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Current Opinion in Nephrology and Hypertension

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https://www.readbyqxmd.com/read/29140821/retarding-progression-of-chronic-kidney-disease-use-of-modalities-that-counter-acid-retention
#1
Jeffrey A Kraut, Nicolaos E Madias
PURPOSE OF REVIEW: Acid retention because of chronic kidney disease (CKD) increases tissue acidity and accelerates progression of CKD, whereas reduction in acid retention slows progression of CKD. Herein, we describe the mechanisms through which increased tissue acidity worsens CKD, modalities for countering acid retention and their impact on progression of CKD, and current recommendations for therapy. RECENT FINDINGS: Studies in animals and humans show that increased tissue acidity raises the renal levels of endothelin, angiotensin II, aldosterone, and ammoniagenesis, thereby worsening renal fibrosis and causing progression of CKD...
November 14, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29140820/renal-effects-of-cytokines-in-hypertension
#2
Yi Wen, Steven D Crowley
PURPOSE OF REVIEW: Inflammatory cytokines contribute to the pathogenesis of hypertension through effects on renal blood flow and sodium handling. This review will update recent advances that explore the renal actions of immune cells and cytokines in the pathogenesis of hypertension. RECENT FINDINGS: Populations of cells from both the innate and adaptive immune systems contribute to hypertension by modulating functions of the vasculature and epithelial cells in the kidney...
November 14, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29135585/the-regulation-of-aldosterone-secretion-by-leptin-implications-in-obesity-related-cardiovascular-disease
#3
Jessica L Faulkner, Thiago Bruder-Nascimento, Eric J Belin de Chantemèle
PURPOSE OF REVIEW: Although it has been known for some time that increases in body mass enhance aldosterone secretion, particularly in women, the origin of this elevation in aldosterone production is not well defined. Adipocyte-derived factors have emerged as potential candidates to increase aldosterone production in obesity. RECENT FINDINGS: Emerging evidence suggests the presence of a mechanistic link in which the adipocyte-derived hormone leptin stimulates aldosterone production in obesity, thereby creating a positive feedback loop for obesity-associated cardiovascular disease...
November 10, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29059080/leukotrienes-and-kidney-diseases
#4
Menachem Rubinstein, Efrat Dvash
PURPOSE OF REVIEW: This review will critically highlight the role of leukotrienes as mediators of renal diseases and drug nephrotoxicity. It will also discuss the recently identified mechanism of cysteinyl leukotrienes induction and action, and will propose clinical implementation of these findings. RECENT FINDINGS: Since last reviewed in 1994, leukotrienes were shown to mediate drug-associated nephrotoxicity, transplant rejection and morbidity in several models of renal diseases...
November 7, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29084002/central-arteriovenous-anastomosis-to-treat-resistant-hypertension
#5
Vikas Kapil, Paul A Sobotka, Mel D Lobo, Roland E Schmieder
PURPOSE OF REVIEW: Novel, interventional treatments have emerged in the last decade for the treatment of resistant hypertension. This review focuses on a unique device that creates a fixed calibre, central iliac arteriovenous anastomosis that is significantly different in haemodynamic and safety profile from traditional haemodialysis fistulae. The background, physiology, and clinical data to date will be presented. RECENT FINDINGS: The single, randomized, controlled clinical trial using the ROX coupler in patients with resistant hypertension demonstrated substantial reductions in both office and ambulatory blood pressure to 12-month postimplantation...
October 27, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29068796/protein-phosphatases-and-podocyte-function
#6
Pedro Geraldes
PURPOSE OF REVIEW: Deregulation of protecting factor signaling actions in podocytes has emerged as an alternative pathway of podocyte injury mechanisms. Here, we review recent knowledge that highlighted how podocyte protecting factors are modulated by protein phosphatases. RECENT FINDINGS: Protein tyrosine kinases and phosphatases participate in many, if not all, aspects of cellular function by turning on or off multiple signaling cascades and podocytes are no exception...
October 23, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29068795/the-role-of-renal-response-to-amino-acid-infusion-and-oral-protein-load-in-normal-kidneys-and-kidney-with-acute-and-chronic-disease
#7
Francis B Gabbai
PURPOSE OF REVIEW: High protein intake and hyperfiltration have been a focus of major interest as potential mechanism(s) of progression of renal disease. This review will examine: the renal response to a protein meal or amino acid infusion and its use to test the renal functional reserve (RFR); new methods to evaluate RFR; the use of RFR in various pathophysiologic conditions. RECENT FINDINGS: The renal response to protein/amino acid infusion involves several mechanisms, including nitric oxide, insulin, glucagon, arginine vasopressin, urea, the renal N-Methyl-D-Aspartate Glutamate receptor and modulation of the activity of the tubuloglomerular feedback system...
