Volume 17 Issue 9, September 2021

Key differences exist between clinical and research genomics. As genomic testing is adopted in nephrology clinical care, we propose focusing on clinical genomics approaches to obtain genetic diagnoses in order to ensure optimal use of resources and maximum patient benefit.

New data from the ILLUMINATE-A trial of lumasiran demonstrate the safety and efficacy of this RNA interference therapeutic in patients with primary hyperoxaluria type 1. Further studies are required to investigate the potential long-term benefits of this promising therapy.

Nitric oxide (NO) has important roles in the regulation of kidney, cardiovascular and metabolic functions. This Review discusses the physiological roles of NO and its effects on kidney function, as well as its association with cardiometabolic complications and novel approaches to restoring NO homeostasis.

In transplantation, liquid biopsies that can detect donor-derived cell-free DNA (dd-cfDNA) might improve monitoring of organ rejection without invasive biopsies, and might enable effective management of anti-rejection drug therapies. Here, the authors discuss dd-cfDNA quantification methods, the clinical validity of these approaches, their limitations and economic implications.

The development of acute kidney injury (AKI) after major non-cardiac surgery is associated with substantial long-term morbidity and mortality. This joint Consensus Statement from the Acute Disease Quality Initiative and the PeriOperative Quality Initiative provides recommendations for the definition, prevention and management of postoperative AKI.

Focal segmental glomerulosclerosis is a histopathological lesion that has heterogeneous causes. In this Perspectives article, the authors outline a rationale for the stratification of focal segmental glomerulosclerosis based on current understanding of the pathophysiology of podocyte stress and damage and propose that such an approach will improve the rational design and success of therapeutic trials.