January 2010 Volume 6 Number 1
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EDITORIAL
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The promise of cell-based therapy
Susan J. Allison
p1 | doi:10.1038/nrneph.2009.209
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RESEARCH HIGHLIGHTS
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Dialysis: Elderly patients with ESRD at risk of functional decline after
initiation of dialysis
p3 | doi:10.1038/nrneph.2009.195
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Risk factors: Cystatin C and albuminuria predict mortality in diabetes
p4 | doi:10.1038/nrneph.2009.198
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IN BRIEF
Biopsy | Development | Transplantation | Genetics
p4 | doi:10.1038/nrneph.2009.199
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Allograft failure: Histological predictors of late renal graft loss
p5 | doi:10.1038/nrneph.2009.193
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Diabetic nephropathy: Allergies may promote nephropathy in men with diabetes
p5 | doi:10.1038/nrneph.2009.197
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Risk factors: Prehypertension and obesity are associated with increased
risk of treated ESRD and CKD death in a European cohort
p6 | doi:10.1038/nrneph.2009.194
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Dialysis: Nocturnal hemodialysis might improve patient survival
p6 | doi:10.1038/nrneph.2009.196
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NEWS AND VIEWS
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Pediatrics: Uncontrolled hypertension in children on hemodialysis
Mark Mitsnefes and Daniel I. Feig
p7 | doi:10.1038/nrneph.2009.187
Despite the epidemic of cardiovascular disease among patients with end-stage
renal disease, recent findings demonstrate that the pediatric community
needs to make greater efforts to control the known modifiable risk factors.
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Dialysis: Contemporary dialysis: as good as transplantation?
Heidi M. Schaefer and J. Harold Helderman
p8 | doi:10.1038/nrneph.2009.190
Kidney transplantation is well known to increase survival and improve quality
of life over conventional dialysis therapies. But are contemporary, intensive
dialysis therapies, such as nocturnal home hemodialysis, associated with
outcomes as good as those obtained with deceased donor transplantation?
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Proteinuria: Usefulness of RAS inhibition depends on baseline albuminuria
Sadayoshi Ito
p10 | doi:10.1038/nrneph.2009.203
In patients at low risk of renal disease and with low levels of albuminuria,
administration of renin-angiotensin system inhibitors does not seem to
offer renal benefits and might cause adverse renal effects. In these
patients, renin-angiotensin system inhibition should be implemented
judiciously, with doses titrated to individual needs and with careful
monitoring of kidney function.
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Chronic kidney disease: Is angiotensin system blockade indicated in the
elderly?
Carolyn Bauer, Matthew Abramowitz and Thomas H. Hostetter
p11 | doi:10.1038/nrneph.2009.206
Evidence supporting the renal benefits of angiotensin-converting-enzyme
inhibitors and angiotensin II receptor blockers in elderly patients without
proteinuria is lacking. However, until such data are available, if tolerated,
these medications should continue to be used in this patient population
because of their potent effect on blood pressure.
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Transplantation: Cytomegalovirus prophylaxis: how long is enough?
Deepali Kumar and Atul Humar
p13 | doi:10.1038/nrneph.2009.207
Extending the duration of cytomegalovirus prophylaxis to 6 months in
virus-seronegative organ recipients who receive transplants from seropositive
donors decreases the risk of cytomegalovirus disease. But is prophylaxis
extension the best approach to preventing late-onset cytomegalovirus disease?
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Hypertension: The Framingham risk score is valuable in Europeans
Luis M. Ruilope
p14 | doi:10.1038/nrneph.2009.205
The Framingham hypertension risk score developed in the US has been validated
in a large group of London-based civil servants. The score is therefore
a useful tool for estimating the short-term risk of developing hypertension
in a European population.
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Chronic kidney disease: Oral bicarbonate: renoprotective in CKD?
Csaba P. Kovesdy and Kamyar Kalantar-Zadeh
p15 | doi:10.1038/nrneph.2009.204
Preliminary findings suggest that oral sodium bicarbonate administration
could become a major addition to the armamentarium of renoprotective measures
for individuals with chronic kidney disease.
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Dialysis: Warfarin: safe in dialysis patients with atrial fibrillation?
