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  • Hypoxia-dependent changes in cellular metabolism have important implications for the effective functioning of multiple immune cell subtypes. This Review describes the inputs that shape the hypoxic response in individual cell types and contexts, and the implications of this response for cellular metabolism and associated alterations in immune cell function.

    • Cormac T. Taylor
    • Carsten C. Scholz
    Review Article
  • Meaningful involvement of patients in clinical trial design could lead to improvements in participant recruitment and retention, the uptake of the tested intervention and the impact of the findings. Here, the authors discuss the involvement of patients at all stages of trial design.

    • Allison Tong
    • Nicole Scholes-Robertson
    • Jonathan C. Craig
    Review Article
  • In this Review, the authors discuss the roles of extracellular vesicles in kidney physiology and disease as well as the beneficial effects of stem cell-derived extracellular vesicles in preclinical models of acute kidney injury and chronic kidney disease. They also highlight current and future clinical applications of extracellular vesicles in kidney diseases.

    • Cristina Grange
    • Benedetta Bussolati
    Review Article
  • The devastating effects of war are far-reaching and particularly affect people with kidney disease. The Ukrainian conflict has highlighted problems encountered in the provision of support for this vulnerable group. On the basis of these and previous experiences in massive disasters, we propose a sustainable action plan to prepare for similar logistical challenges in future conflicts.

    • Raymond Vanholder
    • Anja De Weggheleire
    • Rukshana Shroff
    Comment
  • Chronic kidney disease is associated with an increased risk of cardiovascular disease, such as heart failure. Here, the authors examine myocardial metabolic remodelling in chronic kidney disease, including changes in energy substrate use, mitochondrial dysfunction and the role of cardiotonic steroids, and discuss potential metabolic therapies.

    • Nikayla Patel
    • Muhammad Magdi Yaqoob
    • Dunja Aksentijevic
    Review Article
  • June marks Pride Month — an event that aims to recognize and celebrate LGBTQ+ communities worldwide. However, it also provides an opportunity to highlight the challenges that LGBTQ+ colleagues and nephrology patients continue to face, and the need to address health inequities.

    Editorial
  • A post hoc analysis of the COAPT trial suggests that transcatheter mitral valve repair for secondary mitral regurgitation is efficacious in patients with heart failure and chronic kidney disease. The intervention also reduced the risk of kidney failure, raising hypotheses regarding the mechanisms that link heart failure and loss of kidney function.

    • Wendy McCallum
    • Mark J. Sarnak
    News & Views
  • Targeting type I interferon immune responses is a potential strategy for the treatment of systemic lupus erythematosus. Although a phase 2 clinical trial of anifrolumab did not meet its primary end point, further studies are needed to assess the effects of interferon blockade on flare rates of lupus nephritis. However, the observed higher risk of herpes zoster associated with anifrolumab use suggests that caution is warranted with this strategy.

    • Stefanie Steiger
    • Hans-Joachim Anders
    News & Views