Francesca Tunesi, Liliana Italia De Rosa, Martina Catania, Marta Vespa, Kristiana Kola, Giuseppe Vezzoli, Donatella Spotti, Micaela Petrone, Marco Simonini, Chiara Livia Lanzani, Maria Teresa Sciarrone Aliprandi
Autosomal dominant polycystic kidney disease (ADPKD) is a genetic kidney disease characterized by gradual kidney enlargement and progressive renal function loss. Pregnancy is a significant risk factor for adverse maternal and fetal outcomes in chronic kidney disease (CKD), regardless of the nephropathy. Women with ADPKD often face concerns about worsening their renal condition and passing the disease on to their offspring. Recent studies show better outcomes due to improved pregnancy surveillance and prior counseling. Risk factors for poor fetal and maternal outcomes include advanced maternal age, pre-existing hypertension, urinary infections, proteinuria, and renal failure. Collaboration between nephrologists and gynecologists is essential for addressing clinically significant concerns in pregnant women with ADPKD. Nephrologists should play an active role in assisting and supporting pregnant ADPKD patients as part of a multidisciplinary team.
{"title":"The crucial role of the nephrologist in the management of pregnancy in women with adult autosomal dominant polycystic kidney disease","authors":"Francesca Tunesi, Liliana Italia De Rosa, Martina Catania, Marta Vespa, Kristiana Kola, Giuseppe Vezzoli, Donatella Spotti, Micaela Petrone, Marco Simonini, Chiara Livia Lanzani, Maria Teresa Sciarrone Aliprandi","doi":"10.33393/gcnd.2023.2628","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2628","url":null,"abstract":"Autosomal dominant polycystic kidney disease (ADPKD) is a genetic kidney disease characterized by gradual kidney enlargement and progressive renal function loss. Pregnancy is a significant risk factor for adverse maternal and fetal outcomes in chronic kidney disease (CKD), regardless of the nephropathy. Women with ADPKD often face concerns about worsening their renal condition and passing the disease on to their offspring. Recent studies show better outcomes due to improved pregnancy surveillance and prior counseling. Risk factors for poor fetal and maternal outcomes include advanced maternal age, pre-existing hypertension, urinary infections, proteinuria, and renal failure. Collaboration between nephrologists and gynecologists is essential for addressing clinically significant concerns in pregnant women with ADPKD. Nephrologists should play an active role in assisting and supporting pregnant ADPKD patients as part of a multidisciplinary team.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135081640","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sex-based disparities in nephrology have been a historically understudied area. In nephrology, gender differences exist with regard to the epidemiology, evolution and prognosis of chronic kidney disease (CKD). In some cases, these differences run contrary to the general population trends. We discuss such gender and sex disparities, including differing impact of traditional and novel risk factors, as well as hormonal factors, all of them potentially influencing propensity, progression and biochemical and psychological aspects of CKD. The factors involved in this gender disparity may include diet, kidney and glomerular size, differences in glomerular hemodynamics, and the direct effects of sex hormones. The progression rate of many renal diseases is affected by sex. In polycystic kidney disease, membranous nephropathy, immunoglobulin A nephropathy, and “chronic renal disease of unknown etiology”, men progress at a faster rate to end-stage renal failure than women do. In many, but not all, animal models of renal disease, estrogens slow progression rate. Animal and experimental studies have tried to offer further mechanistic explanations for gender differences in disease progression. It has been suggested that the gender dimorphism of CKD progression may represent the effects of the interaction of circulating steroids with specific kidney receptors. Endogenous estrogens have in general been considered to have anti-fibrotic and anti-apoptotic effects on the kidney. On the other hand, the faster decline of kidney function in men has been attributed to the specific pro-apoptotic and pro-fibrotic properties of androgens.
