Carmelo Giordano (1930-2016): uremia therapy by protein alimentation and sorbents


Carmelo Giordano was born on August 23, 1930 in Naples and died there on May 12, 2016. He qualified MD in 1954 and then trained with Professor Magrassi and later Professor John Merrill in the USA.

Returning to Naples he established a clinical research laboratory at the University Federico II which was funded for many years from the National Institute of Health in Bethesda. In 1969 he became a full Professor of Nephrology and established the postgraduate school of nephrology.

Giordano developed a worldwide reputation for his work on dietary management of uremia, recognised by the eponym “the Giordano–Giovannetti diet”. In this field he followed on from a galaxy of clinicians dating from antiquity and he worthily followed their high reputations.

He studied treatment of chronic renal failure (CRF) with low protein diets, essential amino acid diets/supplements and was the first to use ketoacids. The effect of these diets was assessed by nitrogen balance studies. He collaborated with other centres in this work including London and Stockholm.

Giordano’s other major interest and contribution to the conservative management of CRF was in the field of sorbents. He manufactured and studied, in patients and animals, the sorbent effects of oxidised starch-oxystarch and oxycellulose in removing, through the gut, significant amounts of nitrogenous waste. These studies raise the possibility of managing CRF using a combination of oral sorbent treatment and hemoperfusion. The latter is discussed in this paper as is dialysate regeneration and “portable” dialyzers.

Keywords: Carmelo Giordano, Low Protein Diet, ketoacids in CKD, oxystarch, oxycellulose, cold carbon apparatus, portable artificial kidneys, wearable artificial kidneys

Ci spiace, ma questo articolo è disponibile soltanto in Inglese Americano.