Foreword
Claudio Ronco is Director of the Department of Nephrology at St Bortolo Hospital in Vicenza. He is a member of the council of several scientific societies and is Editor-in-chief of the International Journal of Artificial Organs. Dr Ronco has earned numerous awards and honours, including the International medal of Excellence from the National Kidney Foundation (NKF) and honorary membership of the Spanish Society of Nephrology (SSN) in 2004. He has organised several congresses and meetings in the area of nephrology and intensive care and is a member of several advisory groups for clinical trials and dialysis research. He has co-authored over 650 papers, 36 book chapters, 45 books and seven monographic journal issues and has delivered more than 450 lectures at international meetings and universities. In 1989, Dr Ronco was awarded his diploma in paediatric nephrology at the University of Naples, having achieved a specialised diploma of medical nephrology at the Postgraduate School of Internal Medicine at the University of Padua in 1979. He graduated in medicine at the University of Padua in 1976, having been an intern at the Institute of Clinical Internal Medicine at the university.
his issue of European Nephrology represents a compendium of the most interesting subjects in the field of nephrology dialysis and transplantation. There is a section dedicated to the interesting and epidemiologically important issue of diabetic nephropathy. Glomerular filtration rate (GFR) in diabetics represents an important marker that well describes the evolution of the disease. In this field, as in other streams of nephrology, the importance of biomarkers generates possibilities to diagnose a progression of the renal damage and dysfunction. New biomarkers may allow diagnosing acute kidney injury (AKI) before creatinine rises or urine output decreases. The validation of new AKI biomarkers becomes essential for an accurate, sensitive and specific detection of the syndrome. At the same time, an early diagnosis of AKI, even in the preclinical stage, may open new avenues in the area of prevention of AKI and organ protection. New biomarkers may therefore help us to start our prevention/protection much earlier and we might even be able to rewrite the overall history of AKI prevention based on these new diagnostic parameters.
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In this issue, further topics are debated with outstanding competence and skills by well-known contributors. The world of biosimilar epoietins is explored, offering the reader a comprehensive review of the available knowledge and evidence. Biosimilars are not generic versions of a micromolecular originator drug. They are true biotechnological products, similar but not identical to an originator in that specific class. Identity in the biotechnology production is impossible and special attention should be placed in the application of these new products to potential immunogenic effects, especially in patients who are going to be treated for long periods of time. Quality is the key issue and post-marketing monitoring is essential to detect potential harms or unwanted consequences. This issue also presents contributions dedicated to the field of peritoneal dialysis (PD) and the clinical benefits of low glucose PD therapies, strategies for the preservation of peritoneal membrane viability and performance and the evolution of peritoneal sclerosis towards encapsulating peritoneal sclerosis. All these topics represent important aspects of this form of renal replacement therapy, affecting its long-term application and the final outcomes. PD is a fantastic resource for the patient with end-stage kidney disease. In Vicenza for many years we have used peritoneal dialysis as a first choice therapy for CKD patients. Not only have we demonstrated that 40–45 % of the entire dialytic population can be effectively treated with this therapy, but we have significantly invested in education and training. Many young investigators, fellows and physicians from all over the world have spent fruitful stages in our department and the International Renal Research Institute of Vicenza. This year from 12–15 of June we are celebrating the 30th anniversary of the International Vicenza Course on Peritoneal Dialysis. We sincerely hope that our efforts have contributed to the dissemination of the knowledge in peritoneal dialysis and the awareness of the scientific community about this important treatment strategy. In the field of transplantation, special attention is placed on the prophylaxis of organ rejection and the preservation of graft function. The occurrence of a typical condition called cardiorenal syndrome type 4 represents an important complication where progressive chronic kidney disease due to graft dysfunction leads to cardiovascular disorders and altered myocardial function. Preventing such complications may be a key issue in the successful maintenance of a good clinical condition of the transplanted patient.
In conclusion, once again, European Nephrology offers a comprehensive review of the most interesting topics and issues in the area of clinical nephrology, dialysis and transplantation. Focusing attention on specific areas such as diabetology, cardiology and critical care, has the special meaning of increasing interest in a more holistic approach to the renal patient and a multidisciplinary pathway for diagnosis and treatment. Working together with specialists from other disciplines will leverage the knowledge of the renal physicians and will contribute to offer our patients a more complete and professional treatment strategy. n
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© TOUCH BRIEFINGS 2012
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