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Terry Strom and Manikkam Suthanthiran present the results of studies investigating the potential of transcriptional profiling, based on both polymerase chain reaction and DNA array technologies, to identify renal allograft rejection from allograft biopsy specimens, blood and urine sediment. They argue that in future, such analysis will function not only as a surrogate for the invasive biopsy procedure, but could also have the capacity to provide predictive, diagnostic, and prognostic information.
The cortex and medulla of the kidney are believed to exist on a tightrope between normal function and hypoxia. The contributions of cortical and medullary hypoperfusion to hypertension have been widely investigated. In this Viewpoint, Thomas Pallone distills current knowledge on the roles of nitric oxide and reactive oxygen species in this setting, and speculates on the implications for future treatment of hypertension.
After outlining the mechanisms of phosphorous homeostasis—in which the kidney has a central role—Amanzadeh and Reilly explain how perturbation of this regulatory system can lead to hypophosphatemia. The authors then critically evaluate the clinical sequelae of this condition, and round out their review with advice on managing hypophosphatemia of varying severity in different patient populations.
In critical care units, acute renal failure is less common in premature infants than in more mature individuals. Recent studies indicate a role for the heat shock response in this clinical phenomenon. Distilled here, these new data could lead to strategies for identifying patients at greatest risk of developing acute renal failure.
The author comprehensively reviews novel data on the molecular mechanisms that underlie progression of kidney damage secondary to urinary tract obstruction. Encompassing inflammation, tubular cell apoptosis and interstitial fibrosis, the potential for the new findings to give rise to predictive biomarkers and molecular therapies for this leading cause of pediatric chronic renal failure is explored.
