Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain
the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in
Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles
and JavaScript.
In the first of two opposing Viewpoints, Daniel W Coyne questions the use of cinacalcet to treat secondary hyperparathyroidism in non-dialysis-dependent patients with chronic kidney disease. He highlights the absence of FDA approval and the lack of published data for cinacalcet in this setting. Cinacalcet does not, he argues, address a universal pathophysiologic feature of secondary hyperparathyroidism; in addition, it has considerable adverse effects.
This, the second of two opposing Viewpoints, presents the case for the use of cinacalcet for the treatment of secondary hyperparathyroidism in patients with chronic kidney disease who are not receiving dialysis. The authors assert that cinacalcet effectively reduces serum parathyroid hormone level in this setting, and that any adverse effects of the drug on calcium or phosphorus levels can be managed by monitoring and treating patients accordingly.
During recent years, awareness has been growing that oxalate is more than simply a metabolic waste product. Evidence is mounting that oxalate affects normal physiology, especially in the kidney. Here, authors from the Case Western Reserve University School of Medicine in Cleveland, OH, review the sources, excretion, and transport of oxalate, and examine the ways in which this molecule might contribute to nephrolithiasis.
Interest in endogenous digitalis-like factors or 'cardiotonic steroids' has increased as a result of the identification of such factors in humans and the delineation of a mechanism by which these hormones signal through the sodium/potassium-transporting ATPase. The authors of this Review, who have both spent more than 20 years conducting research on this topic, examine the role of endogenous cardiotonic steroids in the pathophysiology of renal and cardiovascular disease. They also highlight potential therapeutic strategies involving modulation of cardiotonic steroids.
Renal involvement in type I cryoglobulinemia is uncommon, and management of such disease is difficult and remains poorly defined. Pandrangi and colleagues describe their experience of using rituximab—a chimeric anti-CD20 monoclonal antibody that selectively depletes CD20+B cells—as a novel approach for treating the renal disease of a patient with type I cryoglobulinemia-associated glomerulonephritis.
Rhodococcus equiis an animal pathogen that sometimes causes opportunistic infections in immunocompromised patients. Speck et al. present the case of a 62-year-old male renal transplant recipient who presented with fever, hemoptysis and left-sided pleuritic chest pain. After numerous investigations, a diagnosis of R. equi infection with bacteremic pleuropneumonia and pseudotumor was made. This Case Study describes the diagnosis and management of R. equiinfection, which has a very varied clinical presentation in humans.
