Despite being recommended by most guidelines, the metabolic evaluation of patients with nephrolithiasis has limited diffusion due to difficulties relating both to the access to laboratory investigations and to urine collection modalities. Consequently, in addition to the classical 24-h collection, alternative and simplified collection modes have been proposed.  https://www.selleckchem.com/products/bupivacaine.html  We report here on the comparison between metabolic evaluation carried out on 24-h double collection (Lithotest) and overnight spot urines (RF test). Fifty-four patients with stone disease were enrolled, excluding patients with infection or cystine stones. For Lithotest, we measured all analytes necessary to calculate state of saturation (ß) with calcium oxalate, brushite and uric acid, by means of Lithorisk.com. For RF, we measured calcium, magnesium, oxalate, citrate, sulphate, phosphate, pH and creatinine. The comparison was made with creatinine ratios. An estimate of ßCaOx, ßbrushite and ßAU was obtained also on RF urines by using simplified algorithms. We found highly significant correlations between all parameters, despite quite different means. There was a nice correspondence between the two sets of measurements, assessed by the Bland-Altmann test, for calcium, oxalate, citrate, sulphate, urate and pH. Overnight urine had higher saturations compared to 24-h one owing to higher concentration of the former. In conclusion, RF test on overnight urine cannot completely replace Lithotest on 24-hr urine. However, it can represent a simplified tool for either preliminary evaluation or follow-up of patients with stone disease.Introduction and aims Stages 4 and 5 of chronic kidney disease (CKD) have always been considered hard to modify in their speed and evolution. We retrospectively evaluated our CKD stage 5 patients (from 01/1/2016 to 12/31/2018), with a view to analyzing their kidney function evolution. Material and Methods We included only patients with longer than 6 months follow-up and at least 4 clinical-laboratory controls that included measured Creatinine Clearance (ClCr) and estimated GFR with CKD-EPI (eGFR). We evaluated the agreement between ClCr and eGFR through Bland-Altman analysis; progression rate, classified as fast (eGFR loss >5ml/min/year), slow (eGFR loss 1-5 ml/min/year) and non-progressive (eGFR loss 5 ml/min/year). The vast majority showed a slow progression, stabilisation or even an improvement. Despite the limits due to the small sample size, the data has encouraged us not to consider CKD stage 5 as an inexorable and short journey towards artificial replacement therapy.Waldenström's disease is a rare haematological neoplasm involving B lymphocytes, characterized by medullary infiltrated lymphoplasmacytic lymphoma and by the presence of a monoclonal M paraprotein. Although rarely, this condition may lead to heterogeneous renal involvement and cause severe renal failure. We report the clinical case of a patient with overt nephrotic syndrome in Waldenström's disease treated with a combination chemotherapy (rituximab, cyclophosphamide, dexamethasone) until complete renal and haematological remission.Anti-neutrophil cytoplasmic antibodies (ANCA)-associated vasculitis (AAV) are rare autoimmune diseases characterised by medium and small vessels inflammation. Renal vasculitic involvement is one of the most severe manifestations, with high mortality in case of a delayed diagnosis and a significant impact on patients' long-term prognosis. Histological classifications and scores for the definition of renal involvement in AAV exist and correlate with the renal outcome. Current induction regimen consists of a high dose of glucocorticoids and immunosuppressive drugs cyclophosphamide (CYC), rituximab (RTX) or a combination of both. RTX use is expanding thanks to randomised control trials suggesting its non-inferiority compared to the standard CYC therapy in general AAV and a better safety profile; its cost has also reduced thanks to the availability of biosimilars. However, the equivalence of RTX and CYC in patients with severe renal involvement is still debated. The quest for the ideal induction regimen in AAV is moving towards a more personalized approach on the one hand, efforts are made to use already existing therapies in the most appropriate way; on the other, new insights into AAV pathogenesis has allowed the discovery of new targets, such as the complement factor C5a. Thanks to this new AAV management, renal outcome and overall survival has visibly improved. New studies are needed to reach a more personalized approach in the induction regimen of ANCA-associated glomerulonephritis and AAV in general.Infections continue to be a major cause of morbidity and mortality in patients on renal replacement therapy with peritoneal dialysis (PD). Despite great efforts in the prevention and treatment of infective complications over the two past decades, catheter-related infections represent the most relevant cause of technical failure. Recent studies support the idea that exit-site/tunnel infections (ESI/TI) have a direct role in causing peritonitis. Since the episodes of peritonitis secondary to TI lead to catheter loss in up to 86% of cases, it is advised to remove the catheter when the ESI/TI does not respond to medical therapy. This approach necessarily entails the interruption of PD and, after the placement of a central venous catheter, the shift to haemodialysis (HD). In order to avoid the change of dialytic method, the simultaneous removal and replacement (SCR) of the PD catheter has also been proposed. Although SCR avoids temporary HD, it requires the removal/reinsertion of the catheter and the immediate initiation of PD, with the risk of mechanical complications such as leakage and malfunction. Several mini-invasive surgical techniques have been employed as rescue procedures curettage, cuff-shaving, the partial reimplantation of the catheter and the removal of the superficial cuff with the creation of a new exit-site. These procedures allow to save the catheter and have a success rate of 70-100%. Therefore, in case of ESI/TI refractory to antibiotic therapy, a mini-invasive surgical revision must always be considered before removing the catheter.