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Genetic variants of mineral metabolism in health and disease
Purpose of review Disturbances in mineral metabolism are common among individuals with chronic kidney disease and have consistently been associated with cardiovascular and bone disease. The current review aims to describe the current knowledge of the genetic aspects of mineral metabolism disturbances and to suggest directions for future studies to uncover the cause and pathogenesis of chronic kidney disease – mineral bone disorder. Recent findings The most severe disorders of mineral metabolism are caused by highly penetrant, rare, single-gene disruptive mutations. More recently, genome-wide association studies (GWA...
Source: Current Opinion in Nephrology and Hypertension - May 29, 2020 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Calciprotein particles: mineral behaving badly?
Purpose of review Calciprotein particles (CPP) are formed in supersaturated solutions of calcium, phosphate and the mineral-binding protein fetuin-A. CPP have garnered considerable interest as potential mediators of mineral stress, but little consideration has been given to their origin, clearance and role in metabolism. Recent findings CPP are made whilst buffering the mineral absorbed from the intestine after a meal or during remodelling of bone matrix. The postprandial rise in circulating CPP rise may be sensed by osteoblasts/osteocytes in bone, stimulating the secretion of the master phosphatonin fibroblast growth...
Source: Current Opinion in Nephrology and Hypertension - May 29, 2020 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Circadian rhythms of mineral metabolism in chronic kidney disease–mineral bone disorder
Purpose of review The circadian rhythms have a systemic impact on all aspects of physiology. Kidney diseases are associated with extremely high-cardiovascular mortality, related to chronic kidney disease–mineral bone disorder (CKD–MBD), involving bone, parathyroids and vascular calcification. Disruption of circadian rhythms may cause serious health problems, contributing to development of cardiovascular diseases, metabolic syndrome, cancer, organ fibrosis, osteopenia and aging. Evidence of disturbed circadian rhythms in CKD–MBD parameters and organs involved is emerging and will be discussed in this review. Recent...
Source: Current Opinion in Nephrology and Hypertension - May 29, 2020 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Simultaneous management of disordered phosphate and iron homeostasis to correct fibroblast growth factor 23 and associated outcomes in chronic kidney disease
Purpose of review Hyperphosphatemia, iron deficiency, and anemia are powerful stimuli of fibroblast growth factor 23 (FGF23) production and are highly prevalent complications of chronic kidney disease (CKD). In this manuscript, we put in perspective the newest insights on FGF23 regulation by iron and phosphate and their effects on CKD progression and associated outcomes. We especially focus on new studies aiming to reduce FGF23 levels, and we present new data that suggest major benefits of combined corrections of iron, phosphate, and FGF23 in CKD. Recent findings New studies show that simultaneously correcting iron de...
Source: Current Opinion in Nephrology and Hypertension - May 29, 2020 Category: Urology & Nephrology Tags: MINERAL METABOLISM: Edited by Aline Martin and Tamara Isakova Source Type: research

