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1.
Pathologica ; 115(4): 199-204, 2023 Aug.
Article in English | MEDLINE | ID: mdl-37314869

ABSTRACT

A meeting entitled Renal BIopsy for Kidney Transplantation Therapy (ReBIrth) took place on May 31st, 2022 in Bologna, Italy. The meeting drew together nephrologists, surgeons, and pathologists and recognized as experts in the field of kidney transplantation in Italy. In this paper, we present our experience working with kidney transplants in the current era of immunosuppression therapy. The primary aim is to report the histopathological characteristics of failed kidney allografts after a consensus of experts reviewed the cases on a wholeslide imaging digital platform. Regardless of the cases discussed, digital pathology was reliable in identifying all the morphological and immunohistochemical features required to improve the correct use of immunosuppressive therapy to prevent graft failure and optimize patient management.


Subject(s)
Kidney Transplantation , Nephrology , Humans , Kidney Transplantation/adverse effects , Kidney Transplantation/methods , Kidney/surgery , Kidney/pathology , Immunosuppression Therapy , Biopsy
2.
Nutr Metab Cardiovasc Dis ; 29(8): 822-829, 2019 08.
Article in English | MEDLINE | ID: mdl-31204196

ABSTRACT

BACKGROUND AND AIMS: A Body Shape Index (ABSI) and Body Roundness Index (BRI) are two new anthropometric adiposity indices that have shown to be associated better than BMI with adipose abdominal tissue, with the onset of diabetes and the risk of premature death. Little is known about the influence of ABSI and BRI on subclinical vascular damage. The study was aimed to assess the relationship between ABSI and BRI with carotid atherosclerosis damage in subjects with arterial hypertension. METHODS AND RESULTS: A total of 468 patients with arterial hypertension (30-80 years old) were enrolled; adiposity indices were calculated (BMI, WC, ABSI, BRI) and carotid ultrasonographic examination was performed to detect atherosclerotic damage (IMT or atherosclerotic plaque). BRI, but not ABSI, was higher in subjects with IMT> 0.90 mm in comparison to those with a lower IMT (p < 0.001), whereas patients with carotid plaques showed higher values of ABSI (p = 0.001), as well as of BRI (p = 0.003). Linear regression analysis disclosed significant correlation of IMT with ABSI, BRI and BMI (all p < 0.001). In the multivariate analysis, BRI was independently correlated with cIMT (p = 0.015). On the contrary, ABSI did not show any independent association with cIMT. However, ABSI was strongly associated with carotid plaques in multiple logistic regression analysis after adjustment for potential confounding factors. When BRI or BMI replaced ABSI into the multivariate models, they did not show any independent correlation with carotid plaques. CONCLUSIONS: ABSI may be proposed as a better correlate of carotid atherosclerosis than the traditional measures of adiposity.


Subject(s)
Adiposity , Anthropometry/methods , Arterial Pressure , Body Size , Carotid Artery Diseases/physiopathology , Hypertension/physiopathology , Obesity/diagnosis , Adult , Aged , Aged, 80 and over , Body Mass Index , Carotid Artery Diseases/complications , Carotid Artery Diseases/diagnostic imaging , Carotid Intima-Media Thickness , Cross-Sectional Studies , Female , Humans , Hypertension/complications , Hypertension/diagnosis , Male , Middle Aged , Obesity/complications , Obesity/physiopathology , Predictive Value of Tests , Prognosis , Risk Factors , Waist Circumference
3.
J Am Soc Hypertens ; 10(7): 559-569.e3, 2016 07.
Article in English | MEDLINE | ID: mdl-27247108

ABSTRACT

The role of systemic vascular involvement in mediating the association between serum uric acid (SUA) and renal function in hypertension has not been explored. Main purpose of our study was to investigate whether morphofunctional vascular changes, assessed as carotid intima-media thickness (cIMT) and aortic pulse wave velocity (aPWV), might mediate the association between SUA and renal damage. We enrolled 523 hypertensive subjects with or without chronic kidney disease and divided population into tertiles of SUA based on sex-specific cutoff values. cIMT and aPWV were higher in uppermost SUA-tertile patients when compared to those in the lowest ones (all P < .001). Uricemia strongly correlated with cIMT and aPWV at univariate analysis (P < .001) and with cIMT after adjustment for confounders (P < .001). Adjustment for cIMT attenuated the relationship between SUA and estimated glomerular filtration rate (P = .019). Systemic vascular changes seem partially to mediate the association between SUA and renal function in hypertensive patients, regardless of kidney function.


Subject(s)
Aorta/physiopathology , Carotid Intima-Media Thickness , Hypertension/blood , Kidney/physiopathology , Pulse Wave Analysis , Uric Acid/blood , Adult , Aged , Body Mass Index , Cross-Sectional Studies , Female , Glomerular Filtration Rate , Humans , Male , Middle Aged , Renal Insufficiency, Chronic/blood , Risk Factors , Vascular Stiffness
4.
Ultrasound Med Biol ; 42(5): 1103-10, 2016 May.
Article in English | MEDLINE | ID: mdl-26924695

ABSTRACT

Recent data suggest that renal hemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RRI), may be associated with systemic vascular changes. We evaluated the relationships between RRI and arterial stiffness, assessed by aortic pulse wave velocity, and between RRI and subclinical atherosclerosis, assessed by measuring carotid intima-media thickness in patients with systemic lupus erythematosus. We enrolled 39 patients with systemic lupus erythematosus (mean age 39 y) compared with 19 healthy controls, matched for age and sex. Each participant underwent 24 h of ambulatory blood pressure, aortic pulse wave velocity, carotid intima-media thickness and RRI measurements. RRI correlated significantly with aortic pulse wave velocity (r = 0.44, p = 0.006), and with carotid intima-media thickness (r = 0.46, p = 0.003). Both correlations held (p = 0.01), even after correction for age, mean arterial pressure and glomerular filtration rate. Our results suggest that the RRI may be considered a marker of systemic vascular changes and probably a predictor of cardiovascular risk in patients with systemic lupus erythematosus.


