Current Opinion in Nephrology and Hypertension最新文献

Calciprotein particles: is it time for therapeutic intervention? 钙蛋白颗粒：是时候进行治疗干预了吗？

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-05 DOI: 10.1097/MNH.0000000000001196

Makoto Kuro-O

{"title":"Calciprotein particles: is it time for therapeutic intervention?","authors":"Makoto Kuro-O","doi":"10.1097/MNH.0000000000001196","DOIUrl":"https://doi.org/10.1097/MNH.0000000000001196","url":null,"abstract":"Purpose of review: Calciprotein particles (CPPs) are colloidal nanoparticles composed of solid-phase calcium phosphate and serum proteins (mainly fetuin-A) that form as part of a defense system preventing ectopic mineral crystal growth. Recent studies have repositioned CPPs from passive byproducts of mineral imbalance to biologically active particles implicated in chronic kidney disease (CKD).Recent findings: Experimental studies have shown that CPP uptake by vascular endothelial cells and monocytes induces mitochondrial and lysosomal dysfunction, oxidative stress, and inflammasome activation. In clinical studies, circulating CPP levels and T50, an index of calcification propensity, are consistently associated with vascular calcification, cardiovascular events, and all-cause mortality across CKD stages. Interventional studies further indicate that modulation or removal of CPPs alters vascular and inflammatory phenotypes in vivo.Summary: Accumulating mechanistic and clinical evidence supports the concept that CPPs are plausible pathogenic mediators of CKD-associated complications. Targeting CPP formation, maturation, or clearance therefore represents a promising therapeutic strategy. Whether such approaches will translate into sustained clinical benefit remains an important question for ongoing and future trials.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834822","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Remission in diabetic kidney disease: current evidence and future directions. 糖尿病肾病的缓解：目前的证据和未来的方向。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-04 DOI: 10.1097/MNH.0000000000001197

Michael Reaume, Navdeep Tangri

{"title":"Remission in diabetic kidney disease: current evidence and future directions.","authors":"Michael Reaume, Navdeep Tangri","doi":"10.1097/MNH.0000000000001197","DOIUrl":"https://doi.org/10.1097/MNH.0000000000001197","url":null,"abstract":"Purpose of review: Diabetes is the leading cause of chronic kidney disease (CKD) worldwide. Diabetic kidney disease (DKD) has traditionally been viewed as a progressive condition characterized by declining estimated glomerular filtration rate (eGFR) and worsening albuminuria, with affected individuals facing substantially elevated risks of major adverse cardiovascular events and kidney failure. However, recent advances in pharmacologic therapies have demonstrated dramatic improvements in both cardiovascular and kidney outcomes. The objective of this review is to summarize the evidence for contemporary pharmacologic therapies in DKD, and to examine the emerging concept of disease remission in DKD.Recent findings: Randomized controlled trials of sodium-glucose cotransporter 2 inhibitors, mineralocorticoid receptor antagonists, and glucagon-like peptide-1 receptor agonists have demonstrated significant attenuation of eGFR decline and reductions in albuminuria. These findings have given rise to the hypothesis that, with guideline-directed therapy, some patients with DKD may achieve disease remission, defined by physiologic declines in eGFR and minimal (or resolved) albuminuria. Emerging evidence not only highlights the promise of this paradigm but also underscores the lack of standardized definitions and long-term outcome data.Summary: Emerging pharmacologic therapies are transforming DKD. Reframing DKD management from one of slowing progression to achieving remission could have important implications for clinical practice worldwide.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147812150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Indoxyl sulfate: clinical implications for anemia management in chronic kidney disease. 硫酸吲哚酚：慢性肾脏疾病贫血管理的临床意义。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-01 Epub Date: 2025-12-05 DOI: 10.1097/MNH.0000000000001145

Manoch Rattanasompattikul, Thatsaphan Srithongkul, Ekamol Tantisattamo, Kamyar Kalantar-Zadeh, Kajohnsak Noppakun

