Current Opinion in Nephrology and Hypertension最新文献

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-05-29 DOI: 10.1097/MNH.0000000000001092

引用次数: 0

Impact of the choice of biomarkers and equations to estimate kidney function on the epidemiology of chronic kidney disease. 选择生物标志物和方程来评估肾功能对慢性肾脏疾病流行病学的影响。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-05-16 DOI: 10.1097/MNH.0000000000001085

Pierre Delanaye, Rouvick Mariano Gama, Thomas Stehlé

{"title":"Impact of the choice of biomarkers and equations to estimate kidney function on the epidemiology of chronic kidney disease.","authors":"Pierre Delanaye, Rouvick Mariano Gama, Thomas Stehlé","doi":"10.1097/MNH.0000000000001085","DOIUrl":"10.1097/MNH.0000000000001085","url":null,"abstract":"Purpose of review: The CKD-EPI equations were updated in 2021 to remove the race variable from eGFR estimation. In the same year, the creatinine-based EKFC equation was published, subsequently supplemented by the cystatin C-based EKFC equation. Recent findings suggest that the prevalence of chronic kidney disease (CKD) can vary depending on the equation, the biomarker, and the population studied.Recent findings: Using the CKD-EPI 2021 equation instead of the CKD-EPI 2009 equation results in an increased prevalence of CKD among Black individuals in the U.S. and a decreased prevalence among non-Blacks. The CKD-EPI equations may underestimate the prevalence of CKD in India and in some sub-Saharan African populations. This is corrected by using the EKFC equation and dedicated Q-values. In general, the prevalence of CKD is slightly higher with EKFC than with the CKD-EPI equations. The CKD-EPI cys equation generally leads to a higher CKD prevalence than the CKD-EPIcrea equations. Few epidemiological data are available for EKFC cys .Summary: The choice of biomarkers and equations has an impact on the prevalence of CKD, with implications that also depend on the characteristics of the population being studied.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"336-345"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093160","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

Momentum toward patient outcome trials in chronic kidney disease-mineral bone disorder. 慢性肾脏疾病-矿物质骨紊乱患者结局试验的势头。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-05-19 DOI: 10.1097/MNH.0000000000001087

Varsha Pothula Venkata, Julia J Scialla

{"title":"Momentum toward patient outcome trials in chronic kidney disease-mineral bone disorder.","authors":"Varsha Pothula Venkata, Julia J Scialla","doi":"10.1097/MNH.0000000000001087","DOIUrl":"10.1097/MNH.0000000000001087","url":null,"abstract":"Purpose of review: The purpose of this review is to: evaluate the clinical trial evidence base for the treatment of chronic kidney disease mineral and bone disorder (CKD-MBD) in patients with kidney failure as it relates to highly prioritized clinical outcomes; and discuss approaches and principles to develop needed trials in CKD-MBD.Recent finding: Most clinical trials in CKD-MBD focus on biochemical outcomes, with few trials of surrogate outcomes (e.g., vascular calcification, left ventricular hypertrophy, bone mineral density), and even fewer of highly prioritized clinically important outcomes, such as mortality, cardiovascular disease events, or hospitalization. Within phosphate management, the recent LANDMARK trial did not detect a difference in a cardiovascular composite outcome between patients randomized to lanthanum carbonate vs. a calcium-based phosphate binder strategy over 3 years. The ongoing PHOSPHATE trial will provide needed evidence on phosphate treatment targets. There are no comparable, large trials of parathyroid hormone (PTH) targets. Observational approaches using clinical trial emulation suggest the potential for reduced cardiovascular disease and mortality with an 'emulated' low PTH target, but trials must be designed to confirm this. To ensure success, these trials must focus on practical treatment approaches, leveraging areas of practice variation and recognizing the dynamic nature of longitudinal CKD-MBD care.Summary: More intensive treatment of CKD-MBD remains a promising approach to improve clinical outcomes in patients with kidney failure and should prompt ongoing efforts to obtain needed trials.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"304-313"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093161","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

Editorial: One size does not fit all: moving toward individualized therapy. 社论：一种方式不适合所有人：转向个性化治疗。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-05-29 DOI: 10.1097/MNH.0000000000001088

Aline Martin, Rosa Moyses

引用次数: 0

The impact of sex on blood pressure. 性生活对血压的影响。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-04-07 DOI: 10.1097/MNH.0000000000001077

