Diabetes: Excess mortality in well-controlled T1DM without renal disease
Nature Reviews Nephrology 11, 132 (2015). doi:10.1038/nrneph.2014.249 Authors: Janaka Karalliedde & Giancarlo Viberti The authors of a new study report that independent of renal disease, any level of glycaemia is associated with increased mortality risk in patients with type 1 diabetes mellitus. However, this view may be overly simplistic—a multifactorial approach is required to reduce excess mortality in this population. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - January 20, 2015 Category: Urology & Nephrology Authors: Janaka KarallieddeGiancarlo Viberti Tags: News and Views Source Type: research

Clinical trials: Rituximab for maintenance of remission in AAV
Nature Reviews Nephrology 11, 131 (2015). doi:10.1038/nrneph.2014.254 Authors: Anisha Tanna & Charles Pusey Maintenance therapy for antineutrophil cytoplasmic antibody-associated vasculitis (AAV) should reduce rates of relapse with minimal toxicity. The MAINRITSAN trial—the first randomized controlled trial to compare the efficacies of rituximab and azathioprine in AAV remission maintenance—has demonstrated a superior outcome using rituximab. These data have important implications for the management of AAV. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - January 20, 2015 Category: Urology & Nephrology Authors: Anisha TannaCharles Pusey Tags: News and Views Source Type: research

Clinical trials: Renal safety of TDF as pre-exposure prophylaxis for HIV-1 infection
Nature Reviews Nephrology 11, 127 (2015). doi:10.1038/nrneph.2015.1 Author: Ellen F. Carney Use of tenofovir disoproxil fumarate (TDF) as an antiretroviral therapy is associated with declines in estimated glomerular filtration rate (eGFR) in patients with HIV-1 infection. TDF is also used as a pre-exposure prophylaxis (PrEP) in adults at risk of HIV-1 infection, but limited data are (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - January 20, 2015 Category: Urology & Nephrology Authors: Ellen F. Carney Tags: Research Highlight Source Type: research

Diverse origins of the myofibroblast—implications for kidney fibrosis
Nature Reviews Nephrology 11, 233 (2015). doi:10.1038/nrneph.2014.246 Authors: Lucas L. Falke, Shima Gholizadeh, Roel Goldschmeding, Robbert J. Kok & Tri Q. Nguyen Fibrosis is the common end point of chronic kidney disease. The persistent production of inflammatory cytokines and growth factors leads to an ongoing process of extracellular matrix production that eventually disrupts the normal functioning of the organ. During fibrosis, the myofibroblast is commonly regarded as (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - January 13, 2015 Category: Urology & Nephrology Authors: Lucas L. FalkeShima GholizadehRoel GoldschmedingRobbert J. KokTri Q. Nguyen Tags: Review Source Type: research

Glomerular disease in 2014: Advances in basic science and translational medicine
Nature Reviews Nephrology 11, 67 (2015). doi:10.1038/nrneph.2014.248 Authors: Fernando C. Fervenza & Sanjeev Sethi Knowledge of the pathogenesis of glomerular disease and approaches to therapy continued to advance in 2014. Key studies identified thrombospondin type-1 domain-containing protein 7A as an antigenic target in primary membranous nephropathy, and demonstrated efficacy of rituximab as maintenance therapy in relapsing or steroid-dependent nephrotic syndrome and antineutrophil cytoplasmic antibody-associated vasculitis. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - January 13, 2015 Category: Urology & Nephrology Authors: Fernando C. FervenzaSanjeev Sethi Tags: Year in Review Source Type: research

Cardiac imaging in patients with chronic kidney disease
Nature Reviews Nephrology 11, 207 (2015). doi:10.1038/nrneph.2014.243 Authors: Diana Y. Y. Chiu, Darren Green, Nik Abidin, Smeeta Sinha & Philip A. Kalra Patients with chronic kidney disease (CKD) carry a high cardiovascular risk. In this patient group, cardiac structure and function are frequently abnormal and 74% of patients with CKD stage 5 have left ventricular hypertrophy (LVH) at the initiation of renal replacement therapy. Cardiac changes, such (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - January 6, 2015 Category: Urology & Nephrology Authors: Diana Y. Y. ChiuDarren GreenNik AbidinSmeeta SinhaPhilip A. Kalra Tags: Review Source Type: research

