THE ITALIAN STUDY GROUP ON NEONATAL NEPHROLOGY
of THE ITALIAN SOCIETY OF NEONATOLOGY
1997-1998

 

The following is meant exclusively as an introduction for those who wish to know more about the activities of the Neonatal Nephrology Study Group (NNSG)

In the autumn of 1985, Luigi Cataldi, Professor in Pediatrics, had at that time just been elected president of the Lazio Section of the Neonatology Work Group (NWG) and was an active member of the Italian Society of Pediatrics (ISP). He suggested to Elio Salvaggio, Associate Professor in Pediatric Nephrology at the Catholic University of the Sacred Heart in Rome, to assist him in forming a diagnostic therapeutic protocol for neonatal urinary tract infections. Further co-operation was given by other specialists and chief organisers of the Neonatal Units in Lazio.

THE NNSG AND THE ITALIAN SOCIETY OF NEONATOLOGY.

In September l994 the NNSG was included in the Constitution of the Italian Society of Neonatology (ISN). In June 1996 with the establishment of the rules and regulations of ISN study group, the first directing committee of NNSG was elected for the years l996-1999. This committee consists of five members, four advisers Linda Bertellis (Pontedera), Rossella Galiano (Catanzaro), Raffaele Longo (Lecce), Maria Rosaria Ziccardi (Milan), and a Secretary Luigi Cataldi (Rome). The function of this committee is to propose the Group Study activities and co-ordinate the research projects.

MULTI-CENTRE SURVEYS

1. Neonatal Urinary Tract Infections

The IP-IVU-N Protocol, which had been prepared in only a few weeks, was offered for use on the 1st February 1986 to the various heads of the neonatal units in Lazio and was adopted by the majority of these centres.

The results of the preliminary investigation in the region for the first six months of the study were very encouraging. This widened the IP-IVU-N protocol survey to other interested neonatologists and pediatricians in other regions. Therefore the protocol was presented at the 15th National Congress of the ISP in Modena (1987), and as a result of which the number of participating units in the study rose to 95 nationally, 62 (65.2%) of which carried the survey through to a conclusion during the period from January 1988 to August 1989.

Over the course of the study 2,342 newborn babies were investigated, both full term and premature who were considered to be at risk of UTI, (the risk was determined by patient history, clinical and laboratory criteria ). 428 newborns, 248 males and 180 females, 248 full term and 180 premature, were found to be affected by UTIs.

The results of this study have already been used in numerous publications and presentations at both national and international levels.

2 - NEONATAL POLYTHELIA AND MALFORMATIVE UROPATHY.

Since 1989 the study group has promoted a multicenter collaboration in the investigation of neonatal polythelia and malformative uropathy.

Even if there is a close correlation between the presence of polythelia and malformative uropathy, this has never been demonstrated by italian neonatologists. This study has demonstrated that there is a significant frequency of a malformative pathology which involve various organs and appartus, above all in subjects where there is an excess of not only mammary areola but also of secondary gland tissue.

3 - NEONATAL ACUTE RENAL FAILURE (ARF)

This survey was carried out between 1990 and 1992. The results of this survey confirmed amongst other things the role of asphyxia in determining ARF, and the importance of N-acetil-ß-D-glucosaminidase (NAG) as a marker of hypoxic tubular damage.

 4 - THE PRE- AND POSTNATAL DIAGNOSTIC SONOGRAPHY OF MALFORMATIVE UROPATHY.

The group has for many years now, investigated malformative uropathy with specific reference to diagnostic pre and postnatal sonography with the collaboration of very many Italian University and Hospital Neonatal Units.

The data thus recorded, during the period 1990-91 and 1992-93 and during the following years 1994, '95, '96, has been presented at national and international meetings of Neonatology and Perinatal Medicine in Italy and abroad.

The data is still the only point of reference for a nationwide objective evaluation of the Sonographic Screening of Malformative Uropathy, in our country.

5 - RENAL FUNCTIONS IN THE PREMATURE NEWBORN

This survey, which was proposed towards the end of 1995, was carried out with the participation of the following hospital and 2nd and 3rd level university neonatal units,

Coordinator

Hospital

Town'

Prof. F.F. Rubaltelli

Osp. Careggi Università

Firenze

Prof. G. Sabatino

Università di Chieti

Chieti

Dott. U. Dimita

Osp. Buccheri La Ferla FBF

Palermo

Prof. V. Vigi

Osp. S. Anna - Università

Ferrara

Dott. V. Fanos

Policlinico Borgo Roma - Università

Verona

Prof. F. Chiappe

Patologia Neonatale Università

Cagliari

Dott. R. Longo

Osp. Vito Fazzi

Lecce

Dott. L. Fiore

Osp. Santobono

Napoli

Dott.ssa A.C. Cigolotti

Osp. Maggiore - Università. di Torino

Novara

Dott. G. Latini

Osp. Di Summa

Brindisi

Prof. M.G. Romeo

Patologia Neonatale Università

Catania

Dott. M. G. Fiorino Dott. E. Napoliello

Osp. Cardarelli

Napoli

Dott.ssa D. Cianfrini

Osp. di Arezzo

Arezzo

Prof. V. Console

Osp. Maggiore

Milano

Prof. G.P. Salvioli

Ist. Clinico di Ped. Prev. e Neon. - Università.

Bologna

Prof. G. Rondini

Pat. Neon. Pol. S. Matteo IRCCS - Università

Pavia

Dott.ssa R. Galiano

Osp. "G. Pugliese"

Catanzaro

Dott.ssa L. Bertelli

Osp. di Zona Valdera Azienda USL 5

Pontedera (Pi)

Dott.ssa C. Magnani

Neonatologia Ospedale

Reggio Emilia

Dott. L. Gatta

Casa Sollievo della Sofferenza

S.Giovanni Rotondo

The results of this survey, which are still only preliminary, have already been presented at the American Society for Pediatric Research meeting in Washington DC 2nd-6th May 1997, and at the 31st Annual Meeting of the European Society for Pediatric Nephrology in Athens, Greece in September1997.

6 - THE PHYSIOPATHOLOGY OF CISTATINE C IN THE PRENATAL PERIOD

In 1996 a study was begun on the physiopathology of Cistatina C as an early marker of glomerular damage in the neonatal period. The preliminary data has already been published in the European Journal of Laboratory Medicine and in Prenatal and Neonatal Medicine.

MULTI-DISCIPLINARY SCIENTIFIC COLLABORATION

Since 1996 official scientific cooperation has existed, between the neonatologists of the NNSG and the members of the Italian Society of Laboratory Medicine, in order to render more efficient any scientific and cultural collaboration. At the present time talks are taking place on official collaboration between the colleagues in the Italian Society of Pediatric Nephrology, The Italian Society of Perinatal Medicine and other scientific societies.

CONVENTIONS AND CONGRESSES

The NNSG has organised every year since 1988, a national congress. And since 1990, seven international neonatal nephrology workshops have taken place. At these meetings the most relevant arguments in neonatal nephrology have been considered thoroughly by the most competent and representative experts, both Italian and non- italian, in the field of neonatology, nephrology and neonatal and perinatal pharmacology.