Current Opinion in Nephrology and Hypertension最新文献_第6页

APOL1-associated kidney disease: modulators of the genotype-phenotype relationship. apol1相关肾脏疾病：基因型-表型关系的调节因子

IF 2.4 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-05-01 Epub Date: 2025-03-06 DOI: 10.1097/MNH.0000000000001068

Martin R Pollak, David J Friedman

{"title":"APOL1-associated kidney disease: modulators of the genotype-phenotype relationship.","authors":"Martin R Pollak, David J Friedman","doi":"10.1097/MNH.0000000000001068","DOIUrl":"10.1097/MNH.0000000000001068","url":null,"abstract":"Purpose of review: Apolipoprotein-L1 (APOL1) G1 and G2 risk variants, found in people of recent west sub-Saharan African ancestry, dramatically increase the likelihood of kidney disease, yet the incomplete penetrance an diverse clinical manifestations underscore the need to understand the molecular and environmental factors that modulate APOL1-mediated toxicity.Recent findings: Recent studies confirm that risk variants exert a toxic gain-of-function effect, exacerbated by inflammatory triggers such as HIV infection and COVID-19. Epigenetic mechanisms and microRNA pathways further modulate APOL1 expression, influencing disease penetrance. Multiple models have clarified how subcellular localization, signal peptide processing, and interactions with the endoplasmic reticulum may contribute to pathogenesis. Therapeutic advances include inhibitors targeting APOL1 ion channel activity and strategies that block key inflammatory signaling pathways.Summary: These findings highlight a multifaceted disease process driven by both the intrinsic toxic potential of APOL1 variants and numerous extrinsic triggers. Understanding this complex interplay will be pivotal for risk stratification and the development of precision therapies, potentially improving outcomes for populations disproportionately affected by APOL1-associated kidney disease.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"191-198"},"PeriodicalIF":2.4,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565957","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

Impact of intensive blood pressure control on kidney outcomes. 强化血压控制对肾脏预后的影响。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-05-01 Epub Date: 2025-03-07 DOI: 10.1097/MNH.0000000000001070

Jia Xin Huang, Vanessa-Giselle Peschard, Elaine Ku

{"title":"Impact of intensive blood pressure control on kidney outcomes.","authors":"Jia Xin Huang, Vanessa-Giselle Peschard, Elaine Ku","doi":"10.1097/MNH.0000000000001070","DOIUrl":"10.1097/MNH.0000000000001070","url":null,"abstract":"Purpose of review: Hypertension has long been recognized as a modifiable risk factor for cardiovascular events. However, the role of intensive blood pressure (BP) control in preventing kidney disease progression continues to be debated. This review will provide a brief update on the evidence in support of or against the intensive control of BP on kidney outcomes in patient with chronic kidney disease (CKD), focusing particularly on trial-grade evidence.Recent findings: Recently, three large trials conducted in China compared the effects of intensive BP control in adults with cardiovascular risk factors. All three trials demonstrated that intensive BP control confers cardiovascular benefits, but mixed results were noted in terms of the risk of adverse kidney outcomes. In individual-level meta-analyses of six trials of different BP control strategies in patients with CKD, intensive BP control appeared to reduce the risk of kidney replacement therapy in those with CKD stage 4-5, but not in patients with CKD stage 3.Summary: Most guidelines continue to recommend a systolic BP target of 120-130 mmHg for patients with CKD given the cardiovascular benefits observed in trials of intensive BP control, though there are some signals of potential risks to the kidney with this BP treatment strategy.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"224-231"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11949411/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699908","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

Editorial introductions. 编辑介绍。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-05-01 Epub Date: 2025-03-27 DOI: 10.1097/MNH.0000000000001071

引用次数: 0

Glucagon-like peptide-1 receptor agonists to improve cardiorenal outcomes: data from FLOW and beyond. 胰高血糖素样肽-1受体激动剂改善心肾预后：来自FLOW及其他的数据。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-05-01 Epub Date: 2025-03-06 DOI: 10.1097/MNH.0000000000001066

