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Myers SH, Montanino Oliva M, Nordio M, Unfer V. PCOS phenotype focus: phenotype D under the magnifying glass. Arch Gynecol Obstet 2024:10.1007/s00404-024-07408-2. [PMID: 38502188 DOI: 10.1007/s00404-024-07408-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Accepted: 01/29/2024] [Indexed: 03/21/2024]
Abstract
Polycystic ovary syndrome (PCOS) is defined as the combination of polycystic morphology, hyperandrogenism, and ovulatory disruption; this heterogeneity presents a conundrum for the medical community. The Rotterdam criteria have governed the diagnosis of PCOS, separating the patient cohort into four distinct phenotypes. It has been suggested that the lone normoandrogenic phenotype, so-called phenotype D, should not be classified as a PCOS subtype, with phenotypes A, B, and C displaying a hyperandrogenic biochemical and clinical profile thought to be characteristic of PCOS. To understand how to treat phenotype D patients, this review shines a spotlight on the phenotype, gathering various reports of how phenotype D is differentiated from the other PCOS phenotypes.
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Affiliation(s)
| | - Mario Montanino Oliva
- The Experts Group On Inositol in Basic and Clinical Research (EGOI), 00161, Rome, Italy
- Department of Obstetrics and Gynecology, Santo Spirito Hospital, 00193, Rome, Italy
| | - Maurizio Nordio
- The Experts Group On Inositol in Basic and Clinical Research (EGOI), 00161, Rome, Italy
- A.S.L. RMF, Civitavecchia, Italy
| | - Vittorio Unfer
- The Experts Group On Inositol in Basic and Clinical Research (EGOI), 00161, Rome, Italy.
- UniCamillus-Saint Camillus International University of Health Sciences, 00156, Rome, Italy.
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2
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Nordio M. A Joint Vision of Peritoneal Dialysis in Italy: Census and Italian Registry of Dialysis and Transplantation. G Ital Nefrol 2024; 41:2024-vol1. [PMID: 38426675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
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3
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Dinicola S, Unfer V, Soulage CO, Yap-Garcia MIM, Bevilacqua A, Benvenga S, Barbaro D, Wdowiak A, Nordio M, Dewailly D, Appetecchia M, Aragona C, Espinola MSB, Bizzarri M, Cavalli P, Colao A, D'Anna R, Vazquez-Levin MH, Hernàndez Marin I, Kamenov Z, Laganà AS, Monastra G, Montanino Oliva M, Cenk Özay A, Pintaudi B, Porcaro G, Pustotina O, Pkhaladze L, Prapas N, Roseff S, Salehpour S, Stringaro A, Tugushev M, Unfer V, Vucenik I, Facchinetti F. D-chiro-inositol in clinical practice: A perspective from The Experts Group on Inositol in Basic and Clinical Research (EGOI). Gynecol Obstet Invest 2024:000536081. [PMID: 38373412 DOI: 10.1159/000536081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 01/02/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND D-chiro-inositol is a natural molecule that, in association with its well-studied isomer myo-inositol, may play a role in treating various metabolic and gynecological disorders. OBJECTIVES This perspective seeks to explore the mechanisms and functions of D-chiro-inositol, laying the foundations to discuss its use in clinical practice, across dysmetabolism, obesity, and hormonal dysregulation. METHODS A narrative review of all the relevant papers known to the authors was conducted. OUTCOME D-chiro-inositol acts through a variety of mechanisms, acting as an insulin sensitizer, inhibiting the transcription of aromatase, in addition to modulating white adipose tissue/brown adipose tissue trans differentiation. These different modes of action have potential applications in a variety of therapeutic fields including: PCOS, dysmetabolism, obesity, hypoestrogenic/hyperandrogenic disorders, and bone health. CONCLUSIONS D-chiro-inositol mode of action has been studied in detail in recent years, resulting in a clear differentiation between D-chiro-inositol and its isomer myo-inositol. The insulin sensitizing activities of D-chiro-inositol are well understood; however, its potential applications in other fields, in particular obesity and hyperestrogenic/hypoandrogenic disorders in men and women, represent promising avenues of research that require further clinical study.
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4
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Bellini A, Finocchietti M, Rosa AC, Nordio M, Ferroni E, Massari M, Spila Alegiani S, Masiero L, Bedeschi G, Cardillo M, Lucenteforte E, Piccolo G, Leoni O, Pierobon S, Ledda S, Garau D, Davoli M, Addis A, Belleudi V. Effectiveness and safety of immunosuppressive regimens used as maintenance therapy in kidney transplantation: The CESIT study. PLoS One 2024; 19:e0295205. [PMID: 38165971 PMCID: PMC10760756 DOI: 10.1371/journal.pone.0295205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2023] [Accepted: 11/16/2023] [Indexed: 01/04/2024] Open
Abstract
Maintenance immunosuppressive therapy used in kidney transplantation typically involves calcineurin inhibitors, such as tacrolimus or cyclosporine, in combination with mycophenolate or mechanistic target of rapamycin (mTORi) with or without corticosteroids. An Italian retrospective multicentre observational study was conducted to investigate the risk-benefit profile of different immunosuppressive regimens. We identified all subjects who underwent kidney transplant between 2009 and 2019, using healthcare claims data. Patients on cyclosporine and tacrolimus-based therapies were matched 1:1 based on propensity score, and effectiveness and safety outcomes were compared using Cox models (HR; 95%CI). Analyses were also conducted comparing mTORi versus mycophenolate among tacrolimus-treated patients. Patients treated with cyclosporine had a higher risk of rejection or graft loss (HR:1.69; 95%CI:1.16-2.46) and a higher incidence of severe infections (1.25;1.00-1.55), but a lower risk of diabetes (0.66;0.47-0.91) compared to those treated with tacrolimus. Among tacrolimus users, mTORi showed non-inferiority to MMF in terms of mortality (1.01;0.68-1.62), reject/graft loss (0.61;0.36-1.04) and severe infections (0.76;0.56-1.03). In a real-life setting, tacrolimus-based immunosuppressive therapy appeared to be superior to cyclosporine in reducing rejection and severe infections, albeit with an associated increased risk of diabetes. The combination of tacrolimus and mTORi may represent a valid alternative to the combination with mycophenolate, although further studies are needed to confirm this finding.
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Affiliation(s)
- Arianna Bellini
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
- Department of Public Health and Infectious Diseases, Sapienza University of Rome, Rome, Italy
| | | | | | | | | | - Marco Massari
- National Centre for Drug Research and Evaluation, Istituto Superiore Di Sanità, Rome, Italy
| | | | - Lucia Masiero
- Italian National Transplant Centre, Istituto Superiore di Sanità, Rome, Italy
| | - Gaia Bedeschi
- Italian National Transplant Centre, Istituto Superiore di Sanità, Rome, Italy
| | - Massimo Cardillo
- Italian National Transplant Centre, Istituto Superiore di Sanità, Rome, Italy
| | - Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Olivia Leoni
- Department of Health of Lombardy Region, Epidemiology Observatory, Milan, Italy
| | | | - Stefano Ledda
- General Directorate for Health, Sardinia Region, Italy
| | | | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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5
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Rosa AC, Finocchietti M, Agabiti N, Menè P, Bracaccia ME, Bellini A, Massari M, Spila Alegiani S, Masiero L, Bedeschi G, Cardillo M, Lucenteforte E, Piccolo G, Leoni O, Ferroni E, Pierobon S, Nordio M, Ledda S, Garau D, Davoli M, Addis A, Belleudi V. Determinants of immunosuppressive therapy in renal transplant recipients: an Italian observational study (the CESIT project). BMC Nephrol 2023; 24:320. [PMID: 37891504 PMCID: PMC10604923 DOI: 10.1186/s12882-023-03325-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 09/06/2023] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Very scanty evidence is available on factors influencing the choice of immunosuppressive drug therapy after kidney transplantation. METHODS An Italian multiregional real-world study was conducted integrating national transplant information system and claims data. All patients undergoing kidney transplantation for the first time during 2009-2019 (incident patients) were considered. Multilevel logistic models were used to estimate Odds Ratio (OR) and corresponding 95% Confidence intervals. Factors with statistically significance were identified as characteristics associated with treatment regimens: cyclosporin-CsA vs tacrolimus-Tac and, within the latter group, mTOR inhibitors vs mycophenolate-MMF. RESULTS We identified 3,622 kidney patients undergoing transplantation in 17 hospitals located in 4 Italian regions, 78.3% was treated with TAC-based therapy, of which 78% and 22% in combination with MMF and mTOR, respectively. For both comparison groups, the choice of immunosuppressive regimens was mostly guided by standard hospital practices. Only few recipient and donor characteristics were found associated with specific regimen (donor/receipt age, immunological risk and diabetes). CONCLUSIONS The choice of post-renal transplant immunosuppressive therapy seems to be mostly driven by standard Centre practices, while only partially based on patient's characteristics and recognized international guidelines.
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Affiliation(s)
- Alessandro C Rosa
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Marco Finocchietti
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Nera Agabiti
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Paolo Menè
- Department of Clinical Sciences, Division of Nephrology, University of Rome La Sapienza, Sant'Andrea University Hospital, Rome, Italy
| | - Maria Elena Bracaccia
- Department of Clinical Sciences, Division of Nephrology, University of Rome La Sapienza, Sant'Andrea University Hospital, Rome, Italy
| | - Arianna Bellini
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Marco Massari
- National Centre for Drug Research and Evaluation, Istituto Superiore Di Sanità, Rome, Italy
| | | | - Lucia Masiero
- Italian National Transplant Centre, Istituto Superiore Di Sanità, Rome, Italy
| | - Gaia Bedeschi
- Italian National Transplant Centre, Istituto Superiore Di Sanità, Rome, Italy
| | - Massimo Cardillo
- Italian National Transplant Centre, Istituto Superiore Di Sanità, Rome, Italy
| | - Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | | | - Olivia Leoni
- Department of Health of Lombardy Region, Epidemiology Observatory, Milan, Italy
| | | | | | | | - Stefano Ledda
- General Directorate for Health, Sardinia Region, Cagliari, Italy
| | - Donatella Garau
- General Directorate for Health, Sardinia Region, Cagliari, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy
| | - Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, Via Cristoforo Colombo, 112, 00147, Rome, Italy.
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Astley ME, Boenink R, Abd ElHafeez S, Trujillo-Alemán S, Arribas F, Åsberg A, Beckerman P, Bell S, Bouzas-Caamaño ME, Farnés JC, Galvão AA, Gjorgjievski N, Kelmendi VG, Guidotti R, Helve J, Idrizi A, Indriðason ÓS, Ioannou K, Kerschbaum J, Komissarov K, Castro de la Nuez P, Lassalle M, Nordio M, Arévalo OLR, Santiuste C, Seyahi N, Roblero MFS, Steenkamp R, ten Dam MAGJ, Zakharova EV, Ziginskiene E, Bonthuis M, Stel VS, Ortiz A, Jager KJ, Kramer A. The ERA Registry Annual Report 2020: a summary. Clin Kidney J 2023; 16:1330-1354. [PMID: 37529647 PMCID: PMC10387405 DOI: 10.1093/ckj/sfad087] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Indexed: 08/03/2023] Open
Abstract
Background The European Renal Association (ERA) Registry collects data on kidney replacement therapy (KRT) in patients with ESKD. This paper is a summary of the ERA Registry Annual Report 2020, also including comparisons among primary renal disease (PRD) groups. Methods Data were collected from 52 national and regional registries from 34 European countries and countries bordering the Mediterranean Sea: 35 registries from 18 countries providing individual level data and 17 registries from 17 countries providing aggregated data. Using this data, KRT incidence and prevalence, kidney transplantation rates, expected remaining lifetimes and survival probabilities were calculated. Results A general population of 654.9 million people was covered by the ERA Registry in 2020. The overall incidence of KRT was 128 per million population (p.m.p.). In incident KRT patients, 54% were older than 65 years, 63% were men and the most common PRD was diabetes mellitus (21%). Regarding initial treatment modality in incident patients, 85% received haemodialysis (HD), 11% received peritoneal dialysis (PD) and 4% received a pre-emptive kidney transplant. On 31 December 2020, the prevalence of KRT was 931 p.m.p. In prevalent patients, 45% were older than 65 years, 60% were men and glomerulonephritis was the most common PRD (18%). Of these patients, 58% were on HD, 5% on PD and 37% were living with a kidney transplant. The overall kidney transplantation rate in 2020 was 28 p.m.p., with a majority of kidney grafts from deceased donors (71%). The unadjusted 5-year survival, based on incident dialysis patient from 2011-15, was 41.8%. For patients having received a deceased donor transplant, the unadjusted 5-year survival probability was 86.2% and for patients having received a living donor transplant it was 94.4%. When comparing data by PRD group, differences were found regarding the distribution of age groups, sex and treatment modality received.
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Affiliation(s)
| | - Rianne Boenink
- ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands
| | - Samar Abd ElHafeez
- ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Epidemiology Department, High Institute of Public Health, Alexandria University, Alexandria, Egypt
| | - Sara Trujillo-Alemán
- Health Quality Assessment and Information System Service, Dirección General de Programas Asistenciales, Servicio Canario de la Salud, Canary Islands, Spain
| | - Federico Arribas
- Department of Aragon Health, General Direction of Health Care, Zaragoza, Spain
| | - Anders Åsberg
- The Norwegian Renal Registry, Department of Transplantation Medicine, Oslo University Hospital – Rikshospitalet, Oslo, Norway
| | - Pazit Beckerman
- Sheba Medical Center, Ramat Gan, and School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Samira Bell
- Scottish Renal Registry, Public Health Scotland, Glasgow, UK
- Division of Population Health & Genomics, University of Dundee, Ninewells Hospital, Dundee, United Kingdom
| | | | - Jordi Comas Farnés
- Catalan Renal Registry, Catalan Transplant Organization, Health Department, Generalitat of Catalonia, Barcelona, Spain
| | | | - Nikola Gjorgjievski
- Hospital of Nephrology, Skopje, N. Macedonia
- Faculty of Medicine, University “SS Cyril and Methodius” Skopje, Skopje, N. Macedonia
| | | | - Rebecca Guidotti
- Institute of Nephrology, City Hospital Zurich, Zurich, Switzerland
| | - Jaakko Helve
- Finnish Registry for Kidney Diseases and Abdominal Center Nephrology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Alma Idrizi
- Service of Nephrology, UHC Mother Teresa, Tirana, Albania
| | - Ólafur S Indriðason
- Division of Nephrology, Landspitali–The National University Hospital of Iceland, Reykjavik, Iceland
| | | | - Julia Kerschbaum
- Austrian Dialysis and Transplant Registry, Department of Internal Medicine IV–Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria
| | - Kirill Komissarov
- Minsk Scientific and Practical Center of Surgery, Transplantation and Hematology, Minsk, Belarus
| | - Pablo Castro de la Nuez
- SICATA: Information System of the Autonomous Coordination of Transplants of Andalusia, Seville, Andalucia, Spain
| | - Mathilde Lassalle
- REIN Registry, Agence de la Biomédecine, Saint-Denis La Plaine, France
| | - Maurizio Nordio
- Division of Nephrology, AULSS 2, Treviso General Hospital, Treviso, Italy
| | - Olga Lucía Rodríguez Arévalo
- Registry of Renal Patients of the Valencian Community, General Directorate of Public Health and Addictions, Ministry of Universal Health and Public Health, Valencia, Spain
- Health and Well-being Technologies Program, Polytechnic University of Valencia, Valencia, Spain
| | - Carmen Santiuste
- Murcia Renal Registry, Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Murcia, Spain
- CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Nurhan Seyahi
- Department of Nephrology, Cerrahpaşa Medical Faculty, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | | | | | | | - Elena V Zakharova
- Nephrology, Botkin Hospital, Moscow, Russia
- Nephrology and Hemodialysis, Russian Medical Academy of Continuing Professional Education, Moscow, Russia
| | - Edita Ziginskiene
- Lithuanian Nephrology, Dialysis and Transplantation Association, Kaunas, Lithuania
- Nephrology Department, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Marjolein Bonthuis
- ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care, Amsterdam, The Netherlands
- ESPN/ERA Registry, Amsterdam UMC location University of Amsterdam, Department of Medical Informatics, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands
| | - Alberto Ortiz
- Department of Nephrology and Hypertension, IIS-Fundacion Jimenez Diaz UAM, Madrid, Spain
- Department of Medicine, Universidad Autonoma de Madrid, Madrid, Spain
| | - Kitty J Jager
- ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands
| | - Anneke Kramer
- ERA Registry, Department of Medical Informatics, Amsterdam UMC location University of Amsterdam, Amsterdam, The Netherlands
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7
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Giannella M, Huth M, Righi E, Hasenauer J, Marconi L, Konnova A, Gupta A, Hotterbeekx A, Berkell M, Palacios-Baena ZR, Morelli MC, Tamè M, Busutti M, Potena L, Salvaterra E, Feltrin G, Gerosa G, Furian L, Burra P, Piano S, Cillo U, Cananzi M, Loy M, Zaza G, Onorati F, Carraro A, Gastaldon F, Nordio M, Kumar-Singh S, Baño JR, Lazzarotto T, Viale P, Tacconelli E. Using machine learning to predict antibody response to SARS-CoV-2 vaccination in solid organ transplant recipients: the multicentre ORCHESTRA cohort. Clin Microbiol Infect 2023; 29:1084.e1-1084.e7. [PMID: 37150358 PMCID: PMC10212001 DOI: 10.1016/j.cmi.2023.04.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Revised: 04/05/2023] [Accepted: 04/26/2023] [Indexed: 05/09/2023]
Abstract
OBJECTIVES The study aim was to assess predictors of negative antibody response (AbR) in solid organ transplant (SOT) recipients after the first booster of SARS-CoV-2 vaccination. METHODS Solid organ transplant recipients receiving SARS-CoV-2 vaccination were prospectively enrolled (March 2021-January 2022) at six hospitals in Italy and Spain. AbR was assessed at first dose (t0), second dose (t1), 3 ± 1 month (t2), and 1 month after third dose (t3). Negative AbR at t3 was defined as an anti-receptor binding domain titre <45 BAU/mL. Machine learning models were developed to predict the individual risk of negative (vs. positive) AbR using age, type of transplant, time between transplant and vaccination, immunosuppressive drugs, type of vaccine, and graft function as covariates, subsequently assessed using a validation cohort. RESULTS Overall, 1615 SOT recipients (1072 [66.3%] males; mean age±standard deviation [SD], 57.85 ± 13.77) were enrolled, and 1211 received three vaccination doses. Negative AbR rate decreased from 93.66% (886/946) to 21.90% (202/923) from t0 to t3. Univariate analysis showed that older patients (mean age, 60.21 ± 11.51 vs. 58.11 ± 13.08), anti-metabolites (57.9% vs. 35.1%), steroids (52.9% vs. 38.5%), recent transplantation (<3 years) (17.8% vs. 2.3%), and kidney, heart, or lung compared with liver transplantation (25%, 31.8%, 30.4% vs. 5.5%) had a higher likelihood of negative AbR. Machine learning (ML) algorithms showing best prediction performance were logistic regression (precision-recall curve-PRAUC mean 0.37 [95%CI 0.36-0.39]) and k-Nearest Neighbours (PRAUC 0.36 [0.35-0.37]). DISCUSSION Almost a quarter of SOT recipients showed negative AbR after first booster dosage. Unfortunately, clinical information cannot efficiently predict negative AbR even with ML algorithms.
