Editorial Board
(Source: Seminars in Nephrology)
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Source Type: research
Table of Contents
(Source: Seminars in Nephrology)
Source: Seminars in Nephrology - May 1, 2021 Category: Urology & Nephrology Source Type: research
SGLT2 Inhibitors and Other Novel Therapeutics in the Management of Diabetic Kidney Disease
Summary: Over the past 40 years there has been a steady rise in the number of people with chronic kidney disease due mainly to a significant increase in the number of people with diabetic kidney disease (DKD). Current treatments (blood pressure control, blood sugar control, and renin-angiotensin-aldosterone system inhibitors) have had a significant impact on slowing progression of DKD. But the continued rise illustrates that there is a great need for new medications. Recently, a number of potentially reno-protective medicines have been studied. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Robert C. Stanton Source Type: research
Glucose Homeostasis, Hypoglycemia, and the Burnt-Out Diabetes Phenomenon in Kidney Disease
Summary: Chronic kidney disease (CKD) is among the most prevalent and dire complications of diabetes mellitus in adults across the world. Diabetes substantially contributes to the burden of kidney disease, such that one third to one half of CKD in the United States and many other countries is attributable to diabetic kidney disease (DKD). As DKD progresses to end-stage renal disease (ESRD), patients are at heightened risk for atypical glycemic complications, including the development of burnt-out diabetes, manifested by hypoglycemic bouts and poor outcomes. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Connie M. Rhee, Csaba P. Kovesdy, Kamyar Kalantar-Zadeh Source Type: research
Diabetes and the Gut Microbiome
Summary: Gut dysbiosis in diabetes mellitus is associated with decreased short-chain fatty acids and epithelial barrier disruption. Microbial-derived toxins move across the “leaky gut” and incur systemic inflammation and insulin resistance. In children, gut dysbiosis has been associated with risk of developing type 1 diabetes mellitus. In animal models, the obesity phenotype is transferable via microbiota transplantation. Plant-based low protein diets and certain a nti-diabetic drugs have been associated with positive microbiome effects. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Wei Ling Lau, Tiffany Tran, Connie M. Rhee, Kamyar Kalantar-Zadeh, Nosratola D. Vaziri Source Type: research
Testosterone Disorders and Male Hypogonadism in Kidney Disease
Chronic kidney disease (CKD) causes substantial alterations in the male endocrine system, which affect puberty, libido, and sexual function. A major effect of CKD is a reduction in testosterone levels because of both primary and hypogonadotrophic hypogonadism. In addition to impairment of pubertal growth and sexual maturation in children with CKD, clinical evidence suggests that uremic hypogonadism strongly contributes to several CKD complications, including erectile dysfunction, muscle wasting and frailty, anemia, decreased bone mineralization, depression, and cognitive impairment. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Giacomo Garibotto, Pasquale Esposito, Daniela Picciotto, Daniela Verzola Source Type: research
Amenorrhea and Estrogen Disorders in Kidney Disease
Summary: Sexual and reproductive function are impacted negatively in individuals with chronic kidney disease and end-stage renal disease. Disruption of the hypothalamic–pituitary–gonadal axis plays a pivotal role in contributing to these manifestations as a result of decreasing kidney function and the development of uremia. Early menopause is encountered commonly in women with reduced kidney function, and treatment is problemati c as a result of reduced kidney function changing the half-life of medications. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Rebecca Rojas, Deborah J. Clegg, Biff F. Palmer Source Type: research
The Interplay Between Thyroid Dysfunction and Kidney Disease
Summary: Hypothyroidism is a highly prevalent endocrine complication in chronic kidney disease (CKD) patients. A large body of evidence has shown that there is a bidirectional relationship between thyroid dysfunction and kidney disease, yet there are many remaining gaps in knowledge in regards to the clinical management of CKD patients with hypothyroidism, including those receiving hemodialysis and peritoneal dialysis. Given that hypothyroidism has been associated with many deleterious outcomes including a higher risk of (1) mortality, (2) cardiovascular disease, (3) impaired health-related quality of life, and (4) altered...
