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Topic Review
Inflammation in Chronic Kidney Disease
Chronic kidney disease (CKD) affects many adults worldwide. Persistent low-grade inflammation is a substantial factor in its development and progression and has correlated with increased mortality and cardiovascular problems. This low-grade inflammation is a product of dysregulation of the normal balance between pro- and anti-inflammatory markers. Various factors such as increased innate immune system activation, reactive oxygen species production, periodontal disease, dysregulation of anti-inflammatory systems and intestinal dysbiosis result in the dysregulation of this balance.
  • 827
  • 15 Jun 2023
Topic Review
Bariatric Surgery in Patients with Chronic Kidney Disease
Morbid obesity is considered a civilization disease of the 21st century. Not only does obesity increase mortality, but it is also the most important cause of the shortening life expectancy in the modern world. Obesity is associated with many metabolic abnormalities: dyslipidemia, hyperglycemia, cardiovascular diseases, and others. An increasing number of patients diagnosed with chronic kidney disease (CKD) are obese. Numerous additional disorders associated with impaired kidney function make it difficult to conduct slimming therapy and may also be associated with a greater number of complications than in people with normal kidney function.
  • 824
  • 10 Jan 2023
Topic Review
XBP1 Modulates the Aging Cardiorenal System
X-box binding protein 1 (XBP1) is a unique basic-region leucine zipper (bZIP) transcription factor. Over recent years, the powerful biological functions of XBP1 in oxidative stress have been gradually revealed. When the redox balance remains undisturbed, oxidative stress plays a role in physiological adaptations and signal transduction. However, during the aging process, increased cellular senescence and reduced levels of endogenous antioxidants cause an oxidative imbalance in the cardiorenal system.
  • 822
  • 15 Nov 2023
Topic Review
Relations of  UCD and PKU in Rare Diseases
Rare diseases are defined as uncommon conditions with a prevalence of less than 50 per 100,000 (1 in 2000) people or less than 200,000 people in the US. Among all rare diseases, urea cycle disorder (UCD) and phenylketonuria (PKU) are associated with executive dysfunction.
  • 814
  • 12 Oct 2022
Topic Review
Glomerular Filtration Rate' Prognostic Potential
Tumors originating in urothelial cells, including ureter to renal pelvis, are known as upper tract urothelial carcinomas (UTUCs). 
  • 804
  • 28 Sep 2021
Topic Review
Pathophysiology of Radiocontrast-Induced Nephropathy
Contrast-induced nephropathy (CIN) is an impairment of renal function that occurs after the administration of an iodinated contrast medium (CM). Kidney dysfunction in CIN is considered transient and reversible in most cases. However, it is the third most common cause of hospital-acquired acute kidney injury and is associated with increased morbidity and mortality, especially in high-risk patients. Diagnostic and interventional procedures that require intravascular CM are being used with increasing frequency, especially among the elderly, who can be particularly susceptible to CIN due to multiple comorbidities. Therefore, identifying the exact mechanisms of CIN and its associated risk factors is crucial not only to provide optimal preventive management for at-risk patients, but also to increase the feasibility of diagnostic and interventional procedure that use CM.
  • 801
  • 03 Mar 2022
Topic Review
Immune Checkpoint Inhibitors in Urothelial Carcinoma
Urothelial carcinoma is a malignancy that originates in the genitourinary tract. It is a heterogeneous disease that can present at different stages, and the treatment options vary in efficacy. Advances in immunotherapy stimulated adoption in urothelial carcinoma, and published trials have shown promising results when compared to conventional therapies. However, oncologic drugs are historically costly, and immunotherapy is no exception. A cost-effectiveness analysis is a standardized method of weighing the clinical benefits of an intervention against the financial burden to obtain a composite proposed value. Multiple investigators have assessed immunotherapy in urothelial carcinoma, but no consensus has been reached. 
  • 799
  • 29 Dec 2021
Topic Review
Role of Carbohydrates in Chronic Kidney Disease
Patients with chronic kidney disease (CKD) have a higher cardiovascular risk compared to the average population, and this is partially due to the plasma accumulation of solutes known as uremic toxins. The binding of some solutes to plasma proteins complicates their removal via conventional therapies, e.g., hemodialysis. Protein-bound uremic toxins originate either from endogenous production, diet, microbial metabolism, or the environment. Although the impact of diet on uremic toxicity in CKD is difficult to quantify, nutrient intake plays an important role. Dietary carbohydrates can be classified according to their degree of polymerization into sugars, including monosaccharides, disaccharides, polyols, oligosaccharides, and polysaccharides. Due to their role in CKD, especially reducing sugars, i.e., sugars that, because of their aldehyde or ketone group, act as reducing agents in basic solutions. 
