Reviews & Analysis

The SONAR trial reports that treatment with the selective endothelin A receptor antagonist atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease. This study was designed to select patients who were likely to benefit from the therapy and minimize the risk of adverse effects.

Various cell types release extracellular DNA traps that protect the host against microbial infections. In this Review, the authors discuss how DNA traps not only participate in pathogen clearance but can also promote vascular disease and autoimmunity.

In a collaborative effort, researchers have identified unusual protein deposits of exostosin 1 and exostosin 2 in patients with PLA2R and THSD7A-negative membranous nephropathy, many of whom had systemic lupus erythematosus, lupus nephritis or other forms of autoimmunity. Although serum exostosin antibodies were not detected, the findings suggest that these proteins could define a distinct subtype of membranous nephropathy.

This Evidence-Based Guideline developed by members of the European Society for Paediatric Nephrology CKD-MBD, Dialysis and Transplantation working groups presents clinical practice recommendations for the use of growth hormone in children with chronic kidney disease on dialysis and after renal transplantation.

This Review describes the mechanisms by which dietary, hormonal and metabolic factors regulate the expression and function of sodium-dependent phosphate cotransporters. The authors discuss the consequences of dysregulated phosphate transport and how understanding of the structure–function relationships of the transporters provides insights into their transport mechanisms.

In this Review, the authors discuss the biology of canonical and non-canonical inflammasomes and inflammasome-forming genes in the kidney, including their different functions in the various kidney compartments and their potential as therapeutic targets.

Here, the authors discuss the multiple functions of the (pro)renin receptor in physiological processes, including blood pressure regulation, energy metabolism and autophagy, as well as its roles in the pathogenesis of diseases including fibrosis, chronic kidney disease, pre-eclampsia and cancer.

This Consensus Statement developed on behalf of the Network for Early Onset Cystic Kidney Disease provides guidance on counselling, diagnosing and monitoring children with autosomal dominant polycystic kidney disease based on current evidence and a multi-stakeholder discussion of ethical issues.

Antimicrobial resistance is an emergent global problem and patients with chronic kidney disease have some of the highest rates of colonization and infection with antibiotic-resistant bacteria (ARB). This Review focuses on the epidemiology, prevention and treatment of infections with ARB.

In this Evidence-Based Guideline on X-linked hypophosphataemia, the authors identify the criteria for diagnosis of this disease, provide guidance for medical and surgical treatment and explain the challenges of follow-up.

Cardiovascular disease (CVD) is a leading cause of death in young adults with incident end-stage renal disease (ESRD). Unlike children with ESRD, young adults with incident ESRD have high prevalence of diabetes, coronary artery disease and heart failure. These cardiovascular risk factors are associated with increased CVD-related hospitalizations and mortality in young adults.

The ubiquitin–proteasome system (UPS) maintains protein homeostasis through the selective degradation of proteins. In addition to degrading short-lived and misfolded proteins, the UPS regulates a multitude of cellular processes, including gene transcription and translation, cell survival and metabolism, and inflammation. This Review provides an overview of UPS-mediated proteostasis, focusing on the involvement of the UPS in renal physiology and pathophysiology.

Hypertension is one of the most common comorbid conditions that is associated with obesity. Here, the authors discuss the complex interactions between renal, hormonal and nervous system factors that link excess adiposity with elevated blood pressure.

New data from the JAVELIN Renal 101 and KEYNOTE-426 trials provide evidence that immune-based combination therapy has superior efficacy to sunitinib monotherapy in patients with advanced renal cell carcinoma. The new findings raise important questions regarding the optimum choice of combination therapy for these patients.

Autosomal dominant polycystic kidney disease (ADPKD) is caused by pathogenic mutations in the genes that encode polycystin 1 (PC1) and PC2. In this article, the authors discuss findings from structural and electrophysiological studies that give us insight into the function of polycystins and ADPKD pathogenesis.

A new study used genome-wide association data and Mendelian randomization to investigate associations between the gut microbiome and metabolic traits. The researchers demonstrate that host genetic variants influence levels of the short-chain fatty acids butyrate and propionate in the gut, which in turn modulate host glycaemic metabolism.

Effective adjuvant therapies are needed to reduce the risk of recurrence of kidney cancer. Here, the authors discuss the results of adjuvant therapy trials, the potential of immune checkpoint inhibitors as adjuvant therapies and the need for multidisciplinary management of patients with resected kidney cancer.

Chronic kidney disease (CKD) is often clinically silent and traditional clinical data alone cannot differentiate disease subtypes. A recent study of the genetic basis of CKD in adults that examined the prevalence of monogenic kidney disease aetiologies supports the use of genetic analysis to improve diagnostics and treatment in CKD.

This Review describes the current understanding of the role of epigenetics and epigenomics in diabetic kidney disease (DKD) and how epigenetic mechanisms might contribute to metabolic memory. The authors also discuss how epigenetic factors and non-coding RNAs could be used as biomarkers and drug targets for DKD diagnosis, prognosis and treatment.

Glycosylation refers to the addition of carbohydrate chains to proteins and lipids. In this Review, the authors discuss the broad role of glycans in immunity, cancer, xenotransplantation and glomerular filtration and the potential of ‘glycomedicine’.