Subject(s)
Aorta/physiopathology , Atherosclerosis/physiopathology , Carotid Intima-Media Thickness , Lupus Erythematosus, Systemic/physiopathology , Renal Circulation , Vascular Stiffness , Adult , Aorta/diagnostic imaging , Atherosclerosis/complications , Atherosclerosis/diagnostic imaging , Biomarkers , Female , Humans , Lupus Erythematosus, Systemic/complications , Lupus Erythematosus, Systemic/diagnostic imaging , Male , Pulse Wave Analysis , Reproducibility of Results , Sensitivity and Specificity , Ultrasonography, Doppler/methods
5.
Angiology ; 67(7): 676-82, 2016 08.
Article in English | MEDLINE | ID: mdl-26535012

ABSTRACT

Connective tissue diseases, like systemic lupus erythematosus (SLE), are associated with early and accelerated atherosclerosis. Recently, the concept of "early vascular aging" (EVA) has been more widely accepted. Aortic stiffness is one of the important markers of EVA. We evaluated EVA and subclinical atherosclerosis, by measuring aortic pulse wave velocity (aPWV) and carotid intima-media thickness (cIMT), in 50 normotensive patients with SLE (mean age: 39 ± 12 years). We compared these participants with 50 age- and sex-matched patients with essential hypertension (EH) and 20 healthy controls. Each participant underwent 24-hour ambulatory blood pressure monitoring (ABPM), aPWV, and cIMT measurements. Clinic and 24-hour ABPM values were significantly lower in patients with SLE and controls when compared with the participants having EH (all P < .0001), but aPWV and cIMT were significantly lower in the control group when compared with patients having SLE and EH (all P < .001). Overall, patients with SLE and EH had similar cIMT and aPWV values (P = .31 and P = .47, respectively). Our results suggest that SLE has a similar deleterious impact on EVA as EH.


Subject(s)
Atherosclerosis/etiology , Atherosclerosis/physiopathology , Blood Pressure , Carotid Artery Diseases/etiology , Carotid Artery Diseases/physiopathology , Essential Hypertension/physiopathology , Lupus Erythematosus, Systemic/complications , Vascular Stiffness , Adult , Age Factors , Asymptomatic Diseases , Atherosclerosis/diagnosis , Blood Pressure Monitoring, Ambulatory , Carotid Artery Diseases/diagnosis , Carotid Intima-Media Thickness , Case-Control Studies , Essential Hypertension/diagnosis , Female , Humans , Lupus Erythematosus, Systemic/diagnosis , Lupus Erythematosus, Systemic/physiopathology , Male , Middle Aged , Pulse Wave Analysis , Renal Circulation , Risk Factors , Ultrasonography, Doppler, Color , Vascular Resistance
6.
Eur J Prev Cardiol ; 22(4): 415-22, 2015 Apr.
Article in English | MEDLINE | ID: mdl-24519850

ABSTRACT

BACKGROUND: Recent data suggest that renal haemodynamic parameters obtained by duplex Doppler sonography, especially the intrarenal resistive index (RI), may be associated with systemic vascular changes. However, conflicting data exist about the independent relationship between aortic stiffness and RI. The aim of this study was to evaluate the relationship between RI and arterial stiffness, assessed by aortic pulse wave velocity (aPWV), in hypertensive patients. DESIGN: Cross-sectional study. METHODS: We enrolled 264 hypertensive subjects aged between 30 and 70 years. They were divided into two groups, either with normal renal function (n = 140) or with chronic kidney disease (CKD) (n = 124). Each patient underwent assessment of ultrasonographic renal RI and measurement of aPWV through oscillometric device. RESULTS: Patients with renal RI>0.7 showed higher values of aPWV, both in the overall population (p < 0.001) and in the subgroups with (p < 0.01) and without CKD (p < 0.01). Moreover, statistically significant correlations were observed between aPWV and RI in the whole population (r = 0.38, p < 0.001) and in the subgroups with (r = 0.35, p < 0.001) and without CKD (r = 0.31, p < 0.001). These correlations held even after adjustment for several confounding factors in multivariate analyses. CONCLUSIONS: Our results seem to corroborate the concept that the RI may be considered as a marker of systemic vascular changes and therefore a predictor of cardiovascular risk.


Subject(s)
Aorta/physiopathology , Hypertension/diagnosis , Kidney/blood supply , Pulse Wave Analysis , Renal Circulation , Renal Insufficiency, Chronic/diagnosis , Vascular Resistance , Vascular Stiffness , Adult , Aged , Cross-Sectional Studies , Female , Humans , Hypertension/diagnostic imaging , Hypertension/physiopathology , Male , Middle Aged , Predictive Value of Tests , Renal Insufficiency, Chronic/diagnostic imaging , Renal Insufficiency, Chronic/physiopathology , Risk Factors , Ultrasonography, Doppler, Color
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