Seminars in nephrology最新文献

Barry Morton Brenner, MD, Festschrift. 巴里·莫顿·布伦纳，医学博士，费斯施里夫。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-09-04 DOI: 10.1016/j.semnephrol.2026.151725

Joseph V Bonventre

引用次数: 0

Acute Kidney Injury-to-Chronic Kidney Disease Transition: Clinical Evidence, Pathophysiologic Mechanisms, and Emerging Role of Traditional Chinese Medicine. 急性肾损伤到慢性肾病的转变：临床证据、病理生理机制和中医的新作用。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-09-03 DOI: 10.1016/j.semnephrol.2026.151720

Xinyuan Guo, Lan Wang, Wenjing Wu

{"title":"Acute Kidney Injury-to-Chronic Kidney Disease Transition: Clinical Evidence, Pathophysiologic Mechanisms, and Emerging Role of Traditional Chinese Medicine.","authors":"Xinyuan Guo, Lan Wang, Wenjing Wu","doi":"10.1016/j.semnephrol.2026.151720","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2026.151720","url":null,"abstract":"Acute kidney injury (AKI) is common in hospitalized patients and is strongly associated with subsequent acute kidney disease (AKD), chronic kidney disease (CKD), end-stage kidney disease, and increased mortality. The Kidney Disease: Improving Global Outcomes 2026 AKI/AKD public review draft emphasizes the AKI-AKD-CKD continuum and the need for structured follow-up, kidney function and proteinuria reassessment, and risk stratification after AKI or AKD. Mechanistically, the AKI-to-CKD transition is driven by maladaptive tubular repair, characterized by G2/M arrest and sustained profibrotic signaling, microvascular rarefaction-induced hypoxia, mitochondrial dysfunction with impaired fatty acid oxidation, and amplification of injury by regulated cell death pathways, including ferroptosis and necroptosis, in concert with chronic inflammation. Cellular senescence in tubular epithelial cells and immune cells further perpetuates a senescence-associated secretory phenotype-mediated proinflammatory and profibrotic milieu, thereby promoting irreversible fibrosis. Effective targeted therapies remain lacking. Traditional Chinese medicine-derived agents may provide mechanistically plausible multitarget candidates for modulating tubular injury and interstitial fibrosis.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151720"},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Mechanism of Quercetin in Treatment of Vascular Calcification in Chronic Kidney Disease. 槲皮素治疗慢性肾病血管钙化的机制。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-09-03 DOI: 10.1016/j.semnephrol.2026.151717

Xiling Yin, Xingyun Guo, Wenqian Gao, Xiaoxue Dong, Shiyi Liu

{"title":"Mechanism of Quercetin in Treatment of Vascular Calcification in Chronic Kidney Disease.","authors":"Xiling Yin, Xingyun Guo, Wenqian Gao, Xiaoxue Dong, Shiyi Liu","doi":"10.1016/j.semnephrol.2026.151717","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2026.151717","url":null,"abstract":"Vascular calcification (VC) is a major independent risk factor for cardiovascular events in patients with chronic kidney disease (CKD), yet no effective clinical treatment is currently available. Quercetin, a natural flavonoid abundant in fruits and vegetables, demonstrates promising therapeutic potential in CKD-related VC (CKD-VC). This review systematically summarizes the molecular mechanisms by which quercetin ameliorates CKD-VC from two principal aspects: directly targeting the vascular smooth muscle cells (VSMCs) phenotypic transition and indirectly alleviating the procalcification microenvironment. At the cellular level, quercetin inhibits osteoblastic transdifferentiation, restores calcium-phosphorus homeostasis, enhances calcification inhibitor expression, and effectively alleviates pathologic processes, including oxidative stress, inflammation, cellular senescence, and apoptosis, while also regulating epigenetic modifications. In terms of the procalcification microenvironment, quercetin mitigates CKD-VC by improving gut microbiota dysbiosis, reducing uremic toxin accumulation, protecting endothelial barrier function, and inhibiting ferroptosis. In conclusion, based on existing research evidence, quercetin demonstrates the potential to exert anticalcification effects through multitarget and multipathway mechanisms.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151717"},"PeriodicalIF":3.2,"publicationDate":"2026-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148888653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Growing Clinical Challenge-Arsenic-Induced Kidney Injury: Mechanisms and Management of Integrating Conventional and Traditional ChineseMedicine Approaches. 日益增长的临床挑战——砷性肾损伤：中西医结合的机制和治疗。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-09-02 DOI: 10.1016/j.semnephrol.2026.151719

