Sara Dominijanni - Academia.edu (original) (raw)
Papers by Sara Dominijanni
Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia, Feb 27, 2023
The Journal of Vascular Access, 2020
Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients particu... more Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients particularly in the oncological and hematological field. PICCs are a safe alternative to central venous catheters, mainly for medium- and long-term therapy
Journal of nephrology
Dialysis patients show a very high prevalence of cardiovascular complications, affected as they a... more Dialysis patients show a very high prevalence of cardiovascular complications, affected as they are with abnormal and accelerated vascular calcifications and, eventually, calcium and phosphorous metabolism disorders. Multislice computed tomography (MSCT) provides a reproducible, high-resolution imaging of calcium contained in cardiac arteries, measured by Agatston score. The aim of the present study was to evaluate the influence of high-dose and low-dose calcitriol therapy on the progression of cardiac vascular calcifications in dialyzed patients. We enrolled 36 dialyzed patients in a prospective study, including an interventional period of 12 months and a follow-up period of 12 months. Eighteen protocol patients received intravenous pulses of high-doses calcitriol at the end of dialytic treatment and sevelamer hydrochloride therapy. Control patients received low-dose calcitriol and sevelamer hydrochloride as well. Two MSCT scans were performed: 1 at the start of the study and 1 at ...
Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
Hemodiafiltration reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as re... more Hemodiafiltration reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as replacement fluid. We devised a new technique, post-dilution HFR, aimed at increasing the purification efficiency, treatment tolerability and at reducing inflammatory state. We performed post-dilution HFR in six uremic patients during 18 months. Dialytic efficacy, filter blood rest and cytokine behavior were evaluated. Neither pyrogenic reactions nor other adverse phenomena were recorded. The tolerance to the treatment was excellent. We observed a high rate of urea extraction and optimal Kt/V values, a high extraction of beta2 microglobulin (beta2-m) and a reduction in blood rest; in addition, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) significantly decreased. CONCLUSIONS. The inversion of the standard HFR configuration allowed us to improve the removal of both urea and beta2-m, and the blood rest, with an optimal tolerability. Moreover, the reduction in cytokine leve...
Transplantation Proceedings, 2004
Introduction. Reactivation of polyoma virus BK (BKV) is increasingly recognized as a cause of sev... more Introduction. Reactivation of polyoma virus BK (BKV) is increasingly recognized as a cause of severe renal-allograft dysfunction. The aim of the present study was to evaluate prevalence of BKV infection and activity in a population of kidney (KT) and liver (LT) transplant patients and search for a possible correlation with renal dysfunction. Methods. We studied 118 patients for BKV viruria and, when present, for BKV viremia. We also assessed HCV status.
Transplantation Proceedings, 2004
The availability of cadaveric donor organs is insufficient for actual needs. The organ demand inc... more The availability of cadaveric donor organs is insufficient for actual needs. The organ demand increases by 20% per year. Living donor transplant (LDT) may be a valid therapeutical alternative provided one uses proper criteria. LDT provides many advantages, like improved patient and organ survival, short waiting time, and the possibility to carefully plan the procedure. Potential risks include perioperative mortality and renal dysfunction in the kidney donor. At present, kidney LDTs in Italy represent 8% of the total, with an organ survival rate of 97% after 1 year (vs 93% for cadaveric transplants) and donors mortality rate of almost null. Most LDTs are performed from kinsmen. Presently, law no. 458, 26 June 1967, is in force in Italy for kidney LDT and law no. 453, 16 December 1999, for liver LDT. The foundations of LDT are, of course, the recipient's condition, the donor's motivation, and the altruism of the donation. It is desirable that in the future an increasing number of LDT be performed, supported by a careful, widespread health education regarding organ donation from living subjects and by the possibility to obtain insurance for the donor, which has been considered but never provided by actual laws.
