Thrombotic microangiopathy

Approximately 5% of patients with atypical hemolytic–uremic syndrome have mutations in the thrombomodulin gene, according to a study published in the New England Journal of Medicine. Delvaeye et al. sequenced the entire thrombomodulin gene in 152 patients with atypical hemolytic–uremic syndrome and 380 controls, and found six different heterozygous mutations in the thrombomodulin gene in seven unrelated patients.

Delvaeye, M. et al. Thrombomodulin mutations in atypical hemolyticuremic syndrome. N. Engl. J. Med. 361, 345–357 (2009).

Dialysis

An episode of dialysis-requiring acute renal failure during hospitalization is an independent risk factor for long-term progressive chronic kidney disease and mortality, say researchers in the US. These were the findings of a study that included data from 556,090 adults admitted to hospital over an 8-year period with normal or near-normal kidney function at admission (estimated glomerular filtration rate ≤45ml/min/1.73 m2).

Lo, L. J. et al. Dialysis-requiring acute renal failure increases the risk of progressive chronic kidney disease. Kidney Int. doi:10.1038/ki.2009.289

Transplantation

A gene expression microarray study indicates that the renal expression of many complement genes at implantation is significantly higher in kidneys from deceased donors than in those from living donors. Complement gene expression is also increased in post-transplantation biopsies from well-functioning, nonrejecting kidneys, regardless of donor source. Targeted therapy that acts on the complement pathway might, in the future, be useful for improving post-transplantation outcomes.

Naesens, M. et al. Expression of complement components differs between kidney allografts from living and deceased donors. J. Am. Soc. Nephrol. 20, 1839–1851 (2009).

Nutrition

Uncooked meat products enhanced with food additives sometimes contain high levels of potassium and phosphorus that cannot be determined from the label, states a study in the Clinical Journal of the American Society of Nephrology, which compared potassium and phosphate content in additive-free and 'enhanced' meat. These findings have implications for patients with kidney disease, who must limit dietary phosphorus and potassium levels.

Sherman, R. A. & Mehta, O. Phosphorus and potassium content of enhanced meat and poultry products: implications for patients who receive dialysis. Clin. J. Am. Soc. Nephrol. 4, 1370–1373 (2009).