IgA肾病(immunoglobulin A nephropathy, IgAN)是一种以肾小球系膜区IgA或IgA为主的免疫球蛋白沉积为特点的肾小球肾炎。1968年法国肾脏病学家Jacques Berger博士首次发现并报道了IgAN，因此该病也被称为Berger病^[1]。IgAN确诊依赖肾活检，是全球最常见的原发性肾小球疾病，但全球不同地区发病率存在差异，其中亚洲地区IgAN发病率最高，我国IgAN约占全部肾活检病例54.3%^[2]。该病临床表现多样，可表现为发作性肉眼血尿、无症状镜下血尿伴或不伴蛋白尿、高血压、急性肾损伤乃至慢性肾衰竭，IgAN也是我国慢性肾脏病和终末期肾病的主要原因之一^[3]，高达40%的IgAN患者在诊断后20年内达到终末期肾病^[4]。目前认为，IgAN的发病机制可概括为"四重打击"^[5]：(1)遗传易感性导致IgA1产生和糖基化调控缺陷，半乳糖缺乏的IgA1(galactose-deficient IgA1, Gd-IgA1)增多，导致末端N-乙酰半乳糖胺的暴露；(2)由浆细胞产生以末端N-乙酰半乳糖胺为靶点的聚糖特异性IgG或IgA1自身抗体抗聚糖抗体；(3)由抗Gd-IgA1自身抗体与Gd-IgA1以及可溶性sCD89结合，形成Gd-IgA1循环免疫复合物；(4)免疫复合物在系膜沉积激活炎症途径、补体途径导致肾小球损伤。肾活检是确诊IgAN的唯一方法，对于符合慢性肾炎综合征、复发性或持续性血尿与蛋白尿，疑似IgAN的患者，可考虑行肾穿刺活检。本共识针对原发性IgAN，不适用于继发性IgAN(紫癜性肾炎或IgA型血管炎、系统性红斑狼疮等)，以及肝硬化、炎性肠病等疾病所致IgA在肾组织沉积者，旨在为肾内科专科医师，尤其针对地市和县级医疗单位具有一定肾科专业基础的临床医师提供临床诊疗指导。

Adsorption technology is one of the working principles of blood purification. It can be used independently or as a composite component of common materials for blood purification. It has been widely used in the adjuvant treatment of kidney diseases, as well as severe diseases besides nephrology such as autoimmune diseases and poisoning, etc. This article briefly reviewed the preparation requirements of adsorbent materials, currently commonly-used adsorbent materials, and related technologies.

Uremic tumoral calcinosis is a rare complication in patients with end-stage renal disease. It is characterized by disturbance of calcium and phosphorus metabolism and deposition of calcium in soft tissues around joints, which can seriously threaten the quality of life and even life of patients. Due to its extremely low incidence, the clinical understanding of it is often insufficient, and there is currently no unified diagnosis and treatment standard, making it easily misdiagnosed and mistreated. In order to improve clinicians′ understanding of the disease, and to achieve early diagnosis and timely treatment as much as possible, this article reviewed the progress in the diagnosis and treatment of uremic tumoral calcinosis.

足细胞内陷性肾小球病(podocyte infolding glomerulopathy，PIG)，又称为足细胞折叠性肾小球病，是一类罕见的肾小球病，是基于电镜下观察到足细胞折叠和陷入肾小球基底膜(glomerular basement membrane, GBM)内的独特超微结构所命名，表现为微球和微管^[1]。目前全球范围内关于足细胞内陷性肾小球病的病例报道主要是来自于日本，国内报道较少^[1,2,3]。本文报道PIG一例。

In June 2019, the American Society for Apheresis (ASFA) released the eighth edition of guidelines on the use of therapeutic apheresis in clinical practice. Based on the published literature, this guideline determined the quality of evidence and the strength of recommendations for therapeutic apheresis in the treatment of diseases, and discussed the clinical application of therapeutic apheresis in 84 diseases (157 indications). The guideline divided the therapeutic apheresis into two categories: blood cell purification technology, and plasma components purification technology. The plasma purification technology mainly referred to plasma exchange and immunoadsorption. This article focused on the interpretation of clinical multidisciplinary applications of plasma exchange and immunoadsorption.

Arteriovenous fistula (AVF) is the preferred vascular access for maintenance hemodialysis (MHD) in patients with end-stage renal disease (ESRD). The vascular selection and evaluation before AVF establishment, the maturity assessment after AVF establishment, the timely treatment of AVF mature disorders, and the timely monitoring, location, and treatment of complications during AVF use, are all crucial for the MHD treatment. Ultrasound has the advantages of convenience, non-invasiveness, safety, and economy in evaluating vascular anatomy and blood flow, and is helpful for selecting AVF vessels, assessing the maturity of AVF, discovering the AVF maturity disorders and their causes, detecting and locating postoperative complications, guiding the treatment of mature disorders and complications, improving the success rate of AVF establishment, and ensuring the proceeding of MHD. This article reviewed the current status and prospect of the clinical application of conventional ultrasound and contrast-enhanced ultrasound (CEUS) in the AVF of MHD patients in recent years.

