Increase of continuous treatments and regional citrate anticoagulation during renal replacement therapy in the ICUs of the North-West of Italy from 2007 to 2015.

Background: Few reports have addressed the change in renal replacement therapy (RRT) management in the Intensive care Units (ICUs) over the years in western countries. This study aims to assess the trend of dialytic practice in a 4.5-million population-based study of the northwest of Italy.

Differential response to renal replacement therapy in neonatal-onset inborn errors of metabolism.

Severe urea cycle defects (UCD), organic acidemias (OA) and maple syrup urine disease (MSUD) are life-threatening disorders presenting in the first days of life. Renal replacement therapy (RRT) is an emergency option in affected newborns, mostly performed as ultima ratio. We report our 10-year experience using emergency RRT in newborns with UCD, OA and MSUD.

Liver transplantation for aHUS: still needed in the eculizumab era?

Background: The risk of disease recurrence after a kidney transplant is high in patients with atypical hemolytic uremic syndrome (aHUS) and mutations in the complement factor H (FH) gene (CFH). Since FH is mostly produced by the liver, a kidney transplant does not correct the genetic defect. The anti-C5 antibody eculizumab prevents post-transplant aHUS recurrence, but it does not cure the disease.

Neonatal sepsis with multi-organ failure and treated with a new dialysis device specifically designed for newborns.

Neonatal sepsis due to E. coli is often complicated by multiple organ failure (MOF) and a high mortality risk. We report the case of a term newborn discharged in good condition who suddenly fell into septic shock after 11 days and required immediate resuscitation, volume expansion and a high-dosage amine infusion.

[Bioincompatibility of acetate even at low concentrations].

Over the last 20 years a large body of evidence has demonstrated that in chronic renal failure there is progressive chronic inflammation, which increases after the start of dialysis. In this phase a fundamental role is played by bioincompatibility reactions induced by contact with the different dialysis materials: membranes, plastic lines, dialysis fluids as well as contaminants present in water. Clinically evident symptoms induced by bioincompatibility reactions are usually taken into serious account by nephrologists, while more subtle chronic effects, noxious in the long term, are often underconsidered.

Bicarbonate dialysis, unlike acetate-free biofiltration, triggers mediators of inflammation and apoptosis in endothelial and smooth muscle cells.

Background: We previously demonstrated that bicarbonate dialysis solutions incubated with endothelial cells (EC) enhance nitric oxide synthase (NOS). We then investigated whether blood circulated in simulated dialysis circuits triggers inflammatory and apoptotic mediators in vessel wall cells, aiming to compare the effects of bicarbonate hemodialysis (BHD) and acetate-free biofiltration (AFB).

Methods: Blood units from 22 healthy donors were dialyzed on AN69 with BHD in 11 sessions and AFB in another 11 sessions.

Parathyroid hormone levels in pubertal uremic adolescents treated with growth hormone.

We have previously described severe hyperparathyroidism during the pubertal growth spurt in three uremic adolescents treated with recombinant human growth hormone (rhGH). Here we investigate the possible role of puberty in the genesis of hyperparathyroidism during rhGH treatment of a large cohort of patients. Data from 67 uremic patients treated with rhGH from five Italian pediatric nephrology centers were retrospectively recorded every 3 months starting 1 year before rhGH administration.

Epidemiology of chronic renal failure in children: data from the ItalKid project.

Objective: The ItalKid Project is a prospective, population-based registry that was started in 1990 with the aim of assessing the epidemiology of childhood chronic renal failure (CRF), describing the natural history of the disease, and identifying factors that influence its course. This article reports the epidemiologic results.

Methods: Prevalent and incident cases of CRF in children and adolescents were identified throughout Italy (total population base: 16.