Clinical Management of Chronic Kidney Disease Patients in Italy

Results from the IRIDE Study

Mario Cozzolino, Piergiorgio Bolasco, Claudio Ronco, Giuseppe Conte, Paolo Menè, Maria Cristina Mereu, Marina Di Luca, Dario Roccatello, Alberto Rosati, Claudio Jommi, Anna Maria Costanzo, Giuliana Gualberti, Umberto di Luzio Paparatti, Giuseppe Remuzzi

Research output: Contribution to journalArticle

Abstract

BACKGROUND: Lack of adequate management of chronic kidney disease (CKD) often results in delayed diagnosis and inadequate treatment. This study assessed the clinical management and outcome of stages 1-5 CKD patients.

METHODS: Patients were prospectively followed for 3 years in 25 nephrology centers across Italy. Clinical characteristics were measured at baseline and every 6 months. Outcome measures included CKD staging, presence of comorbidities, treatment, mineral bone disorder (MBD) parameters, and patient outcomes.

RESULTS: Of 884 enrolled patients (59.7% males, aged 66.2 ± 14.6 years), 587 (66.4%) completed the study. The majority of patients were referred by a general practitioner (44.7%) and had stage 3 or 4 CKD (40.9 and 23.8% respectively). Data reveal that 91.3% of patients had at least 1 concomitant disease, most frequently hypertension (80.1%) and dyslipidemia (42.5%); 94.6% of patients were receiving cardiovascular medication and 52.6% were receiving lipid-lowering medication. Approximately 40% of patients had proteinuria and intact parathyroid hormone levels outside the normal range. As expected, stages 4 and 5 CKD patients had a higher prevalence of proteinuria (68 and 74%), MBD (59 and 88%) and anemia (28 and 73%), as well as a higher risk of hospitalization (34.3 and 51.9%) and need for dialysis (69.5 and 70%). The overall probability of survival over 36 months was 90.6%.

CONCLUSIONS: This is the first Italian prospective study performed with a large cohort of CKD patients over a 3-year period. Considering the multifactorial burden of diseases associated with CKD patients, the need for greater attention to CKD and related disorders is paramount.

Original languageEnglish
Pages (from-to)39-47
Number of pages9
JournalNephron
Volume140
Issue number1
DOIs
Publication statusPublished - 2018

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Chronic Renal Insufficiency
Italy
Proteinuria
Minerals
Bone and Bones
Nephrology
Delayed Diagnosis
Dyslipidemias
Parathyroid Hormone
General Practitioners
Comorbidity
Anemia
Dialysis
Reference Values
Hospitalization
Outcome Assessment (Health Care)
Prospective Studies
Hypertension
Lipids
Survival

Cite this

Cozzolino, M., Bolasco, P., Ronco, C., Conte, G., Menè, P., Mereu, M. C., ... Remuzzi, G. (2018). Clinical Management of Chronic Kidney Disease Patients in Italy: Results from the IRIDE Study. Nephron, 140(1), 39-47. https://doi.org/10.1159/000490769

Clinical Management of Chronic Kidney Disease Patients in Italy : Results from the IRIDE Study. / Cozzolino, Mario; Bolasco, Piergiorgio; Ronco, Claudio; Conte, Giuseppe; Menè, Paolo; Mereu, Maria Cristina; Di Luca, Marina; Roccatello, Dario; Rosati, Alberto; Jommi, Claudio; Costanzo, Anna Maria; Gualberti, Giuliana; di Luzio Paparatti, Umberto; Remuzzi, Giuseppe.

In: Nephron, Vol. 140, No. 1, 2018, p. 39-47.

Research output: Contribution to journalArticle

Cozzolino, M, Bolasco, P, Ronco, C, Conte, G, Menè, P, Mereu, MC, Di Luca, M, Roccatello, D, Rosati, A, Jommi, C, Costanzo, AM, Gualberti, G, di Luzio Paparatti, U & Remuzzi, G 2018, 'Clinical Management of Chronic Kidney Disease Patients in Italy: Results from the IRIDE Study', Nephron, vol. 140, no. 1, pp. 39-47. https://doi.org/10.1159/000490769
Cozzolino M, Bolasco P, Ronco C, Conte G, Menè P, Mereu MC et al. Clinical Management of Chronic Kidney Disease Patients in Italy: Results from the IRIDE Study. Nephron. 2018;140(1):39-47. https://doi.org/10.1159/000490769
Cozzolino, Mario ; Bolasco, Piergiorgio ; Ronco, Claudio ; Conte, Giuseppe ; Menè, Paolo ; Mereu, Maria Cristina ; Di Luca, Marina ; Roccatello, Dario ; Rosati, Alberto ; Jommi, Claudio ; Costanzo, Anna Maria ; Gualberti, Giuliana ; di Luzio Paparatti, Umberto ; Remuzzi, Giuseppe. / Clinical Management of Chronic Kidney Disease Patients in Italy : Results from the IRIDE Study. In: Nephron. 2018 ; Vol. 140, No. 1. pp. 39-47.
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T1 - Clinical Management of Chronic Kidney Disease Patients in Italy

