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As witnesses to the health consequences of social discrimination, clinicians are uniquely positioned to build coalitions of stakeholders to address inequities and drive change. Such civic engagement is needed to ensure that all populations are given the opportunity to thrive.
Proper glomerular basement membrane (GBM) structure and function are required for appropriate glomerular filtration and abnormalities in the α3α4α5 (α345) network of collagen IV — a GBM component — can lead to disease. New insights into the mechanisms underlying α345 hexamer assembly and function from genetic and structural data identify possible targets for therapeutic modulation.
The AURORA 1 study reports that low-dose voclosporin added to standard immunosuppressive treatment improved rate of remission in patients with lupus nephritis. Further studies are needed to investigate the long-term efficacy and tolerability of voclosporin and to compare the effects of this treatment with those of low doses of tacrolimus or ciclosporin.
Hypertension and ageing have deleterious effects on the cerebral microcirculation that can lead to cognitive dysfunction. This Review discusses cerebrovascular maladaptation to hypertension and microvascular contributions to hypertension-induced cognitive impairment in ageing, as well as the role of hypertension in the pathogenesis of Alzheimer’s disease.
The lymphatic system transports interstitial fluid, immune cells and associated macromolecules to maintain body fluid homeostasis and regulate immune cell trafficking. This Review discusses the origins and organization of the lymphatic system and hybrid lymphatic-like vessels, their role in kidney function and disease, and the potential role of the lymphatic system as a therapeutic target.
Application of big data in nephrology could lead to new insights into kidney diseases, facilitate personalized medicine and improve patient care. This Review discusses the major sources of big data in nephrology and how they could be utilized in research and clinical practice.
In vivo non-invasive molecular imaging techniques have potential to improve clinical research and practices in nephrology. Here, the authors discuss the benefits and challenges of preclinical and clinical applications of molecular imaging to acute kidney injury and chronic kidney disease, transplantation and kidney cancer.