2,489 results match your criteria Current Opinion in Nephrology and Hypertension[Journal]


Blood pressure targets and kidney and cardiovascular disease: same data but discordant guidelines.

Curr Opin Nephrol Hypertens 2019 Feb 12. Epub 2019 Feb 12.

William B. Schwartz Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA.

Purpose Of Review: Hypertension is highly prevalent in the United States and a major risk factor for the development of cardiovascular disease. Hypertension is common in chronic kidney disease (CKD), and likely contributes to the association between CKD and cardiovascular disease. The ideal systolic BP to reduce cardiovascular disease risk in individuals with CKD is controversial. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000492DOI Listing
February 2019

Clinical evidence that treatment of metabolic acidosis slows the progression of chronic kidney disease.

Curr Opin Nephrol Hypertens 2019 Jan 23. Epub 2019 Jan 23.

Department of Internal Medicine, Texas A&M Health Sciences Center College of Medicine.

Purpose Of Review: We review the growing clinical evidence that metabolic acidosis mediates chronic kidney disease (CKD) progression and that treatment to increase the associated low serum bicarbonate (HCO3) in CKD is disease-modifying.

Recent Findings: Seven prospective studies of patients with wide ranges of estimated glomerular filtration rates (eGFRs) and serum HCO3 examined the effect on CKD of increasing serum HCO3 using dietary acid reduction with either oral alkali (sodium bicarbonate or sodium citrate), a vegetarian diet very low in acid-producing protein (0.3 g/kg/day) supplemented with ketoanalogues or added base-producing fruits and vegetables. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000491DOI Listing
January 2019
1 Read

Nonproteinuric progressive diabetic kidney disease.

Curr Opin Nephrol Hypertens 2019 Jan 21. Epub 2019 Jan 21.

CNR National Research Council Clinical Epidemiology and Pathophysiology of Renal Disease and Hypertension Unit.

Purpose Of Review: We will summarize recent epidemiological observations on the risk for overt diabetic kidney disease (DKD) in nonproteinuric patients, will focus on novel studies based on a proteomic biomarker of DKD and will discuss the possibility of preventing the progression of DKD in nonproteinuric patients by sodium glucose transporter 2 (SGLT2) inhibitors.

Recent Findings: Although less frequently than in type 2 diabetes, DKD may develop also in nonproteinuric type 1 diabetes. However, the progression rate to kidney failure in nonproteinuric diabetic people is much lower than in proteinuric ones. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000489DOI Listing
January 2019

Impact of gender and gender disparities in patients with kidney disease.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):178-182

Department of Medicine, Division of Nephrology, SUNY Downstate Medical Center, Brooklyn, New York, USA.

Purpose Of Review: Despite evidence of gender-specific differences in epidemiology and outcomes in all stages of chronic kidney disease (CKD), most studies ignore the issue of gender. This review addresses this knowledge gap by evaluating data on gender disparity in this population.

Recent Findings: Population-based studies indicate a higher prevalence of CKD in women; however, there are fewer women on renal replacement therapy than men. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000482DOI Listing
March 2019
2 Reads

Immunohistochemistry for aldosterone synthase CYP11B2 and matrix-assisted laser desorption ionization imaging mass spectrometry for in-situ aldosterone detection.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):105-112

Department of Uro-Oncology, Saitama Medical University International Medical Center, Saitama, Japan.

Purpose Of Review: Immunohistochemistry for aldosterone synthase (CYP11B2) has markedly provided a comprehensive picture of the adrenocortical diseases, particularly primary aldosteronism. The findings from CYP11B2-immunohistochemistry are consistent with the clinical courses of most patients with primary aldosteronism. We herein review the updated pathophysiology and usefulness of the method for understanding individual patients with different subtypes of primary aldosteronism. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000487DOI Listing
March 2019
9 Reads

Diagnosis of monogenic chronic kidney diseases.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):183-194

Division of Nephrology, Department of Internal Medicine.

Purpose Of Review: The purpose of this review is to emphasize that single gene disorders are an important and sometimes unrecognized cause of progressive chronic kidney disease. We provide an overview of the benefits of making a genetic diagnosis, the currently available genetic testing methods and examples of diseases illustrating the impact of a genetic diagnosis.

