Volume 13 Issue 1, January 2017

In a recent trial, levosimendan therapy failed to ameliorate sepsis-induced organ dysfunction or improve the survival of patients with septic shock. The failure of levosimendan and many other potential therapies for sepsis, together with the findings of histopathologic studies, raise questions regarding the pathophysiologic basis of the disorder.

New data suggest that provision of high-protein, high-calorie intradialytic meals in combination with phosphate binder therapy could be an easy and effective strategy to reduce the risk of malnutrition in patients on haemodialysis. These findings highlight the importance of avoiding excessive dietary restrictions in these patients.

The kidney has a key role in maintaining glucose homeostasis and is the site of action of SGLT2 inhibitors, which enhance glucose excretion to reduce plasma glucose levels. Here, Ralph DeFronzo and colleagues examine the role of the kidney in regulating glucose reabsorption and the effect of SGLT2 inhibition on renal function, glucose homeostasis, and cardiovascular disease.

Hyperphosphataemia is associated with poor clinical outcomes but strong evidence that targeting serum phosphate improves these outcomes is lacking. Here the authors discuss the role, regulation and management of serum phosphate in chronic kidney disease, including the efficacies of phosphate binder therapy and dietary interventions.

Cellular plasticity facilitates organ repair after injury. Here, the authors discuss the modalities and mechanisms of cellular plasticity such as dedifferentiation and progenitor expansion in the kidney and their contribution to renal repair.

New data suggests that, in addition to mutations in tumour-suppressor genes, renal cancer is associated with epigenetic aberrations. Here, the authors discuss the mechanisms by which epigenetically silenced genes and mutations in genes that are involved in histone modification or chromatin remodelling dysregulate crucial cellular pathways in renal cancer.