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Affiliation(s)
- Maddalena Giannella
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Infectious Diseases Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy.
| | - Manuel Huth
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany; Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Elda Righi
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
| | - Jan Hasenauer
- Faculty of Mathematics and Natural Sciences, University of Bonn, Bonn, Germany; Institute of Computational Biology, Helmholtz Zentrum München - German Research Center for Environmental Health, Neuherberg, Germany
| | - Lorenzo Marconi
- Infectious Diseases Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy
| | - Angelina Konnova
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Akshita Gupta
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - An Hotterbeekx
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Matilda Berkell
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Zaira R Palacios-Baena
- Infectious Diseases and Microbiology Clinical Unit, University Hospital Virgen Macarena; Department of Medicine, School of Medicine, University of Seville; and Biomedicine Institute of Seville (IBiS)/CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Maria Cristina Morelli
- Internal Medicine Unit for the Treatment of Severe Organ Failure, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy
| | - Mariarosa Tamè
- Gastroenterology Unit, Department of Digestive, Hepatic and Endocrine-metabolic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy
| | - Marco Busutti
- Nephrology, Dialysis and Renal Transplantation Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy
| | - Luciano Potena
- Division of Cardiology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy
| | - Elena Salvaterra
- Division of Interventional Pulmonology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy
| | | | - Gino Gerosa
- Cardiac Surgery Unit, Department of Cardio-Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Lucrezia Furian
- Kidney and Pancreas Transplantation Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy
| | - Patrizia Burra
- Unit of Gastroenterology and Multivisceral Transplant, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, Padua, Italy
| | - Salvatore Piano
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine - DIMED, University of Padua, Padua, Italy
| | - Umberto Cillo
- Department of Surgery, Oncology and Gastroenterology, Hepatobiliary Surgery and Liver Transplantation Unit, Padua University Hospital, Padua, Italy
| | - Mara Cananzi
- Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, Department of Women's and Children's Health, University Hospital of Padua, Padua, Italy
| | - Monica Loy
- Thoracic Surgery and Lung Transplant Center, Department of Cardio-Thoracic, Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Gianluigi Zaza
- Renal Unit, Department of Medicine, University Hospital of Verona, Verona, Italy
| | | | - Amedeo Carraro
- Liver Transplant Unit, Department of Surgery and Dentistry, University and Hospital Trust of Verona, Verona, Italy
| | - Fiorella Gastaldon
- Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy
| | - Maurizio Nordio
- Nephrology, Dialysis and Transplantation Unit, Treviso Hospital, Treviso, Italy
| | - Samir Kumar-Singh
- Molecular Pathology Group, Cell Biology & Histology, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium; Laboratory of Medical Microbiology, Vaccine & Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | - Jesús Rodríguez Baño
- Infectious Diseases and Microbiology Clinical Unit, University Hospital Virgen Macarena; Department of Medicine, School of Medicine, University of Seville; and Biomedicine Institute of Seville (IBiS)/CSIC, Seville, Spain; Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), Instituto de Salud Carlos III, Madrid, Spain
| | - Tiziana Lazzarotto
- Section of Microbiology, Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy; Microbiology Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy
| | - Pierluigi Viale
- Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy; Infectious Diseases Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico Sant'Orsola, Bologna, Italy
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, Verona, Italy
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8
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Basciani S, Nordio M, Dinicola S, Unfer V, Gnessi L. Diet Plus Inositols, α-Lactalbumin and Gymnema sylvestre: The Successful Combo to Restore Body Weight and Metabolic Profile in Obese and Dysmetabolic Patients. Nutrients 2023; 15:3142. [PMID: 37513560 PMCID: PMC10385591 DOI: 10.3390/nu15143142] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
The primary control of dysmetabolic patients is extremely challenging worldwide, with inadequate dietary habits and sporadic physical activity among the key risk factors for metabolic syndrome onset. Nowadays, there is no exclusive treatment for this condition, and considering that preventive measures usually fail, new therapeutic approaches need to be proposed and investigated. This present pilot study compared the effects of diet alone and in association with a combination of myo-inositol and d-chiro-inositol in their 40:1 ratio, α-lactalbumin, and Gymnema sylvestre on different metabolic parameters in obese dysmetabolic patients. To this purpose, 37 patients with BMI between 30 and 40 and fasting blood glucose between 100 and 125 mg/dL were divided into two groups: (i) the control group followed a hypocaloric Mediterranean diet, (ii) while the study group was also supplemented with a daily dosage of two sachets, each one containing 1950 mg myo-inositol, 50 mg d-chiro-inositol, 50 mg α-lactalbumin, and 250 mg Gymnema Sylvestre. After a 6-month treatment, all parameters improved in both groups. Nevertheless, the treated group experienced a greater improvement, especially concerning the variation from the baseline of HOMA index, triglycerides, BMI, body weight, and waist circumference. These findings support the supplementation with myo-inositol and d-chiro-inositol in the 40:1 ratio, α-lactalbumin, and Gymnema sylvestre as a therapeutical strategy to potentiate the beneficial effects induced via dietary programs in dysmetabolic patients.
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Affiliation(s)
- Sabrina Basciani
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Maurizio Nordio
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
| | - Simona Dinicola
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
- R&D Department, Lo.Li. Pharma, 00156 Rome, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy
- UniCamillus-Saint Camillus International University of Health Sciences, 00131 Rome, Italy
| | - Lucio Gnessi
- Section of Medical Pathophysiology, Food Science and Endocrinology, Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
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9
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Chiantera V, Laganà AS, Basciani S, Nordio M, Bizzarri M. A Critical Perspective on the Supplementation of Akkermansia muciniphila: Benefits and Harms. Life (Basel) 2023; 13:1247. [PMID: 37374030 DOI: 10.3390/life13061247] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 05/18/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Akkermansia muciniphila is a mucin-degrading bacterium of the intestinal niche, exerting beneficial effects on the host metabolic profile. Accumulating evidence indicated Akkermansia as a promising therapeutic probiotic against metabolic disorders such as obesity, type 2 diabetes and cardiovascular diseases. However, in specific intestinal microenvironments, its excessive enrichment may be not beneficial. Conditions like inflammatory bowel disease (IBD), Salmonella typhimurium infection or post-antibiotic reconstitution may not benefit from Akkermansia supplementation. Furthermore, using Akkermansia in patients with endocrine and gynecological disorders-such as polycystic ovary syndrome (PCOS) or endometriosis-that have a higher risk of developing IBD, should be critically evaluated. In addition, a cautionary note comes from the neurological field, as the gut microbiota of patients suffering from Parkinson's disease or multiple sclerosis exhibits a characteristic signature of Akkermansia municiphila abundance. Overall, considering these controversial points, the use of Akkermansia should be evaluated on an individual basis, avoiding risking unexpected effects.
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Affiliation(s)
- Vito Chiantera
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Antonio Simone Laganà
- Unit of Gynecologic Oncology, ARNAS "Civico-Di Cristina-Benfratelli", Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties (PROMISE), University of Palermo, 90127 Palermo, Italy
| | - Sabrina Basciani
- Department of Experimental Medicine, Section of Medical Pathophysiology, Food Science and Endocrinology, Sapienza University of Rome, 00161 Rome, Italy
| | - Maurizio Nordio
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Mariano Bizzarri
- System Biology Group Laboratory, Sapienza University, 00161 Rome, Italy
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10
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Boenink R, Kramer A, Tuinhout RE, Savoye E, Åsberg A, Idrizi A, Kerschbaum J, Ziedina I, Ziginskiene E, Farrugia E, Garneata L, Zakharova EV, Bell S, Arnol M, Segelmark M, Ioannou K, Hommel K, Rosenberg-Ots M, Vazelov E, Helve J, Mihály S, Pálsson R, Nordio M, Gjorgjievski N, de Vries APJ, Seyahi N, Magadi WA, Resić H, Kalachyk A, Rahmel AO, Galvão AA, Naumovic R, Lundgren T, Arici M, de Meester JM, Ortiz A, Jager KJ, Stel VS. Trends in kidney transplantation rate across Europe: Study from the ERA Registry. Nephrol Dial Transplant 2023; 38:1528-1539. [PMID: 36610723 DOI: 10.1093/ndt/gfac333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Indexed: 01/09/2023] Open
Abstract
BACKGROUND The aim of this study was to identify trends in total, deceased donor and living donor kidney transplantation (KT) rates in European countries. METHODS The European Renal Association (ERA) Registry and the Global Observatory on Donation and Transplantation (GODT) databases were used to obtain the number of KTs in individual European countries between 2010 and 2018. General population counts were obtained from Eurostat or the national bureaus of statistics. The KT rate per million population (pmp) and the average annual percentage change (APC) were calculated. RESULTS The total KT rate in the 40 participating countries increased with 1.9% annually (95% confidence interval (CI): 1.5, 2.2) from 29.6 pmp in 2010 to 34.7 pmp in 2018, reflecting an increase of 3.4 pmp in the deceased donor KT rate (from 21.6 pmp to 25.0 pmp, APC: 1.9% [95%CI: 1.3, 2.4]) and of 1.5 pmp in the living donor KT rate (from 8.1 pmp to 9.6 pmp, APC: 1.6% [95%CI: 1.0, 2.3]). The trends in KT rate varied widely across European countries. An East-West gradient was observed for deceased donor KT rate with Western European countries performing more KTs. In addition, most countries performed less living donor KTs. In 2018, Spain had the highest deceased donor KT rate (64.6 pmp) and Turkey the highest living donor KT rate (37.0 pmp). CONCLUSIONS The total KT rate increased due to a rise in the KT rate from deceased donors and to a lesser extent from living donors, with large differences between individual European countries.
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Affiliation(s)
- Rianne Boenink
- ERA Registry, Amsterdam UMC location University of Amsterdam, Department of Medical Informatics, Amsterdam, The Netherlands.,Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands
| | - Anneke Kramer
- ERA Registry, Amsterdam UMC location University of Amsterdam, Department of Medical Informatics, Amsterdam, The Netherlands.,Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands
| | - Rosalie E Tuinhout
- ERA Registry, Amsterdam UMC location University of Amsterdam, Department of Medical Informatics, Amsterdam, The Netherlands
| | - Emilie Savoye
- Direction Prélèvement Greffe Organes-Tissus, Agence de la biomédecine, Saint-Denis La Plaine, France
| | - Anders Åsberg
- The Norwegian Renal Registry, Department of Transplantation, Oslo University Hospital - Rikshospitalet, Oslo, Norway.,Department of Pharmacy, University of Oslo, Oslo, Norway
| | - Alma Idrizi
- Service of Nephrology, UHC "Mother Teresa, Tirana, Albania
| | - Julia Kerschbaum
- Austrian Dialysis and Transplant Registry, Department of Internal Medicine IV - Nephrology and Hypertension, Medical University Innsbruck, Innsbruck, Austria
| | - Ieva Ziedina
- Pauls Stradins clinical university hospital, Riga, Latvia
| | - Edita Ziginskiene
- Lithuanian Nephrology, Dialysis and Transplantation Association, Lithuania.,Nephrology Department, Medical Academy, Lithuanian University of Health Sciences, Lithuania
| | | | - Liliana Garneata
- Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.,Department of Internal Medicine and Nephrology, Dr Carol Davila Teaching Hospital of Nephrology, Bucharest, Romania
| | - Elena V Zakharova
- Nephrology and Hemodialysis, Russian Medical Academy of Continuing Professional Education, Moscow, Russian Federation
| | - Samira Bell
- Scottish Renal Registry, Public Health Scotland, Meridian Court, Glasgow, United Kingdom.,Division of Population Health & Genomics, University of Dundee, Ninewells Hospital, Dundee, United Kingdom
| | - Miha Arnol
- Department of Nephrology, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Mårten Segelmark
- Department of Clinical Sciences in Lund, Lund University and Skane University Hospital, Lund, Sweden
| | | | - Kristine Hommel
- Department of Cardiology, Endocrinology and Nephrology, Holbaek Hospital, Holbaek, Denmark
| | - Mai Rosenberg-Ots
- Department of Internal Medicine, Tartu University and Tartu University Hospital, Tartu, Estonia
| | | | - Jaakko Helve
- Finnish Registry for Kidney Diseases, Helsinki, Finland.,Nephrology, Abdominal Center, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Sándor Mihály
- Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - Runólfur Pálsson
- Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Nikola Gjorgjievski
- University Hospital of Nephrology, Skopje, North Macedonia.,Faculty of Medicine, University Ss Cyril and Methodius, Skopje, North Macedonia
| | - Aiko P J de Vries
- Department of Medicine, Division of Nephrology, Leiden Transplant Center, Leiden University Medical Center, Leiden, The Netherlands
| | - Nurhan Seyahi
- Department of nephrology, Istanbul University-Cerrahpasa, Cerrahpasa medical faculty, Istanbul, Turkey
| | | | - Halima Resić
- Society of nephrology and dialysis of Bosnia and Herzegovina, Sarajevo, Bosnia and Herzegovina
| | - Aleh Kalachyk
- Minsk Scientific and Practical Center for Surgery, Transplantation and Hematology, State Institution, Minsk, Republic of Belarus
| | - Axel O Rahmel
- Deutsche Stiftung Organtransplantation, Frankfurt am Main, Germany
| | - Ana A Galvão
- Portuguese Society of Nephrology, Coimbra, Portugal
| | - Radomir Naumovic
- Zvezdara University Clinical Hospital, Belgrade, Serbia.,High Medical School, University of Belgrade, Belgrade, Serbia
| | - Torbjörn Lundgren
- Division of Transplantation Surgery, CLINTEC, Karolinska Institute, Stockholm, Sweden
| | - Mustafa Arici
- Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Johan M de Meester
- Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), VITAZ, Sint-Niklaas, Belgium
| | - Alberto Ortiz
- Fundación Jiménez Díaz, Universidad Autónoma de Madrid, Fundación Renal Iñigo Alvarez de Toledo, Madrid, Spain
| | - Kitty J Jager
- ERA Registry, Amsterdam UMC location University of Amsterdam, Department of Medical Informatics, Amsterdam, The Netherlands.,Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA Registry, Amsterdam UMC location University of Amsterdam, Department of Medical Informatics, Amsterdam, The Netherlands.,Amsterdam Public Health, Quality of Care and Ageing & Later Life, Amsterdam, The Netherlands
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11
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Nordio M, Bezerra Espinola MS, Bilotta G, Capoccia E, Montanino Oliva M. Long-Lasting Therapies with High Doses of D-chiro-inositol: The Downside. J Clin Med 2023; 12:jcm12010390. [PMID: 36615188 PMCID: PMC9821166 DOI: 10.3390/jcm12010390] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 12/14/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
Background: Recent studies reported possible concerns following long-lasting treatments with high doses of D-chiro-inositol in women. However, to date, no clinical trial has investigated or validated these concerns. We addressed this issue both retrospectively and with a prospective pilot study. Methods: For the retrospective analysis, we searched our databases for insulin-resistant women who took 1200 mg/day D-chiro-inositol for 6 months. In our prospective study, we enrolled 10 healthy women to supplement with the same therapeutic scheme. We performed statistical analyses through the Wilcoxon Signed-Rank Test. A p-value < 0.05 was considered significant. Results: Twenty women underwent 6 months of 1200 mg/day D-chiro-inositol. The treatment significantly decreased BMI, glycemia, insulinemia, HOMA-IR, serum levels of LH, total testosterone, and DHEAS. Serum estradiol rose and menstrual abnormalities occurred following the treatment. In our prospective study, we observed increases in serum levels of total testosterone and asprosin in healthy women. Conclusions: This is the first clinical evidence demonstrating that long-term treatments with high dosages of D-chiro-inositol can predispose women to hormonal and menstrual abnormalities. Moreover, the accumulation of D-chiro-inositol following such treatment regimen may lead to detrimental effects in non-reproductive tissues, as demonstrated by the increase in asprosin levels.