Recent Findings: Although there are now a number of monogenic renal diseases, only a few, such as autosomal dominant polycystic kidney disease (ADPKD), are generally diagnosable without genetic testing. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000486DOI Listing
March 2019
2 Reads

Editorial: Controversies in kidney stones and other chronic kidney disease topics.

Authors:
David S Goldfarb

Curr Opin Nephrol Hypertens 2019 Mar;28(2):128-129

Nephrology Division, New York University Langone Health, NY Harbor VA Medical Center, NYU School of Medicine, New York, New York, USA.

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http://dx.doi.org/10.1097/MNH.0000000000000485DOI Listing
March 2019
2 Reads

Renin-angiotensin system inhibition in advanced chronic kidney disease: how low can the kidney function go?

Curr Opin Nephrol Hypertens 2019 Mar;28(2):171-177

Division of Nephrology, Department of Medicine, Duke University School of Medicine.

Purpose Of Review: To present the available data on the risks and benefits for ACEi/ARB usage in patients with advanced CKD.

Recent Findings: It has been well established that ACEi/ARB use is beneficial in patients with mild-to-moderate CKD, especially in patients with proteinuria. The majority of available data includes patients with diabetes mellitus. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000484DOI Listing
March 2019
3 Reads

New insights regarding epithelial Na+ channel regulation and its role in the kidney, immune system and vasculature.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):113-119

Department of Medicine.

Purpose Of Review: This review describes recent findings regarding the epithelial Na channel (ENaC) and its roles in physiologic and pathophysiologic states. We discuss new insights regarding ENaC's structure, its regulation by various factors, its potential role in hypertension and nephrotic syndrome, and its roles in the immune system and vasculature.

Recent Findings: A recently resolved structure of ENaC provides clues regarding mechanisms of ENaC activation by proteases. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000479DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6349474PMC
March 2019
2 Reads

Citrate therapy for calcium phosphate stones.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):130-139

Department of Internal Medicine, and Charles and Jane Pak Center for Mineral Metabolism and Clinical Research, University of Texas Southwestern Medical Center, Dallas, Texas, USA.

Purpose Of Review: Calcium phosphate (CaP) stones represent an increasingly encountered form of recurrent nephrolithiasis, but current prophylactic medical regimens are suboptimal. Although hypocitraturia is a well-described risk factor for CaP stones, strategies that enhance citrate excretion have not consistently been effective at reducing CaP saturation and stone recurrence. This review summarizes the role of citrate therapy in CaP nephrolithiasis. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000474DOI Listing
March 2019
2 Reads

Gadolinium-based contrast agents: why nephrologists need to be concerned.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):154-162

Kidney Institute of New Mexico.

Purpose Of Review: The hegemony of gadolinium-based contrast agent-induced adverse events stretches beyond those who have renal impairment. 'Nephrogenic' systemic fibrosis is a misnomer: gadolinium-based contrast agents are the known trigger for the disease; kidney impairment is a risk factor. Impaired (true) glomerular filtration may be one catalyst for gadolinium-based contrast agent-induced adverse events, but it is increasingly evident that the same cluster of symptoms occurs in patients with normal renal function. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000475DOI Listing
March 2019
9 Reads

The gut microbiota and blood pressure in experimental models.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):97-104

Heart Failure Research Group, Baker Heart and Diabetes Institute.

Purpose Of Review: To summarize evidence supporting that microorganisms colonizing our gastrointestinal tract, collectively known as the gut microbiota, are implicated in the development and maintenance of hypertension in experimental models.

Recent Findings: The use of gnotobiotic (germ-free) mice has been essential for advancement in this area: they develop higher blood pressure (BP) if they receive faecal transplants from hypertensive patients compared to normotensive donors, and germ-free mice have a blunted response to angiotensin II. Experimental hypertension is consistently accompanied by changes in the composition of the gut microbiota. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000476DOI Listing
March 2019
1 Read

The incessant search for renal biomarkers: is it really justified?

Curr Opin Nephrol Hypertens 2019 Mar;28(2):195-202

Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.

