Ethical and legal aspects of end of life in dialysis patients: an Italian point of view.

In the Western world, thanks to continuous progress in the medical field, and to changes in society, the concept of death seems to be increasingly replaced by that of "keeping alive at all costs". Thus also dialysis, a life-sustaining treatment for patients suffering from kidney failure, in some cases can no longer be seen as a treatment aimed at prolonging life, but as a treatment to temporarily avert death. In fact, the literature highlights that dialysis is not always associated with greater life expectancy and better quality of life for fragile patients with kidney failure.

[Renal Damage and Obesity: a Silent Pairing].

Obesity is recognized as a true chronic disease and an independent risk factor for kidney disease. In particular, a correlation was observed between obesity and the development of focal segmental glomerulosclerosis. The clinical consequences of obesity on the kidney can include albuminuria, nephrotic syndrome, nephrolithiasis, and increased risk of development and progression of renal failure.

No additional benefit of prescribing a very low-protein diet in patients with advanced chronic kidney disease under regular nephrology care: a pragmatic, randomized, controlled trial.

Background: Whether a very low-protein diet supplemented with ketoanalogues (sVLPD), compared with a standard low-protein diet (LPD), improves outcomes in patients with chronic kidney disease (CKD) under stable nephrology care is undefined.

Objectives: To compare the effectiveness of sVLPD compared with LPD in patients regularly seen in tertiary nephrology care.

Methods: Participants were patients with CKD stages 4-5, followed for at least 6 mo, randomly allocated to receive sVLPD or LPD [0.

[Acute HCV-induced hepatitis in a patient affected by atypical hemolytic uremic syndrome (aHUS) treated with Eculizumab - case report].

Atypical hemolytic uremic syndrome (aHUS) is a rare and heterogenous disease caused by a disregulation of the alternative pathway of the complement cascade. Specifically, microvascular damage is produced that can lead to acute kidney disease, hemolytic anemia and thrombocytopenia. It accounts for 10% of all hemolytic uremic syndromes and can result in death or in end stage renal disease since the first episode.

[Development of mesangial immunoglobulin IgA glomerulonephritis and p-ANCA positivity in a patient with psoriatic arthritis].

Tumor necrosis factor (TNF) inhibitors are widely used for the treatment of various rheumatic diseases. These agents may lead to development of systemic autoimmune diseases and renal complications. We report a patient with psoriatic arthritis and renal failure treated with two TNF inhibitors (Etanercept and then Adalimumab).

[Liposomial iron: a new proposal for the treatment of anaemia in chronic kidney disease].

Iron supplementation is essential for the treatment of anemia in the chronic kidney disease (CKD) population. Liposomial iron is a preparation of ferric pyrophosphate carried within a phospholipidic membrane. Compared to other oral formulations, it is well absorbed from the gut and demonstrates high bioavailability together with a lower incidence of side effects.

[Iodide mumps following low-osmolarity contrast medium use in haemodialysis patients].

Sialadenitis (Iodide Mumps) is a rare complication following the administration of iodinated contrast media. It is characterized by the painless bilateral enlargement of the submandibular salivary glands. The pathogenesis of this adverse reaction remains unclear.

Influence of haemodialysis on variability of pulse wave velocity in chronic haemodialysis patients.

Background: The major determinants of pulse wave velocity (PWV) in haemodialysis (HD) patients are not fully known. We studied chronic HD patients to assess the effect of cyclic variations in both hydration status and blood pressure on PWV.

Methods: Twenty patients were examined along three consecutive HD sessions and interdialysis periods during a week-long period.

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.