Fanny Bourdon, Belen Ponte, Anne Dufey Teso

{"title":"The impact of sex on blood pressure.","authors":"Fanny Bourdon, Belen Ponte, Anne Dufey Teso","doi":"10.1097/MNH.0000000000001077","DOIUrl":"10.1097/MNH.0000000000001077","url":null,"abstract":"Purpose of review: Hypertension is the most prevalent cardiovascular disease worldwide and the leading cause of mortality in both men and women. Despite well documented sex differences in prevalence, risk factors, and treatment responses, current guidelines still fail to take these specificities into account. A more tailored approach, accounting for sex-specific pathophysiological mechanisms and risk factors, is essential.Recent findings: Studies show that hypertension is more prevalent in men than in women until menopause. After menopause, the prevalence increases in women, likely due to hormonal changes. Additionally, genetic, metabolic, and social risk factors differ between the sexes, as do cardiovascular risks and associated comorbidities. Pharmacokinetic and pharmacodynamic variations also impact antihypertensive treatment efficacy and side effects, highlighting the need for a more individualized therapeutic strategy. This review explores the pathophysiology of hypertension by sex, global risk factors with a focus on female-specific aspects, and sex-related cardiovascular risks. We also discuss antihypertensive treatments and their effectiveness based on gender-specific characteristics.Summary: Incorporating sex differences into hypertension management could enhance treatment efficacy and reduce cardiovascular mortality. Further research is needed to refine guidelines and develop personalized therapeutic strategies, optimizing hypertension care and improving patient outcomes.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"322-329"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794910","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

Glomerular filtration rate and sexual dimorphism: lessons from animal and human studies. 肾小球滤过率和两性异形：来自动物和人类研究的经验教训。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-04-23 DOI: 10.1097/MNH.0000000000001079

Elise Bouderlique, Romain Pszczolinski, Caroline Prot-Bertoye, Marie Courbebaisse

{"title":"Glomerular filtration rate and sexual dimorphism: lessons from animal and human studies.","authors":"Elise Bouderlique, Romain Pszczolinski, Caroline Prot-Bertoye, Marie Courbebaisse","doi":"10.1097/MNH.0000000000001079","DOIUrl":"10.1097/MNH.0000000000001079","url":null,"abstract":"Purpose of review: Integrating sex-based analyses is becoming a key point in the new recommendations, particularly in nephrology.Recent findings: Whereas single nephron glomerular filtration rate (GFR) is not different between men and women, male sex is associated, after multiple adjustments, with a higher number of nephrons. However, after indexation to body surface area, measured GFR (mGFR) in healthy potential kidney donors is not different between men and women between 20 and 50 years of age. After 50 years, mGFR decline seems faster in women than in men, which is concordant with the protective role of estrogens on renal function, as demonstrated in animal and some human studies. Conversely, testosterone has a detrimental effect on renal function. Of note, although testosterone has been shown to increase the kidney volume of the remnant kidney after a unilateral nephrectomy in animal models, this may generate deleterious hyperfiltration in the longer term.Summary: Taken together, these data highlight the impact of sex on GFR, notably through sexual hormones whose receptors are expressed in glomerular cells.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"330-335"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984335","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

Fibroblast growth factor 23 as a risk factor for incident diabetes. 成纤维细胞生长因子23作为发生糖尿病的危险因素。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-04-15 DOI: 10.1097/MNH.0000000000001078

Martin H de Borst

{"title":"Fibroblast growth factor 23 as a risk factor for incident diabetes.","authors":"Martin H de Borst","doi":"10.1097/MNH.0000000000001078","DOIUrl":"10.1097/MNH.0000000000001078","url":null,"abstract":"Purpose of review: Diabetes is a major global health concern, affecting millions and increasing morbidity and mortality. Recent research highlights fibroblast growth factor 23 (FGF23) as a potential contributor to type 2 diabetes and its cardiovascular complications. This review explores the role of FGF23 in metabolic and cardiovascular dysfunction and discusses possible therapeutic interventions.Recent findings: Deregulated FGF23 is linked to insulin resistance, pancreatic β-cell dysfunction, and systemic inflammation. Studies suggest FGF23 influences glucose metabolism via insulin signaling, oxidative stress, and inflammation. Epidemiological data indicate that elevated FGF23 levels are associated with an increased risk of type 2 diabetes and posttransplant diabetes, independent of traditional risk factors. Higher FGF23 levels have also been linked with an increased cardiovascular risk in patients with diabetes, even without chronic kidney disease.Summary: FGF23 is emerging as a key factor in the cardiovascular-kidney-metabolic syndrome, connecting diabetes and cardiovascular disease. While studies suggest consistent associations, causal mechanisms remain unclear. No therapies specifically target FGF23 to lower diabetes risk, but fibroblast growth factor receptor 4 (FGFR4) inhibitors show promise. Future research should examine the role of FGF23 in individuals with normal kidney function and explore whether modifying its levels could reduce diabetes and cardiovascular risk.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"284-290"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984329","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

The role of calprotectin in vascular calcification. 钙保护蛋白在血管钙化中的作用。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-03-29 DOI: 10.1097/MNH.0000000000001075

