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Current Opinion in Nephrology and Hypertension

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https://www.readbyqxmd.com/read/28538016/hypoxia-inducible-factor-activation-in-diabetic-kidney-disease
#1
Patrik Persson, Fredrik Palm
PURPOSE OF REVIEW: Tissue hypoxia is present in kidneys from diabetic patients and constitutes a central pathway to diabetic kidney disease (DKD). This review summarizes regulation of hypoxia inducible factor (HIF) and interventions towards the same for treatment of DKD. RECENT FINDINGS: In the hypoxic diabetic kidney, HIF activity and the effects of HIF signaling seem to be cell-specific. In mesangial cells, elevated glucose levels induce HIF activity by a hypoxia-independent mechanism...
May 19, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28538015/the-kallikrein-kinin-system-in-diabetic-kidney-disease
#2
Wenjuan Liu, Robert C Stanton, Zhaoyun Zhang
PURPOSE OF REVIEW: Diabetic kidney disease (DKD) is one of the most common complications in diabetes mellitus and accounts for a large proportion of clinical nephrology practice. Studies have shown that the kallikrein-kinin system (KKS) may be involved in several pathogenic mechanisms that contribute to DKD, including oxidative stress, inflammatory cytokines, and profibrotic autacoids. This review focuses on recent research advance on the potential role of the KKS in the development of DKD and its clinical relevance...
May 19, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28520568/endothelin-a-receptor-antagonists-in-diabetic-kidney-disease
#3
Panagiotis I Georgianos, Rajiv Agarwal
PURPOSE OF REVIEW: Despite optimal therapy of diabetic nephropathy with agents blocking the renin-angiotensin-aldosterone system, the residual risk of nephropathy progression to end-stage renal disease (ESRD) remains high. The purpose of this review is to discuss the potential role of endothelin antagonism as a therapeutic tool to reduce residual proteinuria and delay kidney injury progression among patients with diabetic nephropathy. RECENT FINDINGS: Preclinical studies have shown that endothelin receptor antagonists (ERAs) exert proteinuria lowering and nephroprotective actions in experimental models of diabetic nephropathy...
May 17, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28426518/pathophysiologic-insight-into-mesoamerican-nephropathy
#4
Magdalena Madero, Fernando E García-Arroyo, Laura-Gabriela Sánchez-Lozada
PURPOSE OF REVIEW: Mesoamerican nephropathy (MeN) is an emerging pathophysiological entity of Chronic kidney desease (CKD) not related to traditional risk factors (diabetes and hypertension) that have caused thousands of deaths in Central America, mainly in sugarcane workers. The focus of this review is to discuss the risk factors and probable mechanisms involved in the initiation and progression of this devastating disease. RECENT FINDINGS: Frequent episodes of subclinical Acute kidney injury caused by repetitive heat stress, dehydration, and strenuous work have been regarded as the main risk factors for MeN...
April 19, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28410252/molecular-modifiers-of-kidney-stones
#5
Bryan G Alamani, Jeffrey D Rimer
PURPOSE OF REVIEW: This review discusses the role of molecular modifiers as inhibitors of kidney stone formation, drawing largely from in-vitro evidence while also citing relevant in-vivo studies. An emphasis is placed on physical observations of crystal growth inhibition, including mechanisms of action that focus predominantly on the literature of calcium oxalate and L-cystine. RECENT FINDINGS: The last decade has witnessed several breakthroughs in the identification of molecules with promise to curb kidney stone formation, as well as discoveries of the mechanisms by which these molecules (or combinations thereof) function as inhibitors of pathological crystal growth...
April 13, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28403013/vasopressin-and-diabetic-nephropathy
#6
Ronan Roussel, Gilberto Velho, Lise Bankir
PURPOSE OF REVIEW: The prevalence of diabetic kidney disease (DKD) is increasing worldwide. Despite major therapeutic advances in the last decades in DKD, the current standard of care let many people progress to severe stages. Vasopressin secretion is increased in diabetes, and its potential role in the onset and progression of DKD is being re-investigated. RECENT FINDINGS: Recently, observational studies evidenced an association between surrogates of vasopressin secretion (daily fluid intake or urine volume, and plasma copeptin concentration) and chronic kidney disease in the community, but also specifically in type 1 and in type 2 diabetes...
