Пнд, 10/12/2015 - 11:44 — admin

Greetings and warm welcome to the newest edition of our EMJ Nephrology newsletter. Featured below for your reading pleasure are the details of some of the most important upcoming kidney-related events happening around the world. Included among these is the 47thAnnual Meeting of the Swiss Society of Nephrology, 3rd–4th December 2015, which is centred on four main topics this year: basic science, clinical nephrology, dialysis, and transplantation. The meeting will feature a range of interesting presentations as the organisers guide their audience through a range of cutting-edge and fascinating developments. We also report on other exciting progress in the world of nephrology, including the identification of a novel cell–cell protein responsible for the protection of kidney cells; a discovery with the potential to change the face of kidney disease treatment. Keep reading for all the details and if you would like more of the same then please take a look at our EMJ Nephrology eJournal, available from our website.

 

Articles

 

Management of Refractory Lupus Nephritis
A Fanouriakis, G Bertsias
Despite the significant advances in the field, up to one-third of lupus nephritis (LN) patients still do not respond adequately to initial immunosuppressive treatment. This group of patients is heterogeneous in terms of clinical presentation (deterioration of glomerular filtration rate, variable degrees of persistent proteinuria, active urine sediment) and the potential for reversion (ongoing kidney inflammation versus irreversible damage due to scarring and fibrosis). A repeat kidney biopsy can be highly informative in this regard and should be strongly considered. High-quality evidence regarding the treatment of refractory LN is lacking, and management is largely based on observational studies and expert opinion. Options include switching between mycophenolate mofetil (MMF) and cyclophosphamide (CYC), using rituximab as monotherapy or add-on therapy, or combining MMF with a calcineurin inhibitor in cases of persistent proteinuria. Renal response can be maintained with MMF or prolonged pulses of intravenous CYC administered bimonthly or quarterly. The efficacy of novel biological agents and those under development in refractory forms of LN remains to be determined. Tight control of cardiovascular risk factors, use of hydroxychloroquine, immunisations, and osteoporosis prophylaxis are important adjunctive measures. For the future, we anticipate that research efforts for the identification of accurate biomarkers together with accumulating data from observational and controlled studies will assist therapeutic decisions and improve outcomes in patients with refractory LN.

 

Renal Transplantation in Autosomal Dominant Polycystic Kidney Disease
Andrzej Kulesza et al.
Autosomal dominant polycystic kidney disease (ADPKD) affects approximately 1 in 1,000 people in the general population. The natural history of ADPKD includes the progression of chronic kidney disease to end-stage renal disease (ESRD) in a large proportion of patients. Renal transplantation is the treatment modality of choice in these patients. However, there are some specific issues that should be addressed in ADPKD, and the aim of the current review is to describe the issues that need to be considered in the pre and post-transplant management of ADPKD patients, excluding routine procedures.

 

 

News Updates
 
TMIGD1: A Protein; an Immunoglobulin; a Protector of Kidney Cells
“This study demonstrates that by altering the function of TMIGD1, it is possible to reduce kidney epithelial cell death and possibly avoid the high incidence of kidney failure and morbidity associated with kidney injury.”
 
Cool Organ Donors May Improve Kidney Transplantation
“From these findings, potentially more organs could be available for transplantation since we can push the limits with these ‘marginal donors'.”
 

 

What’s Happening in EMJ: Nephrology

 

You can never be too prepared and that’s why all of us here at EMJ are already looking forward to the EAN Congress 2016, which will take place on 21st–24th May in the beautiful city of Copenhagen, Denmark. At the same time we are eagerly planning for the next edition of EMJ Nephrology – to be released early next July. Full coverage of the congress will be available in the next eJournal, alongside interesting new articles focussed on the most pressing topics in nephrology. To keep up to date with the eJournal and to join the debate on all the hottest topics, please visit us on our social media platforms, including Twitter, LinkedIn, and Facebook.