Labib Faruque, Kevin Yau, David Z I Cherney

{"title":"Glucagon-like peptide-1 receptor agonists to improve cardiorenal outcomes: data from FLOW and beyond.","authors":"Labib Faruque, Kevin Yau, David Z I Cherney","doi":"10.1097/MNH.0000000000001066","DOIUrl":"10.1097/MNH.0000000000001066","url":null,"abstract":"Purpose of review: Glucagon-like peptide-1 receptor agonists (GLP1RA), initially approved for glycemic control in type 2 diabetes mellitus (T2DM), have emerged as agents for weight loss, cardiovascular and kidney protection. This review summarizes the evidence supporting the benefits of these therapies on cardiorenal outcomes.Recent findings: Clinical trials have consistently demonstrated reductions in major adverse cardiovascular events with GLP1RA treatments. Recently, the FLOW trial revealed that semaglutide reduced the composite outcome of kidney failure, at least 50% decline in estimated glomerular filtration rate, kidney or cardiovascular mortality by 24% in patients with T2DM, thereby establishing GLP1RA as a pillar of therapy in this population. New evidence suggests favorable effects on kidney endpoints in nondiabetic individuals with overweight or obesity. Dedicated trials have also provided evidence for reduction in the risk for heart failure hospitalization and improvement in symptoms in individuals with heart failure with preserved ejection fraction. Subgroup analyses have suggested that GLP1RAs confer additive cardiorenal benefits irrespective of background medication use.Summary: There is increasing evidence that GLP1RA reduces the risk for cardiovascular events, chronic kidney disease progression, and heart failure hospitalizations. Further data on the effect of dual and triple GLP1-based therapies on cardiorenal outcomes is required.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"232-240"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143565991","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

Rethinking arterial hypertension: the need for a paradigm shift. 重新思考动脉高血压：需要一个范式转变。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-05-01 Epub Date: 2025-02-24 DOI: 10.1097/MNH.0000000000001065

Gian Paolo Rossi, Domenico Bagordo, Federico Bernardo Rossi

{"title":"Rethinking arterial hypertension: the need for a paradigm shift.","authors":"Gian Paolo Rossi, Domenico Bagordo, Federico Bernardo Rossi","doi":"10.1097/MNH.0000000000001065","DOIUrl":"10.1097/MNH.0000000000001065","url":null,"abstract":"Purpose of review: Essential (primary or idiopathic) hypertension is presented as the most prevalent 'cause' of arterial hypertension, which is a paradoxical statement for a condition whose causes are unknown. The consequence of this description is that secondary hypertension is held to be exceptional and, therefore, very rarely sought for in current clinical practice. Labelling a hypertensive patient as 'essential' means that no further investigations will be undertaken to discover the cause of hypertension, therefore neglecting the possibility of long-term cure of hypertension and sentencing the patient to a life-long drug treatment.Recent findings: We will describe how the notion of essential hypertension has developed and whether scientific evidence from the most recent studies still support the conclusion that it is highly prevalent. The concept of secondary hypertension along with the criteria to be used to define it as such are also being examined.Summary: The evidence that secondary hypertension is highly prevalent, when systematically sought for, should increase the awareness of this condition and lead to a broader search for it, which are fundamental steps to achieve cure or a better control of high blood pressure, thus improving patients' outcome and quality of life.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":"34 3","pages":"259-266"},"PeriodicalIF":2.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708996","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 kidney under heat stress: a vulnerable state. 热应激下的肾脏：一种脆弱的状态。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-03-01 Epub Date: 2024-12-13 DOI: 10.1097/MNH.0000000000001050

Fabiano Amorim, Zachary Schlader

{"title":"The kidney under heat stress: a vulnerable state.","authors":"Fabiano Amorim, Zachary Schlader","doi":"10.1097/MNH.0000000000001050","DOIUrl":"10.1097/MNH.0000000000001050","url":null,"abstract":"Purpose of review: This review examines the effects of occupational heat stress on kidney health. It focuses on the role of hyperthermia in the development of acute kidney injury (AKI) and its potential progression to chronic kidney disease of nontraditional etiology (CKDnt). We highlight the physiological mechanisms by which hyperthermia affects kidney function and discuss emerging preventive strategies.Recent findings: Hyperthermia places the kidneys in a vulnerable state. As body temperature increases, blood flow is directed toward the skin to aid in cooling, diverting it away from internal organs like the kidneys to support blood pressure regulation. At the same time, hyperthermia and dehydration increases energetic demand to promote fluid and electrolyte conservation. Collectively, this can create a localized supply-demand mismatch, resulting in tissue hypoxia that can damage kidney tissues. These findings highlight that heat hyperthermia can lead to subclinical kidney damage, with potential long-term implications for kidney health.Summary: Heat-induced AKI is a growing public health concern. Individuals engaged in manual labor with prolonged exposure are at risk of CKDnt. Interventions aimed to prevent hyperthermia show promise in mitigating the risk of AKI. Further research is necessary to refine these strategies and establish evidence-based guidelines for reducing heat-related kidney injuries.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"170-176"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142834065","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 introduction. 编辑介绍。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-03-01 Epub Date: 2025-01-30 DOI: 10.1097/MNH.0000000000001059

