Volume 4 Issue 5, May 2008

It is widely asserted that C-reactive protein (CRP) is a strong independent predictor of atherothrombotic events, and furthermore that CRP is also a pathogenic mediator of atherosclerosis. Here, the author, who first reported the predictive association of CRP with atherothrombotic events, attempts to correct these misapprehensions. He highlights the lack of a convincing association between CRP values and atherosclerosis burden, the fact that the association between baseline CRP values and coronary heart disease is substantially weaker than originally claimed, the nonspecificity of the CRP response and the flaws of cell culture studies with recombinant CRP.

Reports from Japan indicate that renal artery embolization holds promise for relieving the 'mass effect' symptoms of autosomal dominant polycystic kidney disease. Authors from the University of Maryland School of Medicine compare the safety and efficacy of this procedure with that of the techniques more widely used to relieve the symptoms of autosomal dominant polycystic kidney disease, including nephrectomy, cyst marsupialization and cyst decortication.

Since the first successful kidney transplantations were performed in the 1950s, understanding of the factors that improve graft outcome has advanced. Nevertheless, post-transplantation urinary tract infections continue to be a source of morbidity and graft failure. This article reviews urinary tract infection in the renal transplant recipient, covering epidemiology, etiology, prevention, presentation, investigations, diagnosis and management.

Identification of the molecular pathways involved in renal pathophysiology can yield targets for intervention and aid tailored therapy. de Borst and colleagues provide an introduction to the tools that can be used to pinpoint genes involved in renal disease, including gene expression arrays, linkage analysis, association studies and animal models. Examples of genes that have been identified using these techniques are highlighted.

Ozturk et al. present the case of a schizophrenic male who developed hyponatremia due to fluoxetine-induced syndrome of inappropriate secretion of antidiuretic hormone (SIADH) and psychogenic polydipsia. The Case Study highlights the need for routine monitoring of electrolyte levels in patients with schizophrenia who are taking selective serotonin (5-HT) reuptake inhibitors such as fluoxetine.

Polyomavirus-associated nephropathy (PVAN), an important cause of allograft failure in renal transplant recipients, is usually diagnosed within 12 months of renal transplantation. Bansal et al. present a case of PVAN that developed more than 80 months after transplantation, however, highlighting the fact that PVAN can occur late after transplantation and should be considered in any renal transplant recipient who experiences a change in renal function.