Nephron

Clinical Practice: Original Paper

Clinical Management of Chronic Kidney Disease Patients in Italy: Results from the IRIDE Study

Cozzolino M.a · Bolasco P.b · Ronco C.c · Conte G.d · Menè P.e · Mereu M.C.f · Di Luca M.g · Roccatello D.h · Rosati A.i · Jommi C.j,k · Costanzo A.M.l · Gualberti G.l · di Luzio Paparatti U.l · Remuzzi G.m,n,o

Author affiliations

aRenal Division, Department of Health Sciences, University of Milan, San Paolo Hospital, Milan, Italy
bNephrology and Dialysis Unit, ASL 8 Cagliari, Cagliari, Italy
cDepartment of Nephrology, Dialysis and Transplantation, International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy
dNephrology Division School of Medicine-Second University of Naples, Naples, Italy
eDepartment of Clinical and Molecular Medicine, Division of Nephrology, Sapienza University of Rome, Rome, Italy
fU.O. Nefrologia e Dialisi, Ospedale NS di Bonaria, San Gavino Monreale, Cagliari, Italy
gNephrology and Dialysis Unit, A.O Ospedali Riuniti Marche Nord, Pesaro, Italy
hDepartment of Clinical and Biologic Sciences, University of Turin, G. Bosco Hospital, Turin, Italy
iNephrology and Dialysis Unit, Lucca Hospital, Lucca, Italy
jCentre for Research on Health and Social Care Management (CERGAS), SDA Bocconi University, Milan, Italy
kDepartment of Pharmaceutical Sciences, Università del Piemonte Orientale, Novara, Italy
lAbbVie Srl Italy, Campoverde, Latina, Italy
mIRCCS, Istituto di Ricerche Farmacologiche Mario Negri, Centro Anna Maria Astori, Science and Technology Park Kilometro Rosso, Bergamo, Italy
nUnit of Nephrology, Azienda Socio-Sanitaria Territoriale (ASST) Papa Giovanni XXIII, Bergamo, Italy
oDepartment of Biomedical and Clinical Sciences, University of Milan, Milan, Italy

Keywords: Chronic kidney diseaseMetabolic bone disordersRenal failureSecondary hyperparathyroidism

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Nephron 2018;140:39–47
https://doi.org/10.1159/000490769

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Article / Publication Details

First-Page Preview
Abstract of Clinical Practice: Original Paper

Received: February 20, 2018
Accepted: June 03, 2018
Published online: July 17, 2018
Issue release date: August 2018

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 2

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF

Abstract

Background: Lack of adequate management of chronic kidney disease (CKD) often results in delayed diagnosis and inadequate treatment. This study assessed the clinical management and outcome of stages 1–5 CKD patients. Methods: Patients were prospectively followed for 3 years in 25 nephrology centers across Italy. Clinical characteristics were measured at baseline and every 6 months. Outcome measures included CKD staging, presence of comorbidities, treatment, mineral bone disorder (MBD) parameters, and patient outcomes. Results: Of 884 enrolled patients (59.7% males, aged 66.2 ± 14.6 years), 587 (66.4%) completed the study. The majority of patients were referred by a general practitioner (44.7%) and had stage 3 or 4 CKD (40.9 and 23.8% respectively). Data reveal that 91.3% of patients had at least 1 concomitant disease, most frequently hypertension (80.1%) and dyslipidemia (42.5%); 94.6% of patients were receiving cardiovascular medication and 52.6% were receiving lipid-lowering medication. Approximately 40% of patients had proteinuria and intact parathyroid hormone levels outside the normal range. As expected, stages 4 and 5 CKD patients had a higher prevalence of proteinuria (68 and 74%), MBD (59 and 88%) and anemia (28 and 73%), as well as a higher risk of hospitalization (34.3 and 51.9%) and need for dialysis (69.5 and 70%). The overall probability of survival over 36 months was 90.6%. Conclusions: This is the first Italian prospective study performed with a large cohort of CKD patients over a 3-year period. Considering the multifactorial burden of diseases associated with CKD patients, the need for greater attention to CKD and related disorders is paramount.

© 2018 S. Karger AG, Basel



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Article / Publication Details

First-Page Preview
Abstract of Clinical Practice: Original Paper

Received: February 20, 2018
Accepted: June 03, 2018
Published online: July 17, 2018
Issue release date: August 2018

Number of Print Pages: 9
Number of Figures: 2
Number of Tables: 2

ISSN: 1660-8151 (Print)
eISSN: 2235-3186 (Online)

For additional information: https://www.karger.com/NEF

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2018, Vol.140, No. 1

August 2018

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