Purpose Of Review: This review summarizes the most recent and relevant findings in the search for novel biomarkers for the most common renal diseases.

Recent Findings: Unprecedented, fast-paced technical advances in biomedical research have offered an opportunity to identify novel and more specific renal biomarkers in several clinical settings. However, despite the huge efforts made, the molecules identified so far have generally failed to provide relevant information beyond what has already been generated by established biomarkers, such as serum creatinine and proteinuria, whereas the complexity and costs of these technology platforms hamper their widespread implementation. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000481DOI Listing
March 2019
3 Reads
3.862 Impact Factor

The case for cautious consumption: NSAIDs in chronic kidney disease.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):163-170

Department of Medicine & Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.

Purpose Of Review: Strong epidemiological and pathologic evidence associates NSAIDs with kidney disease, both acute and chronic. Hence, the usage of NSAIDs has decreased in patients with, or at risk for, chronic kidney disease (CKD). Coupled with this has been a rise in use of opioids and other non-NSAID alternatives, which do come with significant, and underrecognized, risk of nonrenal adverse events. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000473DOI Listing
March 2019
10 Reads

Leave no stone unturned: defining recurrence in kidney stone formers.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):148-153

Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.

Purpose Of Review: Established guidelines provide recommendations on the management of kidney stones to prevent recurrence. However, clear and clinically useful terminology for recurrence of kidney stones is needed. This review describes the various manifestations of kidney stone recurrence and the reported rates of kidney stone recurrence in various clinical settings. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000478DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6377251PMC
March 2019
2 Reads

Differences in national and international guidelines regarding use of kidney stone formers as living kidney donors.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):140-147

Nephrology Section, New York Harbor VA Medical Center and NYU School of Medicine, New York, New York, USA.

Purpose Of Review: Traditionally, nephrolithiasis was considered a relative contraindication to kidney donation because of a risk of recurrent stones in donors and adverse stone-related outcomes in recipients. However, the scarcity of organs has driven the transplant community to re-examine and broaden selection criteria for living donors with stones. In this review, we summarize and contrast the guidelines published by various prominent national and international societies on this topic. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000480DOI Listing
March 2019
2 Reads

The renin-angiotensin system in the arcuate nucleus controls resting metabolic rate.

Curr Opin Nephrol Hypertens 2019 Mar;28(2):120-127

Department of Pharmacology, Center for Hypertension Research, Obesity Research & Education Initiative, Iowa Neuroscience Institute, Abboud Cardiovascular Research Center, and Fraternal Order of Eagles' Diabetes Research Center, Carver College of Medicine, University of Iowa, Iowa City, USA.

Purpose Of Review: Obesity represents the primary challenge to improving cardiovascular health, and suppression of resting metabolic rate (RMR) is implicated in the maintenance of obesity. Increasing evidence supports a major role for the renin-angiotensin system (RAS) within the brain in the control of RMR.

Recent Findings: The angiotensin II (ANG) Agtr1a receptor colocalizes with the leptin receptor (Lepr) primarily within cells of the arcuate nucleus (ARC) of the hypothalamus that also express Agouti-related peptide (Agrp). Read More

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http://dx.doi.org/10.1097/MNH.0000000000000477DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6366639PMC
March 2019
1 Read

Leveraging pragmatic clinical trial design to advance phosphate management in end-stage renal disease.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):34-39

Division of Nephrology, St. Joseph's Healthcare Hamilton, McMaster University.

Purpose Of Review: Phosphate lowering toward the normal range is advocated and widely practiced in patients with end-stage renal disease receiving dialysis. This approach is guided by basic science data and large observational studies that have demonstrated a consistent association between hyperphosphatemia and adverse events, including cardiovascular morbidity and all-cause mortality. There has never been a clinical trial to assess the efficacy of phosphate lowering in maintenance dialysis recipients. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000460DOI Listing
January 2019
10 Reads

Genes and environment in chronic kidney disease hotspots.

Authors:
David J Friedman

Curr Opin Nephrol Hypertens 2019 Jan;28(1):87-96

Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.

