Risk factors articles within Nature Reviews Nephrology

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  • Review Article |

    A number of epidemiological studies have linked markers of underhydration with an increased risk of adverse health outcomes. This Review provides an overview of the mechanisms that regulate body water balance and the adaptive responses to decreased hydration, and describes current understanding of the physiological consequences of underhydration on health outcomes.

    • Natalia I. Dmitrieva
    • , Manfred Boehm
    •  & Sofia Enhörning

  • Review Article |

    Although potentially harmful in excess, reactive oxygen species (ROS) also act as signalling molecules and contribute to cell survival. This Review describes the relevance of ROS to physiological processes and disease pathogenesis with a focus on the kidney. The authors also outline the current status of clinical trials that aim to target ROS signalling in humans.

    • Seiji Kishi
    • , Hajime Nagasu
    •  & Naoki Kashihara

  • Comment |

    Chronic kidney disease (CKD) is highly prevalent in women in perimenopause and menopause. Both CKD and menopause affect several important pathologies, such as cardiovascular disease (CVD) and bone mineral disease. More research is needed to better understand the relationships between menopause, CKD, CVD and bone disease.

    • Virginia A. Dines
    •  & Vesna D. Garovic

  • Comment |

    Specific policies embedded in organ and tissue donation and transplantation systems discriminate against sexual orientation- and gender identity-diverse populations, restricting or excluding the use of donated organs and tissues. Revision of these policies is needed to promote equity and increase the supply of high-quality organs and tissues for those who need them.

    • Murdoch Leeies
    • , Emily Christie
    •  & David Collister

  • Comment |

    People with kidney disease are particularly vulnerable to the impacts of natural disasters and extreme weather events. As climate change is increasing the frequency and severity of these events, a robust response is needed to improve disaster preparedness and increase the resilience of these patients.

    • Amir Sapkota
    •  & Peter Kotanko

  • Comment |

    Climate change is increasing global temperatures and causing more frequent and severe extreme heat events. The resulting additional disease burden is inequitably distributed. Strategies that reduce inequities in heat exposure and vulnerability to heat-related illness, as well as health protections at multiple levels (from individual to regional), are urgently needed to contain the looming crisis.

    • Jeremy Hess

  • Review Article |

    Chronic kidney disease (CKD) is associated with an elevated risk of cardiovascular disease (CVD). Here, the authors examine CKD-associated risk factors for CVD and consider the prediction and management of CVD risk in patients with CKD, including research and implementation gaps.

    • Kunihiro Matsushita
    • , Shoshana H. Ballew
    •  & Rajiv Agarwal

  • Comment |

    Kidney disease is an underappreciated medical complication of anorexia nervosa. Further research is needed to clarify the mechanisms that drive kidney disease in patients who restrict caloric intake or engage in purging. Education and awareness are also needed, because kidney disease is often under-recognized by these patients and their clinicians.

    • Leah Puckett
    • , Shoshana Mehler
    •  & Philip Mehler

  • Perspective |

    Here, the authors discuss the effects of salt intake on health outcomes, the factors that determine individual susceptibility to dietary salt and approaches to reducing salt intake and improving health at the population and individual levels.

    • Robert W. Hunter
    • , Neeraj Dhaun
    •  & Matthew A. Bailey

  • Year in Review |

    In 2021, extreme weather and climate events caused preventable injuries, illnesses and deaths. A clear imperative exists to reduce greenhouse gas emissions and increase the sustainability and climate resilience of health systems. Countries and communities must implement strategies to mitigate climate change and invest in health systems to protect their populations.

    • Kristie L. Ebi

  • Review Article |

    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.

    • Zoltan Ungvari
    • , Peter Toth
    •  & Anna Csiszar

  • Review Article |

    Chronic kidney disease (CKD) is associated with alterations in serum lipid profiles that contribute to kidney and cardiovascular disease. Here, the authors examine these changes in serum levels, metabolism and post-translational modifications of lipoproteins and fatty acids that characterize CKD-associated dyslipidaemia.

