Review Articles in 2023

Sex differences in immune cell function and immune responses affect the development and outcome of diverse diseases. Here, the authors review current understanding of sex differences in immunity. They describe the key mechanisms that mediate sex differences in immune responses and discuss the functional relevance of such differences for immune-related diseases.

Emerging evidence suggests that cells resident within organs — both immune and parenchymal — can facilitate the instigation and propagation of tissue injury. In this Review, the authors discuss findings that suggest that kidney parenchymal cells provide structural immunity to the kidney through the regulation of immune-relevant processes, with consequences for kidney inflammation and injury.

Improved understanding of kidney disease from a sex- and gender-specific perspective is needed to improve patient care. Here, the authors discuss differences in the epidemiology, management and outcomes of acute kidney injury, chronic kidney disease and kidney failure in men and women.

In this Review, Franck Mauvais-Jarvis discusses how adaptive selection during evolution could have shaped sex differences in energy partitioning, adipose tissue function and distribution, and glucose homeostasis. He also discusses the hormonal and genetic mechanisms that underlie these sex differences and their implications for metabolic disease and sex-based precision medicine.

Clonal haematopoiesis of indeterminate potential (CHIP) is associated with increased risk of disease, including cardiovascular and kidney disease. Here, the authors discuss the consequences of CHIP across various organ systems, including direct and indirect effects on kidney health.

The compartmentalized structure of primary cilia is maintained via interconnected barrier and active transport systems and underlies its unique composition and function. This Review describes the major compartmentalizing pathways that occur at the cilium and how insights into cilia transport and barrier mechanisms have shed light on the mechanisms underlying ciliary diseases.

Although potentially harmful in excess, reactive oxygen species (ROS) also act as signalling molecules and contribute to cell survival. This Review describes the relevance of ROS to physiological processes and disease pathogenesis with a focus on the kidney. The authors also outline the current status of clinical trials that aim to target ROS signalling in humans.

The family of melastatin-like transient receptor potential (TRPM) channels comprises eight multifunctional cation channels. Here, the authors examine the functional role of each TRPM channel, including insights from channelopathies, and discuss the implications for kidney homeostasis and pathology.

Here, the authors discuss the pathophysiology of acute kidney injury (AKI) in patients with burns, approaches to prevention and management of AKI in this population and the application of AKI biomarkers and artificial intelligence approaches to guide treatment and predict short-term and long-term outcomes.

Biomolecular condensates are membraneless compartments that typically contain proteins and RNAs and broadly affect many cell types and organs. In the kidney in particular, rapid and reversible assembly of biomolecular condensates occurs through the process of hyperosmotic phase separation. This Review describes emerging evidence for, and the impact of, biomolecular condensates on kidney physiology and disease.

The complement system is often involved in immune-driven kidney injury. In this Review, the authors discuss complement activation in a variety of kidney diseases, including conditions not traditionally considered to be immune-mediated, and the potential of complement therapeutics for the treatment of kidney disease.

This Review summarizes our current understanding of sex differences in renal fluid and electrolyte transporters, based primarily on studies in rodents. The authors describe the physiological consequences of these differences, based on information from experimental studies and from model predictions, and discuss the differential impact of sex on transporter regulation by hormones, diet and acid–base status.

Here, the authors review the current understanding of interorgan crosstalk mechanisms, with a focus on interorgan communication in the kidney–lung axis during acute or chronic disease of the kidney or lung.

Several factors complicate the identification of effective interventions that can improve the outcomes of patients with acute kidney injury (AKI). Here, the authors discuss key design considerations for clinical trials in hospitalized patients with AKI, including the selection of adequate patient cohorts and study end points.

Primary aldosteronism is the most common cause of endocrine arterial hypertension and is characterized by the autonomous production of aldosterone from one or both adrenal glands. This Review describes the molecular discoveries and developments that have the potential to transform the clinical management of patients with this disease.

Here, the authors review techniques for cardiovascular diagnosis, screening and monitoring in patients with CKD, including approaches to the diagnosis of cardiac ischaemia, left ventricular hypertrophy and dysfunction, arrhythmia, cerebrovascular disease, peripheral arterial disease, arterial stiffness and hypertension.

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.

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.

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.

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.