KCa3.1 in diabetic kidney disease
Purpose of review Diabetic kidney disease (DKD) is a significant health concern. Innovative strategies to prevent or limit the progression of DKD are urgently needed due to the limitation of existing treatments. KCa3.1, a potassium channel, is involved in a range of biological processes from cell survival to cell death. This review summarizes the current knowledge on the pathophysiological functions of the KCa3.1 channel, specifically its involvement in maintaining mitochondrial function. More specifically, the therapeutic potential of targeting KCa3.1 in DKD is systematically discussed in the review. Recent finding...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: HORMONES, AUTACOIDS, NEUROTRANSMITTERS AND GROWTH FACTORS: Edited by Mark Cooper and Merlin Thomas Source Type: research

Current status of the assessment of sarcopenia, frailty, physical performance and functional status in chronic kidney disease patients
Purpose of review Low physical function, frailty, and sarcopenia are common complications of chronic kidney disease (CKD). In this article, we review the epidemiology and pathogenesis of low physical function, as well as its associations with adverse outcomes in CKD patients. Additionally, we present various traditional and novel methods for assessment of physical function in CKD patients. Recent findings In nondialysis dependent (NDD) and dialysis-dependent CKD patients, the prevalence of low physical function, frailty, and sarcopenia are substantially higher than in the general population. The potential mechan...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Novel monitoring of renal function and medication levels in saliva and capillary blood of patients with kidney disease
Purpose of review Serum creatinine, urea, and cystatin C are the main biomarkers used to estimate glomerular filtration rates in persons with and without chronic kidney disease (CKD). Frequent measurements of these assays are needed to identify patients with earlier stages of CKD, detect episodes of acute kidney injury (AKI), and monitor for CKD progression. However, the cumbersome, time-consuming nature of conventional laboratory-based kidney function assays limit more frequent monitoring and greater patient self-management. Recent findings Noninvasive salivary assessments of creatinine, cystatin C, and urea ma...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Kidney dysfunction requiring dialysis is a heterogeneous syndrome: we should treat it like one
Purpose of review Advanced kidney failure requiring dialysis, commonly labeled end-stage kidney disease or chronic kidney disease stage 5D, is a heterogeneous syndrome –a key reason that may explain why: treating advanced kidney dysfunction is challenging and many clinical trials involving patients on dialysis have failed, thus far. Treatment with dialytic techniques – of which maintenance thrice-weekly hemodialysis is most commonly used – is broadly named kidney ‘replacement’ therapy, a term that casts the perception of a priori abandonment of intrinsic kidney function and subsumes patien...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Novel intestinal dialysis interventions and microbiome modulation to control uremia
Purpose of review In patients with chronic kidney disease (CKD), the gut plays a key role in the homeostasis of fluid and electrolyte balance and the production and disposal of uremic toxins. This review summarizes the current evidence on the gut-targeted interventions to control uremia, fluid overload, hyperkalemia and hyperphosphatemia in CKD. Recent findings Studies have emerged that support the concept of intestinal dialysis, such as colonic perfusion with a Malone antegrade continence enema stoma or colonic irrigation with a rectal catheter, as a promising adjuvant approach to control uremia in CKD, althoug...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Novel approaches to hypoglycemia and burnt-out diabetes in chronic kidney disease
Purpose of review Diabetes mellitus is a leading cause of chronic kidney disease (CKD) that confers faster kidney disease progression, higher mortality, and various metabolic derangements including hypoglycemia. Recent findings Even in the absence of diabetes mellitus, growing research demonstrates that CKD patients are at heightened risk for hypoglycemia via multiple pathways. In CKD patients transitioning to end-stage renal disease (ESRD), spontaneous resolution of hyperglycemia and frequent hypoglycemia resulting in reduction and/or cessation of glucose-lowering medications are frequently observed in a phenom...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Novel approach to unpleasant symptom clusters surrounding pruritus in patients with chronic kidney disease and on dialysis therapy
Purpose of review Chronic kidney disease-associated-pruritus (CKD-aP) is a common symptom in patients with end-stage kidney disease (ESKD) undergoing dialysis. CKD-aP typically occurs alongside other debilitating symptoms and may comprise so-called ‘symptom clusters’ which have synergistic effects that adversely impact patient health-related quality of life (HRQoL). Importantly, symptoms in a cluster may share a common biological mechanism. Here we review the clinical impact of CKD-aP and its association with other symptoms reported by dialysis patients. The clinical benefits of treating pruritus and its po...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Reconciling Systolic Blood Pressure Intervention Trial with Eighth Joint National Commission: a nuanced view of optimal hypertension control in the chronic kidney disease population
