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Key Advances in Nephrology

The Key Advances in Nephrology collection offers a unique series of specially commissioned ‘Year in Review’ articles that highlight the key discoveries made each year. In these articles, leading experts in the field describe their pick of the top 3–5 key advances of the year, outlining their clinical impact and implications for current and future research.


  • Nature Reviews Nephrology | Year in Review

    With many failures, a sense of helplessness has overshadowed the field of acute kidney injury (AKI). Publications in 2018 offer new hope: better drug targets, better end points and improved understanding of conditions that cause AKI and its complications bring promise that a drug will soon be available.

    • John A. Kellum
    •  &  Dana Y. Fuhrman
  • Nature Reviews Nephrology | Year in Review

    The function of polycystin proteins and the pathogenesis of autosomal dominant polycystic kidney disease (ADPKD) are not well understood. Studies published in 2018 made important contributions to the understanding of genetic mechanisms, the structure of the polycystin complex and the roles of G-protein signalling and the immune system in ADPKD.

    • Vicente E. Torres
    •  &  Peter C. Harris
  • Nature Reviews Nephrology | Year in Review

    Numerous exciting studies that advanced our understanding of immune-mediated kidney disease were published in 2018. Whereas most of these studies analysed the role of pro-inflammatory mediators, several novel anti-inflammatory mechanisms were discovered that involve immune cells and mediators with previously unrecognized protective roles in renal disease.

    • Christian Kurts
    •  &  Catherine Meyer-Schwesinger
  • Nature Reviews Nephrology | Year in Review

    In 2018, consolidating evidence for renoprotective benefits was seen with respect to sodium–glucose cotransporter 2 inhibitors and glucagon-like peptide 1 agonists, which are currently being incorporated into clinical practice. The focus now turns to novel therapeutic targets to optimize renoprotection as diabetic kidney disease grows to epidemic proportions worldwide.

    • Mark Cooper
    •  &  Annabelle M. Warren
  • Nature Reviews Nephrology | Year in Review

    Discoveries in 2018 using single-cell sequencing and gene-editing technologies have revealed their transformative potential for the investigation of kidney physiology and disease. Their promise is matched by the speed of their evolution.

    • Parker C. Wilson
    •  &  Benjamin D. Humphreys


  • Nature Reviews Nephrology | Year in Review

    Studies of cellular energetics have revealed important roles of metabolic pathways in determining cell fate and response to injury. Insights from 2017 into the mechanisms underlying these pathways might identify therapeutic targets to minimize injury and promote repair.

    • Ton J. Rabelink
    •  &  Peter Carmeliet
  • Nature Reviews Nephrology | Year in Review

    2017 saw the emergence of a new era in renoprotective medicine for diabetic kidney disease with reports of promising renal outcomes with the sodium–glucose cotransporter 2 (SGLT2) inhibitors empagliflozin and canagliflozin from follow-up analyses of the EMPA-REG OUTCOME trial and the CANVAS Program, respectively, and with use of the glucagon-like peptide 1 (GLP1) agonist liraglutide in the LEADER trial.

    • Christoph Wanner
  • Nature Reviews Nephrology | Year in Review

    New findings in 2017 enhanced our understanding of the mechanisms that regulate blood pressure. Key studies provided insights into immune mechanisms, the role of the gut microbiota, the adverse effects of perivascular fat and inflammation on the vasculature, and the contribution of rare variants in renin–angiotensin–aldosterone system genes to salt sensitivity.

    • Ernesto L. Schiffrin
  • Nature Reviews Nephrology | Year in Review

    In 2017, progress was made in several aspects of immune-mediated kidney disease. Mechanistic studies provided new insights into the underlying signals that confer risk to, or protection from, immune pathways, whereas new approaches to the treatment of immunological kidney disease will hopefully translate into a move away from the use of toxic corticosteroids.

    • Stephen R. Holdsworth
    •  &  A. Richard Kitching
  • Nature Reviews Nephrology | Year in Review

    Technical advances in genome sequencing and association studies have yielded critical insights into the genetic architecture of kidney diseases. Here, I summarize four key studies from 2017 that deciphered the genetic basis of known and novel diseases and provided insights into the mechanisms of glomerular, developmental defects and manifestations of kidney disorders.

    • Olivier Devuyst


  • Nature Reviews Nephrology | Year in Review

    Studies published in 2016 provide insights that bring us closer to achieving the goal of personalized therapy for primary glomerular diseases. Moreover, promising renal outcome data with new classes of glucose-lowering agents — SGLT2 inhibitors and GLP-1 agonists — offer new hope for patients with diabetic nephropathy.

