Infectious diseases articles within Nature Reviews Nephrology

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  • Review Article |

    Sex differences in immune cell function and immune responses affect the development and outcome of diverse diseases. Here, the authors review current understanding of sex differences in immunity. They describe the key mechanisms that mediate sex differences in immune responses and discuss the functional relevance of such differences for immune-related diseases.

    • Shannon E. Dunn
    • , Whitney A. Perry
    •  & Sabra L. Klein

  • Review Article |

    In this Review, the authors summarize the challenges associated with the care of patients with kidney disease during the COVID-19 pandemic. They describe the major challenges and missed opportunities, global inequalities in health care, and offer a framework for future pandemic preparedness.

    • Duvuru Geetha
    • , Andreas Kronbichler
    •  & Valerie Luyckx

  • News & Views |

    Two recent randomized trials provide evidence to guide the management of sepsis. The CLASSIC trial reports that restrictive fluid therapy has no mortality benefit compared to a standard regimen in patients with septic shock, whereas the LOVIT trial reports that high-dose intravenous vitamin C might be harmful in patients with severe sepsis.

    • Mark Philip Plummer
    •  & Rinaldo Bellomo

  • Review Article |

    In this Review, the authors focus on kidney involvement in Chagas disease, filariasis, leishmaniasis, malaria and schistosomiasis. They describe the epidemiology, clinical features, mechanisms of kidney injury and renal pathological aspects of these diseases.

    • Elizabeth De Francesco Daher
    • , Geraldo Bezerra da Silva Junior
    •  & Vivekanand Jha

  • Year in Review |

    Patients with kidney disease are particularly vulnerable to COVID-19. In 2021, key studies demonstrated the safety of renin–angiotensin blockade in patients with kidney failure and COVID-19, and provided new data on the therapeutic potential of soluble angiotensin-converting enzyme, COVID-19 vaccine responses and the long-term effects of COVID-19 on kidney function.

    • María José Soler
    •  & Conxita Jacobs-Cachá

  • Review Article |

    Acute kidney injury (AKI) is a common complication of COVID-19. This Review describes current understanding of the pathophysiology of COVID-19-associated AKI, examining potential mechanisms by which SARS-CoV-2 infection might induce direct and indirect effects on the kidney and non-specific factors, including haemodynamic changes and/or organ crosstalk, that may adversely influence kidney function.

    • Matthieu Legrand
    • , Samira Bell
    •  & Vincenzo Cantaluppi

  • Comment |

    Patients with kidney diseases should be prioritized for COVID-19 vaccination and the available data suggest that replication-defective viral-vectored vaccines and mRNA vaccines are safe to use. As vaccine responses are likely to be lower in patients with kidney diseases than in the general population, highly potent vaccines should be preferred.

    • Martin Windpessl
    • , Annette Bruchfeld
    •  & Andreas Kronbichler

  • News & Views |

    A new study reports the seroprevalence of SARS-CoV-2 antibodies among a cross-section of patients on haemodialysis and uses these data to estimate seroprevalence in the general US population. Although this study demonstrates the potential of monitoring infectious disease prevalence in dialysis populations, the findings should be interpreted with caution.

    • Viyaasan Mahalingasivam
    •  & Laurie Tomlinson

  • Review Article |

    This Review describes our current understanding of the pathogenic mechanisms involved in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the progression of coronavirus disease 2019 (COVID-19), focusing on the immunological hyper-response and the induction of widespread endothelial damage, complement-associated blood clotting and systemic microangiopathy, as well as the effects of these processes on the kidney. The authors also discuss therapeutic interventions that currently hold most promise.

    • Luca Perico
    • , Ariela Benigni
    •  & Giuseppe Remuzzi

  • Consensus Statement
    | Open Access

    COVID-19-associated AKI (COVID-19 AKI) is associated with high mortality and is an independent risk factor for all-cause in-hospital death in patients with COVID-19. This Consensus Statement from the Acute Disease Quality Initiative provides recommendations for the diagnosis, prevention and management of COVID-19 AKI and for areas of future research, with the aim of improving understanding of the underlying processes and outcomes for patients with COVID-19 AKI.

