Caterina Vita

Background Chronic hemodialysis (HD) patients exhibit severe morpho-functional cardiac alterations, putting them at a high risk of death and adverse cardiovascular (CV) outcomes. Despite the fact that an unbalanced expression of various microRNAs (miRNAs) has been related to pathological cardiac remodeling and worse CV outcomes, scarce evidence exists on their role in this setting. Methods We evaluated circulating levels of a selected miRNAs panel (30a-5p, 23a-3p, 451a and let7d-5p) in 74 chronic HD patients together with a thorough clinical and echocardiography assessment. Individuals were then prospectively followed (median 22 months). The primary endpoint was a composite of all-cause and CV mortality and non-fatal CV events. Results Circulating levels of all miRNAs were lower in HD patients as compared with healthy controls and independently correlated to the severity of cardiac dysfunction. miRNA 30a-5p, 23a-3p and 451a expression was even lower in 30 subjects (40.5%) reaching t...

Background and Aims Several evidences demonstrate that chronic dialysis treatment alters troponin levels, even in the absence of an acute myocardial event, although the underlying causes remain largely unclear. In this small pilot study, we aimed at analyzing high sensitivity troponin T (HsTnT) in a cohort of dialysis patients to identify the potential clinical predictors. Method HsTnT levels were measured together with common laboratory and clinical parameters in 39 chronic dialysis patients (middle age: 65±12 aa; 82% M; 30 in hemodialysis and 9 in peritoneal dialysis). The patients underwent also a complete echocardiography assessment. Results HsTnT levels were higher than normal reference values (median 46.1 ng/L IQR 33.5-84.3),but showing no differences between hemodialysis and peritoneal dialysis patients (p=0.19). At correlation analyses, HsTnT were strongly associated with beta2-MCG (R=0.43; p=0.008), Hemoglobin (r=-0.47; p=0.002) and, in particular, with some echocardiograph...

Background and Aims Cathepsin-K (Cts-K) is a lysosomal cysteine protease mainly involved in bone remodeling and resorption. Although it is largely released by lung cells, osteoclasts and macrophages, increasing current evidence suggests that the parathyroids may somewhat regulate Cts-K balance. We therefore analyzed Cts-K in a cohort of 85 chronic HD patients (mean age 67+/-12, median dialysis vintage 3.2 yrs), also including some individuals who were previously parathyroidectomized. Method Cts-K serum levels were measured before a mid-week dialysis session together with standard biochemical parameters. Twenty-six healthy subjects matched for age and gender served as controls. Patients were further stratified according to whether they were parathyroidectomized or not. Results Cts-K levels were statistically higher in HD patients than in controls (median 340, IQR 170-835 vs. 190 IQR 20-120 pg/mL, p<0.0001) and significantly associated with ALP (r=0.50, p<0.001), CRP (r=0.46,p&l...

Background and Aims Patients with end stage renal disease (ESKD) on hemodialysis (HD) have a high risk of cardiovascular (CV) events, this being mostly related to the presence of uraemic cardiomyopathy. A deregulation in the expression of various microRNAs (miRNAs: non-coding RNAs that regulate post-transcriptional gene expression) has previously been implied in pathological cardiac remodelling. Nevertheless, scarce evidence has accrued so far on a possible significance in CV morbidity and mortality in HD patients, in relationship with the presence of uremic cardiomyopathy. Method We run a pilot, prospective, multicentre cohort study involving 74 ESKD patients undergoing chronic HD from 3 different hospitals in Italy and Greece. HD patients underwent a thorough clinical, laboratory and echocardiography assessment and were then prospectively followed for 24 months or until the occurrence of a composite endpoint of (CV and all-cause) mortality or non-fatal CV events. Through a systema...

The pandemic blast of COVID-19 uncovered well known weakness of financial chain and put our economic organizations facing off dramatic consequences if new strategies will not be developed to adapt health-care on detailed sub-groups of patients. The exponential number of older and frail subjects aged >65 years represents a challenge for public health. Patients affected by renal disease are an aged population that showed a particular attitude to contract infection and a higher mortality rate respect to general population. In this brief article, we would point out the focus on the management of issues related to renal patients facing off with coronavirus infection, in particular in a geriatric population particularly exposed to contagion like hemodialysis patients and precautions decided to slow the spread of contamination.