Nature Reviews Nephrology最新文献_第4页

A personalized vaccine for kidney cancer 一种针对肾癌的个性化疫苗

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2025-02-25 DOI: 10.1038/s41581-025-00941-6

Susan J. Allison

引用次数: 0

Endoplasmic reticulum stress as a driver and therapeutic target for kidney disease 内质网应激是肾脏疾病的驱动因素和治疗靶点

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-02-24 DOI: 10.1038/s41581-025-00938-1

Jae Hyun Byun, Paul F. Lebeau, Jackie Trink, Nikhil Uppal, Matthew B. Lanktree, Joan C. Krepinsky, Richard C. Austin

{"title":"Endoplasmic reticulum stress as a driver and therapeutic target for kidney disease","authors":"Jae Hyun Byun, Paul F. Lebeau, Jackie Trink, Nikhil Uppal, Matthew B. Lanktree, Joan C. Krepinsky, Richard C. Austin","doi":"10.1038/s41581-025-00938-1","DOIUrl":"https://doi.org/10.1038/s41581-025-00938-1","url":null,"abstract":"The endoplasmic reticulum (ER) has crucial roles in metabolically active cells, including protein translation, protein folding and quality control, lipid biosynthesis, and calcium homeostasis. Adverse metabolic conditions or pathogenic genetic variants that cause misfolding and accumulation of proteins within the ER of kidney cells initiate an injurious process known as ER stress that contributes to kidney disease and its cardiovascular complications. Initiation of ER stress activates the unfolded protein response (UPR), a cellular defence mechanism that functions to restore ER homeostasis. However, severe or chronic ER stress rewires the UPR to activate deleterious pathways that exacerbate inflammation, apoptosis and fibrosis, resulting in kidney injury. This insidious crosstalk between ER stress, UPR activation, oxidative stress and inflammation forms a vicious cycle that drives kidney disease and vascular damage. Furthermore, genetic variants that disrupt protein-folding mechanisms trigger ER stress, as evidenced in autosomal-dominant tubulointerstitial kidney disease and Fabry disease. Emerging therapeutic strategies that enhance protein-folding capacity and reduce the burden of ER stress have shown promising results in kidney diseases. Thus, integrating knowledge of how genetic variants cause protein misfolding and ER stress into clinical practice will enhance treatment strategies and potentially improve outcomes for various kidney diseases and their vascular complications.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"25 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143477475","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

Advances and challenges in kidney fibrosis therapeutics 肾纤维化治疗的进展和挑战

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-02-11 DOI: 10.1038/s41581-025-00934-5

Lilia Abbad, Emmanuel Esteve, Christos Chatziantoniou

{"title":"Advances and challenges in kidney fibrosis therapeutics","authors":"Lilia Abbad, Emmanuel Esteve, Christos Chatziantoniou","doi":"10.1038/s41581-025-00934-5","DOIUrl":"https://doi.org/10.1038/s41581-025-00934-5","url":null,"abstract":"Chronic kidney disease (CKD) is a major global health burden that affects more than 10% of the adult population. Current treatments, including dialysis and transplantation, are costly and not curative. Kidney fibrosis, defined as an abnormal accumulation of extracellular matrix in the kidney parenchyma, is a common outcome in CKD, regardless of disease aetiology, and is a major cause of loss of kidney function and kidney failure. For this reason, research efforts have focused on identifying mediators of kidney fibrosis to inform the development of effective anti-fibrotic treatments. Given the prominent role of the transforming growth factor-β (TGFβ) family in fibrosis, efforts have focused on inhibiting TGFβ signalling. Despite hopes raised by the efficacy of this approach in preclinical models, translation into clinical practice has not met expectations. Antihypertensive and antidiabetic drugs slow the decline in kidney function and could slow fibrosis but, owing to the lack of technologies for in vivo renal imaging, their anti-fibrotic effect cannot be truly assessed at present. The emergence of new drugs targeting pro-fibrotic signalling, or enabling cell repair and cell metabolic reprogramming, combined with better stratification of people with CKD and the arrival of nanotechnologies for kidney-specific drug delivery, open up new perspectives for the treatment of this major public health challenge.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"50 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-02-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143393137","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

Publisher Correction: Clinical practice recommendations for the diagnosis and management of X-linked hypophosphataemia 出版者更正：诊断和管理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 : 2025-02-04 DOI: 10.1038/s41581-025-00939-0

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

引用次数: 0

Artificial intelligence approaches to enable early detection of CKD 人工智能方法使CKD能够早期发现

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2025-02-03 DOI: 10.1038/s41581-025-00933-6

Navdeep Tangri, Charumathi Sabanayagam

引用次数: 0

The kidney harbours a microbiota that may influence lithogenesis 肾脏中有可能影响岩石形成的微生物群

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2025-01-30 DOI: 10.1038/s41581-025-00937-2

Ellen F. Carney

引用次数: 0

Risk-directed management of chronic kidney disease 慢性肾脏疾病的风险导向管理

IF 41.5 1区医学

Nature Reviews Nephrology Pub Date : 2025-01-30 DOI: 10.1038/s41581-025-00931-8

Matthew F. Blum, Brendon L. Neuen, Morgan E. Grams

{"title":"Risk-directed management of chronic kidney disease","authors":"Matthew F. Blum, Brendon L. Neuen, Morgan E. Grams","doi":"10.1038/s41581-025-00931-8","DOIUrl":"https://doi.org/10.1038/s41581-025-00931-8","url":null,"abstract":"The timely and rational institution of therapy is a key step towards reducing the global burden of chronic kidney disease (CKD). CKD is a heterogeneous entity with varied aetiologies and diverse trajectories, which include risk of kidney failure but also cardiovascular events and death. Developments in the past decade include substantial progress in CKD risk prediction, driven in part by the accumulation of electronic health records data. In addition, large randomized clinical trials have demonstrated the effectiveness of sodium–glucose co-transporter 2 inhibitors, glucagon-like peptide 1 receptor agonists and mineralocorticoid receptor antagonists in reducing adverse events in CKD, greatly expanding the options for effective therapy. Alongside angiotensin-converting enzyme inhibitors and angiotensin receptor blockers, these classes of medication have been proposed to be the four pillars of CKD pharmacotherapy. However, all of these drug classes are underutilized, even in individuals at high risk. Leveraging prognostic estimates to guide therapy could help clinicians to prescribe CKD-related therapies to those who are most likely to benefit from their use. Risk-based CKD management thus aligns patient risk and care, allowing the prioritization of absolute benefit in determining therapeutic selection and timing. Here, we discuss CKD prognosis tools, evidence-based management and prognosis-guided therapies.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"53 1","pages":""},"PeriodicalIF":41.5,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143056325","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

Loss of B cell protection in uraemic kidney disease 尿毒性肾病中B细胞保护功能的丧失

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2025-01-29 DOI: 10.1038/s41581-025-00936-3

Monica Wang

引用次数: 0

Insights into the burden of CKDu 洞察CKDu的负担

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2025-01-28 DOI: 10.1038/s41581-025-00935-4

Susan J. Allison

引用次数: 0

Born too soon: lifelong kidney risks and the importance of early intervention 过早出生：终生肾脏风险和早期干预的重要性