    • Heidi Noels
    • , Michael Lehrke
    •  & Joachim Jankowski

  • Comment |

    Living donor kidney transplantation benefits the recipient. However, kidney failure can occur in a small fraction of donors — the risk is not uniform but varies according to donor characteristics. Studies to date have failed to match on important factors, such as era, environment or family history. Long-term studies with well-matched healthy controls are therefore needed.

    • Arthur J. Matas
    •  & Andrew D. Rule

  • News & Views |

    A new study uses the OpenSAFELY health analytics platform to identify risk factors for COVID-19 mortality. This analysis, which includes data for more than 17 million people in the UK, suggests that patients with chronic kidney disease are at higher risk than those with other known risk factors, including chronic heart and lung disease.

    • Ron T. Gansevoort
    •  & Luuk B. Hilbrands

  • Review Article |

    Available data suggest that the prevalence and incidence of kidney stones is increasing; however, much of this variation might result from differences in approaches used to identify stone formers. This Review describes the need for a classification system to facilitate use of consistent terminology and enable meaningful comparisons of the burden of kidney stone disease across different populations.

    • Charat Thongprayoon
    • , Amy E. Krambeck
    •  & Andrew D. Rule

  • Comment |

    Health-care workers involved in the response to the COVID-19 pandemic are often required to work in highly challenging conditions and may therefore be at increased risk of experiencing mental health problems. This Comment sets out a practical approach to protecting the mental health of health-care workers based on contemporary evidence.

    • Neil Greenberg

  • News & Views |

    A new study reports that genome-wide polygenic risk scores can identify individuals at risk of common complex diseases, such as coronary artery disease or type 2 diabetes, with comparable performance to that of monogenic mutation screens. These findings support the potential clinical utility of genome-wide association study (GWAS)-based risk stratification; however, several issues need to be addressed before this approach can be applied to kidney disease.

    • Lili Liu
    •  & Krzysztof Kiryluk

  • Review Article |

    Acute kidney injury (AKI) is a life-threatening complication in critically-ill neonates. This Review explores the evidence that intrauterine growth restriction, premature birth and low birth weight contribute to neonatal AKI, and discusses perinatal and postnatal risk factors that enhance the risk of AKI among neonates.

    • Norberto Perico
    • , David Askenazi
    •  & Giuseppe Remuzzi

  • News & Views |

    Advances in precision medicine have greatly improved outcomes for patients with cancer. New findings that demonstrate a substantial contribution of major chronic diseases and disease markers to the risk of cancer incidence and mortality highlight the impact of chronic disease on cancer risk and suggest that chronic diseases should be targeted in cancer prevention strategies.

    • Andrew S. Allegretti
    •  & Ravi I. Thadhani

  • Viewpoint |

    Here, four leading researchers discuss key considerations related to women's kidney health, including specific risk factors, the main challenges and barriers to care and policies and systems that could be implemented to improve the kidney health of women and their offspring.

    • Gloria E. Ashuntantang
    • , Vesna D. Garovic
    •  & Liz Lightstone

  • Review Article |

    Cardiac surgery-associated acute kidney injury (CSA-AKI) is the most common complication in adult patients undergoing open heart surgery. In this Review, the authors discuss the definition, epidemiology, pathophysiology and risk factors of CSA-AKI. The authors also explore the use of novel biomarkers of AKI and their potential utility in preventing or treating CSA-AKI.

    • Ying Wang
    •  & Rinaldo Bellomo

  • News & Views |

    The FOURIER trial shows that evolocumab, an injectable monoclonal antibody against PCSK9, decreased the risk of cardiovascular events in high-risk patients receiving statin therapy. The beneficial effects of this drug were consistent with an absolute reduction in LDL cholesterol levels, although studies with a longer follow-up period are needed.

