Nature Reviews Nephrology
(NAT REV NEPHROL) 《自然肾脏学评论》
Polycystic kidney disease: Tolvaptan in ADPKD—TEMPO 3:4 trial results |PDF (109 KB)
p1 | doi:10.1038/nrneph.2012.236
Heart failure: Drugs outperform ultrafiltration in acute cardiorenal syndrome| PDF (141 KB)
p2 | doi:10.1038/nrneph.2012.237
Diabetes: Dual RAAS blocker trial stopped prematurely | PDF (50 KB)
p3 | doi:10.1038/nrneph.2012.254
Glomerular disease: Gain-of-glycosylation mutation in ITGA3 causes nephrotic syndrome | PDF (48 KB)
p3 | doi:10.1038/nrneph.2012.255
Chronic kidney disease: The effect of age on CKD outcomes | PDF (43 KB)
p3 | doi:10.1038/nrneph.2012.256
Acute kidney injury: Adoptive transfer of tolerized dendritic cells—a potential new strategy for the prevention of AKI | PDF (95 KB)
p4 | doi:10.1038/nrneph.2012.257
Chronic kidney disease: No significant effect of cinacalcet on cardiovascular outcomes in patients undergoing dialysis—EVOLVE results | PDF (52 KB)
p4 | doi:10.1038/nrneph.2012.258
Dialysis: Cellular cholesterol efflux impairment in dialysis patients | PDF (46 KB)
p2 | doi:10.1038/nrneph.2012.250
Development: New insights into mechanisms of kidney tubule elongation |PDF (46 KB)
p2 | doi:10.1038/nrneph.2012.251
Critical care: Hydroxyethyl starch versus saline in the ICU | PDF (46 KB)
p2 | doi:10.1038/nrneph.2012.252
Acute kidney injury: CSF-1 signalling is involved in repair following AKI |PDF (46 KB)
p2 | doi:10.1038/nrneph.2012.253
NEWS AND VIEWS
Transplantation: An end to bone disease after renal transplantation?
Vincent M. Brandenburg & Jürgen Floege
p5 | doi:10.1038/nrneph.2012.245
Surprising new randomized trial data showed no clinically relevant decrease in bone mineral density at various skeletal sites 12 months after kidney transplantation in patients receiving baseline calcitriol and calcium therapy as well as ibandronate or placebo. These data raise important questions regarding strategies to prevent bone loss after renal transplantation.
Vasculitis: Refining phenotypes in ANCA-associated vasculitis
Fernando C. Fervenza & Ulrich Specks
p6 | doi:10.1038/nrneph.2012.261
As granulomatosis with polyangiitis (GPA) and microscopic polyangiitis (MPA) share histopathologic and clinical features, including the presence of antineutrophil cytoplasmic autoantibodies (ANCAs), patients with these syndromes are commonly labelled as having ANCA-associated vasculitis (AAV) and are subjected to similar treatments. A recent study suggests that dividing AAV into five classes based on disease phenotype provides better prognostic information than the classic division into GPA and MPA.
Dialysis: Does daily haemodialysis reduce survival?
Alan S. Kliger
p8 | doi:10.1038/nrneph.2012.247
A new multinational cohort study reports that patients receiving daily haemodialysis had a significantly higher mortality rate than those receiving conventional thrice-weekly treatments. Other studies have suggested that daily haemodialysis has beneficial effects. What are patients and nephrologists to make of these conflicting findings?
Dialysis: Vascular access in children—arteriovenous fistula or CVC?
Robert H. Mak & Bradley A. Warady
p9 | doi:10.1038/nrneph.2012.265
Central venous catheters are currently the primary method of vascular haemodialysis access used by paediatric nephrologists in the USA. However, new data from Ma and colleagues suggest that in children who require chronic haemodialysis, arteriovenous fistulas might be a safer option.
Transplantation: Are calcineurin inhibitors safer than mTOR inhibitors?
Heidi Yeh & James F. Markmann
p11 | doi:10.1038/nrneph.2012.262
Isakova et al. report that kidney transplant recipients on mammalian target of rapamycin (mTOR) inhibitors do not have a lower risk of allograft failure but do have a higher risk of death than those on calcineurin inhibitors. Careful consideration is, therefore, required before converting to mTOR inhibitors to preserve renal function.
