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Editorial: Uronephrology: a new nephrology subspecialty
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - January 30, 2020 Category: Urology & Nephrology Tags: CLINICAL NEPHROLOGY: Edited by David S. Goldfarb Source Type: research

Renal effects of SGLT2 inhibitors: an update
Purpose of review SGLT2 inhibitors are a new class of antihyperglycemic drugs that protect kidneys and hearts of type 2 diabetic (T2DM) patients with preserved kidney function from failing. Here we discuss new insights on renal protection. Recent findings Also in T2DM patients with CKD, SGLT2 inhibition causes an immediate functional reduction in glomerular filtration rate (GFR) and reduces blood pressure and preserves kidney and heart function in the long-term, despite a lesser antihyperglycemic effect. According to modeling studies, the GFR reduction reduces the tubular transport work and metabolic demand, thereby i...
Source: Current Opinion in Nephrology and Hypertension - January 30, 2020 Category: Urology & Nephrology Tags: PATHOPHYSIOLOGY OF HYPERTENSION: Edited by Nancy J. Brown Source Type: research

Targeting angiotensinogen with RNA-based therapeutics
Purpose of review To summarize all available data on targeting angiotensinogen with RNA-based therapeutics as a new tool to combat cardiovascular diseases. Recent findings Liver-targeted, stable antisense oligonucleotides and small interfering RNA targeting angiotensinogen are now available, and may allow treatment with at most a few injections per year, thereby improving adherence. Promising results have been obtained in hypertensive animal models, as well as in rodent models of atherosclerosis, polycystic kidney disease and pulmonary fibrosis. The next step will be to evaluate the optimal degree of suppression, syne...
Source: Current Opinion in Nephrology and Hypertension - January 30, 2020 Category: Urology & Nephrology Tags: PATHOPHYSIOLOGY OF HYPERTENSION: Edited by Nancy J. Brown Source Type: research

PPARγ is a gatekeeper for extracellular matrix and vascular cell homeostasis: beneficial role in pulmonary hypertension and renal/cardiac/pulmonary fibrosis
Purpose of review Pulmonary arterial hypertension (PAH) is characterized by pulmonary arterial endothelial cell (PAEC) dysfunction and apoptosis, pulmonary arterial smooth muscle cell (PASMC) proliferation, inflammation, vasoconstriction, and metabolic disturbances that include disrupted bone morphogenetic protein receptor (BMPR2)-peroxisome proliferator-activated receptor gamma (PPARγ) axis and DNA damage. Activation of PPARγ improves many of these mechanisms, although erroneous reports on potential adverse effects of thiazolidinedione (TZD)-class PPARγ agonists reduced their clinical use in the past decade. Here, we...
Source: Current Opinion in Nephrology and Hypertension - January 30, 2020 Category: Urology & Nephrology Tags: PATHOPHYSIOLOGY OF HYPERTENSION: Edited by Nancy J. Brown Source Type: research

PPARγ and RhoBTB1 in hypertension
Purpose of review This review provides an up-to-date understanding of how peroxisome proliferator activated receptor γ (PPARγ) exerts its cardioprotective effect in the vasculature through its activation of novel PPARγ target genes in endothelium and vascular smooth muscle. Recent findings In vascular endothelial cells, PPARγ plays a protective role by increasing nitric oxide bioavailability and preventing oxidative stress. RBP7 is a PPARγ target gene enriched in vascular endothelial cells, which is likely to form a positive feedback loop with PPARγ. In vascular smooth muscle cells, PPARγ antagonizes the reninâ...
Source: Current Opinion in Nephrology and Hypertension - January 30, 2020 Category: Urology & Nephrology Tags: PATHOPHYSIOLOGY OF HYPERTENSION: Edited by Nancy J. Brown Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - January 30, 2020 Category: Urology & Nephrology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Preventing a nonexistent entity: the curious case of contrast and acute kidney injury
Purpose of review In recent years, doubt has been cast on the existence of contrast-induced acute kidney injury. The skepticism has stemmed from observational studies from large administrative healthcare databases. Although they correctly call that contrast-induced acute kidney injury is less common than previously thought, they cannot completely exclude selection bias. Recent findings Though less common than previously thought, contrast-induced acute kidney injury still exists. The only prophylactic method that remains valid is that of isotonic volume expansion, which is still deemed beneficial in high-risk patients....
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: SPECIAL COMMENTARY Source Type: research

Mitigating risk of aldosterone in diabetic kidney disease
Purpose of review Diabetic kidney disease is a growing problem leading to end-stage kidney disease but also atherosclerotic cardiovascular disease and heart failure. Aldosterone is a key risk factor promoting inflammation and fibrosis causing cardio-renal failure. Current options and challenges with mitigating the risk of aldosterone are reviewed. Recent findings More aggressive renin–angiotensin–aldosterone system (RAAS) blockade can be maintained in individuals with hyperkalemia if new potassium binders are added. Aldosterone synthase inhibitors may lower aldosterone without causing hyperkalemia. Novel nonsteroi...
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: HORMONES, AUTACOIDS, NEUROTRANSMITTERS AND GROWTH FACTORS: Edited by Mark Cooper and Merlin Thomas Source Type: research