    • David Preiss
    •  & Colin Baigent

  • News & Views |

    A recent study reports that coronary artery calcification (CAC) predicts the risk of heart failure, myocardial infarction and stroke in patients with moderate chronic kidney disease (CKD). This finding suggests that even in CKD, CAC is a marker of cardiovascular risk rather than a benign indicator of vessel healing and stability.

    • Paolo Raggi

  • News & Views |

    Hypertension in pregnancy is a known risk factor for increased cardiovascular risk for both the mother and her offspring. New findings suggest the offspring of normotensive pregnancies should also be considered at risk of high blood pressure if their mother has had hypertension in other pregnancies.

    • Grace Z. Yu
    •  & Paul Leeson

  • News & Views |

    Iodinated contrast media are essential for diagnostic and interventional radiological and cardiological procedures, but may cause kidney damage. Intravenous hydration is the current cornerstone for prevention of contrast-induced acute kidney injury; however, new data from the AMACING trial suggest that this approach might not be beneficial in low-risk patients.

    • Carlo Briguori
    •  & Giuseppe Signoriello

  • News & Views |

    Acute kidney injury continues to challenge physicians, researchers and patients. To date, there is no efficient treatment for acute kidney injury and its occurrence in many critically ill patients seems inevitable. However, a new study might just change the way we approach this seemingly intractable problem.

    • John A. Kellum

  • Review Article |

    Contrast agents can damage the kidney through several mechanisms. Here, the authors discuss current understanding of the incidence and pathophysiology of contrast-induced acute kidney injury and highlight the need to consider individual patient risk factors when considering prevention strategies.

    • Michael Fähling
    • , Erdmann Seeliger
    •  & Pontus B. Persson

  • Review Article |

    Hyperphosphataemia is associated with poor clinical outcomes but strong evidence that targeting serum phosphate improves these outcomes is lacking. Here the authors discuss the role, regulation and management of serum phosphate in chronic kidney disease, including the efficacies of phosphate binder therapy and dietary interventions.

    • Marc G. Vervloet
    • , Siren Sezer
    •  & Denis Fouque

  • Review Article |

    Scleroderma renal crisis is a rare, potentially life-threatening complication of systemic sclerosis. Here, the authors discuss advances made in the detection, management and prognosis of scleroderma renal crisis, which can limit the progression of affected patients to chronic kidney disease.

    • Thasia G. Woodworth
    • , Yossra A. Suliman
    •  & Philip Clements

  • News & Views |

    Low birth weight (LBW) and intrauterine growth restriction are major contributors to the global burden of non-communicable diseases. A Norwegian registry study has confirmed that LBW is associated with an increased risk of developing end-stage renal disease by 40 years of age, which could not be explained by familial factors.

    • Carolyn L. Abitbol
    •  & Marva Moxey-Mims

  • Year in Review |

    Combination therapy with optimal doses of multiple antihypertensive drugs fails to achieve blood pressure (BP) control in up to 15% of hypertensive patients. Key studies in 2015 highlighted the risks of uncontrolled hypertension and evaluated new therapeutic modalities designed to achieve satisfactory BP control in patients with treatment-resistant hypertension.

    • Lilach O. Lerman
    •  & Stephen C. Textor

  • News & Views |

    Autosomal dominant polycystic kidney disease is a challenging disorder to diagnose and treat effectively. Promising research over the past decade has, however, provided novel interventions, modifications to clinical practice and new areas to investigate with the aim of identifying approaches to slow disease progression.

    • Robert W. Schrier

  • News & Views |

    Chronic kidney disease is associated with an increased risk of cardiovascular disease that often exceeds risk of progression to end-stage renal disease. A meta-analysis has shown that the addition of glomerular filtration rate and albuminuria to traditional risk factors for cardiovascular outcomes improves the discrimination of cardiovascular risk prediction models.

    • Maarten W. Taal

  • 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

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