Pathogenesis and Treatment Progress of Chronic Kidney Diseases Volume II

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Cell Biology and Pathology".

Deadline for manuscript submissions: closed (31 January 2024) | Viewed by 15542

Special Issue Editor


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Guest Editor
Division of Nephrology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung 807, Taiwan
Interests: glomerulonephritis; podocyte biology
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Special Issue Information

Dear Colleagues,

Chronic kidney disease (CKD) care has been recognized by the WHO as one of global burdens, and the related health threat is becoming more serious in most countries. Understanding the detailed pathogenesis is of prime importance to ameliorate disease care and improve outcome. Aging and metabolic derangement are undoubtedly universal causes, even though the pathogenic factors may vary between areas and countries. Against the backdrop of hyperendemic obesity and epidemic diabetes, diabetic kidney disease has taken over a large part of clinical care in nephrology practice. Nevertheless, glomerulonephritis is still prevalent, and the principal role of basic researches on cellular pathogenic mechanism still holds. In the past, it is fair to state that there is no specific pharmacological treatment for CKD, with only a renin-angiotensin system blockade and others which are rare and barely qualified. Optimistically, several lines of recently developed agents have cast new light on the effective treatment of CKD. Of them, inhibitors of sodium-dependent glucose cotransporters receive the most worldwide attention. Clinical studies with other lines of medications are ongoing and may hopefully reshape the specific treatment in the future. Eventually, we can advance the care of chronic kidney disease patients through the continuous efforts of both basic and clinical researches.

Dr. Jer-Ming Chang
Guest Editor

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Keywords

  • kidney disease
  • kidney health
  • chronic kidney disease
  • glomerulonephritis
  • diabetic kidney disease
  • SGLT2i

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Related Special Issue

Published Papers (6 papers)

