Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

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Sapientia, 1950, Vol. V, nº 17 (número completo)

Contenido: Descartes o la aventura del angelismo (1650-1950) / La Dirección – El método y la certidumbre en la ciencia política / Benito R. Raffo Magnasco – Thibon intérprete de Nietzsche / Héctor Delfor Mandrioni – La nueva orientación filosófica del Brasil / Evaldo Pauli – El problema moral / Carlo Giacon – Notas y comentarios -- Bibliografí

Sapientia, 1950, Vol. V, nº 16 (número completo)

Contenido: El hombre desamparado / La Dirección – Los fundamentos de la educación en Santo Tomás de Aquino / José Todoli Duque -- La filosofía jurídica de Hans Kelsen/ Julio M. Ojea Quintana – El problema moral / Carlo Giacon – Notas y comentarios -- Bibliografí

Sapientia, 1950, Vol. V, nº 17 (número completo)

Contenido: Descartes o la aventura del angelismo (1650-1950) / La Dirección – El método y la certidumbre en la ciencia política / Benito R. Raffo Magnasco – Thibon intérprete de Nietzsche / Héctor Delfor Mandrioni – La nueva orientación filosófica del Brasil / Evaldo Pauli – El problema moral / Carlo Giacon – Notas y comentarios -- Bibliografí

ATTI DELLA GIORNATA DI STUDI "GIOVANNI GIUDICI I VERSI E LA VITA"

Il volume raccoglie gli atti dela giornata di studi "Giovanni Giudici. I versi e la vita" tenutasi a La Spezia il 13 settembre 2013 nei locali dell'Accademia Lunigianese di Scienze Giovanni Capellini. I relatori hanno affrontato l'opera di Giudici ad ampio raggio, proponendo significativi contributi sulla poesia, la prosa, il rapporto con la tradizione e con il dialetto e l'attivit\ue0 giornalistica