In This Issue
Endothelial dysfunction in CKD. This editorial elegantly describes how the adipose tissue acts as a prime-time player in endothelial dysfunction. The roles of adiponectin and visfatin are emphasized.A related original article suggests that the presence of proteinuria, regardless of the degree of renal function impairment, is an important predictor of endothelial dysfunction in early diabetic nephropathy and is associated with altered circulating levels of NAMPT/visfatin and adiponectin.
(See editorial by Zocalli, pages 783–785 and article by Yilmaz et al., pages 959–965)
The increasing importance of palliative care in nephrology is discussed in a concise editorial comment by one of the rare authorities in this field. The definition of renal palliative care, barriers in diagnosing end of life and the means to achieve a good quality death for the patients are openly described.
(See editorial by Brown et al., pages 789–791)
‘Vaccination in patients with CKD’ is an extremely useful in-depth editorial review, summarizing the current attitude towards hepatitis, varicella, influenza, measles, and other viral disease vaccinations. Vaccination against bacterial infections (Staph aureus, pneumococci, among others) and in selected patient groups, including HIV and asplenic patients, is discussed.
(See editorial by Janus et al., pages 800–807)
The principles and techniques, clinical application in both haemo- and peritoneal dialysis as well as the problems and future areas of research of bioimpedance technologies are discussed in some detail by Kotanko et al., pages 808–812.
Renal cilia are flow sensors that are required for the maintenance of the normal kidney architecture. An original paper demonstrates that the renal cilium not only responds to changes in the renal environment caused by injury, but is also involved in the repair process that re-establishes the epithelial layer of the damaged renal tubule.
(See article by Verghese et al., pages 834–841)
Ischaemia/reperfusion is a major cause of acute kidney injury (AKI), and it has now become well established that a significant portion of patients suffer from progressive deterioration of renal function. An interesting original article describes results suggesting that macrophages play an important role in mediating persistent inflammation and fibrosis after ischaemia/reperfusion leading to the development of chronic kidney disease.
(See article by Ko et al., pages 842–852)
Epithelial-mesenchymal transition (EMT) is a potential mechanism contributing to the characteristic tubulointerstitial renal fibrosis in multiple myeloma. In an elegant in vitro study, myeloma light chains directly induce EMT in human renal proximal tubule epithelial cells. Light chain-induced EMT involved multiple cytokines, is modulated by p38 MAPK, but appeared independent of the action of TGF-ß1.
(See article by Li et al., pages 860–870)
A recent Norwegian study compared data on death-censored graft survival between different recipient age groups. No differences in graft survival were found between 513 senior patients, aged 60–69 years and 512 control patients, aged 45–54 years, transplanted during the same time period. It is concluded that, given the poor prognosis during dialysis treatment, selected elderly patients may successfully be offered a kidney transplant.
(See article by Heldal et al., pages 1026–1031)
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