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Affiliation(s)
- Maurizio Nordio
- Department of Experimental Medicine, University “Sapienza”, 00161 Rome, Italy
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00156 Rome, Italy
- Correspondence:
| | - Maria Salomè Bezerra Espinola
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00156 Rome, Italy
- Systems Biology Group Lab, 00161 Rome, Italy
| | | | | | - Mario Montanino Oliva
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00156 Rome, Italy
- Department of Obstetrics and Gynecology, Santo Spirito Hospital, 00193 Rome, Italy
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12
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Belleudi V, Rosa AC, Finocchietti M, Poggi FR, Marino ML, Massari M, Spila Alegiani S, Masiero L, Ricci A, Bedeschi G, Puoti F, Cardillo M, Pierobon S, Nordio M, Ferroni E, Zanforlini M, Piccolo G, Leone O, Ledda S, Carta P, Garau D, Lucenteforte E, Davoli M, Addis A. An Italian multicentre distributed data research network to study the use, effectiveness, and safety of immunosuppressive drugs in transplant patients: Framework and perspectives of the CESIT project. Front Pharmacol 2022; 13:959267. [PMID: 36188626 PMCID: PMC9521186 DOI: 10.3389/fphar.2022.959267] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Accepted: 07/15/2022] [Indexed: 11/30/2022] Open
Abstract
The goal of post-transplant immunosuppressive drug therapy is to prevent organ rejection while minimizing drug toxicities. In clinical practice, a multidrug approach is commonly used and involves drugs with different mechanisms of action, including calcineurin inhibitors (CNI) (tacrolimus or cyclosporine), antimetabolite (antimet) (mycophenolate or azathioprine), inhibitors of mechanistic target of rapamycin (mTOR) (sirolimus or everolimus), and/or steroids. Although evidence based on several randomized clinical trials is available, the optimal immunosuppressive therapy has not been established and may vary among organ transplant settings. To improve the knowledge on this topic, a multiregional research network to Compare the Effectiveness and Safety of Immunosuppressive drugs in Transplant patients (CESIT) has been created with the financial support of the Italian Medicines Agency. In this article, we describe the development of this network, the framework that was designed to perform observational studies, and we also give an overview of the preliminary results that we have obtained. A multi-database transplant cohort was enrolled using a common data model based on healthcare claims data of four Italian regions (Lombardy, Veneto, Lazio, and Sardinia). Analytical datasets were created using an open-source tool for distributed analysis. To link the National Transplant Information System to the regional transplant cohorts, a semi-deterministic record linkage procedure was performed. Overall, 6,914 transplant patients from 2009–19 were identified: 4,029 (58.3%) for kidney, 2,219 (32.1%) for liver, 434 (6.3%) for heart, and 215 (3.1%) for lung. As expected, demographic and clinical characteristics showed considerable variability among organ settings. Although the triple therapy in terms of CNI + antimet/mTOR + steroids was widely dispensed for all settings (63.7% for kidney, 33.5% for liver, 53.3% for heart, and 63.7% for lung), differences in the active agents involved were detected. The CESIT network represents a great opportunity to study several aspects related to the use, safety, and effectiveness of post-transplant maintenance immunosuppressive therapy in real practice.
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Affiliation(s)
- Valeria Belleudi
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
- *Correspondence: Valeria Belleudi,
| | | | | | | | | | - Marco Massari
- National Center for Drug Research and Evaluation, Istituto Superiore Di Sanità, Rome, Italy
| | | | - Lucia Masiero
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | - Andrea Ricci
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | - Gaia Bedeschi
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | - Francesca Puoti
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | - Massimo Cardillo
- Italian National Transplant Center—Istituto Superiore Di Sanità, Rome, Italy
| | | | | | | | | | | | | | - Stefano Ledda
- General Directorate for Health, Sardinia Region, Italy
| | - Paolo Carta
- General Directorate for Health, Sardinia Region, Italy
| | | | - Ersilia Lucenteforte
- Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy
| | - Marina Davoli
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
| | - Antonio Addis
- Department of Epidemiology, Lazio Regional Health Service, Rome, Italy
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13
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Testa F, Fontana F, Pollastri F, Chester J, Leonelli M, Giaroni F, Gualtieri F, Bolelli F, Mancini E, Nordio M, Sacco P, Ligabue G, Giovanella S, Ferri M, Alfano G, Gesualdo L, Cimino S, Donati G, Grana C, Magistroni R. Automated Prediction of Kidney Failure in IgA Nephropathy with Deep Learning from Biopsy Images. Clin J Am Soc Nephrol 2022; 17:1316-1324. [PMID: 35882505 PMCID: PMC9625090 DOI: 10.2215/cjn.01760222] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/27/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND AND OBJECTIVES Digital pathology and artificial intelligence offer new opportunities for automatic histologic scoring. We applied a deep learning approach to IgA nephropathy biopsy images to develop an automatic histologic prognostic score, assessed against ground truth (kidney failure) among patients with IgA nephropathy who were treated over 39 years. We assessed noninferiority in comparison with the histologic component of currently validated predictive tools. We correlated additional histologic features with our deep learning predictive score to identify potential additional predictive features. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Training for deep learning was performed with randomly selected, digitalized, cortical Periodic acid-Schiff-stained sections images (363 kidney biopsy specimens) to develop our deep learning predictive score. We estimated noninferiority using the area under the receiver operating characteristic curve (AUC) in a randomly selected group (95 biopsy specimens) against the gold standard Oxford classification (MEST-C) scores used by the International IgA Nephropathy Prediction Tool and the clinical decision supporting system for estimating the risk of kidney failure in IgA nephropathy. We assessed additional potential predictive histologic features against a subset (20 kidney biopsy specimens) with the strongest and weakest deep learning predictive scores. RESULTS We enrolled 442 patients; the 10-year kidney survival was 78%, and the study median follow-up was 6.7 years. Manual MEST-C showed no prognostic relationship for the endocapillary parameter only. The deep learning predictive score was not inferior to MEST-C applied using the International IgA Nephropathy Prediction Tool and the clinical decision supporting system (AUC of 0.84 versus 0.77 and 0.74, respectively) and confirmed a good correlation with the tubolointerstitial score (r=0.41, P<0.01). We observed no correlations between the deep learning prognostic score and the mesangial, endocapillary, segmental sclerosis, and crescent parameters. Additional potential predictive histopathologic features incorporated by the deep learning predictive score included (1) inflammation within areas of interstitial fibrosis and tubular atrophy and (2) hyaline casts. CONCLUSIONS The deep learning approach was noninferior to manual histopathologic reporting and considered prognostic features not currently included in MEST-C assessment. PODCAST This article contains a podcast at https://www.asn-online.org/media/podcast/CJASN/2022_07_26_CJN01760222.mp3.
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Affiliation(s)
- Francesca Testa
- Division of Nephrology, Dialysis and Renal Transplantation, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
| | - Francesco Fontana
- Division of Nephrology, Dialysis and Renal Transplantation, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
| | - Federico Pollastri
- Department of Engineering "Enzo Ferrari," University of Modena and Reggio Emilia, Modena, Italy
| | - Johanna Chester
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Marco Leonelli
- Division of Nephrology, Dialysis and Renal Transplantation, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
| | - Francesco Giaroni
- Division of Nephrology, Dialysis and Renal Transplantation, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
| | - Fabio Gualtieri
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Federico Bolelli
- Department of Engineering "Enzo Ferrari," University of Modena and Reggio Emilia, Modena, Italy
| | - Elena Mancini
- U.O. Nefrologia, Dialisi, Ipertensione, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy
| | - Maurizio Nordio
- Nephrology and Dialysis Unit, Unità Locale Socio Sanitaria 15 (ULSS 15), Camposampiero-Cittadella, Padua, Italy
| | - Paolo Sacco
- Nephrology and Dialysis Unit, Azienda Sanitaria Locale 3 (ASL 3), Genoa, Italy
| | - Giulia Ligabue
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Silvia Giovanella
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Maria Ferri
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Gaetano Alfano
- Division of Nephrology, Dialysis and Renal Transplantation, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
| | - Loreto Gesualdo
- Department of Emergency and Organ Transplantation, University of Bari "Aldo Moro," Bari, Italy
| | - Simonetta Cimino
- Nephrology and Dialysis, Azienda Unità Sanitaria Locale (AUSL) Modena, Modena, Italy
| | - Gabriele Donati
- Division of Nephrology, Dialysis and Renal Transplantation, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Costantino Grana
- Department of Engineering "Enzo Ferrari," University of Modena and Reggio Emilia, Modena, Italy
| | - Riccardo Magistroni
- Division of Nephrology, Dialysis and Renal Transplantation, Azienda Ospedaliera Universitaria Policlinico di Modena, Modena, Italy
- Department of Surgery, Medicine, Dental Medicine and Morphological Sciences, University of Modena and Reggio Emilia, Modena, Italy
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14
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Giannella M, Righi E, Pascale R, Rinaldi M, Caroccia N, Gamberini C, Palacios-Baena ZR, Caponcello G, Morelli MC, Tamè M, Busutti M, Comai G, Potena L, Salvaterra E, Feltrin G, Cillo U, Gerosa G, Cananzi M, Piano S, Benetti E, Burra P, Loy M, Furian L, Zaza G, Onorati F, Carraro A, Gastaldon F, Nordio M, Kumar-Singh S, Abedini M, Boffetta P, Rodríguez-Baño J, Lazzarotto T, Viale P, Tacconelli E. Evaluation of the Kinetics of Antibody Response to COVID-19 Vaccine in Solid Organ Transplant Recipients: The Prospective Multicenter ORCHESTRA Cohort. Microorganisms 2022; 10:microorganisms10051021. [PMID: 35630462 PMCID: PMC9147204 DOI: 10.3390/microorganisms10051021] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Revised: 05/05/2022] [Accepted: 05/07/2022] [Indexed: 02/04/2023] Open
Abstract
Previous studies assessing the antibody response (AbR) to mRNA COVID-19 vaccines in solid organ transplant (SOT) recipients are limited by short follow-up, hampering the analysis of AbR kinetics. We present the ORCHESTRA SOT recipients cohort assessed for AbR at first dose (t0), second dose (t1), and within 3 ± 1 month (t2) after the first dose. We analyzed 1062 SOT patients (kidney, 63.7%; liver, 17.4%; heart, 16.7%; and lung, 2.5%) and 5045 health care workers (HCWs). The AbR rates in the SOTs and HCWs were 52.3% and 99.4%. The antibody levels were significantly higher in the HCWs than in the SOTs (p < 0.001). The kinetics showed an increase (p < 0.001) in antibody levels up to 76 days and a non-significant decrease after 118 days in the SOT recipients versus a decrease up to 76 days (p = 0.02) and a less pronounced decrease between 76 and 118 days (p = 0.04) in the HCWs. Upon multivariable analysis, liver transplant, ≥3 years from SOT, mRNA-1273, azathioprine, and longer time from t0 were associated with a positive AbR at t2. Older age, other comorbidities, mycophenolate, steroids, and impaired graft function were associated with lower AbR probability. Our results may be useful to optimize strategies of immune monitoring after COVID-19 vaccination and indications regarding timing for booster dosages calibrated on SOT patients’ characteristics.
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Affiliation(s)
- Maddalena Giannella
- Infectious Diseases Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.G.); (M.R.); (N.C.); (P.V.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (M.A.); (P.B.)
| | - Elda Righi
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (E.R.); (E.T.)
| | - Renato Pascale
- Infectious Diseases Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.G.); (M.R.); (N.C.); (P.V.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (M.A.); (P.B.)
- Correspondence: ; Tel.: +390-512-143-199
| | - Matteo Rinaldi
- Infectious Diseases Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.G.); (M.R.); (N.C.); (P.V.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (M.A.); (P.B.)
| | - Natascia Caroccia
- Infectious Diseases Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.G.); (M.R.); (N.C.); (P.V.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (M.A.); (P.B.)
| | - Chiara Gamberini
- Microbiology Unit, IRCCS Policlinico Sant’Orsola, University of Bologna, 40138 Bologna, Italy; (C.G.); (T.L.)
| | - Zaira R. Palacios-Baena
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena and Department of Medicine, University of Sevilla/Biomedicines Institute of Sevilla, CSIC, 41009 Sevilla, Spain; (Z.R.P.-B.); (G.C.); (J.R.-B.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
| | - Giulia Caponcello
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena and Department of Medicine, University of Sevilla/Biomedicines Institute of Sevilla, CSIC, 41009 Sevilla, Spain; (Z.R.P.-B.); (G.C.); (J.R.-B.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
| | - Maria Cristina Morelli
- Internal Medicine Unit for the Treatment of Severe Organ Failure, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Mariarosa Tamè
- Gastroenterology Unit, Department of Digestive, Hepatic and Endocrine-Metabolic Diseases, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Marco Busutti
- Nephrology, Dialysis and Transplantation Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.B.); (G.C.)
| | - Giorgia Comai
- Nephrology, Dialysis and Transplantation Unit, Department of Experimental, Diagnostic and Specialty Medicine, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.B.); (G.C.)
| | - Luciano Potena
- Heart Failure and Transplant Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Elena Salvaterra
- Division of Interventional Pulmonology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy;
| | - Giuseppe Feltrin
- Regional Center for Transplant Coordination, 35128 Padua, Italy;
| | - Umberto Cillo
- Hepatobiliary Surgery and Liver Transplantation Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 Padua, Italy;
| | - Gino Gerosa
- Cardiac Surgery Unit, Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padua, 35128 Padua, Italy;
| | - Mara Cananzi
- Unit of Pediatric Gastroenterology, Digestive Endoscopy, Hepatology and Care of the Child with Liver Transplantation, Department of Women’s and Children’s Health, University Hospital of Padua, 35128 Padua, Italy;
| | - Salvatore Piano
- Unit of Internal Medicine and Hepatology (UIMH), Department of Medicine—DIMED, University of Padua, 35128 Padua, Italy;
| | - Elisa Benetti
- Pediatric Nephrology, Dialysis and Transplant Unit, Department of Women’s and Children’s Health, Padua University Hospital, 35128 Padua, Italy;
| | - Patrizia Burra
- Unit of Gastroenterology and Multivisceral Transplant, Department of Surgery, Oncology and Gastroenterology, University Hospital of Padua, 35128 Padua, Italy;
| | - Monica Loy
- Thoracic Surgical Unit, Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua, 35128 Padua, Italy;
| | - Lucrezia Furian
- Kidney and Pancreas Transplantation Unit, Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, 35128 Padua, Italy;
| | - Gianluigi Zaza
- Renal Unit, Department of Medicine, University Hospital of Verona, 37134 Verona, Italy;
| | - Francesco Onorati
- Division of Cardiac Surgery, University of Verona, 37134 Verona, Italy;
| | - Amedeo Carraro
- Liver Transplant Unit, Department of Surgery and Dentistry, University and Hospital Trust of Verona, 37134 Verona, Italy;
| | - Fiorella Gastaldon
- Department of Nephrology, Dialysis and Transplantation, San Bortolo Hospital, 36100 Vicenza, Italy;
| | - Maurizio Nordio
- Nephrology, Dialysis and Transplantation Unit, Treviso Hospital, 35121 Treviso, Italy;
| | - Samir Kumar-Singh
- Molecular Pathology Group, Laboratory of Cell Biology & Histology University of Antwerp, Faculty of Medicine, 2610 Antwerp, Belgium;
| | - Mahsa Abedini
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (M.A.); (P.B.)
| | - Paolo Boffetta
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (M.A.); (P.B.)
- Stony Brook Cancer Center, Stony Brook University, Stony Brook, NY 11794, USA
| | - Jesús Rodríguez-Baño
- Infectious Diseases and Microbiology Unit, Hospital Universitario Virgen Macarena and Department of Medicine, University of Sevilla/Biomedicines Institute of Sevilla, CSIC, 41009 Sevilla, Spain; (Z.R.P.-B.); (G.C.); (J.R.-B.)
- Centro de Investigación Biomédica en Red en Enfermedades Infecciosas (CIBERINFEC), 28029 Madrid, Spain
| | - Tiziana Lazzarotto
- Microbiology Unit, IRCCS Policlinico Sant’Orsola, University of Bologna, 40138 Bologna, Italy; (C.G.); (T.L.)
| | - Pierluigi Viale
- Infectious Diseases Unit, Department of Integrated Management of Infectious Risk, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy; (M.G.); (M.R.); (N.C.); (P.V.)
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy; (M.A.); (P.B.)
| | - Evelina Tacconelli
- Division of Infectious Diseases, Department of Diagnostics and Public Health, University of Verona, 37134 Verona, Italy; (E.R.); (E.T.)
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15
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Ocak G, Boenink R, Noordzij M, Bos WJW, Vikse BE, Cases A, Kerschbaum J, Helve J, Nordio M, Arici M, Mercadal L, Wanner C, Palsson R, Hommel K, De Meester J, Kostopoulou M, Santamaria R, Rodrigo E, Rydell H, Bell S, Massy ZA, Jager KJ, Kramer A. Trends in Mortality Due to Myocardial Infarction, Stroke, and Pulmonary Embolism in Patients Receiving Dialysis. JAMA Netw Open 2022; 5:e227624. [PMID: 35435972 PMCID: PMC9016490 DOI: 10.1001/jamanetworkopen.2022.7624] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE During the past decades, improvements in the prevention and management of myocardial infarction, stroke, and pulmonary embolism have led to a decline in cardiovascular mortality in the general population. However, it is unknown whether patients receiving dialysis have also benefited from these improvements. OBJECTIVE To assess the mortality rates for myocardial infarction, stroke, and pulmonary embolism in a large cohort of European patients receiving dialysis compared with the general population. DESIGN, SETTING, AND PARTICIPANTS In this cohort study, adult patients who started dialysis between 1998 and 2015 from 11 European countries providing data to the European Renal Association Registry were and followed up for 3 years. Data were analyzed from September 2020 to February 2022. EXPOSURES Start of dialysis. MAIN OUTCOMES AND MEASURES The age- and sex-standardized mortality rate ratios (SMRs) with 95% CIs were calculated by dividing the mortality rates in patients receiving dialysis by the mortality rates in the general population for 3 equal periods (1998-2003, 2004-2009, and 2010-2015). RESULTS In total, 220 467 patients receiving dialysis were included in the study. Their median (IQR) age was 68.2 (56.5-76.4) years, and 82 068 patients (37.2%) were female. During follow-up, 83 912 patients died, of whom 7662 (9.1%) died because of myocardial infarction, 5030 (6.0%) died because of stroke, and 435 (0.5%) died because of pulmonary embolism. Between the periods 1998 to 2003 and 2010 to 2015, the SMR of myocardial infarction decreased from 8.1 (95% CI, 7.8-8.3) to 6.8 (95% CI, 6.5-7.1), the SMR of stroke decreased from 7.3 (95% CI, 7.0-7.6) to 5.8 (95% CI, 5.5-6.2), and the SMR of pulmonary embolism decreased from 8.7 (95% CI, 7.6-10.1) to 5.5 (95% CI, 4.5-6.6). CONCLUSIONS AND RELEVANCE In this cohort study of patients receiving dialysis, mortality rates for myocardial infarction, stroke, and pulmonary embolism decreased more over time than in the general population.
