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Novel iron-containing phosphate binders and anemia treatment in CKD: oral iron intake revisited
Recent reports have shown that novel phosphate binders containing iron are not only efficacious for the treatment of hyperphosphatemia but also may reduce the need for erythropoiesis-stimulating agents and intravenous (IV) iron for anemia management in patients on maintenance hemodialysis (MHD). Possible healthcare cost savings, which have not been demonstrated in a long-term study, may be an additional advantage of using such multi-pronged treatment strategies for the control of both hyperphosphatemia and iron needs. It is currently assumed that oral iron supplementation is less efficient than the IV route in patients wit...
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Nakanishi, T., Hasuike, Y., Nanami, M., Yahiro, M., Kuragano, T. Tags: REVIEWS - CLINICAL SCIENCE AND OUTCOME RESEARCH IN NEPHROLOGY Source Type: research

Fetuin-A-containing calciprotein particles in mineral trafficking and vascular disease
Calcium and phosphate combine to form insoluble precipitates in both inorganic and organic materials. This property is useful biologically and has been used by numerous organisms to create hard tissues, a process referred to as biomineralisation [1]. In humans, calcium and phosphate combine to form useful crystal structures largely composed of calcium hydroxyapatite [Ca10(PO4)6(OH)2] and these are essential in the growth, maintenance and strength of parts of the skeleton and other structures like teeth. However, it remains unclear how the body achieves the exquisite specificity involved in biomineralisation. In ageing and ...
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Holt, S. G., Smith, E. R. Tags: REVIEWS - BASIC SCIENCE AND TRANSLATIONAL NEPHROLOGY Source Type: research

Targeting the podocyte cytoskeleton: from pathogenesis to therapy in proteinuric kidney disease
Glomerular injury often incites a progression to chronic kidney disease, which affects millions of patients worldwide. Despite our current understanding of this disease's pathogenesis, there is still a lack of therapy available to curtail its progression. However, exciting new data strongly suggest the podocyte—an actin-rich, terminally differentiated epithelial cell that lines the outside of the glomerular filtration barrier—as a therapeutic target. The importance of podocytes in the pathogenesis of human nephrotic syndrome is best characterized by identification of genetic mutations, many of which regulate th...
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Tian, X., Ishibe, S. Tags: REVIEWS - BASIC SCIENCE AND TRANSLATIONAL NEPHROLOGY Source Type: research

Moderator's view: The use of calcineurin inhibitors in the treatment of lupus nephritis
Lupus nephritis (LN) is one of the most severe manifestations of systemic lupus erythematosus (SLE), affecting ~50% of patients, and both renal disease and treatment-related toxicity contribute to significant morbidity and mortality. Although our understanding of the aetiopathogenesis of LN is improving, treatment still remains a challenge, with the achievement of complete remission at 1 year in <50% of patients treated with current standard of care immunosuppressive therapy; this is associated with considerable short- and long-term side effects, some of which further contribute to non-adherence. Calcineurin inhibitors ...
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Kronbichler, A., Neumann, I., Mayer, G. Tags: POLAR VIEWS IN NEPHROLOGY Source Type: research

Opponent's comments
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Mok, C. C. Tags: POLAR VIEWS IN NEPHROLOGY Source Type: research

Con: The use of calcineurin inhibitors in the treatment of lupus nephritis
Lupus nephritis (LN) therapy has limited efficacy due to its toxicity, and LN patients suffer high risks of renal and cardiovascular morbidity and mortality. Calcineurin inhibitors (CNIs) have been used for over >30 years in LN treatment and are an established alternative therapy for Class V nephritis, but uncertainty remains about their role in proliferative disease or in the maintenance of remission. More recently, the combination of CNIs with mycophenolate mofetil (MMF) and glucocorticoid combination therapy, ‘multitarget’ therapy and the use of tacrolimus as opposed to ciclosporin has received attention....
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Fernandez Nieto, M., Jayne, D. R. Tags: POLAR VIEWS IN NEPHROLOGY Source Type: research

Opponent's comments
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Fernandez Nieto, M., Jayne, D. R. Tags: POLAR VIEWS IN NEPHROLOGY Source Type: research

Pro: The use of calcineurin inhibitors in the treatment of lupus nephritis
Renal disease in systemic lupus erythematosus (SLE) carries significant morbidity and mortality. Cyclophosphamide (CYC)- and mycophenolate mofetil (MMF)–based induction regimens are not ideal in terms of efficacy and toxicity. The adverse effects of CYC, such as infection risk, infertility, urotoxicity and oncogenicity, limit its use in lupus nephritis. Although MMF is non-inferior to CYC as induction therapy and has reduced gonadal toxicity and oncogenic potential, meta-analyses of clinical trials do not show a lower rate of infective and gastrointestinal complications. Tacrolimus (TAC) has recently been shown to ha...
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Mok, C. C. Tags: POLAR VIEWS IN NEPHROLOGY Source Type: research

Intermittent smoking and chronic kidney disease
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Plantinga, L., Gander, J. C. Tags: IN FOCUS Source Type: research

Cum grano salis
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Zietse, B., Van Biesen, W. Tags: IN FOCUS Source Type: research

Skeletal fractures in patients on renal replacement therapy: how large still is the knowledge gap?
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Messa, P. Tags: IN FOCUS Source Type: research

Should we aim for oral health to improve outcomes in chronic kidney disease?
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Krane, V., Wanner, C. Tags: IN FOCUS Source Type: research

Intestinal metabolites, chronic kidney disease and renal transplantation: Enigma Variations?
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - September 27, 2016 Category: Urology & Nephrology Authors: Vanholder, R., Glorieux, G., Massy, Z. A. Tags: IN FOCUS Source Type: research

Announcements
(Source: Nephrology Dialysis Transplantation)
Source: Nephrology Dialysis Transplantation - September 1, 2016 Category: Urology & Nephrology Tags: Announcements Source Type: research

Next generation sequencing and functional analysis of patient urine renal progenitor-derived podocytes to unravel the diagnosis underlying refractory lupus nephritis
Often the cause of refractory lupus nephritis (RLN) remains unclear. We performed next-generation sequencing for podocyte genes in an RLN patient and identified compound heterozygosity for APOL1 risk alleles G1 and G2 and a novel homozygous c.[1049C>T]+[1049C>T] NPHS1 gene variant of unknown significance. To test for causality renal progenitor cells isolated from urine of this patient were differentiated into podocytes in vitro. Podocytes revealed aberrant nephrin trafficking, cytoskeletal structure and lysosomal leakage, and increased detachment as compared with podocytes isolated from controls. Thus, lupus podocyto...
Source: Nephrology Dialysis Transplantation - September 1, 2016 Category: Urology & Nephrology Authors: Romagnani, P., Giglio, S., Angelotti, M. L., Provenzano, A., Becherucci, F., Mazzinghi, B., Müller, S., Amann, K., Weidenbusch, M., Romoli, S., Lazzeri, E., Anders, H.-J. Tags: THE BENCH-TO-BEDSIDE TRANSITION Source Type: research