Current Opinion in Nephrology and Hypertension This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

New insights into muscle function in chronic kidney disease and metabolic acidosis
Purpose of review : Sarcopenia, defined as decreased muscle mass or function, is prevalent in chronic kidney disease (CKD) increasing the risk of mobility impairment and frailty. CKD leads to metabolic acidosis (MA) and retention of uremic toxins contributing to insulin resistance and impaired muscle mitochondrial energetics. Here we focus on the central role of muscle mitochondrial metabolism in muscle function. Recent findings : Mitochondrial dysfunction underlies muscle wasting and poor physical endurance in CKD. Uremic toxins accumulate in muscle disrupting mitochondrial respiration and enzymes. Changes in m...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Sodium/glucose cotransporter 2 inhibitors in chronic kidney disease and heart failure: ready for prime time in patients without diabetes
Purpose of review The benefits of sodium/glucose cotransporter 2 (SGLT2) inhibitors seem to extend beyond glycemic control. We review recent randomized trial evidence evaluating SGLT2 inhibition in nondiabetic settings, including in patients with chronic kidney disease (CKD) and heart failure (HF). Recent findings DAPA-CKD, DAPA-HF and EMPEROR-Reduced compared SGLT2 inhibitors to placebo, enrolling 5868 patients without diabetes. In DAPA-CKD, patients with an estimated glomerular filtration rate (eGFR) of 25–75 ml/min/1.73 m2 and macroalbuminuria irrespective of kidney disease aetiology had improved cardio...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

How common is primary aldosteronism?
Purpose of review Primary aldosteronism, characterized by renin-independent aldosterone secretion from one or both adrenal glands, is the most common and modifiable form of secondary hypertension. The prevalence of primary aldosteronism is increasingly recognized to be much higher than previously thought with many cases still undetected. Recent findings Prior prevalence studies on primary aldosteronism have reported a wide range of estimates due to heterogeneity of both disease definitions and study populations such that it is difficult to claim a single point estimate. More recent evidence demonstrates that pri...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Recent evidence on the effect of urate-lowering treatment on the progression of kidney disease
Purpose of review Several observational studies have shown that hyperuricemia is associated with chronic kidney disease (CKD) progression and is a potential therapeutic target in people with CKD. This review discusses the results of three recently published placebo-controlled randomized trials evaluating the effect of urate-lowering treatment on the progression of CKD with at least 2 years of follow-up. Recent findings The Febuxostat versus Placebo Randomized Controlled Trial Regarding Reduced Renal Function in Patients with Hyperuricemia Complicated by Chronic Kidney Disease Stage 3 trial evaluated the effect...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Approach to stable angina in patients with advanced chronic kidney disease
Purpose of review Chronic kidney disease is one of the major risk factors for coronary artery disease. Both end-stage renal disease (ESRD) and advanced chronic kidney disease patients have atypical presentations of coronary artery disease (CAD) due to modifications in cardinal symptoms and clinical presentation. Data on evaluation and management of coronary artery or stable angina is limited in advanced chronic kidney disease (CKD) patients due to a limited number of trials. There are sparse data supporting either percutaneous coronary intervention (PCI) or coronary artery bypass graft in advanced CKD patients. Rece...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Timing of kidney replacement therapy initiation in acute kidney injury
Purpose of review Over the past 5 years, four major randomized controlled trials were published informing our practice on the optimal timing for kidney replacement therapy (KRT) initiation in critically ill patients with acute kidney injury (AKI). In this review, we summarize the main findings of these trails and discuss the knowledge gaps that still need to be addressed. Recent findings Four recent trials compared early versus delayed initiation of KRT in critically ill patients with acute kidney injury. Though each trial had unique design features, the three largest trials showed that earlier initiation of KRT...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Pathogenesis of coronavirus disease 2019-associated kidney injury
Purpose of review The current review summarizes the pathologic findings in kidneys from severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-infected patients who have had autopsies or undergone biopsy, and the pathogenic mechanisms implicated in coronavirus disease 2019 (COVID-19)-associated kidney diseases. Recent findings Direct infection of the kidney by SARS-CoV-2 is not common, and convincing morphologic evidence of substantive kidney infection by SARS-CoV-2 is lacking. Severe COVID-19-associated acute kidney injury is likely multifactorial and results from the physiologic disturbances and therapie...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

