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The clinical management of chronic kidney disease leads to an inevitable interplay between recommended therapies and the hazards of impaired renal function. Disturbances in potassium level are a common byproduct of this interaction and can increase the risk of adverse safety outcomes in patients with chronic kidney disease.
Changes in serum creatinine concentration are used to define acute kidney injury after the intravascular administration of iodinated contrast media, but less is known about the short-term increases in levels of cystatin C after angiography. A new study investigates whether cystatin C is a reliable marker of contrast-induced acute kidney injury after angiography.
The possible cardioprotective and renoprotective effects of statins in patients with chronic kidney disease remain an unsolved enigma for clinicians and researchers in the field of nephrology. Do the recently published AURORA and JUPITER studies shed light on this controversy?
The Oxford classification of IgA nephropathy identified four histological features with adequate reproducibility and clinical relevance to predict renal outcome in patients with IgA nephropathy. Does the predictive value of biopsy lesions apply across a range of patient ages?
Non-melanoma skin cancer occurs at an alarmingly high rate in transplant recipients, causing considerable morbidity and sometimes even mortality. A recent prospective clinical study performed by nephrologists and dermatologists at the Johann Wolfgang Goethe University in Frankfurt suggests that switching renal transplant recipients with skin lesions onto the mTOR inhibitor sirolimus might keep non-melanoma skin cancer in check.
Prerenal azotemia is a common occurrence in hospitalized patients and is generally easier to define in clinical practice than in clinical research. Monitoring the duration of acute kidney injury and biomarkers of kidney function might help distinguish prerenal azotemia from acute tubular necrosis in both clinical practice and research settings.
Renal fibrosis is the common end point of virtually all progressive kidney diseases and a detailed understanding of the underlying mechanisms is required for the development of effective therapeutic strategies. In this Review, Boor and colleagues discuss the most recent advances in renal, or more specifically, tubulointerstitial fibrosis. Consideration is given to novel mechanisms as well as potential treatment targets based on different cell types.
Hereditary disorders of renal phosphate wasting are rare genetic diseases. Affected patients can be symptomatic during childhood or adulthood, depending on the disease entity. In this Review, Alizadeh Naderi and Reilly provide an overview of a number of renal phosphate wasting disorders, focusing on their mode of inheritance, the effect of the responsible mutation, and clinical symptoms.
Tubulointerstitial hypoxia is increasingly recognized to have a key role in the progression of chronic kidney disease to end-stage renal disease. In this Review, Mimura and Nangaku discuss the different factors that contribute to the development of hypoxia in the tubulointerstitium and the susceptibility of different kidney cell types to hypoxia. Methods to detect hypoxia and potential therapeutic approaches to target chronic hypoxia in the kidney are also described.
Contrast-induced acute kidney injury (CIAKI) is a leading cause of iatrogenic renal failure. Multiple studies have shown that patients with diabetic nephropathy who are exposed to contrast media are at high risk of CIAKI. This Review describes the pathogenesis of CIAKI in patients with diabetic nephropathy and discusses both currently available strategies and potential future strategies for CIAKI prevention.