{"title":"Indoxyl sulfate: clinical implications for anemia management in chronic kidney disease.","authors":"Manoch Rattanasompattikul, Thatsaphan Srithongkul, Ekamol Tantisattamo, Kamyar Kalantar-Zadeh, Kajohnsak Noppakun","doi":"10.1097/MNH.0000000000001145","DOIUrl":"10.1097/MNH.0000000000001145","url":null,"abstract":"Purpose of review: This review examines the role of indoxyl sulfate, a gut-derived uremic toxin, in the development of anemia in chronic kidney disease. It dissects the cellular and biochemical mechanisms through which indoxyl sulfate suppresses erythropoietin production, disrupts iron metabolism, and promotes oxidative stress and inflammation.Recent findings: Indoxyl sulfate interferes directly with the hypoxia-inducible factor pathway, thereby reducing the transcriptional activation of erythropoietin. In parallel, indoxyl sulfate-induced oxidative stress damages red blood cells and accelerates premature cell death, while its stimulation of pro-inflammatory pathways further downregulates erythroid progenitor cell function. Therapeutic strategies such as dietary protein modulation, gut microbiota interventions, oral adsorbents, and enhanced dialysis modalities have shown promise in lowering indoxyl sulfate levels and, consequently, improving erythropoietin responsiveness and iron homeostasis in chronic kidney disease patients.Summary: The review synthesizes evidence from clinical and experimental studies that position indoxyl sulfate as a central yet underappreciated mediator of anemia in chronic kidney disease. Indoxyl sulfate establishes a vicious cycle that exacerbates anemia and contributes to erytropoiesis-stimulating agent hyporesponsiveness. The article advocates for targeted interventions aimed at reducing indoxyl sulfate burden, which could transform anemia management in chronic kidney disease and pave the way for personalized treatment strategies.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"387-393"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145699879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New pharmacological therapies for hypertension. 高血压的新药物疗法。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-01 Epub Date: 2026-01-22 DOI: 10.1097/MNH.0000000000001163

Manish Saxena, Feng J He, Mark J Caulfield

{"title":"New pharmacological therapies for hypertension.","authors":"Manish Saxena, Feng J He, Mark J Caulfield","doi":"10.1097/MNH.0000000000001163","DOIUrl":"10.1097/MNH.0000000000001163","url":null,"abstract":"Purpose of review: Cardiovascular diseases (CVD) are the leading cause for morbidity and mortality, and hypertension (HTN) remain the most important modifiable risk factor for CVD with poor control rates. All guidelines recommend lower blood pressure (BP) target that has made BP control rates in the community even worse. There is high unmet clinical need for novel therapies in HTN that could help achieve lower BP targets consistently across all patient subgroups.Recent findings: There have not been many novel therapies successfully developed for HTN in the last 30 years. Successful therapies such as renal denervation (RDN) or endothelin receptor antagonist aprocetantan have major limitations (poor response rate with RDN, fluid retention and modest BP reduction with aprocetantan) that restricts their use in large cohorts. Novel therapies including RNAi Zilebesiran and aldosterone synthase inhibitors (lorundrostat and baxdrostat) have demonstrated efficacy and safety in large, robust randomized controlled trials with good safety/tolerability and clinically significant BP reduction consistent across all sub-groups.Summary: Novel therapies (Zilebesiran, lorundrostat, baxdrostat) have shown great potential in lowering BP that is clinically meaningful to help improve cardiovascular and renal outcomes. ASI therapies lorundrostat and baxdrostat are close to being licensed for HTN. Once commercially available and recommended in treatment guidelines, the next big challenge will be reimbursement and implementation model in different healthcare systems.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"367-372"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Assessing interstitial fibrosis and tubular atrophy in kidney biopsies - artificial intelligence versus humans. 评估肾活检间质纤维化和肾小管萎缩人工智能与人类。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-01 Epub Date: 2026-03-13 DOI: 10.1097/MNH.0000000000001174

Alton B Farris, Dženan Zukić, Kim Solez

{"title":"Assessing interstitial fibrosis and tubular atrophy in kidney biopsies - artificial intelligence versus humans.","authors":"Alton B Farris, Dženan Zukić, Kim Solez","doi":"10.1097/MNH.0000000000001174","DOIUrl":"10.1097/MNH.0000000000001174","url":null,"abstract":"Purpose of review: The degree to which computerized methods, such as artificial intelligence (AI), will aid in the assessment of kidney histopathology is undergoing intense study and application; and this is particularly true for interstitial fibrosis, which is often used as a surrogate measure of chronic kidney disease progression, since interobserver variability among human pathologists has been demonstrated in the assessment of interstitial fibrosis and other features.Recent findings: Computerized assessment of interstitial fibrosis, including with AI, has been assessed alongside pathologists. Computerized methods such as AI have shown direct interstitial fibrosis measurement and indirect assessment through kidney compartment segmentation; however, some studies have shown lack of complete concordance among computerized methods and humans; and studies have still shown the persistent value of human assessment in many circumstances.Summary: Computerized methods, including AI, are showing increased application in kidney pathology for a wide variety of clinical and histopathologic parameter assessment, including interstitial fibrosis; however, further studies are needed to characterize the performance of AI and handcrafted methods; and additional work is needed to fully integrate computerized methods into routine pathology practice. Ultimately, humans working with AI (\"humans + AI\") may provide enhanced analysis for more effective patient care.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"300-307"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147456250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Continuous glucose monitoring in patients with chronic kidney disease on dialysis and with kidney transplantation. 慢性肾病透析和肾移植患者的持续血糖监测。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-01 Epub Date: 2026-03-06 DOI: 10.1097/MNH.0000000000001169