    • Mitra K. Nadim
    • , Lui G. Forni
    •  & John A. Kellum

  • Comment |

    The COVID-19 pandemic has placed a tremendous strain on sustaining the clinical research enterprise and will also likely affect key study outcomes; these effects must be considered during data analysis and interpretation. Nevertheless, the responses to the pandemic have also introduced innovations that will advance the conduct of clinical research.

    • Katherine R. Tuttle

  • Review Article |

    Staphylococcus infection-associated glomerulonephritis (SAGN) and acute post-streptococcal glomerulonephritis (APSGN) are the two main types of bacterial infection-associated glomerulonephritis. In this Review, the authors discuss the epidemiology of these diseases, common histopathology findings and the complexities of clinical diagnosis, as well as patient management and renal outcomes.

    • Anjali A. Satoskar
    • , Samir V. Parikh
    •  & Tibor Nadasdy

  • Review Article |

    Antimicrobial resistance is an emergent global problem and patients with chronic kidney disease have some of the highest rates of colonization and infection with antibiotic-resistant bacteria (ARB). This Review focuses on the epidemiology, prevention and treatment of infections with ARB.

    • Tina Z. Wang
    • , Rosy Priya L. Kodiyanplakkal
    •  & David P. Calfee

  • Review Article |

    This Review describes the epidemiology and mechanisms underlying the reciprocal relationship between hepatitis C virus (HCV) infection and chronic kidney disease (CKD). The authors also discuss recommended treatment approaches for patients with HCV infection and CKD, and outline remaining issues in the field.

    • Stanislas Pol
    • , Lucia Parlati
    •  & Michel Jadoul

  • Review Article |

    Renal disease is a frequent complication of HIV infection, and a spectrum of renal disorders has been described with diverse histopathologic forms. In this Review, Scott Cohen and colleagues outline the epidemiology of renal disease in HIV and how it has changed since the introduction of combined antiretroviral therapy. They discuss the clinical manifestations and mechanisms underlying renal disease development in patients with HIV, and the issues pertaining to diagnosis and therapeutics.

    • Ehsan Nobakht
    • , Scott D. Cohen
    •  & Paul L. Kimmel

  • News & Views |

    Despite reductions in morbidity and mortality owing to widespread use of highly effective antiretroviral therapy (ART), HIV-positive patients remain at high risk of chronic kidney disease (CKD) and end-stage renal disease. A new report provides a HIV-specific CKD risk score to balance the potential benefits and harms of nephrotoxic ART.

    • Rebecca Scherzer
    •  & Michael G. Shlipak

  • Review Article |

    HIV infection is associated with renal diseases including HIV-associated nephropathy, HIV-immune-complex kidney disease, thrombotic microangiopathy and disorders associated with nephrotoxic HIV therapies. Here, the authors review the epidemiology, histopathology, mechanisms, genetic susceptibility, diagnosis and treatment of HIV-associated nephropathies and highlight remaining questions for future research.

    • Avi Z. Rosenberg
    • , Saraladevi Naicker
    •  & Jeffrey B. Kopp

  • Review Article |

    Hepatitis C virus (HCV) infection imposes a substantial economic, clinical, and societal burden worldwide. In this Review, Morales and Fabrizi compare the treatment options that are available to patients with HCV infection, before and after renal transplantation. The development of novel therapeutic strategies and the clinical complications associated with HCV infection are discussed. The authors conclude with an assessment of the safe use of organs donated from individuals with active HCV infection.

