Submarines travelling along the kidney tubule

Physiological principles underlying the kidney targeting of renal nanomedicines

  • Yingyu Huang
  • Xuhui Ning
  • Jie Zheng
Review Article

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  • A toolbox

    A series of articles that aim to explore the tools and techniques that are improving our understanding of renal development, physiology and disease mechanisms as well as contributing to advances in the screening, diagnosis and management of kidney diseases.

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    This Focus issue examines how tackling the three dimensions of sustainable development — social, economic and environmental — is essential to improving global kidney health.

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    • In this Review, Owen Lyons discusses the diagnosis, epidemiology and pathophysiology of three sleep disorders that commonly affect patients with chronic kidney disease — restless legs syndrome, insomnia and sleep apnoea — and their impact on patient morbidity and mortality.

      • Owen D. Lyons
      Review Article
    • In this Review, the authors summarize the mechanistic rationale for current treatments for podocytopathies and for novel podocyte-targeted therapies. They also discuss potential approaches to regenerate podocytes and to develop podocyte-specific drug delivery systems.

      • Kristin Meliambro
      • John C. He
      • Kirk N. Campbell
      Review Article
    • Spatially resolved transcriptomic technologies enable the mapping of transcripts at single-cell or near single-cell resolution in a multiplex manner. This Review describes current and emerging spatial transcriptomic methods, their applications of relevance to kidney biology and remaining challenges for the field.

      • Sanjay Jain
      • Michael T. Eadon
      Review Article
    • Here, the authors discuss the beneficial effects of sodium–glucose cotransporter 2 (SGLT2) inhibitors for a range of clinical outcomes beyond glucose lowering, including kidney and cardiovascular protection. They also discuss the need for implementation and adherence initiatives to help translate the benefits of these agents into real-world clinical outcomes.

      • Daniel V. O’Hara
      • Carolyn S. P. Lam
      • Meg J. Jardine
      Review Article
    • Chronic kidney disease (CKD) is associated with several alterations in protein post-translational modifications. Here, the authors examine the evidence of these alterations, their links with CKD progression and cardiovascular risk in patients with CKD, and their potential clinical applications.

      • Heidi Noels
      • Vera Jankowski
      • Joachim Jankowski
      Review Article
  • American Indian and Alaska Native peoples have low life expectancy and a disproportionate disease burden (including of chronic kidney disease), owing to inadequate education, poverty, discrimination and underfunding in the delivery of health services, and healthcare institutions’ lack of appreciation for cultural differences. These broad quality-of-life issues are rooted in economic adversity and poor social conditions.

    • Vallabh O. Shah
    • Tassy Parker
    • Mark L. Unruh
    Comment
  • The increasing prevalence of chronic kidney disease (CKD) is placing a growing burden on healthcare systems, which results in considerable economic and environmental challenges. Sustainable CKD care and optimization of patient outcomes requires a new approach to the organization of healthcare systems, in which home monitoring will have a pivotal role.

    • Sabine H. Josemans
    • Lucas Lindeboom
    • Joris I. Rotmans
    Clinical Outlook
  • The use of cystatin C-inclusive equations will continue to propagate the unnecessary overdiagnosis of chronic kidney disease (CKD) in older people. Cystatin C is less biologically specific for CKD than is serum creatinine, inflates the risks of adverse outcomes compared to measured glomerular filtration rate, and does not establish chronicity at a single time point.

    • Andrew D. Rule
    • Richard J. Glassock
    Comment