Connie M Rhee, Yaara Zisman-Ilani, Kamyar Kalantar-Zadeh, Danh V Nguyen

{"title":"Continuous glucose monitoring in patients with chronic kidney disease on dialysis and with kidney transplantation.","authors":"Connie M Rhee, Yaara Zisman-Ilani, Kamyar Kalantar-Zadeh, Danh V Nguyen","doi":"10.1097/MNH.0000000000001169","DOIUrl":"10.1097/MNH.0000000000001169","url":null,"abstract":"Purpose of review: While adequate glycemic control is a cornerstone of mitigating the cardio-kidney-metabolic risk of end-stage kidney disease (ESKD) patients with diabetes, including those receiving dialysis or kidney transplantation, there are limitations in the accuracy and/or convenience of traditional glycemic metrics in these populations. This has led to growing interest in continuous glucose monitoring (CGM) as an automated, minimally-invasive digital technology in diabetic ESKD patients.Recent findings: In the dialysis population, growing research shows that CGM is clinically reliable for use based on error grid analysis, although a wide range of mean absolute relative difference (MARD) values have been observed across cohorts and CGM devices. There are fewer studies of CGM in kidney transplant recipients (KTR's), which suggest reasonable analytical accuracy. While CGM has the potential to empower ESKD patients to participate actively in their disease management, broader adoption is limited by barriers at the healthcare system, financial, patient, and provider levels.Summary: While emerging data support the clinical utility of CGM in ESKD, further research is needed to determine its efficacy and to inform the development and validation of decision support tools, educational interventions, and implementation strategies for broader uptake and integration into routine care in dialysis patients and KTR's.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"394-401"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147364106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Promises and limits of biopsy-based transcriptomics in kidney transplantation: a clinical utility perspective. 基于活检的转录组学在肾移植中的应用前景和局限性：临床应用前景。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-01 Epub Date: 2026-03-05 DOI: 10.1097/MNH.0000000000001168

Karolien Wellekens, Tim Debyser, Candice Roufosse, Maarten Naesens

{"title":"Promises and limits of biopsy-based transcriptomics in kidney transplantation: a clinical utility perspective.","authors":"Karolien Wellekens, Tim Debyser, Candice Roufosse, Maarten Naesens","doi":"10.1097/MNH.0000000000001168","DOIUrl":"10.1097/MNH.0000000000001168","url":null,"abstract":"Purpose of review: Biopsy-based transcriptomics have been proposed as a complement to histopathology in the evaluation of kidney allograft rejection by providing standardized, mechanism-oriented insight into intra-graft immune activity. However, diagnostic performance, interpretability, and clinical relevance vary substantially across rejection phenotypes and clinical contexts. This review critically examines the evidence supporting biopsy-based transcriptomics and evaluates where, and whether, it adds value to practice.Recent findings: Large multicenter studies show that biopsy-based transcriptomics achieve robust analytical performance for antibody-mediated rejection. In contrast, for T cell-mediated rejection, intermediate Banff phenotypes, mixed rejection, and molecular activity detected in histologically negative biopsies, transcriptomic signals are more heterogeneous and frequently discordant with histology. Associations with graft outcome and treatment response have been reported but are largely derived from observational cohorts and lack validated, phenotype-specific thresholds. To date, no interventional studies have demonstrated improved patient outcomes through molecularly guided management.Summary: Biopsy-based transcriptomics provides biologically meaningful information but has not yet demonstrated outcome-improving clinical utility. Its value is highly context- dependent and currently best defined for selected scenarios rather than routine use. Prospective interventional studies and consensus-based interpretative frameworks are required to determine how molecular information should inform clinical decision-making in kidney transplantation.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"308-315"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147354136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New advances in the diagnosis and pathologic spectrum of monoclonal gammopathy of renal significance. 肾脏单克隆γ病诊断及病理谱的新进展。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-01 Epub Date: 2026-03-26 DOI: 10.1097/MNH.0000000000001171

