Volume 10 Issue 8, August 2014

Pre-existing HLA antibodies negatively impact long-term graft survival and might be a major risk factor for the formation of new HLA antibodies. Whether conversion of transplant recipients from calcineurin inhibitors to mammalian target of rapamycin inhibitors increases the risk of allosensitization remains to be determined.

The International Society of Nephrology–Advisory Committee of Clinical Trials and Studies aims to ensure access to timely and unbiased expert advice for all investigators, and to facilitate the development and execution of clinical trials within a highly ethical framework. The initiative will foster high-quality, cost-effective research in a sustainable network.

Childhood-onset chronic kidney disease is the result of congenital anomalies of the kidneys and urinary tract in approximately two-thirds of all patients. An area of intense research in recent years, however, is the potential impact of maternal obesity on renal ontogenesis or postnatal renal function in the offspring.

Acute or chronic antibody-mediated rejection (ABMR) of kidney allografts is currently diagnosed by the presence of donor-specific alloantibodies and distinct pathological findings in biopsy samples. A new study highlights the potential of molecular diagnostics incorporated into standard criteria for acute ABMR to help identify patients at risk of graft loss.

New research indicates that intact soluble urokinase plasminogen activator receptor (suPAR) does not induce albuminuria in mice. These data corroborate the most recent clinical findings, showing that intact suPAR is not the plasma permeability factor responsible for recurrence of focal segmental glomerulosclerosis after renal transplantation.

The introduction of next-generation sequencing has provided revolutionary opportunities for comprehensive genetic testing in research and diagnostics. Here, the authors discuss approaches used for novel gene identification, the potential of these techniques to improve the management of patients with inherited kidney diseases—focusing on nephronophthisis and congenital anomalies of the kidney and urinary tract—and the remaining challenges for implementation of next-generation sequencing in clinical practice.

In this Review, Ian Roberts provides a detailed description of the immunohistology and light microscopical features of IgA nephropathy, and highlights the importance of accurate recognition of the various histological lesions for reproducible classification of the disease. The different schemas used for classifying IgA nephropathy are compared, with particular focus on the Oxford classification.

Renal transplantation is the preferred treatment option for patients with autosomal dominant polycystic kidney disease (ADPKD) and end-stage renal disease. Here, the authors discuss special considerations for pretransplant screening and living-related kidney donation in patients with ADPKD, as well as post-transplant outcomes and complications in these patients.

Several genetic and environmental factors have been implicated in pre-eclampsia, a rare but serious condition leading to maternal and perinatal morbidity and mortality. In the first of this two-part Review, Chaiworapongsa and colleagues discuss the pathophysiology of pre-eclampsia, including imbalance between angiogenic and antiangiogenic factors, which has emerged as the central pathogenetic mechanism.