In This Issue
Silencing genes with antisense oligodeoxynuleotides: close to clinical application?See editorial comment by Wang et al., pages 2115–2118
Circulating microparticles due to plasma cell membrane remodelling play an important role in vascular damage.
See editorial comment by Daniel et al., pages 2129–2132
Advanced glycation end-products (AGEs) are thought to be important mediators of structural and functional renal abnormalities in diabetic nephropathy. An in vitro study shows that AGE-BSA-induced hypertrophy and damage of cultured podocytes occur by a mechanism involving p27Kip1, a cell cycle regulatory protein. This effect can contribute to the loss of podocytes in diabetic nephropathy.
See article by Rüster et al., pages 2179–2191
N-acetylcysteine (NAC), a thiol-containing antioxidant, has been documented to be effective in attenuating renal injury induced by cisplatin-induced nephrotoxicity. In this study in rats, oxidative stress and p38 MAPK-mediated apoptotic cell death pathways are involved, at least in part, in the pathogenesis of cisplatin-induced ARF, and negative regulation of p38 MAPK activation through inhibition of oxidative stress appears to play a central role in the beneficial effects of NAC.
See article by Luo et al., pages 2198–2205
The short-term evolution following a stroke can involve the development of acute kidney injury (AKI) as a possible complication; this complication is frequently overlooked and underestimated in clinical trials.
From a total of 1090 consecutive patients with CT-confirmed stroke, 158 (14.5%) patients were classified as developing AKI. Independent predictors for AKI development were age, GFR, presence of cardiovascular comorbidities and type of stroke.
Baseline renal function emerged as both a significant independent marker for short-term survival after an acute stroke and as a risk factor for subsequent AKI.
See article by Covic et al., pages 2228–2234
A prospective observational study reports long-term renal functional recovery and patient survival after 5 years of acute tubular necrosis (ATN). At 5 years, renal function was normal in 86% of the remaining survivors, it was impaired in 9%, and 5% of the patients still alive needed dialysis again. Partial recovery of renal function was an independent determinant of long-term survival of these patients.
See article by Schiffl et al., pages 2235–2241
See editorial comment on both papers by Bagshaw, pages 2126–2128
Limited data exist on whether the cardioprotective benefit of β-blockers is modified by the presence of chronic kidney disease (CKD).
A post-hoc analysis of the data from the Bezafibrate Infarction Prevention (BIP) study suggests that β-blocker use is associated with a reduction in event risk in patients with coronary heart disease, regardless of the presence or absence of CKD.
See article by Chonchol et al., pages 2274–2279
A multicentre, open-label study showed that combined therapy with cinacalcet and low doses of vitamin D sterols improved control of both PTH and Ca x P among haemodialysis patients with secondary hyperparathyroidism, as recommended by the KDOQI guidelines.
See article by Block et al., pages 2311–2318
An observational cohort of 505 haemodialysis patients was used to analyze the relationship between haematocrit and all-cause mortality. Baseline haematocrit levels did not differ between the 153 patients with cardiovascular diseases (CVD) and the 352 patients without CVD. There was an inverse relationship between haematocrit and mortality in the CVD-negative group, independent of 14 covariates including the use of erythropoietin. In contrast, using the same Cox models, the CVD-positive group did not show such beneficial effects of higher haematocrit. This study supports the hypothesis that the presence of atherosclerosis alters the relationship between anaemia and mortality risk in haemodialysis patients.
See the paper by Maekawa et al., pages 2329–2336
Patients hospitalized for bacterial endocarditis were identified from patients transplanted or waitlisted between 1995 and 2003. Transplant and waitlist cohorts were derived from the United States Renal Data System database. In-hospital mortality rates were 16.0% for the renal transplant cohort and 18.6% for the waitlisted cohort. Waitlisted patients are at higher risk of developing and dying from bacterial endocarditis than renal transplant recipients.
See article by Shroff et al., pages 2381–2385
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