Publications by authors named "Anna Di Sessa"
The role of obesity as a risk factor for chronic kidney disease (CKD) in adulthood has been well established. Over the last years, kidney damage (KD) has emerged as a significant consequence of obesity since childhood. Indeed, a complex interplay of metabolic factors, including insulin resistance (IR), hypertension, oxidative stress, adipose tissue dysfunction, and systemic inflammation, might affect renal hemodynamics, contributing to CKD development over time in at-risk young patients.
View Article and Find Full Text PDFNephrogenic diabetes insipidus (NDI) results from the kidneys' inability to concentrate urine. We describe a 6-month-old male with a history of poor weight gain who presented with an incidental finding of hypernatremia (155 mEq/L) during an episode of acute gastroenteritis. The arginine vasopressin (AVP) test, along with molecular analysis revealing the M272R mutation in the AVP receptor 2 (AVPR2) gene, confirmed the diagnosis of congenital NDI.
View Article and Find Full Text PDFThe pediatric definition of severe obesity (OB) depends on the body mass index (BMI) references. We evaluated different BMI-derived metrics of the World Health Organization (WHO) system to define which cut-off is associated with the highest cardiometabolic risk (CMR); In this multicentric study, data were retrieved for 3727 youths (1937 boys; 2225 children, 1502 adolescents). OB was defined as BMI > 97th percentile (BMI), severe OB was defined as BMI > 99th percentile (BMI), BMI ≥ 120% of the 97th percentile (120% BMI), or BMI Z-score > 3 (WHO tables), or BMI ≥ the International Obesity Task Force (IOTF) value crossing a BMI of 35 kg/m at the age of 18 (IOTF).
View Article and Find Full Text PDFObjectives: Evidence linked metabolic associated steatotic liver disease (MASLD) to kidney damage with the potential contribution of the I148M variant of the Patatin-like phospholipase containing domain 3 (PNPLA3) gene. We aimed at investigating the relationship of MASLD and of its genetics with kidney function in children with obesity.
Methods: A comprehensive evaluation including genotyping for the I148M PNPLA3 polymorphism was performed in 1037 children with obesity.
Background: Pediatric obesity treatment is based on high-intensity lifestyle counseling. However, high dropout rates and low effectiveness have been reported, even in specialized centers. Mobile health technologies have been used to overcome these limits with contrasting results.
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- The study evaluated Friedewald's and Sampson's formulas for measuring LDL-Cholesterol (LDL-C) in overweight and obese youths aged 5-17 in Italy, involving a total of 1,694 participants from two centers.
- Results indicated that both formulas were highly accurate in estimating LDL-C levels, with comparable sensitivity and specificity, though Friedewald's formula had a higher positive predictive value.
- The authors concluded that calculated LDL-C is a practical tool for screening adolescents, particularly favoring Friedewald's formula due to its simplicity in clinical settings.
Article Synopsis
- Childhood obesity continues to rise globally despite preventive measures, posing significant risks for cardiovascular and metabolic diseases.
- Early onset of obesity increases long-term exposure to health risks, including severe cardiovascular issues that can occur as early as age 40.
- Recommendations include early detection and treatment of related health conditions, promoting weight loss to reduce risks, and monitoring for long-term health management.
Article Synopsis
- Researchers looked at children in Italy who were hospitalized for a urinary infection and checked their sodium (Na) and potassium (K) levels.
- They found that 23% of the kids had low sodium, while some had high potassium or both low sodium and high potassium.
- The study also discovered that specific levels in the blood and age were linked to these imbalances, with the most common issue being low sodium.
Article Synopsis
- Researchers studied how heart rate changes (called EHRV) can help predict dehydration and kidney problems in kids at the hospital.
- They tested 256 children from July 2022 to August 2023 and found that a higher EHRV could mean a greater risk of dehydration or kidney issues.
- The study concluded that if a child's EHRV is over 24.5%, doctors might need to check for these health problems, but more studies are needed to be sure.
Article Synopsis
- - The study evaluated the effectiveness, safety, and immune response of Etanercept (ETA) and Adalimumab (ADA) biosimilars in children with juvenile idiopathic arthritis compared to their original drug versions.
- - After 24 months, children treated with biosimilars showed significantly lower disease activity scores and fewer harmful antibodies compared to those on the original drugs, indicating better treatment outcomes.
- - The safety of biosimilars was similar to the originators, but further research with a larger sample size is necessary to confirm these findings.
Article Synopsis
- Acute kidney injury (AKI) in children is often overlooked and poses significant challenges in pediatric healthcare, with various causes including renal damage and inflammation.
- Diagnosis typically uses traditional markers like serum creatinine, as well as new biomarkers such as Cystatin C and NGAL, which help identify AKI more effectively.
- Treatment focuses on supportive care and fluid management, with severe cases potentially requiring renal replacement therapy; raising awareness and incorporating new diagnostic tools could enhance outcomes for affected children.
Background: We aimed to evaluate the baseline performance and improvement of ChatGPT-4 "omni" (ChatGPT-4o) and Gemini 1.5 Flash (Gemini 1.5) in answering multiple-choice questions related to pediatric nephrology after specific training.
View Article and Find Full Text PDFAim: To assess the prevalence and determinants of failure to thrive (FTT) among patients with vesico-ureteral reflux (VUR) and evaluating the effects of supplementation on growth in patients with urinary solute losses.
Methods: We retrospectively enrolled 1277 patients with VUR (mean age at diagnosis = 6.5 months).
Unlabelled: The role of obesity as risk factor for chronic kidney disease (CKD) has been well-recognized. As previously demonstrated in adults, emerging data highlighted the relevant impact of obesity on renal function since childhood. As a matter of fact, obesity also affects renal health through a complex pathogenic mechanism in which insulin resistance (IR) plays a pivotal role.
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- The study aimed to compare the characteristics and outcomes of "occult" vesicoureteral reflux (VUR) found through isotopic cystography (IC) versus those identified by voiding cystourethrography (VCUG) in male children.*
- In a sample of 421 boys, 11.2% were diagnosed with occult VUR, and these patients had significant risks for kidney injury (KI) and febrile urinary tract infections (fUTI), with many showing more severe VUR characteristics.*
- The findings suggest that IC can help identify those with hidden VUR who may need surgical intervention, highlighting the need for careful screening in boys with recurrent fUTIs.*
Article Synopsis
- The study aimed to assess the prevalence and risk factors for acute kidney injury (AKI) in children hospitalized for febrile urinary tract infections (fUTI), and to determine if AKI could indicate underlying vesicoureteral reflux (VUR).
- Out of 849 children studied, 14.6% developed AKI, with a higher prevalence of 30% in those having congenital anomalies of the kidney and urinary tract (CAKUT).
- AKI was identified as a strong predictor for VUR, even after accounting for other diagnostic factors, indicating its relevance in evaluating children with fUTI.