Nature Reviews Nephrology

Globally, more than 5 million people die annually from lack of access to critical treatments for kidney disease — by 2040, chronic kidney disease is projected to be the fifth leading cause of death worldwide. Kidney diseases are particularly challenging to tackle because they are pathologically diverse and are often asymptomatic. As such, kidney disease is often diagnosed late, and the global burden of kidney disease continues to be underappreciated.

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Challenges of access to kidney care for children in low-resource settings

Mignon McCulloch, Valerie A. Luyckx & William E. Smoyer

doi : 10.1038/s41581-020-00338-7

Nature Reviews Nephrology volume 17, pages33–45(2021)

Kidney disease is a global public health concern across the age spectrum, including in children. However, our understanding of the true burden of kidney disease in low-resource areas is often hampered by a lack of disease awareness and access to diagnosis. Chronic kidney disease (CKD) in low-resource settings poses multiple challenges, including late diagnosis, the need for ongoing access to care and the frequent unavailability of costly therapies such as dialysis and transplantation.

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Immunity, endothelial injury and complement-induced coagulopathy in COVID-19

Luca Perico, Ariela Benigni & Giuseppe Remuzzi

doi : 10.1038/s41581-020-00357-4

Nature Reviews Nephrology volume 17, pages46–64(2021)

In December 2019, a novel coronavirus was isolated from the respiratory epithelium of patients with unexplained pneumonia in Wuhan, China. This pathogen, named severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causes a pathogenic condition that has been termed coronavirus disease 2019 (COVID-19) and has reached pandemic proportions. As of 17 September 2020, more than 30 million confirmed SARS-CoV-2 infections have been reported in 204 different countries, claiming more than 1 million lives worldwide.

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Organ protection by SGLT2 inhibitors: role of metabolic energy and water conservation

Adriana Marton, Tatsuroh Kaneko & Jens Titze

doi : 10.1038/s41581-020-00350-x

Nature Reviews Nephrology volume 17, pages65–77(2021)

Therapeutic inhibition of the sodium–glucose co-transporter 2 (SGLT2) leads to substantial loss of energy (in the form of glucose) and additional solutes (in the form of Na+ and its accompanying anions) in urine. However, despite the continuously elevated solute excretion, long-term osmotic diuresis does not occur in humans with SGLT2 inhibition.

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