Transplantation Journal, 2004
Aims: Chronic renal failure (CRF) is a recognized complication of organ transplantation and sever... more Aims: Chronic renal failure (CRF) is a recognized complication of organ transplantation and several risk factors there exist, linked both to patients and the procedure, which can favor its development. The aim of this study was to assess the incidence of post-transplantation CRF in a population of liver transplanted patients and to investigate the presence of possible risk factors for developing renal dysfunction. Methods: We performed a retrospective study on the liver-transplanted patients referring to liver transplantation ambulatory of "Tor Vergata" University of Rome and investigated the incidence of CRF and eventual need for renal replacement therapy (RRT). Furthermore, we searched for some possible risk factors for CRF development, such as systemic hypertension (SH), dyslipidemia, Diabetes Mellitus (DM), HBV and HCV status and calcyneurin inhibitors therapy. Results: From 1992 to today, 261 ortotopic liver transplantation have been performed at our Centre. In the post-transplantation period, 22 patients (8,4 %) developed chronic renal failure and were treated with standard intermittent hemodialysis (for a men time of 3 weeks). Among these, four male patients and one female subject have developed end stage renal disease (ESRD) and at present need chronic RRT. Further data about ESRD patients are reported in the Table below. One of them has died for cardiovascular complications during dialytic session. Among the remaining 17 patients, 5 subjects (29,5%) were HCV positive, 9/17 (52,9%) showed SH, 2/17 (11,8%) showed DM and 10/17 (58,8%) were treated with CsA. They partially recovered their renal function and are at present under conservative therapy. Conclusions: CRF proved to be a relatively common complication in our liver transplanted patients, confirming data reported in literature. Risk factors for developing renal dysfunction present in our patients are also cardiovascular risk factors and this could lead to an increase in mortality for cardiovascular pathology, particularly incident in uremic patients. It could be useful to pay attention to pretransplant renal dysfunction, modifiable cardiovascular risk factors and immunosuppressant protocol in order to avoid CRF onset in liver transplanted patients, thus obtaining a reduction of morbidity and mortality and of the costs for the National Sanitary System.
Therapeutic Apheresis and Dialysis, 2004
A 71-year-old-woman was admitted to the S. Eugenio Hospital for a history of progressively impair... more A 71-year-old-woman was admitted to the S. Eugenio Hospital for a history of progressively impaired standing and gait. Anamnesis revealed systemic hypertension, gastric polyposis and juvenile pulmonary tuberculosis. Neurological examination showed a severe truncal and gait ataxia, without any sensory-motor impairment. Motor and somato-sensory evoked potentials were normal. Brain Magnetic Resonance Imaging (MRI) showed minimal signs of chronic ischemia only at a supratentorial level. Cerebral Single Photon Emission Computed Tomography, spinal MRI, total body computed tomography, Esophagogastroduodenoscopy, and finally total body Positron Emission Tomography resulted negative for neoplasms. Oncological serum markers were negative. Serum antibody against Purkinje's cells (Anti-Yo) was detected and titer was 1:80, while normally it should be undetectable. Other autoantibodies (Anti-Hu, Anti-Ri) were undetectable. Two sessions of plasma exchange (PE) were thus performed, leading to a rapid, marked and durable improvement of standing and gait and to a reduction of the autoantibody, which became undetectable. No serious adverse effect was noted. Although no definite therapy for autoimmune cerebellar ataxia has been established, PE should be considered as one of the main therapeutic choices.
which permits unrestricted noncommercial use, provided the original work is properly cited. Inter... more which permits unrestricted noncommercial use, provided the original work is properly cited. International Journal of Nephrology and Renovascular Disease 2013:6 27–37 International Journal of Nephrology and Renovascular Disease Clinical management of nondialysis patients with chronic kidney disease: a retrospective observational study. Data from the SONDA study (Survey Of Non-Dialysis outpAtients)
Internal and Emergency Medicine, 2020
In the original publication of the article, the given name and family name of all the author were... more In the original publication of the article, the given name and family name of all the author were swapped. The correct author name is given in this erratum.
Clinical Kidney Journal, 2020
Giornale di Clinica Nefrologica e Dialisi, 2020
We describe the multidisciplinary work of nephrological realities belonging to two different Regi... more We describe the multidisciplinary work of nephrological realities belonging to two different Regional Health Systems, Lombardia and Lazio. The interventional nephrologist is a specialist in nephrology with ultra-specialist know-how for vascular access for dialysis. He is the coordinator of a team of vascular accesses and applies a team work with the other interventional nephrologists, with the vascular surgeon and the interventional radiologist, with whom he decides the diagnostic-therapeutic procedure to perform the best possible vascular access for that individual patient.
