Nature Reviews Nephrology最新文献_第5页

Approaches to raise awareness of CKD among patients and the general population 提高患者和公众对慢性肾脏病认识的方法

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2025-01-20 DOI: 10.1038/s41581-025-00928-3

Delphine S. Tuot, Laura Plantinga

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Managing risk factors and early intervention for chronic kidney disease 慢性肾脏疾病的危险因素管理和早期干预

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2025-01-15 DOI: 10.1038/s41581-025-00930-9

Robert Kalyesubula, Valerie Ann Luyckx

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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

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Diuretics in patients with chronic kidney disease 慢性肾脏疾病患者的利尿剂

IF 28.6 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 \u0000 , Ashish Verma, Panagiotis I. Georgianos","doi":"10.1038/s41581-024-00918-x","DOIUrl":"10.1038/s41581-024-00918-x","url":null,"abstract":"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. In this Review, the authors examine the diuretic drug class and its use in the treatment of hypertension and volume overload in chronic kidney disease, including dosage and mode of administration. The authors also discuss the mechanisms underlying diuretic resistance and its management, including the use of combination therapy.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 4","pages":"264-278"},"PeriodicalIF":28.6,"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

引用次数: 0

Protein handling in kidney tubules 肾小管中的蛋白质处理

IF 28.6 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":"10.1038/s41581-024-00914-1","url":null,"abstract":"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. The kidney tubules have a crucial role in homeostasis as they modify and regulate the kidney filtrate. This Review examines current data on how filtered proteins are processed along the kidney tubule, including evidence from defects in the endo-lysosomal system, and their therapeutic implications.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 4","pages":"241-252"},"PeriodicalIF":28.6,"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 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2025-01-06 DOI: 10.1038/s41581-024-00927-w

Jordi Ochando, Alberto Ortiz

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

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 28.6 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":"10.1038/s41581-024-00917-y","url":null,"abstract":"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. Sensory receptors in non-sensory organs respond to chemical stimuli, initiate signalling cascades and have important roles in cell biology and physiology. Here, the authors discuss key examples of sensory receptors with physiological roles in the kidney and other tissues.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 4","pages":"253-263"},"PeriodicalIF":28.6,"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