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Topic Review
Acid–Base Homeostasis and Renal Calcium–Phosphate Handling
Both calcium and phosphate metabolism are involved in acid–base homeostasis at several physiological intersections. Phosphate plays a key role in defense against metabolic acidosis, both as an intracellular and extracellular buffer, as well as in the renal excretion of excess H+ in the form of urinary titratable acid through this buffering reaction (Na2HPO4 ⇌ HPO42−+ 2Na and HPO42− + H+ ⇌ H2PO4−). The skeleton acts as an extracellular buffer in states of metabolic acidosis, as the acid-induced dissolution of bone hydroxyapatite releases Ca2+ and phosphate into the extracellular fluid (ECF).
  • 100
  • 21 Feb 2024
Topic Review
Post-Transplant Bone Disease in Kidney Transplant Recipients
Kidney transplantation is the preferred gold standard modality of treatment for kidney failure. Bone disease after kidney transplantation is highly prevalent in patients living with a kidney transplant and is associated with high rates of hip fractures. Fractures are associated with increased healthcare costs, morbidity and mortality. Post-transplant bone disease (PTBD) includes renal osteodystrophy, osteoporosis, osteonecrosis and bone fractures. PTBD is complex as it encompasses pre-existing chronic kidney disease–mineral bone disease and compounding factors after transplantation, including the use of immunosuppression and the development of de novo bone disease. After transplantation, the persistence of secondary and tertiary hyperparathyroidism, renal osteodystrophy, relative vitamin D deficiency and high levels of fibroblast growth factor-23 contribute to post-transplant bone disease. Risk assessment includes identifying both general risk factors and kidney-specific risk factors. Diagnosis is complex as the gold standard bone biopsy with double-tetracycline labelling to diagnose the PTBD subtype is not always readily available. Therefore, alternative diagnostic tools may be used to aid its diagnosis. 
  • 75
  • 18 Feb 2024
Topic Review
Therapies for Bone Metastasis in Prostate Cancer
In the absence of early detection and initial treatment, prostate cancer often progresses to an advanced stage, frequently spreading to the bones and significantly impacting patients’ well-being and healthcare resources. Therefore, managing patients with prostate cancer that has spread to the bones often involves using bone-targeted medications like bisphosphonates and denosumab to enhance bone structure and minimize skeletal complications. Additionally, researchers are studying the tumor microenvironment and biomarkers to understand the mechanisms and potential treatment targets for bone metastases in prostate cancer. 
  • 62
  • 17 Feb 2024
Topic Review
Molecular Scenario of Kidney Fibrosis and Oxidative Stress
Kidney fibrosis, diffused into the interstitium, vessels, and glomerulus, is the main pathologic feature associated with loss of renal function and chronic kidney disease (CKD). Fibrosis may be triggered in kidney diseases by different genetic and molecular insults. 
  • 132
  • 07 Feb 2024
Topic Review
Electrolyzed Hydrogen Water for CKD and Hemodialysis
Chronic kidney disease (CKD), which is globally on the rise, has become an urgent challenge from the perspective of public health, given its risk factors such as end-stage renal failure, cardiovascular diseases, and infections. The pathophysiology of CKD, including dialysis patients, is deeply associated with enhanced oxidative stress in both the kidneys and the entire body. Therefore, the introduction of a safe and widely applicable antioxidant therapy is expected as a measure against CKD. Electrolyzed hydrogen water (EHW) generated through the electrolysis of water has been confirmed to possess chemical antioxidant capabilities. In Japan, devices producing this water have become popular for household drinking water. In CKD model experiments conducted to date, drinking EHW has been shown to suppress the progression of kidney damage related to hypertension. Furthermore, clinical studies have reported that systemic oxidative stress in patients undergoing dialysis treatment using EHW is suppressed, leading to a reduction in the incidence of cardiovascular complications.
  • 46
  • 26 Jan 2024
Topic Review
Beneficial Effects of Capsaicin in Kidney Diseases
Capsaicin, the organic compound which attributes the spicy flavor and taste of red peppers and chili peppers, has been extensively studied for centuries as a potential natural remedy for the treatment of several illnesses. The identification of novel, effective renoprotective agents for improving the treatment of renal diseases remains a largely unmet need. Nowadays, promising evidence has been accumulated demonstrating different experimental benefits of capsaicin in some of the most important and complicated renal diseases, such as acute kidney injury (AKI) and diabetic kidney disease (DKD). Additionally, capsaicin may also play a protective role against renal fibrosis and pathological arterial calcifications, two hallmarks of progressive chronic kidney disease (CKD), and could partly antagonize the detrimental effects of nephrovascular and salt-sensitive hypertension.
  • 72
  • 23 Jan 2024
Topic Review
Impaired Pressure-Natriuresis
Blood pressure is a heritable trait because hypertension occurs with a familial tendency. The heritability of sitting and standing blood pressure was estimated to be between 39% and 63% in twins and between 16% and 22% in families. Although the brain, kidneys, and blood vessels are major organs involved in regulating blood pressure and inducing hypertension, the kidneys have a unique relationship with blood pressure, suggesting that some genetic factors elevating or decreasing blood pressure exist in the kidney.
  • 154
  • 23 Jan 2024
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.
  • 70
  • 22 Jan 2024
Topic Review
The Role of the Complement System in HUS
Hemolytic uremic syndrome (HUS) is an acute disease and the most common cause of childhood acute renal failure. HUS is characterized by a triad of symptoms: microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. In most of the cases, HUS occurs as a result of infection caused by Shiga toxin-producing microbes: hemorrhagic Escherichia coli and Shigella dysenteriae type 1. They account for up to 90% of all cases of HUS. The remaining 10% of cases grouped under the general term atypical HUS represent a heterogeneous group of diseases with similar clinical signs. Emerging evidence suggests that in addition to E. coli and S. dysenteriae type 1, a variety of bacterial and viral infections can cause the development of HUS. In particular, infectious diseases act as the main cause of aHUS recurrence. The pathogenesis of most cases of atypical HUS is based on congenital or acquired defects of complement system. 
  • 78
  • 22 Jan 2024
Topic Review
Dysuricemia on the Path toward Normouricemia
The disease concept of “dysuricemia” includes hyperuricemia and hypouricemia. Both influence diseases in humans. Uric acid plays dual roles in oxidative stress: it has both an anti-oxidative protective effect and a pro-oxidative and/or a harmful crystal-forming effect. Extensive research on the relationship between the serum urate (SU) level and several common disease risks show characteristic patterns that are broadly classifiable into three patterns: the “gout pattern,” “neurodegenerative disease (ND) pattern,” and “chronic kidney disease (CKD) and cardiovascular disease (CVD) pattern”. In short, “the lower, the better” is incorrect; the ideal is to maintain normouricemia, or an optimal SU level, to reduce the risks of the common diseases associated with dysuricemia.
  • 85
  • 22 Jan 2024
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