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Proteinuria is a prognostic indicator of renal function loss, and understanding the mechanisms underlying proteinuric nephropathy is a topic of intense interest. In this Perspectives article, Richard Baines and Nigel Brunskill consider the importance of megalin, cubilin, and other receptors in the handling of filtered proteins by PTECs and describe how these factors could contribute to the development of proteinuric nephropathy.
Increased uric acid has often been associated with pre-eclampsia in pregnant women, an issue re-examined in this Perspective by Martin and Brown. The authors call for further examination of the relationship between maternal plasma uric acid levels and maternal endothelial dysfunction and utero-placental bloodflow in pre-eclampsia, and suggest that uric acid is a pathogenic amplifier of this condition.
Several distinct pathological patterns of glomerular disorders are associated with abnormal regulation of the complement system. Some of these conditions are characterized by glomerular deposits of complement C3 in the absence or in the presence of marginal deposits of immunoglobulin. In this Perspectives article, the authors suggest that glomerular pathologies where isolated complement C3 deposition is found should be classified by the term 'C3 glomerulopathy'.
New hypoglycemic agents that inhibit renal glucose reabsorption are valuable in the constant search for therapeutic tools that achieve glycemic control in patients with diabetes mellitus. In this Perspectives article, Amanda Mather and Carol Pollock discuss novel agents that inhibit the principal glucose transporter in the kidney, which can be added to the armamentarium against hyperglycemia.
Acute kidney injury (AKI) is a common and potentially serious clinical complication that can be associated with poor outcomes and progression to chronic kidney disease. In this Perspectives article, Tögel and Westenfelder describe the preclinical data demonstrating the ability of mesenchymal stem cells (MSCs) to effectively improve outcome after AKI in experimental models and discuss the promising preliminary clinical data on MSC use in patients at risk of AKI.
The development of new biomarkers that enable the early diagnosis of acute kidney injury (AKI) should facilitate early intervention and reduce the mortality associated with this disease. In this Perspectives article, Robert Schrier discusses the need to develop interventions to attenuate or prevent AKI and the requirement for such interventions to selectively improve renal hemodynamics, increase tubular flow rates, and decrease inflammation without causing systemic vasodilation.
