli, Giorgina, additional, Assia, Djema, additional, Gatault, Philippe, additional, Thierry, Antoine, additional, Bertrand, Dominique, additional, Golbin, Leonard, additional, Anglicheau, Dany, additional, Duveau, Agnès, additional, and François, Augusto Jean, additional

Published
2024
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48. #1121 Identification of kidney transcripts associated with prognosis in ANCA-associated glomerulonephritis

Author

Brilland, Benoit, primary, Riou, Jérémie, additional, Boizard-Moracchini, Andrea, additional, Tortevoie, Nathalie, additional, Piccoli, Giorgina, additional, Assia, Djema, additional, Henry, Nicolas, additional, Copin, Marie-Christine, additional, Langlais, David, additional, Blanco, Patrick, additional, Delneste, Yves, additional, and François, Augusto Jean, additional

Published
2024
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