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Claudio Ronco

Federico Nalesso, Francesco Garzotto, Eva Muraro, Alessandra Brendolan, Claudio Ronco
Arteriovenous fistula cannulation for dialysis treatments in Europe has traditionally been done by metal needles. In -Japan, plastic cannulas have been available for many years and are used in the majority of the dialysis patients. The mechanical structure and the cannulation procedure of the plastic cannulas differ from those of the metal needles. These differences are particularly beneficial for patients with delicate fistulas, tortuous vessels, metal allergies, oligophrenic patients, and also for the safety of the medical staff...
January 26, 2018: Blood Purification
Federico Nalesso, Francesco Garzotto, Ilaria Petrucci, Sara Samoni, Grazia Maria Virzì, Dario Gregori, Mario Meola, Claudio Ronco
INTRODUCTION: Ultrasound and colorDoppler technique, which is relatively inexpensive, rapid, non-invasive and repeatable is a powerful tool used for early diagnosis of vascular access (VA) complications in hemodialysis patients. To date a standard and widely comprehensible echocolorDoppler (ECD) protocol is not available. MATERIALS AND METHODS: A simple step-by-step protocol based on anatomical and hemodynamic parameters of VA has been developed during a 3-years VA ECD follow-up...
January 26, 2018: Blood Purification
Laura Di Leo, Federico Nalesso, Francesco Garzotto, Yun Xie, Bo Yang, Grazia Maria Virzì, Alberto Passannante, Raffaele Bonato, Mariarosa Carta, Davide Giavarina, Dario Gregori, Alessandra Brendolan, Fiorenza Ferrari, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) diagnosis is based on a rise in serum creatinine and/or fall in urine output. It has been shown that there are patients that fulfill AKI definition but do not have AKI, and there are also patients with evidence of renal injury who do not meet any criteria for AKI. Recently the innovative and emerging proteomic technology has enabled the identification of novel biomarkers that allow improved risk stratification. METHODS: Tissue inhibitor of metalloproteinases-2 (TIMP-2), insulin-like growth factor-binding protein 7 (IGFBP7) were measured to a cohort of 719 consecutive patients admitted to Intensive Care Unit (ICU)...
January 26, 2018: Blood Purification
Adrianna Douvris, Gurpreet Malhi, Swapnil Hiremath, Lauralyn McIntyre, Samuel A Silver, Sean M Bagshaw, Ron Wald, Claudio Ronco, Lindsey Sikora, Catherine Weber, Edward G Clark
BACKGROUND: Hemodynamic instability related to renal replacement therapy (HIRRT) may increase the risk of death and limit renal recovery. Studies in end-stage renal disease populations on maintenance hemodialysis suggest that some renal replacement therapy (RRT)-related interventions (e.g., cool dialysate) may reduce the occurrence of HIRRT, but less is known about interventions to prevent HIRRT in critically ill patients receiving RRT for acute kidney injury (AKI). We sought to evaluate the effectiveness of RRT-related interventions for reducing HIRRT in such patients across RRT modalities...
February 22, 2018: Critical Care: the Official Journal of the Critical Care Forum
Silvia DE Rosa, Gianluca Villa, Kenji Inaba, Sara Samoni, Claudio Ronco
INTRODUCTION: This narrative review will describe treatment options for patients in the ICU with major extremity injury requiring extracorporeal myoglobin removal and contemporaneous support for systemic complications, such as sepsis, systemic inflammation and coagulation disorders. EVIDENCE ACQUISITION: Peer-reviewed manuscripts indexed in PubMed. A systematic search for articles describing treatment options for patients in the ICU with major extremity injury were included in the analysis...
February 5, 2018: Minerva Anestesiologica
Jorge Cerdá, Gianluca Villa, Mauro Neri, Claudio Ronco
The integration of modern information communication technology and technologically advanced equipment to routine clinical practice are important technological stepping stones in the management of patients with acute kidney injury (AKI). These tools improve practice and patient outcomes by supporting and individualizing all phases of AKI management. This narrative review describes the most recent bedside technological advances in AKI diagnosis, renal replacement therapy education, prescription, monitoring, delivery, and measurement of outcomes with an emphasis on providing highly personalized patient care...
2018: Contributions to Nephrology
Mitchell H Rosner, Gaetano La Manna, Claudio Ronco
The aging kidney is more susceptible to injury. Thus, it is not surprising that acute kidney injury (AKI) is a disorder with a relative high incidence in the elderly population, especially those with critical illness. Given the comorbid conditions common in the geriatric population as well as the increase in exposure to various nephrotoxic insults, it is likely that the incidence of AKI will grow in the coming decades. Thus, it is critical to gain an understanding of the cellular and molecular pathways operative in increasing the susceptibility to AKI with an aim to design therapies that will mitigate the risk of AKI...
