SARS-CoV-2 Infections and COVID-19 Fatality: Estimation of Infection Fatality Ratio and Current Prevalence.

COVID-19 is one of the most important problems for public health, according to the number of deaths associated to this pathology reported so far. However, from the epidemiological point of view, the dimension of the problem is still unknown, since the number of actual cases of SARS-CoV-2 infected people is underestimated, due to limited testing. This paper aims at estimating the actual Infection Fatality Ratio (number of deaths with respect to the number of infected people) and the actual current prevalence (number of infected people with respect to the entire population), both in a specific population and all over the world.

[Calcific uremic arteriolopathy (Calcyphilaxis): a rare disease? Report of three cases].

Introduction: Calcific uremic arteriolopathy (CUA; CALCYPHILAXIS) is a syndrome that occurs prevalently in patients with chronic kidney disease on dialysis. It is characterized by the medial calcification of skin small arteries leading to necrotic lesions. Several risk factors have been identified: obesity, female gender, diabetes mellitus, hyperphosphatemia, inflammation, treatment with vitamin D, calcium-based phosphate binders and warfarin.

Effects of phosphorus-restricted diet and phosphate-binding therapy on outcomes in patients with chronic kidney disease.

Background: Phosphorus is associated with mortality in patients with chronic kidney disease (CKD) not on dialysis, possibly through phosphorus-dependent vascular calcification. Although a phosphorus-restricted diet reduces serum phosphorus, it is unlikely that it reduces vascular calcification progression in CKD. This study evaluated whether a combined strategy of phosphorus-restricted diet and phosphate-binding therapy can reduce the risk of all-cause mortality and/or dialysis initiation by attenuating coronary artery calcification (CAC) progression in non-dialysis CKD patients.

Plasma p-cresol lowering effect of sevelamer in peritoneal dialysis patients: evidence from a Cross-Sectional Observational Study.

p-Cresol is a by-product of the metabolism of aromatic aminoacid operated by resident intestinal bacteria. In patients with chronic kidney disease, the accumulation of p-cresol and of its metabolite p-cresyl-sulphate causes endothelial dysfunction and ultimately increases the cardiovascular risk of these patients. Therapeutic strategies to reduce plasma p-cresol levels are highly demanded but not available yet.

Blood pressure variability and outcomes in chronic kidney disease.

Background: We investigated the effects of visit-to-visit systolic blood pressure variability (SBPV) on both mortality and dialysis inception in a cohort of chronic kidney disease (CKD) patients not requiring dialysis therapy. Furthermore, we also explored the carry-over effect of visit-to-visit SBPV on mortality after dialysis initiation.

Methods: We conducted a longitudinal retrospective, observational, multi-centre study in three tertiary care nephrology outpatient clinics.

Human mature adipocytes express albumin and this expression is not regulated by inflammation.

Aims: Our group investigated albumin gene expression in human adipocytes, its regulation by inflammation and the possible contribution of adipose tissue to albumin circulating levels.

Methods: Both inflamed and healthy subjects provided adipose tissue samples. RT-PCR, Real-Time PCR, and Western Blot analysis on homogenates of adipocytes and pre-adipocytes were performed.

Evidence on the prevalence and geographic distribution of major cardiovascular risk factors in Italy.

Objective: To assess the prevalence and geographic distribution of major cardiovascular risk factors in a large community-wide sample of the Italian population.

Design: A cross-sectional survey. Standardized methods were used to collect and measure cardiovascular risk factors.

Variability of blood pressure in dialysis patients: a new marker of cardiovascular risk.

Background: Hemodialysis patients have a high cardiovascular mortality, and hypertension is the most prevalent treatable risk factor. We aimed to assess the predictive significance of dialysis-to-dialysis variability in blood pressure in hemodialysis patients.

Methods: We performed a historical cohort study in 1,088 prevalent hemodialysis patients, followed up for 5 years.

Acute effects of very-low-protein diet on FGF23 levels: a randomized study.

Background And Objectives: High levels of fibroblast growth factor 23 are associated with mortality, CKD progression, and calcification in CKD patients. The aim of this pilot study is to assess whether a very-low-protein diet (0.3 g/kg per day) with a consequent low intake of phosphorus would reduce fibroblast growth factor 23 compared with a low-protein diet (0.

Dialysate bath and QTc interval in patients on chronic maintenance hemodialysis: pilot study of single dialysis effects.

Introduction: Serum concentrations of potassium (K) and calcium (Ca) influence ionic currents and play an important role in the duration of ventricular action potential. Further, the influence of alkalosis in reducing ionized calcium has been well known for a long time. The aim of this study was to assess the effects of different dialysate electrolytes and bicarbonate concentrations on changes of QTc interval in patients on chronic hemodialysis.