October 23, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29059081/the-role-of-toll-like-receptors-in-diabetic-kidney-disease
#8
Usha Panchapakesan, Carol Pollock
PURPOSE OF REVIEW: Involved in innate immunity, toll-like receptors (TLRs) recognize pathogenic and endogenous ligands. Ligand binding initiates an inflammatory cascade which if sustained leads to fibrosis. This review summarizes the role of TLRs in diabetic kidney disease (DKD) with particular emphasis on TLR2 and TLR4. RECENT FINDINGS: Collectively, preclinical evidence to date supports the causative role of TLR2 and TLR4 in both type I and type II DKD. The relative importance of each is still unclear...
October 20, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29045337/blood-pressure-regulation-by-the-angiotensin-type-1-receptor-in-the-proximal-tubule
#9
Marloes C van Haaster, Alicia A McDonough, Susan B Gurley
PURPOSE OF REVIEW: The renin-angiotensin system (RAS) plays a critical role in the pathogenesis of hypertension. Homeostatic actions of the RAS, such as increasing blood pressure (BP) and vasoconstriction, are mediated via type 1 (AT1) receptors for angiotensin II. All components of the RAS are present in the renal proximal tubule, which reabsorbs the bulk of the glomerular filtrate, making this segment of the nephron a location of great interest for solute handling under RAS influence...
October 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29045336/bile-acid-receptors-and-the-kidney
#10
Michal Herman-Edelstein, Talia Weinstein, Moshe Levi
PURPOSE OF REVIEW: Bile acids act as activating signals of endogenous renal receptors: the nuclear receptor farnesoid X receptor (FXR) and the membrane-bound G protein-coupled bile acid receptor 1 (GPBAR1, also known as TGR5). In recent years, bile acids have emerged as important for renal pathophysiology by activating FXR and TGR5 and transcription factors relevant for lipid, cholesterol and carbohydrate metabolism, as well as genes involved in inflammation and renal fibrosis. RECENT FINDINGS: Activation of bile acid receptors has a promising therapeutic potential in prevention of diabetic nephropathy and obesity-induced renal damage, as well as in nephrosclerosis...
October 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29045335/angiotensin-converting-enzyme-2-and-renal-disease
#11
Vanessa R Williams, James W Scholey
PURPOSE OF REVIEW: The renin-angiotensin system (RAS) is a pivotal player in the physiology and pathophysiology of cardiovascular and renal systems. Discovery of angiotensin-converting enzyme 2 (ACE2), capable of cleaving RAS effector peptide angiotensin (Ang) II into biologically active Ang-(1-7), has increased the complexity of our knowledge of the RAS. ACE2 expression is abundant in the kidney and is thought to provide protection against injury. This review emphasizes current experimental and clinical findings that examine ACE2 in the context of kidney injury and its potential therapeutic impact for treatment of kidney disease...
October 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/29045334/blood-pressure-parameters-and-morbid-and-mortal-outcomes-in-nondialysis-dependent-chronic-kidney-disease
#12
Carl P Walther, Aravind Chandra, Sankar D Navaneethan
PURPOSE OF REVIEW: Observational and interventional studies provide conflicting evidence regarding optimal blood pressure (BP) control in persons with chronic kidney disease (CKD). Recent publications provide additional information to inform therapeutic decision-making. RECENT FINDINGS: Targeting SBP to less than 120 mmHg, versus less than 140 mmHg, decreased cardiovascular events and all-cause mortality in persons with nondiabetic CKD. A meta-analysis of trials testing blood pressure management among nondialysis-dependent CKD patients (15 924 total patients) found more intensive therapies generally reduced mortality in all subgroups...
October 16, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28877040/ischemic-conditioning-in-solid-organ-transplantation-is-it-worth-giving-your-right-arm-for
#13
Luxme Nadarajah, Muhammed M Yaqoob, Kieran McCafferty
PURPOSE OF REVIEW: Ischemia reperfusion injury (IRI) is an inevitable complication in solid organ transplantation. Limiting this injury can increase patient and graft survival and can decrease complications associated with transplantation. We provide an extensive literature review analyzing the available evidence for ischemic conditioning in solid organ transplantation, including kidney, liver, heart, and lung. RECENT FINDINGS: Ischemic conditioning strategies are a group of interventions, characterized by episodes of ischemia and reperfusion to an organ which confirm tissue protection...
