Volume 3 Issue 5, May 2007

In formulating a clear and succinct answer to the question posed by this Viewpoint, the authors highlight several important considerations. They discuss how the choice of induction agent, the presence of risk factors for relapse and the definition of remission can influence the timing of the switch to maintenance therapy and/or the duration of maintenance treatment in patients with ANCA-associated vasculitis.

The frequency with which central venous catheters are used as permanent access for maintenance hemodialysis is likely to increase in the future as the dialysis population ages and the quality of peripheral vasculature concomitantly declines. It is, therefore, essential that clinicians who manage dialysis patients stay abreast of the latest recommendations for prevention and treatment of catheter-related blood stream infections. This timely Review covers risk factors as well as data that underlie current best practice.

Here, Krisper and Stauber analyze the relative efficiency, clinical outcomes, safety and potential indications of two different 'liver dialysis' systems. Despite their 'experimental' status, the Molecular Adsorbents Recirculating System (MARS^®) and Prometheus^®, developed by Gambro and Fresenius Medical Care, respectively, are increasingly used to treat patients with severe hepatic failure. Preliminary data are promising, and large-scale randomized trials with the aim of proving a survival benefit are underway.

A team from King's College London presents an overview of the role of complement activation and complement regulatory proteins in kidney injury. They extend their discussion beyond immune-complex-mediated glomerular diseases such as lupus nephritis and membranoproliferative glomerulonephritis to other forms of renal injury in which complement has a role, such as atypical hemolytic uremic syndrome and graft rejection. Their concise and easy to read article includes a discussion of the therapeutic potential of manipulating complement inhibition.