Current Opinion in Nephrology and Hypertension最新文献_第3页

Challenges and advances in the management of antineutrophil cytoplasmic antibody vasculitis in 2025. 2025年抗中性粒细胞细胞质抗体血管炎管理的挑战和进展。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-06-20 DOI: 10.1097/MNH.0000000000001094

Li Jin Ooi, Rosemary J Hollick, Silke R Brix

{"title":"Challenges and advances in the management of antineutrophil cytoplasmic antibody vasculitis in 2025.","authors":"Li Jin Ooi, Rosemary J Hollick, Silke R Brix","doi":"10.1097/MNH.0000000000001094","DOIUrl":"10.1097/MNH.0000000000001094","url":null,"abstract":"Purpose of review: Antineutrophil cytoplasmic antibody (ANCA) vasculitides are complex, immune mediated conditions of significant morbidity and mortality. This review highlights the evolving therapeutic landscape and emerging sub-phenotypes of the disease group to support development of more personalised interventions for people living with ANCA vasculitides.Recent findings: The advances in management include steroid-sparing strategies, with avacopan offering complement-based neutrophil inhibition. Rituximab has become central in induction and maintenance therapy, reducing cyclophosphamide use and replacing azathioprine. Cyclophosphamide is still used but often as an additional induction agent in the combination with rituximab to speed up disease control and to reduce glucocorticoid burden in severe kidney disease. Evidence gaps remain, particularly regarding long-term safety of newer agents, the optimal duration of maintenance therapy, and the benefits of plasma exchange in select populations. Recognition of distinct disease trajectories such as slowly sclerosing kidney disease in opposition to rapidly progressive glomerulonephritis highlight the need for more stratified treatment.Summary: Early disease detection, shared decision-making and personalised care are keys to improving outcomes in ANCA vasculitis. Future directions are risk stratifications that incorporate biomarker and novel diagnostic techniques to guide treatment intensity. Identification of key service components associated with improved outcomes such as multidisciplinary care is essential to support equitable translation of medical advances into clinical practice, ensuring both efficacy and safety in this high-risk population.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":"34 5","pages":"375-380"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728515","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

WNK kinase activity is modulated by the pseudokinase NRBP1 and the scaffold proteins of the TSC22D family. WNK激酶活性由假激酶NRBP1和TSC22D家族的支架蛋白调节。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-06-12 DOI: 10.1097/MNH.0000000000001097

Germán Magaña-Ávila, María Castañeda-Bueno

{"title":"WNK kinase activity is modulated by the pseudokinase NRBP1 and the scaffold proteins of the TSC22D family.","authors":"Germán Magaña-Ávila, María Castañeda-Bueno","doi":"10.1097/MNH.0000000000001097","DOIUrl":"10.1097/MNH.0000000000001097","url":null,"abstract":"Purpose of review: With No lysine (WNK) kinases participate in maintaining the homeostasis of water and electrolytes, by regulating the Cation Chloride Cotransporters (CCCs), which are implicated in the regulation of cell volume, neuronal intracellular [Cl-], and regulation of salt balance by the kidneys. Recently, the Nuclear Receptor Binding Proteins (NRBP) and the TGF-β-Stimulated Clone 22 Domain family (TSC22D) proteins were identified as WNK interactors that modulate WNK kinase activity. This review will summarize the findings of recent works that explore this previously unrecognized role of NRBP and TSC22D proteins.Recent findings: Three groups independently described the interaction between components of the WNK/SPAK-OSR1 pathway and NRBP1 or the TSC22D proteins, which are known interactors of NRBP1. These proteins were shown to colocalize with WNK kinases in biomolecular condensates. It was described that NRBP1 and TSC22D proteins have an activating effect on WNK activity and that its deficiency leads to impaired cell volume regulation and impaired electrolyte transport regulation in the distal convoluted tubule.Summary: These findings have implications extending beyond epithelial sodium transport, as they may be relevant for other fundamental processes modulated by WNKs, such as neuronal function, cellular volume regulation, and cell proliferation.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":"34 5","pages":"408-414"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728520","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 the biology and treatment of minimal change disease and focal segmental glomerulosclerosis. 微小变化疾病和局灶节段性肾小球硬化的生物学和治疗新见解。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-07-04 DOI: 10.1097/MNH.0000000000001102

Bryce Barr, Andreas Kronbichler, Astrid Weins

{"title":"New insights into the biology and treatment of minimal change disease and focal segmental glomerulosclerosis.","authors":"Bryce Barr, Andreas Kronbichler, Astrid Weins","doi":"10.1097/MNH.0000000000001102","DOIUrl":"10.1097/MNH.0000000000001102","url":null,"abstract":"Purpose of review: Until recently, the underlying pathophysiology of diffuse podocytopathies associated with nephrotic syndrome was not understood. Since the discovery of antinephrin antibodies and antibodies against other slit diaphragm components in a subset of patients with minimal change disease and focal segmental glomerulosclerosis, there has been a transformation of our understanding of disease pathogenesis and treatment rationale.Recent findings: Antinephrin antibodies are common in patients with acquired diffuse podocytopathy and are most reliably detected among those patients with treatment-naive nephrotic syndrome. Circulating antibodies correlate with disease activity and may be useful for monitoring patients with podocytopathies. Rituximab represents an effective treatment inducing remission in a majority of patients and reducing the frequency of relapses. Optimal dosing and frequency remain unclear, and randomized trials in this space are ongoing.Summary: Our understanding of immune-mediated podocytopathy is rapidly evolving, and changes in treatment paradigms are likely to continue to change, with emphasis on targeted therapies addressing disease pathogenesis. Future prospective studies are required to understand the optimal use of antinephrin antibodies for diagnosis and monitoring and how to tailor therapy to individual patients.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":"34 5","pages":"450-457"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144728517","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