September 5, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28877041/sodium-mri-a-new-frontier-in-imaging-in-nephrology
#14
Susan Francis, Charlotte E Buchanan, Ben Prestwich, Maarten W Taal
PURPOSE OF REVIEW: This review focuses on the recent technological advances in quantitative sodium (Na) MRI to provide a noninvasive measure of tissue viability for use in clinical studies of patients with kidney disease. Na MRI is the only noninvasive imaging technique that allows for the absolute spatial quantification of tissue sodium concentration (TSC), providing assessment of the corticomedullary sodium gradient (CMSG) in the kidney, and allowing measures of TSC in the skin and muscle...
September 4, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28857783/a-critical-review-of-biomarkers-in-kidney-transplantation
#15
Kassem Safa, Ciara N Magee, Jamil Azzi
PURPOSE OF REVIEW: Improved long-term kidney allograft survival remains a critical goal in transplantation; the achievement of this, however, is highly dependent on the identification of biomarkers that can either predict or allow advance detection of patients at risk of allograft injury. The present review outlines the commonly used biomarkers in kidney transplantation, while also highlighting those currently under investigation, discussing their advantages and limitations. RECENT FINDINGS: Most of the approved biomarkers currently used in kidney transplantation capture antigen recognition or alloantibody production...
August 28, 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28985192/incorporating-supportive-care-into-the-hemodialysis-unit
#16
Rebecca J Schmidt
PURPOSE OF REVIEW: Advance care planning is underutilized in patients with dialysis-dependent kidney failure and the provision of high intensity rather than supportive care is a standard practice in most hemodialysis units wherever challenges to incorporating palliative or supportive care into unit processes remain formidable. RECENT FINDINGS: The practice of advance care planning empowers patients, families and physicians and drives decisions about future treatment that align with patients' values, wishes and changing clinical circumstances...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28985191/the-role-of-parathyroidectomy-in-the-management-of-secondary-hyperparathyroidism
#17
Keith E Eidman, James B Wetmore
PURPOSE OF REVIEW: Parathyroidectomy (PTX) is often used to treat severe secondary hyperparathyroidism (SHPT) in patients receiving maintenance dialysis. However, most evidence for the proposed benefits of PTX originates from observational studies, which cannot demonstrate causality. A reconsideration of the potential role of PTX might help guide its appropriate use. RECENT FINDINGS: Several large observational studies have suggested that PTX can reduce mortality risk...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28985190/pregnancy-and-the-kidney-transplant-recipient
#18
Madhusudan Vijayan, Martha Pavlakis
PURPOSE OF REVIEW: The current article reviews the available literature on the incidence, complications, outcomes, and management of pregnancies in kidney transplant recipients. RECENT FINDINGS: Pregnancy can be a reasonable option for women with a kidney transplant. More than 4700 successful pregnancies have been reported after kidney transplantation. New data have emerged regarding the risk of allograft dysfunction following pregnancy. There is a lack of consensus on the optimal time for conception, immunosuppressive targets, the safety of allograft biopsy, and infection surveillance...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28902726/incremental-dialysis-review-of-recent-literature
#19
Thomas A Golper
PURPOSE OF REVIEW: There are clinical, physiological, financial, and practical reasons to perform incremental hemodialysis in selected patients, incident to end-stage renal disease. Recent papers inform us further, especially in the large database studies. RECENT FINDINGS: Small studies suggested, then a larger study corroborated, that incremental hemodialysis was associated with preservation of residual kidney function whenever compared with conventional hemodialysis...
November 2017: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/28901990/the-impact-of-frailty-on-outcomes-in-dialysis
#20
John Sy, Kirsten L Johansen
PURPOSE OF REVIEW: Frailty is highly prevalent in the dialysis population and is associated with mortality. Recent studies have suggested that other dialysis outcomes are compromised in frail individuals. While we do not yet have a consensus as to the best measure of frailty, identification of these poor outcomes and their magnitude of association with frailty will help improve prognostication, allow for earlier interventions, and improve provider-to-patient communication. RECENT FINDINGS: The most widely used assessment of frailty is Fried's physical performance criteria...
November 2017: Current Opinion in Nephrology and Hypertension
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