Acute kidney injury in 2014: A step towards understanding mechanisms of renal repair
Nature Reviews Nephrology 11, 74 (2015). doi:10.1038/nrneph.2014.245 Authors: Azra Bihorac & John A. Kellum In 2014, key articles in the field of acute kidney injury highlighted the importance of tubular homeostasis in renal regeneration. Cell cycle regulators, inflammatory signals and progenitors were identified as important factors that mediate the balance between inflammation and tubular regeneration necessary for renal repair. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - January 6, 2015 Category: Urology & Nephrology Authors: Azra BihoracJohn A. Kellum Tags: Year in Review Source Type: research

Renal artery embolization—indications, technical approaches and outcomes
Nature Reviews Nephrology 11, 288 (2015). doi:10.1038/nrneph.2014.231 Authors: Arnaud Muller & Olivier Rouvière Owing to improvements in catheters and embolic agents, renal artery embolization (RAE) is increasingly used to treat nephrological and urological disease. RAE has become a useful adjunct to medical resuscitation in severe penetrating, iatrogenic or blunt renal traumatisms with active bleeding, and might avoid surgical (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 23, 2014 Category: Urology & Nephrology Authors: Arnaud MullerOlivier Rouvière Tags: Review Source Type: research

HNF1B-associated renal and extra-renal disease—an expanding clinical spectrum
Nature Reviews Nephrology 11, 102 (2015). doi:10.1038/nrneph.2014.232 Authors: Rhian L. Clissold, Alexander J. Hamilton, Andrew T. Hattersley, Sian Ellard & Coralie Bingham Heterozygous mutations in the gene that encodes the transcription factor hepatocyte nuclear factor 1β (HNF1B) represent the most common known monogenic cause of developmental kidney disease. Renal cysts are the most frequently detected feature of HNF1B-associated kidney disease; however, other structural abnormalities, including (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 23, 2014 Category: Urology & Nephrology Authors: Rhian L. ClissoldAlexander J. HamiltonAndrew T. HattersleySian EllardCoralie Bingham Tags: Review Source Type: research

Fibrosis: Dysfunctional fatty acid oxidation in renal fibrosis
Nature Reviews Nephrology 11, 64 (2015). doi:10.1038/nrneph.2014.244 Author: Susan J. Allison Accumulation of lipid in tubular epithelial cells has been proposed to have a pathogenic role in the development of renal fibrosis. New findings, however, indicate that dysfunctional fatty acid oxidation rather than intracellular lipid accumulation per se induces the development of renal fibrosis.Fibrosis (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 23, 2014 Category: Urology & Nephrology Authors: Susan J. Allison Tags: Research Highlight Source Type: research

Kidney care in Haiti—the role of partnerships
Nature Reviews Nephrology 11, 183 (2015). doi:10.1038/nrneph.2014.239 Authors: Brian D. Remillard, Jean H. Buteau & Philip Cléophat Establishing a programme for the prevention and treatment of acute kidney injury, chronic kidney disease and end-stage renal disease in a developing country involves unique challenges. We became involved in a collaborative effort to improve nephrology care in Haiti after participating in the emergency response (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 16, 2014 Category: Urology & Nephrology Authors: Brian D. RemillardJean H. ButeauPhilip Cléophat Tags: Perspectives Source Type: research

Polycystic kidney disease: HALTing PKD progression—revival of blood pressure control
Nature Reviews Nephrology 11, 129 (2015). doi:10.1038/nrneph.2014.241 Author: Thomas Benzing New research suggests that rigorous blood pressure control is beneficial in early autosomal dominant polycystic kidney disease (ADPKD). Although a positive effect on the rate of decline of estimated glomerular filtration rate remains to be demonstrated, this study is likely to change current treatment strategies for young patients with ADPKD. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 16, 2014 Category: Urology & Nephrology Authors: Thomas Benzing Tags: News and Views Source Type: research

Renal transplantation in 2014: Renal transplantation—reducing risk and improving outcome
Nature Reviews Nephrology 11, 72 (2015). doi:10.1038/nrneph.2014.240 Authors: Dennis A. Hesselink & Willem Weimar Several studies published in 2014 might facilitate improvements in the treatment and long-term care of renal transplant recipients. The potential risks of living kidney donation, the efficacy and safety of alemtuzumab-based induction therapy, and the treatment of chronic hepatitis E virus infection have been addressed. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 16, 2014 Category: Urology & Nephrology Authors: Dennis A. HesselinkWillem Weimar Tags: Year in Review Source Type: research