Zhong Wang, Qiuhan Wang, Xuezhong Gong

{"title":"Growing Clinical Challenge-Arsenic-Induced Kidney Injury: Mechanisms and Management of Integrating Conventional and Traditional ChineseMedicine Approaches.","authors":"Zhong Wang, Qiuhan Wang, Xuezhong Gong","doi":"10.1016/j.semnephrol.2026.151719","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2026.151719","url":null,"abstract":"Arsenic is a toxic element that is widely present in both natural and clinical environments, posing a significant threat to human health. Long-term exposure to arsenic may lead to multiorgan damage, with the kidneys, as the primary target organs for arsenic metabolism and excretion, being particularly vulnerable to its toxic effects. Increasing evidence suggests that arsenic exposure is associated with the occurrence of acute kidney injury and the progression of chronic kidney disease. Previous studies have primarily focused on mechanisms such as oxidative stress, mitochondrial dysfunction, and programmed cell death. However, these mechanisms do not fully explain the complexity of arsenic nephrotoxicity. In this review, we systematically review recent advancements in the understanding of arsenic-induced renal injury, with a particular focus on novel mechanisms, including epigenetic regulation, noncoding RNA-mediated gene expression regulation, and metabolic reprogramming, as revealed by omics techniques. These new mechanisms provide a theoretical foundation for enhancing our understanding of arsenic nephrotoxicity, discovering potential biomarkers, and developing targeted intervention strategies. Additionally, we assess the effectiveness and limitations of current management approaches, such as chelation therapy, antioxidant applications, and supportive treatments. It is worth noting that a growing body of evidence suggests that traditional Chinese medicine might offer renal protection through antioxidant, anti-inflammatory, and immunomodulatory pathways. Our previous studies have also demonstrated that the Chuanhuang formula and its active ingredient, tetramethylpyrazine, could effectively alleviate arsenic-induced acute kidney injury. Finally, we hope to mitigate the potential health risks posed by arsenic exposure through multidisciplinary collaboration and comprehensive intervention.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151719"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881476","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Phosphorus Intake and Outcomes in Chronic Kidney Disease: Cardiovascular, Skeletal, and Mortality Risks. 慢性肾脏疾病的磷摄入量和结局：心血管、骨骼和死亡风险。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-09-02 DOI: 10.1016/j.semnephrol.2026.151721

Orlando M Gutiérrez

{"title":"Phosphorus Intake and Outcomes in Chronic Kidney Disease: Cardiovascular, Skeletal, and Mortality Risks.","authors":"Orlando M Gutiérrez","doi":"10.1016/j.semnephrol.2026.151721","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2026.151721","url":null,"abstract":"Chronic kidney disease (CKD) is characterized by progressive disturbances in phosphorus homeostasis that contribute to the development of cardiovascular disease and CKD-mineral and bone disorder. Because dietary phosphorus intake is frequently excessive in Western diets, phosphorus restriction has emerged as a potential strategy to improve clinical outcomes in CKD. This review summarizes the current evidence linking dietary phosphorus intake with cardiovascular disease, mortality, and bone health in CKD. Experimental studies consistently demonstrate that phosphorus excess promotes vascular calcification, endothelial dysfunction, cardiac hypertrophy, inflammation, and increased fibroblast growth factor 23 secretion, providing strong mechanistic support for a causal role in cardiovascular injury. However, observational studies examining dietary phosphorus intake or oral phosphorus binder use and cardiovascular outcomes have yielded inconsistent findings, likely reflecting limitations in dietary assessment, differences in phosphorus bioavailability, and residual confounding by dietary protein intake, nutritional status, and other factors. By contrast, evidence linking dietary phosphorus intake with bone disease is more consistent. Controlled feeding studies demonstrate that higher phosphorus intake increases parathyroid hormone concentrations, whereas reducing total phosphorus intake or limiting phosphorus-containing food additives lowers parathyroid hormone and fibroblast growth factor 23 concentrations, often without changes in serum phosphorus. Collectively, current evidence suggests that therapeutic strategies focusing on phosphorus source and bioavailability may be more important than those targeting total phosphorus intake alone for optimizing cardiovascular and bone health in CKD. Future clinical trials are needed to determine whether reducing highly absorbable inorganic phosphorus additives improves cardiovascular, skeletal, and survival outcomes in patients with CKD.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151721"},"PeriodicalIF":3.2,"publicationDate":"2026-09-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148881549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Managing Potassium Additives in Chronic Kidney Disease Diets: Challenges and Interventions. 管理慢性肾病饮食中的钾添加剂：挑战和干预措施。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-08-28 DOI: 10.1016/j.semnephrol.2026.151715