Purpose of review Universally lowering blood pressure (BP) may adversely affect some populations especially in the older population. Recent landmark trials revealed cardiovascular benefits of tight controlling systolic BP (SBP) more than several recent BP targets. Implementing the evidence from the studies and guidelines in some populations is reviewed. Recent findings Eighth Joint National Commission (JNC-8) on hypertension issued conservative guidelines that provided an evolutionary change to BPcontrol in the elderly. However, intensive BP control with SBP  (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Intravitreal vascular endothelial growth factors hypertension, proteinuria, and renal injury: a concise review
Purpose of review Nearly 20 years ago, vascular endothelial growth factor (VEGF)inhibitors (VEGFi) were adapted from systemic use from antiangiogenesis roles to intravitreal uses. Initially bevacizumab a murine immunoglobulin was injected ‘off label’ as a treatment for diabetic macular edema and age-related macular degeneration. Throughout the following decade aflibercept and finally ranibizumab were adapted and obtained Food and Drug Administration approval for intravitreal use. Initially systemic absorption was thought to be quite low after intravitreal injections and was quoted as being 200-fold lower th...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Kidney in the net of acute and long-haul coronavirus disease 2019: a potential role for lipid mediators in causing renal injury and fibrosis
Purpose of review Severe COVID-19 disease is often complicated by acute kidney injury (AKI), which may transition to chronic kidney disease (CKD). Better understanding of underlying mechanisms is important in advancing therapeutic approaches. Recent findings SARS-CoV-2-induced endothelial injury initiates platelet activation, platelet–neutrophil partnership and release of neutrophil extracellular traps. The resulting thromboinflammation causes ischemia–reperfusion (I/R) injury to end organs. Severe COVID-19 induces a lipid-mediator storm with massive increases in thromboxane A2 (TxA2) and PGD2, which...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Medical nutrition therapy using plant-focused low-protein meal plans for management of chronic kidney disease in diabetes
Purpose of review Nearly half of all Americans with chronic kidney disease (CKD) also have type-2-diabetes (T2D). Whereas traditional and emerging pharmacotherapies are increasingly frequently used for the management of CKD in diabetes (CKD/DM), the role of integrated or multimodal interventions including the potentially synergistic and additive effect of diet and lifestyle modifications in addition to pharmacotherapy has not been well examined, in sharp contrast to the well-known integrated approaches to heart disease. Recent findings Low-carbohydrate low-fat diets are often recommended in T2D, whereas low-prot...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Revisiting glomerular hyperfiltration and examining the concept of high dietary protein-related nephropathy in athletes and bodybuilders
Purpose of review High-protein diets (HPDs) are popular but their consequences for kidney health, especially among athletes and bodybuilders who typically maintain a high protein intake for a long time, have not been investigated. This review focused on recent studies of the association of HPD with long-term kidney health and the concept of high dietary protein-related nephropathy. Recent findings Several long-term observational studies including large populations have reinforced the notion that HPDs are associated with a rapid decline of kidney function. An increase in renal blood flow and glomerular hyperfiltr...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Nutritional and dietary interventions to prolong renal allograft survival after kidney transplantation
Purpose of review Diet plays an important role in slowing progression of chronic kidney disease in native and transplanted kidneys. There is limited evidence on the association on dietary intake with renal allograft function. Mechanisms of major nutrients and dietary patterns with focusing on a plant-based diet related to kidney transplant health and longevity are reviewed. Recent findings High dietary protein intake may adversely affect renal allograft. Low protein plant-focused diets such as Dietary Approaches to Stop Hypertension, plant-dominant low-protein diet and Mediterranean diets appear associated with ...
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Editorial: Novel therapeutic approaches in chronic kidney disease and kidney transplantation: the draw of evolving integrated multimodal approaches in the targeted therapy era
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Ekamol Tantisattamo, Ramy M. Hanna and Kamyar Kalantar-Zadeh Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - December 6, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Recent advances in dialysis membranes
Purpose of review Improvement in hemodialysis treatment and membrane technology are focused on two aims: the first one is to achieve a better control of circulating uremic solutes by enhancing removal capacity and by broadening molecular weight spectrum of solutes cleared; the second one is to prevent inflammation by improving hemocompatibility of the global dialysis system. Recent findings Despite impressive progresses in polymers chemistry few hazards are still remaining associated with leaching or sensitization to polymer additives. Research has focused on developing more stable polymers by means of additives...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by David J. Cohen Source Type: research

