[Analysis of cause of death in the 1st and last periods of the Piedmontese Dialysis and Transplantation Registry]

The aim of this study is to assess the mortality causes in dialysis in the Piedmont Region, using the data of the Dialysis and Transplantation Register (DTR). Data of a 15-year use of the DTR regarding 5519 hospital dialysis admissions were considered. Mortality seems to be particularly due to cardiac causes analyzing, also the incidence of other causes of death such as: cachexia, sudden death and infection causes.

[Patients with neoplastic disease or older than 80 years of age: dialysis survival]

In several European countries, including Italy, the resident population is ageing. This process is at the basis of the progressive increase in incidence of new elderly patients starting dialysis and, to a lesser degree, of patients affected by severe comorbid conditions, such a neoplasia. The aim of the study was an analysis of the situation in Piedmont (Northern Italy, 4,400,000 inhabitants): out of 4483 new entries in 1981-1993, 192 were aged 80 years and 87 were affected by renal neoplasia or by multiple myeloma. Incidence of patients aged 80 increased throughout the period; use of high tolerance techniques increased in the meantime allowing an improvement in survival results. The high incidence of vasculopathic patients and the high rates of death from cachexia pinpoint how much still has to be done in the field of prevention, even before dialysis starts.

[Anti-HCV antibodies in chronically dialyzed uremic patients. 1-year follow-up study]

The sera of 109 patients undergoing chronic haemodialysis treatment were reexamined after one year in order to assess changes in the anti-HVC antibody pattern in the intervening period, June 1992-June 1993. Using the ELISA II generation test, positive cases were found to have risen from 57 to 63 (from 52.3% to 57.8%); the Riba II test showed 60 positive cases (previously 52) with 3 undetermined (previously 5). The incidence of biochemical indicators of necrosis and/or cholestasis, negative in HCV patients, also presents a particular positivity (44%) in the presence of four antibody fractions. These data confirm the importance of serial determinations in anti-HCV antibody time, even if they do not correlate directly with the presence of the virus in the circulation and hence with its infecting capacity, the marker for which should be sought in the polymerase chain reaction.

[Choice of dialysis methods as initial substitutive treatment: trends in the last 10 years]

The authors report data from the Regional Piedmontese Registry about the evolution of choices concerning dialytic therapy in the 20 regional dialysis Units during the years 1981-1990. They confirm a scale-down of acetate dialysis that is replaced with bicarbonate dialysis; besides a limited use of convective dialysis whereas peritoneal dialysis is steady. At the same time they remark an increase in admittance to dialysis and older patients.

[Progression of acquired renal cysts in patients undergoing dialysis]

In uremic and dialysed patients, acquired renal cystic disease (ARCD) and its possible neoplastic degeneration are well-known. The aim of the paper is to assess the incidence of this pathology among dialysed patients in our Renal Unit. Final results have been achieved after three years. The evidence is that this pathology increases in older patients with respect to age and/or to long-term dialysis; we confirm neoplastic degeneration in two patients.