Proteinuria

Determining the presence of microalbuminuria in a first morning void is more reliable than analysis of spot urine samples. A team from The Netherlands demonstrated that the prevalence of microalbuminuria estimated using data from first morning voids was similar to the prevalence ascertained by measurement of 24 h urinary albumin excretion, the gold standard (but less practical) method for diagnosing microalbuminuria.

Witte, E. C. et al. First morning voids are more reliable than spot urine samples to assess microalbuminuria. J. Am. Soc. Nephrol. 20, 436–443 (2009).

Mineral metabolism

Iron–magnesium hydroxycarbonate (Fermagate) shows promise in phase II testing as a calcium-free treatment for hyperphosphatemia in patients on chronic hemodialysis. Doses of 1 g or 2 g given three times daily for 21 days effectively reduced serum phosphate levels. The lower dose had an adverse-event profile comparable to that of placebo, although both doses increased predialysis serum magnesium level.

McIntyre, C. W. et al. Iron–magnesium hydroxycarbonate (Fermagate): a novel non-calcium-containing phosphate binder for the treatment of hyperphosphatemia in chronic hemodialysis patients. Clin. J. Am. Soc. Nephrol. 4, 401–409 (2009).

Dialysis

The addition of a novel induction assay for interleukin 1β to a classic method for determining the purity of dialysis water (the Limulus Amebocyte Lysate test) could improve detection of microbial contaminants. Glorieux and colleagues show that 10.3% of dialysates deemed 'pure' by classic methods and 9.1% of 'ultrapure' fluids elicited a proinflammatory response in the cytokine assay.

Glorieux, G. et al. A novel bio-assay increases the detection yield of microbiological impurity of dialysis fluid, in comparison to the LAL-test. Nephrol. Dial. Transplant. 24, 548–554 (2009).

Transplantation

Rates of living-donor kidney transplantation have increased steadily in many countries over the past 10 years, according to researchers in Canada. An estimated 27,000 living-donor kidney transplantations are now performed worldwide each year, with the highest numbers taking place in the US, Brazil, Iran, Mexico and Japan; Saudi Arabia has the highest rate of living-donor kidney transplantations per million population, most of which involve unrelated donors.

Horvat, L. D. et al. Global trends in the rates of living kidney donation. Kidney Int. doi:10.1038/ki.2009.20 (2009).