Nature Reviews Nephrology最新文献_第5页

The effects of sex hormone therapy on kidney function 性激素治疗对肾功能的影响

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-05-06 DOI: 10.1038/s41581-025-00966-x

Ellen F. Carney

引用次数: 0

Implantable bioelectronics and wearable sensors for kidney health and disease 用于肾脏健康和疾病的植入式生物电子学和可穿戴传感器

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-04-29 DOI: 10.1038/s41581-025-00961-2

Surabhi R. Madhvapathy, Soongwon Cho, Elisa Gessaroli, Eleonora Forte, Yirui Xiong, Lorenzo Gallon, John A. Rogers

{"title":"Implantable bioelectronics and wearable sensors for kidney health and disease","authors":"Surabhi R. Madhvapathy, Soongwon Cho, Elisa Gessaroli, Eleonora Forte, Yirui Xiong, Lorenzo Gallon, John A. Rogers","doi":"10.1038/s41581-025-00961-2","DOIUrl":"10.1038/s41581-025-00961-2","url":null,"abstract":"Established clinical practices for monitoring kidney health and disease — including biopsy and serum biomarker analysis — suffer from practical limitations in monitoring frequency and lack adequate sensitivity for early disease detection. Engineering advances in biosensors have led to the development of wearable and implantable systems for monitoring of kidney health. Non-invasive microfluidic systems have demonstrated utility in the detection of kidney-relevant biomarkers, such as creatinine, urea and electrolytes in peripheral body fluids such as sweat, interstitial fluid, tears and saliva. Implantable systems may aid the identification of early transplant rejection through analysis of organ temperature and perfusion, and enable real-time assessment of inflammation through the use of thermal sensors. These technologies enable continuous, real-time monitoring of kidney health, offering complementary information to standard clinical procedures to alert physicians of changes in kidney health for early intervention. In this Review, we explore devices for monitoring renal biomarkers in peripheral biofluids and discuss developments in implantable sensors for the direct measurement of the local, biophysical properties of kidney tissue. We also describe potential clinical applications, including monitoring of chronic kidney disease, acute kidney injury and allograft health. Advances in biosensor technology have the potential to enable continuous, non-invasive monitoring of kidney health through wearable and implantable systems. Non-invasive microfluidic systems have demonstrated utility in the detection of kidney-relevant biomarkers in peripheral body fluids such as sweat, interstitial fluid, tears and saliva, whereas implantable systems permit the direct measurement of biophysical tissue properties including tissue oxygenation, perfusion and temperature.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 7","pages":"443-463"},"PeriodicalIF":39.8,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143889436","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

Drivers and mechanisms of cognitive decline in chronic kidney disease 慢性肾脏疾病认知能力下降的驱动因素和机制

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-04-25 DOI: 10.1038/s41581-025-00963-0

Giovambattista Capasso, Casper F. M. Franssen, Alessandra F. Perna, Ziad A. Massy, Robert I. Menzies, Carmine Zoccali, Alessandro Tessitore, Maiken Nedergaard, Mark D. Okusa, Alberto Ortiz, Carsten A. Wagner, Robert J. Unwin

{"title":"Drivers and mechanisms of cognitive decline in chronic kidney disease","authors":"Giovambattista Capasso, Casper F. M. Franssen, Alessandra F. Perna, Ziad A. Massy, Robert I. Menzies, Carmine Zoccali, Alessandro Tessitore, Maiken Nedergaard, Mark D. Okusa, Alberto Ortiz, Carsten A. Wagner, Robert J. Unwin","doi":"10.1038/s41581-025-00963-0","DOIUrl":"10.1038/s41581-025-00963-0","url":null,"abstract":"Cognitive impairment is highly prevalent among individuals with chronic kidney disease (CKD). Despite its high prevalence, the contributing factors and mechanisms underlying brain–kidney dysfunction in CKD remain poorly understood. However, advances in neuroscience, including novel imaging techniques and cognitive assessment methods, have begun to clarify this complex relationship. Several factors contribute directly to cognitive decline in people with CKD, including accumulation of uraemic toxins, microvascular damage, malnutrition, chronic inflammation and disruptions in key neuroprotective pathways, such as those involving Klotho and the glymphatic system. These factors are also linked to the accelerated ageing observed in people with CKD, a key contributor to cognitive decline. However, most studies on cognition in people with CKD have been cross-sectional and associative, offering limited insight into causation. Research advances, such as studies on the effect of uraemic toxins on the blood–brain barrier and the role of the endothelial glycocalyx in vascular damage, offer promising new directions. Emerging data from longitudinal cohort studies are also enhancing our understanding of these processes, with potential implications for both the treatment of CKD-related cognitive decline and the broader issue of cognitive dysfunction in ageing populations. Here, we examine key mechanisms linking CKD to cognitive decline and consider potential therapeutic interventions. The prevalence of cognitive dysfunction among people with chronic kidney disease (CKD) is disproportionately high compared with that in the general population. This Review examines current evidence on key drivers of cognitive impairment in people with CKD, and highlights gaps in knowledge and potential therapeutic targets.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 8","pages":"536-552"},"PeriodicalIF":39.8,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143872227","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

