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1. New-onset anemia and associated risk of ESKD and death in non-dialysis CKD patients: A multicohort observational study

Author

Minutolo, R., Provenzano, M., Chiodini, P., Borrelli, S., Garofalo, C., Andreucci, M., Liberti, M. E., Bellizzi, V., Conte, G., De Nicola, L., Zamboli, P., Iodice, F. C., Signoriello, S., Gallo, C., Cianciaruso, B., Pota, A., Nappi, F., Avella, F., Di Iorio, B. R., Cestaro, R., Martignetti, V., Morrone, L., Lupo, A., Abaterusso, C., Donadio, C., Bonomini, M., Sirolli, V., Casino, F., Lopez, T., Detomaso, F., Giannattasio, M., Virgilio, M., Tarantino, G., Cristofano, C., Tuccillo, S., Chimienti, S., Petrarulo, F., Giancaspro, V., Strippoli, M., Laraia, E., Gallucci, M., Gigante, B., Lodeserto, C., Santese, D., Montanaro, A., Giordano, R., Caglioti, A., Fuiano, G., Zoccali, C., Caridi, G., Postorino, M., Savica, V., Monardo, P., Bellinghieri, G., Santoro, D., Castellino, P., Rapisarda, F., Fatuzzo, P., Messina, A., Dal Canton, A., Esposito, V., Formica, M., Segoloni, G., Gallieni, M., Locatelli, F., Tarchini, R., Meneghel, G., Oldrizzi, L., Cossu, M., Di Giulio, S., Malaguti, M., Pizzarelli, F., Quintaliani, G., Pisani, A., Bonofiglio, R., Grandaliano, Giuseppe, Russo, D., Di Micco, L., Torraca, S., Sabbatini, M., Grandaliano G. (ORCID:0000-0003-1213-2177), Minutolo, R., Provenzano, M., Chiodini, P., Borrelli, S., Garofalo, C., Andreucci, M., Liberti, M. E., Bellizzi, V., Conte, G., De Nicola, L., Zamboli, P., Iodice, F. C., Signoriello, S., Gallo, C., Cianciaruso, B., Pota, A., Nappi, F., Avella, F., Di Iorio, B. R., Cestaro, R., Martignetti, V., Morrone, L., Lupo, A., Abaterusso, C., Donadio, C., Bonomini, M., Sirolli, V., Casino, F., Lopez, T., Detomaso, F., Giannattasio, M., Virgilio, M., Tarantino, G., Cristofano, C., Tuccillo, S., Chimienti, S., Petrarulo, F., Giancaspro, V., Strippoli, M., Laraia, E., Gallucci, M., Gigante, B., Lodeserto, C., Santese, D., Montanaro, A., Giordano, R., Caglioti, A., Fuiano, G., Zoccali, C., Caridi, G., Postorino, M., Savica, V., Monardo, P., Bellinghieri, G., Santoro, D., Castellino, P., Rapisarda, F., Fatuzzo, P., Messina, A., Dal Canton, A., Esposito, V., Formica, M., Segoloni, G., Gallieni, M., Locatelli, F., Tarchini, R., Meneghel, G., Oldrizzi, L., Cossu, M., Di Giulio, S., Malaguti, M., Pizzarelli, F., Quintaliani, G., Pisani, A., Bonofiglio, R., Grandaliano, Giuseppe, Russo, D., Di Micco, L., Torraca, S., Sabbatini, M., and Grandaliano G. (ORCID:0000-0003-1213-2177)

Abstract

Background: Anemia is a common complication of chronic kidney disease (CKD), but its incidence in nephrology settings is poorly investigated. Similarly, the risks of adverse outcomes associated with new-onset anemia are not known. Methods: We performed a pooled analysis of three observational cohort studies including 1031 non-anemic CKD patients with eGFR <60 mL/min/1.73 m2 regularly followed in renal clinics. We estimated the incidence of mild anemia (hemoglobin 11-12 g/dL in women and 11-13 g/dL in men) and severe anemia (hemoglobin <11 g/dL or use of erythropoiesis-stimulating agents) during a 3-year follow-up period. Thereafter we estimated the risk of end-stage kidney disease (ESKD) and all-cause death associated with new-onset mild and severe anemia. Results: The mean age was 63 ± 14 years, 60% were men and 20% had diabetes. The mean estimated glomerular filtration rate (eGFR) was 37 ± 13 mL/min/1.73 m2 and the median proteinuria was 0.4 g/day [interquartile range (IQR) 0.1-1.1]. The incidence of mild and severe anemia was 13.7/100 patients-year and 6.2/100 patients-year, respectively. Basal predictors of either mild or severe anemia were diabetes, lower hemoglobin, higher serum phosphate, eGFR <30 mL/min/1.73 m2 and proteinuria >0.50 g/day. Male sex, moderate CKD (eGFR 30-44 mL/min/1.73 m2) and moderate proteinuria (0.15-0.50 g/day) predicted only mild anemia. The incidence of anemia increased progressively with CKD stages (from 8.77 to 76.59/100 patients-year) and the proteinuria category (from 13.99 to 25.02/100 patients-year). During a median follow-up of 3.1 years, 232 patients reached ESKD and 135 died. Compared with non-anemic patients, mild anemia was associated with a higher adjusted risk of ESKD {hazard ratio [HR] 1.42 [95% confidence interval (CI) 1.02-1.98]} and all-cause death [HR 1.55 (95% CI 1.04-2.32)]. Severe anemia was associated with an even higher risk of ESKD [HR 1.73 (95% CI 1.20-2.51)] and death [HR 1.83 (95% CI 1.05-3.19)].

