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Current Opinion in Nephrology and Hypertension

Kelsey Connelly, David Collister, Navdeep Tangri
PURPOSE OF REVIEW: Chronic kidney disease (CKD) is associated with the development of mineral bone disorder (MBD), osteoporosis, and fragility fractures. The purpose of this review is to provide an update on recent findings in the diagnosis and treatment of osteoporosis in patients with CKD. RECENT FINDINGS: Multiple observational studies have shown that bone mineral density measurement using DEXA is equally predictive in CKD stages 1-3, as in the general population...
March 15, 2018: Current Opinion in Nephrology and Hypertension
Kyle L Brown, Billy G Hudson, Paul A Voziyan
PURPOSE OF REVIEW: The purpose of this review is to highlight recent advances in understanding the molecular assembly of basement membranes, as exemplified by the glomerular basement membrane (GBM) of the kidney filtration apparatus. In particular, an essential role of halogens in the basement membrane formation has been discovered. RECENT FINDINGS: Extracellular chloride triggers a molecular switch within non collagenous domains of collagen IV that induces protomer oligomerization and scaffold assembly outside the cell...
March 15, 2018: Current Opinion in Nephrology and Hypertension
H Terence Cook
PURPOSE OF REVIEW: The current review will discuss recent advances in our understanding of the pathology of C3 glomerulopathy and atypical haemolytic uremic syndrome (aHUS). RECENT FINDINGS: C3 glomerulopathy and aHUS are associated with abnormalities of control of the alternative pathway of complement. Recent articles have provided new insights into the classification of C3 glomerulopathy and its relationship to idiopathic immune complex-mediated glomerulonephritis...
March 6, 2018: Current Opinion in Nephrology and Hypertension
Bedra Sharif, Moumita Barua
PURPOSE OF REVIEW: The widespread adoption of next-generation sequencing by research and clinical laboratories has begun to uncover the previously unknown genetic basis of many diseases. In nephrology, one of the best examples of this is seen in focal and segmental glomerulosclerosis (FSGS) and nephrotic syndrome. We review advances made in 2017 as a result of human and molecular genetic studies as it relates to FSGS and nephrotic syndrome. RECENT FINDINGS: There are more than 50 monogenic genes described in steroid-resistant nephrotic syndrome and FSGS, with seven reported in 2017...
February 19, 2018: Current Opinion in Nephrology and Hypertension
Michio Nagata
PURPOSE OF REVIEW: Earlier works of the glomerulogenesis described morphological steps and protein expression during in-vivo and in-vitro kidney development. Recent technologies using cell-specific or conditional knock-out mice for several factors provide important knowledge about cross-talk signaling among resident cells as local events. Based on the recent advancement, this review revisits comprehensive morphological development of the glomerulus. RECENT FINDINGS: Interactions of presumptive podocyte vascular endothelial growth factor with vascular endothelial growth factor-2 on angioblasts initiate glomerular vascularization...
February 9, 2018: Current Opinion in Nephrology and Hypertension
Sean Barbour, Heather Reich
PURPOSE OF REVIEW: Immunoglobulin A (IgA) nephropathy (IgAN) is a heterogeneous disease, and predicting individual patient risk of renal progression is challenging. Recent studies provide new evidence regarding the use of clinical, histologic, and biomarker predictors of renal outcome in IgAN. RECENT FINDINGS: A meta-analysis of clinical trials demonstrated that early change in proteinuria is a valid surrogate outcome measure for longer term decline in renal function, which supports the use of proteinuria to dynamically re-evaluate patient prognosis over time...
February 9, 2018: Current Opinion in Nephrology and Hypertension
Tingting Li, Yan Xie, Ziyad Al-Aly
PURPOSE OF REVIEW: To discuss whether the recently described relationship between proton pump inhibitor (PPI) use and the risk of adverse kidney outcomes represents a causal relationship or is merely the result of confounding. RECENT FINDINGS: A wave of observational studies has described an association between PPI use and the risk of development of chronic kidney disease and its progression to end-stage renal disease. The results are generally robust and remarkably consistent across different studies...