Purpose Of Review: Chronic kidney disease (CKD) can cluster in geographic locations or in people of particular genetic ancestries. We explore APOL1 nephropathy and Balkan nephropathy as examples of CKD clustering that illustrate genetics and environment conspiring to cause high rates of kidney disease. Unexplained hotspots of kidney disease in Asia and Central America are then considered from the perspective of potential gene × environment interactions. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000470DOI Listing
January 2019
7 Reads

Fibroblast growth factor 23 and α-Klotho co-dependent and independent functions.

Authors:
L Darryl Quarles

Curr Opin Nephrol Hypertens 2019 Jan;28(1):16-25

Division of Nephrology, Department of Medicine, College of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, USA.

Purpose Of Review: The current review examines what is known about the FGF-23/α-Klotho co-dependent and independent pathophysiological effects, and whether FGF-23 and/or α-Klotho are potential therapeutic targets.

Recent Findings: FGF-23 is a hormone derived mainly from bone, and α-Klotho is a transmembrane protein. Together they form a trimeric signaling complex with FGFRs in target tissues to mediate the physiological functions of FGF-23. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000467DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6258326PMC
January 2019
11 Reads

Unmet challenges in membranous nephropathy.

Authors:
David J Salant

Curr Opin Nephrol Hypertens 2019 Jan;28(1):70-76

Department of Medicine, Boston University School of Medicine and Section of Nephrology, Boston Medical Center, Boston, Massachusetts, USA.

Purpose Of Review: Despite major advances in since the discovery of the phospholipase A2 receptor (PLA2R) as the major autoantigen on podocytes in primary membranous nephropathy, there are still several unanswered questions as highlighted here.

Recent Findings: A substantial body of literature, included in more than 680 articles since 2009, has documented genetic susceptibility to primary membranous nephropathy involving PLA2R1 and class II MHC alleles, the clinical value of anti-PLA2R assays, the significance of epitope spreading of the anti-PLA2R response, discovery of thrombospondin type I domain-containing 7A (THSD7A) as a minor antigen in primary membranous nephropathy, and the ability to transfer disease into mice by infusion of anti-THSD7A sera. However, the normal physiology and pathophysiology of PLA2R and THSD7A in podocytes is still unknown and the genetic influence on disease susceptibility is unexplained. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000459DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6289589PMC
January 2019
12 Reads

Fluid management and bioimpedance study in peritoneal dialysis.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):58-64

Carol and Richard Yu Peritoneal Dialysis Research Centre, Department of Medicine & Therapeutics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong.

Purpose Of Review: Maintaining euvolaemia is an essential yet challenging objective in management of patients on peritoneal dialysis. Optimal method to assess volume status remains to be determined. In this review, we will discuss the risk factors and clinical outcomes of fluid overload in PD patients, and examine the role of bioimpedance study in fluid management. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000466DOI Listing
January 2019
2 Reads

Dilemmas and challenges in apolipoprotein L1 nephropathy research.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):77-86

Department of Nephrology, Rambam Healthcare Campus.

Purpose Of Review: The purpose of this mini-review is to highlight some unresolved questions and controversies in the evolving story of apolipoprotein L1 (APOL1) nephropathy.

Recent Findings: We highlight studies that introduce complexity in unraveling the mechanisms whereby APOL1 risk variant alleles cause disease. These include studies which support a possible protective role for the APOL1 GO nonrisk ancestral allele, and studies which explore the initiating events that may trigger other downstream pathways mediating APOL1 cellular injury. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000462DOI Listing
January 2019
3 Reads

Pre, peri and posttransplant diabetes mellitus.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):47-57

Department of Diabetes, Endocrinology and Metabolism, City of Hope National Medical Center, Duarte, California, USA.

Purpose Of Review: The leading cause of death in both chronic kidney disease (CKD) and renal transplant patients is cardiovascular events. Post-transplant diabetes mellitus (PTx-DM), which is a major cardiovascular risk factor, is a metabolic disorder that affects 5.5-60. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000469DOI Listing
January 2019
18 Reads

Growth hormone and chronic kidney disease.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):10-15

Departments of Pediatrics and Molecular and Integrative Physiology, University of Michigan, Ann Arbor, Michigan, USA.