Depression in dialysis
Purpose of review The aim of this study was to examine updated prevalence rates, risk factors and the prognosis, diagnosis and treatments for depression among dialysis patients. Recent findings Depression influences prognosis, complications, quality of life (QOL), treatment and costs for dialysis patients worldwide. Reported prevalence of depression is 13.1–76.3%; it is higher for dialysis than transplant and higher post than predialysis. Reported depression rates with peritoneal dialysis (PD) compared with in-centre haemodialysis (HD) are inconsistent. Related medical factors are known, but suspected asso...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by David J. Cohen Source Type: research

The clinical application of frailty in nephrology and transplantation
Purpose of review Clinicians treating end-stage kidney disease (ESKD) and kidney transplant patients face unique challenges in their care because of the high burden of frailty in these patients. Frailty has gained significant attention by medical and surgical specialties for risk stratification in the past decades. This review highlights the importance of measuring frailty in kidney transplant candidates and recipients. Recent findings Emerging data support that frailty is present even at younger ages among patients undergoing dialysis, transplant evaluation, or transplantation. It is estimated that 18.8% of you...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by David J. Cohen Source Type: research

Cellular therapies in kidney transplantation
Purpose of review Current immunosuppressive regimens used in kidney transplantation are sometimes ineffective and carry significant risks of morbidity and mortality. Cellular therapies are a promising alternative to prolong graft survival while minimizing treatment toxicity. We review the recently published breakthrough studies using cell therapies in kidney transplantation. Recent findings The reviewed phase I and II trials showed that cell therapies are feasible and safe in kidney transplantation, sometimes associated with less infectious complications than traditional regimens. Regulatory T cells and macropha...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by David J. Cohen Source Type: research

Efficacy and safety of Sodium-Glucose-Transporter-2 inhibitors in kidney transplant patients
Purpose of review This review discusses current evidence and future perspectives for use of SLT2 inhibitors in kidney transplant recipients (KTRs). Recent findings Sodium-Glucose-Transporter-2 inhibitors (SGLT2is) lower plasma glucose in patients with type 2 diabetes, and protect against heart failure and progression of chronic kidney disease by a glucose-independent mechanism. Most of the current studies with SGLT2is in kidney transplant patients are however short-term retrospective case studies. These, together with one small randomized clinical trial, show that SGLT2is lower glucose also in KTRs with type 2 d...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by David J. Cohen Source Type: research

Role of deceased donor kidney procurement biopsies in organ allocation
Purpose of review There has been an increased emphasis by the transplant community and the federal government to increase the utilization of deceased donor kidneys. Procurement biopsies during allocation are the most common reason for kidney discards. This manuscript reviews the evidence of procurement biopsies practices and utility. Recent findings Procurement biopsies are performed in over half of all the kidneys recovered in the United States and account for more than one third of the kidney discards. However, there is a significant heterogeneity across the organ procurement organizations regarding the indica...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIALYSIS AND TRANSPLANTATION: Edited by David J. Cohen Source Type: research

