Editorial issue 240

Chronic kidney disease alters intestinal microbial flora


In the first issue of NDT-E 2013 you will find several novel interesting papers to read. In a recent Kidney Int paper Kathleen Hill et al. studied eight patients with CKD stages 3 or 4 and found that the positive calcium balance produced by calcium carbonate treatment within 3 weeks cautions against its use as a phosphate binder in patients with CKD stages 3 or 4 if their findings can be extrapolated to long-term therapy. In a recent review published in Kidney Int you will be able to learn more about renal function and intriguing metabolic adaptions in hibernating bears. In this issue of NDT-E you will also be able to read the full Kidney Int article published by Kalani Yamamoto et al. showing that higher dietary phosphorus intake was associated with greater odds of LVH among women, but not men. Nosratola Vaziri et al. present another interesting study showing that uremia profoundly alters the composition of the gut microbiome. The biological impact of this phenomenon is unknown and awaits further investigation. In a study published in Nephrol Dial Transpl, Ana Andres-Hernando et al. show that both increased mononuclear phagocyte production and impaired renal clearance contribute to serum cytokine accumulation in acute kidney injury. Manish Sinha presents in another NDT paper data that will leave the reader with a clearer picture of the FGF-23—GFR relationship. Finally, Biagio Di Iorio et al. conducted a longitudinal retrospective, observational, multi-centre study in three tertiary care nephrology outpatient clinics and found that systolic blood pressure variability may be of use for risk stratification in CKD patients.


In the first issue of NDT-E 2013 we continue to present interesting CME lectures presented at the ERA-EDTA meeting in Paris May 2012. In the first of four lectures Dr. Frans Claas, Leiden, Netherlands will discuss “THE CLINICAL RELEVANCE OF HLA ANTIBODY DETECTION”. The 2nd lecture is entitled ”ANTIBODIES AGAINST VASCULAR RECEPTORS IN TRANSPLANT RECIPIENTS” and is presented by Dr. Duska Dragun, Berlin, Germany. Prof. Josep Grinyó, Barcelona, Spain will present a lecture entitled “TOWARDS PERSONALIZED MEDICINE IN TRANSPLANTATION/ BIOMARKERS IN TRANSPLANTATION” The final CME lecture is presented by Dr. Ondrej Viklicky, Prague, Czech Republicand and is entitled ”MOLECULAR PHENOTYPES OF RENAL ALLOGRAFT REJECTION”.


I would appreciate if you could do the obesity survey in two parts; one testing your knowledge about this common feature of CKD and one practice pattern part. The results of this survey could be of major interest to the renal community. We also have published a new video in the CME Video section: M.S. Sever, a new ERA-EDTA Council member, introduces himself. Moreover, Emanuela Cavallaro and collaborators present an interesting and particular case of adult nephrotic syndrome that could be of interest for you to read. Finally, if you have questions or comments regarding nutritional problems in your renal patient do not hesitate to post them on the nutrtional blog.


Enjoy your NDT-E


Peter Stenvinkel, Editor-in-chief