Dialysis and cognitive impairment 透析和认知障碍

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-04-24 DOI: 10.1038/s41581-025-00960-3

Chris W. McIntyre, Arsh Jain

{"title":"Dialysis and cognitive impairment","authors":"Chris W. McIntyre, Arsh Jain","doi":"10.1038/s41581-025-00960-3","DOIUrl":"10.1038/s41581-025-00960-3","url":null,"abstract":"People with chronic kidney disease who require maintenance dialysis characteristically experience accelerated and aggravated cognitive decline compared with those with advanced kidney disease who are not receiving this form of kidney replacement therapy. This effect is inadequately appreciated, but of crucial importance to patients, their carers and the health-care systems that support them. Although many of the comorbid conditions prevalent in this patient population have the potential to affect brain structure and function, an evolving body of evidence indicates that the dialysis therapy itself has a central role in the pathophysiology of progressive cognitive impairment. Both haemodialysis and peritoneal dialysis are associated with structural and functional changes in the brain that can lead to characteristic short-term symptoms, such as headache, confusion, delirium and brain fog, as well as long-term reductions in cognitive functional ability. Here, we explore the mechanisms, both established and putative, underlying these effects and consider approaches to addressing this issue with both single and complex therapeutic interventions. Treatment with dialysis in people with kidney failure has been implicated in accelerated cognitive impairment. Here, the authors consider how dialysis treatment — haemodialysis and peritoneal dialysis — can promote cerebral injury and might exacerbate chronic kidney disease-associated brain alterations and cognitive decline.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 8","pages":"553-564"},"PeriodicalIF":39.8,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143866383","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

Magnetic resonance imaging of renal oxygenation 肾脏氧合的磁共振成像

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-04-23 DOI: 10.1038/s41581-025-00956-z

Thoralf Niendorf, Thomas Gladytz, Kathleen Cantow, Jason M. Millward, Sonia Waiczies, Erdmann Seeliger

{"title":"Magnetic resonance imaging of renal oxygenation","authors":"Thoralf Niendorf, Thomas Gladytz, Kathleen Cantow, Jason M. Millward, Sonia Waiczies, Erdmann Seeliger","doi":"10.1038/s41581-025-00956-z","DOIUrl":"10.1038/s41581-025-00956-z","url":null,"abstract":"Renal hypoxia has a key role in the pathophysiology of many kidney diseases. MRI provides surrogate markers of oxygenation, offering a critical opportunity to detect renal hypoxia. However, studies that have assessed the diagnostic performance of oxygenation MRI for kidney disorders have provided inconsistent results because MRI metrics do not fully capture the complexity of renal oxygenation. Most oxygenation MRI studies are descriptive in nature and fail to detail the pathophysiological importance of the imaging findings. These limitations have restricted the clinical application of oxygenation MRI and the full potential of this technology to facilitate early diagnosis, risk prediction and treatment monitoring of kidney disease has not yet been realized. Understanding of the relationship between renal tissue oxygenation and MRI metrics, which is affected by kidney size, tubular volume fraction and renal blood volume fraction, and measurement of these factors using novel MR methods is imperative for correct physiological interpretation of renal MR oximetry findings. Next steps to enable the clinical adoption of MR oximetry should involve multidisciplinary collaboration to address standardization of acquisition and data analysis protocols and establish reference values of MRI metrics. MRI is a powerful technology for assessment of renal oxygenation. This Review highlights important considerations for the physiological interpretation of renal oxygenation changes measured by MR oximetry and discusses use of this technology in research as well as potential clinical applications.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 7","pages":"483-502"},"PeriodicalIF":39.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143862195","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

GalNAc-T14-associated defects in B cell homing in IgA nephropathy 与 GalNAc-T14 相关的 IgA 肾病 B 细胞归巢缺陷

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-04-22 DOI: 10.1038/s41581-025-00964-z

Susan J. Allison

引用次数: 0

From big data to smart decisions: artificial intelligence in kidney risk assessment 从大数据到智能决策：肾脏风险评估中的人工智能

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-04-07 DOI: 10.1038/s41581-025-00962-1