Apolipoprotein L1 and mechanisms of kidney disease susceptibility
Purpose of review Allelic variants in the gene for apolipoprotein L1 (APOL1), found only in individuals of African ancestry, explain a majority of the excess risk of kidney disease in African Americans. However, a clear understanding how the disease-associated APOL1 variants cause kidney injury and the identity of environmental stressors that trigger the injury process have not been determined. Recent findings Basic mechanistic studies of APOL1 biochemistry and cell biology, bolstered by new antibody reagents and inducible pluripotent stem cell-derived cell systems, have focused on the cytotoxic effect of the ri...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

Complement and kidney disease, new insights
Purpose of review In this review, we discuss recent studies showing the importance of the complement pathway in kidney disease. Recent findings Recent findings in C3 glomerulopathy (C3G) include: acute postinfectious glomerulonephritis is characterised by the presence of antifactor B antibodies; human leukocyte antigen type, but not rare complement gene variation, is associated with primary immunoglobulin-associated membranoproliferative GN and C3G. Immunohistochemistry in C3G shows that factor H related protein 5 (FHR5) is the most prevalent complement protein and correlates with kidney function. A multicentre ...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

Diagnosis of amyloid beyond Congo red
Purpose of review Amyloidoses are a group of rare and heterogeneous diseases in which abnormally folded proteins deposit in tissues and lead to organ damage. A brief review of advances in the diagnosis of extracerebral systemic amyloidoses in the context of recent advances in their clinical management is provided. Recent findings Although steady progress in the treatment of AL and AA has evolved over many years, significant advances in the treatment of ATTR, transthyretin-derived amyloidosis, have been achieved only recently. This coincides with the emergence of nontissue diagnosis of cardiac ATTR in both the he...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

DNA J homolog subfamily B member 9 and other advances in fibrillary glomerulonephritis
Purpose of review Fibrillary glomerulonephritis (FGN) involves ∼1% of native kidney biopsies and is characterized by glomerular deposition of fibrils larger than amyloid (12–24 nm diameter) composed of polyclonal immunoglobulin G (IgG). The recent discovery of DNA J homolog subfamily B member 9 (DNAJB9) in FGN glomerular deposits has contributed a specific and sensitive biomarker, informing morphologic classification and pathogenesis. This review will consider contemporary FGN incidence and genetics, pathogenesis, (lack of) paraprotein association, variants, treatment, and transplantation. Recent findings ...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

Membranous nephropathy: current understanding of various causes in light of new target antigens
This article covers the literature of the last 2 years devoted to the description of those new antigens and biomarkers including NELL-1 and Semaphorin 3B in primary membranous nephropathy, and exostosins 1 and 2 and NCAM in lupus class V membranous nephropathy, which will be compared with the previously described antigens. These findings will lead to propose a new classification of membranous nephropathy based on serology and tissue antigen identification that could/should substitute for the classical distinction between primary and secondary membranous nephropathy. Summary The discovery of the latest antigens has...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

Towards harmony in defining and reporting glomerular diseases on kidney biopsy
Purpose of review To review recent efforts to develop uniformity and precision in defining individual glomerular histologic and ultrastructural lesions and proposals for developing greater uniformity in reporting of glomerular diseases. Recent findings Over the past 2 decades, scoring systems for multiple glomerular diseases have emerged, as have several consortia for the study of glomerular diseases. However, one important limitation faced by renal pathologists and nephrologists has been a lack of uniformity and precision in defining the morphologic lesions seen by light and electron microscopy on which the sco...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

The epidermal growth factor receptor axis and kidney fibrosis
Purpose of review The aim of this study was to summarize recent findings about the role of the epidermal growth factor receptor (EGFR) in acute kidney injury and in progression of chronic kidney injury. Recent findings There is increasing evidence that EGFR activation occurs as a response to either ischemic or toxic kidney injury and EGFR signalling plays an important role in recovery of epithelial integrity. However, with incomplete recovery or in conditions predisposing to progressive glomerular and tubulointerstitial injury, aberrant persistent EGFR signalling is a causal mediator of progressive fibrotic inju...
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - March 31, 2021 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research