PubMed Health⌕ Search

Biomedical subjects

L Cioni

Publications and source records attributed to L Cioni.

At least 19 recordsLinked to original sources
PubMed1997

Coagulation activation in extracorporeal hemodialysis.

The authors evaluated the behavior of protein C activity, factor X and factor VII coagulant activity and serum lipoprotein(a) before and after dialytic treatment in patients on maintenance hemodialysis. They observed depressed protein C activity that significantly (p < 0.005) increased and became normal immediately after hemodialysis while factor X and factor VII increased (p < 0.01; p < 0.05) despite heparinization together with amount of serum lipoprotein(a). In vitro incubation (30' at 37 degrees C) of uremic and healthy blood showed a decrease in serum lipoprotein(a) concentration. After heparin addition (final concentration 0.5 U/ml) lipoprotein(a) increased in the uremic blood only. The clinical and physiopathological implications of these results are discussed.

Adult↗
PubMed1996

[Coagulation in hemodialysis].

The authors have evaluated the behaviour of protein C activity, factor X and factor VII coagulant activity, and serum lipoprotein(a) before and after haemodialytic treatment in the plasma of patients on maintenance haemodialysis. The plasma level of protein C activity, depressed before haemodialysis, significantly increased during the course of haemodialysis; factor X and factor VII increased as well despite heparinization; serum lipoprotein(a) was abnormally elevated before haemodialysis and did not change after haemodialysis. In vitro incubation (30' at 37 degrees C) of uremic and healthy blood samples resulted in a decrease of serum lipoprotein(a) concentration. After heparin addition (final concentration 0.5 U/ml) lipoprotein(a) became higher in uremic blood only.

Adult↗
PubMed1995

Recombinant human erythropoietin and high flux haemodiafiltration.

Since 1982, 32 uraemic patients were treated in our institution by high flux haemodiafiltration (H-HDF) in order to shorten significantly the dialytic treatment session. H-HDF used a high surface area filter (1.4-1.9 m2) with high hydraulic permeability (polyacrylonitrile and polysulfone), at high blood flow (450 ml/min) and high rates of reinfusion of substitution fluid (22 l/session). In this way the dialytic session was shortened to 140 +/- 19 min, maintaining a good cardiovascular stability and high dialytic efficiency (Kt/V > 1.1). Human recombinant erythropoietin rHuEpo introduced in the therapy of this group in 1987 has resulted in an improvement of renal anaemia, but also a prolongation of the time of dialytic treatment due to a decrease in the efficiency of filters. During the period of the study, the treatment time increased from 140 +/- 19 min to 168 +/- 25 min with a concomitant increase of haematocrit and haemoglobin (from 24% to 36% and from 7.9 to 10.5 g/dl, respectively). H-HDF maintains a noticeable increase in dialytic efficacy with good cardiovascular stability, but the goal of a significant reduction in the time of treatment can no longer be obtained.

Adult↗
PubMed1993

Low-antigen-content diet in the treatment of patients with IgA nephropathy.

Since dietary macromolecular antigens can be involved in the pathogenesis of IgA nephropathy (IgAN), the effect of a low-antigen-content diet was evaluated in 21 patients (10 women, 11 men, mean age 27.7 +/- 10 years) with immunohistochemical findings of active IgAN. The diet was followed for a 14-24-week period (mean 18.8 +/- 6); in all cases the effects of the treatment were evaluated by clinical and serological parameters, and in 11 patients also by repeat renal biopsy. After dietetic therapy a significant reduction of urinary proteins was recorded (P < 0.001); in particular, heavy proteinuria (> 1 g/day), present in 12 cases during the 6 months preceding the treatment, was markedly reduced or disappeared in 11. At post-treatment control biopsy mesangial and parietal deposits of immunoglobulins, complement C5 fraction and fibrinogen were significantly reduced. The improvement of the objective parameters such as heavy proteinuria, a strong predictor of a poor prognosis, and of immunohistochemical alterations indicate that a low-antigen diet can positively affect patients with IgAN. These results could be ascribed to a reduction of nephritogenic food antigen input and to a putative functional restoration of the mononuclear phagocytic system.

Adolescent↗
PubMed1989

High-flux hemodiafiltration: 5 years experience.