Purpose Of Review: Elevated circulating levels of growth hormone (GH) and/or increased expression of the GH receptor in the kidney are associated with the development of nephropathy in type1 diabetes and acromegaly. Conditions of GH excess are characterized by hyperfiltration, glomerular hypertrophy, glomerulosclerosis and albuminuria, whereas states of decreased GH secretion or action are protected against glomerulopathy. The direct role of GH's action on glomerular cells, particularly podocytes, has been the focus of recent studies. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000468DOI Listing
January 2019
19 Reads

Sex hormones and their influence on chronic kidney disease.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):1-9

Nephrology Research Group, Vall d'Hebron Research Institute (VHIR).

Purpose Of Review: The majority of end-stage renal disease including dialysis and kidney transplant patients are men. In contrast, the incidence of chronic kidney disease (CKD) is higher in women compared with men. In this review, we dissect the sex hormone levels and its effects on experimental models and patients with CKD. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000463DOI Listing
January 2019
5 Reads

Methylglyoxal stress, the glyoxalase system, and diabetic chronic kidney disease.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):26-33

Department of Internal Medicine, CARIM School for Cardiovascular Diseases, Maastricht University Medical Center, Maastricht, the Netherlands.

Purpose Of Review: Chronic kidney disease (CKD) remains a serious diabetic complication despite the use of widely employed interventions such as angiotensin-converting enzyme inhibitors and glucose-lowering treatments. Accumulation of methylglyoxal, a highly reactive glucose metabolite and a major precursor in the formation of advanced glycation end products, may link the hemodynamic, inflammatory, metabolic, and structural changes that drive diabetic CKD. Therefore, methylglyoxal may serve as a potential therapeutic target to prevent diabetic CKD. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000465DOI Listing
January 2019
9 Reads

Protective association between JC polyoma viruria and kidney disease.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):65-69

Department of Internal Medicine, Section on Nephrology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.

Purpose Of Review: The presence of viruses in urine (urine virome) typically reflects infection in the kidneys and urinary tract. The urinary virome is associated with HIV-associated nephropathy and chronic glomerulosclerosis. There are many associations of this microbiome with human diseases that remain to be described. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000464DOI Listing
January 2019
15 Reads

Mesenchymal stromal cells in kidney transplantation.

Curr Opin Nephrol Hypertens 2019 Jan;28(1):40-46

Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Bergamo, Italy.

Purpose Of Review: Mesenchymal stromal cells (MSC) have emerged as one of the most promising candidates for immunomodulatory cell therapy in kidney transplantation. Here we describe novel insights into the MSC mechanism of action and provide an overview of initial safety and feasibility studies with MSC in kidney transplantation.

Recent Findings: Clinical studies of MSC-based cell therapy in kidney transplant recipients demonstrated the safety and feasibility of cell therapy and provide the first encouraging evidence of the efficacy of MSC in enabling the minimization of immunosuppressive drugs. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000461DOI Listing
January 2019
2 Reads

Nocturnal hemodialysis: an underutilized modality?

Curr Opin Nephrol Hypertens 2018 Nov;27(6):472-477

Department of Infection Immunity and Inflammation, University of Leicester.

Purpose Of Review: There is increasing evidence that extended-hours regimens are associated with improved outcomes for patients on maintenance hemodialysis programs. Home hemodialysis programs are a well established way for patients to benefit from extended-hours dialysis overnight; however, there are significant barriers to home hemodialysis, which means that for many this is not an option. In center, nocturnal hemodialysis is an increasingly recognized way of offering extended-hours treatment to patients unable to undertake home-based programs and is an underutilized modality for such patients to gain from the physiological benefits of extended-hours dialysis regimens. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000450DOI Listing
November 2018
2 Reads

Point-of-care ultrasound in end-stage kidney disease: beyond lung ultrasound.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):487-496

Department of Anesthesiology and Intensive Care, Montreal Heart Institute.

Purpose Of Review: Following the miniaturization of ultrasound devices, point-of-care ultrasound (POCUS) has been proposed as a tool to enhance the value of physical examination in various clinical settings. The objective of this review is to describe the potential applications of POCUS in end-stage renal disease patients (ESRD).

