Nature Reviews Nephrology最新文献_第2页

Improving outcomes in kidney transplantation through advances in donor organ perfusion 通过供体器官灌注改善肾移植预后

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-09-09 DOI: 10.1038/s41581-025-00993-8

James Hunter, Sarah Hosgood, Cyril Moers, Henri Leuvenink, Ton J. Rabelink, Rutger Ploeg

{"title":"Improving outcomes in kidney transplantation through advances in donor organ perfusion","authors":"James Hunter, Sarah Hosgood, Cyril Moers, Henri Leuvenink, Ton J. Rabelink, Rutger Ploeg","doi":"10.1038/s41581-025-00993-8","DOIUrl":"https://doi.org/10.1038/s41581-025-00993-8","url":null,"abstract":"The global shortage of suitable donor kidneys is the primary challenge in kidney transplantation, and it is exacerbated by ageing donors with increased numbers of health issues. Improving organ assessment, preservation and conditioning could enhance organ utilization and patient outcomes. Hypothermic machine perfusion (HMP) is associated with better results than static cold storage by reducing delayed graft function and improving short-term graft survival, especially in kidneys recovered from marginal-quality donors. Although HMP is useful for organ preservation, it is difficult to assess organ viability during HMP because of the reduced metabolic activity at low temperatures, and the adoption of HMP has faced logistical challenges. The addition of oxygen during HMP is aimed at reducing ischaemia–reperfusion injury, but has shown mixed results in kidney transplantation, often depending on the duration of perfusion, although some studies found that the addition of oxygen improved outcomes in higher-risk donors. Normothermic machine perfusion helps to restore kidney function by delivering oxygen and nutrients at body temperature, potentially reducing ischaemia–reperfusion injury. Early studies suggest its safety, but clinical benefits remain unproven. Normothermic machine perfusion also holds promise for assessing organ viability pre-transplantation by enabling real-time evaluation. In this Review, we will summarize the different methods of kidney preservation, providing details of the effect that each method has on graft and patient outcomes and the strengths and limitations of each method.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"35 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145017619","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

Lived experience and empathy: lessons learned as a nephrologist with kidney disease 生活经验和同理心：作为肾病肾病专家的经验教训

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-09-05 DOI: 10.1038/s41581-025-01003-7

Ken Sutha

引用次数: 0

Long COVID and the kidney 长冠病毒和肾脏

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-09-04 DOI: 10.1038/s41581-025-00997-4

Vanja Ivković, Urmila Anandh, Samira Bell, Andreas Kronbichler, Maria Jose Soler, Annette Bruchfeld

{"title":"Long COVID and the kidney","authors":"Vanja Ivković, Urmila Anandh, Samira Bell, Andreas Kronbichler, Maria Jose Soler, Annette Bruchfeld","doi":"10.1038/s41581-025-00997-4","DOIUrl":"https://doi.org/10.1038/s41581-025-00997-4","url":null,"abstract":"Long coronavirus disease (COVID) — commonly defined as symptoms and/or long-term effects that persist for at least 3 months after acute infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and cannot be explained by an alternative diagnosis — is a complex, multifaceted and heterogeneous disease that affects many organ systems, including the kidney. COVID-19 can cause acute kidney injury, and several studies have reported an increased risk of chronic kidney disease (CKD) following COVID-19, suggesting that CKD can be a manifestation of long COVID. Furthermore, patients with CKD are at an increased risk of severe COVID-19 and of long COVID. COVID-19 has also been associated with the development of COVID-19-associated nephropathy, which is a collapsing form of focal segmental glomerulosclerosis, and an increased incidence of new-onset vasculitis. Some early reports described associations of COVID-19 and/or SARS-CoV-2 vaccines with relapse or new-onset of other glomerular diseases, but this link was not confirmed in large population-based studies. SARS-CoV-2 vaccination reduces the risk of COVID-19 and long COVID and is particularly important for protecting vulnerable populations such as patients with CKD. Structured long-term follow-up of patients with COVID-19 and post-infectious sequelae is needed to provide further insight into the trajectory of long COVID and enable identification of those at risk of CKD.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"48 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144995499","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

Accumulation of pathogenic mitochondrial DNA mutations in the kidney 肾脏中致病性线粒体DNA突变的积累

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-08-29 DOI: 10.1038/s41581-025-01002-8

Ellen F. Carney

引用次数: 0

Regulation of autophagy by a tRNA-derived fragment trna衍生片段对自噬的调控

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-08-26 DOI: 10.1038/s41581-025-01001-9

