Paediatric kidney disease

Content

• Low birth weight and the global burden of kidney disease

  Low birth weight (LBW) and intrauterine growth restriction are major contributors to the global burden of non-communicable diseases. A Norwegian registry study has confirmed that LBW is associated with an increased risk of developing end-stage renal disease by 40 years of age, which could not be explained by familial factors.

  • Carolyn L. Abitbol
  • Marva Moxey-Mims

  News & Views22 Feb 2016 Nature Reviews Nephrology

• Prenatal risk factors for kidney and urinary tract anomalies

  Childhood-onset chronic kidney disease is the result of congenital anomalies of the kidneys and urinary tract in approximately two-thirds of all patients. An area of intense research in recent years, however, is the potential impact of maternal obesity on renal ontogenesis or postnatal renal function in the offspring.

  • Robert H. Mak
  • Franz Schaefer

  News & Views17 Jun 2014 Nature Reviews Nephrology
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  Familial aggregation of ESRD in Europeans—is it in the genes?

  A new population-based study of a Norwegian registry containing data on more than 5 million individuals has confirmed the existence of powerful familial clustering of complex aetiologies of end-stage renal disease. Novel strategies for identifying additional nephropathy risk genes will benefit from such large familial registries.

  • Barry I. Freedman
  • Todd W. Robinson

  News & Views30 Sep 2014 Nature Reviews Nephrology
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  Efficacy of rituximab in challenging nephrotic syndrome

  A new trial provides further evidence that rituximab treatment can reduce the risk of relapse in children with steroid-dependent idiopathic nephrotic syndrome. Addition of a single infusion of rituximab to steroid therapy was associated with a decrease in proteinuria at 3 months and a significant increase in the relapse-free period.

  • Kevin V. Lemley
  • Robert H. Mak

  News & Views10 Mar 2015 Nature Reviews Nephrology
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  Outcomes of prenatal immunosuppression

  A new study reports abnormal peripheral lymphocyte counts and an increased incidence of hospital admission for infections among infants born to mothers with kidney transplants. Further studies are required to investigate the effects of in utero exposure to immunosuppressive agents on immune system development and long-term disease risk in this population.

  • Robert H. Mak
  • Hal M. Hoffman

  News & Views19 May 2015 Nature Reviews Nephrology

• Maintenance of steroid-free remission in nephrotic syndrome

  Maintaining steroid-free remission in children with idiopathic nephrotic syndrome is an important goal of therapy. A new trial provides evidence that mycophenolate mofetil can be added to the list of effective steroid-sparing agents. The majority of participants relapsed, however, highlighting an unmet need for more effective treatment modalities.

  • Jeroen K. Deegens
  • Jack F. Wetzels

  News & Views21 Jul 2015 Nature Reviews Nephrology
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  Exploring the genetic basis of early-onset chronic kidney disease

  Genetic studies over the past few years have led to the discovery that a monogenic cause of disease can be detected in ∼20% of individuals with early-onset chronic kidney disease (CKD). In this Review, Vivante and Hildebrandt discuss some of the known single-gene causes of early-onset CKD and the implication of next-generation sequencing for genetic diagnosis. They describe how the discovery of novel causative genes has led to opportunities for delineating the pathomechanisms of disease and potential treatment approaches.

  • Asaf Vivante
  • Friedhelm Hildebrandt

  Review Article11 Jan 2016 Nature Reviews Nephrology
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  Genetic, environmental, and epigenetic factors involved in CAKUT

  Congenital anomalies of the kidney and urinary tract (CAKUT) are a spectrum of renal disorders that commonly cause end-stage renal disease in children, but their genetic basis is largely unknown. In this Review, Nine Knoers et al. discuss the difficulties in identifying the genetic basis of CAKUT, the approaches used to detect genetic variants that confer risk of these anomalies, and the complex interplay between environmental factors, epigenetics, and genetic variants in contributing to the development of these syndromes.

