[Renal Infarction: multicentric cases in Piedmont].

Unlabelled: We describe factors associated to renal infarction, clinical, instrumental and laboratoristic features, and therapeutic strategies too. This is an observational, review and polycentric study of cases in Nephrologic Units in Piedmont during 2013-2015, with diagnosis of renal infarction by Computed Tomography Angiography (CTA). We collected 48 cases (25 M, age 57±16i; 23 F age 70±18, p = 0.

[Geriatric nephrology: an overview].

Introduction: Chronic kidney disease (CKD) is a highly prevalent condition and its prevalence is increasing worldwide, particularly in adults aged 70 years. Epidemiological studies showed that as many as 2054% of the older adults suffer from CKD in stages 3-5. Nevertheless the question whether this lower eGFR is a consequence of kidney disease or if it is the result of a physiological aging is still debated, even if it implies a reduced renal reserve and vulnerability to drugs overdose with increased risk of acute kidney injury (AKI).

[Acute pielonephritis and renal abscesses in Piedmont and Aosta Valley].

The Piedmont Group of Clinical Nephrology compared the activity of 18 nephrology centers in Piedmont and Aosta Valley as regards acute pielonephritis (APN). Data from more than 500 cases per year of APN were examined. The microbial spectrum of APN consists mainly of Escherichia coli and Klebsiella pneumoniae.

The prevalence of peripheral neuropathy in hemodialysis patients.

Background/aims: Uremic Neuropathy (UN) highly limits the individual self-sufficiency causing near-continuous pain. An estimation of the actual UN prevalence among hemodialysis patients was the aim of the present work.

Methods: We studied 225 prevalent dialysis patients from two Italian Centers.

[Quality of life assessment in dialyzed patients in the Cuneo area].

The concept of quality of life includes several aspects of physical and psychological status. In a medical setting the evaluation of quality of life comprises physiopathological and clinical aspects as well as patient well-being and functioning. The aims of this study were to carry out an updated evaluation of the health status and quality of life of chronic dialysis patients in a defined geographic area; to obtain data comparable with other studies or other populations; and to identify possible action or interventions.

[Application of guidelines in clinical practice: a multicenter analysis of the treatment of membranous glomerulonephritis in Piedmont, Italy].

The treatment of membranous glomerulonephritis (MGN) is controversial, especially in cases of no response to first-line treatment or multiple relapses. The Clinical Nephrology Group of Piedmont carried out a multicenter analysis of the treatment of patients affected by MGN in 15 nephrology units in Piedmont. The first treatment is usually started after a waiting period of 3-6 months in case of proteinuria in the nephrotic range but normal or slightly impaired renal function.

Nephrogenic systemic fibrosis: an unusual scleroderma-like fibrosing disorder.

Nephrogenic systemic fibrosis (NSF) is a fibrosing disorder, recently described in patients with advanced chronic kidney disease, usually after exposure to gadolinium (Gd)-based contrast agents, characterized by progressive fibrotic involvement mainly of the skin. At clinical examination, the cutaneous findings of NSF may partly resemble those of systemic sclerosis. However, the different topographic distribution of the skin thickening and hardening, usually involving the limbs and trunk, whilst sparing the face, the lack of serologic abnormalities and the distinctive histopathological findings allow this new disease entity to be distinguished from systemic sclerosis and other scleroderma-like fibrosing disorders (scleromyxedema, scleredema, eosinophilic fasciitis, etc.

Nephrogenic systemic fibrosis: the first Italian gadolinium-proven case.

Nephrogenic systemic fibrosis (NSF) is a systemic disease, recently described in patients with advanced chronic kidney disease (CKD), characterized by progressive scleromyxedema-like fibrotic involvement mainly of the skin. We describe the case of a 66-year-old woman on chronic hemodialysis for end-stage renal failure, also affected by hypothyroidism, secondary hyperparathyroidism and occluding arteriopathy, for which she underwent a contrast-enhanced magnetic resonance angiography of the lower limbs in February 2007. One month later, she began complaining of progressive, painful distal lower limb stiffness, which subsequently spread to all four limbs and to the whole trunk.

[Hemodialysis monitor assessment].

The choice of a dialysis monitor should be based on a thorough evaluation of multiple factors. The nephrologist must take into account not only the technical features of the device, but also aspects related to the operating environment, the organization of the dialysis unit, and the number and expertise of the nursing staff under his supervision. The enormous technological developments of recent years have contributed to a considerable improvement in the survival and quality of life of patents on chronic hemodialysis.

Coupled plasma filtration adsorption.

Sepsis is one of the main causes of death in critically ill patients worldwide, and in many cases it is associated with renal and/or other organ failure. However, we do not have a unique efficient therapy to reduce this extremely high mortality rate. In the last years interest around the use of extracorporeal blood purification techniques has increased.

Acute renal failure in critically ill patients: indications for and choice of extracorporeal treatment.

The prescription of extracorporeal therapy for patients with acute renal failure involves many options: dialysis sessions may be intermittent or continuous, semicontinuous or slow-extended, with controversial indications still to be defined also depending on technical and logistic issues and related to the multidisciplinary cooperation needed in the management of critically ill patients. All efforts to evaluate extracorporeal treatments in these patients must be targeted not only towards supporting renal function, but towards all functional and metabolic derangements that can result from artificial blood purification, in any way achievable.

[Withdrawing or discontinuing chronic dialysis in adult patients].

Dialysis treatment leads chronic uremic patients to a prolonged survival; incidence and prevalence of dialysis patients are increasing, the population is getting older and many comorbidities coexist, such as diabetes, heart diseases, vasculopathies, neoplasia. The question often arises of whether to start or continue dialysis treatment in compromised patients. Withdrawing and/or discontinuing dialysis represents a therapeutic option with different ratios among countries, due to various cultural, religious, legal and social aspects.

[Continuous renal replacement therapies (CRRT)].

Several techniques are currently available in the continuous renal replacement therapy (CRRT) spectrum, adhering to different clinical conditions and illness severity. Commercially available machines have become more user-friendly, even for non-dialysis staff however, nephrologists need specific knowledge to give an adequate prescription that must be different from chronic hemodialysis. Competence and experience in the technical possibilities of CRRT lead to an individual ultra-filtration and treatment dose prescription.