Progression of coronary artery calcification and cardiac events in patients with chronic renal disease not receiving dialysis.

We tested for the presence of coronary calcifications in patients with chronic renal disease not on dialysis and studied its progression in 181 consecutive non-dialyzed patients who were followed for a median of 745 days. Coronary calcifications (calcium score) were tallied in Agatston units by computed tomography, and the patients were stratified into two groups by their baseline calcium score (100 U or less and over 100 U). Survival was measured by baseline calcium score and its progression.

Effect of a low- versus moderate-protein diet on progression of CKD: follow-up of a randomized controlled trial.

Background: Whether low-protein-diet (LPD) as opposed to moderate-protein-diet (MPD) regimens improve the long-term survival of patients with chronic kidney disease (CKD) or induce protein-caloric malnutrition is unknown.

Study Design: Intention-to-treat analysis of follow-up data from a randomized controlled trial.

Setting & Participants: 423 patients with CKD (stages 4-5) were randomly assigned between January 1999 and January 2003 and followed up until December 2006 or death.

Setting dialysis start at 6.0 ml/min/1.73 m2 eGFR--a study on safety, quality of life and economic impact.

Background: End-stage renal disease care requires enormous economic resources. A timely dialysis start could reduce the costs of the renal replacement therapy (RRT). Our aim was to measure the time to dialysis in CKD patients, with an estimated glomerular filtration rate (eGFR) View Article and Find Full Text PDF

Epoetin therapy and hemoglobin level variability in nondialysis patients with chronic kidney disease.

Background And Objectives: Intrapatient variability of hemoglobin (Hb) is a newly proposed determinant of adverse outcome in chronic kidney disease (CKD). We evaluated whether intensity of epoetin therapy affects Hb variability and renal survival in nondialysis CKD.

Design, Setting, Participants, & Measurements: We calculated the individual therapeutic index (TI) for epoetin (EPO; difference between rates of visits that required EPO dosage change and those with effective EPO change) from 1198 visits during the first year of EPO in 137 patients.

Beneficial effects of better control of secondary hyperparathyroidism with paricalcitol in chronic dialysis patients.

Background: Treatment of secondary hyperparathyroidism (SHPT) with calcitriol is often limited by the occurrence of hypercalcemia, hyperphosphatemia and risk of vascular calcifications. Paricalcitol, a vitamin D analogue with lower calcemic and phosphatemic effects, is successfully utilized in dialysis patients, although some uncertainty remains about the optimal dosage. Amelioration of survival in hemodialysis patients has been correlated to the use of calcitriol and, even better, paricalcitol.

Metabolic effects of two low protein diets in chronic kidney disease stage 4-5--a randomized controlled trial.

Background: International guidelines have not reached a complete agreement about the optimal amount of dietary proteins in chronic kidney disease(CKD). The aim of this study was to compare, with a randomized-controlled design, the metabolic effects of two diets with different protein content (0.55 vs 0.

Stability of target hemoglobin levels during the first year of epoetin treatment in patients with chronic kidney disease.

Background And Objectives: Instability of hemoglobin levels during epoetin therapy is a new problem in hemodialysis. We evaluated extent and correlates of time in target, that is, the time spent with hemoglobin > or = 11 g/dl during the first year of epoetin and its association with renal survival.

Design, Setting, Participants, & Measurements: Data were collected in 917 visits for 12.

Sleep quality in patients with chronic renal failure: a 3-year longitudinal study.

Background: Despite the high prevalence of sleep disorders in patients with kidney disease, no relationship has been demonstrated between sleep quality and the degree of renal function in cross-sectional studies. A prospective trial was, therefore, started in patients with chronic renal failure (CRF) to evaluate whether a link exists between the modifications of these parameters observed during a three-year follow-up period.

Methods: Sleep quality was determined by the Pittsburgh Sleep Quality Index (PSQI) at baseline and after two and three years (Time 0, 2 and 3, respectively) in 78 patients with various degrees of CRF in association with the main clinical and biochemical variables.

Management of cardiovascular risk factors in advanced type 2 diabetic nephropathy: a comparative analysis in nephrology, diabetology and primary care settings.

Objectives: Advanced diabetic nephropathy (DN) is characterized by a marked development of cardiovascular and renal disease. These patients are frequently managed by different health professionals with the consequence that the quality of care may differ substantially. To compare the management of cardiovascular risk factors in patients with type 2 DN and an estimated glomerular filtration rate (GFR) of 15-60 ml/min per 1.