Published
2022

2. Risk factors and action thresholds for the novel coronavirus pandemic. Insights from the Italian Society of Nephrology COVID-19 Survey

Author

Nordio, M., Reboldi, G., Di Napoli, A., Quintaliani, G., Alberici, F., Postorino, M., Aucella, F., Messa, P., Brunori, G., Bosco, M., Malberti, F., Mandreoli, M., Mazzaferro, S., Movilli, E., Ravera, M., Salomone, M., Santoro, D., Postorinolimido, M. A., Bonomini, M., Stingone, A., Maccarone, M., Di Loreto, E., Stacchiotti, L., Malandra, R., Chiarella, S., D'Agostino, F., Fuiano, G., Nicodemo, L., Bonofiglio, R., Greco, S., Mallamaci, F., Barreca, E., Caserta, C., Bruzzese, V., Galati, D., Tramontana, D., Viscione, M., Chiuchiolo, L., Tuccillo, S., Sepe, M., Vitale, F., Ciriana, E., Martignetti, V., Caserta, D., Stizzo, A., Romano, A., Iulianiello, G., Cascone, E., Minicone, P., Chiricone, D., Delgado, G., Barbato, A., Celentano, S., Molfino, I., Coppola, S., Raiola, I., Abategiovanni, M., Borrelli, S., Margherita, C., Bruno, F., Ida, M., Aliperti, E., Potito, D., Cuomo, G., De Luca, M., Merola, M., Botta, C., Garofalo, G., Alinei, P., Paglionico, C., Roano, M., Vitale, S., Ierardi, R., Fimiani, V., Conte, G., Di Natale, G., Romano, M., Di Marino, V., Scafarto, A., Meccariello, S., Pecoraro, C., Di Stazio, E., Di Meglio, E., Cuomo, A., Maresca, B., Rotaia, E., Capasso, G., Auricchio, M., Pluvio, C., Maddalena, L., De Maio, A., Palladino, G., Buono, F., Gigliotti, G., Mancini, E., La Manna, G., Storari, A., Mosconi, G., Cappelli, G., Scarpioni, R., Gregorini, M., Rigotti, A., Mancini, W., Bianco, F., Boscutti, G., Amici, G., Tosto, M., Fini, R., Pace, G., Cioffi, A., Boccia, E., Di Lullo, L., Di Zazzo, G., Simonelli, R., Bondatti, F., Miglio, L., Rifici, N., Treglia, A., Muci, M., Baldinelli, G., Rizzi, E., Lonzi, M., De Cicco, C., Forte, F., De Paolis, P., Grandaliano, Giuseppe, Cuzziol, C., Torre, V. M., Sfregola, P., Rossi, V., Fabio, G., Flammini, A., Filippini, A., Onorato, L., Vendola, F., Di Daniela, N., Alfarone, C., Scabbia, L., Ferrazzano, M., Grotta, B. D., Gamberini, M., Fazzari, L., Mene, P., Morgia, A., Catucci, A., Palumbo, R., Puliti, M., Marinelli, R., Polito, P., Marrocco, F., Morabito, S., Rocca, R., Nazzaro, L., Lavini, R., Iamundo, V., Chiappini, M., Casarci, M., Morosetti, M., Hassan, S., Firmi, G., Galliani, M., Serraiocco, M., Feriozzi, S., Valentini, W., Sacco, P., Garibotto, G., Cappelli, V., Saffioti, C., Repetto, M., Rolla, D., Lorenz, M., Pedrini, L., Polonioli, D., Galli, E., Ruggenenti, P., Scolari, F., Bove, S., Costantino, E., Bracchi, M., Mangano, S., Depetri, G., La Milia, V., Farina, M., Zecchini, S., Savino, R., Melandri, M., Guastoni, C., Paparella, M., Gallieni, M., Minetti, E., Bisegna, S., Righetti, M., Badalamenti, S., Alberghini, E., Bertoli, S., Fabbrini, P., Albrizio, P., Rampino, T., Colturi, C., Rombola, G., Lucatello, A., Guerrini, E., Ranghino, A., Lenci, F., Fanciulli, E., Santarelli, S., Damiani, C., Garofalo, D., Sopranzi, F., Santoferrara, A., Di Luca, M., Galiotta, P., Brigante, M., Manganaro, M., Maffei, S., Berto, I., Besso, L., Viglino, G., Cusinato, S., Chiarinottichiappero, D. F., Tognarelli, G., Gianoglio, B., Forneris, G., Biancone, L., Savoldi, S., Vitale, C., Boero, R., Filiberti, O., Borzumati, M., Gesualdo, L., Lomonte, C., Gernone, G., Pallotta, G., Di Paolo, S., Vernaglione, L., Specchio, A., Stallone, G., Dell'Aquila, R., Sandri, G., Russo, F., Napoli, M., Marangi, A., Morrone, L., Di Stratis, C., Fresu, A., Cicu, F., Murtas, S., Manca, O., Pani, A., Pilloni, M., Pistis, R., Cadoni, M., Contu, B., Logias, F., Ivaldi, R., Fancello, S., Cossu, M., Lepori, G., Vittoria, S., Battiati, E., Arnone, M., Rome, M., Barbera, A., Granata, A., Collura, G., Dico, C. L., Pugliese, G., Di Natale, E., Rizzari, G., Cottone, L., Longo, N., Battaglia, G., Marcantoni, C., Giannetto, G., Tumino, G., Randazzo, F., Bellissimo, L., Faro, F. L., Grippaldi, F., Urso, S., Quattrone, G., Todaro, I., Vincenzo, D., Murgo, A., Masuzzo, M., Pisacane, A., Monardo, P., Pontorierro, M., Quari, C., Bauro, A., Chimenz, R. R., Alfio, D., Girasole, F., Cascio, A. L., Caviglia, A., Tornese, F., Sirna, F., Altieri, C., Cusumano, R., Saveriano, V., La Corte, A., Locascio, G., Rotolo, U., Musso, S., Risuglia, L., Blanco, G., Minardo, G., Castellino, S., Zappulla, Z., Randone, S., Di Francesca, M., Cassetti, C. C., Oddo, G., Buscaino, G., Mucaria, F., Barraco, V. I., Di