Expanded Hemodialysis Enhancement in Middle Molecule Clearance for Patients With Low Blood Flow Rates of Tunneled Dialysis Catheters.

Introduction: Expanded hemodialysis (HDx), being based on medium cut-off (MCO) membranes, improves the removal of medium molecule uremic toxins. HDx efficacy has been proven with blood flow rates (Qb) of 350-400 ml/min, while low Qb have only been assessed in single sessions. We evaluated the effectiveness of HDx in patients with tunneled central venous catheters (CVCs) and low Qb over six months, comparing it with high-flux hemodialysis (HF-HD).

Thrombotic Microangiopathy and Multiple Organ Failure in Scleroderma Renal Crisis: A Case Report.

This case report can be considered a rare occurrence of scleroderma renal crisis (SRC) presenting with a severe clinical course and multiple organ failure. A patient diagnosed with systemic sclerosis four years earlier was admitted to the hospital because of severe malignant systolic-diastolic arterial hypertension and acute kidney injury (AKI). Exacerbating disease suggested thrombotic microangiopathy (TMA) and the PLASMIC (Platelet count; combined hemoLysis variable; absence of Active cancer; absence of Stem-cell or solid-organ transplant; MCV; INR; Creatinine) score was used in the differential diagnosis.

[Nutritional and Functional assessment of peritoneal dialysis patients in the clinical practice: Report from MITO-DP Group].

Nutritional abnormalities and physical inactivity are risk factors of increased morbidity and mortality in patients with ESRD. Identify and define malnutrition, in particular protein-energy depletion (PEW), is an important task in the management of renal patients. The aim of this multicenter observational study was to implement the assessment of nutritional status and functional capacity in patients on peritoneal dialysis, including tests and validated methods which are relatively easy to apply in daily clinical practice.

Effects of vitamin D3 and paricalcitol on immature cardiomyocytes: a novel role for vitamin D analogs in the prevention of cardiovascular diseases.

Cardiovascular diseases are more prevalent in patients with chronic kidney disease than in the general population and they are considered the leading cause of death in patients with end-stage renal disease. The discovery that vitamin D3 plays a considerable role in cardiovascular protection has led, in recent years, to an increase in the administration of therapies based on the use of this molecule; nevertheless, several studies warned that an excess of vitamin D3 may increase the risk of hypercalcemia and vascular calcifications. In this study we evaluated the effects of vitamin D3, and of its selective analog paricalcitol, on immature cardiomyocytes.

Effect of paricalcitol and GcMAF on angiogenesis and human peripheral blood mononuclear cell proliferation and signaling.

Background: In addition to its role in calcium homeostasis and bone mineralization, vitamin D is involved in immune defence, cardiovascular function, inflammation and angiogenesis, and these pleiotropic effects are of interested in the treatment of chronic kidney disease. Here we investigated the effects of paricalcitol, a nonhypercalcemic vitamin D analogue, on human peripheral blood mononuclear cell proliferation and signaling, and on angiogenesis. These effects were compared with those of a known inhibitor of angiogenesis pertaining to the vitamin D axis, the vitamin D-binding protein-derived Gc-macrophage activating factor (GcMAF).

Efficacy of eradicative radiotherapy for limited nodal metastases detected with choline PET scan in prostate cancer patients.

Aims And Background: In patients with recurrent prostate cancer, discriminating local or systemic recurrence is critical to decide second-line treatment. We investigated the capability of stereotactic body radiotherapy to treat limited nodal recurrences, detected using choline PET scan.

Methods And Study Design: Seventy-one patients with biochemical failure were studied after prostate cancer treatment: prostatectomy (28), radiotherapy (15) or both (28).

Vitamin D receptor alleles and C-reactive protein in hemodialysis patients.

Cardiovascular disease due to atherosclerosis is the major determinant of morbidity and mortality in uremic patients. Inflammation is essential in the development of atherosclerosis and markers of inflammation, in particular C-reactive protein, predict the cardiovascular risk. Vitamin D exerts its effects through the Vitamin D Receptor, coded for by a gene showing several polymorphisms associated with a variety of diseases and differential responses to Vitamin D.

A king-size dialysis bed: a couple on hemodialysis for more than 30 years.

Dialysis patients exhibit a higher morbidity and mortality rate than those in the general population of comparable age. Survival on dialysis has become significantly longer and is mainly related to comorbid factors. Patients are usually the main research subjects, but caregivers play a pivotal role in patients' well-being.

Iron indices and vitamin D receptor polymorphisms in hemodialysis patients.

Cardiovascular disease caused by accelerated atherosclerosis is the major determinant of morbidity and mortality in chronic kidney disease patients. Vitamin D and its analogs provide survival benefit for hemodialysis (HD) patients. Vitamin D exerts its effects through the vitamin D receptor (VDR) that is coded for by a gene showing several polymorphisms that, in turn, are associated with a variety of diseases and differential responses to vitamin D.

Relevance of biologically equivalent dose values in outcome evaluation of stereotactic radiotherapy for lung nodules.

Purpose: Different biologically equivalent dose (BED) values associated with stereotactic radiotherapy (SRT) of patients with primary and metastatic pulmonary nodules were studied. The BED values were calculated for tumoral tissue and low alpha/beta ratio, assuming that better local response could be obtained by using stereotactic high-BED treatment.

Methods And Materials: Fifty-eight patients with T1-T3 N0 non-small-cell lung cancer and 46 patients with metastatic lung nodules were treated with SRT.

Nutritional-inflammation status and resistance to erythropoietin therapy in haemodialysis patients.