  • 788
  • 14 Feb 2023
Topic Review
Altered Pathways in Fabry Disease
Fabry disease is a rare X-linked disease characterized by deficient expression and activity of alpha-galactosidase A (α-GalA) with consequent lysosomal accumulation of glycosphingolipid in various organs. Enzyme replacement therapy is the cornerstone of the treatment of all Fabry patients, although in the long-term it fails to completely halt the disease’s progression. This suggests on one hand that the adverse outcomes cannot be justified only by the lysosomal accumulation of glycosphingolipids and on the other that additional therapies targeted at specific secondary mechanisms might contribute to halt the progression of cardiac, cerebrovascular, and renal disease that occur in Fabry patients. 
  • 785
  • 15 Mar 2023
Topic Review
Single-Port Robot-Assisted Radical Prostatectomy
In 2018, the da Vinci Single Port (SP) robotic system was approved by the US Food and Drug Administration for urologic procedures. Available studies for the application of SP to prostate cancer surgery are limited. SP-RALP is safe and feasible, and it can offer comparable outcomes to the standard multiport RALP. Extraperitoneal and transvesical SP-RALP appear to be the two most promising approaches, as they offer decreased invasiveness, potentially shorter length of stay, and better pain control. Long-term, high-quality data are missing and further validation with prospective studies across different sites is required.
  • 783
  • 06 May 2023
Topic Review
Exosomal miRNA in Bladder Cancer
Bladder cancer (BCa) is the most prevalent neoplasia of the urinary tract. 
  • 781
  • 01 Apr 2021
Topic Review
Double J Stents and Reno–Ureteral Lithiasis during COVID-19
Urolithiasis, or kidney stone disease, is a common urological condition that often necessitates emergency medical attention. During the COVID-19 epidemic, significant shifts occurred in the available options for treating urinary stones. Obstructed reno–ureteral stones or infected ones should be treated as an emergency by decompression. Ureteral stents were a safe, efficient, and cost-effective procedure for urolithiasis during the COVID-19 pandemic. In addition, they reduce the risk of infection and hospital visits. Therefore, it was a valuable option in urolithiasis treatment during the pandemic.
  • 781
  • 10 Nov 2023
Topic Review
Peritoneal Damage in Chronic Kidney Disease Patients
Chronic kidney disease (CKD) incidence is growing worldwide, with a significant percentage of CKD patients reaching end-stage renal disease (ESRD) and requiring kidney replacement therapies (KRT). Peritoneal dialysis (PD) is a convenient KRT presenting benefices as home therapy. In PD patients, the peritoneum is chronically exposed to PD fluids containing supraphysiologic concentrations of glucose or other osmotic agents, leading to the activation of cellular and molecular processes of damage, including inflammation and fibrosis.
  • 780
  • 29 Mar 2023
Topic Review
Urinary Bladder Cancer
Urinary bladder cancer (UBC) is the most common malignancy of the urinary tract in humans, with an estimated global prevalence of 1.1 million cases over 5 years. Because of its high rates of recurrence and resistance to chemotherapy, UBC is one of the most expensive cancers to treat, resulting in significant health care costs.
  • 779
  • 28 Jan 2021
Topic Review
Proteinuric Kidney Disease/Nephrotic Syndrome
Proteinuria is known to be associated with all-cause and cardiovascular mortality, and nephrotic syndrome is defined by the level of proteinuria and hypoalbuminemia. With advances in medicine, new causative genes for genetic kidney diseases are being discovered increasingly frequently.
  • 779
  • 04 Jul 2023
Topic Review
Efficacy of Immune Checkpoint Inhibitors
Upper tract urothelial carcinoma (UTUC) represents 5 to 10% of urothelial carcinoma. Their mutational profile is different as compared to bladder urothelial carcinoma (UC). While immune checkpoint inhibitors are now part of the therapeutic landscape of urothelial carcinoma, data concerning their use in UTUC patient’s treatment remain scarce. We reviewed the latest molecular characterization data and proposed an insight for future therapeutic strategies based on molecular alteration profiles.