Management of acute kidney injury associated with Covid-19: what have we learned?
Purpose of review Although initially kidney involvement in COVID-19 infection was felt to occur relatively infrequently, this has proved not to be the case. In critically ill patients with COVID-19, multiorgan failure including acute kidney injury (AKI) is common and is associated with an increased risk of mortality and morbidity. This review focuses briefly on the epidemiology and pathophysiology of COVID-19 associated AKI as well as options for management. Recent findings The risk factors for AKI are common to both noncovid-related AKI and COVID-19 associated AKI. Kidney injury in COVID-19 associated AKI may a...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

Noninvasive continuous intradialytic blood pressure monitoring: the key to improving haemodynamic stability
Purpose of review Intradialytic hypotension (IDH) occurs in 20% of haemodialysis treatments, leading to end-organ ischaemia, increased morbidity and mortality; and contributing to poor quality of life for patients. Treatment of IDH is reactive since brachial blood pressure (BP) is recorded only intermittently during haemodialysis, making early detection and prediction of hypotension impossible. Noninvasive continuous BP monitoring would allow earlier detection of IDH and thus support the development of methods for its prediction and consequently prevention. Recent findings Noninvasive continuous BP monitoring is...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

Complications after native kidney biopsy: definitive data
Purpose of review To assess the risk of complications associated with native kidney biopsies. This review will highlight recent advances on the risk factors for major bleeding and risk management in patients with native kidney biopsy. Recent findings Recent studies provided new important data regarding the individualization of the risk of bleeding after kidney biopsy. A new bleeding risk score was proposed as a risk stratification tool, useful for shared decision making and procedure choice. Summary The risk of complications is low ( (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

How to assess quality of life in persons with chronic kidney disease
This article summarises the current approaches to QoL assessment in CKD and outlines aspirations for future improvement. Recent findings Commonly used tools for assessment of QoL in CKD include the Short Form-36 and -12 and extended versions adapted for specific use in kidney patients (KD-QoL), and the EQ-5D. However, a wide range of other instruments are also reported, making comparisons between research findings challenging. Few of the tools are adequately validated for use in CKD, and relevance to patient values are unclear. Instruments suitable for use in a routine clinical setting are lacking. Summary Qo...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

Lifestyle interventions for preventing and ameliorating CKD in primary and secondary care
Purpose of review Despite the growth in chronic kidney disease (CKD) epidemics, evidence-based lifestyle recommendations for primary prevention of CKD are limited by reliance on observational studies and predominantly pilot clinical trials. Recent findings Emerging data have shown lifestyle modification strategies for primary CKD prevention with the most evidence favoring a healthy dietary pattern (rich in fruit, vegetables, potassium and have a higher plant-based to animal protein ratio), and diet low in sodium, being physically active, avoiding tobacco smoking, moderating alcohol consumption and maintaining a ...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

Plasma and urine biomarkers in chronic kidney disease: closer to clinical application
Purpose of review Chronic kidney disease (CKD) is a silent disease, causing significant health and economic burden worldwide. It is of strong clinical value to identify novel prognostic, predictive, and pharmacodynamic biomarkers of kidney function, as current available measures have limitations. We reviewed the advances in biomarkers in CKD over the preceding year. Recent findings The most frequently studied prognostic plasma biomarkers during recent year were plasma TNFR1, TNFR2, KIM1 and urinary MCP-1 and EGF. New biomarkers such as plasma WFDC2, MMP-7, EFNA4, EPHA2 may also have potential to serve as prognos...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

