2020 Update in basic kidney research: chronic hypoxia, insulin resistance, sarcopenia, phosphate binders, and peritoneal fibrosis in chronic kidney disease.

Abstract

In 2020, Nephrology Dialysis Transplantation (NDT) published a series of fascinating articles in the field of basic research. In the October issue, the team of Naoki Takahashi reported on the role of chronic hypoxia in diabetic nephropathy [1]. In diabetes, the kidney is vulnerable to hypoxaemic injury as the increased metabolic load implies an enhanced cellular oxygen consumption. The authors housed Type 2 diabetic db/db mice in hypoxic chambers at a partial pressure of arterial oxygen of 52 mmHg, which substantially increased the haematocrit. Four weeks of hypoxia exacerbated urinary albumin excretion in association with glomerular microaneurisms and signs of podocyte injury compared with non-hypoxic mice. At 16 weeks of hypoxia, these lesions had progressed to severe nodular glomerulosclerosis (Figure 1), now also in association with markers of oxidative stress, tissue inflammation and fibrogenesis. At first, these data may provide an explanation for the...