The American Heart Association (AHA) recently published a scientific statement on the diagnosis, blood pressure goals, and pharmacotherapy of hypertension in pregnancy (1). Although hypertensive disorders of pregnancy are associated with high maternal and fetal mortality and morbidity (Figures 1 and 2), little has changed in their diagnosis and treatment in the United States over the past decades. Hypertension in pregnancy continues to be defined as blood pressure ≥140/90 mm Hg by most societies, including the International Society for the Study of Hypertension in Pregnancy (ISSHP), despite lowering the threshold in the general population
Matthew A. Sparks and on behalf of the AHA KCVD Council
Inspired by the success of the ASN Innovations in Kidney Education Contest, the American Heart Association (AHA) Council on the Kidney in Cardiovascular Disease (KCVD) is launching a contest to promote educational tools spanning heart disease and kidney diseases. Although the role of the kidney in cardiovascular disease (CVD) is widely recognized among nephrologists, there is a paucity of education about this among primary care practitioners, during medical school, and in residency training. Whereas novel therapies are continuing to be developed (sodium glucose co-transporter 2 [SGLT2] inhibitors, for example), it is imperative to develop new teaching tools that can be
The American Society of Nephrology (ASN) and the American Association of Kidney Patients (AAKP) partnered together for the 10th Annual Kidney Health Advocacy Day on March 23. Advocates from both organizations met virtually with representatives, senators, and their respective staffs to urge Congress to support key legislative priorities including the following:
supporting kidney health research at the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK),
funding kidney health innovation for Kidney Innovation Accelerator (KidneyX), and
protecting living donors to increase organs available for transplant.
Kidney research leads to the discovery of new methods to detect kidney diseases, and
Steven Menez, Ashveena L. Dighe, Ian H. de Boer, and for the Kidney Precision Medicine Project
The Kidney Precision Medicine Project (KPMP) is a National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)-funded, multi-year collaboration of leading research institutions across the United States that aims to better understand the mechanisms of acute kidney injury (AKI) and chronic kidney disease (CKD) (1).
Our understanding of the pathophysiology of certain kidney diseases has improved dramatically in recent years, with discovery of the genetic mechanisms behind phenotypes, such as non-diabetic focal segmental glomerular sclerosis in patients with high-risk APOL1 genotypes (2). However, CKD and, in particular, AKI are defined broadly using serum creatinine and
A series of clinical trials demonstrated promising outcomes of sodium glucose co-transporter 2 (SGLT2) inhibitors, a novel class of anti-diabetic drugs, in patients with heart failure (HF), with either reduced ejection fraction or preserved ejection fraction. Of note, these positive outcomes are irrespective of the diabetic status and with rapid onset, suggesting the clinical benefits of SGLT2 inhibition are not fully attributable to glycemic control. Based on various experimental studies, a substantial number of hypotheses have been proposed to explain the beneficial effects of SGLT2 inhibition in HF. These effects can be divided into two groups: indirect systemic effects and
Jeanne A. Ishimwe, Valentina Kon, and Annet Kirabo
Persistent systemic inflammation is a hallmark of chronic kidney disease (CKD) and several of its risk factors, including diabetes and hypertension. The gut microbiome is defined as the microorganisms and their genetic material in the intestinal tract. Emerging evidence has substantiated the gut microbiome as a key mediator of inflammation in various pathophysiologic states, including kidney diseases (1, 2). Patients with kidney failure on dialysis also exhibit bacterial translocation from the intestines to the circulation, contributing to microinflammation (3). Bacterial translocation is reported in other pathologies, including hypertension and autoimmunity (4,
Laura H. Mariani, Laura Barisoni, Debbie S. Gipson, Lawrence B. Holzman, Crystal Gadegbeku, John R. Sedor, and Matthias Kretzler
Patients with newly diagnosed nephrotic syndrome due to minimal change disease (MCD), focal segmental glomerulosclerosis (FSGS), and membranous nephropathy (MN) display an impressive amount of variability in disease severity, symptom burden, response to initial therapy, and risk of relapse. Although this heterogeneity is a clinical challenge—frustrating patients and clinicians alike—it is also an opportunity for researchers to partner with patients under routine clinical care to collect the data and bio-samples needed to better define mechanistically relevant subgroups. The Nephrotic Syndrome Study Network (NEPTUNE) is a North American multi-center collaborative consortium that was established to develop such a translational research infrastructure
Ten years ago, human kidney organoids were but twinkles in the eyes of a few intrepid inventors. Now, these tiny collections of cells, which bear a striking resemblance to kidney tissue, are well on their way to becoming a standard research tool. As they spread, kidney organoids are also becoming more diverse and gaining new abilities.
The ability of organoids to mimic features of kidney diseases presents new opportunities to discover medications and exciting possibilities for regenerative medicine. To generate the structures more reproducibly and optimize their shapes and sizes, a technique, called cellular extrusion bioprinting, has recently been introduced
For the greater part of the 20th century, exogenous insulin administration and whole organ pancreatic transplantation served as the predominant therapeutic interventions for patients with type 1 diabetes mellitus. The success of the Edmonton group in achieving insulin independence in the early 2000s via islet cell transplantation in a cohort of patients with autoimmune diabetes led to renewed optimism that this treatment could serve as an alternative to solid organ transplantation (1). However, 16 years later, a shortage of donor pancreatic islet cells remains a major challenge in increasing the scale of human allogeneic islet transplantation.
Basic science is fundamental to advancing medicine and improving health outcomes. It is an exciting time to be engaged in basic and translational research focusing on kidney diseases. Novel research tools and methodologies are available to answer questions that have long eluded scientists. Moreover, we are seeing investments in kidney-related research by pharmaceutical companies, industry, societies, and governments. Examples of these investments include the Kidney Precision Medicine Project (KPMP), funded by the National Institute of Diabetes and Digestive and Kidney Diseases; the Transformative Research in Diabetic Nephropathy (TRIDENT) study, which is a private-public partnership; the Kidney Innovation Accelerator (KidneyX) prize;