Circulation articles from across Nature Portfolio

Treatment with dialysis in people with kidney failure has been implicated in accelerated cognitive impairment. Here, the authors consider how dialysis treatment — haemodialysis and peritoneal dialysis — can promote cerebral injury and might exacerbate chronic kidney disease-associated brain alterations and cognitive decline.

Many thrombolytic agents depend on plasminogen, leading to D-dimer accumulation. Here, Tang et al. report a plasminogen-independent thrombolytic enzyme that degrades blood clots and D-dimer without plasminogen.

Body-to-brain communication profoundly affects physiology and behaviour. Sensory neurons that express oxytocin receptors relay mechanical stretch of the gut and heart to the brain. Surprisingly, simultaneous firing of these neurons reliably elicits a hypometabolic state that resembles torpor. These observations could have implications ranging from cardiometabolic therapeutics to space travel.

A recent study reports that adenosine A2A receptor-mediated lymphangiogenesis increases lymphatic clearance of excess Na⁺ from the skin and reduces blood pressure, whereas impairment of this process leads to salt-sensitive hypertension. These findings raise intriguing physiological questions regarding the relationships among sodium, water and blood pressure.

Lipid remodeling, from fatty acid transport and de novo lipid synthesis, is necessary for megakaryocyte differentiation and platelet production. Dietary saturated fatty acids, impaired fatty acid transport and/or dysfunction in lipid biogenesis can contribute to low platelet counts.