Martino, A., Rallo, D., Dani, L., Campolo, G., Manescalchi, F., Biagini, M., Agate, M., Panichi, V., Casani, A., Traversari, L., Garosi, G., Tabbi, M., Selvi, A., Cencioni, L., Fagugli, R., Timio, F., Leveque, A., Manes, M., Mennella, G., Calo, L., Fiorini, F., Abaterusso, C., Calzavara, P., Meneghel, G., Bonesso, C., Gambaro, G., Gammaro, L., Rugiu, C., Ronco, C., Nordio M., Reboldi G., Di Napoli A., Quintaliani G., Alberici F., Postorino M., Aucella F., Messa P., Brunori G., Bosco M., Malberti F., Mandreoli M., Mazzaferro S., Movilli E., Ravera M., Salomone M., Santoro D., PostorinoLimido M.A., Bonomini M., Stingone A., Maccarone M., Di Loreto E., Stacchiotti L., Malandra R., Chiarella S., D'Agostino F., Fuiano G., Nicodemo L., Bonofiglio R., Greco S., Mallamaci F., Barreca E., Caserta C., Bruzzese V., Galati D., Tramontana D., Viscione M., Chiuchiolo L., Tuccillo S., Sepe M., Vitale F., Ciriana E., Martignetti V., Caserta D., Stizzo A., Romano A., Iulianiello G., Cascone E., Minicone P., Chiricone D., Delgado G., Barbato A., Celentano S., Molfino I., Coppola S., Raiola I., Abategiovanni M., Borrelli S., Margherita C., Bruno F., Ida M., Aliperti E., Potito D., Cuomo G., De Luca M., Merola M., Botta C., Garofalo G., Alinei P., Paglionico C., Roano M., Vitale S., Ierardi R., Fimiani V., Conte G., Di Natale G., Romano M., Di Marino V., Scafarto A., Meccariello S., Pecoraro C., Di Stazio E., Di Meglio E., Cuomo A., Maresca B., Rotaia E., Capasso G., Auricchio M., Pluvio C., Maddalena L., De Maio A., Palladino G., Buono F., Gigliotti G., Mancini E., La Manna G., Storari A., Mosconi G., Cappelli G., Scarpioni R., Gregorini M., Rigotti A., Mancini W., Bianco F., Boscutti G., Amici G., Tosto M., Fini R., Pace G., Cioffi A., Boccia E., Di Lullo L., Di Zazzo G., Simonelli R., Bondatti F., Miglio L., Rifici N., Treglia A., Muci M., Baldinelli G., Rizzi E., Lonzi M., De Cicco C., Forte F., De Paolis P., Grandaliano G., Cuzziol C., Torre V.M., Sfregola P., Rossi V., Fabio G., Flammini A., Filippini A., Onorato L., Vendola F., Di Daniela N., Alfarone C., Scabbia L., Ferrazzano M., Grotta B.D., Gamberini M., Fazzari L., Mene P., Morgia A., Catucci A., Palumbo R., Puliti M., Marinelli R., Polito P., Marrocco F., Morabito S., Rocca R., Nazzaro L., Lavini R., Iamundo V., Chiappini M., Casarci M., Morosetti M., Hassan S., Firmi G., Galliani M., Serraiocco M., Feriozzi S., Valentini W., Sacco P., Garibotto G., Cappelli V., Saffioti C., Repetto M., Rolla D., Lorenz M., Pedrini L., Polonioli D., Galli E., Ruggenenti P., Scolari F., Bove S., Costantino E., Bracchi M., Mangano S., Depetri G., La Milia V., Farina M., Zecchini S., Savino R., Melandri M., Guastoni C., Paparella M., Gallieni M., Minetti E., Bisegna S., Righetti M., Badalamenti S., Alberghini E., Bertoli S., Fabbrini P., Albrizio P., Rampino T., Colturi C., Rombola G., Lucatello A., Guerrini E., Ranghino A., Lenci F., Fanciulli E., Santarelli S., Damiani C., Garofalo D., Sopranzi F., Santoferrara A., Di Luca M., Galiotta P., Brigante M., Manganaro M., Maffei S., Berto I., Besso L., Viglino G., Cusinato S., ChiarinottiChiappero D.F., Tognarelli G., Gianoglio B., Forneris G., Biancone L., Savoldi S., Vitale C., Boero R., Filiberti O., Borzumati M., Gesualdo L., Lomonte C., Gernone G., Pallotta G., Di Paolo S., Vernaglione L., Specchio A., Stallone G., Dell'Aquila R., Sandri G., Russo F., Napoli M., Marangi A., Morrone L., Di Stratis C., Fresu A., Cicu F., Murtas S., Manca O., Pani A., Pilloni M., Pistis R., Cadoni M., Contu B., Logias F., Ivaldi R., Fancello S., Cossu M., Lepori G., Vittoria S., Battiati E., Arnone M., Rome M., Barbera A., Granata A., Collura G., Dico C.L., Pugliese G., Di Natale E., Rizzari G., Cottone L., Longo N., Battaglia G., Marcantoni C., Giannetto G., Tumino G., Randazzo F., Bellissimo L., Faro F.L., Grippaldi F., Urso S., Quattrone G., Todaro I., Vincenzo D., Murgo A., Masuzzo M., Pisacane A., Monardo P., Pontorierro M., Quari C., Bauro A., Chimenz R.R., Alfio D., Girasole F., Cascio A.L., Caviglia A., Tornese F., Sirna F., Altieri C., Cusumano R., Saveriano V., La Corte A., Locascio G., Rotolo U., Musso S., Risuglia L., Blanco G., Minardo G., Castellino S., Zappulla Z., Randone S., Di Francesca M., Cassetti C.C., Oddo G., Buscaino G., Mucaria F., Barraco V.I., Di Martino A., Rallo D., Dani L., Campolo G., Manescalchi F., Biagini M., Agate M., Panichi V., Casani A., Traversari L., Garosi G., Tabbi M., Selvi A., Cencioni L., Fagugli R., Timio F., Leveque A., Manes M., Mennella G., Calo L., Fiorini F., Abaterusso C., Calzavara P., Meneghel G., Bonesso C., Gambaro G., Gammaro L., Rugiu C., and Ronco C.