April 11, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28399022/palliative-and-end-of-life-care-in-nephrology-moving-from-observations-to-interventions
#7
Nwamaka D Eneanya, Michael K Paasche-Orlow, Angelo Volandes
PURPOSE OF REVIEW: In comparison with patients who have other serious illnesses, patients with advanced kidney disease have a higher rate of intensive care utilization at the end of life and receive palliative care less frequently. Consensus and clinical practice guidelines have therefore recommended the incorporation of palliative care earlier in the disease trajectory. This review summarizes recent literature on this aspect of care and will highlight future directions for patient-centered care within palliative nephrology...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28399021/an-update-on-the-treatment-of-iga-nephropathy
#8
Sean Barbour, John Feehally
PURPOSE OF REVIEW: The treatment of IgA nephropathy (IgAN) has been limited by several controversies in the literature, including the benefits of corticosteroids in addition to optimized renin-angiotensin system blockers (RASBs), in those with lower estimated glomerular filtration rate (eGFR), or in different ethnic groups. Recent studies have attempted to address these issues. RECENT FINDINGS: Two observational studies suggest the efficacy of corticosteroids in those with lower eGFR, but with a higher risk of adverse events...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28399020/therapeutic-micrornas-in-polycystic-kidney-disease
#9
Matanel Yheskel, Vishal Patel
PURPOSE OF REVIEW: microRNAs (miRNAs) are short noncoding RNAs that function as sequence-specific inhibitors of gene expression. Autosomal dominant polycystic kidney disease (ADPKD) is the most frequent genetic cause of end-stage kidney failure with limited treatment options. The realization that miRNA upregulation, and thus its gain-of-function, can drive the progression of ADPKD has raised the possibility that anti-miRs represent a novel drug class for this disorder. RECENT FINDINGS: A common set of miRNAs are aberrantly expressed in various murine models of polycystic kidney disease...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28399019/pathophysiology-and-implications-of-intradialytic-hypertension
#10
Peter Noel Van Buren
PURPOSE OF REVIEW: Intradialytic hypertension occurs regularly in 10--15% of hemodialysis patients. A large observational study recently showed that intradialytic hypertension of any magnitude increased mortality risk comparable to the most severe degrees of intradialytic hypotension. The present review review discusses the most recent evidence underlying the pathophysiology of intradialytic hypertension and implications for its management. RECENT FINDINGS: Patients with intradialytic hypertension typically have small interdialytic weight gains, but bioimpedance spectroscopy shows these patients have significant chronic extracellular volume excess...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28399018/renal-arteriovenous-oxygen-shunting
#11
Willy Kuo, Vartan Kurtcuoglu
PURPOSE OF REVIEW: Renal arteriovenous oxygen shunting has been proposed as a mechanism by which oxygen supplied to the kidney can bypass the renal parenchyma. Shunting could, therefore, play a crucial role in renal hypoxia and hyperoxia. In the absence of suitable quantitative experimental methods, computational modeling has been employed in recent years to estimate the extent and potential impact of oxygen shunting. RECENT FINDINGS: Overestimation of the separation distance between arteries and veins was suggested to be responsible for previous findings that only negligible amounts of oxygen are shunted in the preglomerular vasculature...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28399017/iron-induced-hypophosphatemia-an-emerging-complication
#12
Heinz Zoller, Benedikt Schaefer, Bernhard Glodny
PURPOSE OF REVIEW: Iron-induced hypophosphatemia is a well documented side-effect but associated complications are largely neglected, because the results from single dosing studies suggest that transient decreases in plasma phosphate concentrations are asymptomatic and fully reversible. However, an increasing number of case reports and case series suggest that some patients develop severe and symptomatic hypophosphatemia. Long-term complications from hypophosphatemia include osteomalacia and bone fractures, which can result from repeated intravenous administration of certain high-dose iron preparations...
April 8, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28375872/something-old-something-new-something-borrowed-something-black
#13
Myles Wolf, David A Bushinsky
No abstract text is available yet for this article.
April 1, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28375871/resurgence-of-parathyroidectomy-evidence-and-outcomes
#14
Hirotaka Komaba, Michio Nakamura, Masafumi Fukagawa
PURPOSE OF REVIEW: Parathyroidectomy (PTx) is the definitive therapy for refractory secondary hyperparathyroidism (SHPT). The drastic effects of PTx on biochemical parameters of SHPT increases the possibility that this intervention will lead to a reduction in the adverse outcomes related to uncontrolled SHPT. RECENT FINDINGS: The effect of PTx on mortality and cardiovascular outcomes among dialysis patients with severe SHPT have been evaluated in many observational studies from different regions of the world, including Asia, Europe, North America, and South America...
