Giornale di Clinica Nefrologica e Dialisi

Ecological transition and health: the role of physicians and healthcare

Franco Bergesio — 2025-04-03

Climate change and pollution are major public health threats, contributing to the rise of chronic diseases such as cardiovascular conditions, cancer, and neurodegenerative disorders. The medical community plays a key role in raising awareness and promoting sustainable healthcare practices. The COVID-19 pandemic highlighted the risks of unsustainable resource exploitation. Pollutants like microplastics, fine particulate matter (PM2.5), and PFAS chemicals contaminate air, water, and food, posing serious health risks. Despite scientific evidence, global efforts to combat climate change remain insufficient, with international agreements struggling to limit fossil fuel use. The medical community must look beyond disease treatment and address the environmental and socioeconomic determinants of health. A sustainable future depends on reducing pollution, limiting global warming to 1.5°C, and implementing eco-friendly healthcare policies. Time is running out, and urgent action is needed.

In memory of Nicola Di Paolo

Marco Lombardi — 2025-05-12

A new chapter for GCND, the Giornale di Clinica Nefrologica e Dialisi

Carlo Maria Alfieri — 2025-04-17

A 30 year-long adventure

Marco Lombardi — 2025-04-07

World Kidney Day: a call to action for chronic kidney disease prevention and multidisciplinary care

Carlo Maria Alfieri — 2025-03-13

Chronic Kidney Disease (CKD) has emerged as a major global public health challenge, affecting approximately 10% of the population worldwide. Often asymptomatic in its early stages, CKD frequently goes undiagnosed until significant renal impairment has occurred, contributing to a strong risk of cardiovascular disease, the leading cause of death in these patients. World Kidney Day is a vital opportunity to advocate for prevention, screening, and early intervention. Large-scale screening programs permit the identification of undiagnosed CKD cases, allowing timely implementation of pharmacological and lifestyle interventions to slow disease progression. Given that modifiable risk factors such as obesity, hypertension, diabetes, and metabolic syndrome play a significant role in CKD development, promoting healthy lifestyles, adequate hydration, and dietary modifications is crucial. Routine screening—including urinalysis, blood pressure monitoring, and metabolic assessments—should become standard in high-risk populations to facilitate early intervention. As CKD progresses, a multidisciplinary approach is essential. Nephrologists, nurses, and dietitians play a key role in ensuring comprehensive patient care, addressing not only renal function but also cardiovascular, metabolic, and nutritional aspects. Advances in personalized therapies have revolutionized CKD treatment, significantly reducing disease progression and cardiovascular mortality. Moreover, in advanced CKD (GFR <30 mL/min), timely preparation for renal replacement therapy and preemptive kidney transplantation are critical to improving outcomes. In conclusion, CKD prevention, early detection, and multidisciplinary management must be prioritized to mitigate its growing burden. World Kidney Day is a call to action for global efforts in prevention, innovation, and patient-centered care.

Prevention of Herpes Zoster in Chronic Kidney Disease

Barbara Maresca — 2025-04-30

The varicella-zoster virus (VZV) is responsible for both primary varicella infection and Herpes Zoster (HZ), the latter
resulting from viral reactivation in immunocompromised or elderly individuals. Patients with chronic kidney
disease (CKD) are particularly vulnerable to HZ due to an impaired immune system, compounded by chronic
inflammation, uremia, and frequent use of immunosuppressive therapy in transplant recipients. HZ incidence
in CKD is significantly higher than in the general population, with increased risks of complications such as postherpetic neuralgia and mortality. The recombinant zoster vaccine (RZV), a non-live subunit vaccine containing
the VZV glycoprotein E and the AS01B adjuvant system, has demonstrated a favorable safety profile in immunocompromised populations, including dialysis and kidney transplant patients. Despite the potentially reduced vaccine efficacy in patients with chronic kidney disease (CKD) due to immunosuppression, RZV has shown strong effectiveness, eliciting robust humoral and cell-mediated immune responses, and has demonstrated clinical protection in CKD populations, including both dialysis and kidney transplant recipients. In addition to preventing HZ, recent evidence indicates that zoster vaccination may reduce the incidence of cardiovascular events. This finding is particularly relevant for CKD patients, who carry an intrinsically elevated cardiovascular risk. Integrating RZV into nephrology care pathways, including on-site vaccination during dialysis sessions, may significantly improve adherence and coverage.

Anti-inflammatory diet or anti-inflammatory lifestyle?

David Mariani — 2025-04-10

Chronic low-grade inflammation is increasingly proving to be one of the main culprits for the onset of numerous pathologies.
Until recently, to try to combat this insidious enemy, we mainly resorted to anti-inflammatory diets, but current scientific evidence seems to support the hypothesis that the maximum impact on health could be obtained above all by following an anti-inflammatory lifestyle.
Nutrition alone, however important, has proven to be insufficient to guarantee physiological homeostasis, the result of an evolution that lasted hundreds of thousands of years and occurred in symbiosis with ecosystems. Our physiological conditions, and psychosocial relationships with the emotions connected to them, together with the environment, are all elements capable of interacting with each other, decisively influencing the low-grade inflammatory process.
The Healthy Habits approach interprets and makes this thought concrete, and, with an integrated and interdisciplinary approach, traces a viable route.

2.0 Shared diagnostic-therapeutic paths in the Sardinian territory in nephrology and dialysis, Oristano, June 11-13, 2024

2025-05-15

The application of a musical intervention in hemodialysis: patient satisfaction and appropriateness

Francesco Burrai — 2025-04-30

Introduction: For patients, hemodialysis represents a challenge in their living conditions, characterized by suf
fering, anxiety, depression, and a poor quality of life. Evidence-based non-pharmacological interventions can
enhance the existential condition of patients. Music is an intervention with the potential to improve their psy
chological well-being.
Methods: This study aimed to evaluate the satisfaction and the appropriateness of a live music intervention dur
ing hemodialysis sessions. Both were measured using a 5-point Likert scale (from 1 to 5). Eleven musicians per
formed using instruments (guitar, flute, violin, accordion, Celtic harp, and oboe) for 30 minutes daily over six days.
Results: The sample included 122 participants: 89 patients and 33 healthcare providers. Among patients,
97.8% expressed satisfaction with the musical intervention, with an average score of 4.98 (SD = 0.447).
Among patients, 98.8% found music during hemodialysis appropriate, with an average score of 4.93 (SD =
0.447). Among healthcare providers, 93.2% were satisfied, with an average score of 4.70 (SD = 0.810), while
97% considered the music intervention appropriate, with an average score of 4.76 (SD = 0.502). There was a
significant association between satisfaction and appropriateness levels (χ² = 98.0, p < 0.001). No undesir
able effects or disruptions to healthcare activities were observed during the musical intervention. Qualitative
observations revealed dynamics such as singing, hand clapping, rhythmic movements, smiles, laughter, a gen
eral atmosphere of well-being, and improved communication between patients and healthcare providers.
Conclusions: Live music during hemodialysis sessions appears to be an appropriate and satisfying intervention
for patients and healthcare providers.

Living with Polycystic Kidney Disease: a story of resilience and hope

Luisa Sternfeld Pavia — 2025-04-30

A journey of hope: the power of a father’s love

Luisa Sternfeld Pavia — 2025-04-30

Don’t wait: take care of yourself and your kidneys!

Luisa Sternfeld Pavia — 2025-04-30

AIRP: 20 Years of Commitment in the Fight Against Polycystic Kidney Disease

Luisa Sternfeld Pavia — 2025-04-30