A Comprehensive Examination of Vegan Lifestyle in Italy.

The popularity of veganism and plant-based diets is rapidly increasing worldwide, including in Italy, where more individuals and families are adopting this lifestyle. However, medical and health professionals often lack the necessary knowledge and are skeptical about this diet despite the scientific evidence. It is important for them to provide support and expertise to those following this diet. The survey evaluated various aspects of the lifestyle of Italian vegans living in Italy and abroad, including food frequency, vitamin and mineral supplementation, relationship with medical and health professionals, and perceived difficulties in daily life. The emphasis was on potentially critical aspects for those following this dietary choice. A cross-sectional survey was conducted in Italy between March and April 2022. A questionnaire was distributed through social media platforms such as Instagram, Facebook, and Telegram, and 2180 Italian adults who follow a vegan diet completed it. The survey found that most of the vegan population surveyed were female, showed a greater sensitivity to ethical issues, were aware of the need for vitamin B12 supplementation, and followed healthy-eating guidelines. It is evident that despite the increasing popularity of plant-based diets, many medical and health professionals remain cautious and hesitant to recommend them.

Novel conservative management of chronic kidney disease via dialysis-free interventions.

PURPOSE OF REVIEW: In advanced chronic kidney disease (CKD) patients with progressive uremia, dialysis has traditionally been the dominant treatment paradigm. However, there is increasing interest in conservative and preservative management of kidney function as alternative patient-centered treatment approaches in this population. RECENT FINDINGS: The primary objectives of conservative nondialytic management include optimization of quality of life and treating symptoms of end-stage renal disease (ESRD). Dietetic-nutritional therapy can be a cornerstone in the conservative management of CKD by reducing glomerular hyperfiltration, uremic toxin generation, metabolic acidosis, and phosphorus burden. Given the high symptom burden of advanced CKD patients, routine symptom assessment using validated tools should be an integral component of their treatment. As dialysis has variable effects in ameliorating symptoms, palliative care may be needed to manage symptoms such as pain, fatigue/lethargy, anorexia, and anxiety/depression. There are also emerging treatments that utilize intestinal (e.g., diarrhea induction, colonic dialysis, oral sorbents, gut microbiota modulation) and dermatologic pathways (e.g., perspiration reduction) to reduce uremic toxin burden. SUMMARY: As dialysis may not confer better survival nor improved patient-centered outcomes in certain patients, conservative management is a viable treatment option in the advanced CKD population.

[Late recovery of renal function in a patient with acute on chronic renal failure treated with peritoneal dialysis]. / Tardivo recupero della funzione renale in un paziente con insufficienza renale acuta su cronica trattato con dialisi peritoneale.

Contrast-induced nephropathy has become a significant source of hospital morbidity and mortality particularly in patients with multi-organs defects. No current treatment can reverse or ameliorate contrast induced nephropathy once it occurs, but prophylaxis is possible. We present the case of a 61-year-old male patient with concomitant chronic kidney disease (CKD stage III K/DOQI) and diabetes complicated by severe multi-vascular disease, who developed acute kidney damage probably due to the simultaneously exposure to intravascular contrast media and cholesterol crystal embolism. In addition, owing to rapid deterioration of renal function, this patient started renal replacement therapy. No renal biopsy was performed due to the poor clinical condition of the patient. After a month of hemodialysis, he switched to a peritoneal dialysis procedure to which specific treatment for vascular lesions, including antibiotics, prostanoids, hyperbaric oxygen therapy, antiaggregants/anticoagulants and physiotherapy, was associated. After 7 months, the dialysis treatment was stopped and he began intensive clinical follow-up. At present, the patient is in conservative medical treatment (the Tenckhoff catheter has been removed), he is in good condition and severe vascular lesions are absent. Our conclusion is that contrast-induced nephropathy in vasculopathic diabetic patients requires a multidisciplinary approach. In particular, good cooperation between nephrologists and angiologists is useful to avoid rapid and chronic deterioration of renal failure and to prevent the onset and development of severe vascular damage.