Bone disease after renal transplantation
Hartmut H. Malluche,
Marie-Claude Monier-Faugere
&
Johann Herberth
Published online: 17 November 2009 | doi:10.1038/nrneph.2009.192
Disturbances in bone metabolism are common in patients after renal transplantation and represent important causes of morbidity and mortality. This Review discusses the etiological factors that contribute to bone metabolic disturbances in renal transplant recipients—pre-existing renal osteodystrophy, the effects of transplant-specific therapies on bone metabolism, and the effects of reduced renal function after transplantation. The clinical implications of bone disease in these patients are also considered.
Prehypertension: epidemiology, consequences and treatment
Eduardo Pimenta
&
Suzanne Oparil
Published online: 17 November 2009 | doi:10.1038/nrneph.2009.191
A prehypertension classification of blood pressure, encompassing a blood pressure range previously regarded to be normal that has been associated with an increased risk of hypertension mortality compared with lower blood pressure, has been established. In this Review, Pimenta and Oparil discuss the epidemiology of prehypertension, the relationship with cardiovascular morbidity and mortality, and the treatment of prehypertensive patients.
Possible renoprotection by vitamin D in chronic renal disease: beyond mineral metabolism
Carolina R. C. Doorenbos,
Jacob van den Born,
Gerjan Navis
&
Martin H. de Borst
Published online: 27 October 2009 | doi:10.1038/nrneph.2009.185
Vitamin D has long been understood to be a key player in the control of bone metabolism through the regulation of calcium and phosphate homeostasis; however, growing evidence suggests this hormone may also have an important role in the progressive loss of renal function. In this Review, the authors discuss the pathogenic consequence of vitamin D deficiency on the kidney and describe the renoprotective potential of vitamin D analogues for patients with kidney disease.
An update on the lipid nephrotoxicity hypothesis
Xiong Z. Ruan,
Zac Varghese
&
John F. Moorhead
Published online: 27 October 2009 | doi:10.1038/nrneph.2009.184
According to the 'lipid nephrotoxicity hypothesis', hyperlipidemia resulting from physiological compensatory synthesis of lipoproteins in response to urinary loss of albumin can itself cause or aggravate glomerular and tubulointerstitial disease. Ruan and colleagues discuss the evidence on the mutual influence that dysregulation of lipid homeostasis and renal disease exert on each other and how such evidence confirms, qualifies and modifies the lipid nephrotoxicity hypothesis.
Application of proteomic analysis to the study of renal diseases
Matthew P. Welberry Smith,
Rosamonde E. Banks,
Steven L. Wood,
Andrew J. P. Lewington
&
Peter J. Selby
Published online: 27 October 2009 | doi:10.1038/nrneph.2009.183
Proteomic research has the potential to provide disease biomarkers to clinical practice and insight into pathological mechanisms. In this Review, Welberry Smith and colleagues present an overview of the state of the art of proteomic analysis applied to the study of kidney diseases and discuss future directions of this research field and likely developments.
