Volume 17 Issue 2, February 2021

The consequences of the COVID-19 pandemic have been devastating; however, evidence suggests that patients with, or at risk of, kidney disease are disproportionally affected. Patients on dialysis and kidney transplant recipients are at higher risk of adverse outcomes from COVID-19, whereas, conversely, patients with severe COVID-19 are at increased risk of acute kidney injury, with short-term and possibly long-term consequences for nephrological care.

Sodium–glucose co-transporter 2 inhibitors offer impressive cardiac and kidney outcome benefits to people with type 2 diabetes mellitus (T2DM). These benefits now appear to extend to people without T2DM, according to three trials published in 2020.

Genetic research in nephrology is rapidly advancing. Key studies published in 2020 demonstrate that genetic findings can provide new tools for patient diagnosis and risk stratification as well as important insights into kidney physiology and disease mechanisms that could potentially lead to novel therapies.

Timely diagnosis and dialytic treatment of acute kidney injury (AKI) came to the forefront at the height of the coronavirus disease 2019 pandemic as admissions surged in intensive care units. Research on early diagnosis, timing of initiation of kidney replacement therapy, and appropriate post-hospitalization patient care remains essential to tackling the burden of AKI.

In 2020 a number of clinical trials have provided insights into therapeutic approaches for the treatment of anti-neutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis and lupus nephritis. Moreover, mechanistic insights have potential to open new therapeutic strategies in the future.

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.

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.

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.