Luigi Triolo - Academia.edu (original) (raw)
Papers by Luigi Triolo
Artificial Cells, Blood Substitutes and Biotechnology, 2003
In hemodialysis patients, oxidative stress results from an imbalance between the production of re... more In hemodialysis patients, oxidative stress results from an imbalance between the production of reactive oxygen species and antioxidant defense mechanisms. Recently, a new dialysis multi-layer membrane has been developed, by modifying the inner surface of regenerated cellulose to support a vitamin E coating. The aim of our study was to investigate the effects of hemodialysis treatment with vitamin E-modified membrane on anemia and erythropoietin requirement in a group of chronic uremic patients. Ten uremic, non diabetic, patients on standard bicarbonate dialysis were treated with vitamin E-bonded dialysis membrane for 12 months. Hematological parameters, erythropoietin requirement, serum vitamin E and serum malonyldialdehyde (MDA) were evaluated before starting the study and monthly. No significant changes in hemoglobin level, RBC count, hematocrit and EPO requirement were observed. Basal vitamin E levels were in the normal range (13.0 +/- 2.88 mg/L vs. 14.79 +/- 3.12 mg/L; NS). On the contrary, basal MDA levels were higher than those observed in the control group (1.87 +/- 0.36 vs. 1.13 +/- 0.18 mmol/mL; p < 0.01) and a significant decrease of MDA levels was found after 1 month of Excebrane treatment (1.39 +/- 0.25 nmol/mL; p < 0.02). In conclusion, the role of the "oxidative hemolysis" in the pathogenesis of anemia in CHD patients is still not clearly defined, but it could be of minor clinical relevance. Although the effectiveness of vitamin E-coated membranes as a scavenger of ROS allows a better control of intradialytic oxidative stress, it doesn't seem to contribute to clinical management of anemia in these patients.
Nephron, 1988
Plasma antithrombin III (AT III) levels were measured as antigen concentration (radial immunodiff... more Plasma antithrombin III (AT III) levels were measured as antigen concentration (radial immunodiffusion) and as heparin cofactor (amidolytic method) in 9 patients on continuous ambulatory peritoneal dialysis (CAPD). The loss of albumin, proteins, AT III antigen and AT III functional activity was calculated from the peritoneal dialysate and the corresponding serum levels were measured. The same determinations were performed on serum and urinary samples from 9 patients with nephrotic syndrome. Mean plasma levels of AT III antigen and AT III heparin cofactor in CAPD patients were normal, whereas nephrotic patients showed a reduction in these values within a wide range. However, the loss of AT III antigen was similar in both groups and was strictly correlated to the loss of albumin. Most AT III in the peritoneal dialysate from CAPD patients was still active, whereas in nephrotic patients only 26% of the excreted AT III was functionally active. The difference in plasma AT III was functionally active. The difference in plasma AT III levels between these two groups, in spite of the roughly similar amounts recovered in the dialysate and in the urine, might be explained by an additional AT III loss in nephrotic patients due to renal metabolism.
Nephron, 1994
In a group of 48 chronic hemodialysis patients, serum levels of coenzyme Q10 (CoQ) have been meas... more In a group of 48 chronic hemodialysis patients, serum levels of coenzyme Q10 (CoQ) have been measured and appeared abnormally low in 62% of cases. Figures were positively correlated to those of serum vitamin E (vit E), although the latter were within a normal range. The chronic hemodialysis (CHD) patients with normal serum values of CoQ exhibited higher blood triglycerides. Pathologically low levels of serum vit E were found only in uremic subjects on conservative regimen with dietary restrictions and low compliance to protein-caloric intake. The reduced CoQ levels may contribute to the defective serum antioxidant activity and the increased peroxidative damage in uremic patients on CHD.
BACKGROUND Many patients with established hypertension have poorly controlled blood pressure (BP)... more BACKGROUND Many patients with established hypertension have poorly controlled blood pressure (BP). We studied demographic and clinical characteristics related to hypertension and analyzed the relationships between BP control and comorbidity. METHODS This study was based on 414 consecutive hypertensive out-patients referred to our nephrology clinic. We recorded systolic and diastolic BP, age, gender, body mass index, total cholesterol, family history of hypertension, glomerular filtration rate (GFR), 24-hr proteinuria, diabetes, coronary artery disease, smoking habits and antihypertensive drug treatment. BP control was considered optimal if BP was < 130/80 mmHg in patients with diabetes or chronic kidney disease (CKD), if BP was < 125/75 mmHg in CKD with proteinuria > 1 g/24 hr and if BP was < 140/90 mmHg in patients with no comorbidity. Multivariate logistic regression analysis was used to investigate the association between BP control and predictors. RESULTS Only 26.6% ...
