Review Articles in 2025

Here, the authors describe the spectrum and global burden of AKI. They discuss the knowledge and practice gaps that must be addressed to improve AKI care and outline a framework for creating a sustainable infrastructure to address this global health issue.

This Review discusses the latest advances in natural killer cell biology, including insights into population heterogeneity, and examines the roles of these innate lymphocytes in kidney health and disease, as well as their contribution to kidney allograft rejection and its therapeutic implications.

Cell–cell crosstalk is essential for the maintenance of organ and whole-body homeostasis. This Review summarizes current understanding of cell–cell crosstalk in the kidney in health and disease and describes how intercellular crosstalk shapes cell states and tissue organization to influence kidney homeostasis, injury responses and disease progression.

The glomerular endothelial glycocalyx lines the glomerular capillaries and contributes to the ability of these specialized blood vessels to limit protein permeability. This Review describes how dysfunction of the glomerular endothelial glycocalyx contributes to the development of proteinuria in glomerular disease and potential therapeutic approaches to protect or restore it.

In this Review, the authors outline the genetic causes and pathophysiology of monogenic syndromes associated with hypertension and discuss how common and rare variants contribute to hypertension at the population level.

As research on human kidney models differentiated directly from human pluripotent stem cells continues to advance rapidly, this Review examines current protocols used in the field, as well as discusses potential caveats and limitations when using these approaches for drug screening, disease modelling and tissue engineering.

Indigenous peoples are disproportionally affected by poor kidney health outcomes globally. Here, a group of Indigenous and non-Indigenous authors provide a global overview of kidney health among Indigenous populations across different regions and its key determinants, including structural factors, and make actionable policy recommendations for addressing these health inequities.

Progress in the development of RNA-based therapeutics has been accelerated by the identification of organ-enriching carriers and cell-specific targeting conjugates, leading to their approval for a range of indications. However, attempts to develop RNA-based therapeutics for kidney diseases have proved challenging. This Review describes the physiological, technological and pharmacological hurdles that need to be overcome to realize the potential of RNA therapeutic approaches to kidney diseases.

Urinary components can reflect kidney biology in health and disease. Here, the authors examine current data on urinary biomarkers that can provide insight into kidney function and metabolism, and discuss their potential application value as diagnostic, prognostic and/or therapeutic monitoring biomarkers.

The authors discuss the dysregulated host response in sepsis and the use of biomarkers to gauge the immunological status of patients and potentially guide precision medicine. They also highlight potential immunomodulatory therapies for sepsis and discuss the future of sepsis clinical trials.

This Review provides a guide to metabolite retention in kidney disease and includes an overview of key uraemic toxins and the complex mechanisms underlying their toxicity, as well as a discussion of key strategies with the potential to prevent or mitigate their adverse effects.

Here, the authors summarize current evidence and guidance for physical activity in chronic kidney disease. They outline barriers and facilitators to the implementation of physical activity and exercise programmes in chronic kidney disease clinical practice and suggest approaches to facilitating translation of research findings into routine care.

A global shortage of suitable donor kidneys is the primary challenge in kidney transplantation. In this Review, the authors describe different methods of donor kidney preservation, discussing the strengths and limitations of each method and noting how advances in donor organ perfusion could improve organ utilization and patient outcomes.

Here, the authors describe the effects of coronavirus disease (COVID) on the kidney, including long COVID in patients with chronic kidney disease. They also discuss potential associations between COVID-19 and glomerular diseases and the impact of severe acute respiratory syndrome coronavirus 2 vaccines on the risk of long COVID.

This Review discusses the pathophysiology of kidney stone formation and examines the contribution of urinary risk factors and genetic variants. The authors also consider current approaches to the management of nephrolithiasis, including the role of metabolic evaluation and interventions for prevention of kidney stone recurrence.

In this Review, the authors focus on the role of collagen IV in Gould syndrome and Alport syndrome. They discuss the molecular and phenotypic similarities and differences between these syndromes, as well as potential targeted therapeutic strategies.

Here, the authors discuss communication between the ER and other intracellular organelles under physiological and pathological conditions. They highlight the potential role of this crosstalk in the pathogenesis of kidney diseases and discuss potential therapeutic strategies aimed at modulating this crosstalk.

Available evidence suggests that the kidney stroma mediates cell communication and supports a variety of processes during kidney development and in the adult kidney. This Review describes the developmental origins of the stroma and current understanding of its roles in the growth and patterning of renal epithelia and endothelia, and in the maintenance and repair of the adult organ.

Although immune checkpoint inhibitors can prolong survival in people with clear-cell renal-cell carcinoma, disease progression is frequent. Here, the authors explore potential mechanisms that might drive intrinsic or acquired resistance to immune checkpoint inhibitors in clear-cell renal-cell carcinoma, including malignant cell-intrinsic and immune-cell factors.

Since the discovery of PLA2R, several target antigens associated with membranous nephropathy have been identified. This Review describes the distinct clinical associations, pathology and prognostic findings associated with each of the identified target antigens and implications for the reclassification of membranous nephropathy.