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AU - Cozzolino, Mario

AU - Bolasco, Piergiorgio

AU - Ronco, Claudio

AU - Conte, Giuseppe

AU - Menè, Paolo

AU - Mereu, Maria Cristina

AU - Di Luca, Marina

AU - Roccatello, Dario

AU - Rosati, Alberto

AU - Jommi, Claudio

AU - Costanzo, Anna Maria

AU - Gualberti, Giuliana

AU - di Luzio Paparatti, Umberto

AU - Remuzzi, Giuseppe

N1 - © 2018 S. Karger AG, Basel.

PY - 2018

Y1 - 2018

N2 - BACKGROUND: Lack of adequate management of chronic kidney disease (CKD) often results in delayed diagnosis and inadequate treatment. This study assessed the clinical management and outcome of stages 1-5 CKD patients.METHODS: Patients were prospectively followed for 3 years in 25 nephrology centers across Italy. Clinical characteristics were measured at baseline and every 6 months. Outcome measures included CKD staging, presence of comorbidities, treatment, mineral bone disorder (MBD) parameters, and patient outcomes.RESULTS: Of 884 enrolled patients (59.7% males, aged 66.2 ± 14.6 years), 587 (66.4%) completed the study. The majority of patients were referred by a general practitioner (44.7%) and had stage 3 or 4 CKD (40.9 and 23.8% respectively). Data reveal that 91.3% of patients had at least 1 concomitant disease, most frequently hypertension (80.1%) and dyslipidemia (42.5%); 94.6% of patients were receiving cardiovascular medication and 52.6% were receiving lipid-lowering medication. Approximately 40% of patients had proteinuria and intact parathyroid hormone levels outside the normal range. As expected, stages 4 and 5 CKD patients had a higher prevalence of proteinuria (68 and 74%), MBD (59 and 88%) and anemia (28 and 73%), as well as a higher risk of hospitalization (34.3 and 51.9%) and need for dialysis (69.5 and 70%). The overall probability of survival over 36 months was 90.6%.CONCLUSIONS: This is the first Italian prospective study performed with a large cohort of CKD patients over a 3-year period. Considering the multifactorial burden of diseases associated with CKD patients, the need for greater attention to CKD and related disorders is paramount.

AB - BACKGROUND: Lack of adequate management of chronic kidney disease (CKD) often results in delayed diagnosis and inadequate treatment. This study assessed the clinical management and outcome of stages 1-5 CKD patients.METHODS: Patients were prospectively followed for 3 years in 25 nephrology centers across Italy. Clinical characteristics were measured at baseline and every 6 months. Outcome measures included CKD staging, presence of comorbidities, treatment, mineral bone disorder (MBD) parameters, and patient outcomes.RESULTS: Of 884 enrolled patients (59.7% males, aged 66.2 ± 14.6 years), 587 (66.4%) completed the study. The majority of patients were referred by a general practitioner (44.7%) and had stage 3 or 4 CKD (40.9 and 23.8% respectively). Data reveal that 91.3% of patients had at least 1 concomitant disease, most frequently hypertension (80.1%) and dyslipidemia (42.5%); 94.6% of patients were receiving cardiovascular medication and 52.6% were receiving lipid-lowering medication. Approximately 40% of patients had proteinuria and intact parathyroid hormone levels outside the normal range. As expected, stages 4 and 5 CKD patients had a higher prevalence of proteinuria (68 and 74%), MBD (59 and 88%) and anemia (28 and 73%), as well as a higher risk of hospitalization (34.3 and 51.9%) and need for dialysis (69.5 and 70%). The overall probability of survival over 36 months was 90.6%.CONCLUSIONS: This is the first Italian prospective study performed with a large cohort of CKD patients over a 3-year period. Considering the multifactorial burden of diseases associated with CKD patients, the need for greater attention to CKD and related disorders is paramount.

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DO - 10.1159/000490769

M3 - Article

VL - 140

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JO - Experimental Nephrology

JF - Experimental Nephrology

SN - 0028-2766

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ER -