Nephrology @ Point of Care
Diabetic nephropathy is one of the most frequent microvascular complications in diabetic patients... more Diabetic nephropathy is one of the most frequent microvascular complications in diabetic patients. This report describes a case of diabetic nephropathy in an male adult (diabetic) patient treated with standard therapy and the contribution of the new antidiabetic drugs on the progression of the disease. We will deal the following questions: 1. What do we know about diabetic nephropathy and its natural history? 2. How should we manage diabetic nephropathy and what do the guidelines suggest on hyperglycemia? 3. How do we manage hyperglycemia in diabetic patients with chronic kidney disease (CKD)? Standard treatment. 4. What's news about antidiabetic medication? New treatment. 5. What's next?
Journal of Nephrology, 2004
Many patients with established hypertension have poorly controlled blood pressure (BP). We studie... more Many patients with established hypertension have poorly controlled blood pressure (BP). We studied demographic and clinical characteristics related to hypertension and analyzed the relationships between BP control and comorbidity. This study was based on 414 consecutive hypertensive out-patients referred to our nephrology clinic. We recorded systolic and diastolic BP, age, gender, body mass index, total cholesterol, family history of hypertension, glomerular filtration rate (GFR), 24-hr proteinuria, diabetes, coronary artery disease, smoking habits and antihypertensive drug treatment. BP control was considered optimal if BP was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 130/80 mmHg in patients with diabetes or chronic kidney disease (CKD), if BP was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 125/75 mmHg in CKD with proteinuria &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 1 g/24 hr and if BP was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 140/90 mmHg in patients with no comorbidity. Multivariate logistic regression analysis was used to investigate the association between BP control and predictors. Only 26.6% of patients had adequately controlled BP. Eighty-five percent of patients aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 65 yrs had uncontrolled systolic hypertension. Univariate analysis showed a significant association between poor BP control and age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;65 yrs, family history of hypertension, diabetes, CKD with or without proteinuria &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 1 g/24 hr and total cholesterol &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 220 mg/dL. Multivariate logistic regression showed that age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 65 yrs, diabetes and CKD with or without proteinuria &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 1 g/24 hr were significantly and independently associated with poor BP control. Inadequate hypertension control is a common cause for referral to our out-patient nephrology clinic. Our data confirm that elderly patients, diabetic patients and nephropathic patients are difficult to treat; and therefore, deserve the highest quality clinical attention.
Artificial Cells, Blood Substitutes and Biotechnology, 2003
In hemodialysis patients, oxidative stress results from an imbalance between the production of re... more In hemodialysis patients, oxidative stress results from an imbalance between the production of reactive oxygen species and antioxidant defense mechanisms. Recently, a new dialysis multi-layer membrane has been developed, by modifying the inner surface of regenerated cellulose to support a vitamin E coating. The aim of our study was to investigate the effects of hemodialysis treatment with vitamin E-modified membrane on anemia and erythropoietin requirement in a group of chronic uremic patients. Ten uremic, non diabetic, patients on standard bicarbonate dialysis were treated with vitamin E-bonded dialysis membrane for 12 months. Hematological parameters, erythropoietin requirement, serum vitamin E and serum malonyldialdehyde (MDA) were evaluated before starting the study and monthly. No significant changes in hemoglobin level, RBC count, hematocrit and EPO requirement were observed. Basal vitamin E levels were in the normal range (13.0 +/- 2.88 mg/L vs. 14.79 +/- 3.12 mg/L; NS). On the contrary, basal MDA levels were higher than those observed in the control group (1.87 +/- 0.36 vs. 1.13 +/- 0.18 mmol/mL; p < 0.01) and a significant decrease of MDA levels was found after 1 month of Excebrane treatment (1.39 +/- 0.25 nmol/mL; p < 0.02). In conclusion, the role of the "oxidative hemolysis" in the pathogenesis of anemia in CHD patients is still not clearly defined, but it could be of minor clinical relevance. Although the effectiveness of vitamin E-coated membranes as a scavenger of ROS allows a better control of intradialytic oxidative stress, it doesn't seem to contribute to clinical management of anemia in these patients.
Nephron, 1988
Plasma antithrombin III (AT III) levels were measured as antigen concentration (radial immunodiff... more Plasma antithrombin III (AT III) levels were measured as antigen concentration (radial immunodiffusion) and as heparin cofactor (amidolytic method) in 9 patients on continuous ambulatory peritoneal dialysis (CAPD). The loss of albumin, proteins, AT III antigen and AT III functional activity was calculated from the peritoneal dialysate and the corresponding serum levels were measured. The same determinations were performed on serum and urinary samples from 9 patients with nephrotic syndrome. Mean plasma levels of AT III antigen and AT III heparin cofactor in CAPD patients were normal, whereas nephrotic patients showed a reduction in these values within a wide range. However, the loss of AT III antigen was similar in both groups and was strictly correlated to the loss of albumin. Most AT III in the peritoneal dialysate from CAPD patients was still active, whereas in nephrotic patients only 26% of the excreted AT III was functionally active. The difference in plasma AT III was functionally active. The difference in plasma AT III levels between these two groups, in spite of the roughly similar amounts recovered in the dialysate and in the urine, might be explained by an additional AT III loss in nephrotic patients due to renal metabolism.
