Nature Reviews Nephrology最新文献

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Clinical practice recommendations for the diagnosis and management of X-linked hypophosphataemia 诊断和治疗 X 连锁低磷血症的临床实践建议
IF 41.5 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-15 DOI: 10.1038/s41581-024-00926-x
Dieter Haffner, Francesco Emma, Lothar Seefried, Wolfgang Högler, Kassim M. Javaid, Detlef Bockenhauer, Justine Bacchetta, Deborah Eastwood, Martin Biosse Duplan, Dirk Schnabel, Philippe Wicart, Gema Ariceta, Elena Levtchenko, Pol Harvengt, Martha Kirchhoff, Oliver Gardiner, Federico Di Rocco, Catherine Chaussain, Maria Luisa Brandi, Lars Savendahl, Karine Briot, Peter Kamenický, Lars Rejnmark, Agnès Linglart
{"title":"Clinical practice recommendations for the diagnosis and management of X-linked hypophosphataemia","authors":"Dieter Haffner, Francesco Emma, Lothar Seefried, Wolfgang Högler, Kassim M. Javaid, Detlef Bockenhauer, Justine Bacchetta, Deborah Eastwood, Martin Biosse Duplan, Dirk Schnabel, Philippe Wicart, Gema Ariceta, Elena Levtchenko, Pol Harvengt, Martha Kirchhoff, Oliver Gardiner, Federico Di Rocco, Catherine Chaussain, Maria Luisa Brandi, Lars Savendahl, Karine Briot, Peter Kamenický, Lars Rejnmark, Agnès Linglart","doi":"10.1038/s41581-024-00926-x","DOIUrl":"https://doi.org/10.1038/s41581-024-00926-x","url":null,"abstract":"<p>X-linked hypophosphataemia (XLH) is a rare metabolic bone disorder caused by pathogenic variants in the <i>PHEX</i> gene, which is predominantly expressed in osteoblasts, osteocytes and odontoblasts. XLH is characterized by increased synthesis of the bone-derived phosphaturic hormone fibroblast growth factor 23 (FGF23), which results in renal phosphate wasting with consecutive hypophosphataemia, rickets, osteomalacia, disproportionate short stature, oral manifestations, pseudofractures, craniosynostosis, enthesopathies and osteoarthritis. Patients with XLH should be provided with multidisciplinary care organized by a metabolic bone expert. Historically, these patients were treated with frequent doses of oral phosphate supplements and active vitamin D, which was of limited efficiency and associated with adverse effects. However, the management of XLH has evolved in the past few years owing to the availability of burosumab, a fully humanized monoclonal antibody that neutralizes circulating FGF23. Here, we provide updated clinical practice recommendations for the diagnosis and management of XLH to improve outcomes and quality of life in these patients.</p>","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"92 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Chronic kidney disease screening in LMICs: benefits and challenges 低收入国家慢性肾脏病筛查:益处与挑战
IF 28.6 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-14 DOI: 10.1038/s41581-025-00929-2
Urmila Anandh, Swarnalatha Guditi
{"title":"Chronic kidney disease screening in LMICs: benefits and challenges","authors":"Urmila Anandh,&nbsp;Swarnalatha Guditi","doi":"10.1038/s41581-025-00929-2","DOIUrl":"10.1038/s41581-025-00929-2","url":null,"abstract":"Chronic kidney disease (CKD) satisfies established criteria for screening. Although the economic burden of screening is substantial, many countries have adopted screening initiatives into their existing national programmes. Recognition of CKD as a major non-communicable disease by international bodies will help&nbsp;to improve global kidney care overall.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 3","pages":"145-146"},"PeriodicalIF":28.6,"publicationDate":"2025-01-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142974709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Diuretics in patients with chronic kidney disease 慢性肾脏疾病患者的利尿剂
IF 41.5 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-07 DOI: 10.1038/s41581-024-00918-x
Rajiv Agarwal, Ashish Verma, Panagiotis I. Georgianos
{"title":"Diuretics in patients with chronic kidney disease","authors":"Rajiv Agarwal, Ashish Verma, Panagiotis I. Georgianos","doi":"10.1038/s41581-024-00918-x","DOIUrl":"https://doi.org/10.1038/s41581-024-00918-x","url":null,"abstract":"<p>Diuretic drugs act on electrolyte transporters in the kidney to induce diuresis and are often used in chronic kidney disease (CKD), given that nephron loss creates a deficit in the ability to excrete dietary sodium, which promotes an increase in plasma volume. This rise in plasma volume is exacerbated by CKD-induced systemic and intra-renal activation of the renin–angiotensin–aldosterone-system, which further limits urinary sodium excretion. In the absence of a compensatory decrease in systemic vascular resistance, increases in plasma volume induced by sodium retention can manifest as a rise in systemic arterial