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Yoko Narasaki, Peter Sohn, Connie M. Rhee Source Type: research
The Role of Growth Hormone in Chronic Kidney Disease
Summary: Growth hormone (GH) has become a critical therapy for treating growth delay and failure in pediatric chronic kidney disease. Recombinant human GH treatment is safe and significantly improves height and height velocity in these growing patients and improved growth outcomes are associated with decreased morbidity and mortality as well as improved quality of life. However, the utility of recombinant human GH in adults with chronic kidney disease and end-stage renal disease for optimization of body habitus and reducing frailty remains uncertain. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Eduardo A. Oliveira, Caitlin E. Carter, Robert H. Mak Source Type: research
Prolactin and Other Pituitary Disorders in Kidney Disease
Summary: Prolactin levels are increased in chronic kidney disease (CKD) as a result of reduced clearance and increased secretion. Hyperprolactinemia manifests as galactorrhea and hypogonadism. Treatment of hyperprolactinemia should focus on improving bothersome galactorrhea or hypogonadism by using dopamine agonists and/or replacement of sex hormone(s). Changes in the hypothalamic –pituitary–adrenal axis in CKD are characterized by increases in adrenocorticotropic hormone (ACTH) and cortisol levels, largely preserved circadian rhythms of ACTH and cortisol, and a normal response of cortisol to ACTH, metyrapone, and insu...
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Wenyu Huang, Mark E. Molitch Source Type: research
Mineral Bone Disorders in Kidney Transplantation
Summary: Bone disease after kidney transplantation is associated with an increased risk of fractures, morbidity, and mortality. Its pathophysiology is complex, involving multiple contributors including pretransplant bone disease, immunosuppressive medications, and changes in the parathyroid –bone–kidney axis. Risk scores, bone turnover markers, and noninvasive imaging modalities are only able to partially predict the fracture risk in kidney transplant recipients. The optimal management of bone disease after kidney transplantation has not yet been established, with only a limited nu mber of randomized clinical trials ev...
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Ayman Al Jurdi, Janaina Da Silva Martins, Leonardo V. Riella Source Type: research
The Interplay Between Nutrition, Metabolic, and Endocrine Disorders in Chronic Kidney Disease
Summary: The kidneys are responsible for maintaining our bodies ’ homeostasis through excretion, biodegradation, and synthesis of different hormones. Therefore, a decline in renal function often results in significant derangements in hormone levels. The most common metabolic and endocrine abnormalities seen in patients with chronic kidney disease include defic iencies in erythropoietin, calcitriol, triiodothyronine, testosterone, and estrogen. In addition, accumulation of hormones such as adiponectin, leptin, triglycerides, and prolactin also is seen. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Tala Mahmoud, Lea Borgi Source Type: research
Obesity, Chronic Kidney Disease, and Kidney Transplantation: An Evolving Relationship
Summary: Obesity has a fundamental role in driving the global kidney disease burden. The perplexing relationship of obesity with chronic kidney disease remains debated. However, a thorough understanding of the interplay of obesity in conjunction with chronic kidney disease and appropriate management options is lacking, leading to further increases in morbidity and mortality. Moreover, underutilization of bariatric procedures and unrealistic expectations of weight reduction based on body mass index, leading to poor access to kidney transplantation, are fueling the fire. (Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Ambreen Azhar, Nabeel Hassan, Mihaly Tapolyai, Miklos Z. Molnar Source Type: research
Introduction: The Inter-relationship Between the Endocrine System and Kidney Health
There is growing appreciation of the complex interaction between various endocrine disorders and kidney disease (Fig. 1).1 Among patients with chronic kidney disease (CKD) and end-stage renal disease (ESRD), numerous endocrine derangements may ensue and progress, particularly in the uremic milieu (ie, insulin resistance,2 hypogonadotropic hypogonadism,3,4 and secondary hyperparathyroidism5). In turn, the kidneys serve as a major target of the endocrine system, such that alterations in renal structure and function may arise from untreated hormonal derangements (ie, diabetes,6 hypothyroidism,7 and testosterone deficiency8). ...
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Authors: Connie M. Rhee Source Type: research
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(Source: Seminars in Nephrology)
Source: Seminars in Nephrology - March 1, 2021 Category: Urology & Nephrology Source Type: research
