Review Articles in 2008

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  • The rapid rise in the incidence and prevalence of obesity and the concomitant increase in the incidence and prevalence of hypertension have fueled investigation into the role of obesity in the pathogenesis of hypertension. The genetic background that predisposes obese individuals to hypertension is being elucidated, and the importance of adipose tissue as an endocrine organ in the pathogenesis of hypertension is increasingly being recognized. In this Review, Bogaert and Linas summarize and highlight the various mechanisms that are postulated to be involved in human obesity-mediated hypertension.

    • Yolanda E Bogaert
    • Stuart Linas
    Review Article
  • Virtually every organ system in the human body seems to possess a local renin–angiotensin system (RAS). Most of these systems are independently regulated and compartmentalized from the plasma circulation. In this Review, Velez focuses on the kidney RAS, which is of critical importance for the regulation of blood pressure and salt balance. The article integrates the traditional understanding of the intrarenal RAS with the emerging role of novel players in the system, and the potential implications of these factors in the mechanisms of tissue injury in progressive chronic kidney diseases.

    • Juan Carlos Q Velez
    Review Article
  • The renal features of sickle cell disease include some of the most common reasons for referral to nephrologists. This author, from the University of Kansas Medical Center, comprehensively reviews the renal effects of sickle cell disease, including hematuria, papillary necrosis, tubular disturbances and chronic glomerulopathy. All aspects of these complications are covered, including their presentation, pathogenesis, pathology, risk factors, diagnosis and treatment.

    • Jon I Scheinman
    Review Article
  • Immunosuppression renders patients with renal transplants particularly susceptible to vaccine-preventable diseases; however, the use of recommended vaccines before and after transplantation is suboptimal because of fears of toxicity or allograft rejection, which are generally unfounded. The authors of this Review describe the general tenets of immunization in patients who are scheduled for or who have undergone kidney transplantation, and they discuss the efficacy, safety, dosage and timing of vaccination for the relevant diseases and the need for post-vaccination monitoring in this setting.

    • Jennifer Cohn
    • Emily A Blumberg
    Review Article
  • Nephrologists are actively looking for ways to improve the outcomes of patients on dialysis. To this end, a number of alternative dialysis strategies, involving longer and/or more-frequent sessions, are being investigated. Here, authors with experience of prolonged hemodialysis outline the beneficial effects of such strategies on cardiovascular complications, phosphate balance, nutrition, survival and other factors, and highlight the barriers preventing more-widespread adoption of these regimens.

    • Charles Chazot
    • Guillaume Jean
    Review Article
  • The authors of this Review propose a new paradigm for the treatment of secondary hyperparathyroidism in chronic kidney disease. They argue that calcitriol deficiency in this setting is simply an adaptive response, and that the primary therapeutic approach (after phosphate control) should be administration of calcimimetics. The actions of fibroblast growth factor 23, the dominant role of the calcium-sensing receptor in regulating parathyroid gland function and the results of clinical trials of cinacalcet and vitamin D analogs are cited in support of their contention.

    • James B Wetmore
    • L Darryl Quarles
    Review Article
  • Because of ethical and religious constraints, few kidney transplantations from deceased donors are performed in Japan. As a result, ABO-incompatible living-donor kidney transplantation is common. Here, authors from the Japanese Society for Transplantation describe Japan's experience with this procedure. They highlight the graft survival, patient survival and rejection rates following this type of transplantation, summarize the preparation protocols used (antibody removal, splenectomy and desensitization) and consider why the outcomes of the procedure are so favorable in Japan.

    • Naotsugu Ichimaru
    • Shiro Takahara
    Review Article
  • The use of traditional remedies is highly prevalent in the developing world and is increasing in Western countries. Despite the frequent assumption by patients that alternative or complementary remedies are 'safe', many of these medicines can cause acute kidney injury. This Review outlines the factors contributing to the nephrotoxicity of traditional remedies and edible plants (including contamination, erroneous preparation and incorrect administration), and the mechanisms and types of renal damage associated with these medicines.

    • Valerie A Luyckx
    • Saraladevi Naicker
    Review Article
  • The severity and extent of cardiovascular complications in patients with chronic kidney disease is disproportionate to the number and severity of traditional risk factors, such as diabetes and hypertension. Could uremia-related factors—including anemia, microalbuminuria, inflammation, oxidative stress, and abnormalities in bone and mineral metabolism—account for this discrepancy? Authors from the University of Colorado Health Sciences Center weigh up the evidence from randomized controlled trials of interventions for these so-called 'nontraditional' risk factors.

    • Jessica Kendrick
    • Michel B Chonchol
    Review Article
  • As a highly vascularized and excretory organ, the kidney is particularly vulnerable to animal toxins. This Review begins with an overview of the mechanisms by which these toxins cause kidney damage—including direct nephrotoxicity and induction of hemodynamic changes. The presentation, pathophysiology and pathology of the renal changes associated with animal toxin poisoning or envenomation are then discussed for each of the relevant animal species in turn.

