Volume 11 Issue 7, July 2015

Despite aggressive therapy, lupus nephritis (LN) remains an important predictor of morbidity in patients with systemic lupus erythematosus. Clinical trials of novel drugs have not improved LN outcomes; however, re-analysis of well-characterized cohorts has identified surrogate end points of long-term renal survival, which will facilitate testing and qualification of novel treatments.

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.

Despite reductions in morbidity and mortality owing to widespread use of highly effective antiretroviral therapy (ART), HIV-positive patients remain at high risk of chronic kidney disease (CKD) and end-stage renal disease. A new report provides a HIV-specific CKD risk score to balance the potential benefits and harms of nephrotoxic ART.

Anaemia is a clinical hallmark of advanced kidney disease, characterized by insufficient erythropoiesis due to inadequate erythropoietin production in the kidney, inflammation and iron deficiency. Here, Mark Koury and Volker Haase discuss the hypoxic regulation of erythropoiesis and renal erythropoietin production, providing insight into the inter-relationships between erythropoietin synthesis, erythrocyte production, iron metabolism and inflammatory mediators. They also describe current clinical experience with pharmacologic activators of hypoxia-inducible factor signalling as an emerging approach to the treatment of renal anaemia.

Transplantation of kidneys from living donors benefits patients with end-stage renal disease, but living donation is associated with short-term and long-term risks. In this Review, the authors summarize studies that have examined the long-term medical outcomes for living kidney donors, focusing on the first 10 years after donation. They also consider the need to further assess risk in specific populations of donors.

Lineage tracing is a sophisticated technique to track cellsin vivo. Here, Paola Romagnani and colleagues describe how lineage tracing can be used to track the fate of cells involved in renal development, pathophysiological changes and regeneration. The authors discuss considerations in selecting an appropriate reporter, promoter, and activating switch for lineage tracing experiments, and approaches to data interpretation.

Abundant evidence suggests a physiological role of magnesium in cardiovascular function. As the kidney is a major regulator of magnesium homeostasis, serum magnesium levels and magnesium balance are often altered in patients with chronic kidney disease (CKD). In this article, Ziad Massy and Tilman Drüeke review the findings of experimental and clinical studies that provide evidence for a role of magnesium in the high frequency of cardiovascular disease in patients with CKD.