The « race » correction in estimating glomerular filtration rate: an European point of view
Purpose of review There is currently a heated debate ongoing whether or not to use the race coefficient for black people in the Modification of Diet in Renal Diseases and Chronic Kidney Disease Epidemiology-equation. The use of the race coefficient is thought by several American authors as a source of discrimination. Recent findings It has recently been shown that the race coefficient is inaccurate in European and African black people. Therefore, it seems that the race correction is more a correction for black Americans, rather than for black in general. This ‘correction’ at the glomerular filtration...
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: DIAGNOSTICS AND TECHNIQUES: Edited by Maarten W. Taal Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - October 10, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Treatment options for managing obesity in chronic kidney disease
Purpose of review Obesity is a risk factor for the development and progression of chronic kidney disease (CKD). In this review, we provide a comprehensive overview of various management options (lifestyle intervention, medications, and bariatric surgery) to address obesity in those with CKD. Recent findings Few clinical trials have examined the benefits of lifestyle modifications in those with preexisting CKD and suggest potential renal and cardiovascular benefits in this population. Yet, superiority of different dietary regimen to facilitate weight loss in CKD is unclear. Although medications could offer short-...
Source: Current Opinion in Nephrology and Hypertension - August 6, 2021 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Communication principles and practices for making shared decisions about renal replacement therapy: a review of the literature
Purpose of review To provide an overview of the skill set required for communication and person-centered decision making for renal replacement therapy (RRT) choices, especially conservative kidney management (CKM). Recent findings Research on communication and decision-making skills for shared RRT decision making is still in infancy. We adapt literature from other fields such as primary care and oncology for effective RRT decision making. Summary We review seven key skills: (1) Announcing the need for decision making (2) Agenda Setting (3) Educating patients about RRT options (4) Discussing prognoses (5) ...
Source: Current Opinion in Nephrology and Hypertension - August 6, 2021 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Advances in management of hepatorenal syndrome
Purpose of review Hepatorenal syndrome (HRS) is encountered frequently in patients with end-stage liver disease and remains an important cause of morbidity and mortality in this patient population. This review will focus and provide updates on pathophysiology, assessment of kidney function, new definitions, and treatment and prevention of HRS. Recent findings Pathophysiology of HRS has been elucidated more recently and in addition to hemodynamic changes, the role of systemic inflammatory response contributes significantly to this process. Assessment of kidney function in patients with liver cirrhosis remains cha...
Source: Current Opinion in Nephrology and Hypertension - August 6, 2021 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Progress in hepatitis C virus management in chronic kidney disease
Purpose of review The current review highlights advances in the use of direct-acting antiviral (DAA) agents in the treatment of hepatitis C virus (HCV) in chronic kidney disease (CKD) stages G4-5, end-stage renal disease, and kidney transplantation. The use of DAA to facilitate kidney transplantation of HCV negative recipients with kidneys from HCV-infected donors and in the management of HCV-related cryoglobulinemia are also reviewed. Recent findings DAA treatment results in rates of viral clearance (sustained virological response or SVR) of 90–100% in all studied CKD populations, comparable to SVR rates ...
Source: Current Opinion in Nephrology and Hypertension - August 6, 2021 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Emerging non-pharmacological interventions in ADPKD: an update on dietary advices for clinical practice
Purpose of review Patients with Autosomal Dominant Polycystic Kidney Disease (ADPKD) reach kidney failure at a median age of 58 years. There has been a strong interest in medical interventions to improve prognosis. With increasing understanding of the underlying pathophysiology, there is also a rationale for non-pharmaceutical interventions. However, these have received little attention. This review, therefore, focuses on dietary interventions in ADPKD. Recent findings Recent studies regarding salt, protein and water intake, caloric restriction, BMI, caffeine and alcohol are discussed in this review. In genera...
Source: Current Opinion in Nephrology and Hypertension - August 6, 2021 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Sodium-glucose cotransporter 2 inhibition in non-diabetic kidney disease
Purpose of review Sodium-glucose cotransporter 2 (SGLT2) inhibitors have proven cardiorenal protection in patients with diabetes and chronic kidney disease (CKD) as seen in cardiovascular outcome trials (CVOTs) and CREDENCE. In this review, we aim to discuss the mechanisms of kidney protection with SGLT2 inhibition as well as review the results of multiple translational studies and clinical trials of SGLT2 inhibition in the nondiabetic kidney disease (non-DKD) population. Recent findings The application of SGLT2 inhibitors as dedicated kidney-protective agents continues to evolve with the publication of the dapa...
Source: Current Opinion in Nephrology and Hypertension - August 6, 2021 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Recent evidence on the effect of treatment of metabolic acid on the progression of kidney disease
Purpose of review Preclinical and epidemiological studies have shown an association between acidosis and progression of chronic kidney disease (CKD) and kidney fibrosis. This review discusses the recent trials evaluating the effect of treatment of metabolic acidosis on kidney outcomes. Recent findings The emerging evidence suggests that bicarbonate treatment may slow the progression of CKD and reduce the risk of kidney failure. However, high-certainty evidence on the efficacy and safety of alkali therapy is still lacking. Ongoing studies are evaluating the effect of veverimer, a novel nonabsorbable polymer, on c...
Source: Current Opinion in Nephrology and Hypertension - August 6, 2021 Category: Urology & Nephrology Tags: PHARMACOLOGY AND THERAPEUTICS: Edited by Sankar D. Navaneethan Source Type: research