Nephron, 1994
In a group of 48 chronic hemodialysis patients, serum levels of coenzyme Q10 (CoQ) have been meas... more In a group of 48 chronic hemodialysis patients, serum levels of coenzyme Q10 (CoQ) have been measured and appeared abnormally low in 62% of cases. Figures were positively correlated to those of serum vitamin E (vit E), although the latter were within a normal range. The chronic hemodialysis (CHD) patients with normal serum values of CoQ exhibited higher blood triglycerides. Pathologically low levels of serum vit E were found only in uremic subjects on conservative regimen with dietary restrictions and low compliance to protein-caloric intake. The reduced CoQ levels may contribute to the defective serum antioxidant activity and the increased peroxidative damage in uremic patients on CHD.
BACKGROUND Many patients with established hypertension have poorly controlled blood pressure (BP)... more BACKGROUND Many patients with established hypertension have poorly controlled blood pressure (BP). We studied demographic and clinical characteristics related to hypertension and analyzed the relationships between BP control and comorbidity. METHODS This study was based on 414 consecutive hypertensive out-patients referred to our nephrology clinic. We recorded systolic and diastolic BP, age, gender, body mass index, total cholesterol, family history of hypertension, glomerular filtration rate (GFR), 24-hr proteinuria, diabetes, coronary artery disease, smoking habits and antihypertensive drug treatment. BP control was considered optimal if BP was < 130/80 mmHg in patients with diabetes or chronic kidney disease (CKD), if BP was < 125/75 mmHg in CKD with proteinuria > 1 g/24 hr and if BP was < 140/90 mmHg in patients with no comorbidity. Multivariate logistic regression analysis was used to investigate the association between BP control and predictors. RESULTS Only 26.6% ...
Nephrology @ Point of Care
Diabetic nephropathy is one of the most frequent microvascular complications in diabetic patients... more Diabetic nephropathy is one of the most frequent microvascular complications in diabetic patients. This report describes a case of diabetic nephropathy in an male adult (diabetic) patient treated with standard therapy and the contribution of the new antidiabetic drugs on the progression of the disease. We will deal the following questions: 1. What do we know about diabetic nephropathy and its natural history? 2. How should we manage diabetic nephropathy and what do the guidelines suggest on hyperglycemia? 3. How do we manage hyperglycemia in diabetic patients with chronic kidney disease (CKD)? Standard treatment. 4. What's news about antidiabetic medication? New treatment. 5. What's next?
Journal of Nephrology, 2004
Many patients with established hypertension have poorly controlled blood pressure (BP). We studie... more Many patients with established hypertension have poorly controlled blood pressure (BP). We studied demographic and clinical characteristics related to hypertension and analyzed the relationships between BP control and comorbidity. This study was based on 414 consecutive hypertensive out-patients referred to our nephrology clinic. We recorded systolic and diastolic BP, age, gender, body mass index, total cholesterol, family history of hypertension, glomerular filtration rate (GFR), 24-hr proteinuria, diabetes, coronary artery disease, smoking habits and antihypertensive drug treatment. BP control was considered optimal if BP was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 130/80 mmHg in patients with diabetes or chronic kidney disease (CKD), if BP was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 125/75 mmHg in CKD with proteinuria &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 1 g/24 hr and if BP was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 140/90 mmHg in patients with no comorbidity. Multivariate logistic regression analysis was used to investigate the association between BP control and predictors. Only 26.6% of patients had adequately controlled BP. Eighty-five percent of patients aged &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 65 yrs had uncontrolled systolic hypertension. Univariate analysis showed a significant association between poor BP control and age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt;65 yrs, family history of hypertension, diabetes, CKD with or without proteinuria &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 1 g/24 hr and total cholesterol &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 220 mg/dL. Multivariate logistic regression showed that age &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 65 yrs, diabetes and CKD with or without proteinuria &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 1 g/24 hr were significantly and independently associated with poor BP control. Inadequate hypertension control is a common cause for referral to our out-patient nephrology clinic. Our data confirm that elderly patients, diabetic patients and nephropathic patients are difficult to treat; and therefore, deserve the highest quality clinical attention.