2018: Contributions to Nephrology
Faeq Husain-Syed, Fiorenza Ferrari, Aashish Sharma, Tommaso Hinna Danesi, Pércia Bezerra, Salvador Lopez-Giacoman, Sara Samoni, Massimo de Cal, Valentina Corradi, Grazia Maria Virzì, Silvia De Rosa, María Jimena Muciño Bermejo, Carla Estremadoyro, Gianluca Villa, Jose J Zaragoza, Carlotta Caprara, Alessandra Brocca, Horst-Walter Birk, Hans-Dieter Walmrath, Werner Seeger, Federico Nalesso, Monica Zanella, Alessandra Brendolan, Davide Giavarina, Loris Salvador, Rinaldo Bellomo, Mitchell H Rosner, John A Kellum, Claudio Ronco
BACKGROUND: Although acute kidney injury (AKI) frequently complicates cardiac surgery, methods to determine AKI risk in patients without underlying kidney disease are lacking. Renal functional reserve (RFR) can be used to measure the capacity of the kidney to increase glomerular filtration rate under conditions of physiological stress and may serve as a functional marker that assesses susceptibility to injury. We sought to determine whether preoperative RFR predicts postoperative AKI...
January 27, 2018: Annals of Thoracic Surgery
Tomoko Fujii, Riki Ganeko, Yuki Kataoka, Toshi A Furukawa, Robin Featherstone, Kent Doi, Jean-Louis Vincent, Daniela Pasero, René Robert, Claudio Ronco, Sean M Bagshaw
Owing to an oversight by the authors, Figure 2 in this article was not the version intended for publication. The correct Figure 2, reproduced here, features footnote symbols and Figure 2b includes three studies as described in the main text.
January 16, 2018: Intensive Care Medicine
Silvia De Rosa, Massimo De Cal, Michael Joannidis, Gianluca Villa, Jose Luis Salas Pacheco, Grazia Maria Virzì, Sara Samoni, Fiorella D'ippoliti, Stefano Marcante, Federico Visconti, Antonella Lampariello, Marina Zannato, Silvio Marafon, Raffaele Bonato, Claudio Ronco
No abstract text is available yet for this article.
December 29, 2017: BMC Nephrology
Zhiyong Peng, Kaijiang Yu, Marlies Ostermann, XiuMing Xi, Raymond Hsu, Jean-Louis Vincent, John R Prowle, Bin Du, Martin Gallagher, Changsong Wang, Raghavan Murugan, Haibo Qiu, Thomas Rimmelé, Jianguo Li, Lui G Forni, Kianoush Kashani, Claudio Ronco, John A Kellum
PURPOSE: Acute kidney injury (AKI) has become a major medical and financial burden in China along with the rest of the world. There have been considerable advances in the understanding of the epidemiology and pathogenesis of AKI. However, there is no consensus regarding the optimal care for patients. The Acute Disease Quality Initiative (ADQI) 19 meeting focused on identifying and designing relevant and achievable AKI-related studies in China. MATERIALS & METHODS: The working group developed a list of preliminary questions and objectives and performed analysis of the existing literature...
December 12, 2017: Journal of Critical Care
Stefano Romagnoli, William R Clark, Zaccaria Ricci, Claudio Ronco
Severe acute kidney injury (AKI) requiring renal replacement therapy (RRT) is a serious clinical disorder in the intensive care unit (ICU), occurring in a significant proportion of critically ill patients. However, many questions remain about the optimal administration of RRT with regard to several important considerations, including treatment dose, timing of treatment initiation and cessation, therapy mode, type of anticoagulation, and management of fluid overload. While Level 1 evidence exists for RRT dosing in AKI, all the studies contributing to this evidence base employed fixed-dose regimens throughout a patient's continuous RRT (CRRT) course, without regard for the possibility of individualizing treatment dose according to the clinical status of a given patient at a specific time...
September 2017: Best Practice & Research. Clinical Anaesthesiology
Tomoko Fujii, Riki Ganeko, Yuki Kataoka, Toshi A Furukawa, Robin Featherstone, Kent Doi, Jean-Louis Vincent, Daniela Pasero, René Robert, Claudio Ronco, Sean M Bagshaw
PURPOSE: Polymyxin B-immobilized hemoperfusion (PMX-HP) is an adjuvant therapy for sepsis or septic shock that clears circulating endotoxin. Prior trials have shown that PMX-HP improves surrogate endpoints. We aimed to conduct an evidence synthesis to evaluate the efficacy and safety of PMX-HP in critically ill adult patients with sepsis or septic shock. METHODS: We searched for randomized controlled trials (RCTs) in MEDLINE, EMBASE, the Cochrane Library, the Health Technology Assessment Database, CINAHL, "Igaku Chuo Zasshi", the National Institute of Health Clinical Trials Register, the World Health Organization International Clinical Trials Registry Platform, the University Hospital Medical Information Network Clinical Trials Registry, the reference lists of retrieved articles, and publications by manufacturers of PMX-HP...
