Nature Reviews Nephrology Nature Reviews Nephrology provides physicians and academics with authoritative and topical discussions of key developments in the field. http://www.nature.com/nrneph/current_issue/ Nature Publishing Group en © 2009 Nature Publishing Group Nature Reviews Nephrology 1759-5061 1759-507X © 2009 Nature Publishing Group permissions@nature.com Nature Reviews Nephrology http://www.nature.com/includes/rj_globnavimages/nrneph_logo.gif http://www.nature.com/nrneph/ The fallacy of 'alternative' medicine http://dx.doi.org/10.1038/nrneph.2009.96 A company founded by Prince Charles was reprimanded by UK regulators earlier this year for making unsubstantiated claims about the efficacy of three of its herbal remedies. The Advertising Standards Authority ruled that promoting the Echinacea, Hypericum and 'Detox' tinctures as “alternative and natural ways The fallacy of 'alternative' medicine

Nature Reviews Nephrology 5, 361 (2009). doi:10.1038/nrneph.2009.96

Author: Chloë Harman

A company founded by Prince Charles was reprimanded by UK regulators earlier this year for making unsubstantiated claims about the efficacy of three of its herbal remedies. The Advertising Standards Authority ruled that promoting the Echinacea, Hypericum and 'Detox' tinctures as “alternative and natural ways

]]> The fallacy of 'alternative' medicine Chloë Harman doi:10.1038/nrneph.2009.96 Nature Reviews Nephrology 5, 361 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.96 http://dx.doi.org/10.1038/nrneph.2009.96 5 7 Editorial 361 361 Dialysis: AURORA confirms lack of statin benefit in dialysis patients http://dx.doi.org/10.1038/nrneph.2009.79 Dialysis: AURORA confirms lack of statin benefit in dialysis patients

Nature Reviews Nephrology 5, 363 (2009). doi:10.1038/nrneph.2009.79

Author: Chloë Harman

]]> Dialysis: AURORA confirms lack of statin benefit in dialysis patients Chloë Harman doi:10.1038/nrneph.2009.79 Nature Reviews Nephrology 5, 363 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.79 http://dx.doi.org/10.1038/nrneph.2009.79 5 7 Research Highlight 363 363 Hypertension: RF ablation of renal nerves http://dx.doi.org/10.1038/nrcardio.2009.63 Hypertension: RF ablation of renal nerves

Nature Reviews Nephrology 5, 364 (2009). doi:10.1038/nrcardio.2009.63

Author: Alexandra King

]]> Hypertension: RF ablation of renal nerves Alexandra King doi:10.1038/nrcardio.2009.63 Nature Reviews Nephrology 5, 364 (2009) Nature Reviews Nephrology 10.1038/nrcardio.2009.63 http://dx.doi.org/10.1038/nrcardio.2009.63 5 7 Research Highlight 364 364 High cut-off dialysis in myeloma http://dx.doi.org/10.1038/nrneph.2009.80 Hutchison, C. A. et al. Treatment of acute renal failure secondary to multiple myeloma with chemotherapy and extended high cut-off hemodialysis. Clin. J. Am. Soc. Nephrol.4, 745–754 (2009).Patients with multiple myeloma often experience High cut-off dialysis in myeloma

Nature Reviews Nephrology 5, 364 (2009). doi:10.1038/nrneph.2009.80

Author: Baldo Lucchese

Hutchison, C. A. et al. Treatment of acute renal failure secondary to multiple myeloma with chemotherapy and extended high cut-off hemodialysis. Clin. J. Am. Soc. Nephrol.4, 745–754 (2009).Patients with multiple myeloma often experience

]]> High cut-off dialysis in myeloma Baldo Lucchese doi:10.1038/nrneph.2009.80 Nature Reviews Nephrology 5, 364 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.80 http://dx.doi.org/10.1038/nrneph.2009.80 5 7 Research Highlight 364 364 Transplantation: Immunosuppression tapering in HLA-identical transplantation http://dx.doi.org/10.1038/nrneph.2009.83 Transplantation: Immunosuppression tapering in HLA-identical transplantation