blood pressure. Management of sodium and volume overload in patients with CKD is therefore typically based on restriction of dietary sodium intake and the use of diuretic agents to enhance urinary sodium excretion. Thiazide and thiazide-type diuretics are foundational therapies for the management of hypertension, whereas loop diuretics are often needed for volume overload, which might also require combination therapies. Mineralocorticoid receptor antagonists have an important role in the management of diuretic-resistant volume overload or treatment-resistant hypertension. Additionally, diuretics can be used for the diagnosis of kidney diseases and in the management of hyperkalaemia or hypokalaemia, hyponatraemia, hypercalcaemia and hypomagnesaemia.</p>","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"78 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934923","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Multifaceted innovations needed to advance transplant nephrology 推进移植肾病学需要多方面的创新
IF 28.6 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-07 DOI: 10.1038/s41581-024-00924-z
Vidya A. Fleetwood, Krista L. Lentine
{"title":"Multifaceted innovations needed to advance transplant nephrology","authors":"Vidya A. Fleetwood,&nbsp;Krista L. Lentine","doi":"10.1038/s41581-024-00924-z","DOIUrl":"10.1038/s41581-024-00924-z","url":null,"abstract":"Over the past year, several new research insights and policy changes have advanced the field of kidney transplantation: kidney xenotransplantation has reached its first human recipients, previously under-used organs are becoming transplantable with new procurement and preservation approaches, and post-transplant care, including prevention of complications, has become safer.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 2","pages":"81-82"},"PeriodicalIF":28.6,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142934934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Protein handling in kidney tubules 肾小管中的蛋白质处理
IF 41.5 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-06 DOI: 10.1038/s41581-024-00914-1
Andrew M. Hall
{"title":"Protein handling in kidney tubules","authors":"Andrew M. Hall","doi":"10.1038/s41581-024-00914-1","DOIUrl":"https://doi.org/10.1038/s41581-024-00914-1","url":null,"abstract":"<p>The kidney proximal tubule reabsorbs and degrades filtered plasma proteins to reclaim valuable nutrients and maintain body homeostasis. Defects in this process result in proteinuria, one of the most frequently used biomarkers of kidney disease. Filtered proteins enter proximal tubules via receptor-mediated endocytosis and are processed within a highly developed apical endo-lysosomal system (ELS). Proteinuria is a strong risk factor for chronic kidney disease progression and genetic disorders of the ELS cause hereditary kidney diseases, so deepening understanding of how the proximal tubule handles proteins is crucial for translational nephrology. Moreover, the ELS is both an entry point for nephrotoxins that induce tubular damage and a target for novel therapies to prevent it. Cutting-edge research techniques, such as functional intravital imaging and computational modelling, are shedding light on spatial and integrative aspects of renal tubular protein processing in vivo, how these are altered under pathological conditions and the consequences for other tubular functions. These insights have potentially important implications for understanding the origins of systemic complications arising in proteinuric states, and might lead to the development of new ways of monitoring and treating kidney diseases.</p>","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"37 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142929477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Trained immunity: from kidney failure to organ transplantation 训练免疫:从肾衰竭到器官移植
IF 41.5 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-06 DOI: 10.1038/s41581-024-00927-w
Jordi Ochando, Alberto Ortiz
{"title":"Trained immunity: from kidney failure to organ transplantation","authors":"Jordi Ochando, Alberto Ortiz","doi":"10.1038/s41581-024-00927-w","DOIUrl":"https://doi.org/10.1038/s41581-024-00927-w","url":null,"abstract":"Innate immune memory represents a barrier to successful kidney transplantation. The discovery that uraemic toxins in people with kidney failure induce trained immunity suggests that, as chronic kidney disease progresses, long-lived memory macrophages promote systemic chronic inflammation, which could contribute to organ transplant rejection.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"125 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142929475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Insights into the mechanisms of fibrosis and progressive kidney injury 纤维化和进行性肾损伤机制的深入研究