February 2018: Intensive Care Medicine
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
No abstract text is available yet for this article.
December 1, 2017: Intensive Care Medicine
Ying Wang, Martin Gallagher, Qiang Li, Serigne Lo, Alan Cass, Simon Finfer, John Myburgh, Catherine Bouman, Robert Faulhaber-Walter, John A Kellum, Paul M Palevsky, Claudio Ronco, Patrick Saudan, Ashita Tolwani, Rinaldo Bellomo
Background: There is no consensus whether higher intensity dose renal replacement therapy (RRT) compared with standard intensity RRT has survival benefit and achieves better renal recovery in acute kidney injury (AKI). Methods: In an individual patient data meta-analysis, we merged individual patient data from randomized controlled trials (RCTs) comparing high with standard intensity RRT in intensive care unit patients with severe AKI. The primary outcome was all-cause mortality...
November 23, 2017: Nephrology, Dialysis, Transplantation
Zaccaria Ricci, Stefano Romagnoli, Claudio Ronco
Innovation in continuous renal replacement therapies (CRRT) utilized to treat acute kidney injury (AKI) and sepsis, has brought new machines and techniques. Part of these new advances are due to the availability of innovative biomaterials and the construction of membranes with larger pores and wide distribution of pore sizes. This includes the creation of a new generation of high cut-off membranes whose utilization in clinical practice is promising for the wide spectrum of solutes that are removed during extracorporeal therapies...
November 24, 2017: International Journal of Artificial Organs
Grazia Maria Virzì, Anna Clementi, Alessandra Brocca, Claudio Ronco
Gram-negative sepsis is a major cause of morbidity and mortality in critical ill patients. Recent findings in molecular biology and in signaling pathways have enhanced our understanding of its pathogenesis and opened up opportunities of innovative therapeutic approaches. Endotoxin plays a pivotal role in the pathogenesis of multi-organ dysfunction in the setting of gram-negative sepsis. Indeed, heart and kidney impairments seem to be induced by the release of circulating pro-inflammatory and pro-apoptotic mediators triggered by endotoxin interaction with immune cells...
November 22, 2017: Blood Purification
Jin-Gang Zhu, Jin-Bor Chen, Ben-Chung Cheng, Chih-Hsiung Lee, Gang Long, Yu-Shu Chien
BACKGROUND/AIMS: We examined the association between markers of chronic kidney disease - mineral and bone disorder (CKD-MBD) and mortality in hemodialysis (HD) patients. METHODS: We retrospectively reviewed the association between markers of CKD-MBD and mortality in 1,126 HD patients from 2009 to 2013 with baseline (B), time-average (TA), and time-dependent (TD) Cox regression models. RESULTS: Hypercalcemia (10.9-11.9 mg/dL) indicated an increased risk of all-cause mortality (TA: hazard ratio [HR] 3...
November 22, 2017: Blood Purification
Yun Xie, Bo Yang, Gengru Jiang, Wei Lu, Claudio Ronco
INTRODUCTION: Spontaneous perirenal hemorrhage (SPH) or Wunderlich syndrome, is a rare but potentially life-threatening condition. It is characterized by an unexpected bleeding in the kidneys and usually presents as an abdominal pain. Angiography and more recently selective renal arterial embolization are emerging as effective modalities for the diagnosis and treatment of SPH. In this article, we report a total of three cases of SPH in hemodialysis (HD) patients. METHODS: This is the experience of diagnosis and treatment of SPH in HD patients...
November 20, 2017: Hemodialysis International
Alejandra Molano-Triviño, Benjamin Wancjer, Mauro M Neri, Akash N Karopadi, Mitchell Rosner, Claudio Ronco
INTRODUCTION: Hemodialysis (HD) is an expensive therapy in economic and in ecological terms, owing to a high carbon footprint and significant consumption of natural sources, especially water. Our aim was to review strategies to diminish waste of water in maintenance dialysis, exploring previously described water reuse trends and less known strategies for reducing the dialysate flow. METHODS: We conducted a systematic review of water-sparing strategies, including the reuse of reverse osmosis rejected water and the reduction of dialysate flux...
November 8, 2017: International Journal of Artificial Organs
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