Recent Findings: With basic training, the clinician can perform pulmonary, vascular, cardiac, and abdominal POCUS at the bedside of ESRD patients. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000453DOI Listing
November 2018
1 Read

Expanding deceased donor kidney transplantation: medical risk, infectious risk, hepatitis C virus, and HIV.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):445-453

Department of Surgery, Johns Hopkins University School of Medicine.

Purpose Of Review: Due to the organ shortage, which prevents over 90 000 individuals in the United States from receiving life-saving transplants, the transplant community has begun to critically reevaluate whether organ sources that were previously considered too risky provide a survival benefit to waitlist candidates.

Recent Findings: Organs that many providers were previously unwilling to use for transplantation, including kidneys with a high Kidney Donor Profile Index or from increased risk donors who have risk factors for window period hepatitis C virus (HCV) and HIV infection, have been shown to provide a survival benefit to transplant waitlist candidates compared with remaining on dialysis. The development of direct-acting antivirals to cure HCV infection has enabled prospective trials on the transplantation of organs from HCV-infected donors into HCV-negative recipients, with promising preliminary results. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000456DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6352990PMC
November 2018
5 Reads

Update on posttransplant lymphoproliferative disease.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):440-444

Hematology Department, Clinica Universidad de Navarra and Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain.

Purpose Of Review: Posttransplant lymphoproliferative disorder (PTLD), frequently associated with Epstein-Barr virus (EBV), is one of the most serious complications leading to worse patient and graft outcomes. Hence, we summarize in this review relevant studies published about PTLD in the last 18 months.

Recent Findings: Recent studies have improved the knowledge about epidemiology, prophylaxis, diagnosis and PTLD treatment. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000457DOI Listing
November 2018
1 Read

Protein carbamylation in end stage renal disease: is there a mortality effect?

Authors:
Sahir Kalim

Curr Opin Nephrol Hypertens 2018 Nov;27(6):454-462

Nephrology Division, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.

Purpose Of Review: Protein carbamylation is a posttranslational protein modification caused, in part, by exposure to urea's dissociation product cyanate. Additional modulators of protein carbamylation include circulating free amino acid levels, inflammation, diet, smoking, and environmental pollution exposures. Carbamylation reactions can modify protein charge, structure, and function, leading to adverse molecular and cellular responses. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000454DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6235170PMC
November 2018
2 Reads

Hemodialysis versus peritoneal dialysis in resource-limited settings.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):463-471

Institute of Biomedical Ethics and the History of Medicine, University of Zurich, Winterthurerestrasse, Zurich, Switzerland.

Purpose Of Review: To assess the use, access to and outcomes of hemodialysis and peritoneal dialysis in low-resource settings.

Recent Findings: Hemodialysis tends to predominate because of costs and logistics, however services tend to be located in larger cities, often paid for out of pocket. Outcomes of dialysis-requiring acute kidney injury and end-stage kidney disease may be similar with hemodialysis and peritoneal dialysis, and therefore choice of therapy is dominated by availability, accessibility and patient or physician choice. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000455DOI Listing
November 2018
10 Reads

Urgent start peritoneal dialysis.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):478-486

UNESP - Botucatu School of Medicine, University Sao Paulo State.

Purpose Of Review: Although historically peritoneal dialysis was widely used in nephrology, it has been underutilized in recent years. In this review, we present several key opportunities and strategies for revitalization of urgent start peritoneal dialysis use, and discuss the recent literature on clinical experience with peritoneal dialysis use in the acute and unplanned setting.

Recent Findings: Interest in using urgent start peritoneal dialysis to manage acute kidney injury (AKI) and unplanned chronic kidney disease (CKD) stage 5 patients has been increasing. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000451DOI Listing
November 2018
2 Reads

Techniques to improve intradialytic haemodynamic stability.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):413-419

Centre for Kidney Research and Innovation, Division of Medical Sciences and Graduate Entry Medicine, University of Nottingham.

Purpose Of Review: Intra-dialytic hypotension (IDH) remains a significant problem for patients undergoing chronic haemodialysis. IDH causes symptoms that degrade patients' experience, compromises dialysis delivery and is strongly associated with adverse patient outcomes. Greater understanding of the link between IDH and dialysis-induced ischaemia in heart and brain has characterized mechanistic pathways, with repeated episodes of ischaemia resulting in organ dysfunction. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000449DOI Listing
November 2018
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Nocturnal haemodialysis: an underutilized modality?