The Journal of Vascular Access, 2020
Background: Native arteriovenous fistula is the preferred vascular access in term of functionalit... more Background: Native arteriovenous fistula is the preferred vascular access in term of functionality, efficiency and complication rate. Nevertheless, research continues to seek strategies to reduce the risk of neointimal hyperplasia and hemodynamic modification. The aim of the study was to evaluate the impact on hemodynamic of the VasQ device in arteriovenous fistulae creation. Methods: The analysis included patients who underwent to fistula creation with or without implantation of the VasQ device between May and September 2019. The hemodynamic parameters were evaluated pre-operatively and at a follow-up of 1, 3, 6 months. The patency and complication rate were evaluated. Results: Fifteen VasQ devices were implanted during 30 arteriovenous fistula surgery. The baseline patients features were similar between groups (VasQ treated/control). At baseline, preoperative arterial flow was similar; radial artery diameter at surgical site was 3.4 ± 0.8 mm in treated and 2.8 ± 0.5 mm in the cont...
Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2018
A 39-year man with primary steroid resistant focal segmental glomerulosclerosis (FSGS) was treate... more A 39-year man with primary steroid resistant focal segmental glomerulosclerosis (FSGS) was treated with mycophenolate mofetil and ACE-inhibitors. After six months a different therapeutics approach was mandatory due to the worsening of renal function and the relapse of proteinuria at the nephrotic range. The combination of cascade plasmafiltration and single dose of rituximab (375 mg/m²) achieved clinical remission and improved renal function in six months follow up. Cascade plasmafiltration in association with rituximab can be considered as a salvage method for primary steroid-resistant FSGS. Clinical trials should be carried out for protocol approval.
Nephrology @ Point of Care, 2017
QUESTIONS @ POINT OF CARE an initial damage with rare microaneurysm and intraretinal hemorrhages,... more QUESTIONS @ POINT OF CARE an initial damage with rare microaneurysm and intraretinal hemorrhages, without edema or exudates. The echocardiogram showed normal values for the whole cardiac measurement except for the initial left ventricular hypertrophy (LVH), with a normal result of 60% for the left ventricular ejection fraction (LVEF) and without valvular abnormalities. Finally, the results of the arterial venous Doppler ultrasound examination of the neck and lower limbs and of the upper and lower limbs electromyography (EMG) were normal. The glycemic parameters were kept under control with metformin 1000 mg twice a day. The patient was a nonsmoker, not addicted to alcohol, but his overweight suggested that a prompt lifestyle change was mandatory. He started taking omega-3 (1000 mg twice a day) and a combination of ezetimibe-simvastatin 10/20 mg once a day. What do we know about diabetic nephropathy and its natural history? The incidence and prevalence of type 2 diabetes mellitus (T2DM) will continue to increase and it's widely recognized that the number of adults with diabetes worldwide will rise from 382 million in 2013 to 592 million in 2035, especially in developing countries (1). Diabetic nephropathy (DN) is one of the most frequent microvascular complications of diabetes. Whereas in the USA has been estimated that 50% of prevalent patients under dialysis are affected by diabetes (2), in Italy the prevalence of diabetic patients on dialysis has been estimated at 25.3% (3). Fortunately, only one-third of patients with T2DM experience DN (4). According to medical literature, diabetes leads to significant renal abnormalities in a period of approximately 20 years and the reduction in estimated glomerular filtration
International journal of nephrology and renovascular disease, 2013
A lack of awareness of chronic kidney disease (CKD) often results in delayed diagnosis and inadeq... more A lack of awareness of chronic kidney disease (CKD) often results in delayed diagnosis and inadequate treatment. The objective of this study was to assess the therapeutic management and outcome of nondialysis CKD patients. Three hundred ninety-seven patients (54.9% males aged 67.5 ± 14.6 years) were retrospectively screened at the Nephrology Department, GB Grassi Hospital, Rome, Italy. After a baseline visit, patient data were collected every 6 months for a total of 24 months. Clinical characteristics were measured at baseline, then the following outcomes were measured every 6 months: staging of CKD, presence of concomitant diseases, treatment and adherence to Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines for anemia management. Three hundred sixty-eight (92.7%) patients attended at least one visit and 92 (23.2%) patients attended all four visits. Patients were mainly referred to a nephrologist for chronic renal failure (61.7%) or hypertension (42.8%). At baseline, 7...
Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia, Feb 27, 2023
The Journal of Vascular Access, 2020
Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients particu... more Peripherally Inserted Central Catheters (PICCs) are widely used for hospitalized patients particularly in the oncological and hematological field. PICCs are a safe alternative to central venous catheters, mainly for medium- and long-term therapy
Journal of nephrology
Dialysis patients show a very high prevalence of cardiovascular complications, affected as they a... more Dialysis patients show a very high prevalence of cardiovascular complications, affected as they are with abnormal and accelerated vascular calcifications and, eventually, calcium and phosphorous metabolism disorders. Multislice computed tomography (MSCT) provides a reproducible, high-resolution imaging of calcium contained in cardiac arteries, measured by Agatston score. The aim of the present study was to evaluate the influence of high-dose and low-dose calcitriol therapy on the progression of cardiac vascular calcifications in dialyzed patients. We enrolled 36 dialyzed patients in a prospective study, including an interventional period of 12 months and a follow-up period of 12 months. Eighteen protocol patients received intravenous pulses of high-doses calcitriol at the end of dialytic treatment and sevelamer hydrochloride therapy. Control patients received low-dose calcitriol and sevelamer hydrochloride as well. Two MSCT scans were performed: 1 at the start of the study and 1 at ...
Giornale italiano di nefrologia : organo ufficiale della Società italiana di nefrologia
Hemodiafiltration reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as re... more Hemodiafiltration reinfusion (HFR) is characterized by the use of regenerated ultrafiltrate as replacement fluid. We devised a new technique, post-dilution HFR, aimed at increasing the purification efficiency, treatment tolerability and at reducing inflammatory state. We performed post-dilution HFR in six uremic patients during 18 months. Dialytic efficacy, filter blood rest and cytokine behavior were evaluated. Neither pyrogenic reactions nor other adverse phenomena were recorded. The tolerance to the treatment was excellent. We observed a high rate of urea extraction and optimal Kt/V values, a high extraction of beta2 microglobulin (beta2-m) and a reduction in blood rest; in addition, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) significantly decreased. CONCLUSIONS. The inversion of the standard HFR configuration allowed us to improve the removal of both urea and beta2-m, and the blood rest, with an optimal tolerability. Moreover, the reduction in cytokine leve...
Transplantation Proceedings, 2004
Introduction. Reactivation of polyoma virus BK (BKV) is increasingly recognized as a cause of sev... more Introduction. Reactivation of polyoma virus BK (BKV) is increasingly recognized as a cause of severe renal-allograft dysfunction. The aim of the present study was to evaluate prevalence of BKV infection and activity in a population of kidney (KT) and liver (LT) transplant patients and search for a possible correlation with renal dysfunction. Methods. We studied 118 patients for BKV viruria and, when present, for BKV viremia. We also assessed HCV status.
Transplantation Proceedings, 2004
The availability of cadaveric donor organs is insufficient for actual needs. The organ demand inc... more The availability of cadaveric donor organs is insufficient for actual needs. The organ demand increases by 20% per year. Living donor transplant (LDT) may be a valid therapeutical alternative provided one uses proper criteria. LDT provides many advantages, like improved patient and organ survival, short waiting time, and the possibility to carefully plan the procedure. Potential risks include perioperative mortality and renal dysfunction in the kidney donor. At present, kidney LDTs in Italy represent 8% of the total, with an organ survival rate of 97% after 1 year (vs 93% for cadaveric transplants) and donors mortality rate of almost null. Most LDTs are performed from kinsmen. Presently, law no. 458, 26 June 1967, is in force in Italy for kidney LDT and law no. 453, 16 December 1999, for liver LDT. The foundations of LDT are, of course, the recipient's condition, the donor's motivation, and the altruism of the donation. It is desirable that in the future an increasing number of LDT be performed, supported by a careful, widespread health education regarding organ donation from living subjects and by the possibility to obtain insurance for the donor, which has been considered but never provided by actual laws.
