Review Articles in 2020

Mitochondrial dysfunction has roles in acute kidney injury, chronic kidney disease and abnormal kidney repair. Here, the authors discuss the role of mitochondrial quality control mechanisms in kidney injury and repair and highlight their potential as therapeutic targets.

Clinical trials have demonstrated that glucagon-like peptide 1 receptor (GLP1R) agonists have therapeutic benefits beyond glycaemic control. Here, the authors examine the protective effects of incretin-based therapies in patients with diabetic kidney disease and how the immunomodulatory and anti-inflammatory effects of GLP1 might underlie this protection.

Working towards sustainable development is essential to tackle the rise in the global burden of non-communicable diseases, including kidney disease. Five years after the Sustainable Development Goal agenda was set, this Review examines the progress thus far, highlighting future challenges and opportunities, and explores the implications for kidney disease.

Here, the authors describe the mechanisms of ultrafiltration during kidney replacement therapy, the effects of ultrafiltration on cardiovascular physiology and the principles of volume management in critically ill patients. They also discuss potential mechanisms that could underlie the association between ultrafiltration rate and organ dysfunction.

The molecular features that define the initiation and progression of clear cell renal cell carcinoma (ccRCC) are being increasingly defined. This Review summarizes common genomic and chromosomal copy number abnormalities in ccRCC, providing a mechanistic framework with which to organize these features into initiating events, drivers of progression and factors that confer lethality.

This Review describes our current understanding of the pathogenic mechanisms involved in severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and the progression of coronavirus disease 2019 (COVID-19), focusing on the immunological hyper-response and the induction of widespread endothelial damage, complement-associated blood clotting and systemic microangiopathy, as well as the effects of these processes on the kidney. The authors also discuss therapeutic interventions that currently hold most promise.

Technological advances continue to expand the use of proteomics in medicine. In this Review, the authors discuss proteomics research findings in nephrology and the potential, as well as the limitations, of using proteomics techniques to uncover disease mechanisms and develop new therapeutic strategies.

Many children die from preventable and/or treatable kidney disease in low-resource settings. Here, the authors examine strategies to improve the care of these children, including the need to invest in disease prevention and early detection, promote disease awareness and education, and adapt treatments to expand provision.

This Review discusses advances in the understanding of WNT–β-catenin signalling and its regulation during kidney injury, along with its potential diagnostic and therapeutic implications.

Here, the authors discuss the mechanisms by which food and specific nutrients could affect the uraemic phenotype in chronic kidney disease (CKD). They suggest that a food-as-medicine approach could potentially be used to prevent and treat CKD and its complications.

Acute kidney injury is a common complication of trauma. Here, the authors examine how, in addition to direct trauma to the kidneys, the pathophysiological responses to traumatic injuries in distant organs, including immune responses, can result in kidney dysfunction.

This Review provides an overview of fluorescence-based microscopy techniques that have been used to study molecular processes within the kidney. The authors describe how the development of cutting-edge technologies has enabled high spatiotemporal resolution of molecular interactions and processes, and how these approaches have aided our understanding of kidney dynamics.

Nuclear receptors have important roles in normal physiological functions and in the pathophysiology of various diseases. Here, the authors focus on the roles of nuclear receptors in podocyte biology and non-diabetic glomerular disease as well as their potential as therapeutic targets.

Ontologies are powerful tools that facilitate the integration of large and disparate data sets. Here, researchers from the Kidney Precision Medicine Project provide an introduction to ontologies, including those developed by the consortium, describing how these will be used to improve the annotation of kidney-relevant data, eventually leading to new definitions of kidney disease in support of precision medicine.

Developments in digital pathology and computational image analysis have the potential to identify new disease mechanisms, improve disease classification and prognostication, and ultimately aid the identification of targeted therapies. In this Review, the authors provide an outline of the digital ecosystem in nephropathology and describe potential applications and challenges associated with the emerging armamentarium of technologies for image analysis.

Effective treatment of kidney failure depends on reliable vascular access; however, options for chronic vascular access for haemodialysis have remained unchanged for decades. This Review evaluates the key existing challenges in establishing and maintaining vascular access and describes novel and innovative technologies under development that address these issues.

The glomerular basement membrane (GBM) is essential for kidney filtration. This Review describes how studies of GBM composition and structure have provided insights into GBM assembly, its developmental transitions and its role in glomerular filtration. The authors also discuss GBM-associated diseases and current and potential future treatments for these disorders.

An increasing body of evidence suggests that genomic disorders and monogenic aetiologies contribute meaningfully to seemingly complex forms of chronic kidney disease (CKD). This Review describes rare genetic causes of CKD and the genetic and phenotypic complexity of this group of disorders, and discusses novel approaches to help to address the challenges posed by the complexity of CKD.

Obesity is a risk factor for the progression of chronic kidney disease. In this Review, the authors discuss the renoprotective effects of bariatric surgery and its potential as a therapeutic intervention in patients with chronic kidney disease and obesity.

Available data suggest that the prevalence and incidence of kidney stones is increasing; however, much of this variation might result from differences in approaches used to identify stone formers. This Review describes the need for a classification system to facilitate use of consistent terminology and enable meaningful comparisons of the burden of kidney stone disease across different populations.