Subjects
Male, Contextual analysis, medicine.medical_treatment, Population, 030232 urology & nephrology, Recursive partitioning, 030204 cardiovascular system & hematology, Rate ratio, Risk Assessment, 03 medical and health sciences, 0302 clinical medicine, Classification tree, COVID-19, Renal replacement therapy, Risk Factors, Medical, Surveys and Questionnaires, Health care, medicine, Settore MED/14 - NEFROLOGIA, Humans, education, Pandemics, Societies, Medical, Female, Italy, Nephrology, education.field_of_study, business.industry, Multilevel model, Decision rule, Confidence interval, Original Article, Hemodialysis, business, Contextual analysi, Societies, Demography
Abstract

Background and aim: Over 80% (365/454) of the nation’s centers participated in the Italian Society of Nephrology COVID-19 Survey. Out of 60,441 surveyed patients, 1368 were infected as of April 23rd, 2020. However, center-specific proportions showed substantial heterogeneity. We therefore undertook new analyses to identify explanatory factors, contextual effects, and decision rules for infection containment. Methods: We investigated fixed factors and contextual effects by multilevel modeling. Classification and Regression Tree (CART) analysis was used to develop decision rules. Results: Increased positivity among hemodialysis patients was predicted by center location [incidence rate ratio (IRR) 1.34, 95% confidence interval (CI) 1.20–1.51], positive healthcare workers (IRR 1.09, 95% CI 1.02–1.17), test-all policy (IRR 5.94, 95% CI 3.36–10.45), and infected proportion in the general population (IRR 1.002, 95% CI 1.001–1.003) (all p < 0.01). Conversely, lockdown duration exerted a protective effect (IRR 0.95, 95% CI 0.94–0.98) (p < 0.01). The province-contextual effects accounted for 10% of the total variability. Predictive factors for peritoneal dialysis and transplant cases were center location and infected proportion in the general population. Using recursive partitioning, we identified decision thresholds at general population incidence ≥ 229 per 100,000 and at ≥ 3 positive healthcare workers. Conclusions: Beyond fixed risk factors, shared with the general population, the increased and heterogeneous proportion of positive patients is related to the center’s testing policy, the number of positive patients and healthcare workers, and to contextual effects at the province level. Nephrology centers may adopt simple decision rules to strengthen containment measures timely.

Published
2021

4. Meritocracy

Author

Quintaliani, G. and Quintaliani, G.

Abstract

No abstract (Clinical_Management), non disponibile (Clinical_Management)

Published
2018

5. ICT in Health: old problems and new challenges

Author

Quintaliani, G., Torpia, R., Giovannelli, M., Orecchini, A., De Angelis, L., Quintaliani, G., Torpia, R., Giovannelli, M., Orecchini, A., and De Angelis, L.

Abstract

No abstract (Clinical_Management), non disponibile (Clinical_Management)

Published
2018

7. Conservative Treatment of CKD' Study Group of the Italian Society of Nephrology. Controversial issues in CKD clinical practice: position statement of the CKD-treatment working group of the Italian Society of Nephrology

Author

Bellizzi, V, Conte, G, Mandreoli, M, Borrelli, S, Cupisti, A, De Nicola, L, Di Iorio, Br, Cabiddu, G, Paoletti, E, Piccoli, Gb, Quintaliani, G, Ravera, M, Santoro, Domenico, Torraca, S, and Minutolo, R.

Subjects
Position statement CKD Renal biopsy Diabetes RAAS Iron Salt intake Protein intake Low protein diet Bicarbonate Overweight Obesity Conservative therapy
Published
2017

13. Pazienti con insufficienza renale cronica:risultati dallo studio Nefrodata®

Author

Cupisti, A., Bottai, A., Bellizzi, V., Brunori, G., Cianciaruso, B., De Nicola, L., Oldrizzi, L., Quintaliani, G., Santoro, D., Rapisarda, Francesco, Di Iorio, B., NefroData Study Group: Loreto Gesualdo, Castellino, Dea Saulle P., Fatuzzo, Pasquale Mario, Bonofiglio, F. Rapisarda R., Lofaro, D., Rosati, F. Armentano A., Coppola, G. Rosso S. Chimienti S., De Blasio, Cesaro A. L. Bozzoli A., Sirico, M., and Di Micco, L.

Subjects
malattia renale cronica, dieta, ckd, epidemiologia, terapia, ckd, dieta, epidemiologia, malattia renale cronica, terapia
Published
2015

14. Survival in patients treated by long-term dialysis compared with the general population

Author

Nordio, M, Limido, A, Maggiore, U, Nichelatti, M, Postorino, M, Quintaliani, G, Italian, Dialysis, Transplantation Registry Collaborators: Molino, Italian Dialysis, Collaborators: Molino A, Transplantation R. e. g. i. s. t. r. y., Salomone, M, Cappelli, Gianni, Conte, F, Arosio, E, Antonucci, F, Giacon, B, Adorati, M, Romanini, D, Santoro, A, Mancini, E, Rosati, A, Frascà, Gm, Gaffi, G, Standoli, M, Bonomini, M, Di Liberato, L, Di Giulio, S, Cirillo, M, Bilancio, G, Schena, Fp, Torres, D, Casino, F, Zoccali, C, Marino, C, Sparacino, V, Agnello, V, Pinna, A. m., Nordio, M, Limido, A, Maggiore, U, Nichelatti, M, Postorino, M, Quintaliani, G, Molino, A, Salomone, M, Cappelli, G, Conte, F, Arosio, E, Antonucci, F, Giacon, B, Adorati, M, Romanini, D, Santoro, A, Mancini, E, Rosati, A, Frascà, Gm, Gaffi, G, Standoli, M, Bonomini, M, Di Liberato, L, Di Giulio, S, Cirillo, Massimo, Bilancio, G, Schena, F, P, Torres, D, Casino, F, Zoccali, C, Marino, C, Sparacino, V, Agnello, V, and Pinna, A. M.

