Infection articles within Nature Reviews Nephrology

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  • Review Article |

    The bladder and kidney engage adaptive and innate immune responses to prevent urinary tract infections and minimize tissue injury following infection. Here, the authors describe the mechanisms used by uropathogenic bacteria to establish and promote kidney infection, as well as the immune defence mechanisms used by resident kidney cells and infiltrating immune cells to eradicate infection.

    • Laura Schwartz
    • , Juan de Dios Ruiz-Rosado
    •  & John David Spencer

  • Consensus Statement |

    Sepsis-associated acute kidney injury (SA-AKI) is linked with poor outcomes in critically ill patients. This Consensus Statement from the Acute Disease Quality Initiative discusses the definition, epidemiology and pathophysiology of SA-AKI, fluid, resuscitation and extracorporeal therapies, and the role of biomarkers in risk stratification and diagnosis.

    • Alexander Zarbock
    • , Mitra K. Nadim
    •  & Lui G. Forni

  • Review Article |

    Effective vaccination strategies are crucial to mitigate the high risk of infection-associated morbidity and mortality in patients with kidney failure. Here, the authors examine vaccine-induced immunity in these patients, in particular their responses to COVID-19 vaccination, in the context of the immune impairment induced by kidney dysfunction and the use of immunosuppressive medications.

    • Nina Babel
    • , Christian Hugo
    •  & Timm H. Westhoff

  • News & Views |

    Although direct kidney infection by SARS-CoV-2 remains controversial, a study based largely on autopsies shows increased tubulointerstitial fibrosis in patients with COVID-19 and suggests direct kidney infection. Moreover, in human kidney organoids, SARS-CoV-2 infection upregulates several pro-fibrotic and pro-inflammatory pathways.

    • Luise Hassler
    •  & Daniel Batlle

  • Comment |

    The current COVID-19 pandemic is associated with unprecedented morbidity and mortality. Early reports suggested an association between disease severity and hypertension but did not account for sources of confounding. However, the responsible virus — SARS-CoV-2 — gains entry to host cells via angiotensin-converting enzyme 2 (ACE2), highlighting the need to understand the relationship between the virus and the renin–angiotensin system (RAS) and how this might be affected by RAS inhibitors.

    • Andrew M. South
    • , Laurie Tomlinson
    •  & Matthew A. Sparks

  • Review Article |

    In this Review, the authors discuss the pathological mechanisms related to Toll-like receptors, nucleotide-binding oligomerization domain receptors and the NACHT, LRR and PYD domains-containing protein 3 inflammasome in various kidney diseases. Although these receptors are protective in the host defence against urinary tract infection, they can perpetuate tissue damage in sterile inflammatory and immune-mediated kidney diseases—making them promising drug targets.

    • Jaklien C. Leemans
    • , Lotte Kors
    •  & Sandrine Florquin

  • Review Article |

    Infection is one of the most common causes of morbidity, mortality and hospitalization in patients undergoing dialysis. This Review focuses on the epidemiology and characteristics of access-related infections—bloodstream infections in hemodialysis and peritonitis in peritoneal dialysis—as well as access-unrelated infections, such as viral hepatitis and respiratory infection.

    • Philip Kam-Tao Li
    •  & Kai Ming Chow

  • Review Article |

    Peritoneal dialysis is the preferred dialysis modality for most children with end-stage renal disease. Although advances in treatment have led to increased technique and patient survival, challenges remain. In this Review, Schaefer and Warady discuss data from multiple pediatric dialysis registries and describe the technical issues associated with peritoneal dialysis in pediatric patients.

    • Franz Schaefer
    •  & Bradley A. Warady

  • Case Study |

    This article reports the case of a 73-year-old man who developed spondylodiscitis as a result of methicillin-sensitiveStaphylococcus aureusbacteremia. The patient's catheter was identified as the source of bacteremia, which had spread to the vertebral discs as confirmed by microbiological tests and MRI. The authors also discuss the characteristics of 12 other patients with spondylodiscitis and describe the risk factors for developing this condition and its most appropriate management.

    • Masoud Afshar
    •  & Robert F. Reilly

  • News & Views |

    Results of a clinical trial reported in the New England Journal of Medicine suggest that the use of recombinant tissue plasminogen activator as a lock solution improves catheter patency and reduces the risk of catheter-related infections. These effects have important clinical and economic ramifications. So why is tissue plasminogen activator not more widely used?

    • Anatole Besarab
    •  & Carol L. Moore

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