Devon A. Barnes, Luiz Ladeira, Rosalinde Masereeuw
{"title":"From big data to smart decisions: artificial intelligence in kidney risk assessment","authors":"Devon A. Barnes, Luiz Ladeira, Rosalinde Masereeuw","doi":"10.1038/s41581-025-00962-1","DOIUrl":"10.1038/s41581-025-00962-1","url":null,"abstract":"Artificial intelligence approaches that link patient data with chemical-induced kidney injury patterns are revolutionizing nephrotoxicity risk assessment. Substantial progress has been made in the development of integrated approaches that leverage big data, molecular profiles and toxicological understanding to identify at-risk patients, provide insights into molecular mechanisms and advance predictive nephrology.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 9","pages":"578-579"},"PeriodicalIF":39.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797923","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}
{"title":"Assessing the effect of social and environmental burdens on kidney disease","authors":"Mukoso N. Ozieh, Bessie A. Young","doi":"10.1038/s41581-025-00955-0","DOIUrl":"10.1038/s41581-025-00955-0","url":null,"abstract":"Social and environmental exposures are strong drivers of health inequity and adverse health outcomes. However, data from studies that examine the longitudinal effect of social and environmental exposure burdens on kidney disease outcomes are limited. The environmental justice index–social environmental ranking, although imperfect, provides an important tool to address this gap in knowledge.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 7","pages":"437-438"},"PeriodicalIF":39.8,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143775627","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}
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}
{"title":"Association of LILRB3 variants with kidney transplant failure in African Americans","authors":"Susan J. Allison","doi":"10.1038/s41581-025-00959-w","DOIUrl":"10.1038/s41581-025-00959-w","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 5","pages":"283-283"},"PeriodicalIF":39.8,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744680","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}
{"title":"Cardiovascular mortality increases with stage of cardiovascular–kidney–metabolic syndrome","authors":"Ellen F. Carney","doi":"10.1038/s41581-025-00957-y","DOIUrl":"10.1038/s41581-025-00957-y","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 5","pages":"283-283"},"PeriodicalIF":39.8,"publicationDate":"2025-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143736597","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}
{"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}
Brittney L. Gorman, Catelynn C. Shafer, Nagarjunachary Ragi, Kumar Sharma, Elizabeth K. Neumann, Christopher R. Anderton
{"title":"Imaging and spatially resolved mass spectrometry applications in nephrology","authors":"Brittney L. Gorman, Catelynn C. Shafer, Nagarjunachary Ragi, Kumar Sharma, Elizabeth K. Neumann, Christopher R. Anderton","doi":"10.1038/s41581-025-00946-1","DOIUrl":"10.1038/s41581-025-00946-1","url":null,"abstract":"The application of spatially resolved mass spectrometry (MS) and MS imaging approaches for studying biomolecular processes in the kidney is rapidly growing. These powerful methods, which enable label-free and multiplexed detection of many molecular classes across omics domains (including metabolites, drugs, proteins and protein post-translational modifications), are beginning to reveal new molecular insights related to kidney health and disease. The complexity of the kidney often necessitates multiple scales of analysis for interrogating biofluids, whole organs, functional tissue units, single cells and subcellular compartments. Various MS methods can generate omics data across these spatial domains and facilitate both basic science and pathological assessment of the kidney. Optimal processes related to sample preparation and handling for different MS applications are rapidly evolving. Emerging technology and methods, improvement of spatial resolution, broader molecular characterization, multimodal and multiomics approaches and the use of machine learning and artificial intelligence approaches promise to make these applications even more valuable in the field of nephology. Overall, spatially resolved MS and MS imaging methods have the potential to fill much of the omics gap in systems biology analysis of the kidney and provide functional outputs that cannot be obtained using genomics and transcriptomic methods. In this Review, the authors discuss mass spectrometry (MS) imaging and spatially resolved MS approaches that are being employed in nephrology applications. They also highlight emerging MS methods and applications, as well as the integration of MS data with data from other omics approaches.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 6","pages":"399-416"},"PeriodicalIF":39.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712964","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}
{"title":"Expanding access to dialysis coverage in Mexico","authors":"Magdalena Madero","doi":"10.1038/s41581-025-00954-1","DOIUrl":"10.1038/s41581-025-00954-1","url":null,"abstract":"Mexico faces a high burden of chronic kidney disease, which is worsened by fragmented health care and a lack of universal coverage for kidney replacement therapy. The Mexico City CKD Project has improved access for uninsured patients through policy reforms, workforce expansion and infrastructure development, demonstrating a scalable model to reduce kidney health disparities.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 7","pages":"435-435"},"PeriodicalIF":39.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143723168","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}
{"title":"Genetic determinants of urine and plasma metabolite levels","authors":"Seth L. Alper, David J. Friedman","doi":"10.1038/s41581-025-00953-2","DOIUrl":"10.1038/s41581-025-00953-2","url":null,"abstract":"Advanced instrumentation and rapid computation are generating ever more data on human genetics, epigenetics, transcriptomics, proteomics and metabolomics, posing challenges of integration and interpretation. New research has applied rigorous statistical analyses to genetic variations identified in patients with kidney disease to find drivers of (patho)physiological differences in urine and plasma metabolomes.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 7","pages":"441-442"},"PeriodicalIF":39.8,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143712965","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}
{"title":"GWAS scorecard prioritizes kidney genes using coding and regulatory variants","authors":"Matthias Wuttke, Cristian Pattaro","doi":"10.1038/s41581-025-00952-3","DOIUrl":"10.1038/s41581-025-00952-3","url":null,"abstract":"Based on genome-wide association study data from 2.2 million individuals, a functional prioritization scorecard integrates classical omics with allele-specific gene expression, chromatin accessibility and gene regulatory circuits in kidney tissues and specific cell types. This approach prioritized 601 kidney function-related genes, including genes associated with nephropathy in mice and humans.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 7","pages":"439-440"},"PeriodicalIF":39.8,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143660913","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}