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Review

16 pages, 3708 KiB  
Review
Renal Arterial and Venous Doppler in Cardiorenal Syndrome: Pathophysiological and Clinical Insights
by Roberta Barone, Vito Di Terlizzi, Giovanni Goffredo, Domenico Paparella, Natale Daniele Brunetti and Massimo Iacoviello
Biomedicines 2024, 12(6), 1166; https://doi.org/10.3390/biomedicines12061166 - 24 May 2024
Viewed by 2979
Abstract
In recent decades, there has been considerable effort in investigating the clinical utility of renal Doppler measurements in both cardiovascular and renal disorders. In particular, a measure of renal arterial resistance, the renal resistive index (RRI), has been demonstrated to predict chronic kidney [...] Read more.
In recent decades, there has been considerable effort in investigating the clinical utility of renal Doppler measurements in both cardiovascular and renal disorders. In particular, a measure of renal arterial resistance, the renal resistive index (RRI), has been demonstrated to predict chronic kidney disease progression and acute kidney injury in different clinical settings. Furthermore, it is linked to a poorer prognosis in individuals suffering from chronic heart failure. Examining the renal venous flow through pulsed Doppler can offer additional insights into renal congestion and cardiovascular outcomes for these patients. This review seeks to summarize the existing data concerning the clinical significance of arterial and venous renal Doppler measurements across various cardiovascular and renal disease contexts. Full article
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18 pages, 6592 KiB  
Review
A Primer for Utilizing Deep Learning and Abdominal MRI Imaging Features to Monitor Autosomal Dominant Polycystic Kidney Disease Progression
by Chenglin Zhu, Xinzi He, Jon D. Blumenfeld, Zhongxiu Hu, Hreedi Dev, Usama Sattar, Vahid Bazojoo, Arman Sharbatdaran, Mohit Aspal, Dominick Romano, Kurt Teichman, Hui Yi Ng He, Yin Wang, Andrea Soto Figueroa, Erin Weiss, Anna G. Prince, James M. Chevalier, Daniil Shimonov, Mina C. Moghadam, Mert Sabuncu and Martin R. Princeadd Show full author list remove Hide full author list
Biomedicines 2024, 12(5), 1133; https://doi.org/10.3390/biomedicines12051133 - 20 May 2024
Viewed by 2169
Abstract
Abdominal imaging of autosomal dominant polycystic kidney disease (ADPKD) has historically focused on detecting complications such as cyst rupture, cyst infection, obstructing renal calculi, and pyelonephritis; discriminating complex cysts from renal cell carcinoma; and identifying sources of abdominal pain. Many imaging features of [...] Read more.
Abdominal imaging of autosomal dominant polycystic kidney disease (ADPKD) has historically focused on detecting complications such as cyst rupture, cyst infection, obstructing renal calculi, and pyelonephritis; discriminating complex cysts from renal cell carcinoma; and identifying sources of abdominal pain. Many imaging features of ADPKD are incompletely evaluated or not deemed to be clinically significant, and because of this, treatment options are limited. However, total kidney volume (TKV) measurement has become important for assessing the risk of disease progression (i.e., Mayo Imaging Classification) and predicting tolvaptan treatment’s efficacy. Deep learning for segmenting the kidneys has improved these measurements’ speed, accuracy, and reproducibility. Deep learning models can also segment other organs and tissues, extracting additional biomarkers to characterize the extent to which extrarenal manifestations complicate ADPKD. In this concept paper, we demonstrate how deep learning may be applied to measure the TKV and how it can be extended to measure additional features of this disease. Full article
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26 pages, 1349 KiB  
Review
Role of Nutrients in Pediatric Non-Dialysis Chronic Kidney Disease: From Pathogenesis to Correct Supplementation
by Flavia Padoan, Matteo Guarnaroli, Milena Brugnara, Giorgio Piacentini, Angelo Pietrobelli and Luca Pecoraro
Biomedicines 2024, 12(4), 911; https://doi.org/10.3390/biomedicines12040911 - 19 Apr 2024
Cited by 3 | Viewed by 1746
Abstract
Nutrition management is fundamental for children with chronic kidney disease (CKD). Fluid balance and low-protein and low-sodium diets are the more stressed fields from a nutritional point of view. At the same time, the role of micronutrients is often underestimated. Starting from the [...] Read more.
Nutrition management is fundamental for children with chronic kidney disease (CKD). Fluid balance and low-protein and low-sodium diets are the more stressed fields from a nutritional point of view. At the same time, the role of micronutrients is often underestimated. Starting from the causes that could lead to potential micronutrient deficiencies in these patients, this review considers all micronutrients that could be administered in CKD to improve the prognosis of this disease. Full article
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19 pages, 743 KiB  
Review
Improving Kidney Disease Care: One Giant Leap for Nephrology
by Michele Provenzano, Lilio Hu, Edoardo Tringali, Massimo Senatore, Roberta Talarico, Michele Di Dio, Chiara Ruotolo, Gaetano La Manna, Carlo Garofalo and Gianluigi Zaza
Biomedicines 2024, 12(4), 828; https://doi.org/10.3390/biomedicines12040828 - 9 Apr 2024
Cited by 4 | Viewed by 1931
Abstract
Nephrology is an ever-evolving field of medicine. The importance of such a discipline is related to the high clinical impact of kidney disease. In fact, abnormalities of kidney function and/or structure are common in the general population, reaching an overall prevalence of about [...] Read more.
Nephrology is an ever-evolving field of medicine. The importance of such a discipline is related to the high clinical impact of kidney disease. In fact, abnormalities of kidney function and/or structure are common in the general population, reaching an overall prevalence of about 10%. More importantly, the onset of kidney damage is related to a strikingly high risk of cardiovascular events, mortality, and progression to kidney failure which, in turn, compromises quality and duration of life. Attempts to comprehend the pathogenesis and molecular mechanisms involved in kidney disease occurrence have prompted the development and implementation of novel drugs in clinical practice with the aim of treating the ‘specific cause’ of kidney disease (including chronic kidney disease, glomerular disease, and genetic kidney disorders) and the main immunological complications following kidney transplantation. Herein, we provide an overview of the principal emerging drug classes with proved efficacy in the context of the aforementioned clinical conditions. This can represent a simplified guide for clinical nephrologists to remind them of the vast and heterogeneous armamentarium of drugs that should be used in the present and the future to improve the management of patients suffering from kidney disease. Full article
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23 pages, 2507 KiB  
Review
Is Chronic Kidney Disease Due to Cadmium Exposure Inevitable and Can It Be Reversed?
by Soisungwan Satarug
Biomedicines 2024, 12(4), 718; https://doi.org/10.3390/biomedicines12040718 - 23 Mar 2024
Cited by 2 | Viewed by 2372
Abstract
Cadmium (Cd) is a metal with no nutritional value or physiological role. However, it is found in the body of most people because it is a contaminant of nearly all food types and is readily absorbed. The body burden of Cd is determined [...] Read more.
Cadmium (Cd) is a metal with no nutritional value or physiological role. However, it is found in the body of most people because it is a contaminant of nearly all food types and is readily absorbed. The body burden of Cd is determined principally by its intestinal absorption rate as there is no mechanism for its elimination. Most acquired Cd accumulates within the kidney tubular cells, where its levels increase through to the age of 50 years but decline thereafter due to its release into the urine as the injured tubular cells die. This is associated with progressive kidney disease, which is signified by a sustained decline in the estimated glomerular filtration rate (eGFR) and albuminuria. Generally, reductions in eGFR after Cd exposure are irreversible, and are likely to decline further towards kidney failure if exposure persists. There is no evidence that the elimination of current environmental exposure can reverse these effects and no theoretical reason to believe that such a reversal is possible. This review aims to provide an update on urinary and blood Cd levels that were found to be associated with GFR loss and albuminuria in the general populations. A special emphasis is placed on the mechanisms underlying albumin excretion in Cd-exposed persons, and for an accurate measure of the doses–response relationships between Cd exposure and eGFR, its excretion rate must be normalised to creatinine clearance. The difficult challenge of establishing realistic Cd exposure guidelines such that human health is protected, is discussed. Full article
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17 pages, 2039 KiB  
Review
Application of Machine Learning in Chronic Kidney Disease: Current Status and Future Prospects
by Charlotte Delrue, Sander De Bruyne and Marijn M. Speeckaert
Biomedicines 2024, 12(3), 568; https://doi.org/10.3390/biomedicines12030568 - 3 Mar 2024
Cited by 3 | Viewed by 3593
Abstract
The emergence of artificial intelligence and machine learning (ML) has revolutionized the landscape of clinical medicine, offering opportunities to improve medical practice and research. This narrative review explores the current status and prospects of applying ML to chronic kidney disease (CKD). ML, at [...] Read more.
The emergence of artificial intelligence and machine learning (ML) has revolutionized the landscape of clinical medicine, offering opportunities to improve medical practice and research. This narrative review explores the current status and prospects of applying ML to chronic kidney disease (CKD). ML, at the intersection of statistics and computer science, enables computers to derive insights from extensive datasets, thereby presenting an interesting landscape for constructing statistical models and improving data interpretation. The integration of ML into clinical algorithms aims to increase efficiency and promote its adoption as a standard approach to data interpretation in nephrology. As the field of ML continues to evolve, collaboration between clinicians and data scientists is essential for defining data-sharing and usage policies, ultimately contributing to the advancement of precision diagnostics and personalized medicine in the context of CKD. Full article
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