Pasquali S.,Nephrology and Dialysis Unit |
Iannuzzella F.,Nephrology and Dialysis Unit |
Corradini M.,Nephrology and Dialysis Unit |
Mattei S.,Nephrology and Dialysis Unit |
And 4 more authors.
Journal of Nephrology | Year: 2015
Background: In myeloma cast nephropathy, fast reduction of serum free light chain (FLC) levels correlates with renal recovery. Recently, extracorporeal treatments using filters with a high-molecular weight cut-off have been successfully used for FLC removal. However, using these new filters, high cost and elevated albumin leakage are common drawbacks. We studied a new and cheaper therapeutic approach with adsorbent resins to evaluate its efficacy. Methods: We treated four patients, affected by dialysis-dependent acute kidney injury (AKI) due to biopsy proven de novo FLC myeloma cast nephropathy. Each patient underwent bortezomib chemotherapy and extracorporeal treatment with the supra-hemodiafiltration with endogenous reinfusion (HFR) technique (Supra-HFR, Bellco Mirandola, Modena, Italy). Supra-HFR is a kind of hemodiafiltration that utilizes separated convection, diffusion and adsorption. The sorbent cartridge has a high affinity for FLC (both κ and λ) but is able to re-infuse albumin, avoiding the need for albumin perfusions. Supra HFR treatments (4 h each) were carried out for eight consecutive days and then every other day. Results: All patients showed a significant reduction of serum FLC, whereas serum albumin concentration remained unchanged. Renal function recovered in three out of four patients. Conclusions: FLC removal with adsorbent resins represents an effective therapeutic strategy that does not require replacement with albumin. © 2014, Italian Society of Nephrology.
Solano F.G.,Nephrology and Dialysis |
Bellei E.,University of Modena and Reggio Emilia |
Bellei E.,Foundation Medicine |
Cuoghi A.,University of Modena and Reggio Emilia |
And 3 more authors.
Case Reports in Nephrology and Dialysis | Year: 2015
Lupus nephritis is one of the most serious complications of systemic lupus erythematosus (SLE). In the kidney, immune complexes and autoantibodies activate mesangial cells that secrete cytokines that can further amplify inflammatory processes. We present the case of a 42-year-old woman with lupus nephritis accompanied by periods of exacerbation of SLE, with necrotic-like skin lesions, psoriatic arthritis without skin psoriasis, purpura of the lower limb, petechial rash, joint pain, fever, eyelid edema with bilateral conjunctival hyperemia and itch-ing. The patient underwent a dialytic treatment of hemodiafiltration with endogenous reinfu-sion. The technique uses the super-high-flux membrane Synclear 02 (SUPRA treatment) cou-pled with an adsorbent cartridge that has affinity for many toxins and mediators. Fever and joint pain were immediately reduced after treatment and, subsequently, there was a notable reduction of the skin damage. Prednisone and immunosuppressive drugs were gradually reduced until complete suspension. High-performance liquid chromatography coupled with quadrupole time-of-flight mass spectrometer was performed for identification of proteins captured by a resin bed during a dialysis session of the patient. This technique identified several biomarkers of kidney injuries, uremic toxins, fragments of immunoglobulins, antigens involved in antiphospholipid syndrome and a new marker (α-defensin) that correlated signif-icantly with disease activity. The removal of these different proteins could possibly provide an explanation of the improvement in the patient's symptoms and the normalization of her SLE. SUPRA coupled with an adsorption may be a promising new technique for the treatment of lupus nephritis. © 2015 S. Karger AG, Basel.
Tura A.,CNR Institute of Biomedical Engineering |
Sbrignadello S.,CNR Institute of Biomedical Engineering |
Cianciavicchia D.,Bellco srl |
Pacini G.,CNR Institute of Biomedical Engineering |
Ravazzani P.,CNR Institute of Biomedical Engineering
Sensors | Year: 2010
In recent years there has been considerable interest in the study of glucose-induced dielectric property variations of human tissues as a possible approach for non-invasive glycaemia monitoring. We have developed an electromagnetic sensor, and we tested in vitro its ability to estimate variations in glucose concentration of different solutions with similarities to blood (sodium chloride and Ringer-lactate solutions), differing though in the lack of any cellular components. The sensor was able to detect the effect of glucose variations over a wide range of concentrations (~78-5,000 mg/dL), with a sensitivity of ~0.22 mV/(mg/dL). Our proposed system may thus be useful in a new approach for non-invasive and non-contact glucose monitoring. © 2010 by the authors.
Lai Q.,University of LAquila |
Di Pietro V.,University of LAquila |
Iesari S.,University of LAquila |
Amabili S.,Bellco srl |
And 4 more authors.
Blood Purification | Year: 2015
Coupled plasma filtration adsorption (CPFA) is an extracorporeal treatment based on plasma filtration associated with an adsorbent cartridge and hemofiltration. CPFA is able to remove inflammatory mediators and it has been used to treat severe sepsis, septic shock and multiple organ dysfunction syndrome. Limited experience exists on the use of CPFA after solid organ transplantation. We report our experience with CPFA in 2 kidney transplant recipients with post-nephrolithotomy septic shock and severe unexplained rhabdomyolysis. In both the cases, excellent results were observed. In selected cases, CPFA can be safely and effectively used in patients with a solid organ transplant. However, additional studies are needed in this particular setting, to further investigate the potential role of CPFA for the treatment of other conditions associated with excessive inflammation, such as in rheumatologic disorders and delayed graft function. © 2015 The Author(s) Published by S. Karger AG, Basel.
BELLCO S.r.l. | Date: 2012-06-20
It is described a kit for treating a systemic inflammatory related disease comprising a) a high permeability filter having a pore size designed to let inflammatory mediators to pass and b) means to retain said mediators but not serum albumin.