David E St-Jules, Biff F Palmer, Deborah J Clegg

引用次数: 0

Advances in the Treatment of Diabetic Kidney Disease With Traditional Chinese Medicine. 中医药治疗糖尿病肾病的研究进展。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-08-24 DOI: 10.1016/j.semnephrol.2026.151712

Jiang Li, Guo Shuang, Zhang Yufei, Zhao Tingting, Li Ping

{"title":"Advances in the Treatment of Diabetic Kidney Disease With Traditional Chinese Medicine.","authors":"Jiang Li, Guo Shuang, Zhang Yufei, Zhao Tingting, Li Ping","doi":"10.1016/j.semnephrol.2026.151712","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2026.151712","url":null,"abstract":"Diabetic kidney disease (DKD) persists as the predominant etiology of end-stage renal disease globally. Despite advances in conventional pharmacotherapies, which primarily target single pathogenic pathways, a considerable residual risk of renal function decline and end-stage renal disease progression remains unresolved, highlighting the need for alternative therapeutic paradigms. This review involves dissecting and integrating mechanistic insights derived from preclinical investigations, including in vitro cellular models, in vivo animal models of DKD, and molecular biology-based analyses. It uses Tangshen formula, a classic traditional Chinese medicine (TCM) for DKD, to detail TCM's protective mechanisms and concisely summarizes the DKD-related preclinical progress of other TCMs over 5 years. Unlike monotarget strategies, TCM interventions exert synergistic effects across multiple organ systems: they reshape the renal microenvironment by mitigating oxidative stress and extracellular matrix accumulation, reprogram hepatic glucose and lipid metabolism to alleviate insulin resistance, and fortify the intestinal mucosal barrier to prevent endotoxemia-induced systemic inflammation. At the microscopic and molecular levels, these TCM-derived agents orchestrate coordinated crosstalk among key pathogenic cascades, including chronic inflammation, renal fibrosis, gut microbiota dysbiosis, metabolic flux dysregulation, microcirculatory impairment, and hypoxic injury. By targeting these interconnected pathways simultaneously, TCM facilitates the restoration of systemic homeostasis, thereby addressing the complex, multifactorial pathogenesis of DKD more comprehensively than pathway-specific interventions.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151712"},"PeriodicalIF":3.2,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148814125","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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 Therapeutic Application of Epigenetic Regulation by Natural Herbal Compounds in Kidney Diseases. 天然草药表观遗传调控在肾脏疾病治疗中的应用。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-08-04 DOI: 10.1016/j.semnephrol.2026.151711

Qiu-Xiang Bai, Kang-Meng Luo, Long-Hao Jia, Jian Jia, Fahsai Kantawong, Rui-Zhi Tan, Li Wang