February 9, 2018: Current Opinion in Nephrology and Hypertension
Jane F Reckelhoff
PURPOSE OF REVIEW: The review is a short discussion of sex/gender differences in blood pressure control with a focus on gender differences in hypertension awareness, prevalence, and treatment, the new American College of Cardiology/American Heart Association Guidelines, and recent discoveries in animal models and humans on mechanisms responsible for sex/gender differences in hypertension. RECENT FINDINGS: Hypertension awareness is greater in women than men, the prevalence of hypertension is higher in men than women until after menopause, and although the American College of Cardiology/American Heart Association Guidelines recommend similar treatment for men and women, this is not currently the case in practice...
February 5, 2018: Current Opinion in Nephrology and Hypertension
Adam Papini, Pietro Ravani, Robert R Quinn
PURPOSE OF REVIEW: There is renewed interest in vascular access research, fueled by new perspectives and a critical re-examination of traditional thinking. This review summarizes important developments in vascular access from the past year, highlight areas of controversy, and makes recommendations for future research. RECENT FINDINGS: Recent studies provide an innovative and critical look at the assumptions underlying the promotion of fistulas as the preferred form of vascular access and highlight the need for a randomized comparison of different forms of access...
February 5, 2018: Current Opinion in Nephrology and Hypertension
Jeffrey B Kopp, Hila Roshanravan, Koji Okamoto
PURPOSE OF REVIEW: To review publications relating to apolipoprotein L1 (APOL1) renal risk variants published 2017. RECENT FINDINGS: The study of APOL1 variants continues to be highly active; 24 articles published in 2017 were selected to highlight. These include clinical studies of kidney disease, kidney transplantation, hypertension, cardiovascular disease, and genetic diversity. Laboratory studies included APOL1 association with vesicle-associated membrane soluble N-ethylmaleimide-sensitive factor activating protein receptor protein and with soluble urokinase-type plasminogen activator receptor, mitochondrial dysfunction, endolysosomal dysfunction, and inflammasome activation...
January 30, 2018: Current Opinion in Nephrology and Hypertension
Qing Zhu, Tianxin Yang
PURPOSE OF REVIEW: (Pro)renin receptor (PRR) belongs to type I transmembrane receptor family and binds both prorenin and renin, representing a potential regulator of the activity of the renin-angiotensin system. Soluble form of PRR (sPRR) is generated by intracellular protease-mediated cleavage of full-length PRR. The purpose of this review is to highlight recent advances in understanding the mechanisms of action and production of sPRR. RECENT FINDINGS: It has recently been demonstrated that site-1-protease (S1P) plays a dominant role in the generation of sPRR...
January 16, 2018: Current Opinion in Nephrology and Hypertension
Jean Hou, Cynthia C Nast
PURPOSE OF REVIEW: Human immunodeficiency virus (HIV)-associated nephropathy (HIVAN) was identified as the major renal manifestation of HIV infection early in the HIV epidemic. However, HIV infection now is associated with a different spectrum of renal lesions leading to chronic kidney disease. This review examines the changes in kidney injury occurring in the current HIV era and the factors involved in this transformation of disease expression. RECENT FINDINGS: The incidence of HIVAN and opportunistic infections in HIV-infected individuals has declined in concert with the use of effective combination antiretroviral agents...
January 13, 2018: Current Opinion in Nephrology and Hypertension
Bertrand L Jaber
No abstract text is available yet for this article.