The emerging role of activins in renal disease
Purpose of review This review highlights recent discoveries and advances that have been made in understanding the role of the TGFβ superfamily members activins, and in particular, activin A (ActA), in renal disease. Recent findings A deleterious role for ActA in renal disease and its complications has begun to emerge. We summarize data supporting an important contribution of ActA to kidney fibrosis and inflammation of varying causes, as well as its role in the development of a particular bone mineral disorder seen in chronic kidney disease (CKD) called mineral bone disorder (MBD), including vascular calcification. Fi...
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: HORMONES, AUTACOIDS, NEUROTRANSMITTERS AND GROWTH FACTORS: Edited by Mark Cooper and Merlin Thomas Source Type: research

Nuclear factor erythroid 2-related factor 2 as a treatment target of kidney diseases
Purpose of review Nuclear factor erythroid 2-related factor 2 (Nrf2) is a transcription factor which regulates a wider range of downstream pathways than previously thought. This review focuses on the novel findings about the internal regulatory mechanisms of Nrf2, the expanding understanding of its role in maintaining cellular homeostasis and the attempts to broaden the clinical application of its activators. Recent findings Nrf2 is in charge of the maintenance of cellular homeostasis under stress and there exist the internal regulatory mechanisms for Nrf2 which have recently been elucidated. New downstream pathways o...
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: HORMONES, AUTACOIDS, NEUROTRANSMITTERS AND GROWTH FACTORS: Edited by Mark Cooper and Merlin Thomas Source Type: research

Promoting resolution in kidney disease: are we nearly there yet?
We describe our current understanding of SPMs for this purpose in acute and chronic kidney disease. These studies cement the place of inflammation and its defective resolution in the pathogenesis of kidney disease, and highlight new avenues for therapy. Summary Targeting resolution of inflammation is a viable approach to treating kidney disease. We optimistically look forward to translating these experimental advances into tractable therapeutics to treat kidney disease. (Source: Current Opinion in Nephrology and Hypertension)
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: HORMONES, AUTACOIDS, NEUROTRANSMITTERS AND GROWTH FACTORS: Edited by Mark Cooper and Merlin Thomas Source Type: research

Renoprotective effects of sodium-glucose cotransporter-2 inhibitors and underlying mechanisms
Purpose of review Emerging data have demonstrated that sodium-glucose cotransporter-2 (SGLT2) inhibitors prevent cardiovascular events, especially heart failure-associated endpoints. Cardiovascular outcome trials have also suggested their renoprotective effects. One large clinical trial investigated renal primary endpoints and demonstrated that SGLT2 inhibitors slowed the progression of diabetic kidney disease (DKD). This review summarizes clinical trial data on renal outcomes and discusses potential underlying mechanisms. Recent findings The EMPA-REG, CANVAS, and DECLARE-TIMI 58 studies revealed that SGLT2 inhibitors...
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: HORMONES, AUTACOIDS, NEUROTRANSMITTERS AND GROWTH FACTORS: Edited by Mark Cooper and Merlin Thomas Source Type: research

Renoprotection in diabetic kidney disease: can incretin-based therapies deliver?
Purpose of review Incretin-based therapies mimic or augment the gut-hormone glucagon-like peptide (GLP)-1 and, due to their glucose-lowering potential and beneficial safety profile, as well as their cardiovascular safety and/or protection, are prescribed on a large scale to treat individuals with type 2 diabetes (T2D). However, whether the two drug-classes that belong to this category, respectively GLP-1 receptor agonists and dipeptidyl peptidase (DPP)-4 inhibitors, also reduce the risk of diabetic kidney disease (DKD) is at present heavily debated. This review aims to discuss the current evidence. Recent findings Evi...
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: HORMONES, AUTACOIDS, NEUROTRANSMITTERS AND GROWTH FACTORS: Edited by Mark Cooper and Merlin Thomas Source Type: research

Conservative vs. preservative management of chronic kidney disease: similarities and distinctions
Purpose of review Dialysis has been the prevailing treatment paradigm in advanced chronic kidney disease (CKD) for patients ineligible for or unlikely to receive kidney transplantation. As dialysis may neither offer survival benefit nor improved quality of life in certain groups, there has been increasing interest in conservative management as an alternative approach. Recent findings Experts and workgroups suggest the main goals of conservative management are to optimize quality of life, treat symptoms of end-stage renal disease without dialysis or transplant, and improve survival and cardiovascular health. Given the ...
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Kamyar Kalantar-Zadeh and Ekamol Tantisattamo Source Type: research

Novel options for failing allograft in kidney transplanted patients to avoid or defer dialysis therapy
Purpose of review Despite improvement in short-term renal allograft survival in recent years, renal transplant recipients (RTR) have poorer long-term allograft outcomes. Allograft function slowly declines with periods of stable function similar to natural progression of chronic kidney disease in nontransplant population. Nearly all RTR transitions to failing renal allograft (FRG) period and require transition to dialysis. Conservative chronic kidney disease management before transition to end-stage renal disease is an increasingly important topic; however, there is limited data in RTR regarding how to delay dialysis init...
Source: Current Opinion in Nephrology and Hypertension - November 29, 2019 Category: Urology & Nephrology Tags: NOVEL THERAPEUTIC APPROACHES IN NEPHROLOGY AND HYPERTENSION: Edited by Kamyar Kalantar-Zadeh and Ekamol Tantisattamo Source Type: research