Review Articles

Urinary components can reflect kidney biology in health and disease. Here, the authors examine current data on urinary biomarkers that can provide insight into kidney function and metabolism, and discuss their potential application value as diagnostic, prognostic and/or therapeutic monitoring biomarkers.

The authors discuss the dysregulated host response in sepsis and the use of biomarkers to gauge the immunological status of patients and potentially guide precision medicine. They also highlight potential immunomodulatory therapies for sepsis and discuss the future of sepsis clinical trials.

This Review provides a guide to metabolite retention in kidney disease and includes an overview of key uraemic toxins and the complex mechanisms underlying their toxicity, as well as a discussion of key strategies with the potential to prevent or mitigate their adverse effects.

Here, the authors summarize current evidence and guidance for physical activity in chronic kidney disease. They outline barriers and facilitators to the implementation of physical activity and exercise programmes in chronic kidney disease clinical practice and suggest approaches to facilitating translation of research findings into routine care.

A global shortage of suitable donor kidneys is the primary challenge in kidney transplantation. In this Review, the authors describe different methods of donor kidney preservation, discussing the strengths and limitations of each method and noting how advances in donor organ perfusion could improve organ utilization and patient outcomes.

Here, the authors describe the effects of coronavirus disease (COVID) on the kidney, including long COVID in patients with chronic kidney disease. They also discuss potential associations between COVID-19 and glomerular diseases and the impact of severe acute respiratory syndrome coronavirus 2 vaccines on the risk of long COVID.

This Review discusses the pathophysiology of kidney stone formation and examines the contribution of urinary risk factors and genetic variants. The authors also consider current approaches to the management of nephrolithiasis, including the role of metabolic evaluation and interventions for prevention of kidney stone recurrence.

In this Review, the authors focus on the role of collagen IV in Gould syndrome and Alport syndrome. They discuss the molecular and phenotypic similarities and differences between these syndromes, as well as potential targeted therapeutic strategies.

Here, the authors discuss communication between the ER and other intracellular organelles under physiological and pathological conditions. They highlight the potential role of this crosstalk in the pathogenesis of kidney diseases and discuss potential therapeutic strategies aimed at modulating this crosstalk.

Available evidence suggests that the kidney stroma mediates cell communication and supports a variety of processes during kidney development and in the adult kidney. This Review describes the developmental origins of the stroma and current understanding of its roles in the growth and patterning of renal epithelia and endothelia, and in the maintenance and repair of the adult organ.

Although immune checkpoint inhibitors can prolong survival in people with clear-cell renal-cell carcinoma, disease progression is frequent. Here, the authors explore potential mechanisms that might drive intrinsic or acquired resistance to immune checkpoint inhibitors in clear-cell renal-cell carcinoma, including malignant cell-intrinsic and immune-cell factors.

Since the discovery of PLA2R, several target antigens associated with membranous nephropathy have been identified. This Review describes the distinct clinical associations, pathology and prognostic findings associated with each of the identified target antigens and implications for the reclassification of membranous nephropathy.

This Review examines the bidirectional relationship between hypertensive disorders of pregnancy and kidney disease, which is currently underrecognized, with potential long-term implications for kidney health in both mothers and their offspring. The authors also discuss prevention and management of hypertensive disorders of pregnancy, including kidney health follow-up, and current research gaps.

The impact of exposure to particulate plastics on human health is a topic of increasing concern. Here, the authors discuss routes of exposure to microparticles and nanoparticles and potential mechanisms of toxicity in the kidney and cardiovascular systems.

Here, the authors discuss the heterogeneity and origins of fibroblasts in various organs, the mediators that induce fibroblast activation and fibroblast trajectory and fate. They also highlight potential approaches to targeting fibroblasts as a therapeutic strategy for chronic fibrotic diseases.

This Review examines the use of pangenomic analysis to improve molecular diagnoses in adult nephrology, including available sequencing methods and their applications. The authors also discuss current barriers to translating genetic information into actionable diagnoses, ethical challenges and the key role of multidisciplinary collaboration.

This Review provides an overview of the epidemiological link between chronic kidney disease and dementia. It describes current knowledge of underlying mechanisms, methodological challenges and potential solutions, and implications for clinical practice and future research.

Podocytes reside in a unique microenvironment where they are exposed to mechanical force and a variety of molecules that cross the filtration barrier. This Review describes the various mechanisms by which podocytes sense and respond to their complex environment and how these processes affect glomerular and kidney health.

Advances in biosensor technology have the potential to enable continuous, non-invasive monitoring of kidney health through wearable and implantable systems. Non-invasive microfluidic systems have demonstrated utility in the detection of kidney-relevant biomarkers in peripheral body fluids such as sweat, interstitial fluid, tears and saliva, whereas implantable systems permit the direct measurement of biophysical tissue properties including tissue oxygenation, perfusion and temperature.

The prevalence of cognitive dysfunction among people with chronic kidney disease (CKD) is disproportionately high compared with that in the general population. This Review examines current evidence on key drivers of cognitive impairment in people with CKD, and highlights gaps in knowledge and potential therapeutic targets.