Agents to treat osteoporosis in chronic kidney disease. 治疗慢性肾脏疾病骨质疏松症的药物。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-05-16 DOI: 10.1097/MNH.0000000000001091

Pascale Khairallah

{"title":"Agents to treat osteoporosis in chronic kidney disease.","authors":"Pascale Khairallah","doi":"10.1097/MNH.0000000000001091","DOIUrl":"10.1097/MNH.0000000000001091","url":null,"abstract":"Purpose of review: Fracture risk is significantly elevated in patients with chronic kidney disease (CKD), yet the diagnosis and treatment of CKD-associated osteoporosis remain complex. This review addresses the current gaps in managing bone health in CKD and highlights emerging strategies in this high-risk population.Recent findings: Diagnosis of CKD-associated osteoporosis requires integration of imaging, bone turnover markers, and occasionally bone biopsy. Correction of mineral metabolism disturbances is foundational, while bone-targeted therapies must be carefully selected. Treatment strategies are informed by bone turnover status. Antiresorptives such as bisphosphonates and denosumab are used in high-turnover disease, and osteoanabolic agents such as teriparatide and romosozumab are promising for low-turnover disease.Summary: Management of osteoporosis in CKD requires individualized approaches based on bone turnover and mineral metabolism status. While several pharmacologic options exist, evidence from randomized trials in CKD populations is limited. Further research is needed to guide treatment selection, define well tolerated therapeutic targets, and improve skeletal outcomes in this vulnerable group.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"397-407"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076466","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

Calcium-binding protein 39 in with-no-lysine kinase signaling and the modulation of renal tubular transport. 钙结合蛋白39与无赖氨酸激酶信号传导和肾小管运输的调节。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-05-13 DOI: 10.1097/MNH.0000000000001083

Mohammed Z Ferdaus, Eric Delpire

{"title":"Calcium-binding protein 39 in with-no-lysine kinase signaling and the modulation of renal tubular transport.","authors":"Mohammed Z Ferdaus, Eric Delpire","doi":"10.1097/MNH.0000000000001083","DOIUrl":"10.1097/MNH.0000000000001083","url":null,"abstract":"Purpose of review: The regulation of renal tubular transport is essential for maintaining electrolyte balance and blood pressure. Calcium-binding protein 39 (Cab39), also known as mouse protein-25 (MO25), plays a pivotal role in modulating this process through its interaction with WNK (with no lysine) kinases and Ste20-like kinases, including STE20/SPS1-related proline-alanine-rich kinase (SPAK) and oxidative stress response 1 (OSR1). By stabilizing and facilitating the activation of these kinases, Cab39 plays a crucial role in the regulation of key ion transporters, such as the sodium-chloride cotransporter (NCC) and the sodium-potassium-chloride cotransporters (NKCC1 and NKCC2). This review provides a comprehensive analysis of Cab39 structural properties, molecular interactions, and functional roles in renal physiology, emphasizing its significance in ion homeostasis.Recent findings: Studies reveal that Cab39 enhances SPAK activity up to 100-fold. Importantly, the role of Cab39 extends beyond simple kinase activation, as it supports kinase complex assembly and localization, enabling precise control over transporter regulation. Evidence also suggests that Cab39 may influence the regulation of NCC and NKCC2 through similar mechanisms, making it a promising target for therapeutic interventions in disorders such as hypertension and salt-wasting syndromes.Summary: The discovery of a small-molecule Cab39 inhibitor highlights its potential as a pharmacological target. Understanding the multifaceted functions of Cab39 may unlock novel strategies for managing renal and cardiovascular disorders.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"415-424"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12307122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143962967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

IgA nephropathy: a paradigm shift in treatment strategies. IgA肾病：治疗策略的范式转变。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-07-14 DOI: 10.1097/MNH.0000000000001105