Curr Opin Nephrol Hypertens 2018 Aug 16. Epub 2018 Aug 16.

Department of Infection Immunity and Inflammation, University of Leicester.

Purpose Of Review: There is increasing evidence that extended-hours regimens are associated with improved outcomes for patients on maintenance haemodialysis programmes. Home haemodialysis programmes are a well established way for patients to benefit from extended-hours dialysis overnight; however, there are significant barriers to home haemodialysis, which means that for many this is not an option. In centre, nocturnal haemodialysis is an increasingly recognized way of offering extended-hours treatment to patients unable to undertake home-based programmes and is an underutilized modality for such patients to gain from the physiological benefits of extended-hours dialysis regimens. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000450DOI Listing
August 2018
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Personalized medicine in nephrology: a novel approach or just good medicine?

Authors:
Maarten W Taal

Curr Opin Nephrol Hypertens 2018 Nov;27(6):395-397

Department of Renal Medicine, Royal Derby Hospital.

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http://dx.doi.org/10.1097/MNH.0000000000000448DOI Listing
November 2018
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Personalized medicine in diabetic kidney disease: a novel approach to improve trial design and patient outcomes.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):426-432

Department of Clinical Pharmacy and Pharmacology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.

Purpose Of Review: In the last decade many attempts have been made to reduce the high residual risk of end-stage kidney disease and cardiovascular disease in patients with diabetic kidney disease by targeting a variety of risk markers. Subsequent analyses revealed that the variation in individual drug response to the tested interventions partly explains why these trials did not result in additional kidney or cardiovascular protection. This review summarizes recent insights regarding individual variation in drug response. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000447DOI Listing
November 2018
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Role of microRNAs in aldosterone signaling.

Curr Opin Nephrol Hypertens 2018 Sep;27(5):390-394

Department of Cell Biology, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.

Purpose Of Review: The review describes studies investigating the role of microRNAs in the signaling pathway of the mineralocorticoid hormone, aldosterone.

Recent Findings: Emerging evidence indicates that aldosterone alters the expression of microRNAs in target tissues thereby modulating the expression of key regulatory proteins.

Summary: The mineralocorticoid hormone aldosterone is released by the adrenal glands in a homeostatic mechanism to regulate blood volume. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000440DOI Listing
September 2018
2 Reads

Systems biology approaches to identify disease mechanisms and facilitate targeted therapy in the management of glomerular disease.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):433-439

Division of Nephrology, Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA.

Purpose Of Review: Current clinical pathological classifications of glomerular diseases are inadequate at predicting patient disease progression or response to therapy. With the advent of precision medicine and its successes in oncology, it is important to understand if similar approaches in glomerular diseases can improve patient management. The purpose of this review is to summarize approaches to obtain comprehensive molecular profiles from human biopsies and utilize them to define the pathophysiology of glomerular failure. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000446DOI Listing
November 2018
2 Reads
3.862 Impact Factor

Hypoxia-inducible factor stabilizers for treating anemia of chronic kidney disease.

Curr Opin Nephrol Hypertens 2018 Sep;27(5):331-338

Division of Nephrology and Endocrinology, the University of Tokyo Graduate School of Medicine, Tokyo, Japan.

Purpose Of Review: Small-molecule inhibitors of prolyl hydroxylase domain enzymes (PHD inhibitors) are novel renal anemia therapies that increase endogenous erythropoietin (EPO) production by stabilizing hypoxia-inducible factor (HIF). This review summarizes recent findings and future perspectives of PHD inhibitors (HIF stabilizers) in chronic kidney disease (CKD)-associated anemia.

Recent Findings: Clinical trials have demonstrated that HIF stabilizers effectively increase hemoglobin levels of both nondialysis and dialysis CKD patients without causing serious adverse effects. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000431DOI Listing
September 2018
15 Reads

The use of bioimpedance spectroscopy to guide fluid management in patients receiving dialysis.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):406-412

Faculty of Medicine and Health Sciences, Keele University, Keele, UK.