Editorial: New and repurposed therapeutics for mineral, stone and vascular disorders
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - May 29, 2020 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 - May 29, 2020 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Anemia management in dialysis patients: a PIVOT and a new path?
Purpose of review We will examine the current and future options in management of anemia in dialysis patients focusing on recent trials in iron supplementation and alternatives to erythropoietin-stimulating agents (ESAs). Recent findings We review the literature on Erythropoietin (EPO)-stimulating agents, focusing on the risk benefits of various options available. We review the recent practice changing trial in iron supplementation in dialysis patients with chronic kidney disease and movements in the research on alternatives to EPO-stimulating agents primarily hypoxia-inducible factor prolyl hydroxylase inhibitors (HI...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Assessing physical function in chronic kidney disease
Purpose of review People with chronic kidney disease have a high prevalence of poor physical function, which in turn is associated with poor health-related quality of life, and an increased risk of adverse events, including hospitalizations and all-cause mortality. Implementing early interventions may prove to be effective for preventing decline in physical function; however, it is imperative that clinicians screen patients to identify those at the highest risk of decline. In this review, we present subjective and objective screening tools that can easily and cost-effectively be implemented into routine nephrology practi...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Integrating risk prediction models into chronic kidney disease care
Purpose of review Although the concept of risk prediction in chronic kidney disease (CKD) is not new, how to integrate risk prediction models into CKD care remains largely unknown, particularly in the prevention and early management of CKD. The present review presents a timely overview of recent CKD risk prediction models and conceptualizes how these may be integrated into the care of patients with CKD. Recent findings In recent literature, prediction of time-to-ESKD has been thoroughly validated in multiple international cohorts, new models focused on CKD incidence, morbidity, and mortality have been developed, and o...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Screening for chronic kidney disease: moving toward more sustainable health care
Purpose of review Chronic kidney disease (CKD) is a pervasive and growing health concern that has a significant impact on mortality and morbidity, putting stress on global healthcare systems. CKD affects ∼14% of general populations and ∼36% of high-risk populations and is projected to rise in the coming decade due to increasing rates of diabetes and hypertension. Recent findings Screen, triage, and treat programs aim to detect early stage disease with the intention of promoting medical and lifestyle interventions in line with a patient's level of risk that may slow disease progression and reduce morbidity and mort...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Blood pressure targets in chronic kidney disease: an update on the evidence
Purpose of review Hypertension is the leading modifiable cause of cardiovascular events and of mortality and is generally considered as a direct cause of chronic kidney disease. Defining optimal blood pressure targets in patients with chronic kidney disease is therefore of critical importance. Recent findings Over the recent years, results and post-hoc analyses of several important trials comparing blood pressure targets which included patients with chronic kidney disease have been published. Although these results provide important means to understand the consequences of high blood pressure and to improve the managem...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Applications of machine learning methods in kidney disease: hope or hype?
Purpose of review The universal adoption of electronic health records, improvement in technology, and the availability of continuous monitoring has generated large quantities of healthcare data. Machine learning is increasingly adopted by nephrology researchers to analyze this data in order to improve the care of their patients. Recent findings In this review, we provide a broad overview of the different types of machine learning algorithms currently available and how researchers have applied these methods in nephrology research. Current applications have included prediction of acute kidney injury and chronic kidney d...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: EPIDEMIOLOGY AND PREVENTION: Edited by Navdeep Tangri Source Type: research

Acute kidney injury and maladaptive tubular repair leading to renal fibrosis
Purpose of review Despite improvements in acute kidney injury (AKI) detection, therapeutic options to halt the progression of AKI to chronic kidney disease (CKD) remain limited. In this review, we focus on recent discoveries related to the pathophysiology of the AKI to CKD continuum, particularly involving the renal tubular epithelial cells, and also discuss related ongoing clinical trials. While our focus is on injured renal tubular epithelial cells as initiators of the cascade of events resulting in paracrine effects on other cells of the kidney, the summation of maladaptive responses from various kidney cell types ult...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

The glomerular crescent: triggers, evolution, resolution, and implications for therapy
Purpose of review Crescents are classical histopathological lesions found in severe forms of rapidly progressive glomerulonephritis, also referred to as crescentic glomerulonephritis (CGN). Crescent formation is a consequence of diverse upstream pathomechanisms and unraveling these mechanisms is of great interest for improving the management of patients affected by CGN. Thus, in this review, we provide an update on the latest insight into the understanding on how crescents develop and how they resolve. Recent findings Cellular crescents develop from activated parietal epithelial cells (PECs) residing along Bowman's ca...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research

Parietal epithelial cells role in repair versus scarring after glomerular injury
Purpose of review The recent years have been marked by the publication of several articles highlighting the pathophysiological role of glomerular parietal epithelial cells (PEC) and refining their phenotypic heterogeneity. Recent findings The present review synthetizes recent findings on (i) the potential regenerative role of PEC in glomerular diseases, and (ii) the mechanisms and signaling of leading to PEC pathogenic involvement in crescentic glomerulonephritis (CGN) and focal segmental glomerulosclerosis (FSGS). Summary The debate is still open regarding the podocyte regenerative properties of PEC in glomerular ...
Source: Current Opinion in Nephrology and Hypertension - April 1, 2020 Category: Urology & Nephrology Tags: RENAL IMMUNOLOGY AND PATHOLOGY: Edited by Agnes B. Fogo Source Type: research