Susan J. Allison

引用次数: 0

A strength-based community: transforming renal care through connection and meaning 以力量为基础的社区：通过联系和意义改变肾脏护理。

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-08-19 DOI: 10.1038/s41581-025-00998-3

Paula A. Marioli

引用次数: 0

Kidney stone disease: risk factors, pathophysiology and management 肾结石疾病：危险因素、病理生理和管理

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-08-11 DOI: 10.1038/s41581-025-00990-x

Matteo Bargagli, Martin Scoglio, Sarah A. Howles, Daniel G. Fuster

{"title":"Kidney stone disease: risk factors, pathophysiology and management","authors":"Matteo Bargagli, Martin Scoglio, Sarah A. Howles, Daniel G. Fuster","doi":"10.1038/s41581-025-00990-x","DOIUrl":"https://doi.org/10.1038/s41581-025-00990-x","url":null,"abstract":"Nephrolithiasis is the most common health condition affecting the kidney and urinary tract and constitutes a major global health-care problem. The prevalence of nephrolithiasis has increased substantially over the past five decades, irrespective of age, sex or ethnicity. Kidney stones cause substantial morbidity, reduced quality of life and enormous health-care expenditure, largely due to their frequent recurrence. Furthermore, nephrolithiasis is now recognized as a systemic condition associated with increased risks of chronic kidney disease, cardiovascular disease, metabolic syndrome and low bone mass. Nephrolithiasis exhibits marked pathophysiological heterogeneity. Dietary and environmental exposures interact with genetic predisposition to shape individual disease risk. Calcium oxalate stones are most prevalent, commonly driven by hypercalciuria, hyperoxaluria, hypocitraturia and low urine volume, whereas the formation of uric acid and calcium phosphate stones is commonly linked to urinary pH. A comprehensive clinical evaluation can uncover underlying metabolic abnormalities, distinguish idiopathic, secondary and Mendelian forms of nephrolithiasis, identify systemic disease associations and guide therapy. Recurrence prevention requires individualized strategies that combine dietary and pharmacological interventions. For established stones, surgical management is effective, with ureteroscopy and percutaneous nephrolithotomy achieving high stone-free rates. Despite its considerable clinical and societal burden, nephrolithiasis remains under-recognized, underserved and under-researched. Greater awareness and investments in research, innovation and education are urgently needed.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"8 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144812845","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 call for funds and training for kidney genomics programmes 呼吁为肾脏基因组学项目提供资金和培训

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-08-08 DOI: 10.1038/s41581-025-00995-6

Kar Hui Ng

引用次数: 0

The increasing burden of mild and moderate anaemia in CKD 慢性肾病患者轻中度贫血负担的增加

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-08-05 DOI: 10.1038/s41581-025-00994-7

Hiroshi Nishi, Masaomi Nangaku

引用次数: 0

Endoplasmic reticulum-mediated organelle crosstalk in kidney disease. 肾脏疾病内质网介导的细胞器串扰。

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-07-31 DOI: 10.1038/s41581-025-00989-4

Yu Ah Hong,Reiko Inagi

{"title":"Endoplasmic reticulum-mediated organelle crosstalk in kidney disease.","authors":"Yu Ah Hong,Reiko Inagi","doi":"10.1038/s41581-025-00989-4","DOIUrl":"https://doi.org/10.1038/s41581-025-00989-4","url":null,"abstract":"The endoplasmic reticulum (ER) is a key organelle involved in a wide range of intracellular biological processes, including Ca2+ homeostasis; lipid metabolism; proteostasis through protein synthesis, folding and processing of secretory and transmembrane proteins; and signal transduction. The ER forms extensive physical interactions with various intracellular organelles through the membrane contact sites, enabling direct exchange of ions and lipids without vesicular transport. At mitochondria-associated membranes, ER-mitochondria communication governs calcium transfer, lipid synthesis, mitochondrial dynamics, the unfolded protein response and inflammation, all of which are essential for maintaining cellular homeostasis. The ER also interacts with the Golgi apparatus, endosomes and plasma membrane to facilitate transfer of calcium and lipids. Disruption of ER-organelle communication contributes to the development and progression of various kidney diseases, including diabetic kidney disease, acute kidney injury and polycystic kidney disease. Accordingly, ER-organelle communication has emerged as a promising therapeutic target. Pharmacological agents such as SGLT2 inhibitors, AMPK activators, mTOR inhibitors and RAAS blockers have been shown to restore ER-mitochondria communication and alleviate kidney injury in experimental models. Advancing our understanding of ER-organelle crosstalk may offer new mechanistic insights and contribute to the optimization of current treatment strategies for kidney disease.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"17 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144756080","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