Cardiovascular disease in CKD in 2014: New insights into cardiovascular risk factors and outcomes
Nature Reviews Nephrology 11, 70 (2015). doi:10.1038/nrneph.2014.242 Authors: Pantelis A. Sarafidis & George L. Bakris Chronic kidney disease (CKD) is an established independent risk factor for increased cardiovascular events and cardiovascular mortality. During 2014, several research efforts focused on clarifying the complex pathophysiology, assessing the prognostic associations and improving the treatment of cardiovascular disease in patients with CKD. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 16, 2014 Category: Urology & Nephrology Authors: Pantelis A. SarafidisGeorge L. Bakris Tags: Year in Review Source Type: research

Urea transporter proteins as targets for small-molecule diuretics
Nature Reviews Nephrology 11, 113 (2015). doi:10.1038/nrneph.2014.219 Authors: Cristina Esteva-Font, Marc O. Anderson & Alan S. Verkman Conventional diuretics such as furosemide and thiazides target salt transporters in kidney tubules, but urea transporters (UTs) have emerged as alternative targets. UTs are a family of transmembrane channels expressed in a variety of mammalian tissues, in particular the kidney. UT knockout mice and humans (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 9, 2014 Category: Urology & Nephrology Authors: Cristina Esteva-FontMarc O. AndersonAlan S. Verkman Tags: Review Source Type: research

Diabetic nephropathy in 2014: Improved cardiorenal prognosis in diabetic nephropathy
Nature Reviews Nephrology 11, 68 (2015). doi:10.1038/nrneph.2014.238 Authors: Hans-Henrik Parving & Peter Rossing In 2014, key studies in the field of diabetic nephropathy highlighted the importance of albuminuria as a predictor of cardiovascular risk and showed that the incidence of renal and cardiovascular complications is decreasing. Promising efficacy data were obtained with atrasentan, whereas a trial of bardoxolone methyl led to safety concerns. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 9, 2014 Category: Urology & Nephrology Authors: Hans-Henrik ParvingPeter Rossing Tags: Year in Review Source Type: research

Glomerular disease: Autophagy failure and mitochondrial dysfunction in FSGS
Nature Reviews Nephrology 11, 66 (2015). doi:10.1038/nrneph.2014.233 Author: Ellen F. Carney Researchers report that failure of autophagy may be a central mechanism in the pathogenesis of focal segmental glomerulosclerosis (FSGS). Jeremy Duffield and colleagues showed that abrogation of autophagic pathways in murine nephrons is sufficient to recreate many of the characteristic features of the human disease. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 9, 2014 Category: Urology & Nephrology Authors: Ellen F. Carney Tags: Research Highlight Source Type: research

Sepsis: β1-adrenoreceptor blockade in sepsis
Nature Reviews Nephrology 11, 64 (2015). doi:10.1038/nrneph.2014.237 Activation of the sympathetic nervous system during sepsis is thought to be beneficial; however, excessive activation might cause damage. A new study to determine the effects of selective β1-adrenoceptor blockade on cardiac and renal function in sheep with hyperdynamic sepsis found that atenolol reduced heart (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 9, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Basic research: Role of mTOR in regulation of ENaC activity
Nature Reviews Nephrology 11, 64 (2015). doi:10.1038/nrneph.2014.236 The epithelial Na+ channel (ENaC) is a key regulator of Na+ homeostasis and new findings show that mammalian target of rapamycin (mTOR) can modulate ENaC function. Gleason et al. found that administration of mTOR inhibitors to mice prevented mTOR-dependent (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 9, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Transplantation: Sirolimus: effects on malignancy and survival
Nature Reviews Nephrology 11, 64 (2015). doi:10.1038/nrneph.2014.235 Use of sirolimus after kidney transplantation is associated with a reduced risk of malignancy but an increased overall risk of death, according to findings of a systematic review and meta-analysis. Knoll and colleagues analysed data from 5,876 participants of randomized controlled trials that compared immunosuppressive (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 9, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Chronic kidney disease: MicroRNA inhibition in Alport syndrome
Nature Reviews Nephrology 11, 64 (2015). doi:10.1038/nrneph.2014.234 Inhibition of microRNA (miRNA)-21 could represent a therapeutic strategy for the treatment of chronic kidney diseases, including Alport nephropathy, say the researchers of a new study. Gomez et al. assessed the therapeutic potential of highly specific oligonucleotides that distribute to the kidney and (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 9, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Chronic kidney disease: Arterial stiffness and renal function—a complex relationship
Nature Reviews Nephrology 11, 11 (2015). doi:10.1038/nrneph.2014.226 Authors: Paolo Salvi & Gianfranco Parati New data suggest that aortic stiffness results in the transmission of excessive flow pulsatility to the renal microcirculation. Further understanding of the mechanisms that regulate the relationship between large arteries and the renal microcirculation could lead to new strategies to protect the kidneys from increased blood pressure load owing to systemic hypertension. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 9, 2014 Category: Urology & Nephrology Authors: Paolo SalviGianfranco Parati Tags: News and Views Source Type: research