Transplantation Journal, 2004
Aims: Chronic renal failure (CRF) is a recognized complication of organ transplantation and sever... more Aims: Chronic renal failure (CRF) is a recognized complication of organ transplantation and several risk factors there exist, linked both to patients and the procedure, which can favor its development. The aim of this study was to assess the incidence of post-transplantation CRF in a population of liver transplanted patients and to investigate the presence of possible risk factors for developing renal dysfunction. Methods: We performed a retrospective study on the liver-transplanted patients referring to liver transplantation ambulatory of "Tor Vergata" University of Rome and investigated the incidence of CRF and eventual need for renal replacement therapy (RRT). Furthermore, we searched for some possible risk factors for CRF development, such as systemic hypertension (SH), dyslipidemia, Diabetes Mellitus (DM), HBV and HCV status and calcyneurin inhibitors therapy. Results: From 1992 to today, 261 ortotopic liver transplantation have been performed at our Centre. In the post-transplantation period, 22 patients (8,4 %) developed chronic renal failure and were treated with standard intermittent hemodialysis (for a men time of 3 weeks). Among these, four male patients and one female subject have developed end stage renal disease (ESRD) and at present need chronic RRT. Further data about ESRD patients are reported in the Table below. One of them has died for cardiovascular complications during dialytic session. Among the remaining 17 patients, 5 subjects (29,5%) were HCV positive, 9/17 (52,9%) showed SH, 2/17 (11,8%) showed DM and 10/17 (58,8%) were treated with CsA. They partially recovered their renal function and are at present under conservative therapy. Conclusions: CRF proved to be a relatively common complication in our liver transplanted patients, confirming data reported in literature. Risk factors for developing renal dysfunction present in our patients are also cardiovascular risk factors and this could lead to an increase in mortality for cardiovascular pathology, particularly incident in uremic patients. It could be useful to pay attention to pretransplant renal dysfunction, modifiable cardiovascular risk factors and immunosuppressant protocol in order to avoid CRF onset in liver transplanted patients, thus obtaining a reduction of morbidity and mortality and of the costs for the National Sanitary System.
Therapeutic Apheresis and Dialysis, 2004
A 71-year-old-woman was admitted to the S. Eugenio Hospital for a history of progressively impair... more A 71-year-old-woman was admitted to the S. Eugenio Hospital for a history of progressively impaired standing and gait. Anamnesis revealed systemic hypertension, gastric polyposis and juvenile pulmonary tuberculosis. Neurological examination showed a severe truncal and gait ataxia, without any sensory-motor impairment. Motor and somato-sensory evoked potentials were normal. Brain Magnetic Resonance Imaging (MRI) showed minimal signs of chronic ischemia only at a supratentorial level. Cerebral Single Photon Emission Computed Tomography, spinal MRI, total body computed tomography, Esophagogastroduodenoscopy, and finally total body Positron Emission Tomography resulted negative for neoplasms. Oncological serum markers were negative. Serum antibody against Purkinje's cells (Anti-Yo) was detected and titer was 1:80, while normally it should be undetectable. Other autoantibodies (Anti-Hu, Anti-Ri) were undetectable. Two sessions of plasma exchange (PE) were thus performed, leading to a rapid, marked and durable improvement of standing and gait and to a reduction of the autoantibody, which became undetectable. No serious adverse effect was noted. Although no definite therapy for autoimmune cerebellar ataxia has been established, PE should be considered as one of the main therapeutic choices.
which permits unrestricted noncommercial use, provided the original work is properly cited. Inter... more which permits unrestricted noncommercial use, provided the original work is properly cited. International Journal of Nephrology and Renovascular Disease 2013:6 27–37 International Journal of Nephrology and Renovascular Disease Clinical management of nondialysis patients with chronic kidney disease: a retrospective observational study. Data from the SONDA study (Survey Of Non-Dialysis outpAtients)
Internal and Emergency Medicine, 2020
In the original publication of the article, the given name and family name of all the author were... more In the original publication of the article, the given name and family name of all the author were swapped. The correct author name is given in this erratum.
Clinical Kidney Journal, 2020
Giornale di Clinica Nefrologica e Dialisi, 2020
We describe the multidisciplinary work of nephrological realities belonging to two different Regi... more We describe the multidisciplinary work of nephrological realities belonging to two different Regional Health Systems, Lombardia and Lazio. The interventional nephrologist is a specialist in nephrology with ultra-specialist know-how for vascular access for dialysis. He is the coordinator of a team of vascular accesses and applies a team work with the other interventional nephrologists, with the vascular surgeon and the interventional radiologist, with whom he decides the diagnostic-therapeutic procedure to perform the best possible vascular access for that individual patient.
