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A new report suggests that differences in albuminuria might contribute to disparities in susceptibility to nephropathy in African American and white individuals. Interpretation of this finding requires consideration of renal histology, clinical trials and genetic studies. These factors indicate that a far more complex scenario is likely to exist than previously thought.
A recent report from the Alberta Kidney Disease Network demonstrates that high estimated glomerular filtration rate is associated with an increased risk of all-cause mortality in both young and elderly individuals, as well as in those with and without proteinuria. Potential explanations and implications of these findings are discussed.
For patients who undergo desensitization treatment to reduce or neutralize circulating donor-specific anti-HLA antibodies prior to transplantation, survival is lower than for unsensitized patients. However, a new study suggests that for sensitized patients, desensitization and transplantation might be better than remaining on dialysis or waiting for a compatible kidney transplant.
Renal fibrosis is the common final outcome of almost all chronic kidney diseases, and can predict prognosis and determine renal insufficiency. This process consists of four overlapping phases: priming, activation, execution and progression. In this Review, Youhua Liu outlines the cellular and molecular mechanisms of renal fibrosis, which could help the development of new therapeutic strategies.
Antiglomerular basement membrane (anti-GBM) disease is an autoimmune disorder that presents as raised titers of antibodies against the GBM, mostly together with rapidly progressive glomerulonephritis and pulmonary hemorrhage. This Review summarizes current knowledge on the prevalence, clinical manifestations, treatment and outcomes of human anti-GBM disease, and discusses advances in our understanding of its pathogenesis.
Scarring occurs in the kidneys of most people as they age, which is associated with a gradual decline in renal function. Several genetic and environmental factors have been found to accelerate the age-related decline in kidney function. In this Review, the authors describe the current clinical and tissue factors that are associated with progressive renal aging and highlight the factors that might slow this process.
Lupus nephritis is one of the most common serious manifestations of systemic lupus erythematosus (SLE). Antimalarial agents are part of the immunomodulatory regimen used to treat patients with SLE, but the role of antimalarial agents in the treatment of lupus nephritis has been underappreciated by nephrologists. In this Review, the authors discuss the use of chloroquine and hydroxychloroquine in the treatment of patients with SLE, focusing on those with lupus nephritis.
Hyperreninemic hypertension is a clinical condition in which the kidneys produce too much renin autonomously and independently of angiotensin II and aldosterone levels. This Case Study reports the case of a previously normotensive 18-year-old man who developed renin-dependent hypertension following presumed sports-related blunt renal trauma. The diagnosis, treatment and management of this patient are discussed.