Causes and pathogenesis of focal segmental glomerulosclerosis
Nature Reviews Nephrology 11, 76 (2015). doi:10.1038/nrneph.2014.216 Author: Agnes B. Fogo Focal segmental glomerulosclerosis (FSGS) describes both a common lesion in progressive kidney disease, and a disease characterized by marked proteinuria and podocyte injury. The initial injuries vary widely. Monogenetic forms of FSGS are largely due to alterations in structural genes of the podocyte, many of (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 2, 2014 Category: Urology & Nephrology Authors: Agnes B. Fogo Tags: Review Source Type: research

Transplantation: Induction of chimerism and immune tolerance using belatacept
Nature Reviews Nephrology 11, 66 (2015). doi:10.1038/nrneph.2014.230 Author: Ellen F. Carney A new study has demonstrated successful induction of transient mixed chimerism and long-term renal allograft tolerance in cynomolgus monkeys using a conditioning regimen that includes belatacept. This CTLA4–Ig fusion protein blocks T-cell costimulation by binding to B7 molecules expressed on antigen presenting cells.Researcher Tatsuo (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 2, 2014 Category: Urology & Nephrology Authors: Ellen F. Carney Tags: Research Highlight Source Type: research

Risk factors: Sickle cell trait increases the risk of chronic kidney disease
Nature Reviews Nephrology 11, 65 (2015). doi:10.1038/nrneph.2014.229 Author: Jessica K. Edwards Data regarding the health consequences of sickle cell trait (SCT)—including a potential relationship with impairment of renal function— are conflicting. A large prospective population-based study by Alexander Reiner and colleagues has now shown that SCT is associated with an increased risk of chronic kidney disease (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 2, 2014 Category: Urology & Nephrology Authors: Jessica K. Edwards Tags: Research Highlight Source Type: research

Transplantation: Levofloxacin treatment does not prevent BK virus infection
Nature Reviews Nephrology 11, 65 (2015). doi:10.1038/nrneph.2014.228 Author: Ian Fyfe A 3-month course of levofloxacin does not prevent BK viruria after kidney transplantation but does increase the risk of adverse events, according to data from a new study. “Quinolone prophylaxis was ineffective in preventing BK viruria ... this finding contradicts previous observational data,” says senior (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 2, 2014 Category: Urology & Nephrology Authors: Ian Fyfe Tags: Research Highlight Source Type: research

Glomerular disease: Thrombospondin type-1 domain-containing 7A—a new player in membranous nephropathy
Nature Reviews Nephrology 11, 63 (2015). doi:10.1038/nrneph.2014.227 Author: Susan J. Allison In 2009, the podocyte receptor phospholipase A2 receptor 1 (PLA2R1) was identified as the first major autoantigen involved in the pathogenesis of adult idiopathic membranous nephropathy (iMN). Subsequent studies confirmed circulating autoantibodies to PLA2R1 in approximately 70% of affected patients; however, the cause of disease (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 2, 2014 Category: Urology & Nephrology Authors: Susan J. Allison Tags: Research Highlight Source Type: research