Editorial introduction
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - August 6, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTION Source Type: research

Endothelin receptor antagonists for the treatment of diabetic and nondiabetic chronic kidney disease
Purpose of review To summarize new clinical findings of endothelin receptor antagonists (ERA) in various etiologies of kidney disease targeted in clinical trials. Recent findings Endothelin-1 is a multifunctional peptide with potential relevance to glomerular and tubulointerstitial kidney diseases. The phase 3 SONAR trial demonstrated a significant reduction in clinically relevant kidney outcomes for patients with diabetic kidney disease (DKD) after long-term treatment with the ERA, atrasentan, in addition to blockade of the renin-angiotensin-aldosterone system. Promising preclinical disease models and small cli...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: SPECIAL COMMENTARY Source Type: research

Kidney lymphatics: new insights in development and disease
Purpose of review This review will highlight recent advances in our understanding of the kidney lymphatics regarding their development, physiologic function, and their potential role in the progression of kidney disease. Recent findings Although sparse in comparison to the blood vasculature, lymphatic vessels within the healthy kidney perform an important role in maintaining homeostasis. Additionally, in response to kidney injury, lymphatic vessels undergo substantial expansion, termed lymphangiogenesis, which shows a direct correlation to the extent of tubulointerstitial fibrosis. Kidney lymphatics expand throu...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: RENAL PATHOPHYSIOLOGY: Edited by Orson W. Moe and Susan E. Quaggin Source Type: research

Coronavirus disease 2019 and kidney injury
Purpose of review In this paper, we seek to review coronavirus disease 2019 (COVID-19) associated kidney injury with a focus on what is known about pathophysiology. Recent findings Kidney injury is a common complication of SARS-CoV-2 infection and is associated with increased morbidity and mortality. Acute tubular necrosis and glomerular injury are two common findings. Direct viral effect, endothelial dysfunction, and podocyte and tubular epithelial injury have been described. COVID-19-related glomerular injury may also be associated with high-risk APOL1 genotype. Summary Data on COVID-19 renal involvemen...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: RENAL PATHOPHYSIOLOGY: Edited by Orson W. Moe and Susan E. Quaggin Source Type: research

Cystic fibrosis in the kidney: new lessons from impaired renal HCO3− excretion
Purpose of review A key role of cystic fibrosis transmembrane conductance regulator (CFTR) in the kidney has recently been uncovered. This needs to be integrated into the understanding of the developed phenotypes in cystic fibrosis (CF) patients. Recent findings In the beta-intercalated cells of the collecting duct , CFTR functions in very similar terms as established in the exocrine pancreatic duct and both CFTR and SLC26A4 (pendrin) orchestrate regulated HCO3− secretion. Like in the pancreas, the hormone secretin is a key agonist to activate renal HCO3− secretion. In mice lacking CFTR or pendrin, a...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: RENAL PATHOPHYSIOLOGY: Edited by Orson W. Moe and Susan E. Quaggin Source Type: research