  • 775
  • 02 Nov 2021
Topic Review
Cancer Treatment Vaccines for Treatment of Prostate Cancer
Prostate cancer (PCa) is the most commonly diagnosed cancer and the second most common cause of death due to cancer. About 30% of patients with PCa who have been castrated develop a castration-resistant form of the disease (CRPC), which is incurable. In the last decade, new treatments that control the disease have emerged, slowing progression and spread and prolonging survival while maintaining the quality of life. These include immunotherapies; however, we do not yet know the optimal combination and sequence of these therapies with the standard ones. All therapies are not always suitable for every patient due to co-morbidities or adverse effects of therapies or both, so there is an urgent need for further work on new therapeutic options. Advances in cancer immunotherapy with an immune checkpoint inhibition mechanism (e.g., ipilimumab, an anti-CTLA-4 inhibitor) have not shown a survival benefit in patients with CRPC. Other immunological approaches have also not given clear results, which has indirectly prevented breakthrough for this type of therapeutic strategy into clinical use. Currently, the only approved form of immunotherapy for patients with CRPC is a cell-based medicine, but it is only available to patients in some parts of the world. Based on what was gained from recently completed clinical research on immunotherapy with dendritic cell-based immunohybridomas, the aHyC dendritic cell vaccine for patients with CRPC, the current status and possible alternatives should be considered in the future.
  • 774
  • 07 Jul 2023
Topic Review
Gut-Derived and Cardiovascular Dysfunction in Experimental AKI Models
The formation and metabolism of IS, PCS, and IAA, from their precursors (indole for IS and IAA and p-cresol for PCS), produced by gut microbiota, to their kidney excretion through organic anion transporters (OATs) and the mechanisms that lead to their accumulation in kidney disease, have been well described in recent reviews. A number of experimental studies have explored the relationship between gut microbiota and the kidney in acute and chronic models, highlighting inter-organ crosstalk. Kidney failure is indeed responsible for the disturbance of the gut microbiota, and dysbiosis is linked to the progression of kidney failure. However, factors that may influence PBUT accumulation in the gut–kidney axis appear to be different between CKD and AKI. In CKD, external factors associated with a specific diet (low fiber intake), longterm antibiotic treatment, phosphate binder treatment, and iron supplementation, and the internal factor of high urea levels modify the gut microbiota and intestinal barrier permeability. Although AKI and CKD may share common factors, such as a specific diet or the use of antibiotics, a reduction in short-chain fatty acid levels in AKI may play a specific role in the formation of PBUTs by favoring an inflammatory state associated with intestinal barrier disruption. 
  • 773
  • 30 May 2022
Topic Review
Etiology of Hyponatremia
A perturbation in the water balance rather than any change in salt content is the main cause of hyponatremia, the most frequent electrolyte abnormality, defined as a serum sodium concentration <135 mEq/L. Hyponatremia may be divided between mild (Na > 120 mEq/L) or severe (Na < 120 mEq/L) hyponatremia, and is most frequently observed in elderly ICU hospitalized patients. Based on tonicity, hyponatremia may be hypotonic (a decreased concentration of the solute), isotonic, and hypertonic (falsely low sodium). According to the volume of extracellular fluid (ECF), hyponatremia is further divided among hypovolemic, euvolemic, or hypervolemic hyponatremia. Finally, hyponatremia may develop rapidly as acute (<48 h), usually with severe symptoms, or slowly as chronic hyponatremia, usually being asymptomatic or with mild symptoms. Acute severe hyponatremia presents with severe CNS problems, increased hospitalization rates, and mortality. The treatment with 3% sodium chloride and a 100 mL IV bolus based on severity and persistence of symptoms needs careful monitoring. A non-severe hyponatremia may be treated with oral urea. In asymptomatic mild hyponatremia, an adequate solute intake with an initial fluid restriction of 500 mL/d adjusted according to the serum sodium levels is preferred. Vaptans could be considered in patients with high ADH activity regardless of whether they are euvolemic or hypervolemic. In general, the treatment of hyponatremia should be based on the underlying cause, the duration and degree of hyponatremia, the observed symptoms, and volume status of patient.
  • 757
  • 01 Mar 2024
Topic Review
Epigenetics and Age-Related Kidney Diseases
The main types of epigenetic processes including DNA methylation, histone modifications, non-coding RNA (ncRNA) modulation have all been implicated in the progression of age-related kidney diseases, and therapeutic targeting of these processes will yield novel therapeutic strategies for the prevention and/or treatment of age-related kidney diseases.
  • 755
  • 22 Jun 2022
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