Dissecting and refining the staging of chronic kidney disease

The current Kidney Disease Outcomes Quality Initiative (KDOQI) staging system of chronic kidney disease (CKD) is simple but too rigid to accommodate variations in renal function observed in the general population. The formula most commonly used to estimate renal function is not validated in subjects without a priori evidence of renal disease. Their combined use results in inappropriate diagnosis of CKD and improbable estimates of prevalence rates. Although this initiative has raised the profile of kidney disease, the exaggeration of the scope of the problem could distract nephrologists from their specialist role. The nephrology community needs a revised staging system for CKD that allows accurate, effective, and timely communication with patients, primary care doctors, public health physicians, and policy makers. Its single most important function will be to identify those patients who will benefit from targeted screening and effective and safe interventions. We offer for discussion a modified definition and staging system of CKD based on the presence of unequivocal, irreversible structural kidney disease, the presence or degree of impairment of kidney function, and the consequences thereof

IgA nephropathy at two score and one

On May 26–28, 2009, an international symposium on IgA nephropathy was convened in Stresa, Italy, as a Satellite Symposium of the World Congress of Nephrology held in Milan. This meeting was attended by a large number of scientists and clinicians working in the field of IgA nephropathy. The oral and poster presentations (over 70) ranged from very fundamental structural biology to clinical management. This article attempts to summarize the main findings of the meeting and to put forth some new perspectives and hypotheses regarding human IgA nephropathy on the 41st anniversary of its original description by Berger and Hinglais in 1968

Chronic kidney disease

Chronic kidney disease (CKD) is defined by persistent urine abnormalities, structural abnormalities or impaired excretory renal function suggestive of a loss of functional nephrons. The majority of patients with CKD are at risk of accelerated cardiovascular disease and death. For those who progress to end-stage renal disease, the limited accessibility to renal replacement therapy is a problem in many parts of the world. Risk factors for the development and progression of CKD include low nephron number at birth, nephron loss due to increasing age and acute or chronic kidney injuries caused by toxic exposures or diseases (for example, obesity and type 2 diabetes mellitus). The management of patients with CKD is focused on early detection or prevention, treatment of the underlying cause (if possible) to curb progression and attention to secondary processes that contribute to ongoing nephron loss. Blood pressure control, inhibition of the renin-angiotensin system and disease-specific interventions are the cornerstones of therapy. CKD complications such as anaemia, metabolic acidosis and secondary hyperparathyroidism affect cardiovascular health and quality of life, and require diagnosis and treatmen

High peak and average power Ti:sapphire thin disk amplifier with extraction during pumping

The combination of the extraction during pumping (EDP) amplification scheme and the thin disk (TD) technology has been successfully applied to the Ti:sapphire (Ti:sa) laser medium for the first time, to the best of our knowledge. In a proof-of-principle experiment, we demonstrate high energy broadband amplification in a room temperature water cooled EDP-TD head of stretched femtosecond pulses at a 10 Hz repetition rate, instead of performing a cryogenically cooled traditional multi-pass scheme. Hence, the EDP-TD combination can overcome the limits associated with thermal effects and transverse amplified spontaneous emission, enabling Ti:sa laser systems to have a petawatt peak and hundreds of watts of average power. (C) 2016 Optical Society of Americ