ABSTRACT
Increased vascular calcification is a major cause of cardiovascular events in patients with chronic kidney disease (CKD). It is the result of an active ossification process counteracted by ''bone'' proteins such as osteopontin, alkaline phosphatase, osteoprotegerin, and osteocalcin. Chronic kidney disease - mineral and bone disorder (CKD-MBD) is a systemic disorder of mineral and bone metabolism that occurs in CKD. In addition to abnormalities in the serum calcium and phosphate profile, CKD-MBD is characterized by abnormalities of bone turnover, mineralization, volume and growth as well as vascular calcification. Considering that the presence and extent of vascular calcification in CKD portend a poor prognosis, many efforts have been made to shed light on this complicated phenomenon to prevent vascular calcium deposition and its progression. Indeed, careful control of calcium load, serum phosphate and parathyroid hormone along with the use of calcium-free phosphate binders and vitamin D receptor activators represent a new therapeutic armamentarium to improve quality of life and reduce mortality in CKD.
Subject(s)
Calcinosis/drug therapy , Calcinosis/metabolism , Kidney Diseases/complications , Kidney Diseases/metabolism , Vascular Diseases/drug therapy , Vascular Diseases/metabolism , Biomarkers/blood , Calcinosis/blood , Calcinosis/pathology , Calcium/blood , Chelating Agents/therapeutic use , Chronic Disease , Coronary Artery Disease/metabolism , Disease Progression , Drug Therapy, Combination , Evidence-Based Medicine , Humans , Kidney Diseases/blood , Kidney Diseases/drug therapy , Kidney Diseases/pathology , Parathyroid Hormone/blood , Phosphates/blood , Practice Guidelines as Topic , Prognosis , Quality of Life , Renal Insufficiency, Chronic/metabolism , Vascular Diseases/blood , Vascular Diseases/pathology , Vitamin D/therapeutic useABSTRACT
A study on the coverage of influenza vaccination among elderly people was carried out. Fity-six per cent of those interviewed had been vaccinated (weighted coverage 50%), compared with the target of 75%, but higher rates were reported in those older than 74 years and those with chronic diseases.
Subject(s)
Influenza Vaccines/administration & dosage , Vaccination/statistics & numerical data , Aged , Chronic Disease , Female , Health Care Surveys , Humans , Italy , Male , Sex DistributionABSTRACT
Levels of anti-albumin autoantibodies (AAA) of the IgG class were determined by ELISA in sera of patients with acute and chronic hepatitis B virus (HBV) infection. Mean AAA levels were higher than normal in both acute and chronic hepatitis patients. AAA levels were higher than the upper normal limits in practically all patients with acute self-resolving hepatitis, and decreased to normal levels when the patients recovered. Enhanced IgG AAA levels were observed in many patients with chronic hepatitis and serological markers of HBV replication. Elevated AAA levels were not associated with either more elevated transaminase levels or more severe histological forms of chronic hepatitis. The results of this study suggest that the interaction of albumin with HBV determinants is involved in AAA elevations, probably by mediating an increase in albumin immunogenicity. Moreover, the fall in AAA levels in the recovery phase of acute hepatitis, the coexistence of elevated levels with HBeAg and HBV-DNA, and the lack of correlation between AAA levels and different evolutive forms of chronic hepatitis, seem to exclude AAA from playing a relevant role, be it protective or damaging, during HBV infection.
