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Polycystic Kidney disease (PKD) is caused by mutations in genes that affect cilia structure and composition. Impaired mechanosensation through primary cilia has been proposed as a pathogenic mechanism in PKD; however, a new study challenges this hypothesis by showing an absence of mechanically induced Ca2+ increases in primary cilia.
The first, highly anticipated randomized trial of adjuvant antiangiogenic therapy in renal cancer was recently reported. Although far from assuring, data from the adjuvant sorafenib or sunitinib for unfavorable renal carcinoma (ASSURE) trial offer a wealth of insights into the disease, treatments, and biological considerations for studies aimed at risk reduction.
A single-centre study found that desensitization therapy permits a good success rate of kidney transplantation with an incompatible living donor. Data from 22 US centres now suggest that this technique could be employed across multiple hospitals to prolong the lives of sensitized transplant recipients.
New data demonstrate that caplacizumab treatment accelerates normalization of platelet count in patients with acute episodes of acquired thrombotic thrombocytopenic purpura (TTP). Although not curative, this drug might reduce ischaemic organ damage and be potentially lifesaving for patients with TTP who do not respond to conventional therapy.
New data from the BENEFIT study demonstrate that belatacept improves long-term allograft and patient survival after kidney transplantation, despite higher rates of biopsy-proven acute rejection than with ciclosporin. The noninferiority design of BENEFIT represents a feasible strategy to further the development of innovator drugs to reduce late graft loss.
Clinical trials in patients with acute kidney injury (AKI) have been stymied by a lack of consensus on suitable renal-specific end points. In a recent analysis, Grams et al. suggest that a sustained 30–40% reduction in estimated glomerular filtration rate after hospital discharge might be a suitable intermediate end point for AKI clinical trials.
New data suggest that a fall in parathyroid hormone (PTH) 12 months after initiating haemodialysis is associated with cardiovascular death at 12–24 months. The main independent predictor for the fall in PTH is a high dialysate calcium concentration, which might not only reduce PTH but also induce vascular calcification.
A new study reports that a single blood test can be used to rule out the development of pre-eclampsia in women in whom the syndrome is suspected. Early interventions for pre-eclampsia are not yet available, but this finding is likely to change the approach to diagnosis of hypertensive disorders in pregnancy.
A recent meta-analysis reports that blood-pressure-lowering treatments reduce the rate of cardiovascular events in patients with baseline systolic blood pressures ranging from >160 mmHg to <130 mmHg. Notwithstanding their diverse data sources, the researchers assert that a blood pressure target of <130 mmHg should be adopted when treating hypertension.
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.
The SPRINT data suggest a cardiovascular benefit of intensive blood pressure (BP) lowering in high-risk individuals. The BP measurement protocol, however, likely resulted in lower BP values than would normally be obtained in the clinic. Intensive BP targets might not be as safe if routine BP measurements are used.
