Nephrology

The exact mechanism of benefit with steroids in minimal change nephrotic syndrome is not known. The authors show that adriamycin treatment causes rearrangement of actin cytoskeleton of podocytes, which is restored by dexamethasone. This action is mediated via alpha-actinin 4.

Newer drugs that have been useful in transplantation may find a niche in treating immune renal disease. Yap et al. present their recent experience with sirolimus and everolimus in lupus nephritis.

The authors report the incidence of infection and its associated factor in children with nephrotic syndrome (NS) from the viewpoint of public health in Taiwan, using the Taiwan National Health Insurance Database.

This study demonstrated decreased serum carnitine levels and elevated skin advanced glycation end products in haemodialysis patients, and provides a possible novel marker of cardiovascular outcomes in this group of patients.

The results showed that the multi-frequency bioimpedance analysis (MFBIA)-derived total body water change has the best agreement with acute clinical volume change during haemodialysis compared to extracellular or intracellular volume change alone in end-stage renal disease patients during haemodialysis. MFBIA nutritional measures are confounded by hydration status, except for fat mass.

The percentage of home dialysis in Australia has steadily decreased over the past 40 years. Consumer factors related to the delivery of pre-dialysis education do not support all options of dialysis for all individuals. State variances indicate that local policy and health professional teams significantly influence the operation of dialysis programs.

This paper examines the complex relationship betwen peripheral neuropathy and itch in patients receiving haemodialysis and considers whether treatment with gabapentin or pregabalin provides effective therapy. Either treatment was useful for modification of both pruritus and neuropathic pain. Further trials are required to explore this in greater detail.

This study shows that elevated serum levels of soluble VCAM-1 and ICAM-1 are associated with peripheral artery disease in haemodialysis patients, and suggests that these adhesion molecules can be used as a biomarker for cardiovascular disease.

This article demonstrates that low estimated glomerular filtration rate measured at the first day of admission of ischemic stroke is a good predictor of death.

Wang et al. evaluated the bacterial translocation in the intestinal tract in non-dialysed ESRD patients and its contribution to micoinflammation in the patient population.

Stayner et al. investigated the effect of rapamycin on polycystic kidney disease in utero. Their data showed the potential beneficial effects of rapamycin administered during pregnancy in a rodent model of polycystic kidney disease, while cyst number remains unchanged; the size of the cysts is reduced by rapamycin treatment. Furthermore, they also showed that the inhibition of the mTOR pathway by rapamycin most likely is not mediated via Pax2 in their experimental animal model. The result provides evidence that mTOR inhibition may be therapeutically useful for slowing the progression of polycystic kidney disease with a prenatal onset.

Effects of steroids in acute tubulointerstitial nephritis (ATIN) are still controversial. This study shows a greater degree of improvement in renal function in steroid-treated patients with ATIN. Yet, no correlation was shown between the degree of renal recovery and delay in starting steroids.

This paper details how PD catheter revision may be an alternative option to catheter removal for refractory exit site infections and tunnel infections. This involves the removal of the external cuff and infected tissue above the internal cuff and creation of a new subcutaneous tunnel and exit-site under local anaesthetic. There were 36 catheter revisions performed and the outcomes are presented in addition to details of this group's PD exit site infection rate, organisms involved and outcomes over 32 581 PD patient months.

In this study, mice developed hypocalcaemia and hyperparathyroidism following ureteric obstruction. The authors describe subsequent changes in the mRNA expression of target genes and microarchitectrural changes in the proximal tibia, likely to be precursors of renal osteodystrophy. They suggest that in addition to established genetic pathways, the renin-angiotensin system may also be involved.