Volume 12 Issue 2, February 2016

Podocyte biologists can boast of some important advances in 2015. Some of the key developments include defining the transcriptional targets of the Wilms' tumour protein on a genome-wide scale, the identification of new mitochondria-centred pathways for maintaining podocyte homeostasis, and new insights into the regulation and pathogenic activation of TRPC6.

Numerous studies in 2015 focused on therapeutic immune modulation and immunosuppression. Trials of budenoside in patients with IgA nephropathy who are unresponsive to supportive therapy, and of low-dose IL-2 to enforce regulatory T-cell-mediated immunosuppression in autoimmune disease all produced promising results.

2015 saw the publication of several important studies in the renal stem cell and developmental biology fields. Key studies provided insights into the ageing of nephron progenitors and optimal conditions to stimulate the expansion of nephron progenitors, and reported the in vitro generation of kidney organoids.

The year 2015 has seen great progress in the renal fibrosis field, as key studies began to build a consensus on the importance of epithelial-to-mesenchymal transition, cell cycle arrest, and defective metabolism in the pathogenesis of kidney fibrosis. New findings also point to a role of developmental signalling in renal fibrogenesis.

Combination therapy with optimal doses of multiple antihypertensive drugs fails to achieve blood pressure (BP) control in up to 15% of hypertensive patients. Key studies in 2015 highlighted the risks of uncontrolled hypertension and evaluated new therapeutic modalities designed to achieve satisfactory BP control in patients with treatment-resistant hypertension.

Chronic kidney disease (CKD) is a common comorbidity in patients with type 2 diabetes mellitus (T2DM). In this Review, Paul Zimmet and colleagues discuss the changing epidemiology of T2DM and the effect of these changes on the prevalence of CKD. They indicate how the decreasing prevalence of cardiovascular disease in T2DM has resulted in an increased prevalence of CKD, outline differences in the prevalence and disease burden of T2DM and CKD in various populations worldwide, and describe the financial, societal, and clinical impact of these diseases.

Renal involvement in primary Sjögren syndrome (pSS) is a rare complication, but regular screening is required for early detection and prevention of progression to chronic kidney disease. In this Review, Hélène François and Xavier Mariette discuss the most frequent renal complications that can occur in pSS, namely tubulointerstitial nephritis and membranoproliferative glomerular nephritis. They outline the pathophysiology of these complications, the differential diagnoses, and current treatment options.

In the past decade considerable advances have been made in understanding the physiology and pathophysiology of coagulation proteases, their regulators and receptors in renal disease. In this Review, Berend Isermann and colleagues discuss the haemostatic and non-haemostatic functions of coagulation regulators and receptors in the kidney, the roles of coagulation proteases in acute kidney injury, chronic kidney disease and renal transplantation, and the potential for translating these insights into targeted therapies.

Hypertension is an important risk factor for cardiovascular and renal disease; however, despite the availability of several antihypertensive drug classes only about half of patients with treated hypertension achieve appropriate blood pressure control. This Review describes the potential of pharmacogenomics and other 'omics' approaches to identify genetic signals to predict an individual's response to a particular drug and enable a more personalized, or precision approach to antihypertensive treatment strategies.