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Topic Review
Urinary Tract Infection and Microbiome
Urinary tract infection is one of the most common bacterial infections and can cause major burdens, not only to individuals but also to an entire society. Urinary tract infection is not only caused by invading uropathogenic bacteria but also by changes to the uromicrobiome milieu, and interactions with other microbial communities can also contribute. 
  • 620
  • 08 Jun 2023
Topic Review
PSMA-PET Imaging in Prostate Cancer
There has been remarkable development in “theranostics”, in which antibodies or small molecular compounds that bind to prostate-specific membrane antigen (PSMA) are coupled with the diagnostic emitter or therapeutic alpha- or beta-emitters to diagnose or treat prostate cancer, respectively.
  • 619
  • 09 Aug 2023
Topic Review
Immune System Dysfunction and Inflammation in Hemodialysis Patients
Biocompatibility in hemodialysis (HD) has considerably improved, but remains an open issue to be solved, appearing essential to reduce systemic inflammation and enhance patients’ clinical outcomes. Clotting prevention, reduction in complement and leukocyte activation, and improvement of antioxidant effect represent the main goals. Platelet activation is one of the first steps occurring in HD patients, determining several events causing chronic sub-clinical inflammation and immune dysfunction involvement. Moreover, oxidative stress processes, resulting from a loss of balance between pro-oxidant factors and antioxidant mechanisms, have been described, highlighting the link with inflammation.
  • 617
  • 21 Jul 2022
Topic Review
Care for Acute Kidney Injury Survivors
Acute kidney injury (AKI) is a serious problem, affecting multiple organs, and is associated with a high mortality. The severe consequences of AKI extend beyond hospital discharge to the outpatient setting. The post-hospital discharge of patients with AKI can have short- and/or long-term sequela. Patients with AKI are at a higher risk of progressively losing their kidney function up to end-stage kidney disease (ESKD). 
  • 614
  • 18 Nov 2022
Topic Review
FGF23 in Chronic Kidney Disease
Fibroblast growth factor 23 (FGF23) is a phosphaturic hormone produced mainly in osteocytes. In chronic kidney disease (CKD) FGF23 levels increase due to higher production, but also as the result of impaired cleavage and reduced excretion from the body. FGF23 has a significant role in disturbed bone and mineral metabolism in CKD, which leads to a higher cardiovascular risk and mortality in these patients. 
  • 612
  • 10 Mar 2023
Topic Review
Prevention of Renal Cell Carcinoma
With 400,000 diagnosed and 180,000 deaths in 2020, renal cell carcinoma (RCC) accounts for 2.4% of all cancer diagnoses worldwide. The highest disease burden developed countries, primarily in Europe and North America. Incidence is projected to increase in the future as more countries shift to Western lifestyles. Risk factors for RCC include fixed factors such as gender, age, and hereditary diseases, as well as intervening factors such as smoking, obesity, hypertension, diabetes, diet and alcohol, and occupational exposure. Intervening factors in primary prevention, understanding of congenital risk factors and the establishment of early diagnostic tools are important for RCC. 
  • 611
  • 07 Nov 2022
Topic Review
Pathophysiological Mechanisms of the Podocytopathies
Nephrotic syndrome (NS) is a clinical entity characterized by the triad of proteinuria, hypoalbuminemia, and edema. The main pathophysiological alteration in NS is the impairment of the glomerular filtration barrier. Therefore, its permeability becomes non-selective, and urinary protein loss occurs. Being the final barrier to protein loss in the glomerulus, alterations in podocyte structure can explain why injuries in these cells, such as the effacement of their foot processes, are typically related to proteinuria and hypoalbuminemia and, therefore, to the conditions under the NS umbrella.
  • 611
  • 10 Jan 2024
Topic Review
Oligo-Recurrent and Oligo-Progressive Renal Cell Carcinoma
One-third of renal cell carcinomas (RCCs) without metastases develop metastatic disease after extirpative surgery for the primary tumors. The majority of metastatic RCC cases, along with treated primary lesions, involve limited lesions termed “oligo-recurrent” disease. The role of metastasis-directed therapy (MDT), including stereotactic body radiation therapy (SBRT) and metastasectomy, in the treatment of oligo-recurrent RCC has evolved. Although the surgical resection of all lesions alone can have a curative intent, SBRT is a valuable treatment option, especially for patients concurrently receiving systemic therapy. Contemporary immune checkpoint inhibitor (ICI) combination therapies remain central to the management of metastatic RCC. However, one objective of MDT is to delay the initiation of systemic therapies, thereby sparing patients from potentially unnecessary burdens. Undertaking MDT for cases showing progression under systemic therapies, known as “oligo-progression”, can be complex in considering the treatment approach. Its efficacy may be diminished compared to patients with stable disease. SBRT combined with ICI can be a promising treatment for these cases because radiation therapy has been shown to affect the tumor microenvironment and areas beyond the irradiated sites. This may enhance the efficacy of ICIs, although their efficacy has only been demonstrated in clinical trials.