    • Visith Sitprija
    Review Article
  • Maintenance of a functioning vascular access for hemodialysis is a major challenge. This Review summarizes recent insights into the pathophysiology of the major complications of vascular accesses—thrombosis, stenosis, aneurysms, fistula maturation failure and catheter infection—and outlines innovative ideas for the prevention and treatment of these complications that have emerged as a result of our improved understanding. These ideas include interfering with bacterial quorum sensing, blocking growth factors that are involved in intimal hyperplasia, and inhibiting matrix metalloproteinases.

    • Charles J Diskin
    • Thomas J Stokes
    • Thomas B Carter
    Review Article
  • Acute phosphate nephropathy has emerged as an important complication of bowel preparation with oral sodium phosphate solution for colonoscopy. Retrospective studies have revealed that acute kidney injury occurs in 1–4% of individuals exposed to oral sodium phosphate. This Review outlines the presentation, risk factors and pathogenesis of acute phosphate nephropathy. The author proffers several recommendations for minimizing the renal risks of oral sodium phosphate.

    • Yeong-Hau H Lien
    Review Article
  • This Review analyzes the changing face of acute kidney injury in children in terms of etiology, incidence, diagnosis, treatment and long-term outcomes. The evidence base for conservative management of pediatric acute kidney injury (with agents such as diuretics, nesiritide and fenoldopam) is assessed, and the author offers advice on the optimal timing and modality of renal replacement therapy.

    • Timothy E Bunchman
    Review Article
  • This Review will help physicians to make the best case-by-case decisions when treating the three most common types of primary glomerulonephritis that progress to end-stage renal disease—membranous nephropathy, focal segmental glomerulosclerosis and IgA nephropathy. The authors systematically assess the benefits of reducing proteinuria in each of these diseases, and then place these benefits in the context of the early and late adverse effects of currently available therapies.

    • David Philibert
    • Daniel Cattran
    Review Article
  • This Review sets out the case for updating the nomenclature of inherited salt-losing tubulopathies. The author argues that the so-called 'Bartter-like syndromes' constitute a diverse group of diseases whose only common feature is hyperaldosteronism secondary to a salt leak along the distal nephron. Since there is considerable phenotypic overlap between some of these syndromes, he outlines a more logical classification based on the exact location of the defective ion transporter or channel in the distal nephron.

    • Hannsjörg W Seyberth
    Review Article
  • The blood-pressure response to antihypertensive medications varies between ethnic groups. Whether ethnicity determines the outcomes of patients with hypertensive kidney disease is less clear. Here, authors from the US examine key ethnic variations in hypertensive chronic kidney disease and proffer their pharmacologic and lifestyle recommendations for blood-pressure control in this setting, with an emphasis on African Americans. The authors highlight the need for adequate representation of minority populations in future studies, in order to improve the evidence base for these recommendations.

    • Keith C Norris
    • Naureen Tareen
    • Nosratola D Vaziri
    Review Article
  • Proteinuria and the underlying glomerulosclerosis seem to be reversible. Could such reversal be achieved by targeting endothelin via the ETAreceptor? This Review begins with a summary of the mechanisms involved in the development of glomerulosclerosis—particularly those responsible for podocyte injury—and continues with an evaluation of the growth-promoting and vasoconstricting properties of endothelin. Finally, the findings of preclinical and clinical studies of endothelin receptor antagonists in proteinuric renal disease are summarized.

    • Matthias Barton
    Review Article
  • Considerable progress has been made over the past few years in understanding the pathogenesis of pre-eclampsia. In particular, the contribution of the circulating antiangiogenic factors soluble fms-like tyrosine kinase 1 and endoglin to the vascular and glomerular dysfunction of pre-eclampsia has been recognized. Inspired by these findings, Alexandre Hertig and colleagues from France, the US and Switzerland propose an updated and standardized protocol for the post-delivery follow-up of women with pregnancy-induced hypertension or pre-eclampsia.

    • Alexandre Hertig
    • Suzanne Watnick
    • Eric Rondeau
    Review Article
  • Dialysis units are facing a growing number of patients who disrupt the smooth functioning of the unit and even jeopardize the health and safety of other patients and staff. Here, authors from West Virginia University outline a set of ethical principles that can assist dialysis staff to deal with difficult or disruptive patients while meeting their ethical obligations to other patients. These principles can also be used to identify the limited situations in which involuntary patient discharge from a dialysis unit is ethically justified.

    • Adnan Hashmi
    • Alvin H Moss
    Review Article
  • This Review provides an overview of nocturia in the elderly for the practicing nephrologist. The authors attempt to correct the misconception that nocturia is usually caused by urologic problems, arguing that, in fact, nocturia in the elderly results from the interacting effects of aging and sleep on renal and urinary function. Specific causes of this condition, including the syndrome of nocturnal polyuria, are discussed, and the best strategies for evaluation and treatment—both pharmacologic and non-pharmacologic—are summarized.

    • Dean A Kujubu
    • Sherif R Aboseif
    Review Article