Nature Reviews Nephrology 5, 365 (2009). doi:10.1038/nrneph.2009.83

Author: Rebecca Ireland

]]> Transplantation: Immunosuppression tapering in HLA-identical transplantation Rebecca Ireland doi:10.1038/nrneph.2009.83 Nature Reviews Nephrology 5, 365 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.83 http://dx.doi.org/10.1038/nrneph.2009.83 5 7 Research Highlight 365 365 In brief http://dx.doi.org/10.1038/nrneph.2009.84 TransplantationLiving in a remote or rural location does not seem to reduce access to kidney transplantation. Analyzing a median of 2 years' follow-up data from 699,751 US adults on renal replacement therapy, Tonelli et al. were surprised to find that those who In brief

Nature Reviews Nephrology 5, 365 (2009). doi:10.1038/nrneph.2009.84

TransplantationLiving in a remote or rural location does not seem to reduce access to kidney transplantation. Analyzing a median of 2 years' follow-up data from 699,751 US adults on renal replacement therapy, Tonelli et al. were surprised to find that those who

]]> In brief doi:10.1038/nrneph.2009.84 Nature Reviews Nephrology 5, 365 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.84 http://dx.doi.org/10.1038/nrneph.2009.84 5 7 Research Highlight 365 365 Dialysis: Autologous grafts offer vascular access hope http://dx.doi.org/10.1038/nrneph.2009.82 Dialysis: Autologous grafts offer vascular access hope

Nature Reviews Nephrology 5, 366 (2009). doi:10.1038/nrneph.2009.82

Author: Baldo Lucchese

]]> Dialysis: Autologous grafts offer vascular access hope Baldo Lucchese doi:10.1038/nrneph.2009.82 Nature Reviews Nephrology 5, 366 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.82 http://dx.doi.org/10.1038/nrneph.2009.82 5 7 Research Highlight 366 366 In brief http://dx.doi.org/10.1038/nrneph.2009.85 TransplantationOutcomes of third renal transplants are similar to those of primary transplants, according to a study published in Transplantation. Despite the technical and immunological obstacles associated with retransplantation, Horovitz and colleagues found that 1-year and 5-year patient and graft survival of individuals receiving In brief

Nature Reviews Nephrology 5, 366 (2009). doi:10.1038/nrneph.2009.85

TransplantationOutcomes of third renal transplants are similar to those of primary transplants, according to a study published in Transplantation. Despite the technical and immunological obstacles associated with retransplantation, Horovitz and colleagues found that 1-year and 5-year patient and graft survival of individuals receiving

]]> In brief doi:10.1038/nrneph.2009.85 Nature Reviews Nephrology 5, 366 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.85 http://dx.doi.org/10.1038/nrneph.2009.85 5 7 Research Highlight 366 366 Proteinuria: Increased angiotensin-receptor blocking is not the first option http://dx.doi.org/10.1038/nrneph.2009.77 Candesartan doses in excess of the recommended antihypertensive maxima have been reported to lead to greater reductions of proteinuria than the advised doses. High-dose angiotensin-converting-enzyme inhibitors, however, are at least as effective as high-dose angiotensin blockers and less expensive. Angiotensin-converting-enzyme inhibition is thus the first-line strategy to halt kidney disease progression. Proteinuria: Increased angiotensin-receptor blocking is not the first option

Nature Reviews Nephrology 5, 367 (2009). doi:10.1038/nrneph.2009.77

Authors: Piero Ruggenenti, Paolo Cravedi & Giuseppe Remuzzi

Candesartan doses in excess of the recommended antihypertensive maxima have been reported to lead to greater reductions of proteinuria than the advised doses. High-dose angiotensin-converting-enzyme inhibitors, however, are at least as effective as high-dose angiotensin blockers and less expensive. Angiotensin-converting-enzyme inhibition is thus the first-line strategy to halt kidney disease progression.