Ana Amaya-Garrido, Julie Klein

{"title":"The role of calprotectin in vascular calcification.","authors":"Ana Amaya-Garrido, Julie Klein","doi":"10.1097/MNH.0000000000001075","DOIUrl":"10.1097/MNH.0000000000001075","url":null,"abstract":"Purpose of review: Vascular calcification significantly contributes to cardiovascular morbidity and mortality, particularly in high-risk populations like chronic kidney disease (CKD) patients. Calprotectin, a heterodimeric protein with pro-inflammatory and pro-calcific properties, has emerged as a key molecule in vascular pathology. This review highlights the mechanisms linking calprotectin to vascular calcification, its clinical relevance, and its potential as a therapeutic target.Recent findings: Vascular calcification is an active, cell-mediated process involving vascular smooth muscle cell (VSMC) dysfunction, inflammation, matrix remodeling, and cellular senescence. Calprotectin is strongly associated with cardiovascular disease and vascular calcification, particularly in CKD. Mechanistic studies reveal that calprotectin promotes calcification through the activation of RAGE and TLR4 signaling pathways, driving inflammatory cascades. Preclinical studies demonstrate that pharmacological inhibition of calprotectin attenuates vascular calcification in animal models, supporting its potential as a therapeutic target.Summary: Calprotectin is emerging as a promising biomarker and therapeutic target in vascular calcification, particularly in CKD and aging-related vascular diseases. However, further studies are required to clarify its mechanisms and assess the long-term efficacy and safety of calprotectin-targeted therapies. A deeper understanding of calprotectin's multifaceted role could pave the way for innovative therapeutic strategies targeting both inflammation and mineralization in calcification-related vascular diseases.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"276-283"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143735737","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

The role of osteopontin in chronic kidney disease-mineral bone disorder. 骨桥蛋白在慢性肾病-矿物质骨紊乱中的作用。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-04-01 DOI: 10.1097/MNH.0000000000001074

Eduardo J Duque, Cecilia Giachelli, Rosa M A Moysés

{"title":"The role of osteopontin in chronic kidney disease-mineral bone disorder.","authors":"Eduardo J Duque, Cecilia Giachelli, Rosa M A Moysés","doi":"10.1097/MNH.0000000000001074","DOIUrl":"10.1097/MNH.0000000000001074","url":null,"abstract":"Purpose of review: Chronic kidney disease-mineral bone disorder (CKD-MBD) is associated with several adverse outcomes, including bone fragility and sarcopenia. Identification of new agents mitigating systemic damage related to uremia is critical and needed to unveil pathways implicated in CKD-MBD.Recent findings: Osteopontin (OPN) is involved in different physiological and pathological processes and works as a bridge connecting several systems. It may serve as a biomarker for many diseases, including human cancers, neurodegenerative disorders and autoimmune diseases. OPN has been implicated in disturbances of bone mineralization and remodeling, and has an interplay with parathyroid hormone and FGF23 in experimental models. In patients with CKD and severe hyperparathyroidism, OPN expression in muscle tissue has been linked to worse functionality and local inflammation, which is partially reverted after parathyroidectomy.Summary: Future studies could confirm the role of OPN as a biomarker in nephrology. Greater understanding of its role in CKD-MBD will help us define a better therapeutic strategy in patients with CKD.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"291-296"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751562","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

Effects of aging on chronic kidney disease mineral and bone disorder. 衰老对慢性肾脏疾病、矿物质和骨骼紊乱的影响。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-07-01 Epub Date: 2025-05-02 DOI: 10.1097/MNH.0000000000001084

Washington A Freire-Filho, Maria Aparecida Dalboni, Rosilene M Elias

{"title":"Effects of aging on chronic kidney disease mineral and bone disorder.","authors":"Washington A Freire-Filho, Maria Aparecida Dalboni, Rosilene M Elias","doi":"10.1097/MNH.0000000000001084","DOIUrl":"10.1097/MNH.0000000000001084","url":null,"abstract":"Purpose of review: Aging and chronic kidney disease mineral and bone disorder (CKD-MBD) interact to worsen bone health, vascular calcification, and frailty in older patients. The altered FGF23-Klotho axis and disrupted mineral homeostasis emphasize the need for early interventions to mitigate fractures and cardiovascular complications in this vulnerable population. This review provides an updated overview of the current knowledge on CKD-MBD in older patients.Recent findings: CKD-MBD exacerbates bone fragility and vascular calcification in older populations. Early vascular aging and cognitive decline are associated with increased mortality. Disruptions in calcium, phosphate, and vitamin D homeostasis accelerate bone loss and fracture risk, whereas secondary hyperparathyroidism worsens cardiovascular outcomes. Additionally, polypharmacy, sarcopenia, and cognitive impairment further intensified the clinical burden in aging CKD patients.Summary: Aging potentially worsens CKD-MBD, vascular calcification, and cardiovascular disease in older patients. This growing field offers promising opportunities for further research to enhance understanding, improve bone health outcomes, and reduce fracture risk.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"297-303"},"PeriodicalIF":2.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143984808","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