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Affiliation(s)
- Gurbey Ocak
- Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, the Netherlands
| | - Rianne Boenink
- European Renal Association Registry, Department of Medical Informatics, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Marlies Noordzij
- European Renal Association Registry, Department of Medical Informatics, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Willem Jan W. Bos
- Department of Internal Medicine, Sint Antonius Hospital, Nieuwegein, the Netherlands
- Department of Internal Medicine, Leiden University Medical Center, Leiden, the Netherlands
| | - Bjorn E. Vikse
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Medicine, Haugesund Hospital, Haugesund, Norway
| | - Aleix Cases
- Nephrology Department, Hospital Clínic, Universitat de Barcelona, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
- Registre de Malalts Renals de Catalunya, Barcelona, Spain
| | - Julia Kerschbaum
- Department of Internal Medicine IV - Nephrology and Hypertension, Austrian Dialysis and Transplant Registry, Medical University Innsbruck, Innsbruck, Austria
| | - Jaakko Helve
- Finnish Registry for Kidney Diseases, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Maurizio Nordio
- Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy
- Nephrology Dialysis and Renal Transplantation Unit, Treviso, Italy
| | - Mustafa Arici
- Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Lucile Mercadal
- Department of Nephrology and Renal Transplantation, Assistance Publique-Hôpitaux de Paris, Hôpital de La Pitié Salpêtrière Hospital, Paris, France
| | - Christoph Wanner
- Division of Nephrology, Department of Medicine, University Hospital of Würzburg, Würzburg, Germany
| | - Runolfur Palsson
- Division of Nephrology, Landspitali, The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Johan De Meester
- Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium
| | | | - Rafael Santamaria
- Andalusian Autonomous Transplant Coordination Information System, Seville, Spain
- Nephrology ServiceReina Sofia University Hospital, Cordoba, Spain
| | - Emilio Rodrigo
- Nephrology Service, University Hospital Marqués de Valdecilla/IDIVAL, University of Cantabria, Santander, Spain
| | - Helena Rydell
- Division of Renal Medicine, Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Stockholm, Sweden
- Swedish Renal Registry, Department of Internal Medicine, Ryhov Regional Hospital, Jönköping, Sweden
| | - Samira Bell
- Scottish Renal Registry, Meridian Court, Glasgow, United Kingdom
- Division of Population health And Genomics, University of Dundee, Dundee, United Kingdom
| | - Ziad A. Massy
- Division of Nephrology, Ambroise Paré University Hospital, Boulogne-Billancourt, France
- Institut National de la Santé et de la Recherche Médicale, Research Centre in Epidemiology and Population Health, University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Kitty J. Jager
- European Renal Association Registry, Department of Medical Informatics, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
| | - Anneke Kramer
- European Renal Association Registry, Department of Medical Informatics, Amsterdam Universitair Medische Centra, University of Amsterdam, Amsterdam Public Health research institute, Amsterdam, the Netherlands
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Ferraro PM, Bolignano D, Aucella F, Brunori G, Gesualdo L, Limido A, Locatelli F, Nordio M, Postorino M, Pecoits-Filho R, Karaboyas A. Hyperkalemia excursions and risk of mortality and hospitalizations in hemodialysis patients: results from DOPPS-Italy. J Nephrol 2022; 35:707-709. [PMID: 35032015 DOI: 10.1007/s40620-021-01209-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2021] [Accepted: 11/09/2021] [Indexed: 10/19/2022]
Affiliation(s)
- Pietro Manuel Ferraro
- U.O.S. Terapia Conservativa della Malattia Renale Cronica, U.O.C. Nefrologia, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo Agostino Gemelli 8, 00168, Rome, Italy. .,Università Cattolica del Sacro Cuore, Rome, Italy.
| | - Davide Bolignano
- Department of Medical and Surgical Sciences, Nephrology and Dialysis Unit, "Magna Graecia" University, Catanzaro, Italy
| | - Filippo Aucella
- Casa Sollievo della Sofferenza Hospital, Scientific Institute for Research and Health Care, Foggia, Italy
| | | | - Loreto Gesualdo
- Department of Emergency and Organ Transplantation, Nephrology, Dialysis and Transplantation Unit, University of Bari "A. Moro", Bari, Italy
| | - Aurelio Limido
- SC Nefrologia e Dialisi, ASST Fatebenefratelli Sacco, Milano, Italy
| | | | | | - Maurizio Postorino
- U.O.C. Nefrologia Dialisi e Trapianto, Grande Ospedale Metropolitano Reggio Calabria, Reggio Calabria, Italy
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17
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Pierobon S, Braggion M, Fedeli U, Nordio M, Basso C, Zorzi M. Impact of vaccination on the spread of SARS-CoV-2 infection in north-east Italy nursing homes. A propensity score and risk analysis. Age Ageing 2022; 51:6424572. [PMID: 34902858 PMCID: PMC8754709 DOI: 10.1093/ageing/afab224] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 08/24/2021] [Indexed: 01/16/2023] Open
Abstract
Background In the Veneto Region, 421,000 coronavirus 2019 disease (COVID-19) cases and 11,000 deaths have been reported since 21 February 2020. The pandemic spread particularly in nursing homes (NH). Objective This study estimated the impact of SARS-CoV-2 infection among NH residents, focusing on the risk of hospitalisation and death due to COVID-19 compared with the general older population. It also provided evidence of risk changes over time. Methods Older people, resident in Veneto, were enrolled from the regional registry of the population. We collected also information about demographic characteristics, chronic diseases, COVID-19 positivity, NH institutionalization, hospitalisation and date of death. Patients were assigned to NH or non-NH residents groups through a propensity score 1:1 matching. The follow-up period was defined as 21 February 2020 – 3 May 2021 and then divided into three waves. Risk ratios (RRs) and 95% confidence interval were estimated by using Poisson models with robust estimation of variance. Results NH residents showed a higher risk of COVID-19 infection (RR = 6.28; 6.03–6.54), hospitalisation for COVID-19 (RR = 2.20; 2.05–2.36) and death with COVID-19 (RR = 6.07; 5.58–6.61). Conclusion NH residents shared common spaces with other patients and healthcare professionals and were more exposed to infections. Nonetheless, in Italy from late December 2020 to May 2021, 95% of NH residents and their healthcare professionals received at least one vaccine dose and RRs for all outcomes decreased in NH.
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Affiliation(s)
- Silvia Pierobon
- Epidemiological Department, Azienda Zero, Veneto Region, Padova 35132, Italy
| | - Marco Braggion
- Epidemiological Department, Azienda Zero, Veneto Region, Padova 35132, Italy
| | - Ugo Fedeli
- Epidemiological Department, Azienda Zero, Veneto Region, Padova 35132, Italy
| | | | - Cristina Basso
- Epidemiological Department, Azienda Zero, Veneto Region, Padova 35132, Italy
| | - Manuel Zorzi
- Epidemiological Department, Azienda Zero, Veneto Region, Padova 35132, Italy
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18
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Pkhaladze L, Russo M, Unfer V, Nordio M, Basciani S, Khomasuridze A. Treatment of lean PCOS teenagers: a follow-up comparison between Myo-Inositol and oral contraceptives. Eur Rev Med Pharmacol Sci 2021; 25:7476-7485. [PMID: 34919250 DOI: 10.26355/eurrev_202112_27447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Polycystic ovary syndrome (PCOS) is an endocrinological and metabolic disorder widely diffused and diagnosed in women of reproductive age. The pathology exhibits alteration of the reproductive functions, including conditions as hyperandrogenism, menstrual cycle irregularity, type 2 diabetes. These conditions are visible in the patients through phenotypical manifestations as hirsutism, acne, and obesity. Even if the syndrome is characterized by common features among both adult and adolescent women, the diagnostic criteria are different for the two age categories and to date still controversial. We investigated different treatments in PCOS adolescents with non-severe metabolic conditions, to evaluate which could be the appropriate therapeutical approach for these patients. PATIENTS AND METHODS We enrolled lean teenagers with PCOS, and we divided the patients in two age ranges: 13-16 years old and 17-19 years old. They were treated for 3 months either with oral contraceptive pills (OCP) drospirenone/ethinylestradiol (group A), myo-Inositol (myo-Ins) (group B), or OCP plus myo-Ins (group C). Data were analyzed with a descriptive statistics summarizing quantitative variables including median, 25th and 75th percentiles. RESULTS We pointed out that the group of 13-16 years old lean teenagers treated with myo-Ins exhibit a significant decrease of weight and body mass index (BMI), and an effective improvement the metabolic and hormonal parameters achieved with a non-pharmacological treatment. In the older teenagers aged 17-19 years, data highlights that myo-Ins treatment in combination with OCP prevents the increases of weight and BMI, improves the metabolic profile of the patients, and strongly ameliorates the hormonal parameters analyzed. CONCLUSIONS The results indicate a different scenario in the two age ranges considered and interestingly suggest an important role of myo-Ins in the PCOS context. A therapy based on this natural compound alone or in combination with OCP seems effective to improve both metabolic and hormonal parameters of PCOS adolescents and thus could represent a novel and valid option to consider for the treatment of this syndrome.
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Affiliation(s)
- L Pkhaladze
- Zhordania and Khomasuridze Institute of Reproductology, Tbilisi, Georgia.
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19
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Nordio M, Kumanov P, Chiefari A, Puliani G. D-Chiro-Inositol improves testosterone levels in older hypogonadal men with low-normal testosterone: a pilot study. Basic Clin Androl 2021; 31:28. [PMID: 34763665 PMCID: PMC8588714 DOI: 10.1186/s12610-021-00146-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 09/14/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several recent journal articles report that D-chiro-inositol (DCI), primarily known as insulin second messenger, influences steroidogenesis. In particular, new evidence is arising on DCI ability to regulate aromatase expression and testosterone biosynthesis. In this regard, DCI administration could represent a good therapeutic opportunity in case of reduced levels of testosterone. Older men generally have lower testosterone concentrations than younger men, and recent randomized controlled trials have examined whether testosterone treatment might improve health outcomes in this age group. There is limited information about the safety of testosterone replacement therapy in these men, hence DCI could represent an interesting alternative for future trials. Therefore, this study aims to evaluate the effect of DCI treatment on testosterone levels in older male patient. RESULTS Ten older men with basal low testosterone levels were enrolled in this study. Patients took 600 mg of DCI, two-times per day, for 30 days. We evaluated hormonal and glycaemic parameters, weight, waist circumference, and Body-Mass Index at baseline (T0) and after 30 days (T1). Finally, all patients also filled in the standardized International Index of Erectile Function questionnaire and performed the Handgrip test at T0 and T1. Men receiving DCI showed increased androgen and reduced oestrogen concentrations, and improved glycaemic profiles. DCI was also associated with reduced weight, Body-Mass Index, waist circumference, and improved grip strength and self-reported sexual function. All these effects led to the improvement of sexual function and physical strength. CONCLUSIONS In this pilot study, DCI treatment improved the levels of testosterone and androstenedione at the expense of oestrogens in elder men with low basal levels of these hormones without adverse effects. TRIAL REGISTRATION Clinicaltrials.gov: D-chiroinositol Administration in Hypogonadal Males, NCT04708249.
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Affiliation(s)
- Maurizio Nordio
- The Expert Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy. .,Department of Experimental Medicine, Sapienza University, Rome, Italy.
| | - Philip Kumanov
- Medical Faculty, University Hospital of Endocrinology and Gerontology Ivan Penchev, Sofia, Bulgaria
| | - Alfonsina Chiefari
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
| | - Giulia Puliani
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, Rome, Italy
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Gambioli R, Montanino Oliva M, Nordio M, Chiefari A, Puliani G, Unfer V. New Insights into the Activities of D-Chiro-Inositol: A Narrative Review. Biomedicines 2021; 9:biomedicines9101378. [PMID: 34680494 PMCID: PMC8533370 DOI: 10.3390/biomedicines9101378] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Revised: 09/29/2021] [Accepted: 09/30/2021] [Indexed: 12/14/2022] Open
Abstract
D-chiro-inositol (DCI) is a natural compound detectable in cell membranes, which is highly conserved as a biological signaling molecule. In mammals, its function is primarily characterized in the intracellular transduction cascade of insulin. In particular, insulin signal promotes the release of pivotal DCI-containing molecules. In fact, impaired release of DCI is a common feature of insulin-resistant tissues, and insulin-sensitizing pharmaceuticals induce higher concentrations of free DCI. Moreover, it also plays important roles in several other processes. DCI is involved in the regulation of steroidogenesis, due to its regulatory effects on steroidogenic enzymes, including 17α-hydroxylase, 3β-hydroxysteroid dehydrogenase, and aromatase. Such regulation of various enzymes indicates a mechanism by which the body regulates different processes via a single molecule, depending on its concentration. DCI also reduces the expression of integrin β3, which is an adhesion molecule involved in embryo implantation and cellular phenomena such as survival, stemness, and invasiveness. In addition, DCI seems to have important anti-inflammatory activities, like its 3-O-methyl-ether, called pinitol. In vitro evidence demonstrates that treatment with both compounds induces a reduction in pro-inflammatory factors—such as Nf-κB—and cytokines—such as TNF-α. DCI then plays important roles in several fundamental processes in physiology. Therefore, research on such molecule is of primary importance.
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Affiliation(s)
| | - Mario Montanino Oliva
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy; (M.M.O.); (M.N.)
- Department of Obstetrics and Gynecology, Santo Spirito Hospital, 00193 Rome, Italy
| | - Maurizio Nordio
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy; (M.M.O.); (M.N.)
- Department of Experimental Medicine, Sapienza University, 00185 Rome, Italy
| | - Alfonsina Chiefari
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (A.C.); (G.P.)
| | - Giulia Puliani
- Oncological Endocrinology Unit, IRCCS Regina Elena National Cancer Institute, 00144 Rome, Italy; (A.C.); (G.P.)
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), 00161 Rome, Italy; (M.M.O.); (M.N.)
- System Biology Group Lab, 00161 Rome, Italy
- Correspondence:
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21
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Dinicola S, Unfer V, Facchinetti F, Soulage CO, Greene ND, Bizzarri M, Laganà AS, Chan SY, Bevilacqua A, Pkhaladze L, Benvenga S, Stringaro A, Barbaro D, Appetecchia M, Aragona C, Bezerra Espinola MS, Cantelmi T, Cavalli P, Chiu TT, Copp AJ, D’Anna R, Dewailly D, Di Lorenzo C, Diamanti-Kandarakis E, Hernández Marín I, Hod M, Kamenov Z, Kandaraki E, Monastra G, Montanino Oliva M, Nestler JE, Nordio M, Ozay AC, Papalou O, Porcaro G, Prapas N, Roseff S, Vazquez-Levin M, Vucenik I, Wdowiak A. Inositols: From Established Knowledge to Novel Approaches. Int J Mol Sci 2021; 22:10575. [PMID: 34638926 PMCID: PMC8508595 DOI: 10.3390/ijms221910575] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 09/13/2021] [Accepted: 09/22/2021] [Indexed: 12/24/2022] Open
Abstract
Myo-inositol (myo-Ins) and D-chiro-inositol (D-chiro-Ins) are natural compounds involved in many biological pathways. Since the discovery of their involvement in endocrine signal transduction, myo-Ins and D-chiro-Ins supplementation has contributed to clinical approaches in ameliorating many gynecological and endocrinological diseases. Currently both myo-Ins and D-chiro-Ins are well-tolerated, effective alternative candidates to the classical insulin sensitizers, and are useful treatments in preventing and treating metabolic and reproductive disorders such as polycystic ovary syndrome (PCOS), gestational diabetes mellitus (GDM), and male fertility disturbances, like sperm abnormalities. Moreover, besides metabolic activity, myo-Ins and D-chiro-Ins deeply influence steroidogenesis, regulating the pools of androgens and estrogens, likely in opposite ways. Given the complexity of inositol-related mechanisms of action, many of their beneficial effects are still under scrutiny. Therefore, continuing research aims to discover new emerging roles and mechanisms that can allow clinicians to tailor inositol therapy and to use it in other medical areas, hitherto unexplored. The present paper outlines the established evidence on inositols and updates on recent research, namely concerning D-chiro-Ins involvement into steroidogenesis. In particular, D-chiro-Ins mediates insulin-induced testosterone biosynthesis from ovarian thecal cells and directly affects synthesis of estrogens by modulating the expression of the aromatase enzyme. Ovaries, as well as other organs and tissues, are characterized by a specific ratio of myo-Ins to D-chiro-Ins, which ensures their healthy state and proper functionality. Altered inositol ratios may account for pathological conditions, causing an imbalance in sex hormones. Such situations usually occur in association with medical conditions, such as PCOS, or as a consequence of some pharmacological treatments. Based on the physiological role of inositols and the pathological implications of altered myo-Ins to D-chiro-Ins ratios, inositol therapy may be designed with two different aims: (1) restoring the inositol physiological ratio; (2) altering the ratio in a controlled way to achieve specific effects.
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Affiliation(s)
- Simona Dinicola
- Systems Biology Group Lab, 00161 Rome, Italy; (S.D.); (V.U.); (M.B.); (C.A.); (M.S.B.E.); (G.M.)
| | - Vittorio Unfer
- Systems Biology Group Lab, 00161 Rome, Italy; (S.D.); (V.U.); (M.B.); (C.A.); (M.S.B.E.); (G.M.)
| | - Fabio Facchinetti
- Obstetrics and Gynecology Unit, Mother-Infant and Adult Department of Medical and Surgical Sciences, University of Modena and Reggio Emilia, 41121 Modena, Italy
| | - Christophe O. Soulage
- CarMeN Lab, INSA-Lyon, INSERM U1060, INRA, University Claude Bernard Lyon 1, 69100 Villeurbanne, France;
| | - Nicholas D. Greene
- Newlife Birth Defects Research Centre and Developmental Biology and Cancer Programme, Institute of Child Health, University College London, London WC1E 6BT, UK; (N.D.G.); (A.J.C.)
| | - Mariano Bizzarri
- Systems Biology Group Lab, 00161 Rome, Italy; (S.D.); (V.U.); (M.B.); (C.A.); (M.S.B.E.); (G.M.)