Subjects
Adult, Male, medicine.medical_specialty, Time Factors, dialysis registry, medicine.medical_treatment, Population, Relative survival, Risk Assessment, Peritoneal dialysis, Cohort Studies, Young Adult, Renal Dialysis, Cause of Death, Internal medicine, medicine, Humans, Registries, Renal replacement therapy, Mortality, education, excess mortality rate, Dialysis, Survival analysis, Aged, Retrospective Studies, education.field_of_study, business.industry, Mortality rate, Retrospective cohort study, Middle Aged, Prognosis, Long-Term Care, Survival Analysis, Surgery, Italy, Nephrology, Kidney Failure, Chronic, Female, business
Abstract

BACKGROUND: Relative survival, a methodology previously used in epidemiologic studies of cancer, compares the observed survival of a patient cohort with expected survival derived from general population life tables. We examined relative survival in patients treated by long-term dialysis in the Italian Dialysis and Transplantation Registry in order to determine the prognosis of dialysis patients. STUDY DESIGN: Cohort study drawn from a registry. SETTING & PARTICIPANTS: Patients enrolled in the Italian Dialysis and Transplantation Registry. FACTORS: Sex, age, primary kidney disease, renal replacement therapy modality, and main comorbid conditions. OUTCOMES: Death from any cause. MEASUREMENTS: Relative survival ratio (the ratio of observed survival in the population of interest to the survival expected given the age- and period-specific mortality of the general population) and excess mortality rate (difference between observed and expected mortality rates). RESULTS: In January 2000 to December 2008, a total of 27,642 patients were included. The 5-year relative survival estimate was 55.6% (95% CI, 54.7%-56.5%). The excess mortality rate showed a peak at 3 months (21 deaths/100 patient-years), then decreased, becoming constant from the end of year 1 to year 8, with leveling off at about 10 deaths/100 patient-years. Older age, systemic diseases, and diabetes showed the strongest association with excess mortality. Peritoneal dialysis was associated with a lower relative excess risk in only the first year of treatment. LIMITATIONS: The patient cohort comprises about half the Italian patients beginning dialysis therapy in the period. CONCLUSIONS: This study highlights the applicability of relative survival methods in dialysis patients. This measure allows estimation of disease prognosis and severity comparisons among chronic diseases. The excess mortality rate appears to be a more sensitive and informative measure than the simple proportion of survivors.

Published
2012

15. Management of CKD-MBD in non-dialysis patients under regular nephrology care: a prospective multicenter study

Author

Gallieni, M., De Luca, N., Santoro, D., Meneghel, G., Formica, M., Grandaliano, Giuseppe, Pizzarelli, F., Cossu, M., Segoloni, G., Quintaliani, G., Di Giulio, S., Pisani, A., Malaguti, M., Marseglia, C., Oldrizzi, L., Pacilio, M., Conte, G., Dal Canton, A., Minutolo, R., Grandaliano G. (ORCID:0000-0003-1213-2177), Gallieni, M., De Luca, N., Santoro, D., Meneghel, G., Formica, M., Grandaliano, Giuseppe, Pizzarelli, F., Cossu, M., Segoloni, G., Quintaliani, G., Di Giulio, S., Pisani, A., Malaguti, M., Marseglia, C., Oldrizzi, L., Pacilio, M., Conte, G., Dal Canton, A., Minutolo, R., and Grandaliano G. (ORCID:0000-0003-1213-2177)

Abstract

Background: Knowledge about mineral bone disorder (MBD) management in non-dialysis chronic kidney disease (ND-CKD) patients is scarce, although essential to identifying areas for therapeutic improvement. Methods: We prospectively evaluated current management of CKD-MBD in two visits, performed 6 months apart, in 727 prevalent ND-CKD stage 3b–5 patients from 19 nephrology clinics. Therapeutic inertia was defined as lack of treatment despite hyperphosphatemia and/or hypocalcemia, and/or hyperparathyroidism. The primary endpoint was the prevalence of achieved target for CKD-MBD parameters and related treatments (phosphate binders, vitamin D and calcium supplements). The secondary endpoint was the assessment of prevalence and clinical correlates of therapeutic inertia. Results: Over 65 % of patients did not reach parathormone (PTH) targets, while 15 and 19 % did not reach phosphate and calcium targets, respectively. The proportion of untreated patients decreased from stage 3b to 5 (at baseline, from 60 to 16 %, respectively). From baseline to the 6-month visit, the achievement of targets remained stable. Low protein diet was prescribed in 26 % of patients, phosphate binders in 17.3 % (calcium-based binders 15.5 %, aluminium binders 1.8 %), and vitamin D in 50.5 %. The overall prevalence of therapeutic inertia at the 6-month visit was 34.0 % (for hyperphosphatemia, 54.3 %). Compared to CKD stage 3, the likelihood of therapeutic inertia was 40 and 68 % lower at stage 4 and 5, respectively. Conclusions: PTH, calcium and phosphate targets were not reached in a significant proportion of patients. One-third of patients with at least one MBD parameter not-at-target remained untreated. Therapeutic inertia regarding CKD-MBD treatment may be a major barrier to optimizing the prevention and cure of CKD-MBD.

Published
2016

17. Anaemia management in non-dialysis chronic kidney disease (CKD) patients: a multicentre prospective study in renal clinics

Author

Dal Canton, ., Esposito, V., Formica, M., Segoloni, G., Gallieni, M., Locatelli, F., Tarchini, R., Meneghel, G., Oldrizzi, L., Cossu, M., Di Giulio, S., Malaguti, M., Pizzarelli, F., Quintaliani, G., Cianciaruso, B., Pisani, A., Conte, G., De Nicola, L., Minutolo, R., Bonofiglio, R., Fuiano, G., Grandaliano, G., Bellinghieri, Guido, Santoro, Domenico, Minutolo, Roberto, Locatelli, F, Gallieni, M, Bonofiglio, R, Fuiano, G, Oldrizzi, L, Conte, Giuseppe, DE NICOLA, Luca, Mangione, F, Esposito, P, Dal Canton, A, and REport of COmorbidities in non Dialysis Renal Disease Population in Italy Study, Group