The introduction of hemodiafiltration in the substitutive treatment of chronic renal failure has arisen from the need to find new techniques that could improve the efficiency of the traditional systems and, therefore, to treat adequately chronic uremia in the shortest possible time. 61 months of experience at our institution have shown that such a goal can be achieved, offering also practical advantages such as a better quality of life for the patients as well as the possibility to treat a greater number of them.

Adult↗
PubMed1986

Soft and hard hemodiafiltration (HDF).

Soft and Hard Hemodiafiltration (HDF). A 32-month study was made to assess efficiency and clinical tolerance in a comparison between "soft" and "hard" HDF. Soft HDF was performed in 18 patients using a polyacrylonitrile AN 69 S 1.2m2 membrane and hard HDF in 12 patients using a polyacrylonitrile hollow-fibre 1.8m2 membrane. Different technical parameters were used for each of the two methods. Biochemical data registered during a single session showed the efficiency of both kinds of treatment and in this study clinical tolerance and patient well-being were significantly better than with hemodialysis. Hard HDF permits considerable shortening of treatment time.

Acrylic Resins↗
PubMed1985

Hypotensive effect of plasma exchange in immune complex nephritis.

The effect of plasma exchange (PE) on blood pressure (BP) in 20 hypertensive patients (9 with mixed cryoglobulinemia, 7 with systemic lupus erythematosus, and 4 with idiopathic glomerulonephritis) was evaluated retrospectively. In each PE 1.5-2.5 L of plasma was replaced with an equal volume of 4% albumin polysaline solution. The frequency of PE was three times per week for the first 2 weeks and twice per week subsequently. Sixteen patients were on hypotensive treatment at the onset of PE. Their systolic/diastolic BP was 171 +/- 4.7/102 +/- 3.0 mm Hg (mean +/- 1 SEM). After 4 weeks, BP decreased to 141 +/- 2.8/89 +/- 2.3 mm Hg (p less than 0.001), although in 10 patients antihypertensive drug therapy had been reduced or discontinued. The most marked decrease of BP occurred after the first week (152 +/- 5.3/92 +/- 2.9 mm Hg), and this decrement correlated remarkably well with pressure levels before PE despite the great heterogeneity of the individual patients (for diastolic BP, r = 0.87, p less than 0.001; for systolic BP, r = 0.60, p less than 0.01). A mild decrease of serum creatinine was observed during PE, but its time course was different from that of BP, and did not correlate with this parameter.

Adolescent↗
PubMed1984

beta 2-Microglobulin and other low molecular weight proteins in haemodiafiltrates and in haemofiltrates.

Uraemic patients underwent haemodialysis by cuprophan membrane, or haemodiafiltration by polyacrylonitrile membrane, or haemofiltration by acetate cellulose membrane. Plasma samples drawn before and after treatment with the dialyser were gel-filtered on Sephadex G-75. A comparison of the chromatograms showed that the treatment causes a removal of middle molecules, which is more consistent when haemodiafiltration and haemofiltration are used. Protein removal was examined in the fluids from the three dialysers. It was observed that proteins (300 +/- 45 mg and 410 +/- 60 mg respectively) were removed when polyacrylonitrile and acetate cellulose membranes were used, but not in the case of cuprophan membrane. beta 2-Microglobulin was the protein lost in the greatest amount.

Acrylic Resins↗
PubMed1983

Plasma exchange in the treatment of lupus nephritis.

Seven women with severe Systemic Lupus Erythematosus Nephritis were treated with Plasma Exchange, without any additional therapy with cytotoxic agents. All patients had failed to respond to high doses of corticosteroids and, in 3 cases, to 6-methylprednisolone pulses. In 4 patients the indication for plasma exchange treatment was a rapid deterioration of renal function, and in the others a need to better control symptoms without using toxic corticosteroid dosages. The total number of plasma exchange sessions ranged from 14 to 57 depending on the patient. After PE treatment, serum creatinine values significantly decreased in all 4 patients with rapidly developing, nephritis while in the others it remained unchanged. No major side effects were recorded and no relapse of renal disease occurred whenever Plasma Exchange treatment was gradually tapered or discontinued. These data suggest that prolonged Plasma Exchange treatment without the concomitant administration of cytotoxic agents may be effective in the treatment of steroid resistant severe lupus nephritis.

Adult↗