Hypertension: Synergy of antihypertensives in elderly patients with CKD
Ravi Nistala & James R. Sowers
p13 | doi:10.1038/nrneph.2012.264
A recent study reports that the combination of an angiotensin-receptor blocker (ARB) and a calcium-channel blocker (versus a high-dose ARB) is associated with improved blood pressure control and reduced cardiovascular, cerebrovascular and heart failure events in an elderly chronic kidney disease population. This finding raises the possibility of using fixed-dose drug combinations to improve efficacy and compliance of antihypertensive medications.
Paediatrics: Infant dialysis—what makes it special?
p15 | doi:10.1038/nrneph.2012.263
The European Paediatric Dialysis Working Group has recently produced recommendations for the management of infants on dialysis. This document is timely because, despite the fact that such infants are increasingly being accepted onto renal replacement therapy programmes, most centres have very little experience in the care of this demanding group of patients.
Assessing risk in chronic kidney disease: a methodological review
Morgan E. Grams & Josef Coresh
p18 | doi:10.1038/nrneph.2012.248
Chronic kidney disease (CKD) is an important public health issue that is strongly associated with adverse outcomes. Evaluation of existing therapies, development of new interventions, and timely patient counselling requires accurate prediction models that estimate individual-level risk. Here, Grams and Coresh outline the fundamentals of risk prediction, including considerations pertinent to CKD, common methodological shortcomings in risk prediction studies, and metrics often used to assess the performance of risk prediction models.
Key developments in renin–angiotensin–aldosterone system inhibition
Bruno Sevá Pessôa, Nils van der Lubbe, Koen Verdonk, Anton J. M. Roks, Ewout J. Hoorn & A. H. Jan Danser
p26 | doi:10.1038/nrneph.2012.249
The development of blockers of the renin–angiotensin–aldosterone system (RAAS) has led to the identification of new RAAS components that might contribute to the effectiveness and/or adverse effects of these drugs. Here, the authors describe the roles of the prorenin receptor, type 2 angiotensin II receptors, angiotensin 1–7 and aldosterone–angiotensin II interactions and discuss the potential of modulators of these components to enhance RAAS blockade with potentially beneficial effects in patients with cardiovascular and renal diseases.
Hyponatraemia: more than just a marker of disease severity?
Robert W. Schrier, Shailendra Sharma & Dmitry Shchekochikhin
p37 | doi:10.1038/nrneph.2012.246
Hyponatraemia—the most common serum electrolyte disorder—is an important marker of the severity and prognosis of a number of diseases. In this Review, Schrier et al. discuss the effect of hyponatraemia in different patient groups, including those with pneumonia, heart failure, cirrhosis, and the elderly population. The authors discuss the need for prospective studies to examine whether correcting hyponatraemia can improve outcomes or whether hyponatraemia is just a marker of severe disease.
Resistant hypertension—its identification and epidemiology
Pantelis A. Sarafidis, Panagiotis Georgianos & George L. Bakris
p51 | doi:10.1038/nrneph.2012.260
Resistant hypertension is defined as failure to reach goal blood pressure in patients who are compliant with maximal doses of three antihypertensive drugs, one of which is a diuretic. Despite improvements in controlling blood pressure in the past decade, studies show the prevalence of resistant hypertension is increasing. In this Review, the authors define resistant hypertension and discuss current data on its prevalence, associated comorbidities and prognostic implications.
Why does the treatment of anaemia not improve cardiac outcomes in CKD?
Patrick S. Parfrey
p59 | doi:10.1038/nrneph.2012.239
Prospective cohort studies have shown that anaemia is an independent predictor of adverse outcomes in patients with chronic kidney disease. However, randomized controlled trials of the use of erythropoiesis-stimulating agents to correct moderate anaemia in this patient group have failed to show clinical benefit, and indicate that such treatment may even be harmful. Here, Patrick Parfrey discusses possible explanations for these seemingly contradictory results.