Volume 12 Issue 12, December 2016

Three large-scale association studies provide insights into the genetic architecture of blood pressure regulation, identifying new common variants of modest effect and providing insights into the impact of rare and low-frequency variants. The findings suggest that newly identified variants act through indirect disease pathways and suggest targeting of causal networks might improve outcomes in patients with hypertension.

Noradrenaline is the currently recommended first-line vasopressor agent for patients with refractory septic shock. Although vasopressin adjunct therapy might be beneficial, new data from the VANISH trial do not support use of vasopressin as a first-line agent in these patients.

Renal and vascular insulin resistance results in pathophysiological alterations including sodium retention, renal gluconeogenesis and podocyte dysfunction. Here, the authors discuss the mechanisms and effects of insulin resistance in the kidney and vasculature as well as therapeutic approaches to improve insulin sensitivity.

The use of nanoparticles has great potential for targeted delivery of therapeutics to specific cell types in the kidney. Here, the authors discuss the characteristics of nanoparticles and of renal physiology that must be considered when developing nanomedicines to treat kidney disease, as well as the remaining challenges in clinical translation of this technology.

In this Review, the authors discuss spatial, temporal and molecular features of nephron formation through branching morphogenesis during kidney development. They also reflect on how genetic and environmental factors can alter these mechanisms and decrease nephron endowment in the adult kidney.

Minimal change disease and idiopathic focal segmental glomerulosclerosis are often described as separate disease entities. Here, the authors propose that they are in fact different manifestations of the same disease process and review the evidence that led to this hypothesis.