  • 600
  • 28 Dec 2023
Topic Review
Therapeutic Options for IgA Nephropathy
In 1968, Jean Berger first introduced the medical world to IgA nephropathy (IgAN). Fifty-five years later, its pathogenesis is still unclear, but treatments such as renin–angiotensin–aldosterone system inhibitors (RAAS-Is), tonsillectomies, and glucocorticoids are currently used worldwide. There have been great strides in the past 20 years since the discoveries of the specific dysregulation of mucosal immunity, galactose-deficient IgA1 (Gd-IgA1), and Gd-IgA1 immune complexes in patients with IgAN. According to these findings, a multi-hit hypothesis was developed, and this multi-hit hypothesis has provided several putative therapeutic targets.
  • 599
  • 22 Jan 2024
Topic Review
Imaging-Based Biomarkers in Renal Cell Carcinoma
Cross-sectional imaging is the standard diagnostic tool to determine underlying biology in renal masses, which is crucial for subsequent treatment. Standard CT imaging is limited in its ability to differentiate benign from malignant disease. Therefore, various modalities have been investigated to identify imaging-based parameters to improve the noninvasive diagnosis of renal masses and renal cell carcinoma (RCC) subtypes. MRI was reported to predict grading of RCC and to identify RCC subtypes, and has been shown in a small cohort to predict the response to targeted therapy. Dynamic imaging is promising for the staging and diagnosis of RCC. PET/CT radiotracers, such as 18F-fluorodeoxyglucose (FDG), 124I-cG250, radiolabeled prostate-specific membrane antigen (PSMA), and 11C-acetate, have been reported to improve the identification of histology, grading, detection of metastasis, and assessment of response to systemic therapy, and to predict oncological outcomes.
  • 595
  • 29 Mar 2023
Topic Review
Benign Prostatic Hyperplasia Surgical Treatments and Sexual Health
Benign prostatic hyperplasia (BPH), a prevalent condition in older men, is often managed through various surgical interventions.
  • 593
  • 22 Feb 2024
Topic Review
Influence of Uremic Toxins in Chronic Kidney Disease
Patients with chronic kidney disease (CKD) often experience a high accumulation of protein-bound uremic toxins (PBUTs), specifically indoxyl sulfate (IS) and p-cresyl sulfate (pCS). In the early stages of CKD, the buildup of PBUTs inhibits bone and muscle function. As CKD progresses, elevated PBUT levels further hinder bone turnover and exacerbate muscle wasting. In the late stage of CKD, hyperparathyroidism worsens PBUT-induced muscle damage but can improve low bone turnover. PBUTs play a significant role in reducing both the quantity and quality of bone by affecting osteoblast and osteoclast lineage. IS, in particular, interferes with osteoblastogenesis by activating aryl hydrocarbon receptor (AhR) signaling, which reduces the expression of Runx2 and impedes osteoblast differentiation. High PBUT levels can also reduce calcitriol production, increase the expression of Wnt antagonists (SOST, DKK1), and decrease klotho expression, all of which contribute to low bone turnover disorders. Furthermore, PBUT accumulation leads to continuous muscle protein breakdown through the excessive production of reactive oxygen species (ROS) and inflammatory cytokines.
  • 590
  • 23 Aug 2023
Topic Review
Matrix Remodeling in Diabetic Nephropathy
Diabetic nephropathy (DN) remains the leading cause of vascular morbidity and mortality in diabetes patients. Despite the progress in understanding the diabetic disease process and advanced management of nephropathy, a number of patients still progress to end-stage renal disease (ESRD). The underlying mechanism still needs to be clarified. Gaseous signaling molecules, so-called gasotransmitters, such as nitric oxide (NO), carbon monoxide (CO), and hydrogen sulfide (H2S), have been shown to play an essential role in the development, progression, and ramification of DN depending on their availability and physiological actions. Although the studies on gasotransmitter regulations of DN are still emerging, the evidence revealed an aberrant level of gasotransmitters in patients with diabetes. 