April 1, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28375870/calciphylaxis
#15
Sagar U Nigwekar
PURPOSE OF REVIEW: Calciphylaxis remains a poorly understood vascular calcification disorder with predilection for patients with end-stage renal disease (ESRD). Recent data from large patient registries and databases have begun to provide information regarding incidence, risk factors, and outcomes in patients with calciphylaxis. RECENT FINDINGS: The most recent estimate places the incidence of calciphylaxis at 3.5 new cases/1000 patient-years among the patients with ESRD on chronic hemodialysis...
April 1, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28375869/hungry-bone-syndrome
#16
Nishank Jain, Robert F Reilly
PURPOSE OF REVIEW: In the United States, the number of parathyroidectomies among patients with chronic dialysis has remained stable in the last decade. A fall in serum calcium concentration is common postparathyroidectomy in patients with hyperparathyroidism, which usually resolves in 2-4 days. A severe drop in serum total calcium concentration less than 2.1 mmol/L and/or prolonged hypocalcemia for more than 4 days postparathyroidectomy is called hungry bone syndrome (HBS). Concomitant hypophosphatemia, hypomagnesemia, and hyperkalemia can be seen...
April 1, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28319485/recent-trends-in-the-prevalence-of-chronic-kidney-disease-not-the-same-old-song
#17
Raymond K Hsu, Neil R Powe
PURPOSE OF REVIEW: We aim to review recent updates on the epidemiology of chronic kidney disease (CKD). RECENT FINDINGS: Recent analyses from the National Health and Nutritional Examination survey describe the temporal trend in CKD prevalence in US adults. The overall prevalence of estimated glomerular filtration rate less than 60 ml/min/1.73 m increased from 4.8% in 1988-1994 to 6.9% in 2003-2004, but has since stabilized at 6.4-6.9% up to 2011-2012. Prevalence of CKD stages 1-4 has also stabilized at ∼14% of adults since 2003-2004...
May 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28306566/anemia-management-in-chronic-kidney-disease-and-dialysis-a-narrative-review
#18
David Collister, Claudio Rigatto, Navdeep Tangri
PURPOSE OF REVIEW: This review describes the current state of anemia management with erythropoietin (EPO)-stimulating agents and iron supplementation in both chronic kidney disease and dialysis patients, with a focus on novel therapies. RECENT FINDINGS: We review the benefits and risks of EPO-stimulating agents, focusing on health-related quality of life and the uncertainties regarding optimal iron utilization in patients with kidney disease. We discuss novel therapies for iron supplementation including iron-based phosphate binders and dialysate iron delivery as well as alternatives to EPO-stimulating agents including hypoxia-inducible factor prolyl hydroxylase inhibitors...
May 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28306565/can-podocytes-be-regenerated-in-adults
#19
Stuart J Shankland, Benjamin S Freedman, Jeffrey W Pippin
PURPOSE OF REVIEW: Podocytes are critical components of the nephron filtration barrier and are depleted in many kidney injuries and disease states. Terminally differentiated adult podocytes are highly specialized, postmitotic cells, raising the question of whether the body has any ability to regenerate lost podocytes. This timely question has recently been illuminated by a series of innovative studies. Here, we review recent progress on this topic of significant interest and debate. RECENT FINDINGS: The innovation of genetic labeling techniques enables fate tracing of individual podocytes, providing the strongest evidence yet that podocytes can be replaced by nearby progenitor cells...
May 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28221174/iga-nephropathy-an-update
#20
Maria F Soares, Ian S D Roberts
PURPOSE OF REVIEW: To provide an update on recent developments since the publication of the Oxford Classification of IgA nephropathy and to consider lesions that were not included in the original classification. RECENT FINDINGS: Over 20 validation studies of the Oxford Classification have been published. Tubular atrophy/interstitial fibrosis is consistently the strongest predictor of renal survival, whereas mesangial hypercellularity predicts rate of loss of renal function...
May 2017: Current Opinion in Nephrology and Hypertension
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