Purpose Of Review: To summarize the findings of recent trials and meta-analyses designed to determine whether bioimpedance spectroscopy adds value to the clinical assessment of fluid status in dialysis patients so as to achieve a normally hydrated weight and put these in a contemporary context.

Recent Findings: Eight trials (published 2010-2018) and two meta-analyses (2017) are reviewed. Both haemodialysis and peritoneal dialysis modalities are represented. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000445DOI Listing
November 2018
9 Reads
3.862 Impact Factor

How best to estimate glomerular filtration rate? Novel filtration markers and their application.

Curr Opin Nephrol Hypertens 2018 Nov;27(6):398-405

Division of Nephrology, Tufts Medical Center, Boston, Massachusetts, USA.

Purpose Of Review: Chronic kidney disease is an increasing health burden. Estimating equations using serum concentrations of creatinine and cystatin C facilitate the assessment of kidney function as reflected in estimated glomerular filtration rate (eGFR). Reduced eGFR is associated with increased risk for numerous adverse outcomes and is an important aspect in many clinical situations. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000444DOI Listing
November 2018
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Which anticoagulants should be used for stroke prevention in non-valvular atrial fibrillation and severe chronic kidney disease?

Curr Opin Nephrol Hypertens 2018 Nov;27(6):420-425

Department of Nephrology, University of Medicine and Pharmacy 'Gr. T. Popa', Iasi, Romania.

Purpose Of Review: Non-valvular atrial fibrillation is common in patients with severe chronic kidney disease (CKD) and historically patients have been treated with vitamin K antagonists (VKA). However, these agents have questionable efficacy and are associated with increased bleeding risk. Non-vitamin K oral anticoagulants (NOAC) have advantages over VKA in early stage CKD. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000443DOI Listing
November 2018
11 Reads

Renal tubular solute transport and oxygen consumption: insights from computational models.

Curr Opin Nephrol Hypertens 2018 Sep;27(5):384-389

Department of Medicine.

Purpose Of Review: To maintain electrolyte homeostasis, the kidneys reabsorb more than 99% of the filtered Na under physiological conditions, resulting in less than 1% of the filtered Na excreted in urine. In contrast, due to distal tubular secretion, urinary K output may exceed filtered load. This review focuses on a relatively new methodology for investigating renal epithelial transport, computational modelling and highlights recent insights regarding renal Na and K transport and O2 consumption under pathophysiological conditions, with a focus on nephrectomy. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000435DOI Listing
September 2018
9 Reads

Adaptive remodeling of renal Na+ and K+ transport during pregnancy.

Curr Opin Nephrol Hypertens 2018 Sep;27(5):379-383

Division of Nephrology and Hypertension, Department of Medicine, Georgetown University, Washington, DC, USA.

Purpose Of Review: Renal ion transport undergoes dramatic changes during the course of gestation. These adaptations are necessary to meet the dynamic requirements of pregnancy and support fetal development. Pregnancy is characterized by a high demand for both sodium and potassium. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000441DOI Listing
September 2018
2 Reads

Emerging therapeutic options for management of anaemia in with patients with chronic kidney disease.

Curr Opin Nephrol Hypertens 2018 Sep;27(5):329-330

Selzman Institute for Kidney Health, Section of Nephrology, Department of Medicine, Baylor College of Medicine.

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http://dx.doi.org/10.1097/MNH.0000000000000434DOI Listing
September 2018
4 Reads

Epithelial sodium channel biogenesis and quality control in the early secretory pathway.

Curr Opin Nephrol Hypertens 2018 Sep;27(5):364-372

Department of Biological Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.

Purpose Of Review: The epithelial sodium channel, ENaC, is responsible for Na reabsorption in several epithelia and is composed of homologous α, β, and γ subunits. Here, we will explore the differential regulation of ENaC subunits during biogenesis in the early secretory pathway.

Recent Findings: ENaC subunits are subject to numerous posttranslational modifications, including glycosylation, protease activation, disulfide bond formation, palmitoylation, and glycosylation, each of which modulate channel function. Read More

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http://dx.doi.org/10.1097/MNH.0000000000000438DOI Listing
September 2018
5 Reads