Articles in 2016

Polycystic Kidney disease (PKD) is caused by mutations in genes that affect cilia structure and composition. Impaired mechanosensation through primary cilia has been proposed as a pathogenic mechanism in PKD; however, a new study challenges this hypothesis by showing an absence of mechanically induced Ca²⁺ increases in primary cilia.

Fibrosis is a reactive process that develops in response to excessive epithelial injury and inflammation. Here, Katalin Susztak and colleagues discuss the reactivation of three key developmental signalling pathways — Notch, Wnt and Hedgehog — in response to injury, and describe the roles of these pathways in the development of renal fibrosis.

LncRNAs are important regulators of kidney and heart morphogenesis and contribute to the development of cardiac disease. Studies over the past 5 years have shown that lncRNAs are also involved in renal diseases such as acute kidney injury, glomerular diseases, acute allograft rejection and renal cell carcinoma. In this Review, Lorenzen and Thum describe current understanding of the function of lncRNAs in renal and cardiovascular diseases and how these non-coding RNAs might be targeted for therapeutic purposes.

The first, highly anticipated randomized trial of adjuvant antiangiogenic therapy in renal cancer was recently reported. Although far from assuring, data from the adjuvant sorafenib or sunitinib for unfavorable renal carcinoma (ASSURE) trial offer a wealth of insights into the disease, treatments, and biological considerations for studies aimed at risk reduction.

Transforming growth factor-β (TGF-β) is a key driver of fibrosis in chronic kidney disease, acting via canonical and non-canonical signalling pathways to activate myofibroblasts and induce the production of extracellular matrix. This Review describes the mechanisms by which TGF-β promotes renal fibrosis, the pathways that modulate TGF-β signalling, and new therapeutic opportunities for the inhibition of TGF-β-driven renal fibrosis

A single-centre study found that desensitization therapy permits a good success rate of kidney transplantation with an incompatible living donor. Data from 22 US centres now suggest that this technique could be employed across multiple hospitals to prolong the lives of sensitized transplant recipients.

Radiologic techniques are routinely used to assess tissue macrostructure and gross morphology. In this Review, Nicolas Grenier and colleagues discuss how technological advancements in CT, MRI, and ultrasonography have faciliated the assessment of organ microstructure and function, and how these techniques can be applied to the kidney. They outline the benefits of incorporating radiologic data with routine clinical diagnostics, and the technical challenges that remain to be addressed when imaging the kidney.