Volume 2 Issue 2, February 2006

Elevated blood pressure is a strong and independent risk factor for the development of end-stage renal disease. Various investigators have examined whether all renal diseases are similarly sensitive to high blood pressure and whether they benefit similarly from antihypertensive therapy. Reviewing data from different renal disease populations, authors from the Medical University of Silesia provide their recommendations on the optimal blood pressure goals for slowing progression of renal insufficiency.

If detected early, damage to the kidneys caused by medications can be reversed in most instances. Physician awareness of which drugs have pathogenic potential is therefore essential. This article synthesizes current knowledge of the mechanisms by which commonly used drugs induce renal injury. Comprehensive summary tables that present the drug types associated with each mechanism, clinical findings and recommended management strategies are included.

Optimal management of anemia in patients with end-stage renal disease on hemodialysis usually demands intravenous iron supplementation. Michael et al. review the current safety data for the nondextran intravenous iron formulation sodium ferric gluconate complex, and examine the emerging concerns related to use of intravenous iron, including the risks of infection, oxidative stress and cell toxicity.

Currently, there is little that can be done to treat fibrosis of the kidney. Recent advances in renal pathophysiology are yielding insight into the derivation of fibroblasts and their role in this inflammatory disease. Eric Neilson reviews this progress, catalogs the new targets for intervention that have been identified, and asserts that the future for clinical management of fibrosis is bright.