  • 589
  • 17 May 2023
Topic Review
Immune-Related Adverse Events in Metastatic Renal Cell Carcinoma
Immune checkpoint inhibitors (ICI) are, among other cancers, routinely used for the treatment of advanced or metastatic renal cell carcinoma (mRCC). A profound understanding of immune-related adverse events (irAE) and the differential diagnosis of adverse reactions caused by other therapeutic agents in combination therapies is of paramount importance.
  • 588
  • 28 Sep 2022
Topic Review
Kidney Failure in Extrapulmonary Sarcoidosis in Children
Sarcoidosis is a non-necrotizing granulomatous inflammatory multisystemic disorder of unknown etiology. In children, as in adults, it can involve a few or all organ systems to a varying extent and degree, entailing multisystemic manifestations. Kidney involvement in pediatric-onset adult-type sarcoidosis is rare, with a wide range of renal manifestations, most of them related to calcium metabolism. Children with renal sarcoidosis tend to be more symptomatic than adults, although male patients have a higher prevalence.
  • 588
  • 20 Apr 2023
Topic Review
Hypercalciuria and Urolithiasis
The link between hypercalciuria (HC) and urolithiasis (UL) has its roots in studies dated about one century ago. In 1939, Flocks RH reported on increased levels of calcium in the urine of stone former (SF) patients, supporting a direct role of increased urinary calcium concentration in the pathogenesis of UL. From then onward, a growing interest in the research field has been witnessed to better define the mechanisms and pathogenetic factors of HC, also suggesting diagnostic methodologies, easily executable in the real world of clinical medicine.
  • 584
  • 04 May 2023
Topic Review
Urinary Peptide and Proteomic Biomarkers in CKD
Biomarker development, improvement, and clinical implementation in the context of kidney disease have been a central focus of biomedical research. Only serum creatinine and urinary albumin excretion are well-accepted biomarkers in kidney disease. With their known blind spot in the early stages of kidney impairment and their diagnostic limitations, there is a need for better and more specific biomarkers. With the rise in large-scale analyses of the thousands of peptides in serum or urine samples using mass spectrometry techniques, hopes for biomarker development are high. Advances in proteomic research have led to the discovery of an increasing amount of potential proteomic biomarkers and the identification of candidate biomarkers for clinical implementation in the context of kidney disease management.
  • 572
  • 08 Jun 2023
Topic Review
Semaphorin 3A and Kidney Diseases
Kidney diseases are worldwide public health problems affecting millions of people. However, there are still limited therapeutic options against kidney diseases. Semaphorin 3A (SEMA3A) is a secreted and membrane-associated protein, which regulates diverse functions, including immune regulation, cell survival, migration and angiogenesis, thus involving in the several pathogeneses of diseases, including eyes and neurons, as well as kidneys. SEMA3A is expressed in podocytes and tubular cells in the normal adult kidney, and recent evidence has revealed that excess SEMA3A expression and the subsequent signaling pathway aggravate kidney injury in a variety of kidney diseases, including nephrotic syndrome, diabetic nephropathy, acute kidney injury, and chronic kidney disease. 
  • 568
  • 09 Oct 2023
Topic Review
Conservative Bladder Management and Medical Treatment
To review the available data on non-surgical management for neurogenic lower urinary tract dysfunction (NLUTD) in patients with chronic spinal cord injury (SCI) and provide the most updated knowledge for readers. Researchers categorized the bladder management approaches into storage and voiding dysfunction separately; both are minimally invasive, safe, and efficacious procedures. The main goals for NLUTD management are to achieve urinary continence; improve quality of life; prevent urinary tract infections and, last but not least, preserve upper urinary tract function. Annual renal sonography workups and regular video urodynamics examinations are crucial for early detection and further urological management.
  • 566
  • 17 Mar 2023
Topic Review
Importance of Nephrologist in Diuretic-Resistant Heart Failure Treatment
Heart failure is not only a global problem but also significantly limits the life prospects of these patients. The risk factors leading to heart failure are well known; however, the real challenge is to provide effective treatments. A vicious cycle develops in heart failure of all etiologies, sooner or later compromising both cardiac and kidney functions simultaneously. This can explain the repeated hospital admissions due to decompensation and the significantly reduced quality of life. Moreover, diuretic-refractory heart failure represents a distinct challenge due to repeated hospital admissions and increased mortality.
  • 565
  • 15 Jun 2023
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