{"title":"Gender and sex in the development and progression of renal diseases","authors":"Marcora Mandreoli","doi":"10.33393/gcnd.2023.2627","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2627","url":null,"abstract":"Sex-based disparities in nephrology have been a historically understudied area. In nephrology, gender differences exist with regard to the epidemiology, evolution and prognosis of chronic kidney disease (CKD). In some cases, these differences run contrary to the general population trends. We discuss such gender and sex disparities, including differing impact of traditional and novel risk factors, as well as hormonal factors, all of them potentially influencing propensity, progression and biochemical and psychological aspects of CKD. The factors involved in this gender disparity may include diet, kidney and glomerular size, differences in glomerular hemodynamics, and the direct effects of sex hormones. The progression rate of many renal diseases is affected by sex. In polycystic kidney disease, membranous nephropathy, immunoglobulin A nephropathy, and “chronic renal disease of unknown etiology”, men progress at a faster rate to end-stage renal failure than women do. In many, but not all, animal models of renal disease, estrogens slow progression rate. Animal and experimental studies have tried to offer further mechanistic explanations for gender differences in disease progression. It has been suggested that the gender dimorphism of CKD progression may represent the effects of the interaction of circulating steroids with specific kidney receptors. Endogenous estrogens have in general been considered to have anti-fibrotic and anti-apoptotic effects on the kidney. On the other hand, the faster decline of kidney function in men has been attributed to the specific pro-apoptotic and pro-fibrotic properties of androgens.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"42 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134903557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Anna Laura Fantuzzi, Elisa Berri, Lida Tartaglione, Rossella Giannini, Sara Dominjanni, Silvia Porreca
Renal transplantation represents the best treatment for end-stage kidney disease, leading to improved quality of life and life-expectancy for most of the patients. However, gender disparities are evident both in access and in outcomes of kidney transplantation. Women on dialysis are less likely to be on the waiting list for kidney transplantation and to receive an organ from a deceased donor or living donor. Several biological and sociocultural aspects could explain this disparity. On the contrary, more women than men are living kidney donors. Italian women are the first organ donors for living transplants in Europe. The gender difference in living donation is certainly affected by different comorbidities, but such a marked trend highlights a greater predisposition to donate of women, especially in the family context. Some differences are also found in kidney outcomes, even not fully understood. Our paper analyzes the main differences in different aspects of kidney transplantation related to gender, including nutritional aspects.
{"title":"Renal transplant: gender differences","authors":"Anna Laura Fantuzzi, Elisa Berri, Lida Tartaglione, Rossella Giannini, Sara Dominjanni, Silvia Porreca","doi":"10.33393/gcnd.2023.2606","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2606","url":null,"abstract":"Renal transplantation represents the best treatment for end-stage kidney disease, leading to improved quality of life and life-expectancy for most of the patients. However, gender disparities are evident both in access and in outcomes of kidney transplantation. Women on dialysis are less likely to be on the waiting list for kidney transplantation and to receive an organ from a deceased donor or living donor. Several biological and sociocultural aspects could explain this disparity. On the contrary, more women than men are living kidney donors. Italian women are the first organ donors for living transplants in Europe. The gender difference in living donation is certainly affected by different comorbidities, but such a marked trend highlights a greater predisposition to donate of women, especially in the family context. Some differences are also found in kidney outcomes, even not fully understood. Our paper analyzes the main differences in different aspects of kidney transplantation related to gender, including nutritional aspects.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"17 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136083582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"#insiemePerLaVita","authors":"Luisa Sternfeld Pavia","doi":"10.33393/gcnd.2023.2597","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2597","url":null,"abstract":"","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84632360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beyond total kidney and cyst volume, non-cystic tissue plays an important role in autosomal dominant polycystic kidney disease (ADPKD) progression. Recent advancements in magnetic resonance imaging (MRI) offer the possibility to study kidney microstructure and function, besides anatomy. In particular, Diffusion Weighted Imaging (DWI), an MRI technique sensitive to water molecule motion (diffusion) in biological tissues, allows to investigate microstructure. This study, recently published in the European Radiology scientific journal, proposes and preliminary validates a novel method to segment cystic and non-cystic volume on DWI scans from ADPKD patients. The study also provides evidence of DWI potential in characterising non-cystic kidney tissue, denoted by higher diffusion and lower perfusion than healthy tissue, in line with its fibrotic nature and the likely presence of microcysts. Overall, this study provides evidence in support of DWI potential in ADPKD. DWI could complement existing biomarkers for noninvasively staging, monitoring, and predicting ADPKD progression and evaluating the impact of novel therapies, possibly targeting damaged non-cystic tissue besides cyst expansion.