{"title":"The Therapeutic Application of Epigenetic Regulation by Natural Herbal Compounds in Kidney Diseases.","authors":"Qiu-Xiang Bai, Kang-Meng Luo, Long-Hao Jia, Jian Jia, Fahsai Kantawong, Rui-Zhi Tan, Li Wang","doi":"10.1016/j.semnephrol.2026.151711","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2026.151711","url":null,"abstract":"Kidney diseases, represented by chronic kidney disease (CKD) and acute kidney injury (AKI), pose significant global public health challenges due to their complex pathogenesis and limited therapeutic options. In recent years, epigenetic regulation-including DNA methylation, histone modifications, and non-coding RNAs-has been shown to play a crucial role in the progression of kidney diseases, offering new directions for therapeutic strategies. Natural herbal compounds have emerged as a research focus for modulating epigenetic mechanisms owing to their multi-target effects, low toxicity, and broad bioactivity. This review outlines the regulatory functions of epigenetic mechanisms across various kidney diseases and illustrates how natural herbal compounds can mitigate renal injury via multi-target epigenetic modulation. These compounds have been shown to reverse renal fibrosis, attenuate inflammatory responses, suppress oxidative stress, and protect podocytes and renal tubular epithelial cells by targeting DNA methyltransferases, histone-modifying enzymes, and non-coding RNAs, including microRNAs and long non-coding RNAs. However, challenges such as limited bioavailability and insufficiently elucidated in vivo mechanisms impede clinical translation. Future research should prioritize structural optimization, advanced delivery systems, and investigations into gut microbiome interactions to enhance therapeutic applicability. Overall, this review highlights the promise of epigenetics-based therapeutic strategies using herbal active ingredients for kidney disease intervention, though further validation and optimization are needed for clinical application.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151711"},"PeriodicalIF":3.2,"publicationDate":"2026-08-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148702193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Targeting Cellular Senescence in Kidney Aging with Traditional Chinese Medicine: Potential Senolytic and Senomorphic Strategies. 中药靶向肾衰老细胞衰老：潜在的抗衰老和促衰老策略。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-08-03 DOI: 10.1016/j.semnephrol.2026.151713

Jian Li, Yuqing Li, Yuan Liu, Letian Yang, Liang Ma, Ping Fu

{"title":"Targeting Cellular Senescence in Kidney Aging with Traditional Chinese Medicine: Potential Senolytic and Senomorphic Strategies.","authors":"Jian Li, Yuqing Li, Yuan Liu, Letian Yang, Liang Ma, Ping Fu","doi":"10.1016/j.semnephrol.2026.151713","DOIUrl":"https://doi.org/10.1016/j.semnephrol.2026.151713","url":null,"abstract":"Cellular senescence, a key driver of kidney aging and functional decline, manifests in 2 primary forms: (1) replicative senescence, primarily caused by telomere shortening; and (2) stress-induced senescence, triggered by factors such as oxidative stress and DNA damage. Senescent cells are characterized by permanent cell cycle arrest, activation of senescence-associated secretory phenotype (SASP), and epigenetic alterations, among others. It is important to note that cellular senescence is not exclusively detrimental; it also serves necessary, programmed functions in physiologic tissue remodeling and tumor suppression. However, its chronic accumulation with age is a major driver of organ decline. Currently, specific treatments targeting senescent cells are lacking. Strategies to counteract senescent cells fall into 2 main categories: (1) senolytics, which eliminate senescent cells; and (2) senomorphics, which mitigate their detrimental paracrine effects, including SASP inhibitors. Traditional Chinese Medicine (TCM) has demonstrated potential in combating aging through both senolytic and senomorphic mechanisms. Current evidence suggests that several TCM-derived compounds and formulations may modulate renal senescence-related pathways, including BCL-2 family-dependent apoptosis resistance, NF-κB/JAK2-STAT3/NLRP3-mediated SASP, NOX4-ROS/Nrf2 oxidative stress signaling, AMPK/mTOR/SIRT1 nutrient-sensing pathways, Klotho expression, and the gut-kidney axis. This review explores the emerging role of TCM in addressing renal aging, highlighting its advantages as a multi-targeted, low-toxicity therapeutic strategy to mitigate aging-related kidney diseases.","PeriodicalId":21756,"journal":{"name":"Seminars in nephrology","volume":" ","pages":"151713"},"PeriodicalIF":3.2,"publicationDate":"2026-08-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148670566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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

Glomerular Disease in Vietnam: Diagnosis and Treatment Challenges. 肾小球疾病在越南：诊断和治疗挑战。

IF 3.2 3区医学

Seminars in nephrology Pub Date : 2026-07-13 DOI: 10.1016/j.semnephrol.2026.151693

Huong T B Tran, Thang H D Tran, David Harris

引用次数: 0