    • Rutger J. Maas
    •  &  Jack F. Wetzels
  • Nature Reviews Nephrology | Year in Review

    The genetic background of many kidney diseases is complex and involves multiple genes, genetic variants and molecular pathways. Here, we look at how researchers tackled this challenging topic in 2016, focusing on studies that used ingenious data-integration tactics, which led to new insights into kidney disease aetiology and renal disease progression.

    • Kirsten Y. Renkema
    •  &  Nine V.A.M. Knoers
  • Nature Reviews Nephrology | Year in Review

    Tyrosine kinase inhibitors that target pro-angiogenic pathways improve progression-free and overall survival in patients with metastatic kidney cancer and were thus tested in the adjuvant setting in studies published this past year. 2016 also saw the emergence of new inhibitors of pro-angiogenic pathways that might represent the next step in kidney cancer therapy.

    • Chung-Han Lee
    •  &  Robert J. Motzer
  • Nature Reviews Nephrology | Year in Review

    Approaches to effectively prevent and manage organ dysfunction in critically ill patients remain elusive. Key studies in 2016 highlighted the challenges in finding effective treatments for renal failure in sepsis and assessed the optimal timing of renal replacement therapy initiation in critically ill patients with acute kidney injury.

    • Ravindra L. Mehta
  • Nature Reviews Nephrology | Year in Review

    Kidney transplantation was the focus of numerous publications in 2016. Key studies demonstrated a survival advantage of HLA-incompatible kidney transplantation and suggested that novel approaches such as co-stimulation blockade using belatacept and treatment of antibody-mediated rejection using a C1 esterase inhibitor might prove to be future game changers.

    • Paolo Malvezzi
    •  &  Lionel Rostaing
  • Nature Reviews Nephrology | Year in Review

    Blood pressure (BP) goals and the management of BP in patients with chronic kidney disease (CKD) remain controversial topics. Key articles in the past year have addressed BP goals in CKD, the use of new agents to slow CKD progression and the effects of visit-to-visit variability in systolic BP on cardiovascular events and renal progression in patients with CKD.

    • Debbie L. Cohen
    •  &  Raymond R. Townsend

Current related Reviews

  • Nature Reviews Nephrology | Review Article

    Mitochondria provide the kidney with energy to remove waste from the blood and regulate fluid and electrolyte balance. This Review discusses how mitochondrial homeostasis is maintained, the changes in mitochondrial energetics that occur in acute kidney injury and diabetic nephropathy, and how targeting mitochondrial energetics might aid the treatment of renal disease.

    • Pallavi Bhargava
    •  &  Rick G. Schnellmann
  • Nature Reviews Nephrology | Review Article

    In this plenary Review, Hoste and colleagues describe the global epidemiology of acute kidney injury (AKI). The influence of modifiable and non-modifiable AKI risk factors, delayed diagnosis, variation in diagnostic criteria and disparities in access to health care are also discussed.

    • Eric A. J. Hoste
    • , John A. Kellum
    • , Nicholas M. Selby
    • , Alexander Zarbock
    • , Paul M. Palevsky
    • , Sean M. Bagshaw
    • , Stuart L. Goldstein
    • , Jorge Cerdá
    •  &  Lakhmir S. Chawla
  • Nature Reviews Nephrology | Review Article

    Acute kidney injury is a heterogeneous clinical syndrome with multiple aetiologies, including sepsis, surgery, hypoperfusion and nephrotoxin exposure. Here, Kellum and Prowle discuss the different causes, phenotypes and pathogenic pathways of AKI and describe how consideration of such paradigms could be used to guide treatment.

    • John A. Kellum
    •  &  John R. Prowle
  • Nature Reviews Nephrology | Review Article

    In this Review, Caplan and colleagues describe the metabolic alterations in autosomal dominant polycystic kidney disease and how these might be novel therapeutic targets in the treatment of polycystic kidney disease.

    • Valeria Padovano
    • , Christine Podrini
    • , Alessandra Boletta
    •  &  Michael J. Caplan
  • Nature Reviews Nephrology | Review Article

    Autosomal dominant polycystic kidney disease (ADPKD) is characterized by a variable rate of cyst development, variable kidney function decline and variable presentation of renal and extrarenal manifestations. In this Review, the authors discuss pharmacological and non-pharmacological interventions for the treatment of patients with ADPKD and provide recommendations for the management of renal complications.

    • Matthew B. Lanktree
    •  &  Arlene B. Chapman
  • Nature Reviews Nephrology | Review Article

    Dysfunctional mitochondria are postulated to be central to the development and progression of diabetic kidney disease (DKD). Here, the authors review the role of mitochondrial dysfunction in the pathogenesis of DKD and novel therapeutic strategies to target mitochondria and improve kidney function.

    • Josephine M. Forbes
    •  &  David R. Thorburn