Current Perspectives in Kidney Diseases

for the prevention of circuit blood clotting during continuous renal replacement therapy and the high bleeding risk related to AKI itself remains a critical issue in nephrological clinical practice. Ricci et al. [11] suggest the use of citrate as a successful alternative to common anticoagulation strategies. As a result of the latest technological innovations, it can be used safely also in patients with a high risk of citrate accumulation, including during liver dysfunction [11] . In view of the key role of the kidney in multiorgan failure, descriptive and useful case series are reported, indicating novel possible applications of coupled plasma filtration adsorption for toxin removal during the course in liver failure or in serious medical emergencies, such as thyrotoxicosis [12] . The potential and clinical opportunities of new sorbent materials represent important topics of discussion in today’s art of extracorporeal therapies. Discussions on new sorbents seem to shed light on some grey areas concerning the use of sorbents in acute and/or chronic renal replacement therapies [13] . In CKD, particular attention is paid to mineral metabolism, a well-known trigger of cardiovascular disease. Undeniably, the impact of phosphate represents a hot topic in current nephrology, as both hyperand hypoThe volume of Contributions to Nephrology entitled Current Perspectives in Kidney Diseases , edited by La Manna and Ronco [1] , provides on the one hand an exhaustive presentation of the state of the art in different areas of nephrological research and on the other some helpful indications for daily clinical practice. One of the mainstays of the volume is an emphasis on the kidney as the final ring of the complex chain of multiple organ failure. Recent advances in technology and research on the pathogenesis and therapies of sepsis-associated acute kidney injury (AKI), responsible for the high mortality incidence and progression toward chronic kidney disease (CKD), represent some important aspects discussed in the past and seem to be discussion topics for the present [2–9] . The last two decades have provided new insights into the pathophysiology of sepsis-associated AKI, correlating evident hemodynamic changes with the direct impact of several molecules on renal tissue. Improved knowledge of the pathogenesis of the disease has led to the discovery of some new potential therapeutic targets able to interfere with the mechanisms of tissue injury. However, large phase III clinical trials are still needed [10] . Sepsis-related AKI, or in general AKI, requires continuous renal replacement therapy. Achievement of the correct balance between any anticoagulation strategy Published online: October 30, 2017