Background: Infection related to Coronavirus-19 (CoV-2) is pandemic affecting more than 4 million people in 187 countries worldwide. By May 10, 2020, it caused more than 280 000 deaths all over the world. Preliminary data reported a high prevalence of CoV-2 infection and mortality due to severe acute respiratory syndrome related CoV-2 (SARS-CoV-2) in kidney-transplanted patients (KTRs). Nevertheless, the outcomes and the best treatments for SARS-CoV-2-affected KTRs remain unclear.

Because of the great problem of viral hepatitis in hemodialysis patients, the Italian Society of Nephrology decided to perform a national epidemiologic survey. We contacted 467 nephrological centers by a questionnaire which let us have information on 25,746 uremic patients: 18,338 on HD, 2,250 on PD and 5,176 with kidney transplant, respectively 78.5% of the total Italian dialysed patients and 91.4% of the total transplanted patients. Statistical analyses were performed. HBV infections occur in 7.8% of the patients (2,008 cases) but considering that 485 cases became spontaneously negative, the true overall incidence of chronic carriers falls to 4.9%. The main causes of the infection are reported as transfusions (64.3%) and dialysis environment (12%). The vaccination program performed by 93.2% of the centers, obtained an efficacious seroconversion in 4,626 of 7,790 cases vaccinated: the vaccine currently most utilized is the recombinant type administered by means of 3 versus 4 boosters. In the 2nd part of the survey, we report information concerning the presence of nephropaties associated with HBV infections in nonuremic patients (208 cases). We present and discuss the clinical picture of the nephropaties, the hystologic bioptic pattern and the prognosis of the kidney pathology.

Encapsulating peritoneal sclerosis (EPS) is a rare but serious complication of long-term peritoneal dialysis, often occurring after patients have been shifted to haemodialysis or undergone renal transplantation. EPS is still associated with high morbidity and mortality but, although various treatment modalities have been tried, the optimal therapy is still debated. The present paper reports a 16-year-old patient who developed EPS 6 months after shifting to haemodialysis and, following adhesiolysis, was successfully treated with a combination of steroids, tamoxifen and everolimus, this last drug chosen for its antiproliferative effect through mammalian target of rapamycin (mTOR) inhibition and its ability to block vascular endothelial growth factor and neoangiogenesis. EPS progressively improved and the patient successfully underwent renal transplantation 5 years later. The case suggests that, in view of their mechanism of action, mTOR inhibitors should be considered as an immunosuppressive agent after renal transplantation in patients at risk and merit investigation in future trials on this condition.

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Role of clinical risk factors and polymorphisms in glucocorticoid receptor gene in the determining the risk of developing diabetes after kidney transplantation INTRODUCTION:New-onset diabetes after transplantation (NODAT) is a recognized metabolic complication of kidney transplantation: its estimated rates at 12 months post transplant are between 20% and 50% for kidney transplants and it is associated with increased risks of graft rejection, infection, cardiovascular disease and death. Transplant-specific risk factors for NODAT ,such as corticosteroids and calcineurin inhibitors, play a dominant role in its pathogenesis. Furthermore polymorphisms in glucocorticoid receptor gene are common in the human population and play a role in regulation of glucocrticoid sensitivity. OBJECTIVE:Determine the incidence genetic and clinical risk factors for NODAT among kidney recipients in our centre. PATIENTS AND METHODS: We studied 96 kidney allograft recipients ( Male 53, Female 43, mean age 56.02 ± 11.03 year) regularly followed at our Transplantation Center (at 3, 6 and 12 months), without evidence of preexisting diabetes. The presence of arterial hypertension, dyslipidaemia and BMI were assessed in all patients. All the patients were genotyped for two GR polymorphism (BclI, A3669G). Analysis of the GR gene polymorphisms were determined using Real-Time PCR System and Taqman allelic discrimination assays. RESULTS: Three months after renal transplantation 27% recipients developed NODAT. There were no significant differences in gender, age, mean daily steroids doses and genetic polymorphism in GR between patients with NODAT and healthy control. Patients with NODAT had a BMI significantly increased compared with patients without NODAT (25 ± 4.56 vs. 21.84 ± 2.58, p = 0.02).CONCLUSIONS:The prevalence of NODAT in our center is similar to that found in the literature. BMI and obesity are a risk factors for NODAT; in contrast age, gender, daily steroids doses and genetic polymorphism in GR are not correlates with its development.