Challenges encountered to creating a renal biopsy program at a tertiary care academic institution in the United States.

Biopsy is the gold standard for diagnosing renal pathology and the procedure is required to be learned per ACGME guidelines for Nephrology Fellowship graduation. We describe the process for the planning and development of a new Nephrologist directed native renal biopsy program to increase the opportunity to train Nephrology fellows in this procedure. The article outlines the barriers, complications and lessons learned to developing the program, highlighting the key challenges and progress that has been made within a single American tertiary academic medical center.

Inhibition of Toll-Like Receptor 4 Signaling Mitigates Microvascular Loss but Not Fibrosis in a Model of Ischemic Acute Kidney Injury.

The development of chronic kidney disease (CKD) following an episode of acute kidney injury (AKI) is an increasingly recognized clinical problem. Inhibition of toll-like receptor 4 (TLR4) protects renal function in animal models of AKI and has become a viable therapeutic strategy in AKI. However, the impact of TLR4 inhibition on the chronic sequelae of AKI is unknown.

p53 is renoprotective after ischemic kidney injury by reducing inflammation.

In the rat, p53 promotes tubular apoptosis after ischemic AKI. Acute pharmacologic inhibition of p53 is protective in this setting, but chronic inhibition enhances fibrosis, demonstrating that the role of p53 in ischemic AKI is incompletely understood. Here, we investigated whether genetic absence of p53 is also protective in ischemic AKI.

The p53 inhibitor pifithrin-α can stimulate fibrosis in a rat model of ischemic acute kidney injury.

Inhibition of the tumor suppressor p53 diminishes tubular cell apoptosis and protects renal function in animal models of acute kidney injury (AKI). Therefore, targeting p53 has become an attractive therapeutic strategy in the approach to AKI. Although the acute protective effects of p53 inhibition in AKI have been examined, there is still relatively little known regarding the impact of acute p53 inhibition on the chronic sequelae of AKI.