Histopathology of MPGN and C3 glomerulopathies
Nature Reviews Nephrology 11, 14 (2015). doi:10.1038/nrneph.2014.217 Authors: H. Terence Cook & Matthew C. Pickering 'Membranoproliferative' describes glomerular injury characterized by capillary wall thickening and mesangial expansion owing to increased matrix deposition and hypercellularity. The presence of immune deposits is indicative of membranoproliferative glomerulonephritis (MPGN). Historically, MPGN was further classified into three types according to the appearance and site of (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - December 2, 2014 Category: Urology & Nephrology Authors: H. Terence CookMatthew C. Pickering Tags: Review Source Type: research

Treatment of severe lupus nephritis: the new horizon
Nature Reviews Nephrology 11, 46 (2015). doi:10.1038/nrneph.2014.215 Author: Tak Mao Chan Lupus nephritis is a common and severe manifestation of systemic lupus erythematosus, and an important cause of both acute kidney injury and end-stage renal disease. Despite its aggressive course, lupus nephritis is amenable to treatment in the majority of patients. The paradigm of immunosuppressive treatment (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 25, 2014 Category: Urology & Nephrology Authors: Tak Mao Chan Tags: Review Source Type: research

Podocyte biology: Differentiation of parietal epithelial cells into podocytes
Nature Reviews Nephrology 11, 7 (2015). doi:10.1038/nrneph.2014.218 Authors: Elena Lazzeri & Paola Romagnani A new study demonstrates that knockdown of miR-193a in human parietal epithelial cells induces their differentiation into podocytes. Inhibition of miR-193a in a model of nephrotoxic nephritis resulted in reduced proteinuria and crescent formation. These data suggest that promoting differentiation of parietal progenitors into podocytes has potential therapeutic relevance. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 25, 2014 Category: Urology & Nephrology Authors: Elena LazzeriPaola Romagnani Tags: News and Views Source Type: research

Acute kidney injury: Effect of perioperative aspirin and clonidine on AKI
Nature Reviews Nephrology 11, 4 (2015). doi:10.1038/nrneph.2014.224 Author: Susan J. Allison New findings, presented at ASN Kidney Week, show that perioperative administration of aspirin or clonidine does not reduce the risk of acute kidney injury (AKI) among patients undergoing noncardiac surgery. “These results support the practice of halting aspirin use in the perioperative period among patients (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 25, 2014 Category: Urology & Nephrology Authors: Susan J. Allison Tags: Research Highlight Source Type: research

Polycystic kidney disease: Pathogenic missense mutations result in defective trafficking of polycystin-1 to cilia
Nature Reviews Nephrology 11, 4 (2015). doi:10.1038/nrneph.2014.222 Author: Jessica K. Edwards A new study suggests that missense variants in PKD1 contribute to the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD) through altered G-protein site (GPS) cleavage and aberrant cilial expression of its protein product polycystin-1. The way in which these missense mutations promote disease (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 25, 2014 Category: Urology & Nephrology Authors: Jessica K. Edwards Tags: Research Highlight Source Type: research

Lupus nephritis: Multitarget induction therapy for LN
Nature Reviews Nephrology 11, 3 (2015). doi:10.1038/nrneph.2014.225 Author: Susan J. Allison Multitarget therapy should be considered as an alternative to conventional therapy for induction treatment of lupus nephritis (LN), say the authors of a new study. Zhi-Hong Liu and colleagues found that patients who received multitarget therapy, comprising mycophenolate mofetil, tacrolimus and steroids, were more likely (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 25, 2014 Category: Urology & Nephrology Authors: Susan J. Allison Tags: Research Highlight Source Type: research

Atrial fibrillation: Risk of bleeding with dabigatran versus warfarin particularly high in CKD
Nature Reviews Nephrology 11, 3 (2015). doi:10.1038/nrneph.2014.221 Author: Ellen F. Carney In patients with atrial fibrillation, use of dabigatran etexilate mesylate was associated with a significantly higher risk of bleeding than was use of warfarin sodium. This new finding from a retrospective cohort study by Yuting Zhang and colleagues is in contrast to the results of (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 25, 2014 Category: Urology & Nephrology Authors: Ellen F. Carney Tags: Research Highlight Source Type: research