Lydia Roberts, Max Jones, Jonathan Barratt, Haresh Selvaskandan

{"title":"IgA nephropathy: a paradigm shift in treatment strategies.","authors":"Lydia Roberts, Max Jones, Jonathan Barratt, Haresh Selvaskandan","doi":"10.1097/MNH.0000000000001105","DOIUrl":"10.1097/MNH.0000000000001105","url":null,"abstract":"Purpose of review: This review will provide an overview of the current understanding of mechanisms which drive IgA nephropathy (IgAN), and explore new therapies (those approved or being evaluated in phase 3 studies) which modulate these mechanisms to improve outcomes.Recent findings: IgAN remains the most reported primary glomerular disease worldwide. It is now clear that the majority of those diagnosed with IgAN are likely to progress to kidney failure over their lifetime, unless stringent disease control is achieved early. For decades, therapeutic options have been limited to interventions generic to chronic kidney disease (CKD), which could not alone rescue patients with IgAN from the risk of kidney failure. Recent advances in our understanding of the mechanisms driving IgAN, coupled with regulatory shifts in approvable clinical trial endpoints, have led to a surge in the development and evaluation of targeted therapies.Summary: As of early 2025, four agents have already received regulatory approval, and many more are expected. New treatments act on IgAN-specific disease pathways and modify disease pathways generic to CKD. For the first time, it is now possible to initiate well tolerated, effective, truly disease-modifying interventions early to meaningfully reduce the lifetime risk of kidney failure among those living with IgAN.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"381-388"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144682139","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

Recent advances in treatment options for kidney disease. 肾脏疾病治疗方案的最新进展。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-07-31 DOI: 10.1097/MNH.0000000000001100

Kripa Kohli, Sankar D Navaneethan

引用次数: 0

Sodium-glucose cotransporter 2 inhibitors: a novel approach to prevent the transition from acute kidney injury to chronic kidney disease. 钠-葡萄糖共转运蛋白2抑制剂：防止急性肾损伤向慢性肾病转变的新途径

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-04-23 DOI: 10.1097/MNH.0000000000001080

Miguel Ángel Martínez-Rojas, Norma A Bobadilla

{"title":"Sodium-glucose cotransporter 2 inhibitors: a novel approach to prevent the transition from acute kidney injury to chronic kidney disease.","authors":"Miguel Ángel Martínez-Rojas, Norma A Bobadilla","doi":"10.1097/MNH.0000000000001080","DOIUrl":"10.1097/MNH.0000000000001080","url":null,"abstract":"Purpose of review: Acute kidney injury (AKI) often progresses to chronic kidney disease (CKD), yet standardized clinical guidelines for managing this transition remain lacking. Recent studies suggest that sodium-glucose cotransporter 2 inhibitors (SGLT2i) or flozins improve AKI outcomes. Studies on patients living with diabetes post-AKI show flozins reduce mortality, CKD progression, and recurrent AKI, highlighting their potential in mitigating maladaptive kidney repair. We discuss recent preclinical evidence supporting a role of SGLT2i during AKI repair and subsequent CKD.Recent findings: AKI is characterized by endothelial and tubular injury, hypoperfusion, metabolic dysfunction, inflammation, and cell death. SGLT2i restore renal hemodynamics, mitochondrial dysfunction, and reduce oxidative stress, improving recovery following AKI. Additionally, SGLT2i mitigate cell death by counteracting apoptosis and ferroptosis while reducing inflammation through suppression of pro-inflammatory cytokines and inflammasome activation. Beyond AKI, flozins exhibit long-term antifibrotic effects, reducing extracellular matrix deposition even after treatment discontinuation. Preclinical studies demonstrate a sustained protective effect on kidney integrity months after short-term treatment.Summary: These inhibitors hold promise for broad nephroprotection, with robust biological rationale in maladaptive repair. Further research is needed to optimize their use and establish clinical guidelines for AKI management in both diabetic and nondiabetic populations.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"433-439"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143958371","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

Novel insights in the regulation of intercalated cell differentiation. 插层细胞分化调控的新见解。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1097/MNH.0000000000001095

Yu Feng, Yanmiao Qi, Xiangjian Zheng

{"title":"Novel insights in the regulation of intercalated cell differentiation.","authors":"Yu Feng, Yanmiao Qi, Xiangjian Zheng","doi":"10.1097/MNH.0000000000001095","DOIUrl":"10.1097/MNH.0000000000001095","url":null,"abstract":"Purpose of review: Kidney intercalated cells play critical roles in regulating body acid-base balance. We recently discovered Foxp1 and two downstream transcriptional factors Dmrt2 and Hmx2 are essential for intercalated cell differentiation. This review incorporates these findings with previous reports to add insights to the molecular regulation of intercalated cell differentiation.Recent findings: We reviewed the current understanding of intercalated cell differentiation and plasticity, and the contribution of single-cell sequencing to point to the existence of transitional cells during principal cell and intercalated cell differentiation or trans-differentiation. For molecular regulation of cell differentiation, we discuss how Notch and Foxi1 regulate principal cell/intercalated cell switch and intercalated cell differentiation, and the new finding of Foxp1 and downstream transcriptional factors in intercalated cell subtype specification.Summary: The differentiation and balance of principal cell and intercalated cell subtypes are the foundation for maintaining acid-base balance. A clear understanding of the cellular and molecular controls of these processes provides the basis for designing intervention approaches for metabolism acidosis or alkalosis and other related diseases.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"425-432"},"PeriodicalIF":2.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144224656","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 introductions. 编辑介绍。

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-09-01 Epub Date: 2025-07-31 DOI: 10.1097/MNH.0000000000001104

引用次数: 0