Vitamin K and vascular calcification
Purpose of review Vascular calcification is a common and important cardiovascular risk factor in patients with chronic kidney disease (CKD). Recent advances in the understanding of the biology of vascular calcification implicate vitamin K-dependent proteins as important regulators in this process. This review highlights recent key advances in vascular biology, epidemiology, and clinical trials in this rapidly evolving field. Recent findings Vitamin K deficiency is associated with increasing severity of vascular calcification among patients with CKD, but the relationship with cardiovascular disease and mortality ...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

SNF472: mechanism of action and results from clinical trials
Purpose of review Vascular calcification (VC) is associated with increased cardiovascular event rates, particularly in patients with end-stage kidney disease (ESKD). Dysregulated mineral metabolism and inflammation have been shown to promote VC, however, treatment options targeting VC specifically are not available. This review outlines the pathophysiological mechanisms contributing to VC in ESKD and describes recent studies evaluating the effects of the first-in-class inhibitor of VC, SNF472. Recent findings SNF472 directly inhibits calcium phosphate crystal formation and aggregation. SNF472 has completed early...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Gut microbiome, parathyroid hormone, and bone
Purpose of review Microorganisms in the gut (the ‘microbiome’) and the metabolites they produce (the ‘metabolome’) regulate bone mass through interactions between parathyroid hormone (PTH), the immune system, and bone. This review summarizes these data and details how this physiology may relate to CKD-mediated bone disease. Recent findings The actions of PTH on bone require microbial metabolite activation of immune cells. Butyrate is necessary for CD4+ T-cell differentiation, T-reg cell expansion and CD8+ T-cell secretion of the bone-forming factor Wnt10b ligand. By contrast, mice coloniz...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

The impact of advanced glycation end products on bone properties in chronic kidney disease
Purpose of review Chronic kidney disease (CKD) affects over 15% of Americans and results in an increased risk of skeletal fractures and fracture-related mortality. However, there remain great challenges in estimating fracture risk in CKD patients, as conventional metrics such as bone density assess bone quantity without accounting for the material quality of the bone tissue. The purpose of this review is to highlight the detrimental effects of advanced glycation end products (AGEs) on the structural and mechanical properties of bone, and to demonstrate the importance of including bone quality when assessing fracture ri...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Intestinal phosphorus absorption: recent findings in translational and clinical research
Purpose of review The purpose of this review is to discuss recent findings in intestinal phosphorus absorption pathways, particularly the contributions of paracellular versus transcellular absorption, and the differential findings from studies using in vitro versus in vivo techniques of assessing phosphorus absorption in experimental animal studies. Recent findings Experimental animal studies show that in vivo effects of low phosphorus diets, 1,25D, and chronic kidney disease on intestinal phosphorus absorption efficiency contradict effects previously established ex vivo/in vitro. Recent in vivo studies also sug...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Glycerol-3-phosphate and fibroblast growth factor 23 regulation
Purpose of review Both classical and nonclassical factors regulate fibroblast growth factor 23 (FGF23), with impacts on gene expression and proteolytic cleavage. Here, we review recent publications that extend current knowledge on these factors. Recent findings Emerging nonclassical FGF23 regulators such as erythropoietin cause a balanced increase in FGF23 expression and cleavage, with minimal or no increase in biologically active intact FGF23 (iFGF23) in blood. However, circulating FGF23 profiles may not reflect the bone marrow microenvironment. For example, granulocyte colony-stimulating factor increases local...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Coronavirus disease 2019, vitamin D and kidney function
Purpose of review The purpose of this review is to summarize the emerging studies analyzing the association between vitamin D and risk of COVID-19 infection and severity, as well as the early interventional studies investigating the protective effect of vitamin D supplementation against COVID-19. Recent findings Studies investigating the association between vitamin D levels and risk of COVID-19 infection and risk of severe disease and mortality among those infected have yielded mixed results. Thus far, the majority of studies investigating the association between vitamin D and COVID-19 have been observational an...
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Editorial: A humble way forward amid hype and hope
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - June 3, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research