Pub Date : 2025-11-20DOI: 10.1038/s41581-025-01035-z
Piero Ruggenenti, Giuseppe Remuzzi
Standard treatments to reduce cardiovascular risk, including mineralocorticoid receptor antagonists, have not lowered the high cardiovascular mortality and morbidity of patients on long-term haemodialysis. Future research should focus on targeting inflammatory pathways that are activated when blood interacts with dialysis membranes.
{"title":"Still searching for the right target for cardioprotection in haemodialysis","authors":"Piero Ruggenenti, Giuseppe Remuzzi","doi":"10.1038/s41581-025-01035-z","DOIUrl":"10.1038/s41581-025-01035-z","url":null,"abstract":"Standard treatments to reduce cardiovascular risk, including mineralocorticoid receptor antagonists, have not lowered the high cardiovascular mortality and morbidity of patients on long-term haemodialysis. Future research should focus on targeting inflammatory pathways that are activated when blood interacts with dialysis membranes.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 1","pages":"10-11"},"PeriodicalIF":39.8,"publicationDate":"2025-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.nature.comhttps://www.nature.com/articles/s41581-025-01035-z.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145554136","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-12DOI: 10.1038/s41581-025-01033-1
Vivekanand Jha
A new study reports that in 2010–2019, mortality owing to non-communicable diseases continued to decline in the majority of countries worldwide. However, the data also highlight major disparities between countries and a widespread slowing of progress in reducing mortality compared to the previous decade.
{"title":"Slowing of progress in reducing non-communicable disease mortality","authors":"Vivekanand Jha","doi":"10.1038/s41581-025-01033-1","DOIUrl":"10.1038/s41581-025-01033-1","url":null,"abstract":"A new study reports that in 2010–2019, mortality owing to non-communicable diseases continued to decline in the majority of countries worldwide. However, the data also highlight major disparities between countries and a widespread slowing of progress in reducing mortality compared to the previous decade.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 1","pages":"8-9"},"PeriodicalIF":39.8,"publicationDate":"2025-11-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145492527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-11DOI: 10.1038/s41581-025-01020-6
Gabriel Stölting, Kieu Nhi Tran Vo, Janek Haus, Ute I. Scholl
Hypertension, or persistently elevated blood pressure, affects about one third of the adult population worldwide and causes approximately 8.5 million deaths annually. Family studies have demonstrated that blood pressure shows substantial heritability, suggesting that genetic factors contribute to hypertension. Linkage studies and next-generation sequencing efforts have identified several variants with large effect sizes that cause rare monogenic hypertension syndromes. These syndromes often present with early onset and typically affect adrenal and renal regulation of salt reabsorption. In addition, somatic (tumour-specific) mutations have been identified in hormone-producing tumours that cause hypertension (phaeochromocytomas, aldosterone-producing adenomas, cortisol-producing adenomas, pituitary adenomas, reninomas). However, most cases of hypertension are polygenic. Large genome-wide association studies have identified many variants with small effect sizes that add to our understanding of blood pressure as a complex trait. Epigenetic mechanisms also influence gene expression and contribute to blood-pressure alterations. Several proteins that are affected by Mendelian diseases are targets of existing antihypertensive drugs and other such proteins may be good candidates for future drug development. In this Review, the authors outline the genetic causes and pathophysiology of monogenic syndromes associated with hypertension and discuss how common and rare variants contribute to hypertension at the population level.