Transplantation: Role of AECAS in graft rejection
Nature Reviews Nephrology 11, 3 (2015). doi:10.1038/nrneph.2014.220 Author: Ellen F. Carney Evidence from clinical studies has implicated non-HLA anti-endothelial cell antibodies (AECAs) in transplant rejection. However, the pathogenic mechanisms by which these antibodies might contribute to renal allograft dysfunction are not well understood. Now, new data from Annette Jackson, Tara Sigdel, Minnie Sarwal and colleagues suggest (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 25, 2014 Category: Urology & Nephrology Authors: Ellen F. Carney Tags: Research Highlight Source Type: research

Transplantation: Pregnancy outcomes in living kidney donors
Nature Reviews Nephrology 11, 2 (2015). doi:10.1038/nrneph.2014.223 Author: Ellen F. Carney New findings suggest that the incidences of gestational hypertension and pre-eclampsia might be increased in kidney donors compared with nondonors. Researchers Amit Garg and colleagues—who presented these data at ASN Kidney Week—highlight the need to inform women of childbearing age who are thinking about donating (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 25, 2014 Category: Urology & Nephrology Authors: Ellen F. Carney Tags: Research Highlight Source Type: research

Mineral metabolism: Proteinuria increases phosphate retention
Nature Reviews Nephrology 11, 2 (2015). doi:10.1038/nrneph.2014.214 A pathophysiologic link exists between proteinuria and renal phosphate handling, say researchers. An analysis of 1,738 patients with chronic kidney disease identified albuminuria ≥300 mg per 24 h as an independent predictor of high phosphate levels. Using both rat and mouse animal models, the researchers (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 18, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Transplantation: Disproportionate stunting in children with ESRD
Nature Reviews Nephrology 11, 2 (2015). doi:10.1038/nrneph.2014.213 Children with end-stage renal disease (ESRD) exhibit marked disproportionate stunting, according to a new study. A low average body height, but high average sitting height index during early childhood was identified in a cohort of 389 paediatric renal transplant recipients, as compared with reference data. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 18, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Risk factors: Co-trimoxazole associated with increased mortality
Nature Reviews Nephrology 11, 2 (2015). doi:10.1038/nrneph.2014.212 New research suggests that administration of co-trimoxazole in patients aged ≥66 years receiving angiotensin-converting-enzyme inhibitors or angiotensin-receptor blockers is associated with an increased risk of sudden death compared with administration of amoxicillin. In this case-controlled study, approximately three deaths within 14 days occurred per 1,000 (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 18, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Epidemiology: Genetic association between renal function and stroke
Nature Reviews Nephrology 11, 2 (2015). doi:10.1038/nrneph.2014.211 Using polygenic models constructed from genome-wide association study data, researchers have shown that polygenic scores that correlate with high estimated glomerular filtration rate are associated with a reduced risk of large artery atherosclerosis. They suggest that the association between renal disease and stroke might be (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 18, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Immunology: IgG1 protects against renal disease induced by pathogenic antibody isotypes
Nature Reviews Nephrology 11, 1 (2015). doi:10.1038/nrneph.2014.210 Author: Susan J. Allison Immunoglobulin isotypes that poorly activate effector mechanisms that protect the host against pathogens can induce anti-inflammatory effects and protect against immune-complex-dependent renal disease, according to new research. “Our findings indicate that less pathogenic antibody isotypes, such as mouse IgG1 and probably human IgG4, can protect (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 18, 2014 Category: Urology & Nephrology Authors: Susan J. Allison Tags: Research Highlight Source Type: research

Mechanisms and biological functions of autophagy in diseased and ageing kidneys
Nature Reviews Nephrology 11, 34 (2015). doi:10.1038/nrneph.2014.201 Authors: Sophie Fougeray & Nicolas Pallet Autophagy degrades pathogens, altered organelles and protein aggregates, and is characterized by the sequestration of cytoplasmic cargos within double-membrane-limited vesicles called autophagosomes. The process is regulated by inputs from the cellular microenvironment, and is activated in response to nutrient scarcity and immune triggers, which signal (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 11, 2014 Category: Urology & Nephrology Authors: Sophie FougerayNicolas Pallet Tags: Review Source Type: research

MicroRNAs in kidney physiology and disease
Nature Reviews Nephrology 11, 23 (2015). doi:10.1038/nrneph.2014.202 Authors: Piera Trionfini, Ariela Benigni & Giuseppe Remuzzi MicroRNAs (miRNAs) are small non-coding RNA molecules that regulate gene expression. They have important roles during kidney development, homeostasis and disease. In particular, miRNAs participate in the onset and progression of tubulointerstitial sclerosis and end-stage glomerular lesions that occur in various forms of chronic kidney (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 11, 2014 Category: Urology & Nephrology Authors: Piera TrionfiniAriela BenigniGiuseppe Remuzzi Tags: Review Source Type: research