- Department of Experimental Medicine, University La Sapienza, 00161 Rome, Italy
| | - Antonio Simone Laganà
- Department of Obstetrics and Gynecology, Hospital “Filippo Del Ponte”, University of Insubria, 21100 Varese, Italy;
| | - Shiao-Yng Chan
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore;
| | - Arturo Bevilacqua
- Department of Dynamic, Clinical Psychology and Health Studies, Sapienza University, 00161 Rome, Italy;
| | - Lali Pkhaladze
- Zhordania and Khomasuridze Institute of Reproductology, Tbilisi 0112, Georgia;
| | - Salvatore Benvenga
- Department of Clinical and Experimental Medicine, University of Messina, 98122 Messina, Italy;
| | - Annarita Stringaro
- National Center for Drug Research and Evaluation, Italian National Institute of Health, 00161 Rome, Italy;
| | - Daniele Barbaro
- U.O. Endocrinology in Livorno Hospital, USL Nordovest Toscana, 57100 Livorno, Italy;
| | - Marialuisa Appetecchia
- Oncological Endocrinology Unit, Regina Elena National Cancer Institute, IRCCS, 00161 Rome, Italy;
| | - Cesare Aragona
- Systems Biology Group Lab, 00161 Rome, Italy; (S.D.); (V.U.); (M.B.); (C.A.); (M.S.B.E.); (G.M.)
| | | | - Tonino Cantelmi
- Institute for Interpersonal Cognitive Therapy, 00100 Rome, Italy;
| | - Pietro Cavalli
- Humanitas Research Hospital, Rozzano, 20089 Milan, Italy;
| | | | - Andrew J. Copp
- Newlife Birth Defects Research Centre and Developmental Biology and Cancer Programme, Institute of Child Health, University College London, London WC1E 6BT, UK; (N.D.G.); (A.J.C.)
| | - Rosario D’Anna
- Department of Human Pathology, University of Messina, 98122 Messina, Italy;
| | - Didier Dewailly
- Faculty of Medicine, University of Lille, 59000 Lille, France;
| | - Cherubino Di Lorenzo
- Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino, 04100 Latina, Italy;
| | - Evanthia Diamanti-Kandarakis
- Department of Endocrinology and Diabetes, HYGEIA Hospital, Marousi, 15123 Athens, Greece; (E.D.-K.); (E.K.); (O.P.)
| | - Imelda Hernández Marín
- Human Reproduction Department, Hospital Juárez de México, Universidad Nacional Autónoma de México (UNAM), Mexico City 07760, Mexico;
| | - Moshe Hod
- Department of Obstetrics and Gynecology Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv 6997801, Israel;
| | - Zdravko Kamenov
- Department of Internal Medicine, Medical University of Sofia, 1431 Sofia, Bulgaria;
| | - Eleni Kandaraki
- Department of Endocrinology and Diabetes, HYGEIA Hospital, Marousi, 15123 Athens, Greece; (E.D.-K.); (E.K.); (O.P.)
| | - Giovanni Monastra
- Systems Biology Group Lab, 00161 Rome, Italy; (S.D.); (V.U.); (M.B.); (C.A.); (M.S.B.E.); (G.M.)
| | | | - John E. Nestler
- Division of Endocrinology, Diabetes and Metabolism, Department of Internal Medicine, Virginia Commonwealth University, Richmond, VA 23284, USA;
| | | | - Ali C. Ozay
- Department of Obstetrics and Gynecology, Near East University Hospital, Nicosia 99138, Cyprus;
| | - Olga Papalou
- Department of Endocrinology and Diabetes, HYGEIA Hospital, Marousi, 15123 Athens, Greece; (E.D.-K.); (E.K.); (O.P.)
| | | | - Nikos Prapas
- IAKENTRO, Infertility Treatment Center, 54250 Thessaloniki, Greece;
| | - Scott Roseff
- Reproductive Endocrinology and Infertility, South Florida Institute for Reproductive Medicine (IVFMD), Boca Raton, FL 33458, USA;
| | - Monica Vazquez-Levin
- Instituto de Biología y Medicina Experimental (IBYME, CONICET-FIBYME), Consejo Nacional de Investigaciones Científicas y Técnicas de Argentina (CONICET), Buenos Aires 2490, Argentina;
| | - Ivana Vucenik
- Department of Medical & Research Technology and Pathology, School of Medicine, University of Maryland, Baltimore, MD 21201, USA;
| | - Artur Wdowiak
- Diagnostic Techniques Unit, Medical University of Lublin, 20-081 Lublin, Poland;
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22
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Quintaliani G, Nordio M, Reboldi G, Aucella F, Brunori G. [Nephrology: where we stand and where we should go]. G Ital Nefrol 2021; 38:38-03-2021-01. [PMID: 34169689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
In the last year, the Italian National Health Service as a whole and the Nephrology community have been severely challenged by the pandemic. It has been a dramatic stress test for the entire healthcare system, not only in Italy but worldwide. The general organization of our Nephrology units and our models of care were put under extreme pressure, and we had to quickly adopt unprecedented clinical practice recommendations and organizational models to overcome the impasse caused by the pandemic. The time has come to evaluate these new experiences, ask how we could have been better prepared and look for change. In this editorial, we outline a few proposals and suggestions for the future, weighing the information gathered in the 2018 Nephrology Census against the new organizational requirements imposed by the COVID-19 pandemic.
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Affiliation(s)
| | | | - Gianpaolo Reboldi
- Commissione Epidemiologia SIN; Dipartimento di Medicina, Università di Perugia, Perugia, Italy
| | - Filippo Aucella
- IRCCS "Casa Sollievo Della Sofferenza", Istituto scientifico per la ricerca e cura, San Giovanni Rotondo (FG), Italy
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23
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Pippias M, Stel VS, Arnol M, Bemelman F, Berger SP, Ponikvar JB, Kramar R, Magaz Á, Nordio M, Peters-Sengers H, Reisæter AV, Sørensen SS, Massy ZA, Jager KJ. Temporal Trends in the Quality of Deceased Donor Kidneys and Kidney Transplant Outcomes in Europe: an analysis by the ERA-EDTA Registry. Nephrol Dial Transplant 2021; 37:175-186. [PMID: 33848355 PMCID: PMC8719578 DOI: 10.1093/ndt/gfab156] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Indexed: 01/07/2023] Open
Abstract
Background We investigated 10-year trends in deceased donor kidney quality expressed as the kidney donor risk index (KDRI) and subsequent effects on survival outcomes in a European transplant population. Methods Time trends in the crude and standardized KDRI between 2005 and 2015 by recipient age, sex, diabetic status and country were examined in 24 177 adult kidney transplant recipients in seven European countries. We determined 5-year patient and graft survival probabilities and the risk of death and graft loss by transplant cohort (Cohort 1: 2005–06, Cohort 2: 2007–08, Cohort 3: 2009–10) and KDRI quintile. Results The median crude KDRI increased by 1.3% annually, from 1.31 [interquartile range (IQR) 1.08–1.63] in 2005 to 1.47 (IQR 1.16–1.90) in 2015. This increase, i.e. lower kidney quality, was driven predominantly by increases in donor age, hypertension and donation after circulatory death. With time, the gap between the median standardized KDRI in the youngest (18–44 years) and oldest (>65 years) recipients widened. There was no difference in the median standardized KDRI by recipient sex. The median standardized KDRI was highest in Austria, the Netherlands and the Basque Country (Spain). Within each transplant cohort, the 5-year patient and graft survival probability were higher for the lowest KDRIs. There was no difference in the patient and graft survival outcomes across transplant cohorts, however, over time the survival probabilities for the highest KDRIs improved. Conclusions The overall quality of deceased donor kidneys transplanted between 2005 and 2015 has decreased and varies between age groups and countries. Overall patient and graft outcomes remain unchanged.
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Affiliation(s)
- Maria Pippias
- Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK.,North Bristol, NHS Trust, Renal Unit, Bristol, UK.
| | - Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam Public Health Research Institute, Amsterdam UMC-location AMC, University of Amsterdam, Amsterdam, the, Netherlands.
| | - Miha Arnol
- Department of Nephrology, Centre for Kidney Transplantation, University Medical Centre Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Frederike Bemelman
- Department of Nephrology, Amsterdam, UMC-location, AMC, University of Amsterdam, Amsterdam, the, Netherlands.
| | - Stefan P Berger
- Division of Nephrology, University of Groningen, University Medical Center Groningen, Groningen, the, Netherlands.
| | - Jadranka Buturovic Ponikvar
- Department of Nephrology, University Medical Center Ljubljana, Ljubljana, Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia.
| | - Reinhard Kramar
- Austrian Dialysis and Transplant Registry, A-4532 Rohr, im Kremstal, Austria.
| | - Ángela Magaz
- Unidad de Información sobre Pacientes Renales de la Comunidad Autónoma del País Vasco (UNIPAR), Basque, country, Spain.
| | - Maurizio Nordio
- Nephrology, Dialysis and Transplantation Unit, Treviso General Hospital AULSS2, Treviso, Italy.
| | - Hessel Peters-Sengers
- Center for Experimental and Molecular Medicine, Amsterdam University Medical Centers, location Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands.,the Amsterdam Institute for Infection and Immunity, Amsterdam University Medical Centers, Amsterdam, the Netherlands;
| | - Anna Varberg Reisæter
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Norway. areisate@ous, -hf.no
| | - Søren S Sørensen
- Department of Nephrology P, Rigshospitalet, University Hospital of Copenhagen, Copenhagen, Denmark.
| | - Ziad A Massy
- Division of Nephrology, Ambroise Pare University Hospital, APHP, University of Paris Ouest-Versailles-St-Quentin-en-Yvelines (UVSQ), Boulogne, -Billancourt, /Paris, France.,Institut National de la Sante et de la Recherche Medicale (INSERM) U1018, Team 5, CESP UVSQ, University Paris Saclay, Villejuif, France.
| | - Kitty J Jager
- Kitty J. Jager Professor, : ERA, -EDTA Registry, Department of Medical Informatics, Amsterdam, UMC-location, AMC, Amsterdam Public Health Research Institute, University of Amsterdam, Amsterdam, the, Netherlands.
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24
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Helve J, Kramer A, Abad Diez JM, Aresté-Fosalba N, Arici M, Cases A, Collart F, Heaf J, De Meester J, Nordio M, Palsson R, Pobes A, Rydell H, Reisæter AV, Massy ZA, Jager KJ, Finne P. Effect of comorbidities on survival in patients >80 years of age at onset of renal replacement therapy: data from the ERA-EDTA Registry. Nephrol Dial Transplant 2021; 36:688-694. [PMID: 33537775 DOI: 10.1093/ndt/gfaa278] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 09/15/2020] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND The number of elderly patients on renal replacement therapy (RRT) is increasing. The survival and quality of life of these patients may be lower if they have multiple comorbidities at the onset of RRT. The aim of this study was to explore whether the effect of comorbidities on survival is similar in elderly RRT patients compared with younger ones. METHODS Included were 9333 patients ≥80 years of age and 48 352 patients 20-79 years of age starting RRT between 2010 and 2015 from 15 national or regional registries submitting data to the European Renal Association-European Dialysis and Transplantation Association Registry. Patients were followed until death or the end of 2016. Survival was assessed by Kaplan-Meier curves and the relative risk of death associated with comorbidities was assessed by Cox regression analysis. RESULTS Patients ≥80 years of age had a greater comorbidity burden than younger patients. However, relative risks of death associated with all studied comorbidities (diabetes, ischaemic heart disease, chronic heart failure, cerebrovascular disease, peripheral vascular disease and malignancy) were significantly lower in elderly patients compared with younger patients. Also, the increase in absolute mortality rates associated with an increasing number of comorbidities was smaller in elderly patients. CONCLUSIONS Comorbidities are common in elderly patients who enter RRT, but the risk of death associated with comorbidities is less than in younger patients. This should be taken into account when assessing the prognosis of elderly RRT patients.
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Affiliation(s)
- Jaakko Helve
- Finnish Registry for Kidney Diseases, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
| | - Anneke Kramer
- Department of Medical Informatics, ERA-EDTA Registry, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Nuria Aresté-Fosalba
- Department of Nephrology, University Hospital Virgen Macarena, Seville, Spain.,Information System of the Autonomic Transplant Coordination of Andalucía (SICATA), Andalucía, Spain
| | - Mustafa Arici
- Department of Nephrology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aleix Cases
- Department of Nephrology, Hospital Clinic, Universitat de Barcelona, IDIBAPS, Barcelona, Spain.,Registre de Malalts Renals de Catalunya, Barcelona, Spain
| | | | - James Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Johan De Meester
- Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium
| | - Maurizio Nordio
- Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy.,Nephrology Dialysis Unit, Padua, Italy
| | - Runolfur Palsson
- Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Alfonso Pobes
- Area Gestation Clinica Nefrología VII-VIII Asturias, Spain
| | - Helena Rydell
- Department of Clinical Sciences Intervention and Technology, Karolinska Institutet, Huddinge, Sweden.,Department of Internal Medicine, Swedish Renal Registry, Ryhoy County Hospital, Jönköping, Sweden
| | - Anna Varberg Reisæter
- Department of Transplantation Medicine, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - Ziad A Massy
- Division of Nephrology, Amboise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1018 team5, Research Centre in Epidemiology and Population Health (CESP), University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Kitty J Jager
- Department of Medical Informatics, ERA-EDTA Registry, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Patrik Finne
- Finnish Registry for Kidney Diseases, Helsinki, Finland.,Abdominal Center Nephrology, University of Helsinki, Helsinki University Hospital, Helsinki, Finland
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Nordio M, Reboldi G, Di Napoli A, Quintaliani G, Alberici F, Postorino M, Aucella F, Messa P, Brunori G. Risk factors and action thresholds for the novel coronavirus pandemic. Insights from the Italian Society of Nephrology COVID-19 Survey. J Nephrol 2021; 34:325-335. [PMID: 33387336 PMCID: PMC7776284 DOI: 10.1007/s40620-020-00946-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Accepted: 12/01/2020] [Indexed: 12/13/2022]
Abstract
Background and aim Over 80% (365/454) of the nation’s centers participated in the Italian Society of Nephrology COVID-19 Survey. Out of 60,441 surveyed patients, 1368 were infected as of April 23rd, 2020. However, center-specific proportions showed substantial heterogeneity. We therefore undertook new analyses to identify explanatory factors, contextual effects, and decision rules for infection containment. Methods We investigated fixed factors and contextual effects by multilevel modeling. Classification and Regression Tree (CART) analysis was used to develop decision rules. Results Increased positivity among hemodialysis patients was predicted by center location [incidence rate ratio (IRR) 1.34, 95% confidence interval (CI) 1.20–1.51], positive healthcare workers (IRR 1.09, 95% CI 1.02–1.17), test-all policy (IRR 5.94, 95% CI 3.36–10.45), and infected proportion in the general population (IRR 1.002, 95% CI 1.001–1.003) (all p < 0.01). Conversely, lockdown duration exerted a protective effect (IRR 0.95, 95% CI 0.94–0.98) (p < 0.01). The province-contextual effects accounted for 10% of the total variability. Predictive factors for peritoneal dialysis and transplant cases were center location and infected proportion in the general population. Using recursive partitioning, we identified decision thresholds at general population incidence ≥ 229 per 100,000 and at ≥ 3 positive healthcare workers. Conclusions Beyond fixed risk factors, shared with the general population, the increased and heterogeneous proportion of positive patients is related to the center’s testing policy, the number of positive patients and healthcare workers, and to contextual effects at the province level. Nephrology centers may adopt simple decision rules to strengthen containment measures timely.
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Affiliation(s)
- Maurizio Nordio
- Unit of Nephrology, General Hospital, Piazzale Ospedale, 23, 31100, Treviso, Italy
| | | | - Anteo Di Napoli
- National Institute for Health Migration and Poverty (INMP), Rome, Italy
| | - Giuseppe Quintaliani
- Italian Society of Nephrology, Viale dell'Università, 11, 00185, Rome, RM, Italy
| | - Federico Alberici
- Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Maurizio Postorino
- Unit of Nephrology, Grande Ospedale Metropolitano Reggio Calabria, Reggio Calabria, Italy
| | - Filippo Aucella
- Nephrology and Dialysis Unit, IRCCS "Casa Sollievo Della Sofferenza" Scientific Institute for Research and Health Care, San Giovanni Rotondo, Italy
| | - Piergiorgio Messa
- Division of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Giuliano Brunori
- Italian Society of Nephrology, Viale dell'Università, 11, 00185, Rome, RM, Italy. .,Nephrology and Dialysis Unit, Hospital of Trento, Trento, Italy.
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Nordio M. Critical considerations about the generalized use of n-3 polyunsaturated fatty acids in patients with Polycystic Ovary Syndrome. Ann Palliat Med 2021; 11:407-409. [DOI: 10.21037/apm-21-3430] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Accepted: 01/04/2022] [Indexed: 11/06/2022]
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Benvenga S, Nordio M, Laganà AS, Unfer V. The Role of Inositol in Thyroid Physiology and in Subclinical Hypothyroidism Management. Front Endocrinol (Lausanne) 2021; 12:662582. [PMID: 34040582 PMCID: PMC8143049 DOI: 10.3389/fendo.2021.662582] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 04/12/2021] [Indexed: 01/02/2023] Open
Abstract
Myo-Inositol (MYO) is the most abundant stereoisomer of inositols' family, cyclic polyols with 6 hydroxyl groups. Myo-Inositol has a relevant role in thyroid function and autoimmune diseases, as a precursor of phosphoinositides that takes part in the phosphatidylinositol (PI) signal transduction pathway. Among phosphoinositides, phosphatidylinositol 4,5- bisphosphate (PIP2) is the precursor of inositol triphosphates (IP3), second messenger of several hormones including thyroid-stimulating hormone (TSH). As a second messenger in the phospholipase C (PLC)-dependent inositol phosphate Ca2+/DAG pathway, Myo-Inositol is essential to produce H2O2 required for the synthesis of thyroid hormones. Consequently, depletion of Myo-Inositol or impaired inositol dependent TSH signaling pathway may predispose to the development of some thyroid diseases, such as hypothyroidism. Many clinical studies have shown that after treatment with Myo-Inositol plus Selenium (MYO+Se), TSH levels significantly decreased in patients with subclinical hypothyroidism with or without autoimmune thyroiditis. The TSH reduction was accompanied by a decline of antithyroid autoantibodies. Moreover, Myo-Inositol supplementation seemed to be involved also in the management of thyroidal benign nodules, with a possible effect in the size reduction. This review proposes a summary of the role of inositol, especially of Myo-Inositol, in the thyroidal physiology and its contribution on the management of some thyroid diseases.