IF 28.6 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-03 DOI: 10.1038/s41581-024-00922-1
Santiago Lamas, Marta Ruiz-Ortega
{"title":"Insights into the mechanisms of fibrosis and progressive kidney injury","authors":"Santiago Lamas,&nbsp;Marta Ruiz-Ortega","doi":"10.1038/s41581-024-00922-1","DOIUrl":"10.1038/s41581-024-00922-1","url":null,"abstract":"Progression of chronic kidney disease to kidney fibrosis is a key challenge in nephrology. Several contributions from the past year have shed light not only on the general molecular signature of human kidney fibrosis, but also on specific new mechanisms involved in its development.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 2","pages":"79-80"},"PeriodicalIF":28.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916845","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Roles of sensory receptors in non-sensory organs: the kidney and beyond 感觉受体在非感觉器官中的作用:肾脏及其他
IF 41.5 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-03 DOI: 10.1038/s41581-024-00917-y
Jiaojiao Xu, Blythe D. Shepard, Jennifer L. Pluznick
{"title":"Roles of sensory receptors in non-sensory organs: the kidney and beyond","authors":"Jiaojiao Xu, Blythe D. Shepard, Jennifer L. Pluznick","doi":"10.1038/s41581-024-00917-y","DOIUrl":"https://doi.org/10.1038/s41581-024-00917-y","url":null,"abstract":"<p>Olfactory receptors (ORs), taste receptors and opsins are well-known for their pivotal roles in mediating the senses of smell, taste and sight, respectively. However, in the past two decades, research has shown that these sensory receptors also regulate physiological processes in a variety of non-sensory tissues. Although ORs, taste receptors and opsins have all been shown to have physiological roles beyond their traditional locations, most work in the kidney has focused on ORs. To date, renal ORs have been shown to have roles in blood pressure regulation (OLFR78 and OLFR558) and glucose homeostasis (OLFR1393). However, sensory receptors remain drastically understudied outside of traditional sensory systems, in part because of inherent challenges in studying these receptors. Increased knowledge of the physiological and pathophysiological roles of sensory receptors has the potential to substantially improve understanding of the function of numerous organs and systems, including the kidney. In addition, most sensory receptors are G protein-coupled receptors, which are considered to be the most druggable class of proteins, and thus could potentially be exploited as future therapeutic targets.</p>","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"27 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
A golden year of innovative kidney disease therapeutics 创新肾脏疾病治疗的黄金年
IF 28.6 1区 医学
Nature Reviews Nephrology Pub Date : 2025-01-03 DOI: 10.1038/s41581-024-00916-z
Monica Suet Ying Ng, Carmel M. Hawley
{"title":"A golden year of innovative kidney disease therapeutics","authors":"Monica Suet Ying Ng,&nbsp;Carmel M. Hawley","doi":"10.1038/s41581-024-00916-z","DOIUrl":"10.1038/s41581-024-00916-z","url":null,"abstract":"In 2024, a plethora of novel therapeutic strategies for kidney disease progressed to clinical trials, including an RNA interference therapeutic, a glucagon-like peptide 1 receptor agonist, a soluble guanylate cyclase activator and an off-the-shelf, virus-specific T cell therapy. These advances herald new hope for people with kidney disease.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 2","pages":"75-76"},"PeriodicalIF":28.6,"publicationDate":"2025-01-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142916843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
Steps forward in the treatment of IgA nephropathy IgA肾病治疗的新进展
IF 41.5 1区 医学
Nature Reviews Nephrology Pub Date : 2024-12-18 DOI: 10.1038/s41581-024-00925-y
Rosanna Coppo
{"title":"Steps forward in the treatment of IgA nephropathy","authors":"Rosanna Coppo","doi":"10.1038/s41581-024-00925-y","DOIUrl":"https://doi.org/10.1038/s41581-024-00925-y","url":null,"abstract":"A turning point in the treatment of IgA nephropathy has been marked by several new publications that describe promising outcomes associated with the targeting of key pathogenic disease processes, including the production of galactose-deficient IgA1 and IgA-containing immune complexes, complement and endothelin system activation.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"23 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142841073","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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
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