{"title":"La risonanza magnetica pesata in diffusione (DWI) per la quantificazione del volume delle cisti e la caratterizzazione del tessuto non cistico nella malattia policistica renale: lo studio dell’Istituto Mario Negri","authors":"Ariela Benigni","doi":"10.33393/gcnd.2023.2599","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2599","url":null,"abstract":"Beyond total kidney and cyst volume, non-cystic tissue plays an important role in autosomal dominant polycystic kidney disease (ADPKD) progression. Recent advancements in magnetic resonance imaging (MRI) offer the possibility to study kidney microstructure and function, besides anatomy. In particular, Diffusion Weighted Imaging (DWI), an MRI technique sensitive to water molecule motion (diffusion) in biological tissues, allows to investigate microstructure. This study, recently published in the European Radiology scientific journal, proposes and preliminary validates a novel method to segment cystic and non-cystic volume on DWI scans from ADPKD patients. The study also provides evidence of DWI potential in characterising non-cystic kidney tissue, denoted by higher diffusion and lower perfusion than healthy tissue, in line with its fibrotic nature and the likely presence of microcysts. Overall, this study provides evidence in support of DWI potential in ADPKD. DWI could complement existing biomarkers for noninvasively staging, monitoring, and predicting ADPKD progression and evaluating the impact of novel therapies, possibly targeting damaged non-cystic tissue besides cyst expansion.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87741403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"La voce dei pazienti: Maurizio e Giovanna","authors":"Luisa Sternfeld Pavia","doi":"10.33393/gcnd.2023.2598","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2598","url":null,"abstract":"","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72906127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
ONE HEALTH approach, coined by FAO, perfectly sums up a concept that is strongly emerging in the international scientific community. The environment (especially greenery and trees) plays a decisive role in human health and in wellbeing. A change in the development model that takes these issues into account, starting with the design of greener and more sustainable cities, appears necessary and urgent, given that in 2050 approximately 70% of the world’s population will live in large cities.
{"title":"Are human health and environmental health inextricably linked?","authors":"D. Mariani","doi":"10.33393/gcnd.2023.2594","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2594","url":null,"abstract":"ONE HEALTH approach, coined by FAO, perfectly sums up a concept that is strongly emerging in the international scientific community.\u0000The environment (especially greenery and trees) plays a decisive role in human health and in wellbeing. A change in the development model that takes these issues into account, starting with the design of greener and more sustainable cities, appears necessary and urgent, given that in 2050 approximately 70% of the world’s population will live in large cities.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"12 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75557837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Babini, M. Lombardi, V. Sparacino, Giuseppe Vanacore
Organ transplantation is a life-saving procedure that can significantly improve the quality of life for patients suffering from organ failure. However, the procurement and transplantation of organs involves complex legal and ethical issues. Italy is not an exception, as the country has faced several challenges related to organ transplantation. The article provides an overview of the regulatory framework governing organ transplantation in Italy, focusing on patients’ needs.
{"title":"Renal transplant patients: Review of Italian legislation","authors":"P. Babini, M. Lombardi, V. Sparacino, Giuseppe Vanacore","doi":"10.33393/gcnd.2023.2589","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2589","url":null,"abstract":"Organ transplantation is a life-saving procedure that can significantly improve the quality of life for patients suffering from organ failure. However, the procurement and transplantation of organs involves complex legal and ethical issues. Italy is not an exception, as the country has faced several challenges related to organ transplantation. The article provides an overview of the regulatory framework governing organ transplantation in Italy, focusing on patients’ needs.","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91369702","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Abstracts 41° Congresso Nazionale SIAN ITALIA: Gestione del rischio e sicurezza delle cure in ambito nefrologico","authors":"","doi":"10.33393/gcnd.2023.2581","DOIUrl":"https://doi.org/10.33393/gcnd.2023.2581","url":null,"abstract":"","PeriodicalId":12617,"journal":{"name":"Giornale di Clinica Nefrologica e Dialisi","volume":"27 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82795558","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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