Devon A. Barnes, Luiz Ladeira, Rosalinde Masereeuw

引用次数: 0

Assessing the effect of social and environmental burdens on kidney disease 评估社会和环境负担对肾病的影响

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-04-03 DOI: 10.1038/s41581-025-00955-0

Mukoso N. Ozieh, Bessie A. Young

引用次数: 0

From fat to filter: the effect of adipose tissue-derived signals on kidney function 从脂肪到过滤器：脂肪组织来源的信号对肾功能的影响

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-04-02 DOI: 10.1038/s41581-025-00950-5

Nermin Ahmed, Carolina Dalmasso, Meghan B. Turner, Gertrude Arthur, Cole Cincinelli, Analia S. Loria

{"title":"From fat to filter: the effect of adipose tissue-derived signals on kidney function","authors":"Nermin Ahmed, Carolina Dalmasso, Meghan B. Turner, Gertrude Arthur, Cole Cincinelli, Analia S. Loria","doi":"10.1038/s41581-025-00950-5","DOIUrl":"10.1038/s41581-025-00950-5","url":null,"abstract":"Obesity is associated with severe consequences for the renal system, including chronic kidney disease, kidney failure and increased mortality. Obesity has both direct and indirect effects on kidney health through several mechanisms, including activation of the renin–angiotensin system, mechanical compression, inflammation, fibrosis, increased filtration barrier permeability and renal nerve activity. The expansion of adipose tissue through hypertrophy and hyperplasia can induce haemodynamic changes that promote glomerular hyperfiltration to compensate for the greater metabolic demands of the increased body weight. Adipose expansion is also associated with the release of adipokines and pro-inflammatory cytokines, hyperinsulinaemia and insulin resistance, which exert direct and indirect effects on kidney function via various mechanisms. Increased uptake of fatty acids by the kidney leads to alterations in lipid metabolism and lipotoxicity, also contributing to the pro-inflammatory and pro-fibrotic environment. The role of the adipose tissue–brain–kidney axis in the obesity-associated decline in renal function is sustained by studies showing that stimulation of adipose tissue sensory neurons by locally released factors increases renal sympathetic nerve activity. Conversely, pre-existent kidney disease can contribute to adipose dysfunction through the accumulation of uraemic toxins and hormonal changes. These findings highlight the importance of crosstalk between adipose tissue and the kidneys and provide insights into the mechanisms underlying the associations between obesity and kidney disease. Obesity exerts both direct and indirect effects on the kidney. This Review describes the mechanisms by which adipose-derived signals, including neural and hormonal signals, compromise kidney filtration capacity and discusses current and emerging renoprotective therapies that may provide benefit in the context of obesity and metabolic disease.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 6","pages":"417-434"},"PeriodicalIF":39.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143758090","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

Ureter development and associated congenital anomalies 输尿管发育及相关先天性异常

IF 39.8 1区医学

Nature Reviews Nephrology Pub Date : 2025-03-31 DOI: 10.1038/s41581-025-00951-4

Andreas Kispert

{"title":"Ureter development and associated congenital anomalies","authors":"Andreas Kispert","doi":"10.1038/s41581-025-00951-4","DOIUrl":"10.1038/s41581-025-00951-4","url":null,"abstract":"Malformations of the ureter are among the most common birth defects in humans. Although some of these anomalies are asymptomatic, others are clinically relevant, causing perinatal lethality or progressing to kidney failure in childhood. The genetic causes and developmental aetiology of ureteral anomalies are difficult to study in humans; however, embryological and genetic analyses in the mouse have provided insights into the complex developmental programmes that govern ureter formation from simple tissue primordia, and the pathological consequences that result from disruption of these programmes. Abnormalities in the formation of the nephric duct and ureteric bud lead to changes in the number of ureters (and kidneys), whereas the formation of ectopic ureteric buds, failure of the nephric duct to target the cloaca or failure of the distal ureter to mature underlie vesicoureteral reflux, ureter ectopia, ureterocoele and subsequent hydroureter. Alterations in ureter specification, early growth or cyto-differentiation programmes have now also been associated with various forms of perinatal hydroureter and hydronephrosis as a consequence of functional obstruction. The characterization of cellular processes and molecular drivers of ureterogenesis in the mouse may not only aid understanding of the aetiology of human ureteral anomalies, improve prognostication and benefit the development of therapeutic strategies, but may also prove important for efforts to generate a bioartificial organ. Embryological and genetic analyses in the mouse have provided insights into the complex developmental programmes that govern ureter formation and the pathological consequences that result from their disruption. This Review describes the programmes that underlie ureteral development and its associated anomalies, including the molecular control of specification, early growth and tissue differentiation.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 6","pages":"366-382"},"PeriodicalIF":39.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736601","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