{"title":"The genetics of hypertension","authors":"Gabriel Stölting, Kieu Nhi Tran Vo, Janek Haus, Ute I. Scholl","doi":"10.1038/s41581-025-01020-6","DOIUrl":"10.1038/s41581-025-01020-6","url":null,"abstract":"Hypertension, or persistently elevated blood pressure, affects about one third of the adult population worldwide and causes approximately 8.5 million deaths annually. Family studies have demonstrated that blood pressure shows substantial heritability, suggesting that genetic factors contribute to hypertension. Linkage studies and next-generation sequencing efforts have identified several variants with large effect sizes that cause rare monogenic hypertension syndromes. These syndromes often present with early onset and typically affect adrenal and renal regulation of salt reabsorption. In addition, somatic (tumour-specific) mutations have been identified in hormone-producing tumours that cause hypertension (phaeochromocytomas, aldosterone-producing adenomas, cortisol-producing adenomas, pituitary adenomas, reninomas). However, most cases of hypertension are polygenic. Large genome-wide association studies have identified many variants with small effect sizes that add to our understanding of blood pressure as a complex trait. Epigenetic mechanisms also influence gene expression and contribute to blood-pressure alterations. Several proteins that are affected by Mendelian diseases are targets of existing antihypertensive drugs and other such proteins may be good candidates for future drug development. In this Review, the authors outline the genetic causes and pathophysiology of monogenic syndromes associated with hypertension and discuss how common and rare variants contribute to hypertension at the population level.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 2","pages":"137-151"},"PeriodicalIF":39.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145492572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-11DOI: 10.1038/s41581-025-01023-3
Anthony A. Fung, Lingyan Shi
In this Tools of the Trade article, Fung and Shi describe a label-free optical imaging platform to capture the spatial molecular landscape of same-slide kidney tissue pathology.
{"title":"A label-free optical analysis for molecular nephrology","authors":"Anthony A. Fung, Lingyan Shi","doi":"10.1038/s41581-025-01023-3","DOIUrl":"10.1038/s41581-025-01023-3","url":null,"abstract":"In this Tools of the Trade article, Fung and Shi describe a label-free optical imaging platform to capture the spatial molecular landscape of same-slide kidney tissue pathology.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 1","pages":"6-7"},"PeriodicalIF":39.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491723","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-11DOI: 10.1038/s41581-025-01024-2
Liam McLaughlin
In this Tools of the Trade article, Liam McLaughlin (Jain lab) describes the development of an open-source Python tool that converts volumetric imaging data into quantifiable network graphs.
在这篇Tools of the Trade文章中，Liam McLaughlin （Jain实验室）描述了一个开源Python工具的开发，该工具可以将体积成像数据转换为可量化的网络图。
{"title":"Python image analysis tool reveals the basis of coordinated human kidney function","authors":"Liam McLaughlin","doi":"10.1038/s41581-025-01024-2","DOIUrl":"10.1038/s41581-025-01024-2","url":null,"abstract":"In this Tools of the Trade article, Liam McLaughlin (Jain lab) describes the development of an open-source Python tool that converts volumetric imaging data into quantifiable network graphs.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 1","pages":"5-5"},"PeriodicalIF":39.8,"publicationDate":"2025-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145491722","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-10DOI: 10.1038/s41581-025-01018-0
Melissa H. Little, Sean B. Wilson
The capacity to generate a human model of the kidney via the directed differentiation of human pluripotent stem cells is a remarkable advance. Such three-dimensional multicellular tissues can accurately recapitulate certain kidney disease phenotypes in vitro, enabling the development of novel therapies for inherited kidney disease. These models also suggest the future possibility of engineering kidney tissue for kidney replacement therapy. Here, we focus on the latest advances in the field, including protocols for generating ureteric organoids and their combination with nephron-forming organoids to create integrated assembloid models, as well as examining the challenges in the application of these protocols. Although current protocols are modelled on differentiation in vivo, gaps in this knowledge remain, as well as challenges in recapitulating such complex events in vitro. The scale and complexity of the transcriptional analyses required to evaluate these models can also prove difficult to interpret. The genuine application of stem-cell-derived kidney tissue will require a deep understanding of what cells should not be present, what cell types are missing, how to increase the level of maturity of the component cells and whether organoids can reach a degree of maturation that can replicate postnatal kidney disease. Finally, the development of cellular therapies will require quality-controlled protocols to ensure both safety and efficacy. As research on human kidney models differentiated directly from human pluripotent stem cells continues to advance rapidly, this Review examines current protocols used in the field, as well as discusses potential caveats and limitations when using these approaches for drug screening, disease modelling and tissue engineering.
