Placental growth factor (PlGF) is an increasingly important molecule in the prediction, diagnosis and treatment of pre-eclampsia. It has pro-angiogenic effects on the feto-placental circulation and supports trophoblast growth. Mechanisms by which PlGF expression is regulated continue to be investigated. Low circulating PlGF precedes the manifestation of clinical disease in pre-eclamptic pregnancies and intrauterine growth restriction. This suggests that low PlGF is a marker of abnormal placentation, but it remains uncertain whether this is a cause or consequence. Prediction of pre-eclampsia using PlGF is promising and may assist in the targeting of resources to women at highest risk of adverse pregnancy outcomes. Promisingly, experimental animal models of pre-eclampsia have been successfully treated with supplemental PlGF. Treatment of pre-eclampsia with PlGF is a potential therapeutic option requiring further exploration. This review focuses specifically on the role of PlGF in normal and pathological placental development and in the clinical management of pre-eclampsia.

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Granulomatous interstitial nephritis (GIN) is an uncommon cause of renal failure, which may be caused by drugs. Levetiracetam is an increasingly used anti-epileptic medication that is not known to cause renal toxicity in adults. To our knowledge, levetiracetam has not previously been reported as a cause of GIN. We report the case of a 69-year-old woman who developed haemodialysis-requiring acute renal failure after commencement of treatment with levetiracetam, which was shown to be GIN by renal biopsy. She made a complete recovery with cessation of levetiracetam and treatment with steroids.

BackgroundEnd-stage kidney disease (ESKD) incidence has been increasing over time, contributing signi cantly to morbidity and early mortality.However, there is limited data examining the psychosocial factors affecting people with ESKD and how the social worker ts within the multidisciplinary CKD care. This integrative systematic review aims to summarise the existing evidence on psychosocial determinants of outcomes in ESKD and the role of renal social worker. Method:Literature search was conducted using PubMed and MEDLINE targeting articles published from database inception until May 2021.This systematic review was performed in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. The Joanna Briggs Institute tools were employed to assess the quality of included studies. ResultsOf the 397 citations, 13 studies applicable to 1465 patients met the inclusion criteria. The studies were of cross-sectional, experimental, and exploratory qualitative design in nature. The ndings of the studies were summarised into three major themespsychosocial factors, role of the renal social worker, and impact of the renal social worker. The studies demonstrated that concerns related to adjustment, death and dying, family and social functioning, and loss were common amongst participants of the included studies indicating the need for a social worker. Three studies explored the impact of social workers in ESKD, revealing people who receive support from social workers had an improved quality of life, lower depression scores, reduced hospitalisations, and emergency room visits. ConclusionThis review reports the multitude of physical and psychological stressors that patients with ESRD face, highlights the positive role renal social workers can play in improving the psychosocial stressors in this patient group and the need for large-scale randomised trials to understand the role of renal social workers as part of a multidisciplinary care.

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VC is common in younger patients undergoing transplantation and, similar to older patients, is associated with age, dialysis vintage and cardiovascular pathology. However, in this younger patient group, there was no significant inverse association of VC to BMD.