Subjects
Nephrology, Male, medicine.medical_specialty, Anemia, medicine.medical_treatment, Iron, Renal function, Hemoglobins, Renal Dialysis, hemic and lymphatic diseases, Internal medicine, medicine, Clinical endpoint, Prevalence, Humans, Prospective Studies, Renal Insufficiency, Chronic, Erythropoietin, Aged, Transplantation, Transferrin saturation, business.industry, Iron deficiency, medicine.disease, Italy, Dietary Supplements, Ferritins, Female, Hemodialysis, business, Kidney disease
Abstract

Background: Knowledge on anaemia management in non-dialysis chronic kidney disease (ND-CKD) patients regularly followed in renal clinics is scarce although being essential to identifying areas of therapeutic improvement. Methods: We prospectively evaluated anaemia management in two visits, performed 6 months apart, in 755 prevalent ND-CKD stage 3b-5 patients followed in 19 nephrology clinics from ≥6 months. Anaemia was defined as severe (Hb

Published
2013

19. Awareness of albuminuria in an Italian population-based cohort of patients treated with hypoglycemic drugs

Author

Lilli P, Bartolucci S, Quintaliani G, Degli Esposti E, Didoni G, Di Turi R, Degli Esposti L, Stefano Buda, Stefania Saragoni, and Alessandra Sturani

Subjects
Adult, Male, medicine.medical_specialty, Health Knowledge, Attitudes, Practice, Time Factors, Attitude of Health Personnel, Population, Drug Prescriptions, Cohort Studies, chemistry.chemical_compound, Internal medicine, Diabetes mellitus, Epidemiology, medicine, Prevalence, Albuminuria, Humans, Hypoglycemic Agents, Diabetic Nephropathies, Medical prescription, education, Antihypertensive Agents, Aged, Hypolipidemic Agents, Retrospective Studies, Aged, 80 and over, Creatinine, education.field_of_study, Analysis of Variance, Chi-Square Distribution, business.industry, Awareness, Middle Aged, medicine.disease, Surgery, Regimen, chemistry, Diabetes Mellitus, Type 2, Italy, Nephrology, Cohort, Disease Progression, Female, medicine.symptom, business, Platelet Aggregation Inhibitors
Abstract

Background: Albuminuria is a powerful predictor of renal and cardiovascular outcomes in type 2 diabe- tes and a good indicator of the evolution of renal dis- ease. Our aim was to obtain information concerning the identification of albuminuria as well as the utiliza- tion of antihypertensive, lipid-lowering and antiplatelet drugs in patients with diabetes. Methods: Subjects were enrolled from individuals reg- istered with 3 Italian local health units by querying the drugs reimbursable, hospital laboratory investigation and hospital discharge databases. The determination of albumin to creatinine ratio (ACR) throughout 2007 and 2008 was defined as the index date. Patients who received at least 2 prescriptions of hypoglycemic drugs in the 12 months before the index date were classified as diabetics. We looked also for prescriptions of anti- hypertensive, lipid-lowering and antiplatelet drugs. Results: Among a population of 701,133 subjects, we identified 29,350 patients with diabetes (4.2% of the cohort). ACR had been determined in 5,644 diabetic subjects (19.2% of that cohort). The prevalence of de- termination of ACR in nontreated subjects was 16.0%, while in treated subjects, it ranged from 13.6% to 34.9% according to different schedules of treatment. Drugs acting on the renin-angiotensin system were prescribed in more then 80% of diabetics. The ratio of angiotensin receptor blockers to angiotensin-con- verting enzyme inhibitors regimen was 0.64 in subjects without determination of ACR, 0.88 in subjects with normal albuminuria, 1.02 in subjects with microalbu- minuria and 1.43 in subjects with macroalbuminuria. Conclusions: Our methodology can easily be applied to obtain an epidemiological view of albuminuria and pharmacological treatments of diabetics in a general population.

Published
2011

23. Chronic kidney disease certification process manual by the Italian Society of Nephrology (SIN): Part II: programme management and clinical information management

Author

Quintaliani, G., Gianni Cappelli, Lodetti, L., Manno, C., Petrucci, V., Spinelli, C., Tarchini, R., Virgillio, M., Faini, M., Alloatti, S., Cancarini, G., and Zoccali, C.

Subjects
Certification, Quality Assurance, Health Care, Information Management, Disease Management, Chronic Kidney Disease, certification process, Manuals as Topic, Italy, Surveys and Questionnaires, Chronic Disease, Humans, Kidney Diseases, Delivery of Health Care, Societies, Medical, Quality of Health Care
Abstract

This is the second part of a document describing a voluntary certification process based on Joint Commission International (JCI) criteria developed by the Italian Society of Nephrology (SIN) and JCI representatives. In the first part we discussed standards for clinical care delivery and performance measurements related to chronic kidney disease care. Herein (Part II), we complete the description of Performace measurements and CKD care by describing issues related the management and clinical information management.

Published
2009

24. Chronic kidney disease certification process manual by the Italian Society of Nephrology (SIN): Part I: clinical care delivery and performance measurements and improvement

Author

Quintaliani, G., Gianni Cappelli, Lodetti, L., Manno, C., Petrucci, V., Spinelli, C., Tarchini, R., Virgillio, M., Faini, M., Alloatti, S., Cancarini, G., and Zoccali, C.

Subjects
Certification, Clinical care, JCI, Care delivery, Chronic kidney disease, Clinical performance indicators, Continuous quality improvement, Quality, Data Collection, Manual, Chroinic Kidney Disease, Certification process, Nephrology, Chronic Disease, Database Management Systems, Humans, Kidney Diseases, Societies, Medical, Quality of Health Care
Abstract

Chronic kidney diseases (CKD) has now emerged as a public health priority, and there is an increasing demand by patients and health care organisations that the quality of care delivered by renal units to CKD patients be systematically monitored and evaluated. The Italian Society of Nephrology (SIN) has started an initiative aimed at promoting a quality certification process specifically focused on CKD. To this end, SIN started a collaboration with an independent Italian company which is a partner of Joint Commission International (JCI), a nonprofit international organisation dedicated to the promotion of quality improvement and safety of health services. As a result of this collaboration, a document describing a voluntary certification process developed based on JCI criteria was produced by SIN. This document comprises 2 parts. Herein (Part I) we deal with standards for clinical care delivery and performance measurements related to CKD care. Programme management and clinical information management will be presented in a separate manuscript (Part II).