]]> Proteinuria: Increased angiotensin-receptor blocking is not the first option Piero Ruggenenti Paolo Cravedi Giuseppe Remuzzi doi:10.1038/nrneph.2009.77 Nature Reviews Nephrology 5, 367 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.77 http://dx.doi.org/10.1038/nrneph.2009.77 5 7 News and Views 367 368 Dialysis: Phosphorus binders and survival: need for randomized trials http://dx.doi.org/10.1038/nrneph.2009.78 An observational study suggests that administration of phosphorus binders dramatically improves survival rates in patients on incident hemodialysis—even in those without hyperphosphatemia. Randomized clinical trials should drive changes in the relevant clinical practice. Dialysis: Phosphorus binders and survival: need for randomized trials

Nature Reviews Nephrology 5, 368 (2009). doi:10.1038/nrneph.2009.78

Authors: Joachim H. Ix & Glenn M. Chertow

An observational study suggests that administration of phosphorus binders dramatically improves survival rates in patients on incident hemodialysis—even in those without hyperphosphatemia. Randomized clinical trials should drive changes in the relevant clinical practice.

]]> Dialysis: Phosphorus binders and survival: need for randomized trials Joachim H. Ix Glenn M. Chertow doi:10.1038/nrneph.2009.78 Nature Reviews Nephrology 5, 368 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.78 http://dx.doi.org/10.1038/nrneph.2009.78 5 7 News and Views 368 370 Diabetes: Renal benefits of lowering BP in the absence of hypertension http://dx.doi.org/10.1038/nrneph.2009.92 Regardless of baseline blood pressure, treatment with a combination of an angiotensin-converting enzyme inhibitor and a diuretic decreases incidence of renal events in patients with type 2 diabetes. The combination therapy approach could be the key to achieving renoprotection. Diabetes: Renal benefits of lowering BP in the absence of hypertension

Nature Reviews Nephrology 5, 370 (2009). doi:10.1038/nrneph.2009.92

Author: Hiromichi Suzuki

Regardless of baseline blood pressure, treatment with a combination of an angiotensin-converting enzyme inhibitor and a diuretic decreases incidence of renal events in patients with type 2 diabetes. The combination therapy approach could be the key to achieving renoprotection.

]]> Diabetes: Renal benefits of lowering BP in the absence of hypertension Hiromichi Suzuki doi:10.1038/nrneph.2009.92 Nature Reviews Nephrology 5, 370 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.92 http://dx.doi.org/10.1038/nrneph.2009.92 5 7 News and Views 370 371 Transplantation: To convert or not to convert: lessons from the CONVERT trial http://dx.doi.org/10.1038/nrneph.2009.94 In participants of the CONVERT trial, which enrolled recipients of kidney transplants, conversion of immunosuppressive therapy from calcineurin inhibitors to sirolimus did not improve renal function. More importantly, the intervention was detrimental among patients with impaired kidney function and/or proteinuria. Sirolimus conversion resulted, however, in lower rates of malignancy. Transplantation: To convert or not to convert: lessons from the CONVERT trial

Nature Reviews Nephrology 5, 371 (2009). doi:10.1038/nrneph.2009.94

Authors: Suphamai Bunnapradist & Flavio Vincenti

In participants of the CONVERT trial, which enrolled recipients of kidney transplants, conversion of immunosuppressive therapy from calcineurin inhibitors to sirolimus did not improve renal function. More importantly, the intervention was detrimental among patients with impaired kidney function and/or proteinuria. Sirolimus conversion resulted, however, in lower rates of malignancy.

]]> Transplantation: To convert or not to convert: lessons from the CONVERT trial Suphamai Bunnapradist Flavio Vincenti doi:10.1038/nrneph.2009.94 Nature Reviews Nephrology 5, 371 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.94 http://dx.doi.org/10.1038/nrneph.2009.94 5 7 News and Views 371 373 Emerging therapies for chronic kidney disease: what is their role? http://dx.doi.org/10.1038/nrneph.2009.76 The prevalence of chronic kidney disease (CKD) is increasing worldwide. The best therapies currently available focus on the control of blood pressure and optimization of renin–angiotensin–aldosterone system blockade. Currently available agents are only partially effective against hard end points such as the development of end-stage Emerging therapies for chronic kidney disease: what is their role?