Pulmonary infection in patients with chronic kidney disease (CKD) is one of the common clinical comorbidities, and timely diagnosis and standardized treatment are crucial to the prognosis of the patients. This paper reviewed the epidemiology, hazards, classification, standardized diagnosis ideas, treatment principles and other aspects of pulmonary infection in patients with CKD.

Hypertension is one of the most common chronic diseases, and is the second most recognized risk factor for chronic kidney disease (CKD). Early diagnosis and effective treatment of hypertension can help prevent or delay the occurrence and development of CKD, and also help reduce the risk of cardiovascular events and all-cause death. From 2017 to 2020, the United States, Europe, China, Japan, and the International Society of Hypertension have successively published the latest guidelines for hypertension management. This article mainly reviewed and interpreted the guidelines on the management of hypertension in patients with CKD.

Vascular calcification (VC) is a common complication of chronic kidney disease (CKD). It can significantly increase the incidence of cardiovascular events and mortality of patients with CKD. More and more studies have shown that activin A, a member of the transforming growth factor β superfamily, is not only involved in the development of VC in patients with CKD, but also a target of the common pathway of both VC and bone metabolism. Antagonists of activin A may have the effect of delaying the progression of CKD and its complications. This article reviewed the mechanism of activin A involved in vascular calcification in CKD, aiming to provide new ideas for the diagnosis, treatment, and prevention of VC in CKD.

Intestinal microorganisms constitute the intestinal microecosystem of human body, and participate in physiopathological functions such as nutrition, metabolism, and immunity. Research findings have indicated that intestinal microecology is closely related to chronic kidney disease. By participating in the innate and adaptive immune responses of patients, intestinal microecology profoundly influences the progression of chronic kidney disease and its associated complications. Moreover, the intestinal mucosal immunity constructed by intestinal flora directly affects the production and secretion of IgA, thus affecting the occurrence and progression of IgA nephropathy. This article reviewed the research progress on the relationship between intestinal microecology and immunity in patients with chronic kidney disease, in order to provide new clues and ideas for the diagnosis and treatment of CKD.

Renal fibrosis is the final pathological feature of chronic kidney disease (CKD) progression, and its high incidence seriously threatens the quality of life and prognosis of CKD patients. The pathogenesis of CKD is complex with the micro-inflammation and oxidative stress being its important risk factors. In recent years, studies have found that interleukin-11 (IL-11), as a new type of inflammatory factor, belongs to the interleukin-6 (IL-6) family, and its expression is increased in a variety of fibrotic inflammatory diseases. IL-11 has an important role in both cardiac and renal fibrosis. This article reviewed the relationship between IL-11 and CKD so as to provide ideas and references for the early diagnosis of CKD as well as the exploration of new therapeutic targets.

This article summarized the important progress of clinical research in nephrology in 2020, mainly including primary glomerular diseases (IgA nephropathy, membranous nephropathy) and secondary glomerular diseases (diabetic nephropathy, lupus nephritis, kidney damage due to anti-neutrophil cytoplasmic antibody-associated vasculitis, blood system disease-related kidney damage), acute kidney injury, and chronic kidney disease-mineral and bone disorders. These advances will greatly help the clinical work in terms of disease diagnosis, prognosis judgment, and treatment guidance.

Intradialysis hypotension (IDH) is one of the common complications of maintenance hemodialysis (MHD), and its incidence remains high, affecting the quality of life and long-term prognosis of patients. Therefore, it is necessary to avoid IDH risks. In recent years, with the deepening of pathophysiological research, rapid progress has been made in the optimization of prevention and treatment of IDH, such as biofeedback technology, cold dialysis, and traditional Chinese medicine therapy. This article reviewed the latest progress in the definition, harm, pathophysiology, and prevention and treatment strategies of IDH, aiming to provide information and reference for the prevention and treatment of IDH.

MicroRNA-155 (miR-155) is a typical multifunctional gene, which can participate in a variety of physiological and pathological processes. More and more studies have shown that miR-155 is closely related to the progress and recovery of kidney diseases. This article reviewed the relevant studies on the relationship between miR-155 and various kidney diseases in recent years, including acute kidney injury, lupus nephritis, IgA nephropathy, diabetes nephropathy, chronic renal insufficiency, end-stage renal disease, etc, so as to explore the possibility of using miR-155 as a potential target for the treatment of kidney diseases.