Sepsis: Protocolized care for critically ill patients with AKI
Nature Reviews Nephrology 11, 10 (2015). doi:10.1038/nrneph.2014.204 Authors: Bantayehu Sileshi & Andrew Shaw Findings from the ARISE and TRISS trials indicate that protocolized therapy might be no better than contemporary management for patients in intensive care, and that in the absence of coronary disease a haemoglobin level of 70 g/l should be the new trigger for transfusion in patients with sepsis. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 4, 2014 Category: Urology & Nephrology Authors: Bantayehu SileshiAndrew Shaw Tags: News and Views Source Type: research

Outlook: Implications of climate change for nephrology
Nature Reviews Nephrology 11, 8 (2015). doi:10.1038/nrneph.2014.199 Authors: Charles Tomson & Andrew Connor It is now accepted that climate change is occurring as a result of human activity and that it will have potentially devastating effects on health. Nephrologists are likely to see a changing spectrum of disease as a consequence of climate change and are ideally placed to lead mitigating strategies in health-care provision. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 4, 2014 Category: Urology & Nephrology Authors: Charles TomsonAndrew Connor Tags: News and Views Source Type: research

Diabetes: Risks of strict glycaemic control in diabetic nephropathy
Nature Reviews Nephrology 11, 5 (2015). doi:10.1038/nrneph.2014.209 Authors: Martin H. de Borst & Gerjan Navis A 6-year follow-up study of the ADVANCE trial participants reports that intensive glycaemic control is renoprotective—but does not reduce mortality—in patients with type 2 diabetes mellitus. By contrast, a post hoc analysis of the ACCORD trial suggests that intensive glycaemic control might increase mortality in patients with diabetic nephropathy. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 4, 2014 Category: Urology & Nephrology Authors: Martin H. de BorstGerjan Navis Tags: News and Views Source Type: research

Diabetes: Statins for microvascular complications—all but the kidney
Nature Reviews Nephrology 10, 680 (2014). doi:10.1038/nrneph.2014.203 Authors: Kumar Sharma & Loki Natarajan A new study shows that statin therapy before diagnosis of diabetes mellitus is not associated with an increased risk of microvascular disease and might even be beneficial for retinopathy and neuropathy. These data suggest a potential protective effect of statins in specific complications, which should be further investigated in randomized controlled trials. (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 4, 2014 Category: Urology & Nephrology Authors: Kumar SharmaLoki Natarajan Tags: News and Views Source Type: research

Cardiovascular disease: Role for Klotho and phosphate in cardiac remodelling
Nature Reviews Nephrology 10, 674 (2014). doi:10.1038/nrneph.2014.208 Klotho deficiency is a mediator of pathologic cardiac remodelling, and fibroblast growth factor (FGF)-23 might contribute to this process in the settings of chronic kidney disease (CKD) and ageing, conclude the authors of a new study. Hu et al. found that mice with (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 4, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Dialysis: Sex-specific differences in haemodialysis practices
Nature Reviews Nephrology 10, 674 (2014). doi:10.1038/nrneph.2014.207 An analysis of 35,964 patients by Dialysis Outcomes and Practice Patterns Study (DOPPS) researchers has revealed sex--specific differences in haemodialysis use. Among these patients, more men than women were on haemodialysis (59% versus 41%, respectively). The researchers also found that the survival advantage of women (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 4, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research

Acute kidney injury: TRPM2 and RAC1: mediators of oxidative stress in AKI
Nature Reviews Nephrology 10, 674 (2014). doi:10.1038/nrneph.2014.206 Kidney ischaemia is associated with a loss of intracellular potassium and an increase in intracellular levels of sodium, chloride and calcium; however, the mechanisms involved in the loss of cellular ion homeostasis are unknown. A new study has revealed a critical role for the nonselective (Source: Nature Reviews Nephrology)
Source: Nature Reviews Nephrology - November 4, 2014 Category: Urology & Nephrology Tags: Research Highlight Source Type: research