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Affiliation(s)
- Salvatore Benvenga
- Department of Clinical and Experimental Medicine, Section of Endocrinology, University of Messina, Messina, Italy
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy
| | - Maurizio Nordio
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy
- Department of Experimental Medicine, “Sapienza” Università di Roma, Rome, Italy
| | - Antonio Simone Laganà
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy
- Department of Obstetrics and Gynecology, “Filippo Del Ponte” Hospital, University of Insubria, Varese, Italy
| | - Vittorio Unfer
- The Experts Group on Inositol in Basic and Clinical Research (EGOI), Rome, Italy
- Systems Biology Group Lab, “Sapienza” Università di Roma, Rome, Italy
- *Correspondence: Vittorio Unfer,
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28
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Nordio M, Basciani S, Camajani E. The 40:1 myo-inositol/D-chiro-inositol plasma ratio is able to restore ovulation in PCOS patients: comparison with other ratios. Eur Rev Med Pharmacol Sci 2020; 23:5512-5521. [PMID: 31298405 DOI: 10.26355/eurrev_201906_18223] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this clinical trial was to evaluate the efficacy of seven different ratios between two inositols stereoisomers, myo-inositol (MI) and D-chiro-inositol (DCI), in the therapy of polycystic ovary syndrome (PCOS). PATIENTS AND METHODS fifty-six PCOS patients (8 for each group) were treated by oral route using the following formulations: DCI alone, and 1:3.5; 2.5:1; 5:1; 20:1; 40:1, 80:1 MI/DCI ratio. They received 2 g of inositols twice a day for 3 months. The primary outcome was ovulation, the secondary outcome included the improvement of FSH, LH, Sex Hormone Binding Globulin (SHBG), 17-beta-Estradiol (E2), free testosterone, basal and postprandial insulin levels, as well as HOMA index, BMI and menses. RESULTS We found that the 40:1 MI/DCI ratio is the best for PCOS therapy aimed at restoring ovulation and normalizing important parameters in these patients. The other formulations were less effective. In particular, a decreased activity was observed when the 40:1 ratio was modified in favour of DCI. CONCLUSIONS Our data demonstrated that DCI activity is beneficial mainly at a specific ratio with MI, whereas the increase of DCI causes the loss of the beneficial effects at reproductive level. These results in humans validate a previous preclinical study with different MI/DCI ratios carried out in an experimental model of PCOS mice.
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Affiliation(s)
- M Nordio
- Department of Experimental Medicine, "Sapienza" University, Rome, Italy.
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Quintaliani G, Reboldi G, Di Napoli A, Nordio M, Limido A, Aucella F, Messa P, Brunori G. Exposure to novel coronavirus in patients on renal replacement therapy during the exponential phase of COVID-19 pandemic: survey of the Italian Society of Nephrology. J Nephrol 2020; 33:725-736. [PMID: 32621109 PMCID: PMC7333370 DOI: 10.1007/s40620-020-00794-1] [Citation(s) in RCA: 61] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Accepted: 06/26/2020] [Indexed: 02/06/2023]
Abstract
Background Between February and April 2020, Italy experienced an overwhelming growth of the COVID-19 pandemic. Little is known, at the country level, where and how patients on renal replacement therapy (RRT) have been mostly affected. Methods Survey of the network of Nephrology centers using a simplified 17 items electronic questionnaire designed by Italian Society of Nephrology COVID-19 Research Group. We used spatial epidemiology and geographical information systems to map SARS-CoV-2 spread among RRT patients in Italy. Results On April 9th 2020, all nephrology centers (n = 454) listed in the DialMap database were invited to complete the electronic questionnaire. Within 11 days on average, 365 centers responded (80.4% response rate; 2.3% margin of error) totaling 60,441 RRT patients. The surveyed RRT population included 30,821 hemodialysis (HD), 4139 peritoneal dialysis (PD), and 25,481 transplanted (Tx) patients respectively. The proportion of SARS-CoV-2 positive RRT patients in Italy was 2.26% (95% CI 2.14–2.39) with significant differences according to treatment modality (p < 0.001). The proportion of patients positive for SARS-CoV-2 was significantly higher in HD (3.55% [95% CI 3.34–3.76]) than PD (1.38% [95% CI 1.04–1.78] and Tx (0.86% [95% CI 0.75–0.98]) (p < 0.001), with substantial heterogeneity across regions and along the latitude gradient (p < 0.001). In RRT patients the highest rate was in the north-west (4.39% [95% CI 4.11–4.68], followed by the north-east (IR 2.06% [1.79–2.36]), the center (0.91% [0.75–1.09]), the main islands (0.67% [0.47–0.93]), and the south (0.59% [0.45–0.75]. During the COVID-19 pandemic, among SARS-Cov-2 positive RRT patients the fatality rate was 32.8%, as compared to 13.3% observed in the Italian population as of April 23rd. Conclusions A substantial proportion of the 60,441 surveyed RRT patients in Italy were SARS-Cov-2 positive and subsequently died during the exponential phase of COVID-19 pandemic. Infection risk and rates seems to differ substantially across regions, along geographical latitude, and by treatment modality. Electronic supplementary material The online version of this article (10.1007/s40620-020-00794-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Giuseppe Quintaliani
- Italian Society of Nephrology, Viale dell'Università, 11, 00185, Roma, RM, Italy
| | | | - Anteo Di Napoli
- National Institute for Health, Migration and Poverty (INMP), Rome, Italy
| | - Maurizio Nordio
- Unit of Nephrology, General Hospital, Piazzale Ospedale, 23, 31100, Treviso, Italy
| | - Aurelio Limido
- Nephrology and Dialysis Unit, ASST Fatebenefratelli e Oftalmico, Milan, Italy
| | - Filippo Aucella
- Nephrology and Dialysis Unit, IRCCS "Casa Sollievo Della Sofferenza" Scientific Institute for Research and Health Care, San Giovanni Rotondo, Italy
| | - Piergiorgio Messa
- Division of Nephrology, Dialysis and Renal Transplantation, Fondazione IRCCS Cà Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - Giuliano Brunori
- Italian Society of Nephrology, Viale dell'Università, 11, 00185, Roma, RM, Italy. .,Nephrology and Dialysis Unit, Hospital of Trento, Trento, Italy.
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30
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Kramer A, Boenink R, Noordzij M, Bosdriesz JR, Stel VS, Beltrán P, Ruiz JC, Seyahi N, Comas Farnés J, Stendahl M, Garneata L, Winzeler R, Golan E, Lopot F, Korejwo G, Bonthuis M, Lassalle M, Slon Roblero MF, Kuzema V, Hommel K, Stojceva-Taneva O, Asberg A, Kramar R, Hemmelder MH, De Meester J, Vazelov E, Andrusev A, Castro de la Nuez P, Helve J, Komissarov K, Casula A, Magaz Á, Santiuste de Pablos C, Bubić I, Traynor JP, Ioannou K, Idrizi A, Palsson R, des Grottes JM, Spustova V, Tolaj-Avdiu M, Jarraya F, Nordio M, Ziginskiene E, Massy ZA, Jager KJ. The ERA-EDTA Registry Annual Report 2017: a summary. Clin Kidney J 2020; 13:693-709. [PMID: 32897277 PMCID: PMC7467580 DOI: 10.1093/ckj/sfaa048] [Citation(s) in RCA: 48] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Accepted: 03/16/2020] [Indexed: 11/17/2022] Open
Abstract
Background This article presents a summary of the 2017 Annual Report of the European Renal Association–European Dialysis and Transplant Association (ERA-EDTA) Registry and describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 37 countries. Methods The ERA-EDTA Registry received individual patient data on patients undergoing RRT for ESRD in 2017 from 32 national or regional renal registries and aggregated data from 21 registries. The incidence and prevalence of RRT, kidney transplantation activity and survival probabilities of these patients were calculated. Results In 2017, the ERA-EDTA Registry covered a general population of 694 million people. The incidence of RRT for ESRD was 127 per million population (pmp), ranging from 37 pmp in Ukraine to 252 pmp in Greece. A total of 62% of patients were men, 52% were ≥65 years of age and 23% had diabetes mellitus as the primary renal disease. The treatment modality at the onset of RRT was haemodialysis for 85% of patients. On 31 December 2017, the prevalence of RRT was 854 pmp, ranging from 210 pmp in Ukraine to 1965 pmp in Portugal. The transplant rate in 2017 was 33 pmp, ranging from 3 pmp in Ukraine to 103 pmp in the Spanish region of Catalonia. For patients commencing RRT during 2008–12, the unadjusted 5-year patient survival probability for all RRT modalities combined was 50.8%.
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Affiliation(s)
- Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Rianne Boenink
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Marlies Noordzij
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Jizzo R Bosdriesz
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Palma Beltrán
- Public Health Directorate, RERCA Registry, Oviedo, Asturias, Spain
| | - Juan C Ruiz
- Department of Nephrology, Valdecilla Hospital, University of Cantabria, IDIVAL, Santander, Cantabria, Spain
| | - Nurhan Seyahi
- Department of Nephrology, Cerrahpasa Medical Faculty, Istanbul University, Cerrahpasa, Istanbul, Turkey
| | - Jordi Comas Farnés
- Catalan Renal Registry, Catalan Transplant Organization, Health Department, Generalitat of Catalonia, Barcelona, Spain
| | - Maria Stendahl
- Swedish Renal Registry, Department of Internal Medicine, Jonkoping Regional Hospital, Jonkoping, Sweden
| | - Liliana Garneata
- Romanian Renal Registry, Department of Internal Medicine and Nephrology, "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - Rebecca Winzeler
- Institute of Nephrology, Waid and Triemli City Hospital, Zurich, Switzerland
| | - Eliezer Golan
- Israel Renal Registry, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv-Yafo, Israel
| | - František Lopot
- Department of Medicine, General University Hospital, Prague - Strahov, Czech Republic
| | - Grzegorz Korejwo
- Department of Nephrology, Gdańsk Medical University, Gdansk, Poland
| | - Marjolein Bonthuis
- ESPN/ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Mathilde Lassalle
- Renal Epidemiology and Information Network Registry, Agence de la biomédecine, Saint-Denis La Plaine, France
| | | | - Viktorija Kuzema
- Department of Nephrology, Riga Stradins Clinical University Hospital, Riga, Latvia.,Department of Internal Medicine, Riga Stradins University, Riga, Latvia.,Latvian Nephrology Association, Riga, Latvia
| | | | | | - Anders Asberg
- Department of Transplantation Medicine, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | | | - Marc H Hemmelder
- Dutch Renal Registry, Nefrovisie Foundation, Utrecht, The Netherlands
| | | | - Evgueniy Vazelov
- Dialysis Clinic, "Alexandrovska" University Hospital, Sofia Medical University, Sofia, Bulgaria
| | - Anton Andrusev
- Chronic Dialysis, Russia & CIS Medical Department, Company "Baxter" AO, Moscow, Russia.,Renal Replacement Registry, Russian Dialysis Society, Moscow, Russia
| | - Pablo Castro de la Nuez
- Information System of the Autonomic Transplant Coordination of Andalucia (SICATA), Seville, Andalucia, Spain
| | - Jaakko Helve
- Finnish Registry for Kidney Diseases, Helsinki, Finland.,Abdominal Center, Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Kirill Komissarov
- Minsk Scientific and Practical Center of Surgery, Transplantation and Hematology, Minsk, Belarus
| | | | - Ángela Magaz
- Unidad de Información de Pacientes Renales - UNIPAR, Basque Country, Spain
| | - Carmen Santiuste de Pablos
- Murcia Renal Registry, Department of Epidemiology, Murcia Regional Health Authority, IMIB-Arrixaca, Murcia, Spain.,CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain
| | - Ivan Bubić
- Department of Internal Medicine, Faculty of Medicine, University of Rijeka, Rijeka, Croatia.,Department of Clinical Sciences I, Faculty of Health Sciences, University of Rijeka, Rijeka, Croatia
| | - Jamie P Traynor
- Scottish Renal Registry, Meridian Court, ISD Scotland, Glasgow, UK
| | - Kyriakos Ioannou
- Cyprus Renal Registry, Nicosia, Cyprus.,Nephrology Department, American Medical Center, Nicosia, Cyprus
| | - Alma Idrizi
- Service of Nephrology, UHC "Mother Teresa", Tirana, Albania
| | - Runolfur Palsson
- Division of Nephrology, Landspitali-The National University Hospital of Iceland, Reykjavik, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | | | - Viera Spustova
- Department of Clinical and Experimental Pharmacotherapy, Slovak Medical University, Bratislava, Slovakia
| | | | - Faical Jarraya
- Service de Néphrologie, Faculte de medicine, CHU H Chaker Sfax and LR19ES11, Sfax, Tunisia
| | - Maurizio Nordio
- Division of Nephrology, Dialysis and Transplantation, AULSS2 Treviso, Italy
| | - Edita Ziginskiene
- Lithuanian Nephrology, Dialysis and Transplantation Association, Kaunas, Lithuania.,Nephrology Department, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, Boulogne-Billancourt, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) Unit 1018, Team 5, Research Centre in Epidemiology and Population Health (CESP), University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
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Nordio M, Limido A, Postorino M. Present and future of kidney replacement therapy in Italy: the perspective from Italian Dialysis and Transplantation Registry (IDTR). J Nephrol 2020; 33:1195-1200. [PMID: 32445008 DOI: 10.1007/s40620-020-00750-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 05/11/2020] [Indexed: 02/03/2023]
Abstract
Incidence of kidney replacement therapy (KRT) stabilizes or declines both in Europe and in the US; however, it is predictable that global prevalence of KRT will double by 2030. In this paper, we focus on the patterns of incidence, mortality, and prevalence of KRT in Italy, and we compare, when possible, the findings with other countries. The Italian Dialysis and Transplantation Registry (IDTR) currently collects aggregate data from regional registries. In Italy, KRT yearly incidence is around 160 patients per million population (pmp). This incidence showed an increasing trend up until 2011 with an average annual percentage change (AAPC) of 1.8%, after which it stabilized. Older age is an important determinant for KRT incidence, and it is strongly associated with the variability between Italian regions. Incidence is very stable within patients less than 50 years old; however, it greatly differs between regions for patients over 75 years old, ranging from 400 to 900 pmp. Moreover, the incidence for patients over 50 years old declined from 366 pmp in 2011 to 285 in 2017. An age-period-cohort (APC) model showed a very strong cohort effect, which shows the decline in incidence seems mainly due to the better health conditions of people born after 1940. Mortality rate in KRT patients was 109 per 1000 patient-year (py) between 2011 and 2017 with great differences among treatment modalities: 162 per 1000 py in haemodialysis, 117 per 1000 py in peritoneal dialysis, and 16 per 1000 py in kidney transplantation. Premature death is better detected by the standard expected years of life lost (YLL). The distribution of YLL rate per age shows a sharp increase between 40 and 70 years old both in haemodialysis and peritoneal dialysis patients with an AAPC of 5.2% and 4.1% respectively. Transplanted patients experience a very low YLL rate at any age. KRT prevalence was 1118 pmp in 2017 and it should be close to 1175 pmp by 2025 with a projected increase of transplanted patients' prevalence to 500 pmp, and a decrease of dialysis patients from 714 to 680 pmp. The proportion of patients treated with one of the three modalities strictly depends on age, with a sharp increase of haemodialysis after the age of 50. All data suggests the necessity to improve the care of middle and older age patients who experience the higher incidence of disease and mortality.
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Affiliation(s)
- M Nordio
- Unit of Nephrology, General Hospital, Piazzale Ospedale, 23, 31100, Treviso, Italy.
| | - A Limido
- Unit of Nephrology and Dialysis, ASST Fatebenefratelli Sacco, Milan, Italy
| | - M Postorino
- Unit of Nephrology, Grande Ospedale Metropolitano Reggio Calabria, Reggio Calabria, Italy
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Nordio M, Basciani S. Evaluation of thyroid nodule characteristics in subclinical hypothyroid patients under a myo-inositol plus selenium treatment. Eur Rev Med Pharmacol Sci 2019; 22:2153-2159. [PMID: 29687875 DOI: 10.26355/eurrev_201804_14749] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The anticancer effect of myo-inositol (MI) is catching researchers' attention worldwide. Thyroid nodules (TNs) have been detected by ultrasound (US) in up to 76% of the general population and, although most of them are benign, thyroid cancer is the most common malignancy of the endocrine system. PATIENTS AND METHODS A retrospective, observational study was conducted in 642 patients with suspected hypothyroidism undergoing US. The analysis was addressed exclusively to patients with subclinical hypothyroidism (SCH) or thyroid-stimulating hormone (TSH) levels borderline associated to TNs classified as class I and II; 1 group (control, no. 16) no treatment was prescribed; the other group (treated, no. 18) underwent treatment with 1 tablet containing MI plus selenium (Se) every day, for six months. Clinical data were collected to evaluate the nodular size, number, and elasticity, as well as TSH levels. RESULTS Final data were analyzed from 34 patients: in 76% of mixed TNs was observed a significant reduction of their size and 56% of them significantly regressed nodule stiffness following oral supplementation with MI plus Se. The mean number of mixed nodules for patient shifted from 1.39 ± 0.16 to 1.05 ± 0.15 (p ≤ 0.05). TSH levels dropped from 4.2 ± 0.21 mIU/L at baseline to 2.1 ± 0.20 mIU/L post-treatment (p < 0.001). In the control group, 38% of TNs reduced their diameter but TSH levels significantly increased up to the threshold after six months (from 3.95 ± 0.18 mIU/L to 4.30 ± 0.22 mIU/L, p ≤ 0.05). CONCLUSIONS In SCH patients undergoing treatment with MI plus Se, a reduction of the size, number and elasticity score of TNs as well as TSH levels was observed. Further studies are required, either in vitro and in vivo, to investigate the use of MI plus Se for the management of TNs.