Nature Reviews Nephrology 5, 375 (2009). doi:10.1038/nrneph.2009.76

Authors: Eswari Vilayur & David C. H. Harris

The prevalence of chronic kidney disease (CKD) is increasing worldwide. The best therapies currently available focus on the control of blood pressure and optimization of renin–angiotensin–aldosterone system blockade. Currently available agents are only partially effective against hard end points such as the development of end-stage

]]> Emerging therapies for chronic kidney disease: what is their role? Eswari Vilayur David C. H. Harris doi:10.1038/nrneph.2009.76 Nature Reviews Nephrology 5, 375 (2009) 2009-05-19 Nature Reviews Nephrology 2009-05-19 10.1038/nrneph.2009.76 http://dx.doi.org/10.1038/nrneph.2009.76 5 7 Review 375 383 Sexual dimorphism in the aging kidney: differences in the nitric oxide system http://dx.doi.org/10.1038/nrneph.2009.90 Females—both rats and women—are substantially protected against the age-dependent decrease in renal function that occurs in males of the species. In part, this finding reflects the cardioprotective and renoprotective effects of estrogens, but estrogen has multiple actions, not all of which are beneficial. In addition, Sexual dimorphism in the aging kidney: differences in the nitric oxide system

Nature Reviews Nephrology 5, 384 (2009). doi:10.1038/nrneph.2009.90

Author: Chris Baylis

Females—both rats and women—are substantially protected against the age-dependent decrease in renal function that occurs in males of the species. In part, this finding reflects the cardioprotective and renoprotective effects of estrogens, but estrogen has multiple actions, not all of which are beneficial. In addition,

]]> Sexual dimorphism in the aging kidney: differences in the nitric oxide system Chris Baylis doi:10.1038/nrneph.2009.90 Nature Reviews Nephrology 5, 384 (2009) 2009-06-02 Nature Reviews Nephrology 2009-06-02 10.1038/nrneph.2009.90 http://dx.doi.org/10.1038/nrneph.2009.90 5 7 Review 384 396 Integrating albuminuria and GFR in the assessment of diabetic nephropathy http://dx.doi.org/10.1038/nrneph.2009.91 The evaluation of diabetic nephropathy from research and clinical viewpoints depends on the assessment of two continuous variables, albumin excretion rate (AER) and glomerular filtration rate (GFR). These two parameters form the basis of both the European classification of five stages of diabetic nephropathy, assessed Integrating albuminuria and GFR in the assessment of diabetic nephropathy

Nature Reviews Nephrology 5, 397 (2009). doi:10.1038/nrneph.2009.91

Authors: George Jerums, Sianna Panagiotopoulos, Erosha Premaratne & Richard J. MacIsaac

The evaluation of diabetic nephropathy from research and clinical viewpoints depends on the assessment of two continuous variables, albumin excretion rate (AER) and glomerular filtration rate (GFR). These two parameters form the basis of both the European classification of five stages of diabetic nephropathy, assessed

]]> Integrating albuminuria and GFR in the assessment of diabetic nephropathy George Jerums Sianna Panagiotopoulos Erosha Premaratne Richard J. MacIsaac doi:10.1038/nrneph.2009.91 Nature Reviews Nephrology 5, 397 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.91 http://dx.doi.org/10.1038/nrneph.2009.91 5 7 Review 397 406 Circadian sleep–wake rhythm disturbances in end-stage renal disease http://dx.doi.org/10.1038/nrneph.2009.88 End-stage renal disease (ESRD) is an increasing health problem worldwide. Given the increasing prevalence of this disease, the high cost of hemodialysis treatment and the burden of hemodialysis on a patient's life, more research on improving the clinical outcomes and the quality of life of Circadian sleep–wake rhythm disturbances in end-stage renal disease