Robert R. Quinn and Nairne Scott-Douglas
p17 | doi:10.1038/nrneph.2009.212
Warfarin, an anticoagulant that reduces the risk of stroke in the general
population, might be associated with an increased risk of stroke in
hemodialysis patients with atrial fibrillation. This finding raises important
questions about the role of warfarin in the management of patients with
atrial fibrillation who are undergoing dialysis.
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Chronic kidney disease: Did 'renalism' skew the results of a negative study?
Lynda A. Szczech
p18 | doi:10.1038/nrneph.2009.208
Retrospective data analysis suggests that revascularization provides no
benefit over medical treatment in patients with severe kidney disease who
experience non-ST-elevation myocardial infarction. But are these results
the consequence of treatment bias and/or a failure to address poorly
understood risk factors?
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REVIEWS
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Prehypertension: epidemiology, consequences and treatment
Eduardo Pimenta and Suzanne Oparil
Published online: 17 November 2009
p21 | doi:10.1038/nrneph.2009.191
A prehypertension classification of blood pressure, encompassing a blood
pressure range previously regarded to be normal that has been associated
with an increased risk of hypertension mortality compared with lower blood
pressure, has been established. In this Review, Pimenta and Oparil discuss
the epidemiology of prehypertension, the relationship with cardiovascular
morbidity and mortality, and the treatment of prehypertensive patients.
Abstract: http://links.ealert.nature.com/ctt?kn=45&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=79&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
Bone disease after renal transplantation
Hartmut H. Malluche, Marie-Claude Monier-Faugere and Johann Herberth
Published online: 17 November 2009
p32 | doi:10.1038/nrneph.2009.192
Disturbances in bone metabolism are common in patients after renal
transplantation and represent important causes of morbidity and mortality.
This Review discusses the etiological factors that contribute to bone
metabolic disturbances in renal transplant recipients-pre-existing renal
osteodystrophy, the effects of transplant-specific therapies on bone
metabolism, and the effects of reduced renal function after transplantation.
The clinical implications of bone disease in these patients are also
considered.
Abstract: http://links.ealert.nature.com/ctt?kn=16&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=85&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
The growing problem of intradialytic hypertension
Francesco Locatelli, Andrea Cavalli and Benedetta Tucci
Published online: 24 November 2009
p41 | doi:10.1038/nrneph.2009.200
Intradialytic hypertension is not an uncommon complication in hemodialysis
patients, and seems to be associated with adverse outcomes. This complex
phenomenon is not well understood, and many uncertainties exist regarding
its pathophysiologic mechanisms and appropriate treatment strategies. Many
of the therapeutic approaches currently used come from expert recommendations
rather than from the results of randomized clinical trials. In this Review,
Locatelli et al. describe the possible pathophysiologic mechanisms of
intradialytic hypertension, and consider potential treatment and management
strategies.
Abstract: http://links.ealert.nature.com/ctt?kn=46&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=89&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
Direct renin inhibition and the kidney
Norman K. Hollenberg
Published online: 24 November 2009
p49 | doi:10.1038/nrneph.2009.201
Direct renin inhibition is a novel strategy for the blockade of the
renin-angiotensin system. In this Review, Hollenberg discusses the
evidence indicating that direct renin inhibitors might block the
renin-angiotensin system in the kidney more effectively than either
angiotensin-converting-enzyme inhibitors or angiotensin receptor blockers.
The author also discusses the therapeutic implications of this evidence
and possible mechanisms that underlie the renal effects of direct renin
inhibition.
Abstract: http://links.ealert.nature.com/ctt?kn=47&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=94&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
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PERSPECTIVES
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OPINION
Early intervention in acute kidney injury
Robert W. Schrier
p56 | doi:10.1038/nrneph.2009.170
The development of new biomarkers that enable the early diagnosis of acute
kidney injury (AKI) should facilitate early intervention and reduce the
mortality associated with this disease. In this Perspectives article, Robert
Schrier discusses the need to develop interventions to attenuate or prevent
AKI and the requirement for such interventions to selectively improve renal
hemodynamics, increase tubular flow rates, and decrease inflammation without
causing systemic vasodilation.
Abstract: http://links.ealert.nature.com/ctt?kn=49&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
Article: http://links.ealert.nature.com/ctt?kn=53&m=34505687&r=MTc2NDE4ODIzOQS2&b=2&j=NjI4MTA4NDES1&mt=1&rt=0
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