• The role of innate immunity (Toll-like receptors) and epigenetics (microRNAs) in the pathogenesis of kidney disease: Investigations into the role of these factors is likely to result in the development of novel therapies for a broad spectrum of kidney diseases.
• Discovery of C3 glomerulopathy and factor H abnormality: Recognition of this entity has improved our understanding of membranoproliferative glomerulonephritis and identified a unique subgroup that was previously unresponsive to treatment, and is now treatable.
• The role of FGF23 and Klotho in CKD and mineral bone disease of CKD: Research in this field has broad implications, possibly identifying novel therapies to slow progression of CKD and to reduce cardiovascular morbidity in CKD.
• Noninvasive diagnostics, such as new biomarkers for acute kidney injury and evaluating kidney function: Such biomarkers as cystatin C, kidney injury molecule 1, neutrophil gelatinase-associated lipocalin, and interleukin 18 are likely to be helpful in allowing recognition of acute kidney injury before changes in the serum creatinine level occur.
• Recent insights into glomerular diseases: The discovery of the role of lysophosphatidic acid receptor type 1 in the pathogenesis and diagnosis of idiopathic membranous nephrotic syndrome is important. Also interesting is examination of the role that soluble urokinase receptor plays in the pathogenesis and diagnosis of focal glomerular sclerosis. Aberrantly glycosylated IgA1 was found to be a factor in the pathogenesis of IgA nephropathy. Discovery of the APOL1 gene and the role of APOL1 variants in vulnerability to kidney disease and progression of kidney disease has also been helpful. These findings have contributed to our understanding of glomerular diseases and are likely to be helpful in noninvasive diagnosis of some glomerular diseases.
Top nephrology advances selected by Vecihi Batuman, MD, Huberwald Professor of Medicine, Section of Nephrology-Hypertension, Tulane University School of Medicine; Chief, Renal Section, Southeast Louisiana Veterans Health Care System, New Orleans, Louisiana.
For more on advancements in noninvasive diagnostics in nephrology, read here.
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Cite this: What Do You Consider to Be the Top Medical Advances of the Past 20 Years? - Medscape - May 27, 2015.