[Home hemodialysis: multicenter observational study].

Home dialysis is a primary objective of Italian Ministry of Health. As stated in the National Chronicity Plan and the Address Document for Chronic Renal Disease, it is mostly home hemodialysis and peritoneal dialysis to be carried out in the patient's home. Home hemodialysis has already been used in the past and today has found new technologies and new applications.

Diagnostic capability of ultrasound in peritoneal catheter malfunction compared to videolaparoscopy.

Background: The approach to peritoneal catheter malfunction consists usually in a diagnostic and therapeutic sequence of laxative prescription, abdominal radiography, brushing of the catheter, guide-wire manipulation or fluoroscopy and in the end of a videolaparoscopy (VLS) rescue intervention. Ultrasound (US) is able to find out major causes of peritoneal catheter malfunction, however without a clearly defined diagnostic value. The aim of the study was to validate the diagnostic capability of US in catheter malfunction compared to the diagnostic reference of VLS.

[The COVID-19 pandemic and hemodialysis: a multicentric experience].

The SARS-CoV-2 pandemic has forced a reshaping of economic, productive, commercial and healthcare systems. The last one had the dual mandate to limit intra-hospital infections and strengthen its ability to deal with the ongoing emergency. In this paper we report the experience gained by the staff of the Nephrology and Dialysis Unit of the AULSS7 Pedemontana (Vicenza - Veneto region) and the organizational model pursued during the first wave of the pandemic.

Clinical management of patients on peritoneal dialysis in Italy: results from the ATENA study.

Background: In Italy, few studies have examined the clinical management of peritoneal dialysis (PD) patients, resulting in a lack of information and awareness.

Methods: A total of 378 PD patients (64.7 ± 14.

Stroke volume variation and serum creatinine changes during abdominal aortic aneurysm surgery: a time-integrated analysis.

Background: Patients undergoing abdominal aortic aneurysm (AAA) surgery with suprarenal clamping are at high risk for acute kidney injury (AKI) and major cardiac and cerebrovascular events (MACCE). We aimed to assess whether the stroke volume variation (SVV), a measure of hemodynamic instability, is associated with AKI in hypertensive patients undergoing elective AAA surgery with suprarenal clamping.

Methods: In a cohort of 51 hypertensive patients, we performed serial measurements of SVV (n = 459) and serum creatinine (sCr) (n = 255).

Kidney and heavy metals - The role of environmental exposure (Review).

Heavy metals are extensively used in agriculture and industrial applications such as production of pesticides, batteries, alloys, and textile dyes. Prolonged, intensive or excessive exposure can induce related systemic disorders. Kidney is a target organ in heavy metal toxicity for its capacity to filter, reabsorb and concentrate divalent ions.

[The role of bioelectrical impedance in peritoneal dialysis].

Dialysis must control the bodys fluid content accurately in order to maintain optimal health. Determination of body hydration and nutritional status are significant problems in dialysis patients. In practice, clinical evaluation is usually used to estimate the ultrafiltration target, since accurate knowledge of dry weight is lacking.

The peritoneal dialysis catheter.

The results obtained from the positioning and management of the catheter for peritoneal dialysis depend on the techniques used, but also and above all, on the experience of the practitioners. A comparison between practitioners may help to change their convictions, as well as to further improve results, in the interests of patient welfare. This is the aim of these Best Practice Guidelines.

[Unconventional hemodiafiltration: double-high-flux and push-pull].

Growing evidence demonstrates that morbidity and mortality in patients with end-stage renal disease correlate significantly with retention of larger uremic toxins including β2 microglobulin. Even when hemodialysis is performed, complications such as dialysis-associated amyloidosis are likely to develop. These complications seem to be related to the retention and accumulation of larger uremic substances, only a small amount of which are removed by hemodialysis.

Bioelectrical impedance analysis in the assessment of hydration status in peritoneal dialysis patients.

Objective: Assessment of fluid status in chronic peritoneal dialysis (PD) patients is complex. Clinical evaluation based solely on body weight, blood pressure, volume of ultrafiltration (UF) and peripheral edema is insufficient. A non-invasive test, bioelectrical impedance analysis (BIA) might be of potential benefit.

[Diagnosis and therapy of exit-site infection in peritoneal dialysis: an update].

Exit-site infection (ESI) is still one of the most important technical complications in peritoneal dialysis because it can lead to peritonitis and catheter loss. Catheter choice does not appear to affect exit-site infection in most cases. Early diagnosis is extremely important in reducing such complications.

Advances in the technology of automated, tidal, and continuous flow peritoneal dialysis.

Automated peritoneal dialysis (APD) has undergone substantial growth in recent years because of an increased demand for higher doses of peritoneal dialysis (PD) treatment and a need to improve quality of life for patients. The evolution of this treatment is closely linked with the development of new automatic machines and with recent advances in prescription and monitoring of PD treatment. In the present article, we describe the characteristics of the new generation of APD cyclers with particular regard to adequacy targets and safety.

Rational choice of peritoneal dialysis catheter.

The peritoneal catheter should be a permanent and safe access to the peritoneal cavity. Catheter-related problems are often the cause of permanent transfer to hemodialysis (HD) in up to 20% of peritoneal dialysis (PD) patients; in some cases, these problems require a temporary period on HD. Advances in connectology have reduced the incidence of peritonitis, and so catheter-related complications during PD have become a major concern.

A new home based bioimpedance system for PD.

Fluid overload and uncontrolled hypertension may be considered important mortality risk factors in peritoneal dialysis (PD) population. Even malnutrition is highly prevalent in PD patients. It is now well established that lower levels of serum markers of nutrition such as albumin, creatinine, and prealbumin are associated with increased mortality in PD patients [Fein, P.

Evolution of technology for automated peritoneal dialysis.

Automated peritoneal dialysis (APD) is important for the further penetration of PD in the dialysis marketplace. Long dwell, equilibration PD (CAPD) has limited applicability in many patients due to inadequate solute clearance or fast membrane transport characteristics. Providing large volumes of dialysate over circumscribed hours is highly labor intensive without an automated system.

Integration of peritoneal dialysis in the treatment of uremia.

The real integration of a specific therapy into the renal replacement program is represented by the possibility of easy and free patient transfer from one treatment to another without restrictions. In the case of peritoneal dialysis we feel that its integration in the therapeutic approach of uremia represents an ethical obligation for the physician, a clinical opportunity for the patient and a good cost/benefit solution for care givers. A full conviction that peritoneal dialysis represents a real therapeutic option for ESRD patients is necessary to achieve a real integration of this therapy in the uremia treatment program.

Dent's disease and prevalence of renal stones in dialysis patients in Northeastern Italy.

Dent's disease (DD) involves nephrocalcinosis, urolithiasis, hypercalciuria, LMW proteinuria, and renal failure in various combinations. Males are affected. It is caused by mutations in the chloride channel CLCN5 gene.

APD prescription: achieving the adequacy goals.

In the last few years, automated peritoneal dialysis (APD) has undergone considerable improvements due to technological developments. The definition of a minimal dose of peritoneal dialysis (PD) has not yet been completely assessed. Appropriate use of APD requires an evaluation of dialytic efficiency in terms of dialytic indexes and their targets.

Catheter design for continuous flow peritoneal dialysis.

A new catheter for continuous flow peritoneal dialysis is presented. One of the main issues in this field is the safety and good clinical tolerance of the catheter. In this case, the size and diameter of the cannula has not been increased in comparison to previous PD catheters.