引用次数: 0

Preparing for stormy weather: building VA health system resilience for dialysis emergency preparedness in the era of climate change. 为暴风雨天气做准备：在气候变化时代建立VA卫生系统透析应急准备的复原力。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-03-01 Epub Date: 2024-12-17 DOI: 10.1097/MNH.0000000000001054

DeAndra Martin, Peter Brewster, Susan T Crowley

{"title":"Preparing for stormy weather: building VA health system resilience for dialysis emergency preparedness in the era of climate change.","authors":"DeAndra Martin, Peter Brewster, Susan T Crowley","doi":"10.1097/MNH.0000000000001054","DOIUrl":"10.1097/MNH.0000000000001054","url":null,"abstract":"Purpose of review: Climate change has been implicated as the driver for the increasing number, intensity, duration, and consequences of catastrophic weather events. As a result of extreme weather events, climate change has also been implicated as an important mediator of adverse kidney health outcomes, not only increasing the risk for the development of acute and chronic kidney diseases, but also disrupting the delivery of critical kidney health services. In particular, the delivery of dialysis services during major emergencies remains an ongoing and increasing problem, with a recognized need for improved emergency preparedness and disaster management (EP-DM) strategies to mitigate the increased risk of morbidity and mortality associated with missed dialysis treatment.Recent findings: There are increasing reports detailing the challenges of kidney dialysis care in times of crisis, to include those resulting from both man-made and natural disasters. Optimized management of the high-risk vulnerable dialysis patient population must include both facility-facing comprehensive continuity of operations and emergency response plans, and ongoing patient-facing emergency preparedness education.Summary: This review discusses the adverse impact of climate change-related natural disasters on the delivery of dialysis services, and the evolving EP-DM strategies developed and implemented by the Veterans Health Administration (VA) to optimize the care and well being of the vulnerable end stage kidney disease (ESKD) patient population.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":" ","pages":"156-163"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142853355","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

Use of water in dialysis and its impact on the environment. 透析用水及其对环境的影响。

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-03-01 Epub Date: 2024-12-17 DOI: 10.1097/MNH.0000000000001058

Suzanne Watnick

引用次数: 0

Citrate in autosomal dominant polycystic kidney disease: biomarker or therapeutic agent? 常染色体显性多囊肾病的柠檬酸盐：生物标志物还是治疗剂？

IF 2.2 3区医学

Current Opinion in Nephrology and Hypertension Pub Date : 2025-03-01 Epub Date: 2024-11-13 DOI: 10.1097/MNH.0000000000001047

Daniel Ribeiro Rocha, Ana Cristina Carvalho Matos, Ita Pfeferman Heilberg

{"title":"Citrate in autosomal dominant polycystic kidney disease: biomarker or therapeutic agent?","authors":"Daniel Ribeiro Rocha, Ana Cristina Carvalho Matos, Ita Pfeferman Heilberg","doi":"10.1097/MNH.0000000000001047","DOIUrl":"10.1097/MNH.0000000000001047","url":null,"abstract":"Purpose of review: This review highlights the latest findings regarding hypocitraturia in autosomal dominant polycystic kidney disease (ADPKD), from both experimental and clinical studies, exploring the underlying pathophysiology and potential therapeutic approach.Recent findings: Experimental studies have shown that the lodging of microcrystals in the tubules can trigger cyst formation and growth in polycystic kidney disease (PKD). ADPKD patients are prone to developing hypocitraturia in early stages, which could predispose to calcium microcrystal formation. Low urinary citrate excretion has been associated with a more rapid decline in eGFR and poorer renal survival in ADPKD patients. Animal studies employing citrate supplementation have shown promising effects on preserving the decline in estimated glomerular filtration rate (eGFR) and cyst growth.Summary: Current knowledge suggests that urinary citrate could be incorporated into existing prognostic markers for disease progression and potential adjuvant therapy in ADPKD, but further clinical studies to support such hypothesis must be undertaken.","PeriodicalId":10960,"journal":{"name":"Current Opinion in Nephrology and Hypertension","volume":"34 2","pages":"138-142"},"PeriodicalIF":2.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143058349","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