Published
2009

25. [Low-protein diet in Italy today: the conclusions of the Working Group from the Italian Society of Nephrology]

Author

Cianciaruso, B, Bellizzi, V, Brunori, G, Cupisti, Adamasco, Filippini, A, Oldrizzi, L, Quintaliani, G, and Santoro, D.

Subjects
Diet, Protein-Restricted, Humans, Kidney Failure, Chronic, Congresses as Topic
Abstract

The high estimated prevalence of chronic kidney disease (CKD) forcefully supports the need for collaboration among nephrologists, cardiologists, diabetologists and general practitioners, to reduce the cardiovascular risk of CKD patients and delay the start of dialysis. Many studies confirm that reducing the dietary intake of proteins improves uremia as well as acid-base and phosphorus disorders without exposing the CKD patient to the risk of malnutrition. The possibility of delaying renal death and the start of dialysis by almost one to two years is also recognized, thanks in part to the antiproteinuric effect of low-protein diets supplemented with keto acids and essential amino acids. Reducing the dietary protein intake delays the start of dialysis independently of the effect of renin-angiotensin system (RAS)-active antihypertensive drugs. Reduction of the dietary protein intake is indicated in patients with a glomerular filtration rate25 mL/min (CKD stages 4 and 5). Some situations may, however, require an earlier switch to a low-protein diet, e.g., high proteinuria, renal function worsening at more than 5 mL/min/year, diabetes, and metabolic decompensation. If well designed and properly carried out, reduction of the dietary intake of proteins is not associated with low serum albumin levels or malnutrition, and does not affect patients death. Today, highly palatable, high-quality reduced protein preparations are widely available to reduce the protein intake of CKD patients.

Published
2008

30. Update of the Italian Society of Nephrology Project No. 1 of the 2004-2006 SIN programme

Author

Manno, C, Virgilio, M, Giangrande, A, Stalteri, A, Contu, B, Quintaliani, G, Spinelli, C, Avella, F, Cappelli, Gianni, Casino, F, Cicchetti, T, DI GIULIO, S, DI LUCA, M, Meneghel, G, Milone, F, Moriconi, L, Panzetta, Go, Procaccini, Ad, Triolo, G, Zoccali, C, and Accreditamento, COMMITTEE QUALITA E.

Subjects
Quality Control, Italian Society of Nephrology, patient satisfaction, Italy, Nephrology, Renal Dialysis, Surveys and Questionnaires, Humans, Kidney Transplantation, Accreditation
Abstract

In the last few years the Italian Society of Nephrology has addressed many technical-scientific and management aspects to better patient satisfaction. Project No. 1 of the 2004-2006 programme on 'Quality and Accreditation of National Renal Units' focuses on four essential points. The first is the questionnaire mailed to all the Presidents and Regional Delegates on the relationship between Nephrology units, Local Government Health-System and the Regional Healthcare Agency. The results evidence that the 'political' decision-making power of nephrologists decreases in the absence of a national strategy. The second point, in collaboration with the National Census Group, includes the quality analysis and the standardization of resources (human and structural) and management of the Renal Units. The third point is based on 'Educational Courses for Quality and Accreditation' held in Rome (3-5 October 2005: L'Accreditamento all'Eccellenza dell'Unita' Operativa di Nefrologia, Dialisi e Trapianto; 17-19 October 2005: Il Manuale di Accreditamento della Specialità di Nefrologia). The courses aim at training members responsible for each region to hold courses in their specific region to create a network including each single Renal Unit to create an acceptable homogenous language on the models of analysis and on the correct use of 'The Guide for Excellence Accreditation'. The fourth point concerns both the on-line Guide for Excellence Accreditation and 'Peer Review Accreditation' and the NEQUASY (Nephrology Quality System) project. The manual must be 'user friendly' allowing each Centre to self-evaluate using national and regional standards.

Published
2006

31. [Italian Registry of Dialysis and Transplantation: 1996-2001 experience]

Author

Conte, F, Cappelli, G, Casino, F, Postorino, M, Quintaliani, G, Salomone, M, DI NAPOLI, A, Limido, A, Mancini, E, Nordio, M, Pinna, A, Santoro, Domenico, Alloatti, S, Bellinghieri, G, Bonadonna, A, Bonomini, M, Colasanti, G, DI GIULIO, S, DI IORIO, B, DI LALLO, D, Gaffi, G, Gesualdo, L, Locatelli, F, Piccoli, G, Quarello, F, Riegler, P, Salvadori, M, Santoro, A, Sparano, G, Vasile, A, and Trapianto, COMMISSIONE NAZIONALE REGISTRO ITALIANO DIALISI E.

Subjects
Adult, Male, Adolescent, Italian Registry of Dialysis and Transplantation, Incidence, Infant, Newborn, Infant, epidemiological data collected, Middle Aged, Kidney Transplantation, Italy, Renal Dialysis, Child, Preschool, Prevalence, Humans, Kidney Failure, Chronic, Female, Registries, Child, Peritoneal Dialysis, Aged
Abstract

