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Artificial intelligence is increasingly being used to improve diagnosis and prognostication for acute and chronic kidney diseases. Studies with this objective published in 2019 relied on a variety of available data sources, including electronic health records, intraoperative physiological signals, kidney ultrasound imaging, and digitized biopsy specimens.
Acute kidney injury (AKI) is an important clinical problem that is associated with adverse short- and long-term outcomes. Studies published in 2019 provide new insights into the staging, risk stratification and subphenotyping of AKI as well as the adverse effects of AKI on the heart.
After nearly two decades, a new therapeutic agent, canagliflozin, received regulatory approval to prevent loss of kidney function, end-stage kidney disease, hospitalization for heart failure and cardiovascular death in patients with diabetic kidney disease. Nonetheless, the residual risk of kidney disease progression and complications remains high, underlining the importance of ongoing therapeutic development.
Single-cell genomics provide a powerful approach to investigate the intrinsic complexity of the kidney and understand the diverse cell types and states that exist during kidney development, homeostasis and disease. Several advances were made in 2019 that enhance our understanding of kidney immune cell states in health and disease and the quality of current kidney organoid model systems for studying human diseases.
2019 saw advances in the generation of induced pluripotent stem cell (iPSC)-derived nephron progenitors and in our understanding of how nephrons form in a kidney organoid. Fundamental studies of regeneration in zebrafish continue to provide vital clues as to how we might use iPSC-derived cells to regenerate a human nephron in vivo.
The function of polycystin proteins and the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD) are not well understood. Studies published in 2018 made important contributions to the understanding of genetic mechanisms, the structure of the polycystin complex and the roles of G-protein signalling and the immune system in ADPKD.