Nature Reviews Nephrology 5, 407 (2009). doi:10.1038/nrneph.2009.88

Authors: Birgit C. P. Koch, J. Elsbeth Nagtegaal, Gerard A. Kerkhof & Piet M. ter Wee

End-stage renal disease (ESRD) is an increasing health problem worldwide. Given the increasing prevalence of this disease, the high cost of hemodialysis treatment and the burden of hemodialysis on a patient's life, more research on improving the clinical outcomes and the quality of life of

]]> Circadian sleep–wake rhythm disturbances in end-stage renal disease Birgit C. P. Koch J. Elsbeth Nagtegaal Gerard A. Kerkhof Piet M. ter Wee doi:10.1038/nrneph.2009.88 Nature Reviews Nephrology 5, 407 (2009) 2009-05-26 Nature Reviews Nephrology 2009-05-26 10.1038/nrneph.2009.88 http://dx.doi.org/10.1038/nrneph.2009.88 5 7 Review 407 416 Malacoplakia presenting with obstructive nephropathy with bilateral ureter involvement http://dx.doi.org/10.1038/nrneph.2009.86 Background. A 48-year-old woman with chronic urinary tract infections presented with uremia. Imaging studies revealed bilateral hydronephrosis and segmental ureteral thickening.Investigations. Physical examination, urine and blood analysis, radiography of the chest, chest CT, abdominal and pelvis CT, renal ultrasonography, cystoscopy, anterograde pyelogram, Malacoplakia presenting with obstructive nephropathy with bilateral ureter involvement

Nature Reviews Nephrology 5, 418 (2009). doi:10.1038/nrneph.2009.86

Authors: Lorin M. Sanchez, Sean I. Sanchez & James L. Bailey

Background. A 48-year-old woman with chronic urinary tract infections presented with uremia. Imaging studies revealed bilateral hydronephrosis and segmental ureteral thickening.Investigations. Physical examination, urine and blood analysis, radiography of the chest, chest CT, abdominal and pelvis CT, renal ultrasonography, cystoscopy, anterograde pyelogram,

]]> Malacoplakia presenting with obstructive nephropathy with bilateral ureter involvement Lorin M. Sanchez Sean I. Sanchez James L. Bailey doi:10.1038/nrneph.2009.86 Nature Reviews Nephrology 5, 418 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.86 http://dx.doi.org/10.1038/nrneph.2009.86 5 7 Case Study 418 422 Weibel–Palade bodies—sentinels of acute stress http://dx.doi.org/10.1038/nrneph.2009.87 Weibel–Palade bodies are uniquely present in endothelial cells and harbor a range of bioactive substances that participate in hemostasis, vasomotion, inflammation and fibrinolysis, in addition to modulating vascular permeability, angiogenic sprouting, and stem cell mobilization. This Perspectives article examines the latest insights into the biogenesis Weibel–Palade bodies—sentinels of acute stress

Nature Reviews Nephrology 5, 423 (2009). doi:10.1038/nrneph.2009.87

Authors: Michael S. Goligorsky, Daniel Patschan & Mei-Chuan Kuo

Weibel–Palade bodies are uniquely present in endothelial cells and harbor a range of bioactive substances that participate in hemostasis, vasomotion, inflammation and fibrinolysis, in addition to modulating vascular permeability, angiogenic sprouting, and stem cell mobilization. This Perspectives article examines the latest insights into the biogenesis

]]> Weibel–Palade bodies—sentinels of acute stress Michael S. Goligorsky Daniel Patschan Mei-Chuan Kuo doi:10.1038/nrneph.2009.87 Nature Reviews Nephrology 5, 423 (2009) Nature Reviews Nephrology 10.1038/nrneph.2009.87 http://dx.doi.org/10.1038/nrneph.2009.87 5 7 Perspectives 423 426