Daniela Bergamo

Risk management of renal biopsy: 1387 cases over 30 years in a single centre

Background  Although renal biopsy is largely employed, even in old patients with systemic diseases, few clinical studies have addressed its risk management. We aimed to obtain a comprehensive assessment of safety/utility ratio of percutaneous renal biopsy.

Rubidium, salami and depression. You cannot have everything in life.

Background: Depression may induce malnutrition, but, as a paradoxical hypothesis, malnutrition may induce depression. This relationship, of course, depends on how we define malnutrition. Current Knowledge: Rubidium is a trace element strongly linked with depression, and is deficient in uremia sufferers. However, in uremic patients, rubidium deficiency is more evident during predialysis, as it is at least partially corrected during dialysis and after transplantation. It seems that diet restrictions might be the main cause of rubidium deficiency, as it is mainly found in red meat. Conclusion: If rubidium is found in salami, then the occasional slice could be more beneficial for people suffering from depression than taking a lot of medication.

The Challenges of Diagnosing Fabry Disease

p s b w i t l abry disease is an X-linked panethnic disorder with an estimated incidence of 1 in 17,000 live births caused by deficient activity of ysosomal enzyme -galactosidase A. The enyme is responsible for the hydrolysis of termial -galactosyl residues from glycolipids and lycoproteins, and the disorder is caused by utations in the -galactosidase A gene located n the X chromosomal region Xq22. The enzyatic deficit results in progressive intracellular ccumulation of globotriaosylceramide (Gb3) in ifferent tissues, including skin, kidneys, vascuar endothelium, ganglion cells of the peripheral ervous system, and heart. Disease presentation often may be subtle, and ts signs and symptoms are easily neglected or istakenly attributed to other disorders. Subtle orms are not uncommon and may remain undignosed until the onset of chronic renal failure, s in our patient.

Burns and Acute Kidney Failure

Renal alterations such as proteinuria, hematuria, and electrolyte disturbances are common in patients with severe burns. Two distinct pictures with an early and a late form of acute kidney failure (ARF) have been described: The early form occurs in the immediate postburns period and can in most cases be effectively prevented by early aggressive fluid resuscitation. The late form develops after 2–3 weeks from initial injury and is usually due to sepsis and multiorgan dysfunction syndrome. In the last 20 years, onset and outcome of acute kidney failure in these patients has been improved by early aggressive burn wound excision, new powerful antibiotics, and early enteral nutrition for maintaining gastrointestinal trophism. In patients with established ARF, early intensive extracorporeal treatment is effective in reaching a mean survival rate of 20–50% of treated patients.