Lihong Bu, Samih H Nasr

{"title":"New advances in the diagnosis and pathologic spectrum of monoclonal gammopathy of renal significance.","authors":"Lihong Bu, Samih H Nasr","doi":"10.1097/MNH.0000000000001171","DOIUrl":"https://doi.org/10.1097/MNH.0000000000001171","url":null,"abstract":"Purpose of review: Monoclonal gammopathy of renal significance (MGRS) refers to clonal plasma cell or B-cell proliferative disorders that cause kidney disease by nephrotoxic monoclonal immunoglobulins but do not meet criteria for hematologic malignancy. This review will discuss recent advances in the diagnosis and pathologic spectrum of MGRS.Recent findings: New noninvasive prediction tools that can calculate the risk of finding MGRS in a kidney biopsy have been developed, and can potentially help in decision-making, particularly when kidney biopsy is contraindicated. A joint working group of nephropathologists and nephrologists from Renal Pathology Society (RPS) and International Kidney and Monoclonal Gammopathy Research Group (KMG) reported a consensus-based terminology and precise definitions for monoclonal gammopathy-associated kidney lesions. Recent studies have broadened the spectrum of MGRS-associated crystalline nephropathies to include lesions of light chain crystalline podocytopathy and crystalglobulin induced nephropathy, and revealed distinct characteristics of the rare immunoglobulin (Ig)M and IgG1 variants of PGNMID from the IgG3 variant. Solid evidence using RACE-RepSeq and immunofluorescence staining with antibodies specific for immunoglobulin light chain variable region subgroups revealed that most cases of PGNMID involve oligoclonal or polyclonal production of nephrotoxic IgG3 rather than representing monoclonal disorders.Summary: Novel MGRS prediction tools, highly sensitive sequencing techniques, new ancillary renal pathology techniques, and the recent RPS/IKMG consensus definitions have the potential to significantly improve MGRS diagnosis.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":"35 3","pages":"294-299"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147510326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Implications of the cystatin C/creatinine discordance. 胱抑素C/肌酐不一致的意义。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-01 Epub Date: 2026-03-12 DOI: 10.1097/MNH.0000000000001178

Ian E McCoy

{"title":"Implications of the cystatin C/creatinine discordance.","authors":"Ian E McCoy","doi":"10.1097/MNH.0000000000001178","DOIUrl":"10.1097/MNH.0000000000001178","url":null,"abstract":"Purpose of review: Clinicians may estimate the glomerular filtration rate using serum creatinine (eGFRcr) or cystatin C (eGFRcys). But the difference between these estimates (eGFRdiff) is often large. In addition to presenting a clinical conundrum, eGFRdiff is associated with adverse outcomes. Often, these associations have been attributed to low muscle mass, wherein creatinine production is low, artificially increasing eGFRcr above eGFRcys. Less prominent theories propose the adverse associations may be due to artificial depression of eGFRcys when cystatin C production is increased by obesity or inflammation or when cystatin C clearance is decreased relative to creatinine clearance (shrunken pore syndrome).Recent findings: Recent analyses have revealed our understanding of the determinants and consequences of eGFRdiff remains poor. Models incorporating iothalamate GFR measurements and objective measures of muscle mass, obesity, inflammation, shrunken pore syndrome, have explained only a minority of the variation in eGFRdiff among individuals. Moreover, adjustment for these factors does not extinguish the associations with outcomes.Summary: The pathophysiology underlying the associations between eGFRdiff and adverse outcomes remains poorly understood. Until our understanding improves to allow prediction of whether eGFRcr or eGFRcys is likely to be more accurate in a particular patient, the combined equation estimate should be favored.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"323-328"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147431427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

New insights into clinical spectrum of antineutrophil cytoplasmic autoantibody associated disease. 抗中性粒细胞胞浆自身抗体相关疾病临床谱的新认识。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2026-05-01 Epub Date: 2026-02-18 DOI: 10.1097/MNH.0000000000001164

Marco A Alba, J Charles Jennette

{"title":"New insights into clinical spectrum of antineutrophil cytoplasmic autoantibody associated disease.","authors":"Marco A Alba, J Charles Jennette","doi":"10.1097/MNH.0000000000001164","DOIUrl":"10.1097/MNH.0000000000001164","url":null,"abstract":"Purpose of review: Antineutrophil cytoplasmic autoantibody (ANCA) vasculitis is a systemic autoimmune disease characterized by small-vessel inflammation caused by pathogenic autoantibodies directed against myeloperoxidase or proteinase 3. The clinical spectrum of ANCA vasculitis has expanded in recent years. This review summarizes emerging phenotypes and novel disease associations that have increased our understanding of ANCA disease and may be relevant for classification and treatment.Recent findings: ANCA disease exhibits marked clinical heterogeneity in terms of organ involvement and disease severity. Recent studies have further increased phenotypic diversity of ANCA vasculitis by describing less common manifestations, such as involvement of large vessels and interstitial lung disease, characterizing features associated with elderly and ANCA-negative patients, and exploring new cluster associations defined by clinical and serologic features. Novel entities, such as immune checkpoint inhibitor-induced vasculitis and vasculitis associated with monogenic and autoinflammatory conditions, have also been increasingly recognized.Summary: Recognition of less frequent manifestations within major clinicopathological variants of ANCA vasculitis and the identification of new disease associations underscore the diversity of pathogenic mechanisms (e.g., immune, genetic, and environmental) involved in ANCA-associated disease. Future disease phenotyping refinement will likely improve precision medicine and patient care.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"287-293"},"PeriodicalIF":2.4,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146257600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0