January 4, 2018: Current Opinion in Nephrology and Hypertension
Mark Haas
PURPOSE OF REVIEW: To review changes in the Banff schema for antibody-mediated renal allograft rejection over the past decade, including key revisions agreed upon during and immediately subsequent to the 2017 Banff Conference on Allograft Pathology. RECENT FINDINGS: The original Banff schema for diagnosis of acute and chronic active antibody-mediated rejection (ABMR) in renal allografts was formulated at the 2001 and 2007 Banff Conferences, and required histologic (primarily microvascular inflammation and transplant glomerulopathy), immunohistologic (C4d in peritubular capillaries), and serologic [circulating donor-specific antibodies (DSA)] evidence for a definitive diagnosis of ABMR...
January 2, 2018: Current Opinion in Nephrology and Hypertension
Amjad Mehboob, Robert Zimmerman, Stuart Abramson, Mark G Parker
PURPOSE OF REVIEW: Quality measure assessment and reporting is evolving in end-stage renal disease care and is inchoate in ambulatory nephrology clinic care. Acute kidney injury (AKI) quality measures have not received sufficient attention, yet deserve consideration in view of the substantial proportion of effort nephrology providers devote to AKI care. RECENT FINDINGS: Accumulating literature permits consideration of timing of nephrology consultation, follow-up after AKI hospitalization, early detection, medication dosing, hospital readmissions and length of stay, cost, and mortality as potential AKI quality measures...
March 2018: Current Opinion in Nephrology and Hypertension
Bertrand L Jaber
No abstract text is available yet for this article.
March 2018: Current Opinion in Nephrology and Hypertension
Lili Chan, Benjamin Asriel, Ellen F Eaton, Christina M Wyatt
PURPOSE OF REVIEW: The antiviral agent tenofovir is highly effective for the treatment of HIV and hepatitis B virus infections, and the older prodrug tenofovir disoproxil fumarate (TDF) is also a component of daily preexposure prophylaxis (PrEP) to reduce the risk of HIV infection in high-risk populations. Although TDF is well tolerated, the potential for kidney and bone toxicity has important implications for public health given the large number of individuals exposed to TDF worldwide...
March 2018: Current Opinion in Nephrology and Hypertension
Theodore W Kurtz, Stephen E DiCarlo, Michal Pravenec, R Curtis Morris
PURPOSE OF REVIEW: For decades, it has been widely accepted that initiation of salt-induced hypertension involves a type of kidney dysfunction (natriuretic handicap), which causes salt-sensitive subjects to initially excrete less of a sodium load than normal subjects and undergo abnormal increases in cardiac output, and therefore blood pressure. Here we discuss emerging views that renal vasodysfunction, not natriuretic dysfunction (subnormal sodium excretion), is usually a critical factor initiating salt-induced hypertension...
March 2018: Current Opinion in Nephrology and Hypertension
Madhumathi Rao, Bertrand L Jaber, Vaidyanathapuram S Balakrishnan
PURPOSE OF REVIEW: Sarcopenia and muscle weakness contribute to fragility and limit exercise tolerance among patients with CKD. This review focuses on the role of reduction in mitochondrial mass and function in the myopathy associated with CKD, causes for these muscle mitochondrial abnormalities, and potential therapeutic interventions that may improve mitochondrial biogenesis and function as well as skeletal muscle function and performance in patients with CKD. RECENT FINDINGS: Multiple abnormalities of mitochondrial structure, function, and composition have been shown in both experimental models and patients with CKD...
March 2018: Current Opinion in Nephrology and Hypertension
Joe Aoun, Diala Nicolas, Jeremiah R Brown, Bertrand L Jaber
PURPOSE OF REVIEW: Contrast-induced acute kidney injury (CI-AKI) is a serious complication. Although nonmodifiable and modifiable risk factors have been thoroughly characterized, the utility of the maximal allowable contrast dose (MACD) has not received adequate attention. The focus of this review is to provide a critical appraisal of this modifiable risk factor. RECENT FINDINGS: Several retrospective and prospective cohort studies have demonstrated that the incidence of CI-AKI among patients receiving contrast media in volumes exceeding the MACD is consistently higher compared with those who do not exceed the MACD (an average of 24 vs...
March 2018: Current Opinion in Nephrology and Hypertension
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