The Italian Registry of Dialysis and Transplantation (RIDT) was born in 1996 under the aegis of the Italian Society of Nephrology, and it is organized as a federation of regional registries. This study aimed to completely revise the epidemiological data collected during the first 5 yrs (1996-2001) of RIDT activity to evaluate the trends of the main epidemiological features. During this period, regional registries were not always able to assure complete and exhaustive information according to RIDT requirements, owing to different levels of organization and functioning. To avoid any possible error in data analysis, information inadequately assessed was refused. The incidence of end-stage renal disease (ESRD) patients on renal replacement therapy (RRT) in Italy has increased from 114 pmp in 1996 to 139 pmp in 2001, that means an increase of 3.5%/yr, corresponding to 5718 patients during 1996 and 8000 patients during 2001. Primary renal diseases (according to the EDTA) in incident ESRD patients are vascular and diabetic nephropathy. Main dialysis modality in incident patients was hemodialysis (HD) (85%), while peritoneal dialysis (PD) was only 15%; pre-emptive transplantation was a very unusual modality. The prevalence of ESRD patients at 31 December was 693 pmp in 1996 and 827 pmp in 2001; among dialysis patients, the corresponding rates were 575 pmp and 657 pmp, respectively. Consequently, the number of dialyzed patients increased, respectively, from 28892 to 37919. The prevalent dialysis modality was bicarbonate dialysis in 74% of cases, followed by hemodiafiltration (HDF) in 15%, continuous ambulatory peritoneal dialysis (CAPD) in 7% and APD in 3%. The gross mortality rate in dialyzed patients was stable during this period, at approximately 14%, the main causes of death being cardiovascular diseases and cachexia.

Published
2004

38. Linee Guida per la terapia conservativa dell’insufficienza renale cronica

Author

Barsotti, G, Oldrizzi, L, Gentile, Mg, Del Vecchio, L, De Marchi, S, De Pascale, C, De Vecchi, A, Enia, G, Fuiano, G, Gallucci, M, Garibotto, Giacomo, Maggiore, Q, Mangiacapra, S, Panarello, G, Poggi, A, Quintaliani, G, Salvadori, M, Terracciano, V, Timio, M, and Tizianello, A.

Subjects
insufficienza renale cronica, linee guida, insufficienza renale cronica, linee guida
Published
1999

39. Nutrition / inflammation

Author

Wong, M. M. Y., primary, Thijssen, S., additional, Usvyat, L. A., additional, Kotanko, P., additional, Maddux, F. W., additional, Speer, T., additional, Rohrer, L., additional, Blyzszuk, P., additional, Krankel, N., additional, Zewinger, S., additional, Martin, T., additional, von Eckardstein, A., additional, Luscher, T., additional, Landmesser, U., additional, Fliser, D., additional, Prats, M., additional, Font, R., additional, Garcia, C., additional, Cabre, C., additional, Jariod, M., additional, Martinez Vea, A., additional, Costa, E., additional, Ribeiro, S., additional, do Sameiro-Faria, M., additional, Rocha-Pereira, P., additional, Kohlova, M., additional, Fernandes, J., additional, Reis, F., additional, Miranda, V., additional, Quintanilha, A., additional, Bronze-da-Rocha, E., additional, Belo, L., additional, Santos-Silva, A., additional, Nascimento, H., additional, Schepers, E., additional, Glorieux, G., additional, Van den Abeele, T., additional, Neirynck, N., additional, Vanholder, R., additional, Boelaert, J., additional, Liabeuf, S., additional, Massy, Z., additional, Kaynar, K., additional, Kural, B. V., additional, Ulusoy, S., additional, Cansiz, M., additional, Akcan, B., additional, Misir, N., additional, Yaman, S., additional, Kaya, N., additional, Dimas, G. G., additional, Iliadis, F. S., additional, Tegos, T. J., additional, Spiroglou, S. G., additional, Pitsalidis, C. G., additional, Karamouzis, I. M., additional, Didaggelos, T. P., additional, Adamidou, A. P., additional, Savopoulos, C. G., additional, Karamouzis, M. I., additional, Orologas, A. G., additional, Hatzitolios, A. I., additional, Grekas, D. M., additional, Flisinski, M., additional, Brymora, A., additional, Stefanska, A., additional, Strozecki, P., additional, Manitius, J., additional, Khalfina, T. N., additional, Maksudova, A. N., additional, Valeeva, I. K., additional, Bantis, C., additional, Kouri, N.-M., additional, Bamichas, G., additional, Stangou, M., additional, Tsantekidou, E., additional, Natse, T., additional, Fazio, M. R., additional, Basile, G., additional, Lucisano, S., additional, Montalto, G., additional, Valeria, C., additional, Donato, V., additional, Lupica, R., additional, Trimboli, D., additional, Aloisi, C., additional, Buemi, M., additional, Henze, A., additional, Raila, J., additional, Scholze, A., additional, Schweigert, F., additional, Tepel, M., additional, Nakamichi, R., additional, Prates, E., additional, Redublo Quinto, B. M., additional, Zanella, M. T., additional, Batista, M. C., additional, Masajtis-Zagajewska, A., additional, Kurnatowska, I., additional, Wajdlich, M., additional, Nowicki, M., additional, Mennini, F., additional, Russo, S., additional, Marcellusi, A., additional, Quintaliani, G., additional, Andrulli, S., additional, Chiavenna, C., additional, Bigi, M. C., additional, Tentori, F., additional, Crepaldi, M., additional, Corti, M. M., additional, Dell'Oro, C., additional, Bacchini, G., additional, Limardo, M., additional, Pontoriero, G., additional, Williams, C., additional, Abbas, S. R., additional, Zhu, F., additional, Flores-Gama, C., additional, Moskowitz, J., additional, Cartagena, C., additional, Carter, M., additional, Levin, N., additional, de Oliveira, R. B., additional, Okazaki, H., additional, Lenglet, A., additional, Desjardins, L., additional, Lemke, H.-D., additional, Valholder, R., additional, Choukroun, G., additional, and Massy, Z. A., additional

Published
2013
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42. Multidisciplinarity could be a growth opportunity for nephrolithiasis

Author

Lombardi, M., Miceli, M., Amodei, A., Guerrini, B., Marianelli, R.B., Palazzo, S., Terragni, S., Marzocca, U., Quintaliani, G., Lombardi, M., Miceli, M., Amodei, A., Guerrini, B., Marianelli, R.B., Palazzo, S., Terragni, S., Marzocca, U., and Quintaliani, G.

Abstract

No abstract, non disponibile

Published
2004

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