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Affiliation(s)
- M Nordio
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy.
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Saladini F, Saladini F, Polo A, Verlato R, Nordio M, Simioni N, Piovesana P. A3217 Cardiac remodelling in renal transplanted patients. J Hypertens 2018. [DOI: 10.1097/01.hjh.0000548460.65063.d3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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34
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Hemke AC, Heemskerk MBA, van Diepen M, Kramer A, de Meester J, Heaf JG, Abad Diez JM, Torres Guinea M, Finne P, Brunet P, Vikse BE, Caskey FJ, Traynor JP, Massy ZA, Couchoud C, Groothoff JW, Nordio M, Jager KJ, Dekker FW, Hoitsma AJ. Performance of an easy-to-use prediction model for renal patient survival: an external validation study using data from the ERA-EDTA Registry. Nephrol Dial Transplant 2018; 33:1786-1793. [PMID: 29346645 DOI: 10.1093/ndt/gfx348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 11/15/2017] [Indexed: 11/12/2022] Open
Abstract
Background An easy-to-use prediction model for long-term renal patient survival based on only four predictors [age, primary renal disease, sex and therapy at 90 days after the start of renal replacement therapy (RRT)] has been developed in The Netherlands. To assess the usability of this model for use in Europe, we externally validated the model in 10 European countries. Methods Data from the European Renal Association-European Dialysis and Transplant Association (ERA-EDTA) Registry were used. Ten countries that reported individual patient data to the registry on patients starting RRT in the period 1995-2005 were included. Patients <16 years of age and/or with missing predictor variable data were excluded. The external validation of the prediction model was evaluated for the 10- (primary endpoint), 5- and 3-year survival predictions by assessing the calibration and discrimination outcomes. Results We used a data set of 136 304 patients from 10 countries. The calibration in the large and calibration plots for 10 deciles of predicted survival probabilities showed average differences of 1.5, 3.2 and 3.4% in observed versus predicted 10-, 5- and 3-year survival, with some small variation on the country level. The concordance index, indicating the discriminatory power of the model, was 0.71 in the complete ERA-EDTA Registry cohort and varied according to country level between 0.70 and 0.75. Conclusions A prediction model for long-term renal patient survival developed in a single country, based on only four easily available variables, has a comparably adequate performance in a wide range of other European countries.
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Affiliation(s)
- Aline C Hemke
- Dutch Transplant Foundation, Organ Centre, Leiden, The Netherlands.,Dutch Renal Replacement Registry, Leiden, The Netherlands
| | | | - Merel van Diepen
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Johan de Meester
- Department of Nephrology, Dialysis, and Hypertension, AZ Nikolaas, Sint-Niklaas, Belgium
| | - James G Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | | | | | - Patrik Finne
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.,Finnish Registry for Kidney Diseases, Helsinki, Finland
| | - Philippe Brunet
- Centre de Nephrologie et Transplantation Renale, Hospital de la Conception, Aix Marseille Université, AP-HM, Marseille, France
| | - Bjørn E Vikse
- Department of Medicine, Haugesund Hospital, Haugesund, Norway.,Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Fergus J Caskey
- UK Renal Registry, Southmead Hospital, Bristol, UK.,School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Jamie P Traynor
- Scottish Renal Registry, Information Services Division Scotland, Glasgow, UK
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Research Centre in Epidemiology and Population Health (CESP) Team 5, University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, Paris, France
| | - Cécile Couchoud
- Renal Epidemiology and Information Network (REIN) Registry, French Biomedical Agency, Saint-Denis-la-Plaine, France
| | - Jaap W Groothoff
- Emma Children's Hospital, Academic Medical Center, Amsterdam, The Netherlands
| | - Maurizio Nordio
- Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy.,Nephrology and Dialysis Unit, AULSS 6, Padua, Italy
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Friedo W Dekker
- Department of Clinical Epidemiology, Leiden University Medical Centre, Leiden, The Netherlands
| | - Andries J Hoitsma
- Dutch Transplant Foundation, Organ Centre, Leiden, The Netherlands.,Division of Nephrology, University Nijmegen Medical Centre, Nijmegen, The Netherlands
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Mazzaferro S, Tartaglione L, Cascone C, Di Daniele N, Pani A, Morosetti M, Francisco M, Nordio M, Leonardi M, Martello M, Grimaldi C, Cozzolino M, Rotondi S, Pasquali M. Multicenter study on parathyroidectomy (PTX) in Italy: preliminary results. J Nephrol 2018; 31:767-773. [PMID: 30155676 DOI: 10.1007/s40620-018-0527-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Accepted: 08/16/2018] [Indexed: 11/30/2022]
Abstract
BACKGROUND When medical therapy is unable to achieve biochemical control of secondary hyperparathyroidism, parathyroidectomy (PTX) is indicated, fortunately in a minority of patients. Thus, data on PTX prevalence and biochemical control are limited and, in particular in Italy, date back to 1999. METHODS We designed a prospective, observational and multicenter study to collect data from dialysis units distributed throughout the Italian regions. Clinical data were collected with a dedicated data sheet. RESULTS From January to December 2010, 149 Centers serving a total of 12,515 patients provided data on 528 living PTX cases (PTX prevalence = 4.2%). Prevalence was higher in hemo- than in peritoneal dialysis (4.5 vs. 1.9%, X2 = 21.52; p < 0.001), with non-significant regional differences (range 0.8-7.4%). PTX patients were younger (57.6 ± 12.5 vs. 67.1 ± 14.5 years; p < 0.001), more frequently female (56 vs. 38%, X2 = 68.05, p < 0.001) and had been on dialysis for a longer time (14.63 ± 8.37 vs. 4.8 ± 6.0 years, p < 0.001) compared to the 11,987 who did not undergo neck surgery. Median time since surgery was 6.0 years (3.0-9.0; 50%, IQR). The most frequent type of surgery was subtotal PTX (sPTX = 55.0%), significantly higher than total PTX (tPTX = 38.7%) or total PTX plus auto-transplantation (aPTX = 6.3%) (X2 = 5.18; Bonferroni post-hoc test, sPTX vs. tPTX + aPTX = p < 0.05). As for parathyroid hormone (PTH), calcium and phosphate control, cases targeting the KDOQI ranges were 18, 50.1 and 54.4%, respectively. The most prevalent biochemical condition was low PTH (62.7%). CONCLUSION PTX prevalence in Italy is stable compared to previous observations, is higher in hemodialysis than in peritoneal dialysis and results in a suboptimal biochemical control.
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Affiliation(s)
- Sandro Mazzaferro
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy. .,Nephrology Unit, Azienda Policlinico Umberto I, Rome, Italy. .,Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, Rome, Italy.
| | - Lida Tartaglione
- Department of Cardiovascular, Respiratory, Nephrologic and Geriatric Sciences, Sapienza University of Rome, Viale del Policlinico 155, 00161, Rome, Italy
| | | | | | - Antonello Pani
- Division of Nephrology and Dialysis, Azienda Ospedaliera G. Brotzu, Cagliari, Italy
| | | | - Marco Francisco
- Nephrology and Dialysis Unit, Ospedale Civile di Ivrea, Turin, Italy
| | - Maurizio Nordio
- Nephrology and Dialysis Unit, Provincial Hospital, Camposampiero, Padua, Italy
| | - Maria Leonardi
- Nephrology and Dialysis Unit, Ospedale Santa Maria Goretti, Latina, Italy
| | - Mauro Martello
- Nephrology and Dialysis Unit, Azienda Ospedaliera Ospedali Riuniti Marche Nord, Presidio S. Salvatore, Pesaro, Italy
| | | | - Mario Cozzolino
- Nephrology and Dialysis Unit, ASST Santi Paolo e Carlo, Presidio San Paolo, Milan, Italy
| | - Silverio Rotondi
- Nephrology and Dialysis Unit, ICOT Hospital, Polo Pontino Sapienza University of Rome, Rome, Italy
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Helve J, Kramer A, Abad-Diez JM, Couchoud C, de Arriba G, de Meester J, Evans M, Glaudet F, Grönhagen-Riska C, Heaf JG, Lezaic V, Nordio M, Palsson R, Pechter Ü, Resic H, Santamaria R, Santiuste de Pablos C, Massy ZA, Zurriaga Ó, Jager KJ, Finne P. Factors associating with differences in the incidence of renal replacement therapy among elderly: data from the ERA-EDTA Registry. Nephrol Dial Transplant 2018; 33:1428-1435. [DOI: 10.1093/ndt/gfy056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 02/01/2018] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jaakko Helve
- Finnish Registry for Kidney Diseases, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | | | - Cecile Couchoud
- Coordination nationale de REIN, Agence de la biomédecine, France
| | - Gabriel de Arriba
- Sección de Nefrologia, Hospital Universitario de Guadalajara, Guadalajara, Spain
| | - Johan de Meester
- Department of Nephrology, Dialysis and Hypertension, Dutch-speaking Belgian Renal Registry (NBVN), Sint-Niklaas, Belgium
| | - Marie Evans
- Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - Florence Glaudet
- Service de Néphrologie, Centre hospitalier et universitaire de Limoges, Limoges, France
| | | | - James G Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Visnja Lezaic
- Department of Nephrology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Maurizio Nordio
- Veneto Dialysis and Transplantation Registry, Regional Epidemiology System, Padua, Italy
- Nephrology Dialysis Unit, Padua, Italy
| | - Runolfur Palsson
- Division of Nephrology, Landspitali–The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Ülle Pechter
- Department of Internal Medicine, University of Tartu, Estonia
| | - Halima Resic
- Clinic for Hemodialysis, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | | | - Carmen Santiuste de Pablos
- Registro de Enfermos Renales de la Región de Murcia, Servicio de Epidemiologia, Consejeria de Sanidad, IMIB-Arrixaca, Murcia, Spain
| | - Ziad A Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, Paris, France
- Institut National de la Santé et de la Recherche Medical Unit 1018 team5, Research Centre in Epidemiology and Population Health, University of Paris Ouest-Versailles-St Quentin-en-Yveline, Villejuif, France
| | - Óscar Zurriaga
- Dirección General de Salud Pública. Conselleria de Sanitat Universal i Salut Pública, Valencia, Spain
- Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública, Instituto de Salud Carlos III, Madrid, Spain
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Patrik Finne
- Finnish Registry for Kidney Diseases, Helsinki, Finland
- Abdominal Center Nephrology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Nordio M, Basciani S. Myo-inositol plus selenium supplementation restores euthyroid state in Hashimoto's patients with subclinical hypothyroidism. Eur Rev Med Pharmacol Sci 2017; 21:51-59. [PMID: 28724185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Clinical evidence suggests that oral supplementation with myo-inositol (MI) and selenium (Se) is useful in the treatment of autoimmune thyroiditis. The purpose of this study was to highlight the positive response of Hashimoto's patients with subclinical hypothyroidism (SH) treated with MI and Se (MI-Se) in restoring a normal thyroid function. PATIENTS AND METHODS A total of 168 patients with Hashimoto's thyroiditis (HT) having Thyroid Stimulating Hormone (TSH) levels between 3 and 6 µIU/ml were randomized into 2 groups: one receiving MI-Se and the other one Se alone. RESULTS TSH, anti-thyroid peroxidase (TPOAb) and anti-thyroglobulin (TgAb) levels were significantly decreased in patients treated with combined MI-Se after six months of treatment. Also, a significant free serum T4 increase was observed in MI-Se group, along with an amelioration of patients' quality of life. CONCLUSIONS The administration of MI-Se is significantly effective in decreasing TSH, TPOAb and TgAb levels, as well as in enhancing thyroid hormones and personal wellbeing. Such treatment restored euthyroidism in patients diagnosed with autoimmune thyroiditis.
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Affiliation(s)
- M Nordio
- Department of Experimental Medicine, University of Rome "Sapienza", Rome, Italy.
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Nordio M. Editorial - Modern approach to the infertile male: the use of andrositol® test (myo-inositol in diagnostics). Eur Rev Med Pharmacol Sci 2017; 21:60-61. [PMID: 28724174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- M Nordio
- Department of Experimental Medicine, University "Sapienza", Rome, Italy.
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Nordio M. A novel treatment for subclinical hyperthyroidism: a pilot study on the beneficial effects of l-carnitine and selenium. Eur Rev Med Pharmacol Sci 2017; 21:2268-2273. [PMID: 28537653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The definition itself of subclinical hyperthyroidism (SHyper) and, therefore, the therapeutic approach to patients with SHyper still remains undefined and controversial. Therefore, the interest of finding a novel and alternative therapy for SHyper has caught the attention. An observational pilot study was performed to assess the effects of l-carnitine and selenium in the management of SHyper symptoms and endocrine profile in patients affected by this disease. PATIENTS AND METHODS Patients with TSH levels between 0.1-0.4 mIU/L and positive antibodies were recruited in this study. Subjects received orally one tablet containing 500 mg of l-carnitine and 83 mcg of selenium (L-Carn + Se), daily for 1 month. The primary outcome was the improvement of the quality of life (QoL) with the disappearance of main symptoms (subjective symptomatology) associated to SHyper, evaluated through a 9-items short form survey. Secondary outcomes included TSH, fT3, and fT4, TPOAb, TgAb measurement. Primary and secondary outcomes were evaluated at baseline, after the completion of treatment and after a successive month without treatment. RESULTS After 1-month treatment, the subjective symptomatology significantly dropped from 25.61 ± 1.19 to 12.11 ± 1.15 (p < 0.05). On the other hand, during the following 1-month period without treatment, it increased back to 23.33 ± 1.35 (p < 0.05). Thyroid hormones and auto-antibodies remained in their normal range. CONCLUSIONS The present pilot study has shown that L-Carn + Se significantly reduced symptoms associated with SHyper, improving QoL of patients, without significant modifications of their endocrine profile. In addition, it is noteworthy that the extension of treatment seems necessary to prevent symptoms reappearance. Prospective randomized controlled trials are needed to address clinicians to define the appropriate treatment-settings for this disorder.
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Affiliation(s)
- M Nordio
- Department of Experimental Medicine, "Sapienza" University of Rome, Rome, Italy.
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Nordio M, Basciani S. Treatment with Myo-Inositol and Selenium Ensures Euthyroidism in Patients with Autoimmune Thyroiditis. Int J Endocrinol 2017; 2017:2549491. [PMID: 28293260 PMCID: PMC5331475 DOI: 10.1155/2017/2549491] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2016] [Revised: 10/27/2016] [Accepted: 11/21/2016] [Indexed: 01/06/2023] Open
Abstract
Clinical evidences have highlighted the efficacy of myo-inositol and selenium in the treatment of autoimmune thyroiditis. Aim of this study was to further analyze the role of myo-inositol plus selenium (Myo-Ins-Se) in restoring a normal thyroid function of Hashimoto's patients with subclinical hypothyroidism. Eighty-six patients with Hashimoto's thyroiditis having thyroid-stimulating hormone (TSH) levels between 3 and 6 mIU/L, elevated serum antithyroid peroxidase (TPOAb) and/or antithyroglobulin (TgAb), and normal free thyroxine (fT4) and free triiodothyronine (fT3) levels were enrolled in the study: one hyperthyroid subject with TSH about 0.14 μU/ml was included in this trial as a single case. Patients were assigned to receive Myo-Ins-Se. TSH, TPOAb, and TgAb levels were significantly decreased in patients treated with combined Myo-Ins-Se after 6 months of treatment. In addition, a significant fT3 and fT4 increase, along with an amelioration of their quality of life, was observed. Remarkably, TSH values of the hyperthyroid patient increased from 0.14 μU/ml up to 1.02 μU/ml, showing a complete restoration of TSH values at a normal range. In conclusion, the administration of Myo-Ins-Se is significantly effective in decreasing TSH, TPOAb, and TgAb levels, as well as enhancing thyroid hormones and personal wellbeing, therefore restoring euthyroidism in patients diagnosed with autoimmune thyroiditis.
