Nature Reviews Nephrology最新文献_第5页

Deep learning applications in digital pathology 数字病理学中的深度学习应用

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-07-16 DOI: 10.1038/s41581-024-00870-w

Peter Boor

引用次数: 0

Treatment of chronic kidney disease in older populations 老年人慢性肾病的治疗

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-07-08 DOI: 10.1038/s41581-024-00854-w

Seiji Kishi, Hiroyuki Kadoya, Naoki Kashihara

{"title":"Treatment of chronic kidney disease in older populations","authors":"Seiji Kishi, Hiroyuki Kadoya, Naoki Kashihara","doi":"10.1038/s41581-024-00854-w","DOIUrl":"10.1038/s41581-024-00854-w","url":null,"abstract":"As the world population ages, an expected increase in the prevalence of chronic kidney disease (CKD) among older individuals will pose a considerable challenge for health care systems in terms of resource allocation for disease management. Treatment strategies for older patients with CKD should ideally align with those applied to the general population, focusing on minimizing cardiovascular events and reducing the risk of progression to kidney failure. Emerging therapies, such as SGLT-2 inhibitors and GLP-1 receptor agonists, hold promise for the effective management of CKD in older individuals. In addition, non-pharmacological interventions such as nutritional and exercise therapies have a crucial role. These interventions enhance the effects of pharmacotherapy and, importantly, contribute to the maintenance of cognitive function and overall quality of life. Various factors beyond age and cognitive function must be taken into account when considering kidney replacement therapy for patients with kidney failure. Importantly, all treatment options, including dialysis, transplantation and conservative management approaches, should be tailored to the individual through patient-centred decision-making. The dynamic integration of digital technologies into medical practice has the potential to transform the management of CKD in the aging population. Aging of the global population is expected to increase the prevalence of chronic kidney disease. This Review describes approaches to the management of kidney disease in older populations, highlighting the need for a holistic approach aimed at meeting the treatment goals of the patient.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 9","pages":"586-602"},"PeriodicalIF":28.6,"publicationDate":"2024-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141556777","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

Application of spatial-omics to the classification of kidney biopsy samples in transplantation 空间组学在移植肾活检样本分类中的应用

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-07-04 DOI: 10.1038/s41581-024-00861-x

Paola Tasca, Bernard M. van den Berg, Ton J. Rabelink, Gangqi Wang, Bram Heijs, Cees van Kooten, Aiko P. J. de Vries, Jesper Kers

{"title":"Application of spatial-omics to the classification of kidney biopsy samples in transplantation","authors":"Paola Tasca, Bernard M. van den Berg, Ton J. Rabelink, Gangqi Wang, Bram Heijs, Cees van Kooten, Aiko P. J. de Vries, Jesper Kers","doi":"10.1038/s41581-024-00861-x","DOIUrl":"10.1038/s41581-024-00861-x","url":null,"abstract":"Improvement of long-term outcomes through targeted treatment is a primary concern in kidney transplant medicine. Currently, the validation of a rejection diagnosis and subsequent treatment depends on the histological assessment of allograft biopsy samples, according to the Banff classification system. However, the lack of (early) disease-specific tissue markers hinders accurate diagnosis and thus timely intervention. This challenge mainly results from an incomplete understanding of the pathophysiological processes underlying late allograft failure. Integration of large-scale multimodal approaches for investigating allograft biopsy samples might offer new insights into this pathophysiology, which are necessary for the identification of novel therapeutic targets and the development of tailored immunotherapeutic interventions. Several omics technologies — including transcriptomic, proteomic, lipidomic and metabolomic tools (and multimodal data analysis strategies) — can be applied to allograft biopsy investigation. However, despite their successful application in research settings and their potential clinical value, several barriers limit the broad implementation of many of these tools into clinical practice. Among spatial-omics technologies, mass spectrometry imaging, which is under-represented in the transplant field, has the potential to enable multi-omics investigations that might expand the insights gained with current clinical analysis technologies. Technological advances continue to enhance the clinical value of kidney biopsies. Here, the authors consider the potential of using spatial-omics in transplantation, including the use of mass spectrometry imaging, as graft monitoring and diagnostic tools, to improve patient management and outcomes.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 11","pages":"755-766"},"PeriodicalIF":28.6,"publicationDate":"2024-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141521722","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

The role of antibody glycosylation in autoimmune and alloimmune kidney diseases 抗体糖基化在自身免疫性和同种免疫性肾病中的作用。

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-07-03 DOI: 10.1038/s41581-024-00850-0

