Now we must work even harder
Authors: Detlef Schlöndorff
Journal: Kidney International (2012)

During a visit to Japan years ago, I was impressed that most sumo wrestlers stated during interviews after their victories, ‘Now we must work even harder.’ This sentiment describes the feeling of the new editorial team after the 40th birthday jubilee of Kidney International in January 2012, when it succeeded the editorial team led by Qais Al-Awqati.1.Al-Awqati Q. Forty years and counting….Kidney Int. 2012; 81: 3-4Abstract Full Text Full Text PDF PubMed Scopus (1) Google Scholar Under his leadership, KI, the flagship journal of the International Society of Nephrology, has become one of the two leading nephrology journals worldwide, a position that the new editorial team will work hard to maintain and strengthen by publishing the newest and most exciting developments covering all aspects of nephrology. In order to achieve this goal, we have expanded the editorial team to achieve broad thematic and geographic diversification. The team includes associate editors Daniel Cattran (Toronto, Canada), covering clinical glomerular diseases and research; P. Toby Coates (Adelaide, Australia), for immunology and transplantation; Andrew Davenport (London, UK), for dialysis and ICU nephrology; Tilman Drüeke (Paris/Amiens, France), for the broad range of comorbidity and complications of chronic renal diseases; Masaomi Nangaku (Tokyo, Japan), for studies on clinical and experimental aspects of the generation and progression of renal diseases, including the role of genetics; Mark Okusa (Charlottesville, VA, USA), for experimental and clinical acute kidney injury and for fluid, electrolyte, and acid–base problems; Jai Radhakrishnan (New York, NY, USA), for the latest clinical studies and the Nephrology Image and Make Your Diagnosis sections of KI; and Maria Pia Rastaldi (Milan, Italy), for clinical and experimental pathology and cell biology; and finally, Michael Ross (New York) as deputy editor, covering molecular aspects of kidney disease. Hypertension, diabetic kidney disease, and renal physiology and development are topics covered by several members of the editorial team. I have the privilege of coordinating this wonderful team in our efforts to provide you with enjoyable and enlightening reading of cutting-edge nephrology papers. To achieve our goals, the editorial team has a weekly video-telephone conference, where we discuss all the papers submitted to KI, presently an impressive 1500+ per year and continuously increasing. We take seriously our motto, ‘now we must work even harder,’ as some of the editors join the conference at 6 am while for others it will already be 10 or 11 pm in their parts of the world. We debate which submissions to choose for publication and how to help the authors to improve their papers. For this difficult task, we rely heavily on the help of our expert reviewers, who generously devote large amounts of their time and efforts to KI. This selfless contribution of the nephrology community toward our nephrology journals cannot be overstated, as the review process remains essential in guiding us to make the best and fairest choices, debatably a mission not always achieved. Over the next several years, we will strive to maintain an optimal balance between clinical, experimental, and basic studies while expanding our focus on the most exciting translational kidney disease research. Rapid advances in research methodology, especially in immunology, genetics, and molecular and cellular biology, are revolutionizing our understanding of normal kidney physiology and are elucidating novel mechanisms of renal diseases. Current and future reviews in KI will be devoted to important aspects of translational nephrology. For example, the advent of improved gene arrays and the next generation, whole genome sequencing, may uncover novel DNA mutations that contribute not only to Mendelian inheritance of specific hereditary kidney diseases but also to predisposing factors for the generation or progression of kidney diseases.2.Keller B. Martini S. Sedor J. Kretzler M. A systems view of genetics in chronic kidney disease.Kidney Int. 2012; 81: 14-21Abstract Full Text Full Text PDF PubMed Scopus (37) Google Scholar,3.He J. Chuang P. Ma’Ayan A. Iyengar R. Systems biology of kidney diseases.Kidney Int. 2012; 81: 22-39Abstract Full Text Full Text PDF PubMed Scopus (71) Google Scholar The power of these approaches is clearly demonstrated by the recent discoveries of numerous genes involved in familial forms of glomerular diseases and the identification of polymorphisms in the ApoL1 gene as predisposing patients of African ancestry to the development of focal segmental glomerulosclerosis. Other important examples include the clarification of the molecular basis for the roles of phosphate, FGF23, and vitamin D in the progression of chronic kidney disease (CKD) and its complications.4.Wolf M. Update on fibroblast growth factor 23 in chronic kidney disease. Submitted to Kidney Int, in press.Google Scholar,5.Dusso A. Tokumoto M. Defective renal maintenance of the vitamin D endocrine system impairs vitamin D renoprotection: a downward spiral in kidney disease.Kidney Int. 2011; 79: 715-729Abstract Full Text Full Text PDF PubMed Scopus (115) Google Scholar Successful translational research is further exemplified by the recent identification of the M-type phospholipase A2 receptor as the target antigen in membranous nephropathy, which followed decades of painstaking immunological experimental work.6.Beck L.H. Salant D.J. Membranous nephropathy: recent travels and new roads ahead.Kidney Int. 2010; 77: 765-770Abstract Full Text Full Text PDF PubMed Scopus (163) Google Scholar It is our hope that these advances will lead to novel therapeutic approaches that ultimately improve the health of our patients. We are expanding our series on translational medicine by publishing reviews detailing the roles of epigenetic modifications and microRNAs as modifiers of gene expression.7.Chandrasekaran K. Karolina D.S. Sepramaniam S. et al.Role of microRNAs in kidney homeostasis and disease.Kidney Int. 11 January 2012https://doi.org/10.1038/ki.2011.448Abstract Full Text Full Text PDF Scopus (176) Google Scholar These may contribute significantly to the development and progression of such devastating diseases as diabetic nephropathy, the loss of renal function in the elderly, and nutritional aspects of CKD and their vascular and musculoskeletal complications. Although inhibition of the renin–angiotensin–aldosterone system can slow the progression of diabetic nephropathy and many forms of CKD, unfortunately this approach has only modestly reduced the eventual development of end-stage renal disease, requiring dialysis or transplantation as renal replacement therapy. Similarly, despite advances in immunosuppressive therapy, which have made acute allograft rejection a relatively uncommon complication, attempts to reduce allograft loss due to slowly progressive transplant nephropathy have been far less successful. In short, progression of all forms of CKD will require new forms of preventive and therapeutic interventions. Hopefully, improved understanding of the molecular and cellular pathways contributing to disease pathogenesis will provide us with novel therapies, the ultimate goal of translational medicine. These statements are also applicable to acute kidney injury, for which we still lack successful therapeutic and, even more importantly, preventive measures. To this end, KI is currently publishing a series of articles devoted to ICU nephrology. Finally, I would like to mention the enormous problems facing nephrology in emerging countries, which often lack the financial resources and infrastructure to allow implementation of even the most basic therapies for kidney diseases8.Couser W. Remuzzi G. Mendis S. Tonelli M. The contribution of chronic kidney disease to the global burden of major noncommunicable diseases.Kidney Int. 2011; 80: 1258-1270Abstract Full Text Full Text PDF PubMed Scopus (913) Google Scholar. KI and KI Supplements, as journals of the International Society of Nephrology, are committed to covering important aspects of global medicine concerning kidney disease. In summary, the editorial team of KI remains devoted to the goal of maintaining KI as a leading journal for nephrology, a goal that we can reach only if clinical and basic researchers working in nephrology continue to submit their best papers to KI. ‘Now we all must work even harder.’