    • Jose M. Morales
    •  & Fabrizio Fabrizi

  • Year in Review |

    Several studies published in 2014 might facilitate improvements in the treatment and long-term care of renal transplant recipients. The potential risks of living kidney donation, the efficacy and safety of alemtuzumab-based induction therapy, and the treatment of chronic hepatitis E virus infection have been addressed.

    • Dennis A. Hesselink
    •  & Willem Weimar

  • Review Article |

    Each year, over 70,000 organs are transplanted worldwide. The degree of risk of transmission of infection from transplanted organs to the recipient is largely unknown and is difficult to assess for specific organs. Here, Jay A. Fishman and Paolo A. Grossi describe the major risk factors for organ donor-derived transmission of infection and discuss opportunities to reduce the incidence of such events.

    • Jay A. Fishman
    •  & Paolo A. Grossi

  • Review Article |

    Although vulnerable to infection, substantial numbers of kidney transplant recipients remain unvaccinated. This missed opportunity for protection can result in serious infection, graft loss and mortality. Here, Camille Kotton discusses the safety, efficacy, need for and timing of vaccination in adult transplant recipients, including discussion of specific vaccines and indications.

    • Camille N. Kotton

  • News & Views |

    According to new data from Hirsch et al., the risk of polyomavirus BK (BKV) viraemia in kidney transplant recipients is increased by high steroid exposure early after transplantation, treatment with tacrolimus rather than ciclosporin A, older donor age and male gender. However, confounding of results due to variations in immunosuppressive drug exposure cannot be excluded.

    • Phuong-Thu T. Pham
    •  & Uttam G. Reddy

  • News & Views |

    An observational study associates azithromycin use with accelerated stool decolonization in patients infected with Shiga toxin-producing Escherichia coli O104:H4. Even if this association is causal, however, the value of late-in-illness treatment is not established and the results provide no support for early-in-illness treatment of Shiga toxin-producing E. coli infections.

    • Michael E. Seifert
    •  & Phillip I. Tarr

  • News & Views |

    Individuals with HIV disease frequently experience kidney dysfunction, which is accompanied by an increased risk of cardiovascular disease and death. Choi et al. have found that albuminuria and an estimated glomerular filtration rate of <60 ml/min/1.73 m2, estimated using serum cystatin C level, accounted for 17% of the population-attributable 5-year mortality risk in a cohort of patients with HIV infection.

    • Jeffrey B. Kopp

  • Review Article |

    Central venous catheters used for hemodialysis continue to be associated with high rates of bloodstream infections. In this article, Michiel Betjes reviews the evidence showing that such infections can be prevented by meticulous catheter care and discusses how improved management protocols could help to reduce the incidence of catheter-related infections, even in the absence of topical antimicrobial agents and/or lock solutions.

    • Michiel G. H. Betjes

  • Review Article |

    Infection with hepatitis B virus (HBV) or hepatitis C virus (HCV) in kidney transplant candidates was once considered a contraindication to transplantation, but advances in antiviral therapy have now enabled successful transplantation in these patients. In this Review, Huskey and Wiseman discuss the management of chronic HBV and HCV infection in both kidney donors and recipients, including post-transplantation outcomes and recommendations for treatment and organ allocation in these individuals.

    • Janna Huskey
    •  & Alexander C. Wiseman

  • News & Views |

    Several randomized clinical trials with short-term follow-up have shown that patients on hemodialysis with prophylactic antibiotic catheter locks have reduced catheter-related bacteremia. However, the long-term safety of such locks remains a subject of ongoing debate. Landry et al. now report that prophylactic gentamicin catheter locks can promote the emergence of gentamicin-resistant bacteremia during long-term use.

    • Michael Allon

  • Review Article |

    Cytomegalovirus (CMV) infections are among the most common infections that can occur following solid organ transplantation. Although overall awareness of CMV disease has improved, several challenges remain with regards to its management. In this Review, Camille Kotton provides an overview of CMV diagnostics, methods for the prevention of CMV infection, and progress in the management of this disease.

    • Camille N. Kotton

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