{"title":"Advances and continuing challenges in differentiation of stem cells to human kidney tissue","authors":"Melissa H. Little, Sean B. Wilson","doi":"10.1038/s41581-025-01018-0","DOIUrl":"10.1038/s41581-025-01018-0","url":null,"abstract":"The capacity to generate a human model of the kidney via the directed differentiation of human pluripotent stem cells is a remarkable advance. Such three-dimensional multicellular tissues can accurately recapitulate certain kidney disease phenotypes in vitro, enabling the development of novel therapies for inherited kidney disease. These models also suggest the future possibility of engineering kidney tissue for kidney replacement therapy. Here, we focus on the latest advances in the field, including protocols for generating ureteric organoids and their combination with nephron-forming organoids to create integrated assembloid models, as well as examining the challenges in the application of these protocols. Although current protocols are modelled on differentiation in vivo, gaps in this knowledge remain, as well as challenges in recapitulating such complex events in vitro. The scale and complexity of the transcriptional analyses required to evaluate these models can also prove difficult to interpret. The genuine application of stem-cell-derived kidney tissue will require a deep understanding of what cells should not be present, what cell types are missing, how to increase the level of maturity of the component cells and whether organoids can reach a degree of maturation that can replicate postnatal kidney disease. Finally, the development of cellular therapies will require quality-controlled protocols to ensure both safety and efficacy. As research on human kidney models differentiated directly from human pluripotent stem cells continues to advance rapidly, this Review examines current protocols used in the field, as well as discusses potential caveats and limitations when using these approaches for drug screening, disease modelling and tissue engineering.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 2","pages":"122-136"},"PeriodicalIF":39.8,"publicationDate":"2025-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145477839","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-07DOI: 10.1038/s41581-025-01026-0
Priyanka Singh, Kate Bramham, June Fabian, Robert Kalyesubula, Valerie Luyckx, Cathy Haldane
Chronic kidney disease is a silent epidemic that is disproportionately affecting low- and middle-income countries. The landmark WHO global kidney health resolution signals urgency, but impact depends on action. Point-of-care diagnostics are essential to bridge the gap between recognition and reality, enabling equitable early detection, prevention and strengthening of health systems.
{"title":"From resolution to reality: advancing point-of-care diagnostics for kidney disease in low-resource settings","authors":"Priyanka Singh, Kate Bramham, June Fabian, Robert Kalyesubula, Valerie Luyckx, Cathy Haldane","doi":"10.1038/s41581-025-01026-0","DOIUrl":"10.1038/s41581-025-01026-0","url":null,"abstract":"Chronic kidney disease is a silent epidemic that is disproportionately affecting low- and middle-income countries. The landmark WHO global kidney health resolution signals urgency, but impact depends on action. Point-of-care diagnostics are essential to bridge the gap between recognition and reality, enabling equitable early detection, prevention and strengthening of health systems.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"22 1","pages":"1-2"},"PeriodicalIF":39.8,"publicationDate":"2025-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145455423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-31DOI: 10.1038/s41581-025-01017-1
Kinanti Khansa Chavarina, Randall Lou-Meda, Valerie A. Luyckx
Implementation of the recently adopted World Health Organization resolution on kidney health will require not only additional funding, but also strategic investment. Embedding kidney health interventions into primary care and community-based non-communicable disease prevention and treatment platforms can rebalance resource allocation across the care continuum, improving both sustainability and fairness.
{"title":"Strategic rebalancing of kidney-related investments is key to implementing the WHO kidney health resolution","authors":"Kinanti Khansa Chavarina, Randall Lou-Meda, Valerie A. Luyckx","doi":"10.1038/s41581-025-01017-1","DOIUrl":"10.1038/s41581-025-01017-1","url":null,"abstract":"Implementation of the recently adopted World Health Organization resolution on kidney health will require not only additional funding, but also strategic investment. Embedding kidney health interventions into primary care and community-based non-communicable disease prevention and treatment platforms can rebalance resource allocation across the care continuum, improving both sustainability and fairness.","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 12","pages":"813-814"},"PeriodicalIF":39.8,"publicationDate":"2025-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145404668","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-10-30DOI: 10.1038/s41581-025-01027-z
Ellen F. Carney
{"title":"The slit diaphragm has a conserved fishnet architecture","authors":"Ellen F. Carney","doi":"10.1038/s41581-025-01027-z","DOIUrl":"10.1038/s41581-025-01027-z","url":null,"abstract":"","PeriodicalId":19059,"journal":{"name":"Nature Reviews Nephrology","volume":"21 12","pages":"817-817"},"PeriodicalIF":39.8,"publicationDate":"2025-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145403825","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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