Background: Chronic kidney disease patients who are resistant to erythropoietin (EPO) treatment may suffer from malnutrition and/or inflammation.

Methods: In a cross-sectional study of haemodialysis patients, we investigated the relationship between the natural logarithm of the weekly EPO dose normalized for post-dialysis body weight and outcome measures of nutrition and/or inflammation [BMI, albumin and C reactive protein (CRP)] by means of multiple linear regression analysis. On the basis of the decile distribution of weekly EPO doses, we also evaluated four groups of patients: untreated, hyper-responders, normo-responders and hypo-responders.

Pure red-cell aplasia in a peritoneal dialysis patient with HCV-related cryoglobulinemia in the absence of neutralizing antierythropoietin antibodies.

Pure red-cell aplasia (PRCA) in recombinant human erythropoietin (rHuEpo) treated patients is a matter of growing concern. In most cases, neutralizing anti-EPO antibodies have been detected in patient serum and held responsible for the development of PRCA. We describe a 68-year-old white woman suffering from HCV-related cryoglobulinemia and chronic kidney disease on renal replacement therapy with peritoneal dialysis.

Exposure to global system for mobile communication (GSM) cellular phone radiofrequency alters gene expression, proliferation, and morphology of human skin fibroblasts.

Human skin fibroblasts were exposed to global system for mobile communication (GSM) cellular phone radiofrequency for 1 h. GSM exposure induced alterations in cell morphology and increased the expression of mitogenic signal transduction genes (e.g.

Influence of static magnetic field on the antiproliferative effects of vitamin D on human breast cancer cells.

We describe the effect of a 0.2 tesla (T) static magnetic field generated by a magnetic resonance tomograph and of vitamin D treatment on a human breast cancer cell line (MCF-7). Cell damage and proliferation were monitored by measuring the incorporation of [3H]thymidine in duplicating DNA and by the clonogenic assay.

Lack of association between body weight, bone mineral density and vitamin D receptor gene polymorphism in normal and osteoporotic women.

In an ethnically homogeneous population of women living in Tuscany, Italy, the relationships between age, body weight, bone mineral density and the vitamin D receptor (VDR) gene polymorphism were studied, with the objective of recognizing patients at risk for osteoporosis. In 275 women bone mineral density was measured by Dual Energy X-rays Absorptiometry (DEXA). In 50 of them the individual genetic pattern for VDR was evaluated by DNA extraction followed by PCR amplification of the VDR gene, and digestion with the restriction enzyme BsmI.

Bone mineral density and anthropometric measures in normal and osteoporotic men.

In an ethnically homogeneous men population living in Tuscany, Italy, the relationship between age, height, body weight and bone mineral density were studied. In 50 men bone mineral density was measured by Dual Energy X ray Absorptiometry (DEXA). 13 subjects (26%) were osteoporotic.

Association between vitamin D receptor gene polymorphism and nephrolithiasis.

Aims: To study the distribution of vitamin D receptor (VDR) gene alleles in hypercalciuric and nonhypercalciuric nephrolithiasis patients, hypothesizing that distinct biochemical parameters would be associated with different VDR genotypes.

Methods: 12 hypercalciuric, 15 normocalciuric nephrolithiasis patients, and 150 healthy subjects were recruited. The individual genetic pattern for VDR was evaluated by DNA extraction followed by polymerase chain reaction amplification of the VDR gene and digestion with the restriction enzyme BsmI.

Vitamin D receptor gene polymorphism is associated with metastatic breast cancer.

The vitamin D receptor (VDR) has been detected in breast tumor cells. We tested the hypothesis that VDR gene polymorphism might influence the outcome of women affected by breast cancer. A total of 88 breast cancer patients were recruited: 50 women were affected by newly diagnosed breast cancer whereas 38 women suffered from relapsing disease.

Cellular proliferation and second messenger formation altered by dialysis membranes.

Background: In this study we investigated the effect of different dialysis membranes on the clonal murine haematopoietic cell line 32D cells transmembrane signalling machinary, monitored by 1,2-diacylglycerol (DAG) formation, and on their ability to respond to the physiological growth factor interleukin-3 (IL-3).

Methods: Cells were exposed to dialysers (cuprophane, CU; polysulphone, PS; cellulose diacetate, CA; polyacrylonitrile, AN69; polymethylmethacrylate, PMMA; cellulose triacetate, CT; polyamide, PA; and polycarbonate, PC); they were collected, counted, and treated with physiological amount of IL-3. Cell proliferation was monitored as incorporation of radioactivity in duplicating DNA.

[The determination of BB genotype of vitamin D receptors identifies patients at risk for osteoporosis].

The gene responsible for peak bone mass has been recently identified as the gene coding for the Vitamin D Receptor (VDR); there exist two alleles, termed "B" and "b", determining a typical allelic polymorphism. We determined the VDR genotype of 50 young post-menopausal women (mean age: 56 years), and measured bone density by Dual Energy X ray Absorptiometry (DEXA) twice: at the beginning of the study and after one year. VDR genotype was determined using the DNA extracted from hair cells, thus avoiding the use of blood samples.

Second messenger formation altered by different dialysis membranes in human leukocytes.

A number of agents stimulate transmembrane cell-signaling in different cell types through the formation of the second messenger diacylglycerol (DAG) which activates protein kinase C (PKC). The aim of this study was to investigate phospholipase C activation, DAG formation, and cellular adhesion to dialysis membranes after simulated dialytic treatment of either human leukocytes or clonal hematopoietic cells. Cells were circulated for 60 minutes in a closed-loop dialysis system using three different dialyzers: cuprophan (CU), polysulphone (PS), and AN69 (PAN).