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Recurrence of lupus nephritis after kidney transplantation is often regarded as rare, and transplantation of patients with end-stage renal disease secondary to this condition is common. Several studies, however, have reported a higher incidence of recurrence of lupusnephritis after renal transplantation than the 1–4% which is usually quoted. Weng and Goral discuss reasons for the variation in reported incidence of recurrent lupus nephritis and consider the potential clinical impact of recurrence.
The escalating burden of diabetic nephropathy is largely a function of the increased frequency of type 2 diabetes, which is associated with obesity and the metabolic syndrome. Prevention is dependent on elucidation of causal mechanisms. Here, Richard Johnson and colleagues present evidence for a mechanism that might form the basis of novel intervention strategies.
In this comprehensive review, Giuseppe Remuzzi and colleagues present a hypothesis for the pathophysiology of pre-eclampsia that unifies findings from a recent flurry of research. These new insights should spur the development of novel treatments for the hypertension and proteinuria that are hallmarks of this leading cause of fetal and maternal morbidity.
Does erythropoietin have the potential to ameliorate renal injury in humans? This article addresses this question in the context of our current understanding of the pathophysiology of acute renal failure. Recent findings from experimental models are presented, and their relevance to mechanisms of acute renal failure—including endothelial and tubular cell injury, and inflammation—are discussed.
In 1955, the Swiss hematologist Conrad von Gasser coined the term ‘hemolytic uremic syndrome’ to describe the combined symptoms of diarrhea, hemolytic anemia, thrombocytopenia and acute renal failure, which he had observed in five children. Since then, investigators have realized that some forms of hemolytic uremic syndrome can be attributed to genetic abnormalities in circulating and membrane-bound proteins that regulate the complement system. How do these abnormalities influence the course and outcome of the disease, and how should they affect its treatment?
Age-related decline in the capacity of the kidney to repair itself is a significant contributor to mortality associated with acute renal failure. In this well-balanced overview of renal and bone-marrow stem cells, Lloyd Cantley summarizes current knowledge and speculates on mechanisms of regeneration that have therapeutic potential.
Despite the implications of the term 'focal segmental glomerulosclerosis', subtypes of this form of idiopathic nephrotic syndrome are not always focal, segmental or sclerotic. Here, Alain Meyrier presents a comprehensive update of our understanding of the processes that underlie the development of variants of this condition, with emphasis on the unifying role of the podocyte.
Thiazolidinediones are synthetic agonists of peroxisome proliferator-activated receptors that have shown promise inin vitroand animal models of nephropathy. Encouraging early-stage data have also been generated in patients with diabetic nephropathy. Carol Pollock and colleagues outline what we know and what we need to find out before thiazolidinediones such as pioglitazone and rosiglitazone can fulfill their clinical potential.