Anaïs Beyze, Christian Larroque, Moglie Le Quintrec

{"title":"The role of antibody glycosylation in autoimmune and alloimmune kidney diseases","authors":"Anaïs Beyze, Christian Larroque, Moglie Le Quintrec","doi":"10.1038/s41581-024-00850-0","DOIUrl":"10.1038/s41581-024-00850-0","url":null,"abstract":"Immunoglobulin glycosylation is a pivotal mechanism that drives the diversification of antibody functions. The composition of the IgG glycome is influenced by environmental factors, genetic traits and inflammatory contexts. Differential IgG glycosylation has been shown to intricately modulate IgG effector functions and has a role in the initiation and progression of various diseases. Analysis of IgG glycosylation is therefore a promising tool for predicting disease severity. Several autoimmune and alloimmune disorders, including critical and potentially life-threatening conditions such as systemic lupus erythematosus, anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis and antibody-mediated kidney graft rejection, are driven by immunoglobulin. In certain IgG-driven kidney diseases, including primary membranous nephropathy, IgA nephropathy and lupus nephritis, particular glycome characteristics can enhance in situ complement activation and the recruitment of innate immune cells, resulting in more severe kidney damage. Hypofucosylation, hypogalactosylation and hyposialylation are the most common IgG glycosylation traits identified in these diseases. Modulating IgG glycosylation could therefore be a promising therapeutic strategy for regulating the immune mechanisms that underlie IgG-driven kidney diseases and potentially reduce the burden of immunosuppressive drugs in affected patients. Here, the authors review the impact of IgG glycosylation in kidney diseases, particularly autoimmune diseases and antibody-mediated rejection. They also discuss the signalling pathways that govern antibody glycosylation, the impact of glycosylation on antibody functions and implications for therapy.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 10","pages":"672-689"},"PeriodicalIF":28.6,"publicationDate":"2024-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141498536","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

Regulation of kidney fibrosis by ILC3s via a gut–kidney axis ILC3s通过肠道-肾脏轴调节肾脏纤维化

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-07-02 DOI: 10.1038/s41581-024-00867-5

Susan J. Allison

引用次数: 0

Avenciguat reduces albuminuria in patients with chronic kidney disease Avenciguat 可减少慢性肾病患者的白蛋白尿。

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-07-02 DOI: 10.1038/s41581-024-00866-6

Ellen F. Carney

引用次数: 0

A pre-specified analysis of the SELECT trial suggests a kidney benefit of semaglutide in patients without diabetes SELECT 试验的预设分析表明，在无糖尿病的患者中，semaglutide 对肾脏有益。

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-07-02 DOI: 10.1038/s41581-024-00865-7

Ellen F. Carney

引用次数: 0

Natural killer cell-mediated innate microvascular rejection 自然杀伤细胞介导的先天性微血管排斥反应

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-06-19 DOI: 10.1038/s41581-024-00862-w

Olivier Thaunat

引用次数: 0

Unlocking the benefits of transplantation with kidneys from older donors 利用老年捐献者的肾脏释放移植的益处。

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-06-18 DOI: 10.1038/s41581-024-00851-z

Vidya A. Fleetwood, Krista L. Lentine

引用次数: 0

Pulmonary hypertension and chronic kidney disease: prevalence, pathophysiology and outcomes 肺动脉高压和慢性肾脏病：发病率、病理生理学和结果。

IF 28.6 1区医学

Nature Reviews Nephrology Pub Date : 2024-06-18 DOI: 10.1038/s41581-024-00857-7

Katarina Zeder, Edward D. Siew, Gabor Kovacs, Evan L. Brittain, Bradley A. Maron

{"title":"Pulmonary hypertension and chronic kidney disease: prevalence, pathophysiology and outcomes","authors":"Katarina Zeder, Edward D. Siew, Gabor Kovacs, Evan L. Brittain, Bradley A. Maron","doi":"10.1038/s41581-024-00857-7","DOIUrl":"10.1038/s41581-024-00857-7","url":null,"abstract":"Pulmonary hypertension (PH) is common in patients with chronic kidney disease (CKD) or kidney failure, with an estimated prevalence of up to 78% in those referred for right-heart catheterization. PH is independently associated with adverse outcomes in CKD, raising the possibility that early detection and appropriate management of PH might improve outcomes in at-risk patients. Among patients with PH, the prevalence of CKD stages 3 and 4 is estimated to be as high as 36%, and CKD is also independently associated with adverse outcomes. However, the complex, heterogenous pathophysiology and clinical profile of CKD–PH requires further characterization. CKD is often associated with elevated left ventricular filling pressure and volume overload, which presumably leads to pulmonary vascular stiffening and post-capillary PH. By contrast, a distinct subgroup of patients at high risk is characterized by elevated pulmonary vascular resistance and right ventricular dysfunction in the absence of pulmonary venous hypertension, which may represent a right-sided cardiorenal syndrome defined in principle by hypervolaemia, salt avidity, low cardiac output and normal left ventricular function. Current understanding of CKD–PH is limited, despite its potentially important ramifications for clinical decision making. In particular, whether PH should be considered when determining the suitability and timing of kidney replacement therapy or kidney transplantation is unclear. More research is urgently needed to address these knowledge gaps and improve the outcomes of patients with or at risk of CKD–PH. In this Review, the authors discuss potential pathophenotypes of coexisting chronic kidney disease and pulmonary hypertension, discuss the principles of clinical management of patients with chronic kidney disease or kidney failure and pulmonary hypertension, and outline key areas for further research.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"20 11","pages":"742-754"},"PeriodicalIF":28.6,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141419906","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