  • Nayia Nicolaou
  • Kirsten Y. Renkema
  • Nine V. A. M. Knoers

  Review Article18 Aug 2015 Nature Reviews Nephrology
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  Primary disease recurrence—effects on paediatric renal transplantation outcomes

  Renal transplantation is the optimal form of renal replacement therapy for children with end-stage renal disease; however, disease recurrence can lead to graft loss, morbidity and death. In this Review, Justine Bacchetta and Pierre Cochat provide an update on the epidemiology, pathophysiology, effects and management of disease recurrence after paediatric renal transplantation. They also describe pretransplantation and post-transplantation risk-reduction strategies that aim to minimize the possibility of disease recurrence, and thus improve both graft and patient outcomes.

  • Justine Bacchetta
  • Pierre Cochat

  Review Article28 Apr 2015 Nature Reviews Nephrology
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  Pathophysiology, diagnosis and management of nephrogenic diabetes insipidus

  Nephrogenic diabetes insipidus (NDI) is caused by inability of the kidneys to respond to arginine vasopressin and concentrate urine by reabsorption of water in the collecting duct. The disease can be congenital or acquired and has a substantial detrimental effect on the quality of life of affected patients. In this article, Bockenhauer and Bichet review the pathophysiology, diagnosis and current clinical management of NDI as well as potential future treatment strategies.

  • Detlef Bockenhauer
  • Daniel G. Bichet

  Review Article16 Jun 2015 Nature Reviews Nephrology
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  Long-term effects of paediatric kidney transplantation

  Renal transplantation can be successfully performed in patients of all ages, and the short-term and medium-term outcomes have improved over the past decades. In this Review, Christer Holmberg and Hannu Jalanko discuss the long-term effects of kidney transplantation on paediatric recipients. They outline the adverse effects that can occur with regard to growth, bone health, metabolic and cardiovascular complications, and malignancies, and highlight the challenges that remain in managing the care of paediatric renal transplant recipients.

  • Christer Holmberg
  • Hannu Jalanko

  Review Article14 Dec 2015 Nature Reviews Nephrology
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  Henoch–Schönlein purpura nephritis in children

  Nephritis is observed in around 30% of children with Henoch–Schönlein purpura (HSP). The treatment of these patients is complicated by similarity to IgA nephropathy. Here, the authors discuss advances in understanding of the pathophysiology, diagnosis and treatment of paediatric HSP nephritis. They suggest that current treatment guidelines based evidence obtained in adults with IgA nephropathy might be inappropriate for children with HSP nephritis.

  • Jean-Claude Davin
  • Rosanna Coppo

  Review Article29 Jul 2014 Nature Reviews Nephrology
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  Birth weight, malnutrition and kidney-associated outcomes—a global concern

  Fetal exposure to an adverse intrauterine environment is associated with an increased risk of numerous chronic diseases in later life. Here, Luyckx and Brenner highlight the emerging developmental risk factors for chronic kidney disease and hypertension, including high birth weight, maternal diabetes mellitus and rapid growth during childhood. The authors discuss the burden imposed on resource-poor countries by suboptimal nutritional intake, and address the benefits of nutritional interventions in reducing the global epidemic of these chronic diseases.

  • Valerie A. Luyckx
  • Barry M. Brenner

  Review Article20 Jan 2015 Nature Reviews Nephrology
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  Next-generation sequencing for research and diagnostics in kidney disease

  The introduction of next-generation sequencing has provided revolutionary opportunities for comprehensive genetic testing in research and diagnostics. Here, the authors discuss approaches used for novel gene identification, the potential of these techniques to improve the management of patients with inherited kidney diseases—focusing on nephronophthisis and congenital anomalies of the kidney and urinary tract—and the remaining challenges for implementation of next-generation sequencing in clinical practice.

  • Kirsten Y. Renkema
  • Marijn F. Stokman
  • Nine V. A. M. Knoers

  Review Article10 Jun 2014 Nature Reviews Nephrology
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  Kidney disease in children: latest advances and remaining challenges

  In this Viewpoint, six leading researchers reflect on progress made in their specialist field of paediatric kidney disease. They provide their insight as to the direction research will take in future years, and comment on areas in which additional research or initiatives are required to improve renal outcomes and patient care for the paediatric and neonatal population.

  • John F. Bertram
  • Stuart L. Goldstein
  • Bradley A. Warady

  Viewpoint1 Feb 2016 Nature Reviews Nephrology