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Affiliation(s)
- Maurizio Nordio
- Department of Experimental Medicine, University “Sapienza”, Rome, Italy
| | - Sabrina Basciani
- Department of Experimental Medicine, University “Sapienza”, Rome, Italy
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Pippias M, Kramer A, Noordzij M, Afentakis N, Alonso de la Torre R, Ambühl PM, Aparicio Madre MI, Arribas Monzón F, Åsberg A, Bonthuis M, Bouzas Caamaño E, Bubic I, Caskey FJ, Castro de la Nuez P, Cernevskis H, de Los Ángeles Garcia Bazaga M, des Grottes JM, Fernández González R, Ferrer-Alamar M, Finne P, Garneata L, Golan E, Heaf JG, Hemmelder MH, Idrizi A, Ioannou K, Jarraya F, Kantaria N, Kolesnyk M, Kramar R, Lassalle M, Lezaic VV, Lopot F, Macario F, Magaz Á, Martín de Francisco AL, Martín Escobar E, Martínez Castelao A, Metcalfe W, Moreno Alia I, Nordio M, Ots-Rosenberg M, Palsson R, Ratkovic M, Resic H, Rutkowski B, Santiuste de Pablos C, Seyahi N, Fernanda Slon Roblero M, Spustova V, Stas KJF, Stendahl ME, Stojceva-Taneva O, Vazelov E, Ziginskiene E, Massy Z, Jager KJ, Stel VS. The European Renal Association - European Dialysis and Transplant Association Registry Annual Report 2014: a summary. Clin Kidney J 2017; 10:154-169. [PMID: 28584624 PMCID: PMC5455253 DOI: 10.1093/ckj/sfw135] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Accepted: 11/07/2016] [Indexed: 11/30/2022] Open
Abstract
Background: This article summarizes the European Renal Association – European Dialysis and Transplant Association Registry’s 2014 annual report. It describes the epidemiology of renal replacement therapy (RRT) for end-stage renal disease (ESRD) in 2014 within 35 countries. Methods: In 2016, the ERA-EDTA Registry received data on patients who in 2014 where undergoing RRT for ESRD, from 51 national or regional renal registries. Thirty-two registries provided individual patient level data and 19 provided aggregated patient level data. The incidence, prevalence and survival probabilities of these patients were determined. Results: In 2014, 70 953 individuals commenced RRT for ESRD, equating to an overall unadjusted incidence rate of 133 per million population (pmp). The incidence ranged by 10-fold; from 23 pmp in the Ukraine to 237 pmp in Portugal. Of the patients commencing RRT, almost two-thirds were men, over half were aged ≥65 years and a quarter had diabetes mellitus as their primary renal diagnosis. By day 91 of commencing RRT, 81% of patients were receiving haemodialysis. On 31 December 2014, 490 743 individuals were receiving RRT for ESRD, equating to an unadjusted prevalence of 924 pmp. This ranged throughout Europe by more than 10-fold, from 157 pmp in the Ukraine to 1794 pmp in Portugal. In 2014, 19 406 kidney transplantations were performed, equating to an overall unadjusted transplant rate of 36 pmp. Again this varied considerably throughout Europe. For patients commencing RRT during 2005–09, the 5-year-adjusted patient survival probabilities on all RRT modalities was 63.3% (95% confidence interval 63.0–63.6). The expected remaining lifetime of a 20- to 24-year-old patient with ESRD receiving dialysis or living with a kidney transplant was 21.9 and 44.0 years, respectively. This was substantially lower than the 61.8 years of expected remaining lifetime of a 20-year-old patient without ESRD.
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Affiliation(s)
- Maria Pippias
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Anneke Kramer
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marlies Noordzij
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Nikolaos Afentakis
- Hellenic Renal Registry, Board of Registry, Coordination and Control of RRT, General Hospital of Athens 'G. Gennimatas', Athens, Greece
| | | | - Patrice M Ambühl
- Swiss Dialysis Registry, Renal Division, Stadtspital Waid, Zurich, Switzerland
| | - Manuel I Aparicio Madre
- Registro Madrileño de Enfermos Renales (REMER), Oficina Regional de Coordinación de Trasplantes, Madrid, Spain
| | | | - Anders Åsberg
- Norwegian Renal Registry, Department of Transplant Medicine, Oslo University Hospital - Rikshospitalet, Oslo, Norway
| | - Marjolein Bonthuis
- ESPN/ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Ivan Bubic
- Department of Internal Medicine, Clinical Hospital Centre Rijeka, School of Medicine University of Rijeka, Rijeka, Croatia
| | - Fergus J Caskey
- UK Renal Registry, Learning and Research, Southmead Hospital, Bristol, UK
| | - Pablo Castro de la Nuez
- Information System of Regional Transplant Coordination in Andalucia (SICATA), Andalucia, Spain
| | - Harijs Cernevskis
- Department of Internal Medicine, Riga Stradins University, Riga, Latvia
| | - Maria de Los Ángeles Garcia Bazaga
- Dirección General de Salud Pública, Servicio Extremeño de Salud, Consejería de Sanidad y Políticas Sociales, Junta de Extremadura, Cáceres, Spain
| | | | - Raquel Fernández González
- Registro de Enfermos Renales de Castilla y León, Coordinación de Trasplantes, Castilla y León, Spain
| | - Manuel Ferrer-Alamar
- Técnico Registro de Enfermos Renales Comunitat Valenciana, Servicio de Estudios Epidemiológicos y Registros Sanitarios, Subdirección General Epidemiología, Dirección General Salut Pública, Consellería Sanitat, Valencian Region, Spain
| | - Patrik Finne
- Department of Nephrology, Helsinki University Central Hospital, Helsinki, Finland.,Finnish Registry for Kidney Diseases, Helsinki, Finland
| | - Liliana Garneata
- Department of Internal Medicine and Nephrology 'Dr Carol Davila' Teaching Hospital of Nephrology, 'Carol Davila' University of Medicine and Pharmacy, Bucharest, Romania
| | - Eliezer Golan
- Department of Nephrology and Hypertension, Meir Medical Center, Kfar-Saba and Sackler Faculty of Medicine, Tel Aviv, Israel
| | - James G Heaf
- Department of Medicine, Zealand University Hospital, Roskilde, Denmark
| | - Marc H Hemmelder
- Dutch Renal Registry (Renine), Nefrovisie, Utrecht, The Netherlands
| | - Alma Idrizi
- Service of Nephrology, UHC 'Mother Teresa', Tirana, Albania
| | - Kyriakos Ioannou
- Nephrology Department, Nicosia General Hospital, Nicosia, Cyprus
| | - Faical Jarraya
- Research Unit 12ES14, Faculty of Medicine, Sfax University and Hedi Chaker University Hospital, Sfax, Tunisia
| | - Nino Kantaria
- Department of Internal Medicine, Tbilisi State Medical University, Tbilisi, Georgia
| | - Mykola Kolesnyk
- Main Coordinator of National Register of CKD and AKI Patients, State Institute of Nephrology, National Academy of Medical Sciences of Ukraine, Kiev, Ukraine
| | | | | | - Visnja V Lezaic
- Department of Nephrology, Clinical Centre of Serbia, Belgrade, Serbia
| | - Frantisek Lopot
- Department of Medicine, General University Hospital and 1st Charles University Medical School, Strahov, Czech Republic
| | - Fernando Macario
- Nephrology Department, Portuguese Society of Nephrology, University Hospital of Coimbra, Coimbra, Portugal
| | - Ángela Magaz
- Unidad de Información sobre Pacientes Renales de la Comunidad Autónoma del País Vasco (UNIPAR), Basque Country, Spain
| | | | - Eduardo Martín Escobar
- Registro Español de Enfermos Renales (REER), Organización Nacional de Trasplantes, Madrid, Spain
| | - Alberto Martínez Castelao
- Member of the Catalan Renal Registry Committee, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
| | - Wendy Metcalfe
- Scottish Renal Registry, Meridian Court, ISD Scotland, Glasgow, UK
| | - Inmaculada Moreno Alia
- Registro de Enfermos Renales en Tratamiento Sustitutivo de Castilla-La Mancha, Servicio de Epidemiología, Dirección General de Salud Pública y Consumo Castilla-La Mancha, Toledo, Spain
| | | | - Mai Ots-Rosenberg
- Department of Internal Medicine, Faculty of Medicine, Institute of Clinical Medicine, Tartu University, Tartu, Estonia
| | - Runolfur Palsson
- Division of Nephrology, Landspitali - The National University Hospital of Iceland, Reykjavík, Iceland.,Faculty of Medicine, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Marina Ratkovic
- Nephrology and Hemodialysis Department, Clinical Center of Montenegro, Ljubljanska, Montenegro
| | - Halima Resic
- Head of Clinic for Hemodialysis, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Boleslaw Rutkowski
- Polish Renal Registry, Department of Nephrology, Transplantology and Internal Medicine, Medical University, Gdansk, Poland
| | - Carmen Santiuste de Pablos
- Registro de Enfermos Renales de la Región de Murcia, Servicio de Epidemiología, Consejería de Sanidad, IMIB-Arrixaca, Murcia, Spain
| | - Nurhan Seyahi
- Department of Internal Medicine, Cerrahpasa Medical Faculty, Division of Nephrology, Istanbul University, Istanbul, Turkey
| | - María Fernanda Slon Roblero
- Consultant Nephrologist at Complejo Hospitalario de Navarra, Complejo Hospitalario de Navarra, Pamplona, Navarra, Spain
| | | | - Koenraad J F Stas
- Dienst Nefrologie, Jessa Ziekenhuis, Campus Virga Jesse, Hasselt, Belgium
| | - María E Stendahl
- Swedish Renal Registry, Department of Medicine, Ryhov County Hospital, Jonkoping, Sweden
| | | | - Evgueniy Vazelov
- Dialysis Clinic, 'Alexandrovska' University Hospital, Sofia Medical University, Sofia, Bulgaria
| | - Edita Ziginskiene
- Lithuanian Nephrology, Dialysis and Transplantation Association, Kaunas, Lithuania.,Department of Nephrology, Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania.,Nephrological Clinic, Hospital of Lithuanian University of Health Sciences Kaunas Clinics, Kaunas, Lithuania
| | - Ziad Massy
- Division of Nephrology, Ambroise Paré University Hospital, APHP, Boulogne-Billancourt, France.,Institut National de la Santé et de la Recherche Médicale (INSERM) U1018, Team 5, CESP UVSQ, and University Paris Saclay, Villejuif, France
| | - Kitty J Jager
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Vianda S Stel
- ERA-EDTA Registry, Department of Medical Informatics, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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Medrano J, Nordio M, Manzolini G, van Sint Annaland M, Gallucci F. On the measurement of solids circulation rates in interconnected fluidized beds: Comparison of different experimental techniques. POWDER TECHNOL 2016. [DOI: 10.1016/j.powtec.2016.08.035] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Nordio M, Limido A, Conte F, Di Napoli A, Quintaliani G, Reboldi G, Sparacino V, Postorino M. [Italian Registry Dialysis and Transplant 2011-2013]. G Ital Nefrol 2016; 33:gin/00241.6. [PMID: 27374391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
UNLABELLED The Italian Registry of Dialysis and Transplantation (RIDT) has recently resumed the collection of data of patients on RRT in Italy. Data were requested to Regional Registries for the years 2011-2013 and they contributed according to their possibilities. Eighteen Regions or autonomous Provinces provided data with various degrees of completeness and this made possible to bridge the gap between the current and the previous census (referring to 2010). RESULTS Incidencedata were associated to a sample with a coverage of 77% of the national population (46/60 million inhabitants). Patients who started dialysis in these three years were, respectively, 168, 166 and 160 patients pmp. If we project this data to the national population is reasonable to think that 9500-10000 patients per year start the dialytic treatment. PREVALENCE The prevalence of patients on dialysis in Italy range, in the 10 years of RIDT, between 750 and 825 patients pmp. Based on this we can reasonably estimate that in Italy there are 45-49000 dialysis patients. Incidence and prevalence vary widely in different regions. Mortalityon dialysis in Italy during the period 2011-2013 was on average 16.2 per 100 patient-years (95% CI: 16.1-16.7) with regional variation smaller than that observed in incidence and prevalence. CONCLUSIONS In this paper, data analysis are presented in a direct and non comparative manner. However, it provides information on the status of the RRT in Italy and the temporal consistency of the data is a proof of their validity. Registry data were published in the official site of Italian Registry that can be reached through the website of SIN (www.sin-italy.org).
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Nordio M, Tessitore N, Abaterusso C, Feriani M, Rossi B, Virga G, Antonucci F. FP697A COHORT EFFECT COMPATIBLE WITH LIFESTYLE CHANGES IS A MAJOR DETERMINANT OF THE INCIDENCE OF END STAGE RENAL DISEASE (ESRD) IN THE ELDERLY NORTH-EASTERN ITALIAN POPULATION DURING THE PERIOD 1998-2012. Nephrol Dial Transplant 2015. [DOI: 10.1093/ndt/gfv183.15] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Nordio M, Basciani S. Efficacy of a food supplement in patients with hashimoto thyroiditis. J BIOL REG HOMEOS AG 2015; 29:93-102. [PMID: 25864745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Thyroid inflammation has been commonly seen in recent decades, due to a series of factors and is considered as the most frequent thyroid illness. It is characterized by some distinctive traits, which include morphological and hormonal modifications, often in association with an elevated anti-thyroid autoantibody title. The aim of the therapy is to improve symptoms as fast as possible, treating inflammation and subsequent hypothyroidism, when present. Therefore, we evaluated the efficacy of a Food Supplement (FS) containing enzymes which is commonly used in various inflammatory processes and is able to modulate immune reactions during inflammation in a very rapid and efficacious way. An open, controlled study was then designed and 45 patients with Hashimoto thyroiditis were enrolled and divided into 3 groups (FS alone; thyroid hormones alone; FS plus thyroid hormones). Blood, morphological and subjective parameters were considered. The results obtained indicate that the FS used in our study is efficacious and safe when used alone and/or in combination with thyroid hormones in the treatment of autoimmune thyroiditis, as documented by the improvement of the majority of the parameters considered. The efficacy was considered faster than thyroid hormones alone as far as subjective symptomatology is considered. In conclusion, the use of the food supplement evaluated herein during inflammation may be considered an additional tool in clinicians hands, when facing patients with autoimmune thyroiditis, especially in presence of subjective symptomatology, in order to rapidly alleviate it.
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Affiliation(s)
- M Nordio
- Department of Experimental Medicine, University Sapienza, Rome, Italy
| | - S Basciani
- Department of Experimental Medicine, University Sapienza, Rome, Italy
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Virga G, La Milia V, Russo R, Bonfante L, Iadarola GM, Maffei S, Sandrini M, Zeiler M, Nordio M. A load volume suitable for reaching dialysis adequacy targets in anuric patients on 4-exchange CAPD. J Nephrol 2014; 27:209-15. [DOI: 10.1007/s40620-014-0065-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2013] [Accepted: 05/14/2013] [Indexed: 11/30/2022]
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Vianello F, Furian L, Nordio M, Treleani M, Fabris F. Concomitant use of argatroban and warfarin during hemodialysis in heparin-induced thrombocytopenia. Hematology 2014; 20:48-9. [DOI: 10.1179/1607845414y.0000000157] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Affiliation(s)
| | - Lucrezia Furian
- Kidney and Pancreas Transplantation UnitDepartment of Surgery and Organ Transplantation, University of Padua, Padua, Italy
| | - Maurizio Nordio
- Nephrology and Dialysis UnitCamposampiero District Hospital, Padua, Italy
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Minozzi M, Nordio M, Pajalich R. The Combined therapy myo-inositol plus D-Chiro-inositol, in a physiological ratio, reduces the cardiovascular risk by improving the lipid profile in PCOS patients. Eur Rev Med Pharmacol Sci 2013; 17:537-540. [PMID: 23467955] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Women with Polycystic Ovarian Syndrome (PCOS) present several factors that increase the cardiovascular risk, such as insulin resistance and dyslipidemia. Myo-inositol and D-chiro-inositol have been shown to improve insulin resistance, hyperandrogenism and to induce ovulation in PCOS women. However, their effects on dyslipidemia are less clear. The aim of the present study was to evaluate whether the combined therapy myo-inositol plus D-chiro-inositol (in a in a physiological ratio of 40:1) improve the metabolic profile, therefore, reducing cardiovascular risk in PCOS patients. PATIENTS AND METHODS Twenty obese PCOS patients [BMI 33.7 ± 6 kg/m2 (mean ± SD)] were recruited. The lipid profile was assessed by measuring total cholesterol, LDL, HDL and triglycerides before and after 6 months treatment with the combined therapy. Secondary end points included changes in BMI, waist-hip ratio, percentage of body fat, HOMA-IR and blood pressure. RESULTS The combined therapy myo-inositol and D-chiro-inositol improved LDL levels (3.50 ± 0.8 mmol/L versus, 3 ± 1.2 mmol/L p < 0.05), HDL (1.1 mmol/L ± 0.3 versus 1.6 mmol/L ± 0.4 p < 0.05) and triglycerides (2.3 ± 1.5 mmol/L versus 1.75 ± 1.9 mmol/L p < 0.05). Furthermore, significant improvements in HOMA-IR were also observed. CONCLUSIONS The combined therapy myo-inositol plus D-chiro-inositol is able to improve the metabolic profile of PCOS women, therefore, reducing the cardiovascular risk.
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Affiliation(s)
- M Minozzi
- Institute of Obstetrics and Gynecology, ''Sapienza'' University of Rome, Italy
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Limido A, Nichelatti M, Postorino M, Levialdi Ghiron JH, Di Napoli A, Maggiore U, Nordio M, Quintaliani G, Rustici A. [Changes in the uremic population overtime: data from the Italian Registry of Dialysis and Transplantation (RIDT)]. G Ital Nefrol 2012; 29 Suppl 58:S21-S26. [PMID: 23229599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
Over the last years in the industrialized countries there have been many changes in the number and characteristics of patients starting renal replacement therapy. This review reports the changes that took place in Italy, analyzing the data from the Italian Registry of Dialysis and Transplantation (RIDT), which collects information from all Italian regions according to common inclusion and coding parameters. The years between 1999 and 2009 were analyzed for the calculation of the average and median age of incident patients, the percent distribution of the different diseases necessitating dialysis, and the mortality after one year. Patients who underwent a kidney transplant as the first event were not included in the analysis. The incidence of uremia in Italy showed a constant increase from 1999 (131 pmp) to 2009 (160 pmp), mainly due to an increase in patients aged over 70 years. In fact, in recent years about 50% of the patients who started renal replacement therapy were aged over 72, 25% were older than 78 years, and only 25% were younger than 60 years. According to the Italian epidemiological data, the percentage of patients with diabetic nephropathy or diabetes as comorbidity has risen steadily (from 19% in 1999 to 27% in 2009). However, in spite of the progressive increase in the two main risk factors for survival (older age and diabetes), the mortality after one year of renal replacement therapy did not show a significant rise from 1999 to 2009.
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Affiliation(s)
- Aurelio Limido
- Commissione Nazionale del RIDT, Registro Italiano Dialisi e Trapianto, Societa' Italiana di Nefrologia, Roma - Italy
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Nordio M, Limido A, Maggiore U, Nichelatti M, Postorino M, Quintaliani G. Survival in Patients Treated by Long-term Dialysis Compared With the General Population. Am J Kidney Dis 2012; 59:819-28. [DOI: 10.1053/j.ajkd.2011.12.023] [Citation(s) in RCA: 73] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2011] [Accepted: 12/12/2011] [Indexed: 11/11/2022]
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