Browse Articles

Perivascular cells have beneficial roles that maintain kidney homeostasis but can also contribute to kidney pathology. Here, the authors focus mainly on pericytes and fibroblasts to examine these roles, including the contribution of perivascular cells to the myofibroblast pool in kidney fibrosis, and their crosstalk with tubular, immune and endothelial cells.

The diagnosis of glomerular disease relies largely on meticulous histological and laboratory investigations that continue to improve with technological advances. However, low-income countries such as Uganda lack this investigatory armamentarium and patients are often treated on the basis of suboptimal evidence.

Among global destabilizing events, natural disasters often receive widespread attention whereas protracted conflicts and economic crises fade into the background. Low- and middle-income countries bear the brunt of this indifference, resulting in severely weakened health systems. People who require dialysis are particularly vulnerable, necessitating urgent collaboration to ensure equitable and sustainable care during such crises.

Kidney disease risk and outcomes are strongly associated with inequities that occur across the entire clinical course of the disease. The authors of this Review describe the different inequities that affect kidney health and care worldwide, and consider potential solutions to help to mitigate these.

In this Consensus Statement, the authors discuss a framework for the development, validation and implementation of digital health technologies across the acute kidney injury continuum — risk prediction, prevention, detection and management.

Racial and ethnic minoritized populations are underrepresented in clinical trials in nephrology, but overrepresented in adverse kidney disease outcomes. Targeted enrolment, revision of problematic policies, inclusion of minoritized populations in trial planning, and language-, race- and ethnicity-concordant investigative teams can improve representation in clinical trials.

Acute kidney injury (AKI) is a global concern that affects patient outcomes and resource utilization. An effective educational programme aimed at improving early AKI identification, triaging and treatment, using risk scores and care bundles coupled with access to point-of-care diagnostics, can help to prevent AKI-related deaths in regions with limited resources.

Here, the authors provide an overview of genetic causes of CAKUT and their impact on signalling pathways during nephrogenesis. They also discuss the impact of a molecular genetic diagnosis on the clinical care and potentially the personalized treatment of patients with CAKUT.

In a ground-breaking development, rat kidneys have been cryopreserved for an unprecedented duration of 100 days and subsequently transplanted successfully after nano-rewarming. This extraordinary achievement opens new possibilities for the field of organ banking.

Chronic kidney disease is characterized by dyslipidaemia and lipid accumulation in the kidney. In this Review, the authors examine the evidence that links alterations in lipid metabolism to kidney injury and progression of kidney disease, and explore potential lipid-targeted therapeutic approaches.

Kidney failure is a serious but rare consequence of progressive chronic kidney disease. A meta-analysis of individual participant-level trial data, across heterogeneous treatments and disease groups, has shown glomerular filtration rate (GFR) slope to be a valid, fit-for-purpose and robust surrogate marker of kidney failure.

This Review examines the role of alterations in the gut microbial ecosystem, as well as inflammation and oxidative stress, in the bone and mineral disorder that affects patients with chronic kidney disease. The authors also explore novel therapeutic options that can target these disease factors.

During disasters, the morbidity and mortality of patients with kidney disease far exceeds that of the general population. Here, the authors discuss the medical and logistical problems that are faced by these patients and their care-givers during mass disasters and suggest pragmatic approaches to improve patient outcomes.

The bladder and kidney engage adaptive and innate immune responses to prevent urinary tract infections and minimize tissue injury following infection. Here, the authors describe the mechanisms used by uropathogenic bacteria to establish and promote kidney infection, as well as the immune defence mechanisms used by resident kidney cells and infiltrating immune cells to eradicate infection.

Aquaporins have diverse roles in various homeostatic and physiological systems beyond their role in renal water handling. This Review describes the role of mammalian aquaporins in the transport of solutes other than water and their involvement in processes such as metabolism, cellular migration, cell adhesion, cell polarity and cell signalling.