The Journal of Vascular Access, 2020
Background: Native arteriovenous fistula is the preferred vascular access in term of functionalit... more Background: Native arteriovenous fistula is the preferred vascular access in term of functionality, efficiency and complication rate. Nevertheless, research continues to seek strategies to reduce the risk of neointimal hyperplasia and hemodynamic modification. The aim of the study was to evaluate the impact on hemodynamic of the VasQ device in arteriovenous fistulae creation. Methods: The analysis included patients who underwent to fistula creation with or without implantation of the VasQ device between May and September 2019. The hemodynamic parameters were evaluated pre-operatively and at a follow-up of 1, 3, 6 months. The patency and complication rate were evaluated. Results: Fifteen VasQ devices were implanted during 30 arteriovenous fistula surgery. The baseline patients features were similar between groups (VasQ treated/control). At baseline, preoperative arterial flow was similar; radial artery diameter at surgical site was 3.4 ± 0.8 mm in treated and 2.8 ± 0.5 mm in the cont...
Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia, 2018
A 39-year man with primary steroid resistant focal segmental glomerulosclerosis (FSGS) was treate... more A 39-year man with primary steroid resistant focal segmental glomerulosclerosis (FSGS) was treated with mycophenolate mofetil and ACE-inhibitors. After six months a different therapeutics approach was mandatory due to the worsening of renal function and the relapse of proteinuria at the nephrotic range. The combination of cascade plasmafiltration and single dose of rituximab (375 mg/m²) achieved clinical remission and improved renal function in six months follow up. Cascade plasmafiltration in association with rituximab can be considered as a salvage method for primary steroid-resistant FSGS. Clinical trials should be carried out for protocol approval.
Nephrology @ Point of Care, 2017
QUESTIONS @ POINT OF CARE an initial damage with rare microaneurysm and intraretinal hemorrhages,... more QUESTIONS @ POINT OF CARE an initial damage with rare microaneurysm and intraretinal hemorrhages, without edema or exudates. The echocardiogram showed normal values for the whole cardiac measurement except for the initial left ventricular hypertrophy (LVH), with a normal result of 60% for the left ventricular ejection fraction (LVEF) and without valvular abnormalities. Finally, the results of the arterial venous Doppler ultrasound examination of the neck and lower limbs and of the upper and lower limbs electromyography (EMG) were normal. The glycemic parameters were kept under control with metformin 1000 mg twice a day. The patient was a nonsmoker, not addicted to alcohol, but his overweight suggested that a prompt lifestyle change was mandatory. He started taking omega-3 (1000 mg twice a day) and a combination of ezetimibe-simvastatin 10/20 mg once a day. What do we know about diabetic nephropathy and its natural history? The incidence and prevalence of type 2 diabetes mellitus (T2DM) will continue to increase and it's widely recognized that the number of adults with diabetes worldwide will rise from 382 million in 2013 to 592 million in 2035, especially in developing countries (1). Diabetic nephropathy (DN) is one of the most frequent microvascular complications of diabetes. Whereas in the USA has been estimated that 50% of prevalent patients under dialysis are affected by diabetes (2), in Italy the prevalence of diabetic patients on dialysis has been estimated at 25.3% (3). Fortunately, only one-third of patients with T2DM experience DN (4). According to medical literature, diabetes leads to significant renal abnormalities in a period of approximately 20 years and the reduction in estimated glomerular filtration
International journal of nephrology and renovascular disease, 2013
A lack of awareness of chronic kidney disease (CKD) often results in delayed diagnosis and inadeq... more A lack of awareness of chronic kidney disease (CKD) often results in delayed diagnosis and inadequate treatment. The objective of this study was to assess the therapeutic management and outcome of nondialysis CKD patients. Three hundred ninety-seven patients (54.9% males aged 67.5 ± 14.6 years) were retrospectively screened at the Nephrology Department, GB Grassi Hospital, Rome, Italy. After a baseline visit, patient data were collected every 6 months for a total of 24 months. Clinical characteristics were measured at baseline, then the following outcomes were measured every 6 months: staging of CKD, presence of concomitant diseases, treatment and adherence to Kidney Disease Outcomes Quality Initiative (K/DOQI) guidelines for anemia management. Three hundred sixty-eight (92.7%) patients attended at least one visit and 92 (23.2%) patients attended all four visits. Patients were mainly referred to a nephrologist for chronic renal failure (61.7%) or hypertension (42.8%). At baseline, 7...