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Acute kidney injury (AKI) is a global concern that affects patient outcomes and resource utilization. An effective educational programme aimed at improving early AKI identification, triaging and treatment, using risk scores and care bundles coupled with access to point-of-care diagnostics, can help to prevent AKI-related deaths in regions with limited resources.
In a ground-breaking development, rat kidneys have been cryopreserved for an unprecedented duration of 100 days and subsequently transplanted successfully after nano-rewarming. This extraordinary achievement opens new possibilities for the field of organ banking.
Kidney failure is a serious but rare consequence of progressive chronic kidney disease. A meta-analysis of individual participant-level trial data, across heterogeneous treatments and disease groups, has shown glomerular filtration rate (GFR) slope to be a valid, fit-for-purpose and robust surrogate marker of kidney failure.
Racial and ethnic minoritized populations are underrepresented in clinical trials in nephrology, but overrepresented in adverse kidney disease outcomes. Targeted enrolment, revision of problematic policies, inclusion of minoritized populations in trial planning, and language-, race- and ethnicity-concordant investigative teams can improve representation in clinical trials.
Chronic kidney disease is characterized by dyslipidaemia and lipid accumulation in the kidney. In this Review, the authors examine the evidence that links alterations in lipid metabolism to kidney injury and progression of kidney disease, and explore potential lipid-targeted therapeutic approaches.
This Review examines the role of alterations in the gut microbial ecosystem, as well as inflammation and oxidative stress, in the bone and mineral disorder that affects patients with chronic kidney disease. The authors also explore novel therapeutic options that can target these disease factors.
The bladder and kidney engage adaptive and innate immune responses to prevent urinary tract infections and minimize tissue injury following infection. Here, the authors describe the mechanisms used by uropathogenic bacteria to establish and promote kidney infection, as well as the immune defence mechanisms used by resident kidney cells and infiltrating immune cells to eradicate infection.
During disasters, the morbidity and mortality of patients with kidney disease far exceeds that of the general population. Here, the authors discuss the medical and logistical problems that are faced by these patients and their care-givers during mass disasters and suggest pragmatic approaches to improve patient outcomes.
