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Here, the authors provide an overview of genetic causes of CAKUT and their impact on signalling pathways during nephrogenesis. They also discuss the impact of a molecular genetic diagnosis on the clinical care and potentially the personalized treatment of patients with CAKUT.
In a ground-breaking development, rat kidneys have been cryopreserved for an unprecedented duration of 100 days and subsequently transplanted successfully after nano-rewarming. This extraordinary achievement opens new possibilities for the field of organ banking.
Chronic kidney disease is characterized by dyslipidaemia and lipid accumulation in the kidney. In this Review, the authors examine the evidence that links alterations in lipid metabolism to kidney injury and progression of kidney disease, and explore potential lipid-targeted therapeutic approaches.
Kidney failure is a serious but rare consequence of progressive chronic kidney disease. A meta-analysis of individual participant-level trial data, across heterogeneous treatments and disease groups, has shown glomerular filtration rate (GFR) slope to be a valid, fit-for-purpose and robust surrogate marker of kidney failure.
This Review examines the role of alterations in the gut microbial ecosystem, as well as inflammation and oxidative stress, in the bone and mineral disorder that affects patients with chronic kidney disease. The authors also explore novel therapeutic options that can target these disease factors.
During disasters, the morbidity and mortality of patients with kidney disease far exceeds that of the general population. Here, the authors discuss the medical and logistical problems that are faced by these patients and their care-givers during mass disasters and suggest pragmatic approaches to improve patient outcomes.
The bladder and kidney engage adaptive and innate immune responses to prevent urinary tract infections and minimize tissue injury following infection. Here, the authors describe the mechanisms used by uropathogenic bacteria to establish and promote kidney infection, as well as the immune defence mechanisms used by resident kidney cells and infiltrating immune cells to eradicate infection.
Aquaporins have diverse roles in various homeostatic and physiological systems beyond their role in renal water handling. This Review describes the role of mammalian aquaporins in the transport of solutes other than water and their involvement in processes such as metabolism, cellular migration, cell adhesion, cell polarity and cell signalling.
This Review examines insights from genetic studies of systemic lupus erythematosus (SLE), including observations from reports of monogenic SLE, as well as the role of common and rare variants. The authors also discuss age-associated B cells, as the integration of genetic, epigenetic and transcriptomic data suggests a key role for these cells in SLE.
Here, the authors describe regulatory T (Treg) cell development and function and discuss how molecular anomalies or genetic variations in Treg cells contribute to autoimmune and inflammatory diseases. They also discuss how Treg cells can be exploited to treat kidney diseases and to induce immune tolerance, particularly in kidney transplantation.
A lack of federal access to health-care resources for undocumented immigrants in the USA has led to variability in access to health care — including dialysis — across states. Transforming dialysis care for these individuals is justified both on humanitarian and economic grounds, but requires a roadmap for advocacy and stakeholder engagement.
Meoli and Günzel elucidate the role of claudins (a family of tight junction proteins) in maintaining electrolyte and water homeostasis. With this Review, the authors aim to stimulate investigations on claudins as prognostic markers or as druggable targets in kidney disease.
Circulating non-coding RNAs (ncRNAs) are derived from specific cell types and can be directly transferred to a variety of cells to affect their function. This Review describes the relevance of circulating ncRNAs to the development of kidney disease and discusses the potential use of circulating ncRNAs as diagnostic factors and therapeutic targets.
Portable, wearable and implantable artificial kidney systems require compact and efficient dialysate regeneration systems and novel membranes for improved toxin removal and long-term patency. Here, the authors discuss efforts to overcome these challenges and future perspectives for achieving miniaturized dialysis.