Review Articles

The authors present sexual dimorphism at the molecular, cellular and tissue level and suggest that it contributes to differences in disease onset, susceptibility, prevalence and treatment responses in hypertension and cardiovascular disease. Several factors that confer relative cardioprotection in women are discussed, including biological age, sex hormones, sex chromosome complement and lifestyle.

Increasing evidence suggests that renin-expressing cells are involved in a range of physiological processes beyond their traditional role in blood pressure regulation. Here, the authors describe the role of these cells in nephrovascular development, regeneration, oxygen sensing, haematopoiesis and immune responses.

A growing body of research indicates that sex and gender-specific differences exist in the mechanisms and epidemiology of chronic kidney disease (CKD). Here, the authors describe current understanding of gender and sex differences in the epidemiology, treatment and outcomes of CKD, as well as the possible underlying causes.

Chronic kidney disease (CKD) is associated with an increased risk of adverse pregnancy outcomes. Here, Wiles et al. discuss fertility issues, contraception, important comorbidities, drugs commonly used in nephrology and the effect of dialysis provision in the context of CKD. Advances in biomarkers for CKD and pre-eclampsia are also presented.

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.

Some animals have developed mechanisms to protect them from environmental stresses, whereas others remain susceptible. Here, Stenvinkel et al. discuss how a better understanding of susceptibility and protective mechanisms could provide insights to novel strategies for the prevention and treatment of several human diseases, such as chronic kidney disease and ageing-associated complications.

Genomic medicine approaches are increasingly used for diagnosis of kidney disease. Here, the authors discuss sequencing modalities, the interpretation and clinical application of genetic data, and the challenges that must be overcome to realize the potential of genomic medicine in nephrology.

Sepsis induces an initial activation of the immune system, which is often followed by a compensatory anti-inflammatory response that can lead to immunosuppression. In this Review, the authors discuss advances in the understanding of sepsis-induced immunosuppression and how this understanding might lead to new, more effective treatments for sepsis.

Complement activation has important physiological and pathological implications for kidney-related and other diseases. Here, the authors discuss the state of the art of complement therapeutics, including the targets, candidate drugs, insights from clinical trials and evolving challenges for the field.

Adipose is an important endocrine and immunologic organ, releasing various adipokines and cytokines that regulate the adipocyte microenvironment and systemic metabolism. Here, the authors discuss the immunologic and endocrine functions of adipose tissue that contribute to kidney disease and the converse effects of kidney dysfunction on adipose tissue.

Dyslipidaemia is a common consequence of nephrotic syndrome, and results in various cardiovascular and metabolic complications. In this Review, the authors discuss the mechanisms that underlie the development of dyslipidaemia, and the treatment options that are available to ameliorate its effects.

The perception of thirst is critical for the control of body fluid homeostasis. In this Review, Gizowski and Bourque discuss the importance of thirst for body fluid balance and describe the central neural networks that regulate thirst, including adaptive changes to systemic processes and feedforward anticipatory responses that precede physiological challenges to maintain body fluid balance.

Extracellular vesicles in the urine have potential as disease biomarkers. This Review discusses the different types of extracellular vesicles and the optimization of approaches to enable their isolation and purification, and to characterize their composition by high-throughput 'omics' technologies.

Animal models that faithfully recapitulate human diabetic nephropathy (DN) are needed to study disease pathogenesis, identify drug targets and test new therapies. Here, the authors review progress in developing mouse models of DN, the limitations of current models, and opportunities for future development.

An increasing body of evidence supports a role for B cells in the pathogenesis of type 1 diabetes mellitus (T1DM). Here, the authors discuss the mechanisms and consequences of B cell activation in T1DM and how these cells might contribute to the development of diabetic kidney disease.

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.

In this Review, Mark Okusa and colleagues discuss the role of neural circuits in the control of renal inflammation as well as the therapeutic potential of targeting these circuits in the settings of acute kidney injury, kidney fibrosis and hypertension.

Our understanding of endoplasmic reticulum (ER) stress, the unfolded protein response (UPR) and ER stress-induced autophagy in the kidney has increased — using the presence of ER chaperones in the urine as a biomarker of renal ER stress, and using pharmacological agents that improve protein folding or induce the expression of chaperones, may aid in the diagnosis and treatment of kidney disease, respectively.

CD36 has important roles in lipid homeostasis, metabolic inflammation, reprogramming of energy metabolism, apoptosis and kidney fibrosis. Here, the authors discuss these roles as well as the regulation and post-translational modification of CD36 and its potential as a biomarker and a therapeutic target for kidney disease.

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.